Help with DoDMERB Waiver process - Food Allergy Disqualification

[ETUCKER2007]

Hello, I am an NROTC Scholarship recipient. I received notice of my scholarship for the Marine Option in late March of this year.

I completed all my exams for eyes and physical by April 23rd. I was disqualified medically for an allergy to cashews, for which my doctor had prescribed me an Epi-Pen. I have been fighting tooth & nail for my medical clearance as I worked hard to get the scholarship in the first place.

Two days after my disqualification, I received a signed doctor's note from my primary physician stating that my allergy was localized to hives only, and that the EpiPen prescribed to me was purely precautionary and standard practice. My physician also detailed that I do NOT have anyphylaxis, and my allergy is only a skin reaction. DoDMERB then requested more information and asked me to schedule a blood IgE test, a Skin prick test, and an oral food challenge.

I attended my skin prick test and blood IgE test, and the blood test reflected a low allergy to cashews and pistachios. The skin prick test also showed the same result.

My issue lies in the fact that the allergist I consulted for the skin test is certain that I will "fail" the food challenge (by getting hives, I will fail the challenge), and that he doesn't recommend doing it solely because we already know I have an allergy. But we are proceeding with it because it is what DODMERB has requested of me.

Will failing the food challenge automatically and permanently disqualify me from ROTC even if the reaction is mild? I am concerned about the outcome because I have been working very hard to attend school for ROTC, and I would be in a not-so-great position if I get disqualified now, just a month before my semester starts.

Any advice would be greatly appreciated.

TL;DR:
DoDMERB disqualified me for a Cashew allergy that I have. My allergy is not severe nor life-threatening, but it gives me hives. My blood test indicates a low allergy to cashews and pistachios, but it's still not severe. My allergist appears to believe that my food challenge, requested by DoDMERB, will fail. What is the recourse if I fail the food challenge? How can I obtain a waiver if my allergy isn't severe?

 

[CUAviator]

Hello, I am an NROTC Scholarship recipient. I received notice of my scholarship for the Marine Option in late March of this year.

I completed all my exams for eyes and physical by April 23rd. I was disqualified medically for an allergy to cashews, for which my doctor had prescribed me an Epi-Pen. I have been fighting tooth & nail for my medical clearance as I worked hard to get the scholarship in the first place.

Two days after my disqualification, I received a signed doctor's note from my primary physician stating that my allergy was localized to hives only, and that the EpiPen prescribed to me was purely precautionary and standard practice. My physician also detailed that I do NOT have anyphylaxis, and my allergy is only a skin reaction. DoDMERB then requested more information and asked me to schedule a blood IgE test, a Skin prick test, and an oral food challenge.

I attended my skin prick test and blood IgE test, and the blood test reflected a low allergy to cashews and pistachios. The skin prick test also showed the same result.

My issue lies in the fact that the allergist I consulted for the skin test is certain that I will "fail" the food challenge (by getting hives, I will fail the challenge), and that he doesn't recommend doing it solely because we already know I have an allergy. But we are proceeding with it because it is what DODMERB has requested of me.

Will failing the food challenge automatically and permanently disqualify me from ROTC even if the reaction is mild? I am concerned about the outcome because I have been working very hard to attend school for ROTC, and I would be in a not-so-great position if I get disqualified now, just a month before my semester starts.

Any advice would be greatly appreciated.

TL;DR:
DoDMERB disqualified me for a Cashew allergy that I have. My allergy is not severe nor life-threatening, but it gives me hives. My blood test indicates a low allergy to cashews and pistachios, but it's still not severe. My allergist appears to believe that my food challenge, requested by DoDMERB, will fail. What is the recourse if I fail the food challenge? How can I obtain a waiver if my allergy isn't severe?

Just out of curiosity (and hopefully not blowing HIPPA out of the water), since my son is in kind of the same situation - when you say blood and skin results were “low”, what were your numbers?

 

[Ivy22]

I’m not an expert, but others on the forum in the past have stated they’re looking for pretty much no reaction with the oral challenge. Having a reaction, even hives, shows you’re still allergic which is disqualifying.

Maybe someone with more experience and expertise can chime in

 

[Capt MJ]

Hello, I am an NROTC Scholarship recipient. I received notice of my scholarship for the Marine Option in late March of this year.

I completed all my exams for eyes and physical by April 23rd. I was disqualified medically for an allergy to cashews, for which my doctor had prescribed me an Epi-Pen. I have been fighting tooth & nail for my medical clearance as I worked hard to get the scholarship in the first place.

Two days after my disqualification, I received a signed doctor's note from my primary physician stating that my allergy was localized to hives only, and that the EpiPen prescribed to me was purely precautionary and standard practice. My physician also detailed that I do NOT have anyphylaxis, and my allergy is only a skin reaction. DoDMERB then requested more information and asked me to schedule a blood IgE test, a Skin prick test, and an oral food challenge.

I attended my skin prick test and blood IgE test, and the blood test reflected a low allergy to cashews and pistachios. The skin prick test also showed the same result.

My issue lies in the fact that the allergist I consulted for the skin test is certain that I will "fail" the food challenge (by getting hives, I will fail the challenge), and that he doesn't recommend doing it solely because we already know I have an allergy. But we are proceeding with it because it is what DODMERB has requested of me.

Will failing the food challenge automatically and permanently disqualify me from ROTC even if the reaction is mild? I am concerned about the outcome because I have been working very hard to attend school for ROTC, and I would be in a not-so-great position if I get disqualified now, just a month before my semester starts.

Any advice would be greatly appreciated.

TL;DR:
DoDMERB disqualified me for a Cashew allergy that I have. My allergy is not severe nor life-threatening, but it gives me hives. My blood test indicates a low allergy to cashews and pistachios, but it's still not severe. My allergist appears to believe that my food challenge, requested by DoDMERB, will fail. What is the recourse if I fail the food challenge? How can I obtain a waiver if my allergy isn't severe?

This won’t help much, but you have to work the process, just as you have been doing.

The waiver authority for NROTC will make a decision per waiver policy, precedent, needs of the service and the specifics of your case.

Allergies can be funny things. They can be outgrown, they can get worse, they can react unpredictably to high stress and other factors, they can vary in reaction intensity.

Prepare for the worst.
Hope for the best.

I often post the below comments to help place the risk analysis problem for the service in perspective.

The way to think about this is utilitarian, not from the individual’s POV, but the unit. The military medical accession bar is set very high. Military people routinely work in harsh, harsh operating environments, often remote and far from advanced medical care. High stress. High pressure. Relentless. Sleep deprivation. Physical danger from many sources. Some of the worst working conditions humans can endure. The safety of the unit is paramount, and the safety of the unit often depends on everyone being physically and mentally able to do their jobs and contribute. That’s why the military looks for people who are the least vulnerable to illness, injury or recurrence of past conditions. In “normal” life, these people can carry on just fine. High op tempo evolutions in or near a combat zone, or even the pressure cooker of a service academy, might be a hairsbreadth too much. Utilitarianism: the good of the many outweighs the good of the few. It’s not about you. It’s about the people relying on you - and the mission.

 

[ETUCKER2007]

Just out of curiosity (and hopefully not blowing HIPPA out of the water), since my son is in kind of the same situation - when you say blood and skin results were “low”, what were your numbers?

You can measure the antibody proteins in your blood to the allergy through a blood IgE test. The higher the IgE level, the more antibodies are present, meaning it is possible that your allergy exists and can be severe.

The blood IgE scale ranges from 0 to 100, with 0 indicating no detectable levels and 100 indicating very high levels. In my case, my blood IgE level for cashew nuts was 0.25, and they tested me for a specific protein in cashews called Ana o 3, which measured 0.50. I also measure a 0.31 on pistachios.

 

[ETUCKER2007]

I’m not an expert, but others on the forum in the past have stated they’re looking for pretty much no reaction with the oral challenge. Having a reaction, even hives, shows you’re still allergic which is disqualifying.

Maybe someone with more experience and expertise can chime in

That's disappointing. I am prepared for it, though, and am in the process of obtaining my physician's note to remove my EPI-Pen from my prescription. Along with that, I reached out to the allergist that DoDMERB provided me and sent them my official DoDMERB medical order, as it inquires about my ability to eat peanuts (Which I am not allergic to) and my risk of anaphylaxis (which I don't have). Hopefully, he can explicitly state those in my final report, which will help my case.