The Medical Process

atthe United States Naval Academy

Kelly D. SkanchyCommander, Medical Corps

United States Navy

USNA Medical Process FlowUSNA Medical Process Flow

Applicant DoDMERBContractor(Normally Concorde)

Physical(MedicalProvider)

PhysicalVerified byContractor

DoDMERBInitial

Decision

USNA

USNA

USNAAdmissions

BuMED

SMO

SuperintendentFor Decision

Candidate

USNAAdmissions

Q or NQ

Incomplete or Need More Info

NQ + Competitive, Process Waiver

Waiver Rec

Waiver Rec

More Info

Need More Info

Need More Info

4 of 10 Docs

How to start

1. Begin application to the United States Naval Academy (USNA).

2. Once 4 documents are on file, and you are academically qualified you are considered a viable applicant.

3. Your name is sent to the Department of Defense Medical Evaluation Review Board (DoDMERB)

The Next Step

1. DoDMERB arranges for a history and physical exam via a contract service.

2. You have your history and physical exam performed.

3. Once completed the findings are reviewed by DoDMERB.

4. DoDMERB makes a determination.

The Determination

1. DoDMERB determines if there are disqualifying findings (DQs) in your evaluation.

2. If there are no DQs, then you are medically qualified and the process stops.

3. If there are disqualifying findings, you are notified and additional information is sought.

4. DoDMERB does not grant waivers, and will remove DQs only if the finding is in error.

DQs

1. DQs are physical or historical findings that are deviations from normal.

2. There are 2 main sources that describe normal for the Navy:

Department of Defense Instruction 6130.4 Bureau of Medicine, Manual of the

Medical Department Chapter 15.

3. The standards are different for commissioning, enlistment, retention and among the services.

Waivers

1. The Naval Academy is the waiver authority and the Superintendent makes that decision.

2. If you are being considered for an offer, YOU DO NOT HAVE TO REQUEST ONE!!!

3. The waiver process is automatic, however, you may need to provide additional information if requested to complete the process.

4. DoDMERB does not grant waivers.

Waivers

1. When adequate information is available, your file is reviewed by the Bureau of Medicine (BuMed and USNA).

2. Both opinions are noted and periodically a list of candidates requiring waivers is sent to the Superintendent for a final decision.

Waivers

4. If the waiver is granted, the process is complete and you are considered medically qualified.

5. If the waiver is not granted, the process is technically complete and you are considered medically disqualified.

6. You can ask for another review, if you are able to provide new additional information, your waiver may be granted or the DQ upheld.

Additional Information

Additional information:1. Doctor’s notes2. Additional tests3. Statements of level of activity

Additional information is not:1. Passionate statements of desire2. Copies of previously submitted

information3. Opinions that your DQ will not interfere

with being a Midshipman or naval officer.

Waiverable DQs

Injuries after full recovery Diseases or illness with no recent

occurrence Surgeries that have fully healed Current illness or disease that does not

require regular or significant treatment and which does not have a life threatening potential.

Unlikely DQ waivers Diabetes Chronically unstable joint Psychological disorders Absence of a paired organ Disease or illness that requires

regular medication, therapy or evaluation. (asthma, allergies)

Disease or illness that is likely to worsen with time or in a military environment. (asthma, Backs)

Possible waivers

History of eczema if not requiring prescription medication.

Flat feet if not rigid or requiring custom orthotics

Hypothyroidism if stable and under good control

ADHD if not requiring medication or special accommodations

Why?Why?

The “9 year warranty”The “9 year warranty” Post-graduation 100% employmentPost-graduation 100% employment Expected progression of disease or Expected progression of disease or

abnormalityabnormality Hostile environments:Hostile environments:

ShipboardShipboard CombatCombat

Availability of medical careAvailability of medical care

Vision

1. Normal vision, per BuMed, is Up to 6 diopters correction and 3 diopters astigmatism which is correctable to 20/20 in each eye.

2. Waivers for greater corrections are considered on a case-by-case basis but not routinely granted.

3. Standards for applicants who have had surgery are based on their pre-surgery correction.

Common ConditionsCommon Conditions

Asthma*Asthma* Academic Skills Disorders*Academic Skills Disorders* Mood disordersMood disorders Eating disordersEating disorders GERDGERD Herniated Disk/DDDHerniated Disk/DDD Flat feet with custom orthoticsFlat feet with custom orthotics ACL/knee issuesACL/knee issues Childhood injuriesChildhood injuries Retained orthopedic hardwareRetained orthopedic hardware

AsthmaAsthma

Diagnostic UncertaintyDiagnostic Uncertainty Waived if none after age 13Waived if none after age 13 #1 Reason for MEDEVAC DNBI#1 Reason for MEDEVAC DNBI High Risk Environments – Deserts, High Risk Environments – Deserts,

AltitudeAltitude CHEM-BIO Protective Gear CHEM-BIO Protective Gear

IncompatibilityIncompatibility Fire Fighting EnsemblesFire Fighting Ensembles Chemical Irritants, SmokeChemical Irritants, Smoke

Academic Skills Academic Skills DisordersDisorders

ADHD/ADDADHD/ADD DyslexiaDyslexia Special AccommodationsSpecial Accommodations Non-Standardized TestsNon-Standardized Tests Stimulant Drugs – Ritalin, Stimulant Drugs – Ritalin,

Dexedrine, Adderall, Concerta, Dexedrine, Adderall, Concerta, StratteraStrattera

Not Medical ….Not Medical ….

Body alterations: tattoos and Body alterations: tattoos and piercings – BARBpiercings – BARB

Height and weight standards – Height and weight standards – Flagged during admissions Flagged during admissions process/trackedprocess/tracked

Color vision – Superintendent’s waiver Color vision – Superintendent’s waiver (2%)(2%)

HIPAAHIPAA The passage of Health Insurance Portability and The passage of Health Insurance Portability and

Accountability Act, (HIPAA) demands that we Accountability Act, (HIPAA) demands that we handle medical information of candidates with handle medical information of candidates with appropriate privacy and professionalism. In the effort appropriate privacy and professionalism. In the effort to streamline the process and protect our Naval to streamline the process and protect our Naval Academy Information Officers from conflicts and Academy Information Officers from conflicts and potential legal action, CGO requests that all Blue and potential legal action, CGO requests that all Blue and Gold Officers Gold Officers refrain from personal involvement with refrain from personal involvement with medical waivers and requestsmedical waivers and requests.. Please feel free to Please feel free to point candidates in the right direction to get their point candidates in the right direction to get their medical questions answered. Medical questions medical questions answered. Medical questions should be forwarded to should be forwarded to Yvonne GrahamYvonne Graham at 410-293- at 410-293-18171817..

Contacts

Admissions Medical OfficePhone: 410-293 1817

Fax: 410-293-1819