List of Medical Issues That Could Make It Difficult To Join

The military must make sure that all the individuals joining are in optimal physical health. It will be essential to maintain their safety as well as the safety of those with which they serve. There are certain medical conditions that could disqualify individuals from enlisting, however, it is not a fore gone conclusion. 

Some conditions listed as disqualifying conditions can be waived when applying for enlistment. If you have any of the following potentially disqualifying conditions, it is important to inform your recruiter. Failure to notify the military of any significant medical conditions could result in a less-than-honorable discharge if later discovered. 

Abdominal organs and the gastrointestinal system

• Esophagus – ulcerations, varices, fistula, achalasia, GERD or gastro-esophageal reflux disease, dismotility disorders, chronic or recurrent esophagitis that has been confirmed by an x-ray or endoscopy

• Stomach and duodenum – gastritis that is chronic hypertrophic or severe, active ulcer of the stomach or duodenum that has been confirmed by x-ray or endoscopic exam, congenital abnormalities of the stomach or duodenum causing symptoms or requiring surgical treatment with the exception of surgical correction of the hypertrophic pyloric stenosis of infancy

• Small and large intestines – inflammatory bowel disease, regional enteritis or Crohn’s disease, ulcerative colitis, ulcerative proctitis, duodenal diverticula with symptoms of hemorrhage or perforation or the like, intestinal malabsorption syndromes including postsurgical and idiopathic, congenital conditions to include Meckel’s diverticulum or functional abnormalities which are persisting oar symptomatic within the past 2 years
• Gastroinstestinal bleeding history of gastrointestinal bleeding with positive occult blood that has not been corrected
• Hepatic-biliary tract – Viral hepatitis or unspecified hepatitis in the preceding 6 months or persistence of symptoms after 6 months or objective evidence of impairment of liver function or chronic hepatitis and hepatitis B carrier, if tested positive for hepatitis C virus infection then confirmatory testing must be done and evaluated for liver function impairment, cirrhosis, hepatic cysts and abscess, sequelae of chronic liver disease, cholecystitis either acute or chronic with or without cholelithasis and other disorders of the gallbladder including post-cholecystectomy syndrome and biliary system (cholecystectomy is not disqualifying 60 days post surgery -30 days post-laproscopic surgery providing there are no disqualifying residuals from treatment, pancreatitis both acute and chronic, current or history of metabolic liver disease including but not limited to hemochromatosis, Wilson’s disease or alpha-1 anti-trypsin deficiency, enlargement of the liver from any cause
• Anorectal – anal fissure, anal fistula, anal or rectal polyp, prolapse, stricture, or fecal incontinence, hemorrhoids both internal and external when large and symptomatic or with history of bleeding within the last 60 days
• Spleen – splenomegaly, history of splenectomy except when resulting from trauma
• Abdominal wall – hernia including but not limited to uncorrected inguinal and other abdominal wall hernias with the exception of small asymptomatic umbilical or asymptomatic hiatal hernias, history of abdominal surgery either open or laparoscopic within the 6 months prior
• Other – gastrointestinal bypass or stomach stapling for the control of obesity, artificial openings including but not limited to ostomy

Blood and blood-forming tissue diseases

• Anemia either current hereditary or acquired, aplastic, or unspecified that has not been permanently corrected with therapy
• Hemorrhagic – congenital or acquired tendency to bleed due to a platelet or coagulation disorder, von Willebrand’s Disease, idiopathic thrombocytopenia, or Henoch-Schonlein Purpura
• Leukopenia – current or history of diagnosis of any form of chronic or recurrent agranulocytosis and/or leukopenia
• Immunodeficiency

Dental

• Diseases of the job or associated tissues that prevent normal functioning which are not easily remedied and will cause incapacitation of the individual or otherwise prevent the satisfactory performance of duty including temporomandibular disorders and/or myofascial pain dysfunction that has not been corrected and has potential of causing future problems
• Severe malocclusion which interferes with normal mastication or requires early and protracted treatment, or a relationship between the mandible and maxilla that prevents satisfactory future prosthodontic replacement
• Current insufficient natural healthy teeth or lack of a serviceable prosthesis that prevents adequate mastication and incision of a normal diet including complex (multiple fixtures) dental implant systems with associated complications. Those receiving active endodontic treatment that will be completed prior to being sworn into active duty may be eligible for the Delayed Entry Program
• Orthodontic appliances for continued treatment either attached or removable.  Retainer appliances are permissible as long as all active orthodontic treatment has been satisfactory completed.

Ears

• External ear – atresia or severe microtia, congenital or acquired stenosis, severe chronic or acute otitis externa, severe external deformity which prevents or interferes with the proper wearing of hearing protection
• Mastoids – mastoiditis, residual of mastoid operation with fistula, chronic drainage or conditions requiring frequent cleaning of the mastoid bone, marked external deformity that prevents or interferes with wearing a protective mask or helmet
• Meniere’s Syndrome – Meniere’s Syndrome or other chronic diseases of the vestibular system
• Middle and inner ear – chronic or acute otitis media, cholesteatoma, history of any inner or middle ear surgery including cochlear implantation with the exception of Myringotomy or successful tympanoplasty
• Tympanic membrane – perforation of the tympanic membrane or surgery to correct perforation within 120 days of examination

Hearing

• Audiometers calibrated to the standards of the International Standards Organization or the American National Standards Institute will be used to test the hearing of all applicants
• All audiometric tracings or audiometric readings recorded on reports of medical examination or other medical records will be clearly identified
• Current hearing thresholds – Pure tone at 500, 1000, and 2000 cycles per second for each ear of not more than 30 decibels on average with no individual level greater than 35 decibels at those frequencies; pure tone level not more than 45 decibels at 3000 cycles per second or 55 decibels at 4000 cycles per second for each ear; there is no standard for 6000 cycles per second

Endocrine and metabolic disorders

• Any degree of adrenal dysfunction
• Any type of diabetes mellitus
• Persistent glycosuria when associated with impaired glucose tolerance or renal tubular defects
• Acromegaly, gigantism or other disorders of pituitary function
• Gout
• Hyperinsulinism
• Hyperparathyroidism and hypoparathyroidism
• Thyroid – goiter that are persistent and untreated, hypothyroidism uncontrolled by medication, hyperthyroidism, cretinism, thyroiditis
• Nutritional deficiency diseases – includes but not limited to beriberi, pellagra, scurvy
• Other endocrine or metabolic disorders such as cystic fibrosis, porphyria, and amyloidosis that obviously prevent satisfactory performance of duty or that requires frequent or prolonged treatment

Upper extremities

• Limitation of motion – if current joint ranges of motion are less than the measurements listed below, disqualification is possible
• Shoulder – forward elevation to 90 degrees, abduction to 90 degrees
• Elbow – flexion to 100 degrees, extension to 15 degrees
• Wrist – a total range of 60 degrees (extension + flexion) or radial and ulnar deviation combined arc 30 degrees
• Hand – pronation to 45 degrees, supination to 45 degrees
• Fingers and thumb – inability to clench fist, pick up a pin, grasp an object, or touch the tips of at least three fingers with thumb
• Hands and fingers – absence of distal phalanx of either thumb, absence of distal and middle phalanx of an index or middle or ring finger of either hand irrespective of the absence of the little finger, absence of more than the distal phalanx of any two of the following fingers: index or middle or ring finger of either hand, absence of hand or nay portion thereof except for specific absences of fingers as noted above, polydactyly, scars and deformities of the fingers or hand that are symptomatic or that impair normal functions to such a degree as to interfere with the satisfactory performance of military duty, intrinsic paralysis or weakness of upper limbs including nerve paralysis, carpal tunnel and cubital syndromes, lesions of ulnar and radial nerve, nerve palsy sufficient enough to produce physical findings in the hand such as muscle atrophy and weakness, disease or injury or congenital condition with residual weakness or symptoms such as to prevent satisfactory performance of duty including but not limited to chronic joint pain of the shoulder, upper arm, forearm and hand, late effect of fracture of the upper extremities, late effect of sprains without mention of injury and late effects of tendon injury, grip strength of less than 75% of predicted normal when injured hand is compared with the normal hand

Lower extremities

• Limitation of motion – if current joint ranges of motion are less than the measurements listed below, disqualification is possible
• Hip from either disease or injury – flexion to 90 degrees, no demonstrable flexion contracture, extension to 10 degrees, abduction to 45 degrees, rotation of 60 degrees (internal and external combined)
• Knee from either disease or injury – full extension to 0 degrees, flexion to 110 degrees
• Ankle from either disease, injury or congenital defect – dorsiflexion to 10 degrees, planter flexion to 30 degrees
• Subtalar eversion and inversion totaling 5 degrees due to disease, injury or congenital defect
• Foot and ankle – absence of one or more small toes if it causes poor function of the foot or impairs running or jumping, absence of a foot or any portion thereof except for the above mention toes, absence of great toes, loss of dorsal or plantar flexion if function of the foot is impaired, deformities of the toes either acquired or congenital including but not limited to polydactyly, hallux valgus, hallux varus, hallux rigidicus, hammer toes, claw toes, overriding toes or any conditions that prevents the proper wearing of military footwear or impairs walking, marching, running or jumping, clubfoot or pes cavus if it prevents proper wearing of military footwear or impairs walking, marching, running or jumping, symptomatic pes planus either acquired, congenital or pronounced cases with the absence of subtalar motion, ingrown toenails that are severe, infected or symptomatic, persistent plantar fasciitis, neuroma that is refractory to medical treatment or prevents the proper wearing of military footwear or impairs walking, marching, running or jumping
• Leg, knee, thigh and hip - loose or foreign body within the knee joint, uncorrected anterior or posterior cruciate ligament injury, history of surgical correction of any knee ligaments only if symptomatic or unstable, symptomatic medial and lateral collateral ligament injury, symptomatic medial and lateral meniscal injury, unspecified internal derangement of the knee, history of congenital dislocation of the hip, osteochondritis of the hip (Legg-Perthes disease), or slipped femoral epiphysis of the hip, hip dislocation within the preceding 2 years, osteochondritis of the tibial tuberosity (Osgood-Schlatter disease) if it is symptomatic
• General – current deformities, disease or chronic joint pain of pelvic region, thigh, lower leg, ankle and/or foot interfering with function to such a degree as to prevent the individual from following a physically active vocation in civilian life or that would interfere with walking, running, weight bearing or the satisfactory completion of required military training or military duty, leg-length discrepancy resulting in a limp or scoliosis

Miscellaneous conditions of the extremities

• History of chondromalacia including but not limited to chronic patella-femoral pain syndrome and chronic Retro-Patellar Pain Syndrome with or without confirmatory arthroscopic evaluation
• Arthritis – active, subacute or chronic
• Joint dislocation that is unreduced or recurrent dislocations of any major joint such as shoulder, hip, elbow, knee, ankle or instability of any major joint such as shoulder, elbow, hip, ankle and foot or multiple sites
• Chronic osteoarthritis or traumatic arthritis of isolated joints of more than a minimal degree interfering with following a physically active vocation in civilian life or that prevents the satisfactory performance of military duty
• Fractures – malunion or non-union of any fracture with the exception of asymptomatic ulnar styloid process fracture, retained hardware that is symptomatic and interferes with proper wearing of protective equipment or military uniform and/or is susceptible to trauma with the exception of retained hardware including plates, pins, rods, wires or screws used for fixation if fractures are healed and ligaments are stable and there is no pain and it is not subject to easy trauma
• Contusion of bone or joint, injury of bone or joint that is more than minor in nature and interferes or prevents performance of military duty or requiring frequent or prolonged treatment without fracture nerve injury, open wound, crush or dislocation occurring within the preceding 6 weeks to the upper extremity,, lower extremity, ribs or clavicle
• Joint replacement
• Muscular paralysis, contracture or atrophy, if progress or of sufficient degree that it interferes with or prevents military service or requires frequent or prolonged treatment
• Osteochondritis dessicans
• Osteochondromatosis or multiple cartilaginous exostoses
• Osteoporosis
• Osteomyelitis either active or recurrent
• Scars so extensive or deep that they interfere with muscular movement

Eyes

• Lids – blepharitis either chronic or acute, blepharospasm, dacryocystitis either chronic or acute, complete or extensive lid deformity sufficient to interfere with vision or impair protection of the eye from exposure, growths or tumors of the eyelid other than small non-progressive, asymptomatic, benign lesions
• Conjunctiva – chronic conjunctivitis including but not limited to trachoma and allergic conjunctivitis, pterygium if the condition encroaches on the cornea in excess of 3mm or causes interference with vision or is progressive peripheral pterygium or if it is recurrent after two operative procedures, xerophthalmia,
• Cornea – any type of corneal dystrophy to include keratoconus of any degree, history of refractive surgery such as Lamellar and/or penetrating keratoplasty, radial keratotomy and astigmatic keratotomy, laser surgery or appliance used to reconfigure the cornea, acute and chronic keratitis including corneal ulcers, erosions, abrasion, or hepatic ulcers, corneal vascularization or opacification from any cause that is progressive or causes a reduction of vision below prescribed standards
• Uveitis or iridocyclitis
• Retina – retinal defects and dystrophies, angiomatoses, retinoschisis and retinal cysts, phakomas, congenito-retinal hereditary conditions that are progressive or impair visual function, chorioretinal or retinal inflammatory conditions, conditions leading to neovascularization, chorioretinitis, histoplasmosis, toxoplasmosis, vascular eye conditions such as Coats’ disease, Eales’ disease and retinitis proliferans, degenerative changes of any part of the retina, retinal detachment, history of surgery for retinal detachment or peripheral retinal injury, defect or degeneration that may cause future retinal detachment
• Optic nerve – optic neuritis, neuroretinitis, secondary optic atrophy, documented history of retrobulbar neuritis, optic atrophy or cortical blindness, papilledema
• Lens – aphakia, lens implant, dislocation of lens, opacities of the lens that interfere with vision or are progressive, cataract
• Ocular mobility – documented constant or intermittent diplopia, nystagmus except physiologic “end-point nystagmus, esotropia, hypertropia (entering the USMA or ROTC programs, the following conditions are disqualifying: esotropia over 15 prism diopters; extropia over 10 prism diopters; hypertopia over 5 prism diopters), strabismus uncorrected by lenses to less than 40 diopters or accompanied by diplopia, surgery correcting strabismus within the previous 6 months
• Miscellaneous defects and conditions – abnormal visual fields due to disease of the eye or central nervous system or trauma. The following are the acceptable Meridian-specific visual fields:                                                                                    

1. Temporal – 85 degrees
2. Superior temporal – 55 degrees
3. Superior – 45 degrees
4. Superior nasal – 55 degrees
5. Nasal – 60 degrees
6. Inferior nasal – 50 degrees
7. Inferior – 65 degrees
8. Inferior temporal – 85 degrees

• Absence of the eye, unspecified congenital or acquired clinical anophthalmos, history of globe disorders 
• Asthenopia that is severe in nature
• Unilateral or bilateral non-familial exophthalmos
• Glaucoma including but not limited to primary, secondary, pre-glaucoma which is made evident by intraocular pressure higher than 21 millimeters of mercury, changes in the optic disc or visual field loss associated with glaucoma
• Loss of normal pupillary reflex reactions to accommodation or light to include Adie’s syndrome
• Night blindness
• Retained intraocular foreign body
• Growth or tumors of the eyelid with the exception of basal cell tumors that can be cured through treatment and small nonprogressive asymptomatic benign lesions
• Organic disease of the eye or adnexa that threatens vision or visual function

Vision

Distance visual acuity of any degree that does not correct to at least one of the following with spectacle lenses:

            20/40 in one eye and 20/70 in the other

            20/30 in one eye and 20/100 in the other

20/20 in one eye and 20/400 in the other, for entrance into the USMA or ROTC distant vision acuity must correct to 20/20 in one eye and 20/40 in the other and for entrance into the OCS distant visual acuity must correct to 20/20 in one eye and 20/100 in the other

            Near visual acuity of any degree that is not corrected to 20/40 in the better eye

Refractive error (hyperopia, myopia, astigmatism) or history of refractive error prior to any refractive surgery manifest by any refractive error in spherical equivalent of worse than -8.00 or +8.00 diopeters, if ordinary glasses cause discomfort by reason of ghost images or prismatic displacement, if corrected by orthokeratology or keratorefractive surgery; enterance into USMA or Army ROTC programs have the following disqualifying conditions:

            All types of astigmatism over 3 diopters

            Hyperopia over 8.00 diopters spherical equivalent

            Myopia over 8.00 diopters spherical equivalent

            Refractive error corrected by orthokeratology or keratorefractive surgery

Contact lenses – specific complicated cases that require contact lenses to correct vision for issues such as corneal scarring or irregular astigmatism

Color vision – failure of test not automatic disqualification, adequate color vision is a prerequisite for many military specialties; for entrance into the USMA or Army ROTC or OCS programs, the ability to distinguish and identify without confusion the color of an object, substance, material or light that is uniformly colored a vivid red or vivid green is a requirement

Genitalia

• Female genitalia – abnormal uterine bleeding, menorrhagia, metrorrhagia, polymenorrhea, unexplained amenorrhea, incapacitating dysmenorrhea to a degree that it causes recurrently necessary absences of more than a few hours from routine activities, endometriosis, hermaphroditism, abnormalities or defects of the genitalia such as change of sex, pseudohermaphroditism, pure gonadal dysgenesis, dysfunctional residuals from surgical correction of these conditions, menopausal syndrome if associated with more than mild constitutional or mental symptoms or artificial menopause less than 1 years duration, persistent or symptomatic ovarian cysts, acute or chronic pelvic inflammatory disease, chronic pelvic pain or unspecified symptoms associated with female genital organs, pregnancy until after 6 months after the end of the pregnancy, congenital absence of or enlargement of the uterus, genital infection or ulceration including herpes genitalia and condyloma acuminatum that is so severe it interferes with normal function, abnormal pap smear of the cervix excluding HPV or confirmed Low-Grade Squamous Intraepithelial Lesion confirmed by colposcopy or repeat cytology. 
• Male genitalia - Absence of one or both testicles due to either congenital or undescended causes, epispadias or hypospadias accompanied by evidence of a urinary tract infection, urethral stricture or dysfunction when voiding, enlargement or mass of testicle or epididymis, acute or chronic orchitis or epididymitis, amputation of penis resulting in the inability to permit normal micturition, genital infection or ulceration including herpes genitalis and condyloma acuminatum that is so severe it interferes with normal function, acute or chronic prostatitis, large or symptomatic hydrocele, painful or symptomatic left varicocele or if associtated with testicular atropy or any right varicocele, major abnormalities or defects of genitalia including sex change, hermaphroditism, pseudohermaphroditism, pure gonadal dysgenesis, or dysfunction that is residual from corrective surgery for these conditions

Urinary system

• Chronic or recurrent cystitis
• Chronic or recurrent urethritis
• Enuresis or urine incontinence after age 13
• Hematuria, pyuria or other findings indicative of urinary tract disease
• Urethral stricture or fistula
• Kidney – congenital or acquired absence of kidney, acute or chronic infection or pyelonephritis, confirmed history of polycystic kidney, horseshoe kidney, hydronephrosis, acute or chronic nephritis, proteinuria under normal activities unless consultation determines the condition to be benign orthostatic proteinuria, urolithiasis within the 12 months prior, recurrent calculus, nephrocalcinosis, or bilateral renal calculi at any time

Head

• Injuries to include severe contusions and other wounds of scalp and cerebral concussion until 3 months has passed
• Deformities of the skull, face or mandible that have not been corrected and are severe enough to prevent proper wearing of a protective mask or military headgear
• Loss or absence of the bony substance of the skull that could not be corrected successfully by reconstructive materials or leaving a defect in excess of 1 square inch

Neck

• Symptomatic cervical ribs so severe they are found on routine physical examination
• Congenital cysts of the branchial cleft origin or those developing from remnants of the thyroglossal duct with or without fistulous tracts
• Spastic or non-spastic contraction of the neck muscles or cicatricial contracture of the neck severe enough to interfere with the proper wearing of a uniform or military equipment or so disfiguring as to interfere with or prevent satisfactory performance of military duty

Heart

• All congenital or acquired valvular heart diseases including those improved by surgery except mitral valve prolapse and bicuspid aortic valve unless associated with tachyarrhythmia, mitral regurgitation, aortic stenosis, insufficiency or cardiomegaly
• Coronary heart disease
• Symptomatic arrhythmia or evidence of arrhythmia through electrocardiograph
• Supraventricular tachycardia or any arrhythmia originating from the atrium or sinoatrial such as atrial flutter and atrial fibrillation unless no recurrence during prior 2 years while of medications, premature atrial or ventricular contractions sufficiently symptomatic to require treatment or result in physical or psychological impairment
• Ventricular arrhythmias to include ventricular fibrillation, tachycardia or multifocal premature ventricular contractions with the exception of occasional asymptomatic unifocal premature ventricular contractions
• Ventricular conduction disorders to include disorders with left bundle branch block, Mobitz type II second degree atrioventricular block, third degree atrioventricular block, Lown-Ganong-Levine-Syndrome associated with an arrhythmia, Wolff-Parkinson-White Syndrome unless successfully ablated for at least 2 years with recurrence of arrhythmia and with proof of a normal current electrocardiogram
• Conduction disturbances such as first degree atrioventricular block, left anterior hemiblock, right bundle branch block, Mobitz type I second degree atrioventricular block, if they are symptomatic or associated with underlying cardiovascular disease
• Cardiomegaly, hypertrophy, or dilation of the heart
• Cardiomyopathy to include myocarditis or congestive heart failure
• Pericarditis unless symptom free for 2 years with no evidence of cardiac restriction or persistent pericardial effusion
• Persistent tachycardia with a resting pulse rate of 100 beats per minute or greater
• Congenital anomalies of heart and great vessels with the exception of corrected patent ductus arteriosus

Vascular system

• Abnormalities of arteries and blood vessels, even if corrected, to include aneurysms, atherosclerosis, arteritis
• Hypertensive vascular disease defined as the average of three consecutive sitting blood pressure measurements with a diastolic greater than 90 mmHg or three consecutive systolic pressure measurements greater than 140 mmHg, elevate blood pressure that requires medication or specific diet
• Pulmonary or systemic embolization
• Peripheral vascular disease to include Raynaud’s phenomenon
• Venous diseases to include recurrent thrombophlebitis, thrombophlebitis in the previous year, any evidence of venous incompetence such as symptomatic varicose veins, edema or skin ulceration

Height

            Men – any height below 60 inches or above 80 inches

            Women – any height below 58 inches or above 80 inches

Weight

• Applicants for initial appointment as commissioned officers including commissioned warrant officers must comply with standards of the AR 600-9, body fat composition used as final determinant for evaluation if applicant’s weight exceeds that listed in the weight tables
• All other applicants must meet standards in height and weight tables, body fat composition used as final determinant for evaluation if applicant’s weight exceeds that listed in the weight tables

Body build

• Deficient muscular development that would interfere with completion of required training could be cause for rejection

Lungs, chest wall, pleura and mediastinum

• Abnormal elevation of the diaphragm on either side, nonspecific abnormal findings on radiological or other examination of body structure such as lung field, other thoracic or abdominal organ
• Abscess of lung or mediastinum
• Acute infectious processes of the lung to include viral pneumonia, pneumococcal pneumonia, bacterial pneumonia, pneumonia infectious disease classified elsewhere, unspecified bronchopneumonia organism, unspecified pneumonia organism until disease is cured
• Asthma to include reactive airway disease, exercised induced bronchospasm or asthmatic bronchitis reliably diagnosed and symptomatic after age 13; reliable diagnostic criteria to include any of the following elements: substantiated history of cough, wheeze, chest tightness and/or dyspnea that is persistent or recurrent over periods of time generally more than 12 months, if test results are questionable then a reversible airflow obstruction test can be given
• Bronchitis, chronic or acute and lasting for 3 months and occurring a minimum of 2 times per year
• Bronchiectasis
• Unresolved bronchopleural fistula
• Bullous or generalized pulmonary emphysema
• Chest wall malformation to include pectus excavatum, pectus carinatum if interfering with rigorous physical activity
• Empyema to include unhealed sinuses of chest wall or residual pleural effusion
• Extensive pulmonary fibrosis from any cause that produce respiratory symptoms
• Foreign body in lung, trachea or bronchus
• Lobectomy, removal of more than one lobe or residual pulmonary disease
• Pleurisy with effusion within prior 2 years
• Pneumothorax occurring during the previous year if due to trauma or surgery or during 3 years prior if from spontaneous origin, recurrent spontaneous pneumothorax after surgical correction or pleural sclerosis
• Sarcoidosis
• Silicone breast implants placed less than 9 months prior or those with symptomatic complications
• Open or laparoscopic thoracic or chest wall surgery within prior 6 months
• Tuberculous lesions

Mouth

• Cleft lip or palate defects that have not been satisfactory repaired by surgery
• Leukoplakia (White spots on the tounge)

Nose, sinuses, and larynx

• Rhinitis – allergic or vasomotor rhinitis that cannot be controlled with oral medication, topical corticosteroids or desensitization
• Symptomatic or chronic conditions of the larynx to include vocal cord paralysis, chronic hoarseness, chronic laryngitis, larynx ulcerations, polyps, granulation tissues
• Anosmia or parosomia
• Epistaxis involving greater than one episode per week of bright red blood from noses occurring over a 3 month period
• Nasal polyps with the exception of those surgically corrected at least 12 months prior
• Symptomatic or progressive perforation of nasal septum
• Acute or chronic sinusitis evident by chronic purulent nasal discharge, hyperplastic changes of the nasal tissue or symptoms requiring frequent medical attention or x-ray findings
• Tracheostomy or tracheal fistula
• Deformities, conditions or anomalies of the upper alimentary tract, mouth, tongue, palate, throat, pharynx, larynx and nose that could interfere with chewing, swallowing, speech or breathing
• Chronic pharyngitis or nasopharyngitis

Neurological disorders

• Cerebrovascular conditions to include subarachnoid or intracerebral hemorrhage, vascular insufficiency, aneurysm or arteriovenous malformation
• Congenial or acquired anomalies or malformations of the central nervous system or meningocele even if uncomplicated
• Disorders of the meninges to include cysts
• Degenerative or hereditodegenerative disorders to include disorders affecting the cerebrum, basal ganglia, cerebellum, spinal cord and peripheral nerves
• History of recurrent headaches to include migraines and tension headaches severe enough to interfere with normal function within 3 years or so severe as to require prescription medication

            Head injury - History of head injury with:                 

1. Post-traumatic seizures occurring more than 30 minutes after injury
2. Late post-traumatic epilepsy occurring more than one week after injury
3. Persistent or permanent motor or sensory deficits
4. Impairment of intellectual function
5. Alteration of personality
6. Central nervous system shunt

Applicants who suffered a severe head injury are considered unfit for a period of 5 years following injury at which time a complete neurological and neurophysical evaluation showing no residual dysfunctions or complications are present must be completed to provide evidence of being fit for consideration, applicants who suffered a severe penetrating head injury are considered unfit for a period of 10 years following injury at which time a complete neurological and neurophysical evaluation showing no residual dysfunctions or complications are present must be completed to provide evidence of being fit for consideration.  Severe head injuries are defined by one or more of the following:

• Unconsciousness, amnesia or disorientation of person, place or time alone or in combination, of 24 hours duration or longer
• Decompressed skull fracture, multiple fractures involving the skull or face
• Cerebral laceration or contusion
• Epidural, subdural, subarachnoid or intercerebral hematoma
• Associated abscess or meningitis
• Cerebrospinal fluid rhinorrhea or otorrhea lasting more than 7 days
• Focal neurologic signs
• Radiographic evidence of retained foreign body or bony fragments secondary to trauma and/or operative procedures on the brain
• Leptomeningeal cysts or arteriovenous fistula
• Early post-traumatic seizures occurring within 1 week of the injury but also more than 30 minutes after the injury occurred
• Applicants suffering from moderate head injury are considered unfit for a period of 2 years following injury at which time a complete neurological evaluation showing no residual dysfunctions or complications are present must be completed to provide evidence of being fit for consideration. Moderate head injuries are defined as:  unconsciousness, amnesia or disorientation of person, place or time alone or in combination of more than 1 hour and less than 24 hour duration following the injury, or linear skull fracture
• Applicants suffering from mild head injury are considered unfit for a period of 1 month following injury at which time a complete neurological evaluation showing no residual dysfunctions or complications are present must be completed to provide evidence of being fit for consideration.  Mild head injuries defined as: period of unconsciousness, amnesia or disorientation of person, place or time alone or in combination of 1 hour or less following the injury
• Persistent post-traumatic symptoms of a degree to interfere with normal activities or having a duration of more than 1 month are disqualifying until complete neurological and neuropsychological evaluation confirm a full recovery has been made.  These symptoms include headache, vomiting, disorientation, spatial disequilibrium, impaired memory, poor mental concentration, shortened attention span, dizziness, altered sleep patterns or any findings consistent with organic brain syndrome
• Infectious disease – acute infectious processes of the central nervous system to include meningitis, encephalitis, brain abscess or poliomyelitis within 1 year prior to examination or if residual neurological defects are present, any form of neurosyphilis to include paresis, tabes dorsalis or meningovascular syphilis
• Narcolepsy or sleep apnea syndrome
• Paralysis, weakness, lack of coordination, chronic pain, sensory disturbance or other specified paralytic syndromes
• Epilepsy occurring after the 6^th birthday with the exception of applicants that have been seizure free for 5 years without medication and have a normal electroencephalogram.  Current neurology consultation and current electroencephalogram will be required.
• Chronic nervous system disorders to include myasthenia gravis, multiple sclerosis and tic disorders
• Retained central nervous system shunts of all kinds

Disorders with psychotic features

• Schizophrenia, paranoid disorder and other unspecified psychosis

Neurotic, anxiety, mood, somatoform, dissociative or factitious disorder

• Mood disorders including major depression, bipolar, affective psychoses, depressive not otherwise specified
• Adjustment disorders within the prior 3 months
• History of anxiety disorders, panic, agoraphobia, social phobia, simple phobias, obsessive-compulsive, other acute reactions to stress and post-traumatic stress disorder
• Dissociative disorders to include hysteria, depersonalization
• Somatoform disorders to include hypochondriasis, or chronic pain disorder

History of disorders resulting in any of the following:

• Admission to hospital or residential facility
• Care by a physician or other mental health professional for more than 6 months
• Symptoms or behavior of a repetitive nature that impair social, school or work efficiency

Learning, psychiatric and behavior disorders

• Attention Deficit Dsorder/Attention Deficit Hyperactivity Disorder or Perceptual/Learning disorders with the exception of those applicants who can demonstrate passing academic performance and there has been no use of medication in the 12 months prior
• History of academic skills or perceptual defects secondary to organic or functional mental disorders to include dyslexia that interferes with school after age 12 or employment; applicants able to show passing academic and employment performance without utilization or recommendation of academic and/or work accommodations at any time in the 12 months prior
• Conduct or behavior disorders that involve recurrent encounters with law enforcement agencies, antisocial attitudes or behaviors give tangible evidence of impaired capacity to adapt to military service
• Personality disorder demonstrated by repeated inability to maintain reasonable adjustment in school, with employers or fellow workers or other social groups as shown through interview or psychological testing revealing a degree of immaturity, instability, personality inadequacy, impulsiveness or dependency will likely interfere with the adjustment in the Armed Forces
• Other behavior disorders to include enuresis or encopresis after the 13^th birthday, sleepwalking after the 13^th birthday, eating disorders such as anorexia, bulimia or unspecified eating disorder lasting greater than 3 months
• Receptive or expressive language disorder to include speech impediment, stammering and stuttering of such degree as to significantly interfere with production of speech or to repeat commands
• History of attempted or suicidal behavior including gestures and self-mutilation
• Psychosexual conditions to include transsexualism, exhibitionism, transvestism, voyeurism and other paraphilia
• Alcohol dependence, drug dependence, alcohol abuse other drug use
• Other mental disorders that in the opinion of the civilian or military provider will interfere with or prevent satisfactory performance of military duty

Skin and cellular tissues

• Disease of the sebaceous glands to include severe acne if extensive involvement of the neck, shoulders, chest or back is present and could possibly be aggravated by or interfere with properly wearing military equipment and is not amenable to treatment.  Applicants using isotretinoin (Accutane) are not medically until 8 weeks after treatment is concluded
• Atopic dermatitis or eczema with residual or active lesions in areas of the face, neck, antecubital and or popliteal fossae or occasionally wrists after the 9^th birthday
• Contact dermatitis especially when it involves materials such as rubber used in protective equipment
• Cysts – current cysts, other than pilonidal, where the size and location would interfere with proper wearing of military equipment, current pilonidal cysts made evident by the presence of a tumor or mass or discharging sinus or those surgically resected that are symptomatic, unhealed or less than 6 months post-operative
• Dermatitis factitia
• Bullous dermatoses to include dermatitis herpetiformis, pemphigus and epidermolysis bullosa
• Chronic lymphedema
• Systemic or superficial types of fungus infections that interfere with proper wearing of military equipment or performance of military duties
• Furunculosis or carbuncle either extensive, recurrent or chronic
• Chronic or sever hyperhidrosis of hands or feet
• Ichthyosis or congenital or acquired anomalies of the skin to include nevi or vascular tumors interfering with function or exposed to constant irritation; history of Dysplastic Nevus Syndrome
• Keloid formation if the tendency is marked or interferes with proper wearing of military equipment
• Any type of leprosy
• Lichen planus
• Neurofibromatosis, von Recklinghausen’s disease
• Photosensitivity to include primary sun-sensitive conditions such as polymorphous light eruption or solar urticarial, any dermatosis aggravated by sunlight such as lupus erythematosus
• Psoriasis with the exception of mild cases that do not interfere with wearing military clothing or equipment
• Radiodermatitis
• Scars of such an extensive, deep or adherent nature that they may interfere with the wearing of military clothing or equipment, exhibit a tendency to ulcerate or interfere with function.  This includes scars at skin graft donor or recipient sites if the area is susceptible to trauma
• Extensive scleroderma
• Tattoos prohibited under AR 670-1 or that limit the effective performance of military service
• Chronic or recurrent urticaria
• Symptomatic plantar warts
• Xanthoma that is disabling or accompanied by hyperliopemia
• Any chronic skin disorder so severe as to require frequent outpatient treatment or hospitalization or that would interfere with satisfactory performance of duty

Spine and sacroiliac joints

• Arthritis
• Ankylosing spondylitis or other inflammatory spondylopathies
• Disease, injury or condition of the spine or sacroiliac joints with or without objective signs that prevent the individual from successfully following a physically active vocation in civilian life or is associated with local or referred pain to extremities, muscular spasm, postural deformities or limitation of motion, require external support, require limitation of physical activity or frequent treatment
• Deviation or curvature of the spine from normal alignment, structure or function if:  it prevents the individual from following a physically active vocation in civilian life, interferes with wearing a uniform or military equipment, is symptomatic, there is lumbar scoliosis greater than 20 degrees, thoracic scoliosis greater than 30 degrees, or kyphosis and lordosis greater than 55 degrees when measured using the Cobb method
• Congenital fusion of more than two vertebral bodies, any surgical fusion of spinal vertebrae
• Fractures or dislocation of vertebrae with the exception of a compression fracture involving less than 25 percent of a single vertebra that occurred more than 1 year prior and is asymptomatic or fractures of the transverse or spinous processes that are asymptomatic
• Juvenile epiphysitis with any degree of residual change evident by x-ray or kyphosis
• Herniated nucleus pulposus or surgery to correct this condition
• Spina bifida when symptomatic or if more than one vertebra level involved or with dimpling of the overlying skin, history of surgical repair
• Congenital or acquired spondylolysis and spondylolisthesis

Systemic diseases

• Disorders involving the immune mechanism including immunodeficiencies, presence of Human Immunodeficiency Virus or serologic evidence of infection, positive Enzyme-Linked Immunoabsorbent Assay tests for HIV with ambiguous or inconclusive results on Western Blot testing
• Amyloidosis
• Ankylosing spondylitis
• Histiocytosis X spectrum with the exception of eosinophilic granuloma when occurring as a single localized bony lesion and not associated with soft tissue once healing has occurred.
• Lupus erythematosus or mixed connective tissue disease variant
• Polymyositis/dermatomyositis complex
• Progressive systemic sclerosis including CRST variant with the exception of a single plaque of localized sclerodoerma that has been stable for at least 2 years prior
• Reiter’s disease
• Rheumatoid arthritis
• Sarcoidosis unless concrete evidence of complete spontaneous remission of at least 2 years long
• Sjogren ’s syndrome
• Vasculitis to include polyarteritis nodosa and allied conditions, arteritis, Behcet’s and Wegner’s granulomatosis
• Tuberculosis – active in any form or location in the previous 2 years regardless of treatment, one or more reactivations, residual physical or mental defects from past tuberculosis that will prevent the satisfactory performance of duty;  individuals with past history of tuberculosis greater than 2 years before enlistment and having received a complete course of standard chemotherapy for tuberculosis are qualified to enlist along with individuals with a tuberculin reaction 10 mm or greater without evidence of residual disease in pulmonary or non-pulmonary sites who have received chemoprophylaxis are qualified for enlistment
• Untreated latent tuberculosis evident by positive Purified Protein Derivative with negative chest x-ray
• Untreated syphilis
• Anaphylaxis to include idiopathic and exercise-induced, to venom, insect stings, foods or food additives, natural rubber latex
• Residuals of tropical fevers to include malaria, various parasitic or protozoan infestations that prevent satisfactory performance of military duty
• Sleep disturbances such as sleep apnea
• Malignant hyperthermia
• Industrial solvent or other chemical intoxication
• Motion sickness after the 12^th birthday resulting in recurrent incapacitation symptoms so sever to require pre-medication in the 3 years prior
• History of rheumatic fever
• Muscular dystrophies or myopathies
• Rhabdomyolysis
• Systemic fungus infections

General and miscellaneous conditions and defects

• Acute pathological condition to include acute communicable diseases until recovery has occurred without residual effects         
• Chronic metallic poisoning with lead, arsenic, silver, beryllium or magnesium
• Cold injuries such as those that are residuals of frostbite, chilblain, immersion foot, trench foot, deep-seated ache, paresthesia, hyperhidrosis, easily traumatized skin, cyanosis, amputation of any digit or ankylosis
• Cold urticaria and angioedema, hereditary angioedema
• Symptomatic or carrier states of parasitic conditions such as filariasis, trypanosomiasis, schistosomiasis or uncinarias
• Heat pyrexia, heatstroke or sunstroke – evidence of predisposition to include disorders of sweat mechanism and previous severe episode, recurrent episodes where medical attention was required or residual injury especially cardiac, cerebral, hepatic and renal, malignant hyperthermia
• Mycotic infection of internal organs
• Organ transplant recipient
• Rheumatic fever within the 2 years prior, history of recurrent attacks, Sydenham’s chorea at any age

Tumors and malignant diseases

• Benign tumors or conditions that interfere with function or prevent the proper wearing of the uniform or protective equipment or those that require frequent specialized attention or have a high malignant potential such as Dysplastic Nervus Syndrome
• Malignant tumors with the exception of skin cancer (basal cell carcinoma) that is removed with no residual side effect could be eligible to enlist

Miscellaneous

• Any condition that in the opinion of the medical officer will significantly interfere with the successful performance of military duty or training