Stricter [medical] recruiting rules could save billions

https://www.militarytimes.com/news/...ave-dod-billions-in-disability-payouts-study/

People frequently ask why can’t someone with XYZ enlist, or why is such and such condition disqualifying. Although multifactorial, this article demonstrates well how one seemingly “little” thing can end up costing the government millions.

While not always seemingly “fair” at the individual level it is certainly “just” when looking at the global picture.

An MEB alone costs about $50,000.

kp2001 said:

https://www.militarytimes.com/news/...ave-dod-billions-in-disability-payouts-study/

People frequently ask why can’t someone with XYZ enlist, or why is such and such condition disqualifying. Although multifactorial, this article demonstrates well how one seemingly “little” thing can end up costing the government millions.

While not always seemingly “fair” at the individual level it is certainly “just” when looking at the global picture.

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Very fair point, but the risk of going too selective is a deficit of manpower. The AF in particular is really struggling with manning a large number of career fields. The last thing I'd want to see is a return to more restrictive medical standards.

I see the effects of CRDP (concurrent receipt disability and pension) at least weekly. It is not only costly for the DoD to have soldiers with medical issues, but it also costs the Veterans Administration. Once someone is discharged from the military at 30% or higher and VA grants Compensation at 50% you get both. So not only does the person receive a tax free military disability pension, but the also receive tax free VA payments and no cost VA healthcare for life. JMHO, but I think it is a good thing to have high medical standards, especially mental health, and orthopedic issues as those are usually the first to manifest. I can definitely understand the whole "staffing" problem, I see that too watching news show after news show saying the Army and Marine Corps cannot get enough enlisted people to maintain strength. It appears as if the Academies do not have any shortage of applicants, but on the enlisted side they all seem to be having problems with finding enough recruits after background checks, physicals, and ASVAB testing.

This is a touchy issue....there has to be a middle ground that provides for adequate staffing at ALL levels in ALL services. Anything short of that and the whole country is at risk. BUT, if the soldier or sailor suddenly becomes unable to do their job it could cause harm or worse to other soldiers and sailors, or cause something worse to happen should the failures occur during conflict or combat.

Aren't there mini-seminars on how to retire out with sleep apnea? Gets you 50% I believe.

Impulsive said:

It appears as if the Academies do not have any shortage of applicants, but on the enlisted side they all seem to be having problems with finding enough recruits after background checks, physicals, and ASVAB testing.

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Those are certainly factors. Others, perhaps more impactful, is that fewer and fewer have much awareness of the military, and the economy is pretty darn good right now.

parentalunit2 said:

Aren't there mini-seminars on how to retire out with sleep apnea? Gets you 50% I believe.

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I personally know people who received a disability rating for apnea. I don't recall the exact percentage, but it was definitely more than 10%. Tinnitus is another one that is frequently pushed on separating/retiring servicemembers.

I used to have a problem with people who tried squeezing out every penny of compensation until I retired after 26 years with several issues to include limps, pain, scars, and tinnitus. Not everybody who has a rating is gaming the system.

Devil Doc said:

Not everybody who has a rating is gaming the system.

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I'm speaking more to those that are separating with <10 years, without a deployment, and who have stacked disability ratings hitting 60-70% with the VA. People who worked under me up until a day prior to their separation and had no indication of any disability.

I've sat through the VSO briefings and heard the pressure to "make sure you get your <<fill in the blank>> service connected, and get your rating".

I'll leave it there. I don't want to go too far down this road. Understand that it is frustrating to see genuinely disabled vets struggling to get care for obvious service-connected conditions that are disabling while I have Airman Snuffy printing off his entire medical record (at government expense) so he can trot down to DAV to see how much money he can get for the rest of his life. My irritation comes from viewing the latter benefiting at the expense of the former.

@Tbpxece I understand and was speaking in generalities and not at anyone's post in particular. But as I wrote, I heard the same things through the years from people whose health records I maintained. I even had one CPO ask if I would document a couple years of back pain so he could get compensation. He was a pathetic individual in other ways as well. I personally only get 20 percent but with retirement pay that 20 percent is not above my monthly deposit but just tax free, as you probably already know.

Devil Doc said:

@Tbpxece I understand and was speaking in generalities and not at anyone's post in particular. But as I wrote, I heard the same things through the years from people whose health records I maintained. I even had one CPO ask if I would document a couple years of back pain so he could get compensation. He was a pathetic individual in other ways as well. I personally only get 20 percent but with retirement pay that 20 percent is not above my monthly deposit but just tax free, as you probably already know.

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Thank you, sir. I appreciate the gracious response.

Tbpxece said:

Very fair point, but the risk of going too selective is a deficit of manpower. The AF in particular is really struggling with manning a large number of career fields. The last thing I'd want to see is a return to more restrictive medical standards.

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Is the AF problem a recruiting or retention issue? My understanding is it’s a retention issue, but I could be wrong. If it’s a retention issue then this would have no effect.

kp2001 said:

Is the AF problem a recruiting or retention issue? My understanding is it’s a retention issue, but I could be wrong. If it’s a retention issue then this would have no effect.

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You're right-- it's mostly retention.

But it depends on how you look at that. If you don't consider O-1 & O-2 to be training ranks, then it looks like a retention problem. At face value, I think that's probably where most of the cursory analysis falls-- "we have a problem keeping people in"

I tend to look at O-3 as being the "fully trained, fully qualified" grade, and it seems like we are always slumping there. So to me, it's more of a recruiting problem-- i.e. convincing unmotivated O-2's to stay on past their first ADSC, and avoiding the pitfall of medically DQ'ing those that would stay on.

If I'm losing competent and motivated potential career officers to higher medical accession standards, while the cadets that have no plans to stick around for O-3 are sailing through (and are doing ROTC or SA/SMC just for the free college money for a education at the school of their choice), then that sucks.

Tbpxece said:

You're right-- it's mostly retention.

But it depends on how you look at that. If you don't consider O-1 & O-2 to be training ranks, then it looks like a retention problem. At face value, I think that's probably where most of the cursory analysis falls-- "we have a problem keeping people in"

I tend to look at O-3 as being the "fully trained, fully qualified" grade, and it seems like we are always slumping there. So to me, it's more of a recruiting problem-- i.e. convincing unmotivated O-2's to stay on past their first ADSC, and avoiding the pitfall of medically DQ'ing those that would stay on.

If I'm losing competent and motivated potential career officers to higher medical accession standards, while the cadets that have no plans to stick around for O-3 are sailing through (and are doing ROTC or SA/SMC just for the free college money for a education at the school of their choice), then that sucks.

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Great points! I think the problem is at the point of recruitment everyone (well not everyone, but everyone on their personal statement [emoji23]) claims they want to do 20 years so how do you tell who is who.

I would assume someone has done some analysis on the factors at entrance and length of service. (E.g. State, age, big city/rural, only child/middle child, etc etc)

kp2001 said:

I would assume someone has done some analysis on the factors at entrance and length of service. (E.g. State, age, big city/rural, only child/middle child, etc etc)

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I found a few Rand studies done for the AF, but the information was dated. Some was consistent (chronic shortage of 32EX (civil engineers), 11X(pilots), and weather officers).

The ROTC scholarship program is something I have mixed feelings on. It's a great thing to have, but I really wish it was more accessible to Total Force. There are plenty of reservists and guardsmen that would make better active duty officers, and similarly plenty of 4-and-out new AD lieutenants that would probably go the full 20-30 in the Guard or Reserves. I'd much rather retain that engineering graduate in the reserve component as an enthusiastic part-time traditional (and still have them filling a deployment billet in the future), then have them half-heartedly finish their ADSC and punch out after 4-- just as they are becoming operationally ready.

Having a formal, established program to switch between the components with relative ease would do wonders for retention. And I'm not talking about the current "Total Force" slots, where the AD officer is PCS'd to an ANG base as a squadron commander, or a reservist or guardsman is competing for a time-limited IMA/VLPAD assignment. I'm speaking more to the ability to PCS/PCA into a reserve billet for a few years, and then switch back onto AD as needed.

Even though my two comments on this have been about cost, my real concern is taking the medically under-qualified into an operational environment. Taking sailors and Marines to sea and down range without a physician, X-ray, lab beyond just a microscope, and other 21st century marvels is both a thrill and scary.

The “why can’t I join with XYZ” question is easily answered in the description of the operational platform and the environment in which one operates. Asthmatics do not do well on ships. Even the cleanest warships are dirty and dusty. Throw in hot spaces and the German cockroach and the perfect storm for an asthma attack occurs.

Bad skin is another operational issue due to the proper wearing of job related attire. I’ve had personnel get in fraudulently with ortho problems. Pre-existing low back issues show up quickly on a 12 mile hump. I had a new deck seaman present to sick bay complaining of low back pain due to carrying five gallon paint cans. We were in the yards and everything was being loaded back aboard ship. I wrote him a psych consult which resulted in a hospitalization and recommendation for discharge. He didn’t join with back pain but with a history of personality disorder and suicidal ideation. He said he hated the Navy and wanted to die.

Not all emergencies happen in port though and IDC ships are not always at sea with a doctor ship. Before I stray too far off topic, I’ll say that large sums of money payed out in undeserved disability compensation bothers me as a taxpayer, but lowering the medical standards has other implications that are potentially more serious.

@Devil Doc, I will second those feelings! The money and manpower is one thing, but risking everyone's life because you failed to be totally truthful should be a crime. If one of my sons' happened to be killed while on patrol because 3 of the ten members of their patrol were on "sick call" or "light duty" or even worse failed to perform when needed, for something that truthfully pre-existed military service is not right. Sometimes, I think it is a game some people play. Lets go in the military....Joey served five years, documented everything and now gets $3000 a month from VA and $2500 a month from the military, all tax free, he said he would show us how! Believe me folks...it does happen. Like it was said here before, there are soldiers and sailors who work just fine till the day before discharge, then all of a sudden everything gets broken and the claims for disability fly. And it is sometimes the VSO's fault, they are told by bosses to make sure every members gets EVERYTHING they are entitled to...