Tricky Situation regarding Hernia

Discussion in 'DoDMERB' started by FatherOfFive, Jun 27, 2006.

  1. FatherOfFive

    FatherOfFive Member

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    My son is going to get his physical in the next 35 to 45 days. He was born with an umbilical cord hernia about the size of a dime about 2 inches above his belly button. We never did anything about it because it is without symptoms and has never been tender and we were never advised otherwise. We very recently discovered that According to DOD Instruction 6130.4 (page 19, section E1.11.11) dated January 2005, that this condition is disqualifying. This condition is easily correctable with out-patient surgery.

    Now for my questions:

    Q: Does anyone know if wavers for this type of hernia are routinely granted?

    Q: I’m thinking we should have the hernia fixed before the exam. He will still receive a DQ for “abdominal wall surgery in the last 6 months”. But it would mean that in January he could get the DQ removed as the 6 month waiting period would be over – if we submit the necessary Doctor’s report etc.

    Q: Should we do nothing before the medical exam, get the DQ. Apply for waivers, then get the operation done, then if we do not get the waivers we can submit documentation in February that it was corrected 6 months earlier and has completely healed?

    Q: Given that his final medical status will not be sorted out until as late as February, we are concerned that this will hurt his chances, as we have been told to get his SA application completed as early as possible. What is the real story?

    He has a muscular abdomin which helps to disguise it. Light has to shine on his stomach in just the right way for anyone to see it.

    I sure wish we had this taken care of 10 years ago.
     
  2. RetNavyHM

    RetNavyHM USN (RET)

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    FatherOfFive,

    I'll preface my response with this statement: The following is only my recommendation based on my years at DoDMERB and working with the SA's and waiver authorities. It is not a medical recommendation for any medical treatment.

    Now that I have that out of the way, if this were my child, and based on what I know, I'd have the surgery done as soon as possible. Reason being, I have seen very few waivers get granted on applicants who had an uncorrected hernia (even ones that have caused no problems). You are correct that he will be disqualified for 6 months after the surgery, but as a time limited disqualification it can be removed. I have run across issues where the family physician or surgeons will not repair hernias that are not causing problems. If you run into this, have the physician or surgeon write a letter stating in detail why he/she will not do the surgery and what the possible long term effects of it will be with strenuous activities. This will help the wavier authorities make their decision.

    As for the admissions portion for the SA's, all the SA's make their admission decisions based solely on the application and not on the medical. Speaking from experience with USNA and USAFA waiver authorities, they will not even look at an applicants medical information until the SA's have given the applicant a conditional LOA (conditional on completion of medical or waiver). So this shouldn't hold your son up at all from an admissions standpoint.

    I hope this helps!
     
  3. FatherOfFive

    FatherOfFive Member

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    Hernia advice

    This is the best news we could have hoped for! Not only does it confirm my instincts to get this done ASAP (his consultation with a surgeon is tomorrow), but it is reassuring to know that getting medically qualified in Jan/Feb will not hurt or delay the admission decision. Tomorrow he will be most likely be scheduled for surgery around the middle of July, so the clock will start ticking then.

    Of particular use was your experience stating that "I have seen very few waivers ... granted" for this type of condition. This was the critical piece of information I lacked.

    Thank you very much for your service to our country.
     
  4. FatherOfFive

    FatherOfFive Member

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    My son was mis-diagnosed!

    My son was mis-diagnosed!

    The surgeon examined my son today. He had him lie down and flex his abdominals. The doctor tried to find the hernia visually and manually and he could not.

    My son stood up and pointed it out to the doctor. The doctor then stuck his finger in it and did his examination when he pressed hard, my son complained that it “hurt like crap”. The doctor frowned :confused: and said: “I don’t think this is a hernia”. The doctor then called in another doctor for a consultation. The other doctor examined my son and came to the same conclusion. The diagnosis was – “no hernia”. According to the surgeon, given the location of the condition it was more likely that my son might have what is called “Diastasis Recti” which is a muscle separation - not a hernia. It can also be corrected, but the surgery is actually a bigger deal than a hernia procedure. The surgeon did not recommend it. The doctor is writing up a report that states that my son does not have a hernia and he is approved for any and all physical activity. He is sending these results back to our family practitioner. The doctor went on to say that it is not unusual for a Family Practitioner to diagnose a hernia when there isn’t one. Basically, we believed he had a hernia because the family doctor of 10 years ago said he had one.

    Q: If my son does have “Diastasis Recti” is this condition a disqualifier?

    Q: We now intend to not check the box for “Hernia” on the pre-exam questionnaire. Do you see any other issues?

    Thanks
     
  5. RetNavyHM

    RetNavyHM USN (RET)

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    FatherOfFive,

    Great news that its not a hernia, other than that you've left me scratching my head. I will say that this is the first time I've run across this in 20 years of service.

    I definately say check no to the hernia block, but I'd mention it under question #77, "Consulted, or been treated by clinics, hospitals, physicians, healers, or other practitioners for other than minor illnesses?". DoDMERB will ask for the records, thats when I'd send in the report from the physician. I'd also include a statement from your son stating the activities he's been involved in over the past 5 years (both organized and recreational), and any problems he's had with this, if at all. Don't send it in with the physical exam, as attached paperwork seems to go missing more often than not.

    I can't say if this will be a disqualification or not. There is no specific disqualification for it, but there is a miscellaneous disqualification that states "Current or history of any condition that in the opinion of the medical officer shall significantly interfere with the successful performance of military duty or training is disqualifying". Personally, if this has never stopped your son from any activity and if the physicians reports states there will be no problems in the future, I don't think it will be any problem other than sending paperwork into DoDMERB.

    Keep me updated, I'm interested in seeing what DoDMERB does with this!
     
  6. FatherOfFive

    FatherOfFive Member

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    Thanks again.

    This condition has never stopped my son from any activities including Tennis, Track, X Country and Wrestling. He is currently training for his fitness assessment exam and the situps, pullups etc. have not caused him any notice. Not now, not ever.

    So on the pre-exam questionaire I'll check box #77 and provide the following explanation (Help me with the phrasing if you can)

    "Consulted a physician/surgeon regarding an asymtomatic abdominal condition for possible hernia diagnosis. The specialist concluded that the abdominal condition was not a hernia and no treatment was recommended and I was approved for any and all physical activity."

    What do you think?
     
  7. RetNavyHM

    RetNavyHM USN (RET)

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    I'd actually keep a little shorter than that. I'd just put, diagnosed with diastasis recti, 28JUN06, Dr. X, asymptomatic.

    If you mention that it was to rule out a hernia, the reviewer/physician at DoDMERB may get stuck on that word (its happened to me!). Keep it short, and wait for DoDMERB to request the records and have your son send his physical activity statement in with it.
     
  8. FatherOfFive

    FatherOfFive Member

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    Wow!

    Thanks for the great wording. We will be truthful but we don't want to raise any red flags unnecessarily.

    I will let you know how this shakes out.
     
  9. FatherOfFive

    FatherOfFive Member

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    Glad that's over

    Epilogue
    We took all of your advice and this made my son's experience with DodMERB a piece of cake!

    My son took his physical on July 18th (via contractors) and he got his qualified letter in the mail from DoDMERB on July 28! This must be a world's record!

    U.S. Military Academy - Qualified
    Air Force Academy - Commission Qualified
    in the notes under #9 - ... you are medically qualified to enter the US Naval Academy... if your uncorrected visual acuity is worse than 20/40 ... we will review... you need not request this review.

    Since my son's vision is worse than 20/40 in at least 1 eye, all of this seems to check out - these were the results we were expecting.

    So mission accomplished. Yippee! No additional information was requested! If only the rest of the government operated with this much efficiency!

    Thanks again for all your expert advice. :thumb:
     
  10. RetNavyHM

    RetNavyHM USN (RET)

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    Congratulations!! I'm glad I could help!! Good luck on the rest of the application process!!
     

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