Which ROTC most likely to give tree nut DODMERB waiver?

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

In my own case it is an anaphylactic reaction, however I am not particularly sensitive to Brazil Nuts (i.e. before I was diagnosed with an allergy I would eat out of a mixed can of nuts where Brazil Nuts were present).
 
in our case, we checked the box on medical, a remedial was entered sending him for blood work, the blood work came back positive, a DQ was entered, and status is "awaiting waiver request" - but USAFA won't waive a positive blood test for nut allergy, so he is medically disqualified. A waiver was never started.
 
How severe is the tree nut allergy, and what is the reaction? That will determine if a waiver is even possible.

In my own case it is an anaphylactic reaction, however I am not particularly sensitive to Brazil Nuts (i.e. before I was diagnosed with an allergy I would eat out of a mixed can of nuts where Brazil Nuts were present).

If you have an anaphylactic reaction, you will not get an approved waiver.
 
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

1. A remedial is usually generated when you list you have an allergy. A remedial is a request for additional information.
2. After reviewing the remedial information, you are either Qualified or DQed.
3. If DQed, you can apply for a waiver.

When dealing with an allergy an IgE RAST test is the standard that DODMERB reviews to determine severity of allergy. I would get that done in addition to a challenge.
 
If you have an anaphylactic reaction, you will not get an approved waiver.

Mohhawk -- I am not a doctor but what I have seen over the past 3-4 years is it depends on what you mean by an "anaphylactic reaction" -- some allergists classify any reaction whatsoever as an "anaphylactic reaction" (including itchy throat, or rash, or hives, etc. ) -- Our experience is the AF tends to be in the "any reactions is a No Go" crowd; however, our experience is the Army has been much more reasonable -- making their ruling depending on the specific nut or nuts in question (some are very rare to find in military cooking and MREs), assessing the candidate's history (evidence of nut allergy impact to the candidates school attendance, athletic performance, etc.) and assessing the potential reaction severity from any testing. I think you are correct that someone going into "anaphylactic shock" after eating one nut would seem to be a disqualifier. I hope the Army continues with their reasonable approach for this medical condition . . . they are getting some outstanding people the AF is rejecting.
 
If you have an anaphylactic reaction, you will not get an approved waiver.

Mohhawk -- I am not a doctor but what I have seen over the past 3-4 years is it depends on what you mean by an "anaphylactic reaction" -- some allergists classify any reaction whatsoever as an "anaphylactic reaction" (including itchy throat, or rash, or hives, etc. ) -- Our experience is the AF tends to be in the "any reactions is a No Go" crowd; however, our experience is the Army has been much more reasonable -- making their ruling depending on the specific nut or nuts in question (some are very rare to find in military cooking and MREs), assessing the candidate's history (evidence of nut allergy impact to the candidates school attendance, athletic performance, etc.) and assessing the potential reaction severity from any testing. I think you are correct that someone going into "anaphylactic shock" after eating one nut would seem to be a disqualifier. I hope the Army continues with their reasonable approach for this medical condition . . . they are getting some outstanding people the AF is rejecting.

Yes, the Army is reasonable with waivers. I have had a few waivers for allergies approved and some not. The discriminator is severity and effects of the allergy.
 
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"?

Can she eat peanut butter? That was the peanut oral challenge our allergist gave to our daughter. She had no issues and we plan to send that new result with Dr letter to DODMERB so AFA, Navy ROTC and AF ROTC may reconsider the declined waiver that she recently received.
 
How severe is the tree nut allergy, and what is the reaction? That will determine if a waiver is even possible.

Our daughter's reaction to tree nuts was nausea after more than 30 minutes. She took Benadryl and recoverd quickly so we think it is a food sensitivity and not even an allergy with anaphylaxis reactions. We still have not had waiver declined from Army ROTC so we remain hopeful, especially after we send peanut oral challenge results this week. An allergist reported three years ago that she had a peanut allergy, but she does not. Same doctor gave epipen prescription for tree nut allergy and she has never used or needed epipen so hoping army ROTC does not decline waiver because of that unnecessary prescription.
 
How severe is the tree nut allergy, and what is the reaction? That will determine if a waiver is even possible.

In my own case it is an anaphylactic reaction, however I am not particularly sensitive to Brazil Nuts (i.e. before I was diagnosed with an allergy I would eat out of a mixed can of nuts where Brazil Nuts were present).

If you have an anaphylactic reaction, you will not get an approved waiver.

How does DODMERB define an anaphylactic reaction though? Our allergist called it an anaphylactic reaction, but we have other doctors who have said it was not. Is DODMERB, especially Army ROTC, willing to look deeper? She has nausea and recoverd quickly, but we believe misdiagnosed as an anaphylactic reaction. She has had no reactions in three years and had a successful peanut oral challenge last week so hoping the peanut oral challenge result of no issues will lead army ROTC to give waiver, despite the one Doctor said she had an anaphylactic reaction to tree nuts. Thoughts?
 
ML —

Our experience is this ... this is not an exact science ... Some allergist are very conservative. Others are more reasonable. Some allergists seem to classify any reaction as an anaphylactic reaction ... I think most Doctors worry about anaphylactic shock...some allergists say if you’d had an anaphylactic reaction you might be one nut away from going into anaphylactic shock ... I don’t know ...

Some say peanut butter and peanut oil aren’t allergic issues due to the cooking and processing that takes place to create them. Some say peanut butter is just as bad as raw peanuts. Some say there is no connection between peanuts and tree nuts because peanuts aren’t nuts — the issue is that peanuts and tree nuts get processed on the transfer belts within a facility and the cross contamination is the issue.

Some allergists prescribe Epipens at the drop of a hat ... have been told we have Army cadets and Army active duty carrying epipens ...

... the question on the DoDMERB Form 2492 (#60) is “Have you ever had or do you now have: Adverse reaction to vaccines, drugs, medicines, food, insect bites and stings

... if you check the box YES on the DoDMERB form I believe you are likely to get a DQ. Notice the term “anaphylactic reaction” is not used on the form ... however the term “anaphylactic” is used in the DoDMERB reg ...

The criteria to determine DQ is in DoDI 6130.03 page 39 under the heading of “Anaphylaxis”

“(2) History of systemic allergic reaction to food or food additives (995.60-995.69). Systemic allergic reaction may be defined as a temporally related, systemic, often multi-system, reaction to a specific food. The presence of a food-specific immunoglobulin E antibody without a correlated clinical history DOES meet the standard.”

I believe the Army will take all of the data for DD into account. They may ask for skin tests and blood work to see what her IgE numbers are against specific nuts. It wouldn’t hurt for her to write a letter describing how her supposed allergy has not impacted her life and submit it to her DoDMERB file. Send me a PM and I will see if I can find the letter my son submitted. I think it helped his situation.

Sincere best wishes ...
 
ML —

Our experience is this ... this is not an exact science ... Some allergist are very conservative. Others are more reasonable. Some allergists seem to classify any reaction as an anaphylactic reaction ... I think most Doctors worry about anaphylactic shock...some allergists say if you’d had an anaphylactic reaction you might be one nut away from going into anaphylactic shock ... I don’t know ...

Some say peanut butter and peanut oil aren’t allergic issues due to the cooking and processing that takes place to create them. Some say peanut butter is just as bad as raw peanuts. Some say there is no connection between peanuts and tree nuts because peanuts aren’t nuts — the issue is that peanuts and tree nuts get processed on the transfer belts within a facility and the cross contamination is the issue.

Some allergists prescribe Epipens at the drop of a hat ... have been told we have Army cadets and Army active duty carrying epipens ...

... the question on the DoDMERB Form 2492 (#60) is “Have you ever had or do you now have: Adverse reaction to vaccines, drugs, medicines, food, insect bites and stings

... if you check the box YES on the DoDMERB form I believe you are likely to get a DQ. Notice the term “anaphylactic reaction” is not used on the form ... however the term “anaphylactic” is used in the DoDMERB reg ...

The criteria to determine DQ is in DoDI 6130.03 page 39 under the heading of “Anaphylaxis”

“(2) History of systemic allergic reaction to food or food additives (995.60-995.69). Systemic allergic reaction may be defined as a temporally related, systemic, often multi-system, reaction to a specific food. The presence of a food-specific immunoglobulin E antibody without a correlated clinical history DOES meet the standard.”

I believe the Army will take all of the data for DD into account. They may ask for skin tests and blood work to see what her IgE numbers are against specific nuts. It wouldn’t hurt for her to write a letter describing how her supposed allergy has not impacted her life and submit it to her DoDMERB file. Send me a PM and I will see if I can find the letter my son submitted. I think it helped his situation.

Sincere best wishes ...
ML —

Our experience is this ... this is not an exact science ... Some allergist are very conservative. Others are more reasonable. Some allergists seem to classify any reaction as an anaphylactic reaction ... I think most Doctors worry about anaphylactic shock...some allergists say if you’d had an anaphylactic reaction you might be one nut away from going into anaphylactic shock ... I don’t know ...

Some say peanut butter and peanut oil aren’t allergic issues due to the cooking and processing that takes place to create them. Some say peanut butter is just as bad as raw peanuts. Some say there is no connection between peanuts and tree nuts because peanuts aren’t nuts — the issue is that peanuts and tree nuts get processed on the transfer belts within a facility and the cross contamination is the issue.

Some allergists prescribe Epipens at the drop of a hat ... have been told we have Army cadets and Army active duty carrying epipens ...

... the question on the DoDMERB Form 2492 (#60) is “Have you ever had or do you now have: Adverse reaction to vaccines, drugs, medicines, food, insect bites and stings

... if you check the box YES on the DoDMERB form I believe you are likely to get a DQ. Notice the term “anaphylactic reaction” is not used on the form ... however the term “anaphylactic” is used in the DoDMERB reg ...

The criteria to determine DQ is in DoDI 6130.03 page 39 under the heading of “Anaphylaxis”

“(2) History of systemic allergic reaction to food or food additives (995.60-995.69). Systemic allergic reaction may be defined as a temporally related, systemic, often multi-system, reaction to a specific food. The presence of a food-specific immunoglobulin E antibody without a correlated clinical history DOES meet the standard.”

I believe the Army will take all of the data for DD into account. They may ask for skin tests and blood work to see what her IgE numbers are against specific nuts. It wouldn’t hurt for her to write a letter describing how her supposed allergy has not impacted her life and submit it to her DoDMERB file. Send me a PM and I will see if I can find the letter my son submitted. I think it helped his situation.

Sincere best wishes ...

My daughter received waiver from army and Air Force academy after Doctor supervised successful peanut oral challenge. Then learned that three years scholarship became four year scholarship after third board. She is very excited to become an army ROTC cadet.
 
Just got my hands on DoDMERB DD Form 2492. For Tree Nut history, do Q's #13 (Have any allergies) and #60 (Adverse reaction to...foods) both have to be checked yes? It seems repetitive. Explanation on page 2 would be the same for both questions, so just not sure if both should be checked or only 1. Sort of a stupid question but I'm sure someone here has been through this...Thanks!
 
Army -- I am NOT a doctor. This is my advice from being a Dad that watched his DS go through this:

If you have been diagnosed by a doctor as having an allergy and/or it is in your medical record, check box #13. Do not self diagnose.

#60 is "trickier" since "adverse reaction" is really up to your interpretation. Best not to lie . . . can be expensive later on.

If you check both, then in the comments section just put both numbers followed by the explanation

"#13 & #60: My allergy is to . . . "
 
New to this thread and need advice. DD got 4-year scholarships to AFROTC, AROTC and NROTC-MO, checked the peanut allergy box and was DQd. Air Force passed. No word from Army other than waiting for waiver review, Marines asked for AMI and allergist refuse to let her take oral challenge based on the skin test resulting in hives. She's had multiple exposures to peanuts and peanut products, and while it's not a good time, it IS NOT, nor has it ever been, life-threatening or affected her performance of her duties/activities in any way. She's required no treatment - emergency or otherwise. Can she take the challenge independently and submit the result? Would a letter from her to DoDMERB help? Unfortunately, this dr's opinion is the one that will go to DoDMERB, along with the recommendation for an epipen. Seems a little ridiculous and arbitrary! CGA waived the peanut allergy and she went for half a semester before being DQd and sent home with an eye issue. Poor thing just wants to serve, is (CLEARLY, IMHO :) brilliant, high test scores, athlete, etc and is meeting every hurdle and road block head on with determination and may not be able to. Breaks my heart. Rant over. Thanks for indulging me!
 
Find a different doctor who will administer the test, preferably one who has some knowledge and experience of the military. Just my 2 cents.
 
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.

what happened?
 
Staubitzmil - The postings were in 2018

CORRECTION OF FACT:

DoDMERB does NOT grant/deny waivers. The Services do - Thru the Academies and ROTC programs.
 
yes I was wondering what the outcome was
Given the post was back in 2018, the poster may well have moved on. If a thread seems to have stopped a year or more ago, you can always search for the person’s profile to see if they are still active and determine if you are likely to get a response. It’s perfectly fine to start a fresh thread. The same general questions come up every year, but things do change, and newer feedback might be more accurate.
 
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