Need Guidance

[FLSwimmer19]

I am here writing as my Son who just completed his Junior Year at a University in the DC area, was just told that they are going to move for Medical Disenrollment for a Condition that has no affect on his abilities and is something that I am not completely sure was even diagnosed correctly. Nonetheless let me give you some insight. He is the Captain of the Collegiate Swim team he is on, he just last month scored a 295 score on his PRT test and is one of the more physically fit individuals in the unit and was diagnosed with a condition that requires him to take a Humira Injection every 2 weeks. It has obviously no effect on his physical abilities and according to the CO of the NROTC program he cannot even appeal the decision. Now I understand that he may not be able to fly an aircraft as they are so stringent, but there are so many other things that he can do and it was mentioned to him that he could also go restricted line and possibly maybe to law school or Naval Intelligence. nonetheless there are so many options and the Navy is his life and I just want to find a way to help him with this injustice.

 

[kinnem]

You don't mention his condition and there is no need to here (at least for me). From what I can see Humira is only prescribed for some serious conditions. It's very possible that, while at sea, he might not be able to get his medication. That could be bad for him and also the men and women he serves with. Either that's there rationale or they don't want to incur the cost of treating whatever his condition is (or both). I expect it's the former since there has been talk about unrestricted line which would entail remaining ashore (at least for the most part). In any case this is a business decision and should n0ot be taken personally. Injustice is a point of view.

He might want to push hard on restricted line if he still wishes to serve. Hoping for the best for him.

 

[FLSwimmer19]

Thank you... and actually I am still not completely sure that the condition was diagnosed correctly but as he takes the medication every two weeks I would find it hard to imagine that any ship would be unable to get medication for something that is required that infrequently. Nonetheless I appreciate your input and restricted line especially based on his area of study should seemingly be an option. I plan on reaching out to the Senator and Congressman that nominated him in the first place as well.

 

[jl123]

Thank you... and actually I am still not completely sure that the condition was diagnosed correctly but as he takes the medication every two weeks I would find it hard to imagine that any ship would be unable to get medication for something that is required that infrequently. Nonetheless I appreciate your input and restricted line especially based on his area of study should seemingly be an option. I plan on reaching out to the Senator and Congressman that nominated him in the first place as well.

You might consider getting advice from someone familiar with the military medical system. Not sure if your situation involves DodMerb, but a Dodmerb consultant may be able to help or point you in the right direction.

You may also want to get a second opinion. Incorrect diagnoses happen more than people realize. I was once on a medication for two years until a new primary care physician suspected a misdiagnosis. Turned out to be a food allergy.

 

[FLSwimmer19]

Thank you... We are considering that but think that we should have a Naval Doctor evaluate him for a more comprehensive diagnosis.

 

[Devil Doc]

I have close to 30 years operational Navy medicine experience. About 80 percent of the operational Navy and Marine Corps operational forces serve in an austere environment with no physician. The issue is not the availability of the required meds, but the ability to perform with the condition in which the medication is thus prescribed. As an IDC, I could order any medicine I wanted. I didn't need to because the Sailor or officer would not be there. The sea duty screening before reporting is actually a bit more stringent than the DODMERB physical. I've flunked and refused personnel based on their current health status. I hate to sound negative but ships are industrial work spaces with a demanding OPTEMPO. Also if you have a "naval doctor " evaluate him for a more comprehensive diagnosis, be sure it is one with operational experience. Otherwise it will not be valid.

 

[FLSwimmer19]

Thank you for the reply, and I completely understand, the issue is that he truly has no physical limitations, and just wants to serve this country and be part of something bigger then himself. With that said what would restrict him from going Restricted line, ultimately he wanted to go to law school and become a JAG, so I appreciate the advice and if you have anything else you can recommend it is greatly appreciated.

 

[Capt MJ]

Thank you... We are considering that but think that we should have a Naval Doctor evaluate him for a more comprehensive diagnosis.

People here on SAF have had various results with the for-fee group that comes up when you google “DODMERB consultants.” Some have given thumbs up, some thumbs down. The principal is a retired Navy captain doc, formerly at DODMERB. He can certainly explain what is going on, for the med DQ.

The key is the accession standards for line officers (the most stringent), restricted line (intel, oceanography/weather, etc.), and staff corps (JAG, Med/Dental/Nurse/Medical Service). Though accession standards are less for the latter two categories, they are not much so. In general, I think it is much harder to go restricted line from NROTC. It’s not the usual path. A handful go from USNA. They are either the small group waived to come in with vision problems that prevent them from going URL, or something develops while at USNA.

If you are looking for a civilian doc with military background, look on those MD review sites which list their schools. If you see residencies at Portsmouth Naval Hospital, NNMC Bethesda (now Walter Reed NMMC), Balboa Naval Hospital, and so on, you’ve got an indicator.

Most JAGs attend civilian universities and law schools, then apply to come in. And meet DODMERB. I do not believe there is a funded path from NROTC to law school - but I’ve learned absolutes are rare.

 

[ncbill]

Most JAGs attend civilian universities and law schools, then apply to come in. And meet DODMERB.

I do not believe there is a funded path from NROTC to law school - but I’ve learned absolutes are rare.

Last I heard from my mid there is also no funded path from USNA to law school.

 

[GoCubbies]

I am here writing as my Son who just completed his Junior Year at a University in the DC area, was just told that they are going to move for Medical Disenrollment for a Condition that has no affect on his abilities and is something that I am not completely sure was even diagnosed correctly. Nonetheless let me give you some insight. He is the Captain of the Collegiate Swim team he is on, he just last month scored a 295 score on his PRT test and is one of the more physically fit individuals in the unit and was diagnosed with a condition that requires him to take a Humira Injection every 2 weeks. It has obviously no effect on his physical abilities and according to the CO of the NROTC program he cannot even appeal the decision. Now I understand that he may not be able to fly an aircraft as they are so stringent, but there are so many other things that he can do and it was mentioned to him that he could also go restricted line and possibly maybe to law school or Naval Intelligence. nonetheless there are so many options and the Navy is his life and I just want to find a way to help him with this injustice.

This is unfortunate. If you DS has Crohns disease or ulcerative colitis, then there are potentially other complications with those conditions as well. If he's got psoriasis, then, relatively speaking, that's more tolerable, in my mind, than Crohns or UC. Humira needs to be stored in a cool place also, so storage issues would limit his potential deployment locations. As an example, if he were to deploy to the CENTCOM AOR, then he would need to get a waiver for being on Humira. Finally, Humira depresses the immune system which would put him at risk for infections, particularly fungal and bacterial infections. There are many bugs in a deployed setting that he would be exposed to that he normally wouldn't be exposed to in our country.

Make sure the diagnosis is correct. I'd see if he can get an eval at Walter Reed National Military Medical Center, Johns Hopkins, Georgetown, or some other medical center in the DC area to get a definitive diagnosis.

At this point, his best path my be to take the restricted line if they allow him and then go to law school once his commitment is over.

 

[kp2001]

Unfortunately you are going to have an uphill battle to continue on to commissioning out of ROTC; however, there is still hope to be able to serve as a JAG in the future if that's truly what they want to do, which I will explain in a bit.

Humira is no small matter and isn't necessarily a first line medication for most conditions due to its significant potential risk; however, is an amazing medication when it is needed. That tells me that there is likely some underlying chronic condition that has previously been attempted to treat with another medication (now I could be way off here b/c the actual condition is not mentioned in this case.). Despite your son's stellar athletic performance that has about zero impact on what they will be doing in the future and the "issues" that are caused by an active duty member needing to take a medication such as Humira on a regular basis, or having whatever condition needs that medicine. If your son has a condition that has progressed to needing Humira I don't see an easy route to commissioning through his current program. It sounds harsh, but it is likely. To give some insight, when I was a flight surgeon I would have probably declined any person coming to the squadron who had a sea duty screening annotating the need for Humira (or any biologic for that matter).

Others have mentioned getting a second opinion, and potentially from a military physician. Certainly a reasonable consideration, I don't think it necessarily needs to be a military physician and definitely doesn't have to be someone with "operational experience." It just needs to be a competent physician who can either confirm or refute the diagnosis. It will then be up to the waiver authorities. If your son remains on the medication then the case will very certainly be sent to the active duty doc who is a specialist in the appropriate area who will make the determination. They will be well versed in the impact that a particular diagnosis or need for medication will have. (I get these on an occasional basis for eye issues). They don't necessarily need to have additional information from one of the other military docs. If it's easy enough to get into Walter Reed or Ft. Belvoir seeing they are in the DC area then go for it, but my guess is navigating into the Military Treatment Facility system is going to be extremely difficult, so I would consider heading for Georgetown or George Washington for a second opinion.

Okay, so that was the doom, and here comes the potential upside. As noted above JAG is usually not possible direct out of ROTC. If law school is truly what your son wants then I would take this as a sign to depart the Navy pattern for a bit, go to law school, and then apply as a direct commission JAG. The likelihood of getting a waiver for Humira as a JAG is higher than for unrestricted line. If he doesn't, well he's still got the Law degree, and if they do, well then he gets what he wanted in the first place! I would certainly not take this potential hiccup as an end-all, but rather maybe a sign to take a different path to the end goal.

 

[FLSwimmer19]

Thank you all for the responses, At this point it looks as if they are going to terminate his scholarship and begin disenrollment, However he is going to try to see a rheumatologist at John Hopkins, as of this writing he has only seen one doctor who diagnosis his condition as Ankylosing Spondylitis and from everything I have read that condition has about a 35% misdiagnosis rate, and as well the original condition was a problem with his ankles, so the entire process has been quite confusing.
The good news is that his CO, XO are hell bent on trying to help him find a place within a government agency and are quite upset about this entire thing, they have spent the last three years with him and wanted nothing more than to see him Commission.
I also have a call into the DODMERB Consultant for more advice, but I really appreciate all of your support here. This is an awful situation for him and I feel helpless and just want to see him attain what he has worked so hard to earn.

Thank you!

 

[Capt MJ]

Your son can also serve his country in Federal civil service, and in important ways, that require his brain and a desire to serve, ankles and prescriptions not as important. At the “ABC” agencies, the big ones, there are the field agent operators, but also all the strategic thinkers and tactical planners, the analysts, the logisticians, the trouble-shooters, the engineers.

Most of these ABCs have college and college grad programs. They are very interested in bright young brains with a variety of majors.

Using a search string of “CIA college grad program,” links came up for undergrad internships and college grads. Try it with other Federal agencies and Departments, such as State.

I have posted this recommendation a number of times over the years, including mentioning a sibling of one of our former USNA sponsor mids, who was a Math major and interned at NSA in the summers. The sibling was hired by them. The sibling also happens to have a chronic disease, and Federal workplace protections and robust health benefits were critical. Loves the work but can’t tell me a darn thing about it.

Edit: One more thought. “Adapt and survive” is an essential quality for any successful officer. He can still have a fierce warrior heart while serving in a different way.