DoDMERB applicant(parent) guide part III (final)

sheriff3

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MISCELLANEOUS NOTES:

1. Medications are NOT a reason for a determination of does NOT meet medical accession standards or waiver denials. It is the underlying condition, illness, or disease that is the issue.

2. “History of….” - There are many standards that are NOT related to an applicant’s current medical status; current ability to function; or prognosis for the future. However, these are significant enough to warrant additional scrutiny by the Service where the applicant has applied. Examples regarding knees:
1) This refers to current only - “Current or loose foreign body in the knee joint ” (does NOT meet medical accession standards).
2) “History of uncorrected anterior or posterior cruciate ligament injury” (does NOT meet medical accession standards).

3. VISION ISSUES – Your Optometrist can assist you in understanding these issues better.

Vision: Distant visual acuity not correctable to 20/40 in one eye and 20/70 in the other eye or 20/30 in one eye and 20/100 in the other or 20/20 in one eye and 20/400 in the other is disqualifying.
Refractive Surgery: History of any incisional corneal surgery including, but not limited to, partial or full thickness corneal transplant, Radial Keratotomy (RK), Astigmatic Keratotomy (AK), or Corneal Implant (Intacs) is disqualifying. Refractive surgery performed with an Excimer Laser, including but not limited to, Photorefractive Keratectomy (PRK), Laser Epithelial Keratomileusis (LASEK), and Laser-Assisted in situ Keratomileusis (LASIK) is disqualifying if any of the follow conditions are met: the pre-operative refractive error exceeded +8.00 or –8.00 diopters (spherical equivalent) in either eye, pre-surgical astigmatism exceeded 3.00 diopters, at least six month recovery period has not occurred between last refractive surgery or augmenting procedure and DODMERB medical exam, there have been complications and/or medications or ophthalmic solutions required and post-surgical refraction in each eye is not stable. Implantable Collamer Lenses (ICLs) are not an approved form of refractive surgery at this time.
Refractive Error: Myopia (Near-Sighted) over -8.00 diopters in spherical equivalent, or hyperopia (Far-Sighted) over +8.00 diopters equivalent is disqualifying. Many times waiver authorities will require a normal dilated retinal exam in order to consider a waiver. This is done on a case by case basis.
Diplopia (double vision): Current or recurrent diplopia is disqualifying. A history of Duane’s Syndrome or Brown’s Syndrome is not always disqualifying unless an applicant demonstrates diplopia on ocular motility testing.
Strabismus (misalignment of the eyes): The individual Military Services may set their own standards and requirements.
Color Vision: The individual Military Services may set their own standards and requirements. Pseudo Isochromatic Plates (PIP) testing is the standard screening test for all programs. Only the 14 plate PIP test is acceptable. There is no color vision standard for accession into the Air Force or Marine Corps. Army programs only require that an applicant pass a Vivid Red – Vivid Green Test. Additional color vision testing may be ordered by the individual Military Service if initial color vision screening results in a failure.
Rigid Contact Lenses: Must be removed 21 days prior to the eye examination. This requirement also includes gas permeable lenses. For those applicants undergoing Ortho-Keratology or Corneal Refractive Treatment (CRT), rigid lenses need to have been removed for 90 days prior to the eye examination.
Soft Contact lenses: Must be removed 3 days prior to the eye examination.

4. “Food allergies.” A lay article (a) and then the referenced abstract (b):
a. Food Allergies Send 50,000 People to ER Annually
Monday, December 22nd, 2008
A new study published in the December issue of the Journal of Allergy and Clinical Immunology (JACI) found a higher likelihood of anaphylaxis, or severe and/or life-threatening allergic reactions than previously reported.
In the study, Wyatt W. Decker, MD, Chief of Emergency Medicine at the Mayo Clinic in Rochester, Minnesota, reported that the incidence rate of food-allergic reactions increased significantly from 1990 to 2000. Researchers reported about a 10 percent increase in cases of life-threatening allergic reactions over the 10-year period of the study.
Children ages 0 to 19 are at the highest risk for these severe reactions. Based on the new study, it’s estimated that food allergies cause 50,000 emergency room visits per year, with overall cases approaching 150,000 annually.
“This study shows anaphylaxis affects significantly more people, many of whom are children, than previously reported,” said Anne Muñoz-Furlong, Founder and CEO of the Food Allergy & Anaphylaxis Network (FAAN).
Increased prevalence of peanut and tree nut allergy
Almost every day I am asked by patients, colleagues and the media why there are so many new cases of food allergies — particularly, nuts and peanuts. The prevalence of peanut allergy in the U.S. has been estimated to affect as many as 6 million people. The incidence of peanut allergy is said to have doubled in American children in the five years between 1998 and 2003.


Since there is no treatment or cure for food allergies, avoidance and education are the most important methods of reducing risk. Another important strategy is to become a “label detective.” To better understand food labels, carry a “food allergy identification card” (especially when eating outside of the home), and be prepared to treat severe allergic reactions when they occur
 
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