Remedials..

erbium

10-Year Member
Joined
Aug 28, 2006
Messages
20
After my initial exam this was the result:
R220.00 - Provide copies of all medical and surgical records regarding left foot problem, ankle problem, and use of orthotics.
R254.20 - 3-day blood pressure check
D155.70 - Myopia - Refractive error greater than - 8.00 diopters (spherical equivalent)

The left foot problem is really nothing big, a few years ago my ankle started popping whenever I walked on it, no pain, just noise. So I got it looked at, ended up getting orthopedics for a while. I stopped using it about a year ago. The popping doesn't affect performance at all. I run cross country and it's given me no problems.

After sending in the medical records about it though, I now have R251.30 - REPEAT evaluation(s) at Military Treatment Facility regarding popping of tendon in left ankle. Should be seen by military podiatrist or orthopeadic surgeon. so now I have to do that. I haven't received the letter giving me authorization to get it done at a MTF, what should I do? I am a military dependent, but tricare takes forever.

After USMA reviewed me for a waiver they requested R152.02 - Obtain a dilated fundoscopic exam which I am getting done tomorrow. Should be good results, when I had one done in may I was told my eyes were fine.

Unfortunately, I have somewhat high blood pressure. Is that a DQ that can be waived often?

I think I'm pretty much asking what you think my chances of a waiver for everything is. I'm a very competitive candidate, I have an LOA for USMA and am hoping for one from USNA, and am in the final stages of AROTC scholarship process, also applying NROTC, AFROTC, and USAFA. From what I've heard you're more likely to get a waiver the more competitive you are.
 
erbium,

If you are a competitive applicant your file goes before the waiver authority, as yours has already since the wavier authority is requesting additional information. If the dilated fundoscopic examination shows no retinal problems most likely you will be granted the waiver for the refractive error greater than -8.00 diopters. Once the waiver is granted for that the other requests will go out (blood pressure and ortho eval).

The 3 day blood pressure check, if the average is over 140/90 could be an issue. If the average is below 140/90 then you will not have any problems from that standpoint. If your average is over 140/90 it would be a disqualification, and waivers for hypertension are difficult to come by, as hypertension leads to all sorts of other problems. I would suggest that when you do the 3 days blood pressure check (its twice a day for 3 consecutive days) you make sure that you get the first one in the early morning, and second one early in the afternoon, prior to exercise. Just relax, and don't stress about it. This can be completed by a school nurse or at the local firestation by the EMT's there. Take 10 to 15 minutes after you get there to sit and relax. Grab a book or a magazine and try to detach yourself from what is going on. It really does help.

For the ortho eval, they just want to make sure that the popping isn't going to be an issue now or 15 years down the road, which is why they are requesting the military ortho eval.
 
RetNavyHM said:
Take 10 to 15 minutes after you get there to sit and relax. Grab a book or a magazine and try to detach yourself from what is going on. It really does help.

I second this...

This worked for me and my borderline high blood pressure:
When you take out a large life insurance policy you are usually subject to a private medical exam conducted by a contractor in your home. When I was getting my policy, I scheduled the exam for as early as in the day as possible and made sure I avoided caffeine for 12 hours prior. For good measure I spent 15 minutes in the hottub 30 minutes before she arrived. After she measured me and had me step on a scale she took my blood pressure and to use Doctor speak, it was unremarkable. I asked her what it was and she told by something like 128 / 78. Normally this would be around 140/90.

My blood pressure strategy boils down to this.
a) Get the test done early in the day.
b) unwind right before maybe by taking a hot bath right before the test.
c) avoid caffeine.

For what it's worth it has worked for me.
 
Well, that would have encouraged me, but the results of the eye exam were not good. My right eye's fine. My left retina has a very small tear in it. My optometrist told me it would be negligible, but because it's such an in-depth exam he had to acknowledge it. He's going to write a formal report for me to send in saying he doesn't think it's a big deal. He's also going to refer me to a retina specialist so I can get his opinion and send it in. Hopefully that will help.

For the hypertension, thanks for the advice, I'm definitely going to try it. I haven't had caffeine for a few weeks, because as soon as my doctor found out, they ran a bunch of tests and labs on me. I won't have caffeine until I'm through with the blood pressure checks.

I'm really worried now, and I guess I probably have reason to. If I were medically qualified, I'm sure I could get into any of the academies, but now I'm just praying for a waiver. I'm also looking into civilian scholarships more deeply now. I can't really change my health, so I'm just going to play it by ear and hope atleast one of the programs gives me a waiver.
 
erbium,

I really don't want to give bad news, but I have to. With a retinal tear/hole, or a history of a retinal tear/hole, even if surgically corrected, you will be found medically disqualified by DoDMERB, and the chance of a waiver is very slim.

I would continue on with the process, get the retinal specialists eval and submit it to DoDMERB. When I was at DoDMERB I was surprised everyday with cases that I thought the wavier authorities would never grant but they did, so if this is what you want, continue on with the process, just make sure you have a back up as well.

Again, if there is anything else I can do to help you out please let me know!
 
As always, sound information and counsel offered nicely.:smile:

Thanks for your generous contributions to this forum.:thumb:
 
erbium said:
Well, that would have encouraged me, but the results of the eye exam were not good. My right eye's fine. My left retina has a very small tear in it. My optometrist told me it would be negligible, but because it's such an in-depth exam he had to acknowledge it. He's going to write a formal report for me to send in saying he doesn't think it's a big deal. He's also going to refer me to a retina specialist so I can get his opinion and send it in. Hopefully that will help.

I'm pretty sure there is no such thing as a negligible retinal tear. IF, and I stress IF, your optometrist told you that you had a tear in your retina I would highly suggest you get yourself to an ophthalmologist who is a retina specialist sooner rather than later. Because you are Tricare you may have to go to a regular ophthalmologist first, but they can refer you on to a retina doc.
 
Thanks for the advice everybody. I plan on seeing a retina specialist ASAP. There's nothing I can do to change what's already wrong with me, so I'm just going to pray someone will give me a waiver. I plan on following through with all of my applications and waiting.

I also have a few merit-based full-ride scholarships I'm applying to. Do you have to go through DODMERB if you're enrolling in ROTC without a scholarship?
 
If you are participating with an ROTC unit as a non-scholarship participant you do not need a DoDMERB physical.
 
Another question

I finally had my appointment with a retinal specialist today. As it turns out, I do not have a tear. I have a small hole in my retina. She told me they can use a laser to try to prevent it from getting larger. Would this DQ me, or help me?
 
erbium,

As I said in one of my previous posts, "a retinal tear/hole, or a history of a retinal tear/hole, even if surgically corrected, you will be found medically disqualified by DoDMERB, and the chance of a waiver is very slim."

If one of the service academies are your first choice I would go ahead and forward the information in to DoDMERB. You will be found disqualified, but if this is your first choice, go ahead and request the waivers. You may have to fight for it, and the results may not be favorable for you, but you'll never know if you don't try. I have seen many applicants who were persistent and got waivers when I would have sworn that they would never get one. Just be ready to take your second choice.

As for getting the hole surgically corrected, that is between you and your ophthalmologist, I am in no position to give you medical advise in this forum.
 
Update on status..

I did not send any papers after the first dilated fundoscopic exam where my optomestrist noted the possible retinal tear. I found out it was a hole from a retinal specialist, and I decided to hold off on getting that surgery. I have a new remedial from USMA - Consult - ophthalmologist regarding possible retinal tear OS found by optometrist. Consult RETINA SPECIALIST to assess risk of retinal detachment, particularly in the context of contact sports such as boxing. I took that to mean that they're doing what they can to get me a waiver. Maybe I'm being too optimistic, but atleast I'm somewhat optimistic now. I have my appointment with the retina specialist on the 21st, and hopefully I'll have the official yes/no within a few weeks.
 
erbium,

As long as the waiver authority is requesting additional information its a positive sign. At least you know that they are looking at your medical file and they still have enough questions that they want further evaluations. So I'd keep the positive vibes flowing!
 
Another update...

I saw the retina specialist, it's a retinal hole, low risk. USMA contacted me because the doctor's letters had not gotten there yet, so I emailed them directly to the waiver authority. The specialist had recommended a laser retinopexy to make sure the hole didn't get any worse. USMA requested this remedial: "R151.01 - Consult - ophthalmologist regarding lattice/retinal hole OS. Obtain letter from RETINA SPECIALIST stating that successful laser retinopexy has been performed." I was also given the DQ "D153.10 - Congenital or degenerative changes of retina" once they got the letter stating I had a retinal hole, not just a possible one. I will be having the retinopexy done Tuesday morning, and I'm going to submit the letter from the specialist myself, rather than have them send it. I'm going to be keeping my fingers crossed, I want this to be over with.

On the brighter side, my congressman gave me a nomation to USMA and USNA and Senator Elizabeth Dole gave me a nomination to USNA. I also have an interview for WP tonight.
 
First off, congratulations on the nominations!

The fact that the wavier authority is looking for information after the retinopexy is a very positive sign. If they did not feel that a wavier would be possible they would not have requested additional information at all, and would have just wavier denied you.

So good luck with the retinopexy, and make sure that you send the information as soon as possible!
 
Still waiting...

The retinopexy had no imediate problems, but I have to wait until a follow-up appointment on the 30th to see if scar tissue has formed yet and then it can be called a success. I guess I've waited about 5 months, so another two weeks won't kill me.

Also, the remedial with the 3-day blood pressure check disappeared on the website after I sent it in, and I haven't receieved another DQ, so I believe that issue is cleared.
 
UA repeat

At the begiining of the week, this remedial was listed under both the Naval Academy and NROTC. I did the repeat UA at the beginning of last week and it was normal. As of today the remedial was removed from the Naval Academy but has not been removed from NROTC. I was just wondering why and does it mean I need to do another UA for NROTC?


R263.00 - Please obtain a REPEAT urinalysis, without microscopy
 
drummer14411,

It sounds like the reviewer at DoDMERB missed the fact that you were in for multiple programs. You need to call DoDMERB first thing Monday morning and let the secretary know that the UA was cleared for USNA but not for NROTC. Most likely it'll be cleared while you are on the phone.

DoDMERB is open from 6:30 - 3:30 MST M - F. Call as early as possible. The number is 719-333-3562. At the first menu select option #1, at the second menu select option #3 for the sea services section.
 
Great News

I'm a little unsure of what to do, but this is great news. USMA requested the retinopexy, have the follow-up tomorrow morning. However, I just got a letter from USAFA today.
R259.00 A waiver for congenital or degenerative changes of retina has been approved. However, to finalize your medical qualification process the following evaluations/information must be completed (PLEASE SEE THE FOLLOWING REMEDIAL REQUEST(S) FOR DETERMINATION OF MEDICAL AND/OR ADMINISTRATIVE):
R220.00 DOES NOT REQUIRE A PHYSICIAN'S APPOINTMENT: Please provide copies (NOT ORIGINALS) of ALL treatment and/or hospitalization records regarding left foot problem, ankle problem, and use of orthotics, to include ALL applicable inpatient and outpatient records including, but not limited to, operative reports, anesthesia records, pathology reports, follow-up visits, rehabilitation records, recovery room records, x-ray reports, etc.

So, what do I do now? Do I call DODMERB and inform them about the retinopexy, as USAFA probably didn't know I had it done? I don't believe I'll incur any problems with the foot thing, my left ankle used to pop when I walked about 2 years back, got physical therapy for a while and custom orthotics. Stopped using them last April or so.

One thing I'll definitely be doing is finishing my USAFA application, all I have to do are the essays, and I have til the 31st to do them.


and I have to say: YEEEEEEEEEEEEEEEEEEEEEEEEEEEESSSSSSSSSSSSSSSSSSSSSSSSSS!!!!!!!!!!!!!!!!!!!!!!
 
First, congrats on the USAFA waiver. Make sure you submit the info concerning the ankle and orthotics as soon as possible to DoDMERB. The wavier won't be complete until DoDMERB clears up all outstanding remedial items.

When you submit the follow up exam from the ophthalmologist I would make sure that you attach a cover letter to the exam stating that it is in reply to a USMA wavier authority request for additional information. I would also follow up with a phone call about a week after sending it, making sure that it was forwarded to the wavier authority. There is a small chance that it could get misplaced, since your file is now being worked by 2 separate wavier authorities and 2 separate sections at DoDMERB.

I would also send a copy of the follow up examination to USAFA admissions for inclusion into your admissions file.

I don't believe that USAFA will have an issue with the retinopexy, but there is no need to try and hide that information from them, especially since they already granted the waiver.
 
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