Which ROTC most likely to give tree nut DODMERB waiver?

[MLparent]

Daughter received scholarship offers from Air Force, Army and Navy. Which of these three is most likely to offer a waiver for a tree nut allergy? We are concerned about the length of time that it may take to have a final answer on the DODMERB waiver.

 

[AROTC-dad]

Here is a prior thread that suggests Army:

https://www.serviceacademyforums.com/index.php?threads/food-allergy-dq.58782/

 

[kinnem]

I think more depends on how bad the different programs will want her, although Army might be better.

 

[Falcon A]

I think more depends on how bad the different programs will want her, although Army might be better.

kinnem -- you might be right for Navy or USMC . . .

A subtlety we discovered as we went through the medical waiver process was who the medical waiver authority actually was for each entity. For USNA, Navy ROTC, USMA, and AROTC, the medical waiver authorities are the Superintendents of the SAs or the Commanding General/Admiral for the ROTCs. The USMA/USNA/ROTC medical staffs "advise" those senior leaders, along with the admission staff members, so the Senior leader can weigh all the inputs and make a decision. Obviously some medical issues are an "easy no" but many are on the edge and it is left to the Senior to decide what is best for the Service. For USAFA and AFROTC it is different . . .

I'm not a military pilot/aviator, but my friends that were/are within the Air Force had a saying . . . "Who is the most powerful military officer within the Air Force?" . . . most uninitiated would say "the Chief of Staff of the Air Force", or "the Commander Air Combat Command", or "Commander US Air Forces Europe", etc . . . my pilot friends would then retort . . . "Nope! . . . Its the Air Force Surgeon General/Flight Surgeon because he can take the Chief's / Commanding General's wings away!"

For USAFA and AFROTC, the USAFA Flight Surgeon and the Surgeon General for Air Education and Training Command (AETC) are independent from the USAFA Superintendent or the Commander AETC. They don't advise. They decide . . . no appeal. I think this comes from the early culture of the Air Corps where flight crews would return to base after each mission, and then the Flight Surgeon was making the choice and would tell the commander who could/should fly the next mission the next day. For Army, USMC and Navy I think it was different. You are forward deployed in the line of fire, or you are on board your ship. The "commander" may have been advised by the "doc" whether so-and-so was fit for duty, but the commander may have had to make a decision counter to the medical advice given, because in the commander's view, the best choice for the unit was to employ all "capable" members.

Others may have different experience or different opinions. This is how I have attempted to make sense this situation.

 

[brob]

Daughter received scholarship offers from Air Force, Army and Navy. Which of these three is most likely to offer a waiver for a tree nut allergy? We are concerned about the length of time that it may take to have a final answer on the DODMERB waiver.

My understanding is that all three will initiate waiver process anyway.

 

[foxtrot17]

I think more depends on how bad the different programs will want her, although Army might be better.

kinnem -- you might be right for Navy or USMC . . .

A subtlety we discovered as we went through the medical waiver process was who the medical waiver authority actually was for each entity. For USNA, Navy ROTC, USMA, and AROTC, the medical waiver authorities are the Superintendents of the SAs or the Commanding General/Admiral for the ROTCs. The USMA/USNA/ROTC medical staffs "advise" those senior leaders, along with the admission staff members, so the Senior leader can weigh all the inputs and make a decision. Obviously some medical issues are an "easy no" but many are on the edge and it is left to the Senior to decide what is best for the Service. For USAFA and AFROTC it is different . . .

I'm not a military pilot/aviator, but my friends that were/are within the Air Force had a saying . . . "Who is the most powerful military officer within the Air Force?" . . . most uninitiated would say "the Chief of Staff of the Air Force", or "the Commander Air Combat Command", or "Commander US Air Forces Europe", etc . . . my pilot friends would then retort . . . "Nope! . . . Its the Air Force Surgeon General/Flight Surgeon because he can take the Chief's / Commanding General's wings away!"

For USAFA and AFROTC, the USAFA Flight Surgeon and the Surgeon General for Air Education and Training Command (AETC) are independent from the USAFA Superintendent or the Commander AETC. They don't advise. They decide . . . no appeal. I think this comes from the early culture of the Air Corps where flight crews would return to base after each mission, and then the Flight Surgeon was making the choice and would tell the commander who could/should fly the next mission the next day. For Army, USMC and Navy I think it was different. You are forward deployed in the line of fire, or you are on board your ship. The "commander" may have been advised by the "doc" whether so-and-so was fit for duty, but the commander may have had to make a decision counter to the medical advice given, because in the commander's view, the best choice for the unit was to employ all "capable" members.

Others may have different experience or different opinions. This is how I have attempted to make sense this situation.

Wait... So I cannot refute a "Waiver denied" by the Air Force ROTC??

 

[Falcon A]

If your waiver is denied, you should definitely contact them and ask how to appeal. If there is a process for your condition, they will tell you. My comment about “no appeal” should be taken in the context that you can’t appeal to the SA Supt or the ROTC Commanding/Admiral. If you appeal you are appealing directly to the AF Medical staff and they are the Final authority.

 

[kinnem]

My understanding is that all three will initiate waiver process anyway.

That's my understanding as well, but initiating the waiver process is not granting a waiver.

 

[brob]

My understanding is that all three will initiate waiver process anyway.

That's my understanding as well, but initiating the waiver process is not granting a waiver.

True, the reason I stated that is because, even though the parent did not say so, I wondered if there was thought being given to which branch they should select to try to get the waiver approved. My point was DD will have a chance at all of them through no effort on her part.

 

[MLparent]

Thanks. The thought was if she does not receive the waiver by may 1st and has to make a decision, is she better off choosing the navy or army scholarship. We heard that Air Force is the most difficult waiver to receive.

My understanding is that all three will initiate waiver process anyway.

That's my understanding as well, but initiating the waiver process is not granting a waiver.

True, the reason I stated that is because, even though the parent did not say so, I wondered if there was thought being given to which branch they should select to try to get the waiver approved. My point was DD will have a chance at all of them through no effort on her part.[/QUOTE

 

[Falcon A]

Our experience is that the AF will only give a waiver if can prove via an allergist supervised “nut challenge” that you no longer have any sensitivity. Hives or rash during the test disqualifies you with the AF.

We have no experience with the Navy

The Army has given tree nut allergy waivers.

Best wishes to you. and your DD and many thanks to her for her willingness to serve.

 

[brob]

Thanks. The thought was if she does not receive the waiver by may 1st and has to make a decision, is she better off choosing the navy or army scholarship. We heard that Air Force is the most difficult waiver to receive.

My understanding is that all three will initiate waiver process anyway.

That's my understanding as well, but initiating the waiver process is not granting a waiver.

True, the reason I stated that is because, even though the parent did not say so, I wondered if there was thought being given to which branch they should select to try to get the waiver approved. My point was DD will have a chance at all of them through no effort on her part.[/QUOTE

Thanks. The thought was if she does not receive the waiver by may 1st and has to make a decision, is she better off choosing the navy or army scholarship. We heard that Air Force is the most difficult waiver to receive.

My understanding is that all three will initiate waiver process anyway.

That's my understanding as well, but initiating the waiver process is not granting a waiver.

True, the reason I stated that is because, even though the parent did not say so, I wondered if there was thought being given to which branch they should select to try to get the waiver approved. My point was DD will have a chance at all of them through no effort on her part.[/QUOTE

MLParent - That makes sense. Do any of her schools offer more than one branch?
From what I have read and experienced, and from what others are reporting here, it seems that Army is most likely to grant the waiver. Congratulations on your DD on winning three scholarships! And, best wishes on the waiver process.

 

[Tex232]

A Pecan...

 

[Army1967]

Our experience is that the AF will only give a waiver if can prove via an allergist supervised “nut challenge” that you no longer have any sensitivity. Hives or rash during the test disqualifies you with the AF.

We have no experience with the Navy

The Army has given tree nut allergy waivers.

Best wishes to you. and your DD and many thanks to her for her willingness to serve.

Falcon - thanks for your valuable info that I have seen on several posts. I have a couple of questions that I am curious to know if you have any perspective. First, my daughter is being recruited athletics at both West Point and Navy. She has done visits and has been accepted into the summer seminars. She has her heart set on attending, and is leaning toward West Point. She is in great shape on everything we can think of, BUT...there is a tree nut allergy issue (1 reaction 7 years ago, tested positive, no further issues with avoidance). So, here are my questions: 1) have you heard of OIT (ORAL IMMUNOTHERAPY) treatment where the allergic food is introduced in increasing doses over a 6-12 month timeframe so at the end the patient is able to consume a serving of whatever they test allergic to? It is highly successful (>85%) as measured by a food challenge. We are considering starting this so she would be able to pass a food challenge to show she can consume the nuts in question. Her blood and skin test would still show that she is allergic (current studies show that the numbers often drop but do not go to 0), but she would be able to eat a serving of the nuts. 2) if we go down this road, my thought is that we push off the physical until late in the process (Nov/Dec) when we have a letter from the allergist stating that she passed the test so we can submit it all at the same time. Thoughts? The other option would be to start earlier knowing she would be DQ'd and then go for the waiver. I am just thinking that as a recruited candidate it might be better to wait until we have a food challenge result in hand. My fear without that is that they feel it is too severe and she doesnt get a shot at a waiver

Another related question regarding the challenge: do you know if there is a specified amount of the food that needs to be consumed to "pass"?

 

[Falcon A]

BUT...there is a tree nut allergy issue (1 reaction 7 years ago, tested positive, no further issues with avoidance)

Similar situation with my DS . . . he was 6 . . . developed hives.

1) have you heard of OIT (ORAL IMMUNOTHERAPY) treatment where the allergic food is introduced in increasing doses over a 6-12 month timeframe so at the end the patient is able to consume a serving of whatever they test allergic to? It is highly successful (>85%) as measured by a food challenge. We are considering starting this so she would be able to pass a food challenge to show she can consume the nuts in question. Her blood and skin test would still show that she is allergic (current studies show that the numbers often drop but do not go to 0), but she would be able to eat a serving of the nuts.

Army -- As you know from my other posts, I am NOT a doctor. It was too late for us to try and do OIT . . . we didn't even know when we started the process for my DS that a tree nut allergy would be disqualifying. When my wife and I went into the USAF Academy (Class of '83), we don't remember such an allergy being on the form, and it wasn't listed on USAFA's website as a disqualifying condition. I have since read about OIT and it seems to help severe cases, especially young children, whose lives are severely impacted by the allergy . . . but it is my understanding that the desensitization has to take place over a longer timeframe than 6 months. Perhaps 12 months would be enough. Definitely rely on the advice of your allergist.

2) if we go down this road, my thought is that we push off the physical until late in the process (Nov/Dec) when we have a letter from the allergist stating that she passed the test so we can submit it all at the same time. Thoughts? The other option would be to start earlier knowing she would be DQ'd and then go for the waiver. I am just thinking that as a recruited candidate it might be better to wait until we have a food challenge result in hand. My fear without that is that they feel it is too severe and she doesnt get a shot at a waiver

I'm not sure of this strategy. I think it may be best to do the DoDMERB early. (My DS did his in August, got the final denial in September, and then had time to shift everything from USAFA to West Point and AROTC which worked out for him.) I think regardless of the letter you might have in hand from your allergist, that DoDMERB will hit you with the big "DQ" because you will check the box that your DD has had an allergic reaction in the past. I don't think DoDMERB will rely on the letter from your allergist since DoDMERB doesn't provide waivers. That will be up to the SA medical waiver authority. When the SA (or DoDMERB) asks for "remedial information" then along with the skin test, and blood work information is the time to submit any letter you may have from the allergist. It also doesn't hurt for your DD to write a letter describing how her allergy has had no impact on her life. The Army may or may not require a "nut challenge". They may issue the waiver without it. In the past the Army has been very "reasonable" concerning this condition . . . "Here is your medical waiver and don't eat those kind of nuts!" . . . I am not sure of the Navy since we have no experience with USNA or NROTC.

do you know if there is a specified amount of the food that needs to be consumed to "pass"?

There is . . your allergist will know. Typically 4 doses . . . starts off small . . . one nut . . . and then grows exponentially . . . the 4th dose seemed like more than a cup!

Best wishes to you and your DD!

 

[another13mom]

Have had two cadets at WP - based on their friends, we know USMA WILL waive a tree nut allergy. My youngest applied to USAFA and has been DQ'd for tree nut allergy. DODMERB sent a remedial for blood work to confirm. It returned positive allergy results, and it appears no waiver will be requested on this basis by USAFA. Had he obtained a nomination to USMA, he'd likely be in the running for an appointment.

 

[ORD1812]

Have had two cadets at WP - based on their friends, we know USMA WILL waive a tree nut allergy. My youngest applied to USAFA and has been DQ'd for tree nut allergy. DODMERB sent a remedial for blood work to confirm. It returned positive allergy results, and it appears no waiver will be requested on this basis by USAFA. Had he obtained a nomination to USMA, he'd likely be in the running for an appointment.

So you have heard that USMA will waive Tree Nut allergies? I am an applicant for the WP class of 2023 and I have a Brazil Nut allergy so this definitely hits close to home.

 

[another13mom]

^^ I am aware of cadets (not my own) for whom a tree nut allergy has been waived. Best of luck to you. At this point, wishing mine had a nom to USMA

 

[MohawkArmyROTC]

How severe is the tree nut allergy, and what is the reaction? That will determine if a waiver is even possible.

 

[Army1967]

BUT...there is a tree nut allergy issue (1 reaction 7 years ago, tested positive, no further issues with avoidance)

Similar situation with my DS . . . he was 6 . . . developed hives.

1) have you heard of OIT (ORAL IMMUNOTHERAPY) treatment where the allergic food is introduced in increasing doses over a 6-12 month timeframe so at the end the patient is able to consume a serving of whatever they test allergic to? It is highly successful (>85%) as measured by a food challenge. We are considering starting this so she would be able to pass a food challenge to show she can consume the nuts in question. Her blood and skin test would still show that she is allergic (current studies show that the numbers often drop but do not go to 0), but she would be able to eat a serving of the nuts.

Army -- As you know from my other posts, I am NOT a doctor. It was too late for us to try and do OIT . . . we didn't even know when we started the process for my DS that a tree nut allergy would be disqualifying. When my wife and I went into the USAF Academy (Class of '83), we don't remember such an allergy being on the form, and it wasn't listed on USAFA's website as a disqualifying condition. I have since read about OIT and it seems to help severe cases, especially young children, whose lives are severely impacted by the allergy . . . but it is my understanding that the desensitization has to take place over a longer timeframe than 6 months. Perhaps 12 months would be enough. Definitely rely on the advice of your allergist.

2) if we go down this road, my thought is that we push off the physical until late in the process (Nov/Dec) when we have a letter from the allergist stating that she passed the test so we can submit it all at the same time. Thoughts? The other option would be to start earlier knowing she would be DQ'd and then go for the waiver. I am just thinking that as a recruited candidate it might be better to wait until we have a food challenge result in hand. My fear without that is that they feel it is too severe and she doesnt get a shot at a waiver

I'm not sure of this strategy. I think it may be best to do the DoDMERB early. (My DS did his in August, got the final denial in September, and then had time to shift everything from USAFA to West Point and AROTC which worked out for him.) I think regardless of the letter you might have in hand from your allergist, that DoDMERB will hit you with the big "DQ" because you will check the box that your DD has had an allergic reaction in the past. I don't think DoDMERB will rely on the letter from your allergist since DoDMERB doesn't provide waivers. That will be up to the SA medical waiver authority. When the SA (or DoDMERB) asks for "remedial information" then along with the skin test, and blood work information is the time to submit any letter you may have from the allergist. It also doesn't hurt for your DD to write a letter describing how her allergy has had no impact on her life. The Army may or may not require a "nut challenge". They may issue the waiver without it. In the past the Army has been very "reasonable" concerning this condition . . . "Here is your medical waiver and don't eat those kind of nuts!" . . . I am not sure of the Navy since we have no experience with USNA or NROTC.

do you know if there is a specified amount of the food that needs to be consumed to "pass"?

There is . . your allergist will know. Typically 4 doses . . . starts off small . . . one nut . . . and then grows exponentially . . . the 4th dose seemed like more than a cup!

Best wishes to you and your DD!

Falcon - Thanks for your thoughtful reply. I have given thought to the DoDMERB timing and also talked to some allergists. Based on what I read, can you provide some insight on the steps that will take place. My understanding is that it goes like this:
1) Do the initial DoDMERB - here we check a box stating an allergy and it produces a DQ
2) It then goes to a "remedial information" request of a waiver - are these different? Do we need to do anything in step #1 to endure that this happens?
3) For the nut challenge, if that is what it comes to, do you know if the SA writes some form of specific script or instruction to the allergist, or are they just looking for a pass/fail answer? I spoke with 2 allergists who say that there is a general practice for this process, but there are no specific standards and all doctors follow their own guidelines which are similar but not identical (process or amount). What I want to understand is the end "answer" I am trying to get so I am asking the correct questions! For example, with my daughters blood numbers we have an OIT Allergist who says he is highly confident he can have her eating enough of the nuts for a food challenge, but the question we are not sure about is if we need to give the end result (pass food challenge) or go into all of that detail about the OIT process? What I have heard is answer questions specifically and don't provide additional details, and if that is the case I want to make sure we are using an Allergist that will meet that need. One challenge with OIT is that once you start eating the nuts you need to keep eating a maintenance dose every day, but that is not a detail that i feel needs to be brought up at this point if we can get her to pass a nut challenge.

Any additional feedback on the steps, detail of the SA ask, and level of detail we will need to provide would be of great help since I am on unfamiliar ground! Thanks