Appointment acccepted then turned down

The issue arises from a penny wise, pound foolish approach to medical qualification that stems from years of cost cutting. Those of us old enough remember a system that thoroughly inspected the "merchandise" before buying, rather than placing the onus on the candidate to be doctor, lawyer, and health administrator - a new system guaranteed to cause unnecessary problems.

Before receiving my appointment, I received a complete physical that included blood tests, urine tests, EKG, full dental exam, and more. Greater upfront cost, fewer problems/costs down the road, and far less confusion/anxiety among candidates.
 
The same way the IRS audits your financial records. The same way the FBI conducts background checks.
Would the average American be truthful on their tax return if their was zero chance of an audit?
Even if DoDmerb only randomly selected a handful of candidates each year to review it would cause liars to think twice.
 
The issue arises from a penny wise, pound foolish approach to medical qualification that stems from years of cost cutting. Those of us old enough remember a system that thoroughly inspected the "merchandise" before buying, rather than placing the onus on the candidate to be doctor, lawyer, and health administrator - a new system guaranteed to cause unnecessary problems.

Before receiving my appointment, I received a complete physical that included blood tests, urine tests, EKG, full dental exam, and more. Greater upfront cost, fewer problems/costs down the road, and far less confusion/anxiety among candidates.

Yes and no.... the old system was more thorough, and include a thorough full day exam by Navy medical staff instead of contractors, but still relied upon self reporting your medical history. I also suspect there was less diagnosis of some of the disqualifying medical conditions, partly because people go to the doctor more frequently now and partly because doctors feel the need to cover their a$$.
 
How exactly would you do that? Send out an info request to every medical provider?
Even if DoDmerb only randomly selected a handful of candidates each year to review it would cause liars to think twice.

SWO's point, and I agree, is that until there is system of universal medical records, an audit is impractical. It would still rely upon a person self reporting all medical providers. When I applied (long ago), I had enough trouble reporting where I lived ( I moved 7 times growing up), let alone what Dr's I had seen. Besides, has anyone else here tried to decipher the chicken scratch in medical records. (Way back , early in my legal career, I was involved in defense of personal injury and medical malpractice cases, and could never read a doctors notes !)

DODMERB's role isn't to catch "liars." or to keep people out of a Service Academy, but rather to determine if someome meets the requisite physical qualifications to serve. I don't know how this thread evolved to a discussion about "lying" --very few things medical are so black and white that failure to self report would be fraudulent or a lie. In most cases , something that may seem insignificant at the time could turn into a disqualification.
 
You can easily go around an audit of medical records. If the person was in high school and already had an intention to apply to an academy, the easiest thing to do would be to not see their family doctor and go to another doctor that had no connection to them. There would be no medical trail. I have no idea if your prescriptions purchased can be traced but that would be another way to catch someone. My point being that people can hide their medical records if they so desire. Sometimes it easy because you have moved to five different states and have 10 different doctors. My kids on the other hand were born at Kaiser and have been treated at Kasier so every medical records they have is at Kaiser.
 
The same way the IRS audits your financial records. The same way the FBI conducts background checks.
Would the average American be truthful on their tax return if their was zero chance of an audit?
Even if DoDmerb only randomly selected a handful of candidates each year to review it would cause liars to think twice.

Medical records are private and protected by HIPAA. The Only way anyone can get your medical records if you authorize them to get them. So to be able to audit a person’s records, that person would have to get authorizations for all his prior medical providers and provide the authorizations to USNA. If the person wanted to be dishonest he would not disclose providers that had adverse information. So it impossible to randomly “audit” a candidate’s medical history
 
The academies will accept between 1200 and 1300. They will graduate about 1000. That is an exceptional yield.

A small number leave for medical reasons...

What is the purpose of the audit again?
 
If a candidate or parents try to cheat the DODMERB system by hiding any medical condition(s) to become medically qualified , it (the condition) will likely reveal itself later,
if the condition was bad enough to be a DQ in the first place.
That DQ would probably result in a separation from the Academy or AD service at that point if said condition would’ve been an admission DQ.
This would be a much worse outcome emotionally later on than dealing with it at the admissions process.
That is why there is a waiver process and possible reapplication scenarios available for many candidates with DQ conditions . As was suggested to the OP, possibly reapplying in a year or two may be an option and viable route for them. Seek guidance from DODMERB and admissions....
Sadly, every year there are once perfectly healthy Cadets/Mids that first contract medical conditions or receive severe injuries that place them as a medical DQ, thus requiring a medical separation from the Academy. This again is a failure to meet standards policies that must be enforced for the overall mission of the service.
 
There is a cost benefit analysis to everything. Standardized test scores are easily sent in from primary source (and BTW, a candidate doesn’t have to send them all in...). Transcripts are easily sent in from a primary source.

A medical ‘audit’ isn’t feasible. For all reasons stated above. I’m also not sure why Overwhelmed is thinking it necessary. For me, it’s all covered already because the integrity of an applicant is trusted to disclose their medical information. So not sure what the point is of this change of course of this thread.

Liars are going to lie, cheaters are going to cheat. Hopefully liars and cheaters aren’t applying to USNA. Perhaps some do, but I doubt it’s prevalent. The academies have been do this for a long time and seem to do a pretty good job of it. Like all things, there isn’t a perfect system. I don’t even see that this is something broken that needs fixing.
 
I agree nothing is perfect.

I just find it odd that 17 years of medical history isn't verified but DS was required to send in a 2 minute push-up video to USMA.
 
You can easily go around an audit of medical records. If the person was in high school and already had an intention to apply to an academy, the easiest thing to do would be to not see their family doctor and go to another doctor that had no connection to them. There would be no medical trail. I have no idea if your prescriptions purchased can be traced but that would be another way to catch someone. My point being that people can hide their medical records if they so desire. Sometimes it easy because you have moved to five different states and have 10 different doctors. My kids on the other hand were born at Kaiser and have been treated at Kasier so every medical records they have is at Kaiser.
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.
 
You can easily go around an audit of medical records. If the person was in high school and already had an intention to apply to an academy, the easiest thing to do would be to not see their family doctor and go to another doctor that had no connection to them. There would be no medical trail. I have no idea if your prescriptions purchased can be traced but that would be another way to catch someone. My point being that people can hide their medical records if they so desire. Sometimes it easy because you have moved to five different states and have 10 different doctors. My kids on the other hand were born at Kaiser and have been treated at Kasier so every medical records they have is at Kaiser.
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.
Well if i was going to bother going to see another doctor for that reason, I would also pay in cash. As I mentioned before I belong to Kaiser. However to see a dermatologist, it takes a referral and time plus it can cost additional money. I dont bother going to Kasier for that. I go see a dermatologist in my building and pay him cash. As I cant pay with insurance, I pay cash and because of that, I get a reduced fee. It isnt that the doctor is pocketing the cash but rather he doesnt have to deal with the cost of administrave fees, billing and credit card charges. I mean if you want to hide an ezcema outbreak, how much do you think it would cost to see a doctor and get prescribed a cream. Its funny you make sound like paying cash is some weird thing. As for social security, you can easily write down the wrong number. I am not trying to encourage anyone to go through these steps, but if you are motivated enough, anything can be done.
 
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.

O.K. . so the USNA would send the "blanket HIPPA authorization" to who? They would have to send it every medical provider and health insurance company in the world. A less than candid candidate could just as easily fail to disclose a health insurance company as they could a medical provider. As said before, the system relies upon the integrity of the candidate to reveal their true medical history as well as a reasonable physical exam. Nothing is perfect.
 
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.

O.K. . so the USNA would send the "blanket HIPPA authorization" to who? They would have to send it every medical provider and health insurance company in the world. A less than candid candidate could just as easily fail to disclose a health insurance company as they could a medical provider. As said before, the system relies upon the integrity of the candidate to reveal their true medical history as well as a reasonable physical exam. Nothing is perfect.

Services already compile this information. Insurance companies use it all the time to search for prior treatment - if you aren't involved in the industry, I guess you'd be surprised at what is readily available. Based on the available information, you would know exactly who to request records from.

Well if i was going to bother going to see another doctor for that reason, I would also pay in cash. As I mentioned before I belong to Kaiser. However to see a dermatologist, it takes a referral and time plus it can cost additional money. I dont bother going to Kasier for that. I go see a dermatologist in my building and pay him cash. As I cant pay with insurance, I pay cash and because of that, I get a reduced fee. It isnt that the doctor is pocketing the cash but rather he doesnt have to deal with the cost of administrave fees, billing and credit card charges. I mean if you want to hide an ezcema outbreak, how much do you think it would cost to see a doctor and get prescribed a cream. Its funny you make sound like paying cash is some weird thing. As for social security, you can easily write down the wrong number. I am not trying to encourage anyone to go through these steps, but if you are motivated enough, anything can be done.
.

Paying cash for medical care is very uncommon, unless you are a Mennonite or Amish. Cash for care will be on the rise in the future, but it isn't common at present.
 
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.

O.K. . so the USNA would send the "blanket HIPPA authorization" to who? They would have to send it every medical provider and health insurance company in the world. A less than candid candidate could just as easily fail to disclose a health insurance company as they could a medical provider. As said before, the system relies upon the integrity of the candidate to reveal their true medical history as well as a reasonable physical exam. Nothing is perfect.

Services already compile this information. Insurance companies use it all the time to search for prior treatment - if you aren't involved in the industry, I guess you'd be surprised at what is readily available. Based on the available information, you would know exactly who to request records from.

Really? After two moves and 15 or so years, I can't even remember who the doctor was and my son certainly didn't. And if the doctor retired, moved or otherwise left the practice they were in 15 yrs ago?
 
No, you can't easily go around an audit by failing to disclose, unless you are paying your doctor in cash or chickens. Insurance companies keep records for everyone. Insurance company records are all searchable by social security number, complete with diagnosis/treatment codes. These can easily be searched. As for Hippa, the academies could easily include a blanket Hippa authorization as part of the application packet - problem solved. If an insurance company paid for something, there is no way to hide it.

O.K. . so the USNA would send the "blanket HIPPA authorization" to who? They would have to send it every medical provider and health insurance company in the world. A less than candid candidate could just as easily fail to disclose a health insurance company as they could a medical provider. As said before, the system relies upon the integrity of the candidate to reveal their true medical history as well as a reasonable physical exam. Nothing is perfect.

Services already compile this information. Insurance companies use it all the time to search for prior treatment - if you aren't involved in the industry, I guess you'd be surprised at what is readily available. Based on the available information, you would know exactly who to request records from.

Really? After two moves and 15 or so years, I can't even remember who the doctor was and my son certainly didn't. And if the doctor retired, moved or otherwise left the practice they were in 15 yrs ago?
Doctors don’t take records with them when they leave a practice. Retired solo practice doctors would be an issue, but they barely exist anymore.
 
Medical (DODMERB) always has been -- and will likely continue to be -- primarily an issue of self-disclosure. If you lie, you MAY manage to get in to a SA despite your medical issue. That assumes that your condition doesn't pop up during your medical exam.

Even if you do manage to get in, the issue could well recur during your time at USNA, which could lead to all sorts of issues up to and including dismissal (for medical reasons or for failing to disclose a known issue). Also, the 2/C pre-commissioning physical is very comprehensive. They likely will find the problem at that time. And then, you could find yourself out of the military or limited in the communities into which you can commission.

I think most people are honest about medical issues -- sometimes going well beyond the requirements (i.e., self-diagnosing). There will always be a few dishonest folks -- hopefully, the truth comes out eventually.
 
The issue really isn't lying, it's trying to remember 15+ years of medical history and then describing it accurately. Over reporting and accuracy are greater problems for the candidate than inadvertent under reporting. No one is going to forget a serious medical issue, but a layman's description of a minor issue may be taken out of context by a medical doctor and lead to DodMerb hell.

When there is ambiguity in the interpretation of a contract the interpretation is resolved in favor of the party that did not write the contract. Similar reasoning can be applied to DodMerb. When there is ambiguity in how to report something, report it in a way that is more favorable to the candidate rather than less favorable. Be honest, but be smart.
 
Back
Top