# Medical Condition and Geographic Factor



## brian8225 (23 Aug 2012)

Hi all,

I had my medical recently for pilot, and there is an item on my history that got the med tech's attention (bad news). Essentially, I have an increased risk of cancer and should see a doctor once a year, however this condition would take 3-5 years of me not being seen by a doc to even have a _chance_ or becoming an issue, and has no impact on my physical/mental health. I would assume I'm getting a G2 rating which is fine, but what I really want to avoid is being found unfit for service altogether. I do currently have rated 20 year life insurance, so I'm not knocking on death's door and my insurance co doesn't think I'm going to croak in the next 20 years   I applied knowing this was going to be a possible issue, fully disclosed it with the med tech, and knew when I hit "apply" that even if I was a rockstar candidate that this could be the kiss of death for my app.

Based on the brief chat with the med tech, his best guess was that this was a 50/50 chance of me being found unfit. I've read about people being enlisted post-cancer (I've never had cancer) and would guess I fit into a similar risk profile of someone that needs to be assessed periodically but wouldn't have an issue being deployed for 6 months + or, worst case, get stranded in some remote part of the world for over a year with zero access to treatment/care.

Like I said, this is nothing that has any impact on my ability to do the job or would put myself/someone in harm's way or shorten my career/life span, or I wouldn't be applying in the first place. Not head/spine/major organ related, so I'm not going to spontaneously grow a brain tumor and have a seizure/black out.

I have a physician letter to get filled out, but I'm wondering if there is anything else I can do to help my case? Full doctor's reports from any diagnostic/treatment activities were recommended, and I was also wondering about including the following in the package I send back:

1) Medical journal excerpts
2) Recent articles on the topic
3) Other international guidance on the topic, e.g. American Medical Association guidance/prognosis

Thoughts?


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## Blackadder1916 (23 Aug 2012)

brian8225 said:
			
		

> I have a physician letter to get filled out, but I'm wondering if there is anything else I can do to help my case? Full doctor's reports from any diagnostic/treatment activities were recommended, and I was also wondering about including the following in the package I send back:
> 
> 1) Medical journal excerpts
> 2) Recent articles on the topic
> 3) Other international guidance on the topic, e.g. American Medical Association guidance/prognosis



What makes you think that the physicians (including highly qualified specialists) that will review your medical history are not already familiar with those same medical jourrnal excerpts, recent articles or other international guidance?  Surprise, not only will they have likely read them (or will to refresh their memory if your condition is obsure), they may have been the authors of some of those papers.  Do what is asked of you.  Have your doctor provide the information that is requested.  He is also a professional who (most likely) has done this many times before.  Your situation is not that unusual.


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## The_Falcon (23 Aug 2012)

Personal issues, especially medical ones can only be dealt with the people who actually have access to your particulars.  If you have concerns, bring it up with the medical staff at the RC.  If you are being told you are unfit for your trade there are appeal mechanisms in place, and additional paperwork you will be given.  Be prepared to accept the fact that the regulations/guidelines we have in place are there for a reason, and ultimately you may be disqualified no matter what.


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## brian8225 (23 Aug 2012)

Thanks for the replies. I understand I am not a unique, special nor was I questioning the competency of the folks that review the files or the prescribed medical standards which are there for a good reason. This is a similar question to someone asking about the general application/interview process. No one says you need to wear a suit and tie to an interview, but there probably are things that can give you an edge throughout this process.

I was told by the RC - "the more detail, the better". If I can give someone more information up front so they don't have to waste their time digging for it, that seemed like a logical step to take. This condition is very rare, my family doc and specialist had not seen it before, so my question was simply what else can I do to help myself present a better case. If the correct answer is a letter + physician reports and nothing more, then that's what I will do. 

Thanks.


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## bridges (23 Aug 2012)

Blackadder1916 said:
			
		

> What makes you think that the physicians (including highly qualified specialists) that will review your medical history are not already familiar with those same medical jourrnal excerpts, recent articles or other international guidance?  Surprise, not only will they have likely read them (or will to refresh their memory if your condition is obsure), they may have been the authors of some of those papers.  Do what is asked of you.  Have your doctor provide the information that is requested.  He is also a professional who (most likely) has done this many times before.  Your situation is not that unusual.



Agreed, although I think he can be forgiven for guessing (correctly, in my experience) that current best practices sometimes take a while to be integrated into policy.  There may be a reason for that, in many cases.  

I'd include all that they've asked for, plus the supplementary corroborating info (articles, external orgs' guidelines, etc.) as an annex.  Might as well make your best case up-front.


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## Adam (23 Aug 2012)

"I have an increased risk of cancer and should see a doctor once a year"    

Let me start by saying that I am not a Dr. and this is just my personal opinion.  But I am not sure why having to see a Doctor once a year would change your Geographical Factor from a G2 to  G3.

 All primary Air Crew are required to do either a short or long medical annually?   However if you are required to have special testing done each year like a Colonoscopy, that may damper your ability to deploy?


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## Blackadder1916 (23 Aug 2012)

bridges said:
			
		

> I'd include all that they've asked for, plus the supplementary corroborating info (articles, external orgs' guidelines, etc.) as an annex.  Might as well make your best case up-front.



And I'd disagree.  Based on the details provided by the OP, there has been no decision on his medical category, they have rather routinely requested further details about a specific medical condition.  What they most likely want *from the physician currently treating him* is a diagnosis, history of the condition and past diagnotic procedures/tests/results, any limitations resulting from the condition, the expected prognosis and the current/planned course of treatment (if any).  

At this stage of the process, they are likely (in my experience which I will grant is dated) only seeking *the unbiased professional input of one physician to another*.  If the reporting physician felt that it was necessary to include some of the contemporary literature and refer to it in his report (as a normal course in its preparation), that is one thing.  For the applicant to include "his selection" of contemporary literature about his condition would be seen in a whole different light (not always negatively, but they may not add anything to the process at this time).  If the condition is as obscure and rare as the OP states, then the RMO will likely research the standard texts and databases to confirm that the reporting physician is not out to lunch.  If there would be some question about assigning a lower category based solely on this rare condtion then the RMO will likely refer the matter to higher medical authority for an opinion.  

If the answer is unfavourable, the applicant does have some avenues to appeal the decision and can tailor his response to address the specific points of the decision.   However, if he has already unsuccessfully used his "current literature" arguments then it limits where he goes next.


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## bridges (23 Aug 2012)

Sure, that'd work too.     :nod:

The most important thing is providing the stuff they've asked for.


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## brian8225 (23 Aug 2012)

Blackadder - thanks kindly for your input and experience. I'll consult my physician and provide the letter/reports and not try too hard to sell it by adding extra info that I think is relevant, because factually, no one cares what I think and you make an extremely good point about trying to tell someone who is a professional what they should be looking at when they probably have this figured out by now. He did explain the appeal process and that I may get a letter suggesting what I need to do to rectify the situation, so the appeal/remediation piece is still on the table even if a letter comes back.

Adam - my opinion is that this should be a non-issue, but like the comment above, my opinion is irrelevant . The med tech made it clear this is an issue that can impact my application, so I just want to handle it as such and do what I can to get my app through. The good news is that he still sent me off to get letters and my eyes checked, so if I was totally pooched I'd probably know by now and 50/50 odds are better than just getting sent home.

Thanks again to all for the feedback.


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## The_Falcon (24 Aug 2012)

The Med Tech (most likely a PA) doesn't make the final determination, all files must go to the RMO.


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## brian8225 (27 Aug 2012)

Hatchet Man said:
			
		

> The Med Tech (most likely a PA) doesn't make the final determination, all files must go to the RMO.



I was told it would take approx 4-6 weeks for the RMO review to be completed after I submit my info. It's likely going to take me longer than 30 days to get my letters, specialists are tricky to get a hold of and I'm already on cancellation lists to try and get in sooner. Family doctor was easy and he's drafting that letter already. The med tech is aware and OK if I call him before the due date to request an extension if I need it, but hopefully I can avoid having to make that call.

I'm guessing 3-4 months total to clear this hurdle. Long process, so it's time to hurry up and wait.

Thanks again for the feedback folks.


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## Eye In The Sky (27 Aug 2012)

Hatchet Man said:
			
		

> The Med Tech (most likely a PA) doesn't make the final determination, all files must go to the RMO.



And the AF must be assessed by AUMB (Aerospace Undersea Medical Board) as well @ DRDC, only AUMB can assign AF required for flying duties.  Extra step/hurdle.


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## The_Falcon (27 Aug 2012)

Eye In The Sky said:
			
		

> And the AF must be assessed by AUMB (Aerospace Undersea Medical Board) as well @ DRD, only AUMB can assign AF required for flying duties.  Extra step/hurdle.



Yeah that too, forgot about them


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## brian8225 (27 Aug 2012)

Hatchet Man said:
			
		

> Yeah that too, forgot about them



I'm just hoping to avoid getting a letter from the RMO saying I'm unfit period, will worry about aircrew factor later.


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## medicineman (27 Aug 2012)

To get below G2, you'd need to have a problem that needs to be followed up more frequently than every year or isn't stable or requires ongoing specialist care that precludes you from leaving where you are.  Since you don't actually have the condition, just need annual screening, IMHO, you'd be good for a G2.

MM


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## brian8225 (31 Jan 2013)

Bad news, got a letter stating I fail the universality of service requirement. Not sure if it's due to the need for follow-up or the nature of the condition, but this is likely a tough one to get past. Time for a call to the med tech =/


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## Eye In The Sky (1 Feb 2013)

It didn't state why you didn't meet the UOS, just that you didn't?


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## brian8225 (1 Feb 2013)

It wasn't clear if it was due to the inherent risk associated with the condition or the need for follow-up/monitoring, or a combination of both.


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## ArmyGuy99 (1 Feb 2013)

brian8225,

Sorry to hear about your letter from the RMO.  Do not be discouraged though.  As stated before there is an appeal process.  Read the letter carefully, in it it will state exactly why you do not meet UoS.  You stated earlier that you still need to wait 3-5yrs to be medically clear of the CA.  perhaps that is the reason and you will have to wait.   I do not know, I have not seen your file and I have not worked the medical side of recruiting in a number of years.

Be patient, hang in there.  If you are not sure, contact the Medic/PA/Sgt at the Medical Section of the Recruiting Center and speak to them about it, they are the SME's and can explain it to you.  Speaking from experience.  Go in person if you can, bring the letter.  They have a copy, but it's been filed already.  They will be able to explain what you will need to challenge the decision and how long you will have to wait.

Good Luck, Don't Give Up


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## Eye In The Sky (1 Feb 2013)

MedTech32 said:
			
		

> brian8225,
> 
> Sorry to hear about your letter from the RMO.  Do not be discouraged though.  As stated before there is an appeal process.  Read the letter carefully, in it it will state exactly why you do not meet UoS.  You stated earlier that you still need to wait 3-5yrs to be medically clear of the CA.  perhaps that is the reason and you will have to wait.   I do not know, I have not seen your file and I have not worked the medical side of recruiting in a number of years.
> 
> ...



 :goodpost:   Posts like these on this site are one of the things that make it awesome.


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## ArmyGuy99 (4 Feb 2013)

:-[

Just trying to be nice, like my mommy taught me.  Besides my RTW plan only has me working 3 days /week.  I gotta do something constructive. ;D


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## brian8225 (7 Feb 2013)

MedTech32 said:
			
		

> brian8225,
> 
> Sorry to hear about your letter from the RMO.  Do not be discouraged though.  As stated before there is an appeal process.  Read the letter carefully, in it it will state exactly why you do not meet UoS.  You stated earlier that you still need to wait 3-5yrs to be medically clear of the CA.  perhaps that is the reason and you will have to wait.   I do not know, I have not seen your file and I have not worked the medical side of recruiting in a number of years.
> 
> ...



Going back and reading it again, there's actually a mistake in their conclusion as they linked me to the wrong diagnosis. Basically, they noted I have Condition A which is a byproduct of something that was suspected in early reports that I submitted but later refuted, and is far more terrible than what I actually have.  I am guessing I will need a new letter that more explicitly states what it actually is, as Condition A that they have in here isn't even a real condition, and the linkage to the something more terrible is wrong. I've had genetic testing done, and the testing for the more terrible option was negative and also is contradictory to my medical history. Again when I say this is rare, this is something that most oncologists wouldn't know about without doing supplemental research.

What I do have still results in higher risk than the rest of the world and requires periodic followup, so I could still be hooped either way. It is a significant difference though of "may get cancer by about age 65" vs. "90% chance of cancer by 40 without major surgery".

I called my med tech and he still haven't received the file back from the RMO, so I'll see what he thinks tomorrow when we're scheduled to talk again.

If I can get a letter stating: 

1) Followup is ideally annual, but can go be long as 3+ years without an increase in risk to myself or others, and
2) The condition isn't the terrible one but something that just increases the risk profile of the person,

would that satisfy the UOS requirement, or is the "need for followup" a black/white thing with no out?


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