Bring records of preemptive testing done to DoDmerb exam?

[kbat]

We have already pulled every record we can, knowing she will have to get a waiver if appointed:
DD has bacterial pneumonia at 12yrs 3. Pedi gave proair inhaler and amoxicillin. Thankfully her Pedi was so great at records and documentation, he literally said in his note "no h/o asthma, first bronchospasm, will treat today as if asthma, and watch through teen years".

We have gotten out in front of it, pulled the entire record, pharma record. It was filled twice since 2018. One expired, so we had a refill done in 2020 and still have both of the original meds. One was never used at all, and the other has 186 actuations left. I could kick myself for ever doing the refill!! It was removed from her record/med list in 2021 during a well visit. We have scoured her record and found zero use, zero resp difficulty/wheezing, O2 Sats declined, resp effort, etc. She never showed an issue or used again. We had a consultation with him last week, and he wrote an attestation on her behalf for her file about no further/chronic use, no further resp diagnosis, and a very long hx of club tier 1 & tier 2 hockey from age 5 to current, 10m out of each year, coaches tier 2 hockey 8m a year, as well as 3yrs as a varsity sailor in various weather conditions, physical conditions and seasons. This in addition to training/running with CG mentor for her PFE. Her Pedi stated if she had asthma or reactive airway "it would have declared itself by now." He is also sending her to BCH for a full pulmonary with an adult provider in April, to close the question and issue.

My question is, knowing she will declare and be DQ'd, should she bring all these records to Dodmerb exam or wait till she is Dq'd?

Thanks and good luck to all families & kids busting their butts for this!

 

[PLC007]

You are well prepared. This will help your DD with AMI and/or waiver process. It will be very beneficial to pass the detail knowledge you have on the medical history to her so she knows what, when, and why. This will help her answer questions from the exam doctor accurately.

No harm in bringing the records to the exam, but it is unlikely that they will be used. The exam doctor does not collect records. If DoDMERB wants something, she will be notified to send it directly.

I went to DoDMERB exam with DS.
He was a minor and parent present was required. The exam itself was similar to sport physical. After the exam, the doctor went over DS's DoDMET form (print out of questionnaires he completed online) and asked in more details on areas that are flagged or have potential for DQ. It was a fast pace Q and A, so he answered the questions to best of his knowledge and the doctor jot down notes.

 

[Herman_Snerd]

We have already pulled every record we can, knowing she will have to get a waiver if appointed:
DD has bacterial pneumonia at 12yrs 3. Pedi gave proair inhaler and amoxicillin. Thankfully her Pedi was so great at records and documentation, he literally said in his note "no h/o asthma, first bronchospasm, will treat today as if asthma, and watch through teen years".

We have gotten out in front of it, pulled the entire record, pharma record. It was filled twice since 2018. One expired, so we had a refill done in 2020 and still have both of the original meds. One was never used at all, and the other has 186 actuations left. I could kick myself for ever doing the refill!! It was removed from her record/med list in 2021 during a well visit. We have scoured her record and found zero use, zero resp difficulty/wheezing, O2 Sats declined, resp effort, etc. She never showed an issue or used again. We had a consultation with him last week, and he wrote an attestation on her behalf for her file about no further/chronic use, no further resp diagnosis, and a very long hx of club tier 1 & tier 2 hockey from age 5 to current, 10m out of each year, coaches tier 2 hockey 8m a year, as well as 3yrs as a varsity sailor in various weather conditions, physical conditions and seasons. This in addition to training/running with CG mentor for her PFE. Her Pedi stated if she had asthma or reactive airway "it would have declared itself by now." He is also sending her to BCH for a full pulmonary with an adult provider in April, to close the question and issue.

My question is, knowing she will declare and be DQ'd, should she bring all these records to Dodmerb exam or wait till she is Dq'd?

Thanks and good luck to all families & kids busting their butts for this!

First, great job advocating and supporting your DD through this process. Keep doing all you can.

Agree with advice to have this info ready for the AMI request that likely will follow. I’ll just add if it is in the record, it exists. And if it isn’t, it doesn’t. Don’t offer information not on the medical record. Don’t not offer informs that is in the record.

What seems conflicting is your description “never used “ medication with a description that one of the albuterol inhalers was used for 14 administered doses (albuterol inhalers typically have 200 doses). What happened to the other 14?
You’ll also be exposed if your DD was symptomatic after age 13 and used inhalers in the years 13 forward. How often did she have/ use an inhaler since the first diagnosis? I see the used inhaler as problematic to your appeal. Not to answer here or debate here. No opponent- sharing information. - just for your fyi.

I see an uphill battle to get a waiver but plenty of stories on this board of people getting waivers. 10/10 times, Go for it and good luck. Also, continue to line up plans B,c,d for options to serve and get an education in or out of the armed forces.

According to the Department of Defense’s 2018 Medical Standards for Military Service: Appointment, Enlistment, or Induction, people who have asthma beyond their 13th birthday are disqualified from joining the military services. Perhaps the experts will agree she never had it as you are stating.

 

[GWU PNS (emeritus)]

Not sure if the original treating physician is willing to state, but if in hindsight, the belief is that she NEVER had asthma, then that is what needs to be stated, unequivocally. Something like "Original diagnosis of asthma was precautionary......review of overall history shows Pt never had asthma." But don't be surprised to find a doctor not willing to offer they over-treated.

Of all the instances I have seen where people are trying to get waivers for something like this, your "lay out" of the situation shows a well above average level or preparation --- I would bring it with you/you and her to the initial exam. Transparency will set you free!