Future Marines recite the oath of enlistment before shipping off to begin basic training at Marine Corps Recruit Depot San Diego at Military Entrance Processing Station Salt Lake City, Utah, on Oct. 24, 2022. MEPS processes applicants for military service, putting them through a variety of tests and examinations to ensure that they meet the standards required to serve in the armed forces. (Lydia Gordon/U.S. Marine Corps)
A recruiting pilot program that uses medical data collected on service members through the Pentagon’s new health information system could change enlistment policies on up to 38 health conditions that now disqualify people from military service, defense officials said.
The pilot program includes 38 health conditions that require the military to waive it as disqualifying for service, with the most notable being a diagnosis of attention deficit hyperactivity disorder, or ADHD, said Lin St. Clair, deputy director of the Defense Department’s accession policy directorate. Nearly 900 recruits have enlisted in the last nine months with the diagnosis.
Many of those affected are typically still able to join the military but doing so without the medical waiver would create a more efficient enlistment process for those impacted, officials said.
Other conditions included in the pilot program, such as specific eye conditions, have time frames of three, five or seven years in which a recruit must not take medication or show symptoms of the condition.
“We want to make sure that those time standards that we're using don't have an adverse impact on the individual once they get the basic training and into their units,” St. Clair said.
In March, the Defense Department employed a new health information system called Genesis at all 67 military processing stations. Genesis improves the department’s ability to track the recruits as they move through the service because it holds all medical records in one digital location.
Using the records, the Pentagon can monitor service members who enlisted under the pilot program to see whether they completed their initial enlistment contract, which is typically about four years.
Because of that, it will be at least another year before officials will have data to review about the recruits admitted through the pilot program, St. Clair said.
“We continuously review accession medical standards. This is more data for us to then take a look at those standards and see if they shouldn't be disqualified," he said.
The review comes as the Defense Department looks to recover from a difficult year in recruiting in 2022. The Army missed its recruitment goal by about 15,000 soldiers, according to the service. The Air Force, Navy and Marine Corps met their goals, but service officials have expressed concern about doing so in the new fiscal year, which began Oct. 1.
Military entrance stations conducted 215,000 medical exams in fiscal 2022, which ended Sept. 30, according to the Defense Department. Of all applicants, nearly 30% are disqualified during the exam. That drops to just 16% denied once medical waivers are applied.
While recruits typically could receive a waiver for the conditions in the pilot program, enlisting without the waiver could speed up the process. St. Clair said any obstacle to enlistment, such as locating medical paperwork and scheduling consultations with specialists, which are necessary for the military to waive a disqualifying condition, can cause a potential recruit to give up or lose interest. These things can also take more time since the coronavirus pandemic has stretched medical offices thin and wait times can be longer than they were before the pandemic.
The Rand Corp. published a report in 2021 that looked at whether military recruits who did receive a waiver for ADHD, anxiety or depression had different outcomes than those without a diagnosis. The think tank found recruits seeking waivers did not have a higher likelihood of dropping out than other recruits.
However, if they did leave the service, it was more often related to health reasons than other recruits, said Beth Asch, a senior economist who specializes in defense manpower issues and who authored the report.
“I think it's imperative, frankly, that they revisit these standards, because there's so many of them,” she said. "Medicine is changing, our understanding of treatment is changing, our understanding of diseases is changing and understanding of what people are capable of doing with those conditions, and their performance is changing.”
