USGCA Admissions Tree Nut Allergy

[FixItGal]

USCGA specific:
Any insight on tree nut allergies? Experiences with medical waivers?
My son is currently seeing an allergist specifically to be accepted to USCGA. He should be an ideal high stats candidate and an asset to a sports team.
We’ve read DoD medical standards re: food allergy and understand the reasons for such policies for military service. Also read through each SAs websites for any additional info. Some hopeful signs: USAF last Dec updated their policy to expand waivers for food allergies. Another is that on USCGA site it says their dining services cater to cadets and faculty’s food allergies.
Hoping to hear from current cadets who obtained waivers and/or parents who are able to share their experiences with their applicant’s allergies/process/journeys at USCGA.
We realized it may be a case by case basis. Hoping for insights to know how my son should proceed. He has almost two years before he’d have his DoDMERB exam. Hoping we can learn more to make the most of this time to prepare. Should be ask the AO?

 

[Iblameej]

A swab this summer discovered an unknown allergy, after almost completing Swab summer, and was sent home. I believe an anaphylactic allergy is a DQ at CGA and no waivers are granted.

 

[Stalker97]

as someone on these boards pointed out a while back-Navy and CG are pretty strict about color blindness and food allergies due to prolonged periods at sea. Others may be more lenient with such waivers. Just food for thought.

 

[Nomad@heart]

USCGA specific:
Any insight on tree nut allergies? Experiences with medical waivers?
My son is currently seeing an allergist specifically to be accepted to USCGA. He should be an ideal high stats candidate and an asset to a sports team.
We’ve read DoD medical standards re: food allergy and understand the reasons for such policies for military service. Also read through each SAs websites for any additional info. Some hopeful signs: USAF last Dec updated their policy to expand waivers for food allergies. Another is that on USCGA site it says their dining services cater to cadets and faculty’s food allergies.
Hoping to hear from current cadets who obtained waivers and/or parents who are able to share their experiences with their applicant’s allergies/process/journeys at USCGA.
We realized it may be a case by case basis. Hoping for insights to know how my son should proceed. He has almost two years before he’d have his DoDMERB exam. Hoping we can learn more to make the most of this time to prepare. Should be ask the AO?

If it is an active anaphylactic allergy there will NOT be a waiver. It is a hard no.

 

[happyhiker]

Define “active anaphylactic”

I’ve read through some of the DODMERB board and you’ll find lots of answers there. It seems that to pursue a waiver candidates have to pass a challenge test where they ingest the allergen and prove that the allergy isn’t present anymore. It seems like there’s a way to gradually introduce tiny portions of the nut and build up tolerance? I don’t have any allergy experience though - I just read through other threads trying to learn about the waiver process.

 

[Nomad@heart]

Define “active anaphylactic”

-If you would have an anaphylactic reaction to eating an allergen today… it is active.

-If there has not been a reaction after eating the allergen (simply avoiding it doesn’t count) for a significant period of time and there is official documentation from a doctor of a successful oral challenge it may be possible a waiver would be offered. Still very rare.
*The reason the military takes food allergies so seriously is because there are no special food options when you are deployed and down range. You eat what you are given. Full stop. You have to have enough fuel to complete the mission given… and there are usually no choices of what food is offered.

 

[Capt MJ]

The sea services are indeed the hardest on this, due to the nature of the operating environment, often far from advanced medical care, and out of range for a medevac.

The food challenge came to mind. Anecdotally, some have reported success by taking these, demonstrating they could now tolerate the food if ingested, with a provider’s updated assessment.

 

[USNAGrad_Asp Coastie Dad]

USCGA specific:
Any insight on tree nut allergies? Experiences with medical waivers?
My son is currently seeing an allergist specifically to be accepted to USCGA. He should be an ideal high stats candidate and an asset to a sports team.
We’ve read DoD medical standards re: food allergy and understand the reasons for such policies for military service. Also read through each SAs websites for any additional info. Some hopeful signs: USAF last Dec updated their policy to expand waivers for food allergies. Another is that on USCGA site it says their dining services cater to cadets and faculty’s food allergies.
Hoping to hear from current cadets who obtained waivers and/or parents who are able to share their experiences with their applicant’s allergies/process/journeys at USCGA.
We realized it may be a case by case basis. Hoping for insights to know how my son should proceed. He has almost two years before he’d have his DoDMERB exam. Hoping we can learn more to make the most of this time to prepare. Should be ask the AO?

This will be an issue. In the class of 2029 there were at least two cadets that had food allergies -- one had tree nut and the other a shellfish allergy. All controlled, in the case of one, he had been in military medicine system his entire life (father is service connected). They both got full waivers from DoDMERB...but the PA in the USCGA clinic took it upon herself to disqualify both after they arrived and weeks into Swab Summer. More than disappointing in both cases (the one with the shellfish allergy enlisted in Marine Corps right after). This is not "normal" and she does not have the authority as a PA to make these decisions, but the USCGA continues to allow it for whatever reason. It is best for you to ensure that your son's waiver will be acceptable to Captain Criss (PA at USCGA). If she does not explicitly agree -- expect to get a call mid-Swab Summer that your son is being discharged.

 

[Aleks]

This will be an issue. In the class of 2029 there were at least two cadets that had food allergies -- one had tree nut and the other a shellfish allergy. All controlled, in the case of one, he had been in military medicine system his entire life (father is service connected). They both got full waivers from DoDMERB...but the PA in the USCGA clinic took it upon herself to disqualify both after they arrived and weeks into Swab Summer. More than disappointing in both cases (the one with the shellfish allergy enlisted in Marine Corps right after). This is not "normal" and she does not have the authority as a PA to make these decisions, but the USCGA continues to allow it for whatever reason. It is best for you to ensure that your son's waiver will be acceptable to Captain Criss (PA at USCGA). If she does not explicitly agree -- expect to get a call mid-Swab Summer that your son is being discharged.

omg how is this allowed??

 

[TotallyNotTheIG]

This will be an issue. In the class of 2029 there were at least two cadets that had food allergies -- one had tree nut and the other a shellfish allergy. All controlled, in the case of one, he had been in military medicine system his entire life (father is service connected). They both got full waivers from DoDMERB...but the PA in the USCGA clinic took it upon herself to disqualify both after they arrived and weeks into Swab Summer. More than disappointing in both cases (the one with the shellfish allergy enlisted in Marine Corps right after). This is not "normal" and she does not have the authority as a PA to make these decisions, but the USCGA continues to allow it for whatever reason. It is best for you to ensure that your son's waiver will be acceptable to Captain Criss (PA at USCGA). If she does not explicitly agree -- expect to get a call mid-Swab Summer that your son is being discharged.

What does reg, instruction, manual, etc, say about this? What is the written directive on this process? Did the PA follow the process as written? Was there new information?
Of course, without being directly involved in the office, the exam, or the room when the decision was made, it's difficult for any of us to know exactly what process was followed or whether new information influenced the decision.

 

[Iblameej]

This will be an issue. In the class of 2029 there were at least two cadets that had food allergies -- one had tree nut and the other a shellfish allergy. All controlled, in the case of one, he had been in military medicine system his entire life (father is service connected). They both got full waivers from DoDMERB...but the PA in the USCGA clinic took it upon herself to disqualify both after they arrived and weeks into Swab Summer. More than disappointing in both cases (the one with the shellfish allergy enlisted in Marine Corps right after). This is not "normal" and she does not have the authority as a PA to make these decisions, but the USCGA continues to allow it for whatever reason. It is best for you to ensure that your son's waiver will be acceptable to Captain Criss (PA at USCGA). If she does not explicitly agree -- expect to get a call mid-Swab Summer that your son is being discharged.

This was heartbreaking for Class of 2029! One had been a CGAS prep, and made it through the whole year at GMC. I also heard several cadets that made it to swab summer and then were DQ’d for extra color blindedness testing. They had passed the DODMD eye testing. One happened to be on the baseball team this year. I’m curious why more comprehensive vision testing is not done before they get to swab summer?

 

[StPaulDad]

DoDMERB does not issue waivers for any academy. They decide if a candidate meets broad US military standards and it's up to the individual academy or service to decide if a waiver can be granted. Color blindness, for example, is just not a big a deal to the army (no buoys) compared to ocean-going services where reading buoys or ship lights in a dark harbor is the basis for avoiding collisions. Same with allergies, where you might be half way around the world when anaphylactic shock strikes and there's no help for thousands of miles but be able to airlift a soldier to a clinic a couple hours away.

The disappointment in this case was probably made worse by the late timing, but there's no knowing exactly what happened from out here in the cheap seats. One thing to keep in mind with health data is that we're not entitled to a full discussion of someone else's records, so we're not likely to get an explanation.

And a final note: a full captain in the service interpreted the regs. The disdainful tones in "a PA at the clinic" are not respectful of the process or the health care professional who made the decision. I'm sure it wasn't capricious, but rather rooted in a concern for this future officer and the shipmates who would be counting on this person being ready to go. Go back and read the @Capt MJ post above. There was likely an appeal process open to those swabs, but it may not have been successful for the reasons given.

EDIT: Didn't read the @Iblameej post when I wrote this, so it's mostly in response to earlier remarks. Hopefully USCGA learns from this and does the closer reading of medicals earlier than July to avoid painful calls like this in the future.

 

[Capt MJ]

What does reg, instruction, manual, etc, say about this? What is the written directive on this process? Did the PA follow the process as written? Was there new information?
Of course, without being directly involved in the office, the exam, or the room when the decision was made, it's difficult for any of us to know exactly what process was followed or whether new information influenced the decision.

Good points all.

Someone noted above two candidates got “full waivers from DoDMERB.” DoDMERB makes a recommendation on whether the candidate meets or does not meet (Q/DQ) the military medical accession standard. They are not waiver authorities and do not issue waivers.

I did some research at primary sources.

The commissioning sources can accept the Q/DQ recommendation. Usually they do. But they may disagree. Based on what I read, USCGA’s waiver authority resides at CG HQ. If a case came up at USCGA relating to disagreeing with DoDMERB or a candidate’s medical condition was being re-assessed, the senior medical officer at CGA would coordinate with the CG HQ medical authority. Though a decision may seem like it’s coming from 1 person, I can’t imagine it wouldn’t have been coordinated with the CG HQ medical department and Admissions leadership. We don’t know what additional information may have come to light. Further testing may have been done. Those kinds of decisions are made per policy, precedent and the individual case. Or they may have toughened up, if they had a trend of incidents in sea duty situations that impacted the mission.

If the mention of someone who was released from USCGA was able to enlist in the Marine Corps (which has a different waiver policy for certain allergies), great, but I wonder if they tried to enlist in the Coast Guard. A speculative thought is that perhaps they did, but were not able to obtain a waiver there too. Coast Guard has tough policies on allergies, understandable with smaller ships and crews, where a potential inability of a vulnerable crew member to work can impact unit readiness and safety.

The military can have medical service corps, nurse corps, etc., as the senior medical official or medical unit commander, including at big military hospitals, as those leadership billets are no longer filled solely by med corps (M.D.s). Coast Guard’s medical staffing is a bit different, as a DHS entity, as they often have USPHS commissioned officers embedded with them, and I think some of their own. A P.A. in that role would almost certainly coordinate closely with HQ medical staff.

I do think that is rough timing about the release after they have reported for swab summer. We don’t know if there was further testing and evaluation, what information was reviewed when, or what internal coordination took place between USCGA and CG HQ.

@GoCubbies any thoughts?

 

[Iblameej]

Thank you all for the thoughtful replies. I did not mean any disrespect towards the CG policy and completely agree that what has trickled down, may not be all accurate and medical records are private. I count my blessings every day that my cadet passed the rigorous DODMERB screening, but am grateful for the intense screenings to keep the crew safe.

 

[rhodeydad]

A PA only works under the direct (albeit perhaps only at the end of a phone line) supervision of an M.D. -- so I have to believe that at some point there wan't "just" a P.A. in the loop on this. (C.f."US Army Physician Assistant Handbook", here.)

Sucks for that young person, though -- my heart goes out to them.

 

[Haveaniceday]

A general observation why some cadets separate late during Swab summer or during the first semester after they successfully complete Swab summer:

When members are separated, it is almost never timely due to the extensive "evaluation to remove" process. Whether it is a security clearance issue, medical concern, or a conduct concern, USCG HQ and Academy leadership are involved and there are several levels of review which take time and paperwork. Also, the member in some cases has response rights and appeal rights to be afforded. Separation is an administrative process and is very time consuming. Alternatives to separation are always considered as there has already been an investment in the members success. Usually, the member is somewhat aware of an concern with the first indication often being a request for more information on an issue so USCG HQ can review it more completely.

 

[ilovehockeylol]

-If you would have an anaphylactic reaction to eating an allergen today… it is active.

-If there has not been a reaction after eating the allergen (simply avoiding it doesn’t count) for a significant period of time and there is official documentation from a doctor of a successful oral challenge it may be possible a waiver would be offered. Still very rare.
*The reason the military takes food allergies so seriously is because there are no special food options when you are deployed and down range. You eat what you are given. Full stop. You have to have enough fuel to complete the mission given… and there are usually no choices of what food is offered.

I'm in a similar situation. I still have a peanut allergy but I went through desensitization and no longer carry an epipen. Would I be likely to get a waiver? I can eat a couple peanuts at once without anaphylaxis at all.

 

[Iwutke]

I'm in a similar situation. I still have a peanut allergy but I went through desensitization and no longer carry an epipen. Would I be likely to get a waiver? I can eat a couple peanuts at once without anaphylaxis at all.

How about 1/2 a bag, like I do at an MLB baseball game? Anything then?