Medically Disqualified?

[Impulsive]

My DS applied to USMA and AROTC. He received a 4yr scholarship to AROTC and is considered to be a top candidate for USMA. He checked today to insure his Physical Fitness Results were posted but instead found "DISQUALIFIED" in big red letters on his portal. He called Dodmerb and spoke to his technician. The technician checked his file and confirmed he was disqualified for "patella femoral pain syndrome". I have reviewed my DS's medical file and no where in that file is there any diagnosis of any "patella femoral pain syndrome". He visited my orthopedist almost a year ago, one time because as a Cross Country Runner he was having some tightness after seven or eight straight days of running 6 miles. We wanted to make sure nothing was wrong. The doctor examined him and pronounced him fit to keep running, just advised him to stretch out better prior to running. He took the advice, continues to run distance, has never had surgery or a diagnosis of trouble yet Dodmerb disqualified him. How can this happen? This young man still runs 4 miles daily, yet Dodmerb says NO GOOD! Help, does this happen often?

 

[AJC]

DoDMERB has no latitude for some conditions or history of.
The waiver process for AROTC will start automatically.
Most likely he will need a letter Doctor he saw stating he is " cleared for full and unrestricted activities".
Has he received the remedial or AMI?

 

[Impulsive]

We intend to have his Cross Country Coach write a letter, and we are getting him to my Orthopedist and his family doctor for clearance. I understand what you are saying but how can DodMerb just "make up diagnoses" based on my DS being honest and saying he had some stiffness but was cleared by his doctor and never missed a practice or meet? Seems like they take a statement and twist it and just invent a diagnosis. Should not be! The medical examiner is not a specialist in orthopedics and when a orthopedist says everything is fine they should not try and contradict or "make up" problems. Both my DS's USMA and ROTC advisors were "shocked" with the DodMeb report as they both met my DS and saw him run with other Cadets.

 

[Pima]

As stated, DoDMERB qualifies and disqualifies according to the commissioning source standards. The doctor that performed the exam annotated it in the exam, and because of that annotation DoDMERB had to DQ him. DoDMERB does not diagnose. The doctor that they had contracted did the diagnosis from his medical history which forced DoDMERB's hand to DQ according to USMA standards.
~ It appears as of yet he is not DQd for AROTC. Again it comes back to the commissioning source. It is not uncommon that ROTC would let it fly while the SA may not. Just like it is not uncommon for one SA to DQ and another SA not to DQ. IE look at color vision deficiency, USNA may DQ, but USAFA and USMA may not.

You are on the right track to get a specialist to write a rebuttal. I am not sure how much impact a coach will have regarding the situation. As you stated the DoDMERB doc was not a specialist, but they are a doctor that understands the exam process. The coach is not a doc. In essence, he cannot state anything more than he runs at his typical pace, not one word about his medical condition regarding his knee.

I also would not place the cart before the horse. Many candidates/appointees get a waiver. It is a pain in the arse to jump through more hoops, but it is what it is. I get the frustration and angst, but besides getting a renown specialist to prove that he is fine than you just have to ride it out.

Lastly, the DQ maybe tied to one thing only. Not the diagnosis per se, but because he is only 1 yr out from the diagnosis.
~ IOWS had it happened 3 yrs ago with no more recurrences than he could have been Q'd due to the time constraint. However, what they are seeing is it was a yr ago and they can't be guaranteed that it will not reoccur.
~~ They are thinking not only about the 4 yrs at USMA, but the 5 he will owe. Can he deploy if he blows out his knee and now needs surgery?

In the end they are not only taking on all of the medical costs for any pre-existing condition, but accepting the fact that it may limit the branch regarding the needs of their missions.

 

[GoCubbies]

My DS applied to USMA and AROTC. He received a 4yr scholarship to AROTC and is considered to be a top candidate for USMA. He checked today to insure his Physical Fitness Results were posted but instead found "DISQUALIFIED" in big red letters on his portal. He called Dodmerb and spoke to his technician. The technician checked his file and confirmed he was disqualified for "patella femoral pain syndrome". I have reviewed my DS's medical file and no where in that file is there any diagnosis of any "patella femoral pain syndrome". He visited my orthopedist almost a year ago, one time because as a Cross Country Runner he was having some tightness after seven or eight straight days of running 6 miles. We wanted to make sure nothing was wrong. The doctor examined him and pronounced him fit to keep running, just advised him to stretch out better prior to running. He took the advice, continues to run distance, has never had surgery or a diagnosis of trouble yet Dodmerb disqualified him. How can this happen? This young man still runs 4 miles daily, yet Dodmerb says NO GOOD! Help, does this happen often?

Unfortunately, it happens a lot. Did you keep a copy of the DODMERB medical forms that the doctor forwarded to DODMERB?

In there, what was the explanation that the examining doctor put in?

IF the write-up is good for an acute condition that is fully resolved and happened months/years ago, then oftentimes it is enough to "explain away" the history. DODMERB won't ask for additional info.

If the explanation the doctor put doesn't have the right "buzz words", then DODMERB will ask for additional info. Unfortunately, many of the doctors who do the exams don't know the "buzz words" in the context of a military exam.

 

[Impulsive]

I understand that, but for a doctor...ANY doctor to render a diagnosis without radiological testing based on two minutes and finding no supporting medical evidence is terrible. I understand the military medical issues, I served for ten years before moving on to a civil service law enforcement job that paid a whole lot better, but I fail to see how a examiner can make a diagnosis without findings? I volunteer at the VA and even their examiners cannot make diagnoses, they just report on physical findings, how does Dodmerb's contractors get away with making diagnoses without backup material. My DS was remedial and they asked for medical records, so we sent them his family doctors records and the orthopedist's notes, nothing in there indicated any diagnosis of anything other than tightness after distance running competitively for more than 7 days straight. And all the doctors told my DS was to stretch longer before his runs, all the radiological and physical findings were normal. He competed last year and this year without issue, and still has no issues.

 

[Impulsive]

My DS's examiner would not give us a copy of her report. I know she is the one who "diagnosed" him, but she would not give us a copy of her report. How do we get copies of DodMerb's records?

 

[GoCubbies]

I understand that, but for a doctor...ANY doctor to render a diagnosis without radiological testing based on two minutes and finding no supporting medical evidence is terrible. I understand the military medical issues, I served for ten years before moving on to a civil service law enforcement job that paid a whole lot better, but I fail to see how a examiner can make a diagnosis without findings? I volunteer at the VA and even their examiners cannot make diagnoses, they just report on physical findings, how does Dodmerb's contractors get away with making diagnoses without backup material. My DS was remedial and they asked for medical records, so we sent them his family doctors records and the orthopedist's notes, nothing in there indicated any diagnosis of anything other than tightness after distance running competitively for more than 7 days straight. And all the doctors told my DS was to stretch longer before his runs, all the radiological and physical findings were normal. He competed last year and this year without issue, and still has no issues.

He's the typical doctor who doesn't know the right buzz words to explain away those symptoms your DS had. It appears he overstepped his bounds a bit too.

In medical school, one of the things they say is, "Listen to the patients. They'll tell you what they have." Many interpretations of that saying. One is listen to the history and do a good (focused if you have to) physical exam. You don't have to get fancy tests to diagnose every condition. If you hear hoof beats, then think of horses - not zebras. Common things are common.

The doctor has to explain away the knee pain though. "Knee pain" is NOT a diagnosis- it's a symptom of something going on. You don't need to go to medical school to "diagnose" knee pain. What caused the knee pain (you go to medical school to answer this question)? Maybe that's what the DODMERB examiner was trying to do?

Your DS had a history of knee pain (or tightness somewhere). Based on his activities and quick recovery with conservative treatment, PFPS may NOT have been an unreasonable diagnosis.

What the doctor should have done is explain away the symptom (or more correctly, the diagnosis).

 

[GoCubbies]

My DS's examiner would not give us a copy of her report. I know she is the one who "diagnosed" him, but she would not give us a copy of her report. How do we get copies of DodMerb's records?

I asked for a copy of the DODMERB physical before we left the office when my DD had her exam. The doctor's office staff made a copy and gave to me. The eye doctor did the same thing too for us.

I'd ask the DODMERB technician for a release of medical records form. It's worth the try thru the DODMERB tech first. Tell him/her you want it to keep your son's personal medical records complete.

 

[Impulsive]

My DS has never had a "history or chronic" knee pain. Early last year at the start of Cross Country season, my DS was pushing himself to get back into season shape after the winter and mentioned his knee was bothering him. Out of precaution we took him to his family doctor who could not find anything wrong, but recommended he see my orthopedist. He did, the ortho took x-rays, did all the ortho tests and maneuvers and could only find tightness in his ligament and told him to do better stretching before running which he has done and has had no further issues. Two complete Cross Country seasons, and one tennis season and no issues. I would like to figure out how to get a copy of the examiners notes to give our orthopedist.

 

[GoCubbies]

My DS has never had a "history or chronic" knee pain. Early last year at the start of Cross Country season, my DS was pushing himself to get back into season shape after the winter and mentioned his knee was bothering him. Out of precaution we took him to his family doctor who could not find anything wrong, but recommended he see my orthopedist. He did, the ortho took x-rays, did all the ortho tests and maneuvers and could only find tightness in his ligament and told him to do better stretching before running which he has done and has had no further issues. Two complete Cross Country seasons, and one tennis season and no issues. I would like to figure out how to get a copy of the examiners notes to give our orthopedist.

Ok. So what exactly did your DS check off "yes" to on the DODMERB exam so the examiner can come out with PFPS out of his 4th point of contact?

All I know is, if your DS check off "no" on the entire DODMERB questionnaire, then there is no way ANY doctor can come up with PFPS.

 

[Pima]

My DS was remedial and they asked for medical records, so we sent them his family doctors records and the orthopedist's notes, nothing in there indicated any diagnosis of anything other than tightness after distance running competitively for more than 7 days straight.

I am confused now. Was he 1st given a remedial and after that when they got his ortho records that is when they DQd him? That is how it is reading. IOWS, they did do a deeper look into his medical records and did not just go off of what the DoDMERB doc reported.

 

[GoCubbies]

@dparker2018

I hope my question below is not confusing because it's just hypothetical:

All I know is, if your DS check off "no" on the entire DODMERB questionnaire, then there is no way ANY doctor can come up with PFPS.

I'm not saying your DS checked off "no" to everything. I'm basically asking what your DS checked off as "yes" to on the DODMERB questionnaire to make the examiner do a 2-minute quick-look and get a history of symptoms?

 

[Impulsive]

My DS only checked off "tonsillectomy" on his medical history. The contract doctor specifically asked him additional questions without an adult present and I believe he answered he was a distance runner and had minor stiffness a couple of times in four years. Dodmerb asked for his medical records relating to his joints (not specifically his knee) and the only records we had were the single visit to my orthopedist and his regular doctor visits to out family physician. I only know that he says he is fine now, his doctors say he is fine, and Dodmerb says he isn't. It just does not make any sense to him, when he does his CFE runs and his times are much better than average, he runs 4 miles a day five days a week and an examiner asks a 17 yr old a medical question without his parent in the room and he probably had no idea what they were doing. He probably said something he knew nothing about.

 

[GoCubbies]

My DS only checked off "tonsillectomy" on his medical history. The contract doctor specifically asked him additional questions without an adult present and I believe he answered he was a distance runner and had minor stiffness a couple of times in four years. Dodmerb asked for his medical records relating to his joints (not specifically his knee) and the only records we had were the single visit to my orthopedist and his regular doctor visits to out family physician. I only know that he says he is fine now, his doctors say he is fine, and Dodmerb says he isn't. It just does not make any sense to him, when he does his CFE runs and his times are much better than average, he runs 4 miles a day five days a week and an examiner asks a 17 yr old a medical question without his parent in the room and he probably had no idea what they were doing. He probably said something he knew nothing about.

I agree this is somewhat odd. I guess the DODMERB examiner came up with the PFPS diagnosis from the talk with your DS instead of your DS checking off "yes" on anything.

It does make sense DODMERB would ask for remedials if the examiner's write-up caused some red flags. Or maybe based on the write-up from the examiner, the DODMERB reviewer hit the "PFPS" code. PFPS is a very common and somewhat broad diagnosis.

I think your DS will be fine when they see it's not chronic and he's back to full activity for a couple of sports seasons and doing well. What I mean by fine is either DODMERB will overturn the DQ with the additional info or your DS will get a waiver.

Good luck!

 

[Humey]

My best friends has a daughter who was going to a college were flu was going around and lots of kids were wheezing because of it. When she went to the doctor, she was prescribed an inhaler for breathing if needed and her diagosis was asthma. First she never took the inhaler as she didnt need it and secondly her whole diagnosis of asthama resulted from a five minute consultation. Can you imagine if she had been in Rotc? My friend didnt care what the diagnosis was and was happy to get the inhaler but we were talking how the need to put a named diagnosis down on paper by Doctors has screwed over thousands of kids trying to get into Rotc and the academies. How many times do you read on this forum Doctors saying that a person may have ezcema and in reality all they had was dry skin. Just easier to write ezcema and prescribe some ezcema ointment that will help with the dry skin. Problem is that most of us dont realize that putting down these official but five second diagnosis can have long term affects on those looking to go into the military.

 

[Impulsive]

Thanks for the VERY helpful info. I know they talked about his running because when she can back to the front she commented about what a fine young man he is, and "he should be good to go" and in saying goodbye she specifically wished him good luck in his Cross Country meet the next day. Couldn't have possibly known unless she was asking him a bunch of questions alone with him. I didn't think they could that with a minor? I know every thime I took one of our kids to the doctors either my wife or I had to be present?

 

[Pima]

Again, I really don't think this is all about the DoDMERB examiner. According to your post you DS was first given a remedial, and after submitting your ortho and family docs records they turned it to a DQ.

If I am correct, they already have all of his medical records regarding this situation and now he will have to go through the waiver process.

Do not assume that he will not be waived. It is hard to hold tight, but that is where you are at currently. The fact that they are putting him up for a waiver is a good sign when it comes to being competitive for an appointment. It will now go to their HQ Medical Review Board. They will look at everything you submitted for the remedial.

 

[Impulsive]

Since you all here seem to have the "insight" of how to help clear a DQ and get a waiver I am asking for your advice. My DS made a mistake and told the DoDMerb Examiner that he was a distance runner and had stiffness after running a few times. the Examiner then must have reported "A History of Patella Femoral Pain Syndrome" which in turn went to remediation. After sending in all our DS's medical records (none of which mentioned anything about PFPS or Knee Damage, or restrictions), DoDMerb DQ'd him from USMA, but AROTC has apparently cleared him as his portal says "No waiver needed". His dream is USMA, and his RC has told him he is submitting him for a waiver because he is a "top candidate". My question is, he is scheduled to see both my orthopedist and his family doctor next week to get treatment notes or letters saying he is fine, can do unlimited activity, and never had a diagnosis of PFPS. Should we send in those records immediately to either DoDMerb or USMA or wait and see if they ask for anything else. And does the "No waiver needed" mean he is cleared for AROTC? Thanks!

 

[HuskyPilot]

Im sure some will disagree but for those new to the forums reading these threads I would take note. Never volunteer a self diagnosis. If you're not under treatment for, have a documented history of or have medical record documentation of a medical issue don't create one. Something as innocent as a passing admission as once having "pain" can open a can of worms and cause unnecessary medical clearance delays and worry. Let your medical exam and records speak for themselves. Its laudable that individuals want to go the extra mile to prove 100% openness and accuracy about their health hx but not mentioning a pain you once had as a result of athletic activities is in no way being evasive about your health history. Every kid has had pains, sickness/illness and minor injuries. It's part of life. By the way, not mentioning a minor temporary pain from years ago is not being dishonest....It's using common sense.