DODMERB DQ - premature/inaccurate diagnosis - Is there anything we can do but wait?

[TIME2GO]

I'll try to make a long story brief. At a regular well child exam shortly after Covid restrictions were lifted, I brought up concerns to DS pediatrician. A coach had said ds was struggling to catch breath during races. Heaven forbid anyone cough or clear there throat for fear of going back into quarantine. No episode of wheezing or shortness of breath was ever witnessed but the doctor agreed to have him try an inhaler before exercise for a diagnosis of mild intermittent exercise induced asthma. The prescription was filled but never used, the unopened boxes are still at our house with the date filled on the box as proof. He has never been seen since that one date for any breathing conditions and the medication is currently listed as discontinued in his chart. He went to SS without any medications, participated in all activities without any trouble, maxed out his mile time on the CFA, has made ALL-Conference and qualified for state in his sport. He has a great ACT and SAT, fantastic grades, and a good amount of leadership. Does he just sit back and wait, hoping that the Academies will seek a waiver? I feel sick at the thought that something I brought up at a physical, something he did not believe was a problem, is the thing that could hold him back. I know it has been said that the SA will seek a waiver if they deem you a qualified candidate but with the number of other qualified applicants out there, could they just see "ASTHMA" and decide it's not worth the trouble?

 

[gniyji]

I'll try to make a long story brief. At a regular well child exam shortly after Covid restrictions were lifted, I brought up concerns to DS pediatrician. A coach had said ds was struggling to catch breath during races. Heaven forbid anyone cough or clear there throat for fear of going back into quarantine. No episode of wheezing or shortness of breath was ever witnessed but the doctor agreed to have him try an inhaler before exercise for a diagnosis of mild intermittent exercise induced asthma. The prescription was filled but never used, the unopened boxes are still at our house with the date filled on the box as proof. He has never been seen since that one date for any breathing conditions and the medication is currently listed as discontinued in his chart. He went to SS without any medications, participated in all activities without any trouble, maxed out his mile time on the CFA, has made ALL-Conference and qualified for state in his sport. He has a great ACT and SAT, fantastic grades, and a good amount of leadership. Does he just sit back and wait, hoping that the Academies will seek a waiver? I feel sick at the thought that something I brought up at a physical, something he did not believe was a problem, is the thing that could hold him back. I know it has been said that the SA will seek a waiver if they deem you a qualified candidate but with the number of other qualified applicants out there, could they just see "ASTHMA" and decide it's not worth the trouble?

Can you try to correct DoDMERB on ASTHMA by supply AMI ? I mean there should be some standard Asthma Diagnosis -- such as lung function test etc -- even blood test such as allergy test. It can not be just one single incident of short breath ! Also you have a very strong argument that your son has never used inhaler (usually asthma patients use all the time ! ) This should not be DQ by DoDMERB in the first place based on what you described !

 

[TIME2GO]

Can you try to correct DoDMERB on ASTHMA by supply AMI ? I mean there should be some standard Asthma Diagnosis -- such as lung function test etc -- even blood test such as allergy test. It can not be just one single incident of short breath ! Also you have a very strong argument that your son has never used inhaler (usually asthma patients use all the time ! ) This should not be DQ by DoDMERB in the first place based on what you described !

I agree, but it was a diagnosis in his chart after the age of 13 and he was given a prescription (although we have evidence it was not used). He was trying to be transparent with his medical history and filled everything out to the best of his memory. AMI was requested for a season allergy diagnosis from the same date but when he asked about providing AMI for the asthma medication he was told any diagnosis after age 13 of asthma is a disqualification and that the service academies would seek a waiver if he was determined a qualified candidate. So basically just to wait and see. I am wondering if proactively, I should take him to a pulmonologist, although without any symptoms and I don't know that they would even see a healthy child with no breathing issues. He's never had lung function test done or any allergy tests done (although we suspect hayfever type allergy to ragweed - no official confirmation)

 

[MidCakePa]

Be 100% honest in the questionnaire. Don’t self-diagnose. (With respect, being all-league anything does not substitute for a medical diagnosis.) Omission is dishonesty. Again, be 100% honest.

Let the process play out. If the SA wants a candidate, they’ll request a waiver, which can lead to follow-up tests. If there’s truly no issue, then that will reveal itself and all will be well. Waivers are sought every year for promising candidates, so trust the system.

 

[OfficerToBe750]

I'll try to make a long story brief. At a regular well child exam shortly after Covid restrictions were lifted, I brought up concerns to DS pediatrician. A coach had said ds was struggling to catch breath during races. Heaven forbid anyone cough or clear there throat for fear of going back into quarantine. No episode of wheezing or shortness of breath was ever witnessed but the doctor agreed to have him try an inhaler before exercise for a diagnosis of mild intermittent exercise induced asthma. The prescription was filled but never used, the unopened boxes are still at our house with the date filled on the box as proof. He has never been seen since that one date for any breathing conditions and the medication is currently listed as discontinued in his chart. He went to SS without any medications, participated in all activities without any trouble, maxed out his mile time on the CFA, has made ALL-Conference and qualified for state in his sport. He has a great ACT and SAT, fantastic grades, and a good amount of leadership. Does he just sit back and wait, hoping that the Academies will seek a waiver? I feel sick at the thought that something I brought up at a physical, something he did not believe was a problem, is the thing that could hold him back. I know it has been said that the SA will seek a waiver if they deem you a qualified candidate but with the number of other qualified applicants out there, could they just see "ASTHMA" and decide it's not worth the trouble?

Waivers are very thorough. If they consider the application competitive, they will request a waiver review and then there will to an entire process to look at the situation in more detail. Submitting information on the DQ is putting the cart before the horse as they say. Let the academy give you an indication (by requesting a waiver) that your DS may be considered for an appointment first, otherwise, everything else is irrelevant. Many parents appreciate your angst as you know if you've read any of the DODMERB threads so know that you are not alone. Good luck - I hope you get some good news.

 

[Texark147]

I'll try to make a long story brief. At a regular well child exam shortly after Covid restrictions were lifted, I brought up concerns to DS pediatrician. A coach had said ds was struggling to catch breath during races. Heaven forbid anyone cough or clear there throat for fear of going back into quarantine. No episode of wheezing or shortness of breath was ever witnessed but the doctor agreed to have him try an inhaler before exercise for a diagnosis of mild intermittent exercise induced asthma. The prescription was filled but never used, the unopened boxes are still at our house with the date filled on the box as proof. He has never been seen since that one date for any breathing conditions and the medication is currently listed as discontinued in his chart. He went to SS without any medications, participated in all activities without any trouble, maxed out his mile time on the CFA, has made ALL-Conference and qualified for state in his sport. He has a great ACT and SAT, fantastic grades, and a good amount of leadership. Does he just sit back and wait, hoping that the Academies will seek a waiver? I feel sick at the thought that something I brought up at a physical, something he did not believe was a problem, is the thing that could hold him back. I know it has been said that the SA will seek a waiver if they deem you a qualified candidate but with the number of other qualified applicants out there, could they just see "ASTHMA" and decide it's not worth the trouble?

I will share our experience.....DS is a current class of '28 candidate. I was also terrified that I had ruined my DS's chance at a SA. I casually mentioned during his 12 year old well visit that he had occasional pain in his collar bone area. The doctor listed it as chest pain and he ordered an echocardiogram. I knew it wasn't cardiac pain and I wasn't going to spend the $3,000 they quoted me for the tests. So time went on with no more pain or issues. The doctor did yearly physicals and he passed with flying colors every year. Then came time to do Dodmerb and we realized he had to answer yes the " have you ever experienced chest pain" question. Even though we didn't consider it chest pain, it was listed in his medical records as cardiac chest pain, so he answered yes. It wasn't long before a request for AMI showed up in his portal. I had already gathered his medical records, but we also made an appointment with the same doctor. He checked him over again and listened to his heart. He wrote a letter stating that DS had no recurring chest pain and that his parent's had decided the tests weren't necessary. He also recommended that we include his sports physicals that he had signed off on stating there was no cardiac issues. We did that and sent the medical records from the initial visit, the current visit, the doctor's note, and the sports physicals in to Dodmerb. To our delight and surprise he was qualified later that day. I know that every diagnosis is different, but I say all this to say gather the records to back up claims he doesn't have asthma, have the doctor write a note clearing him, include your pharmacy records showing you didn't refill the prescription, maybe even send in photos of the unused filled prescription with the date on it, and maybe even look into getting tested to prove that he doesn't have asthma. Good luck, I hope all goes well.

 

[ProudMom7]

I agree, but it was a diagnosis in his chart after the age of 13 and he was given a prescription (although we have evidence it was not used). He was trying to be transparent with his medical history and filled everything out to the best of his memory. AMI was requested for a season allergy diagnosis from the same date but when he asked about providing AMI for the asthma medication he was told any diagnosis after age 13 of asthma is a disqualification and that the service academies would seek a waiver if he was determined a qualified candidate. So basically just to wait and see. I am wondering if proactively, I should take him to a pulmonologist, although without any symptoms and I don't know that they would even see a healthy child with no breathing issues. He's never had lung function test done or any allergy tests done (although we suspect hayfever type allergy to ragweed - no official confirmation)

The decision for offering an appointment (conditional in this case) is made separate from the DODMERB/medical process. Many applicants haven't even completed the DODMERB tests by the time appointments are being offered so there are always a lot of conditional appointments given out.

I don't know whether you *should* go ahead and take him for asthma/lung function tests, but you are able to upload any medical tests, letters, etc... to his DODMERB file. The SAs will then have that available when they are considering him for a waiver. For my daughter, we paid out of pocket for the test that we knew would show that the reason she was DQ'd (not asthma related) was not an issue at all. The tests showed the results we had hoped for, and we also met with a specialist who wrote a letter detailing that she had normal function and that her past history would in no way affect her ability to deploy to any location and would not put her at higher risk, etc... Your son's situation sounds pretty straight-forward, so you might not need the tests, but we didn't want the SA (USCGA in her case) to possibly NOT ask for that test when we knew it would definitely show definitive results.

 

[TIME2GO]

Be 100% honest in the questionnaire. Don’t self-diagnose. (With respect, being all-league anything does not substitute for a medical diagnosis.) Omission is dishonesty. Again, be 100% honest.

Let the process play out. If the SA wants a candidate, they’ll request a waiver, which can lead to follow-up tests. If there’s truly no issue, then that will reveal itself and all will be well. Waivers are sought every year for promising candidates, so trust the system.

Thank you. Confirming what I already believed but it's hard to trust the system when we have only been aware of the Academies, processes and possibilities in the last 2 years. I have no inside knowledge of the system, just a kid who I've seen work his tail off toward his goals. If he's not what the Navy wants or needs, so be it. He's put himself in a good spot for whatever his future holds. But if he does not see his goal as an officer in the US Navy based on something I did as a parent, it's heartbreaking.

 

[TIME2GO]

I will share our experience.....DS is a current class of '28 candidate. I was also terrified that I had ruined my DS's chance at a SA. I casually mentioned during his 12 year old well visit that he had occasional pain in his collar bone area. The doctor listed it as chest pain and he ordered an echocardiogram. I knew it wasn't cardiac pain and I wasn't going to spend the $3,000 they quoted me for the tests. So time went on with no more pain or issues. The doctor did yearly physicals and he passed with flying colors every year. Then came time to do Dodmerb and we realized he had to answer yes the " have you ever experienced chest pain" question. Even though we didn't consider it chest pain, it was listed in his medical records as cardiac chest pain, so he answered yes. It wasn't long before a request for AMI showed up in his portal. I had already gathered his medical records, but we also made an appointment with the same doctor. He checked him over again and listened to his heart. He wrote a letter stating that DS had no recurring chest pain and that his parent's had decided the tests weren't necessary. He also recommended that we include his sports physicals that he had signed off on stating there was no cardiac issues. We did that and sent the medical records from the initial visit, the current visit, the doctor's note, and the sports physicals in to Dodmerb. To our delight and surprise he was qualified later that day. I know that every diagnosis is different, but I say all this to say gather the records to back up claims he doesn't have asthma, have the doctor write a note clearing him, include your pharmacy records showing you didn't refill the prescription, maybe even send in photos of the unused filled prescription with the date on it, and maybe even look into getting tested to prove that he doesn't have asthma. Good luck, I hope all goes well.

Thank you. This gives me hope. Good luck to your 28 candidate.

 

[Texark147]

Thank you. This gives me hope. Good luck to your 28 candidate.

Thank you, I realize your DS has already received a DQ, but DODMERB states you can send any AMI in at anytime. I wouldn't think sending in that info could hurt anything. Then have him contact his technician at DODMERB and explain what he sent in and why. I have seen quite a few people get waivers on this forum for the exact situation your son is in. I know that Dodmerb doesn't give waivers the academies do, but sending in pertinent information to the DQ diagnosis could be helpful.

 

[MidCakePa]

But if he does not see his goal as an officer in the US Navy based on something I did as a parent, it's heartbreaking.

You’re concluding that you’ve done something wrong. In fact, if you answered the questionnaire fully and truthfully, you’ve done right. DODMERB is only the first of multiple medical exams your son will undergo should he attend an SA and then serve on AD. Lying — omitting — at this stage is something he’ll then need to track down the road to ensure he maintains the story. If it emerges that an important detail was left out — no matter the intent or magnitude — things will only get worse for him.

 

[TIME2GO]

You’re concluding that you’ve done something wrong. In fact, if you answered the questionnaire fully and truthfully, you’ve done right. DODMERB is only the first of multiple medical exams your son will undergo should he attend an SA and then serve on AD. Lying — omitting — at this stage is something he’ll then need to track down the road to ensure he maintains the story. If it emerges that an important detail was left out — no matter the intent or magnitude — things will only get worse for him.

To clarify, not something wrong in terms of adding it to the DODMERB forms, we know that was the correct thing to do, but rather mentioning it a a well child exam and seeking medication for a breathing problem(generating a diagnosis) when in reality was probably more working really hard to perform along with fear of another season without sport and in isolation due to strict covid policy in our state.

 

[GoCubbies]

I agree, but it was a diagnosis in his chart after the age of 13 and he was given a prescription (although we have evidence it was not used). He was trying to be transparent with his medical history and filled everything out to the best of his memory. AMI was requested for a season allergy diagnosis from the same date but when he asked about providing AMI for the asthma medication he was told any diagnosis after age 13 of asthma is a disqualification and that the service academies would seek a waiver if he was determined a qualified candidate. So basically just to wait and see. I am wondering if proactively, I should take him to a pulmonologist, although without any symptoms and I don't know that they would even see a healthy child with no breathing issues. He's never had lung function test done or any allergy tests done (although we suspect hayfever type allergy to ragweed - no official confirmation)

I would recommend waiting out on the visit for the pulmonologist.

Unfortunately, your DS is probably going to be DQ'ed for being prescribed a medication (doesn't matter if he didn't use) for airway hyper-responsiveness (using the terms right out of DODI 6130.03).

When the waiver authority wants to consider your DS for a waiver, he/she will probably request for a pulmonology evaluation and testing. Right now, you don't know what testing will be requested. It could be a methacholine challenge test. It could be a spirometry pre- and post-bronchodilator testing. The specialist eval and testing will be coordinated through DoDMERB on the government dime. Once the eval is done, the results will go back to DoDMERB who will pass it on to the waiver authority.

Philosophically, I'm not sure it's ok for someone to pay for expensive testing that is being requested by the government. If the government wants it done, then they should pay for it. If you get the pulmonologist eval and testing done now, then it's on your dime.

Good luck!

 

[justdoit19]

Thank you. Confirming what I already believed but it's hard to trust the system when we have only been aware of the Academies, processes and possibilities in the last 2 years. I have no inside knowledge of the system, just a kid who I've seen work his tail off toward his goals. If he's not what the Navy wants or needs, so be it. He's put himself in a good spot for whatever his future holds. But if he does not see his goal as an officer in the US Navy based on something I did as a parent, it's heartbreaking.

If it’s nothing? There is a process to work through for that.

Don’t beat yourself up. I’m sure you came from a place of best care, for your child. Especially during the unknowns surrounding Covid, early on. Our health is most important.

Every application is thoroughly reviewed. It’s not just ‘tossed aside’ for someone else, without xxx. I would make sure his DR’s notes are all thorough and complete. Nothing left open.

Don’t worry. Be prepared with what you can and watch for emails (even from different email addresses than in the past…check SPAM folders!). He is early on in the process, allowing for follow up (AMI’s) if requested. Have your ducks in a row and ready to go.

 

[Humey]

The same kind of thing happened to my friend's daughter friend in college. Everyone was getting sick with a virus (pre-covid) and had a little bit of wheezing. The stuff they gave in the college clinic didn't help that much and by coincidence she was going home for the holidays. He took his daughter to the doctor and gave her an inhaler in case she needed it. She never used it but the doctor placed Asthma as the condition on her medical. The problem is that there was no diagnosis of asthma as there was never any testing for it. The doctor was lazy and used the easiest medical coding she could think of. Not sure how it was resolved but i do know he spoke with administration and was told there were other codes the doctor could have used. The daughter was concerned about Rotc but later changed her mind so it was never an issue.

 

[Impulsive]

Thank you. Confirming what I already believed but it's hard to trust the system when we have only been aware of the Academies, processes and possibilities in the last 2 years. I have no inside knowledge of the system, just a kid who I've seen work his tail off toward his goals. If he's not what the Navy wants or needs, so be it. He's put himself in a good spot for whatever his future holds. But if he does not see his goal as an officer in the US Navy based on something I did as a parent, it's heartbreaking.

As a "parent" you HAVE to have your children's health and care paramount. Don't look at it as something "you" did, but rather you being a good parent And the SA's and ROTC programs usually do not look at a word and make a decision, they ask for records or additional tests to confirm the fitness for service. They are good people, not looking to turn away people, especially in these times of shortage of people volunteering. Normally they will do everything possible to help applicants achieve their goals...

 

[GoCubbies]

The medical waiver reviewers understand that medications like Ritalin, Adderall, Albuterol, etc... are handed put like candies nowadays. They also realize some providers HAVE to put a diagnosis in order to get the insurance to pay. The medical waiver reviewers realize many primary care doctors put kids on antidepressants just because they feel "sad" or "in the dumps" without really meeting the criteria for depression.

All those things come into play for waiver decisions. That's why medical records are requested to see if the diagnosis rendered was a true diagnosis. If the original diagnosis was "fluffy", then the applicant gets the benefit of the doubt and the waiver authorities figure out a way to grant that waiver.

Believe me, these medical waiver authorities are always trying to get to the yes.

 

[BubbaCool12]

I'll try to make a long story brief. At a regular well child exam shortly after Covid restrictions were lifted, I brought up concerns to DS pediatrician. A coach had said ds was struggling to catch breath during races. Heaven forbid anyone cough or clear there throat for fear of going back into quarantine. No episode of wheezing or shortness of breath was ever witnessed but the doctor agreed to have him try an inhaler before exercise for a diagnosis of mild intermittent exercise induced asthma. The prescription was filled but never used, the unopened boxes are still at our house with the date filled on the box as proof. He has never been seen since that one date for any breathing conditions and the medication is currently listed as discontinued in his chart. He went to SS without any medications, participated in all activities without any trouble, maxed out his mile time on the CFA, has made ALL-Conference and qualified for state in his sport. He has a great ACT and SAT, fantastic grades, and a good amount of leadership. Does he just sit back and wait, hoping that the Academies will seek a waiver? I feel sick at the thought that something I brought up at a physical, something he did not believe was a problem, is the thing that could hold him back. I know it has been said that the SA will seek a waiver if they deem you a qualified candidate but with the number of other qualified applicants out there, could they just see "ASTHMA" and decide it's not worth the trouble?

Even if it fully goes over to the waiver process, the academies grant waivers based on if the applicant is what they want enough to be willing to take on the risks of their DQs. If they know that your DS is a rockstar runner and that his supposed DQ has no impact on his athletic abilities, and on top of that know that the diagnosis was faulty, you should have no problem getting a waiver. It's not guaranteed, but you have every reason to be optimistic. Good luck.

 

[Sealion II]

As a veteran poster pointed out to me, there are many, many current Midshipmen who had an inhaler at some point in the past. My daughter was also having difficulty breathing playing soccer around age 12-13. She got the inhaler prescribed and used it sparingly.

Fast forward, she gets recruited for her favorite sport. Goes through all the application process, candidly noted it on medical forms. She was sent to a specific medical practice. Got the all clear and now she just completed PS and had her first two day of classes. Good luck to you.

 

[GrilledCheese94]

The medical waiver reviewers understand that medications like Ritalin, Adderall, Albuterol, etc... are handed put like candies nowadays. They also realize some providers HAVE to put a diagnosis in order to get the insurance to pay. The medical waiver reviewers realize many primary care doctors put kids on antidepressants just because they feel "sad" or "in the dumps" without really meeting the criteria for depression.

All those things come into play for waiver decisions. That's why medical records are requested to see if the diagnosis rendered was a true diagnosis. If the original diagnosis was "fluffy", then the applicant gets the benefit of the doubt and the waiver authorities figure out a way to grant that waiver.

Believe me, these medical waiver authorities are always trying to get to the yes.

GoCubbies...yours is the reply I was looking for!

We're concerned about the same issues relative to an prescription that was filled but never used because doctors and some parents have their patients best interests at heart, especially if it is something that the insurance companies and/or health plans require to close out the treatment loop.

My wife cleans out our medicine cabinet all the time and has thrown away more unused meds of all sorts that were filled but never used.

I don't know how we're ever going to prove that something wasn't used. Polygraph? Blood test? Hair sample? It's frustrating to say the least. Hell, I need a commissioning waiver for seasonal allergies less than a month before graduation and I had been under military medical care for the preceding 8 years!

I hope we have the patience to see this through to a positive outcome if we trust the process.