Advice Needed

Discussion in 'DoDMERB' started by Sowbug, May 23, 2013.

  1. Sowbug

    Sowbug Member

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    This is my first post on this site which has been invaluable in learning about the SAs and ROTC processes. Please forgive the long post.

    My son (rising Sr. in HS) is applying to USAFA, USNA, USCGA, and AFROTC and NROTC scholarships. During freshman year, he had stomach cramps/gas pains (not diarrhea or constipation) that only manifested during the school day. These symptoms started coincidentally after being diagnosed with Mono. We took him to his pediatrician in January 2011 who said “sounds like a clear cut case of irritable bowel syndrome (IBS)” and he put him on prescription anti-spasmodic medication which he continued to take until February 2013. IBS is one of those syndromes that does not have a test (positive or negative) but is diagnosed based on symptoms. The following is a medical DQ associated with IBS:

    “Current or history of irritable bowel syndrome (564.1) of sufficient severity to require frequent intervention or prescription medication or to interfere with normal function.”

    He only took the medicine while school was in session (not on weekends or during summer/winter breaks). Since the initial visit to the doctor in January 2011, he has not visited the doctor again for follow-up for additional problems with his stomach. I believe, as does a doctor where I work, that the medicine may have been having a placebo effect, especially since he went for long periods of time without using the medicine (e.g., summer vacation) and without symptoms and he has not had any problems since fully stopping the medicine this February. Perhaps he outgrew the condition. He has never had any issues with diarrhea or constipation and no real problems since early 2011. Unfortunately, he continued to take the medicine as a precaution and/or mental crutch. We have copies of his medical records which document the January 2011 visit with IBS and the use of the prescription medication since that date. So here are my questions:

    1. Should we have him evaluated by his pediatrician and/or another doctor (specialist?) to document the information that I summarized above and to see if they can provide a letter with evidence or justification to support a waiver or prevent a DQ? If so, should this evidence be included with the DODMERB paperwork when it is submitted or wait until it is requested? Any other suggestions on how to maximize the chance of a waiver or not to receive a DQ?

    2. If he is not granted a waiver (by any of the authorities), can he join ROTC (not on scholarship) and then go through the DODMERB process again recognizing by that point in time (e.g. during soph. year of college for AFROTC before SFT), he will hopefully have been off the medicine for nearly three years. It would seem his waiver chances are greater for the longer period of time that he is off the medicine.

    3. If he cannot go back through the DODMERB process as described in #2 above, should we just suspend applying for the SAs and ROTC scholarships (we can afford to send him to school without a scholarship, but the scholarship would be nice if awarded) and let him join ROTC and take his chances after his sophomore year when he has been off the medicine for three years? Should we discuss this with the ROTC cadre?

    Any other advice would be appreciated because he has had a dream of serving as a military officer since he was 7 or 8 years old.
     
  2. kinnem

    kinnem Moderator

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    First, you should proceed as planned with all scholarships. You're worrying about a bridge that it over the horizon, but it is wise to prepare. #1 seems like a good idea. You might go back to the pediatrician AND a specialist. Don't know about #2, but if ultimately not granted a waiver (if its even needed) then that would be the appropriate time to ask the question of someone in DoDMERB. #3 is a non-issue for now at least, since you should proceed anyway and then make that decision if not awarded a scholarship, etc. Of course this is only my opinion and your mileage may vary.
     
  3. Pima

    Pima Parent

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    +1 kinnem

    The fact is you just need to go through the system.

    I would go to a specialist not a ped., preferably one with military knowledge. DoDMERB will assign a doc to you for the exam, thus it might not be your family doc. These are docs that have been qualified by them.

    Also keep all of your paperwork in order because part of the process is listing dates and docs.
     
  4. Sowbug

    Sowbug Member

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    Kinnen and Pima .... Thanks for your replies:

    Pima ... Would it be ok to go see Pediatrician and also a GI specialists? We already have an annual physical with the Ped in August and could use this as an opportunity to bring this up and document that he is off the medicine and doing fine. Also, when do you recommend seeing the specialist? Soon or wait until further along into the process to maximize the amount of time he has been off the meds?

    If I understand correctly, DODMERB is requested by SAs at a certain point along the application process, but for ROTC, it is not requested until the scholarship is offered.

    Thanks again.
     
  5. kinnem

    kinnem Moderator

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    You are correct that this is the normal process. Occasionally, a ROTC applicant will be asked to go to DoDMERB prior to a scholarship award, but you should read nothing into that, positive or negative. It just happens from time to time.
     
  6. Sowbug

    Sowbug Member

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    Type of Documentation?

    I am consulting with my family physician on DS's IBS diagnosis from 2.5 years ago (see opening post for details and background) to see if he has any recommendations on a path forward. Perhaps he can provide a second opinion or refer me to a GI specialist that would be good. I couldn't find any DODMERB docs in my area through an internet search.

    My question is: What type of documentation should I ask for? A second opinion on the initial diagnosis and/or that the condition has resolved itself?

    I assume that it should be a letter from the doc, but who should it be addressed to? me? DODMERB, or his pediatrician?

    Thanks
     
  7. billyb

    billyb Member

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    Every situation is different but I do know of a active duty military officer that was medically put out of the service due to IBS. Of course, you should go thru the process yourself as your results might be different, but IBS definitely can be an issue. Best of luck!
     
  8. usna1985

    usna1985 USNA Alumnus

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    It's hard to know what you need until you get the DQ from DODMERB. Once you get it, you'll be told what to do and what you need in terms of documentation -- and also directed where to get it.

    You could try calling DODMERB now but my guess is that they'll want to have the results of the medical exam first. Still, they might be able to tell you whether the condition is waiverable or not.

    If your DS has IBS (i.e., not a misdiagnosis) as a current condition, I would think it very unlikely to be waiverable -- but that's only a guess. If the condition no longer exists (i.e., only a "history of" and there is a way medically to demonstrate that it's gone), chances are obviously better. I'm NOT a doctor but one thing DODMERB looks for in SOME conditions is whether the person has been fine without medication for a full year. Thus, if your DS has not been taking any meds for a year and has been symptom free, that might help. However, as noted, the only ones who can give you official advice are at DODMERB -- you might at least call them and see what they say.

    Best of luck!
     
  9. JMS

    JMS Member

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    I'm getting the idea you are thinking you are getting multiple medical exams.
    If applying to the SAs you will get a DODMERB appt soon after one application is mostly completed... probably this summer or fall. That same exam will serve for all the other SAs and for ROTC. It is good for two years. You will not get multiple exams. If only applying to ROTC, then, yes, you will wait until you are in line for a scholarship. That exam (assuming you did not already have one for and SA) would likely be next spring.
     
  10. Jcleppe

    Jcleppe Member

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    Sowbug,

    This may sound like a bit of a stretch but you might have your son stop eating Dairy for a while. The symptoms you have mentioned can also be caused by a Lactose Intolerence. I went through the same thing years ago, took all the tests and had a couple doctors mention IBS. When I saw a specialist he asked if I drank a lot of milk and ate dairy, I said a lot, he said stop. After a couple weeks the symptoms stopped, haven't had a glass of milk since. After several years I am able to eat most dairy in moderation, I just stay away from milk.

    It's worth a try, and a discussion with his doctor.
     
  11. Sowbug

    Sowbug Member

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    Actually, he used to drink a lot of milk and had cut way back this summer, mainly to try to help his acne. However, he has not had any stomach pain for almost two years. Even when he did have stomach spasms, it was not associated with constipation and/or diarrhea which are the other main symptoms of IBS. The unfortunate thing is that he took medicine (only during school days and during the school year) until this past February when he stopped and he has had no addition spasms. As I said, he has been spasm free for almost two years.

    I'm certanly not a doctor, but from what I've read on the internet, he doesn't seem to have most of the typical IBS symptoms as defined by the Rome Criteria. There is no definitive test for IBS; it is all based on symptoms. He only saw his pediatrician one time and was diagnosed without any additional follow-up. Thats why I thought a second opinion may be helpful.

    I'm just struggling with how to document the second opinion such as a letter or report and who it should be addressed to. I'm just trying to be proactive and address the issue head-on when he does submit his DODMERB paperwork later this summer or fall.

    I will call DODMERB as suggested by others to get their insight and advise.
     
  12. sheriff3

    sheriff3 Member

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    Sowbug, I would strongly suggest you find a prior military service MD/DO specialist to examine your son. They would know the regulations and may be helpful in crafting an opinion (if warranted by the diagnosis) that may be favorable to your son. My DS had some allergy issues as a toddler, he out grew and was treated for them with no issues for several years. Fast forward to last year and he was DQ'd by DoDMERB for "history of anaphylaxis". He and I and our family MD wrote letters stating no allergies. Seemed to fall on deaf ears at DoDMERB. We were fortunate enough to find a prior service, retired Army MD who was/is also board certified in allergy and immunology and was chief of allergy and immunology on a few Army bases. He examined and tested DS and determined he had no prior history was misdiagnosed by the previous MD. Tests concluded he currently has no allergies. I firmly believe his favorable diagnosis went a long way in my DS getting a waiver from AROTC CC surgeon general. In my opinion, a favorable diagnosis (especially from a prior service military doctor) gives the medical waiver authority documentation to “hang their hat on” and they are more likely to grant a waiver. As many have stated…. 1) Call DoDMERB to access the likelihood of DQ and waiver. 2) Apply for ROTC/SA. 3) Start gathering medical records and try to find a prior service specialist doctor to examine your son. Best of luck to you.
     
  13. Sowbug

    Sowbug Member

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    Thanks for the advise to everyone.

    I talked to DODMERB a few minutes ago and he said that IBS was a waiverable condition based on specific situation and that there was no established time frame to be off medicines (again, based on specific situation). He said that submitting a second opinion at the time of the initial physical and/or attached to the medical history form would not help like usna1985 suspected. Instead, he suggested that we wait until a the request for medical records is received from DODMERB. At that time, we could pay for the second opinion ourself and submit it with the medical records. Or, we could wait until a DQ and hopefully a waiver request is made by the authority, at which time, they will send him to their doctor and pay for it.

    I 've not had much luck trying to find a prior military service doc to conduct a second opinion, but I will keep trying.
     

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