From: To: WW5: W93 ESE ll HSHEECCH l' I I mm: W: was: Cc: W: WES): Sterngmann. ?352mg: 1 959 USMEEQQM Eangig. Linda A QSQ USMEPCQM Subject: INFO- 17- OQSEP- 213 (New USAREC Waiver Policy and Supplemental Guidance) (UNCLASSIFIED) Date: Monday, September 25 2017 11: 57: 39 AM Attachment!? Wm Attachment 3 (Adjustment of Meg?igal ?aw ansiggm?gg naming: INFORMATION MESSAGE INFO-1 7-09SEP-213 FROM: Commander, USMEPCOM (J SUBJECT: New USAREC Waiver Policy and Supplemental Guidance for Regular Army (RA) and Army Reserve (AR) Applicants TO: Sector Commanders Battalion Commanders MEPS Commanders MEPS Chief Medical Of?cers/Assistant Chief Medical Of?cers MEPS Medical Supervisory Medical Technicians Directors and Special Staff Of?cers References: USAREC Message (UM) 17-070 - Removal of Suspended Waivers for Regular Army (RA) and Army Reserve (AR) (attachment 1) Ops Flash-Supplemental Guidance for UM 17-070 (attachment 2) Adjustment of Medical Waiver Consideration Memorandum (attachment 3) The purpose of this message is to inform MEPS Medical Departments of the recently published USAREC message which changes current waiver restrictions and makes operational changes to USAREC Regulation (UR) 601-210, Enlistment and Accessions Processing, and the Supplemental Guidance issued by the Waivers Branch Chief. Changes to the USAREC waiver policy are highlighted as follows: 1. Self-mutilation, non-isolated mood disorders, and drug and alcohol abuse have been removed from non-waiverable status. Prior policy dictated waivers would never be granted for these conditions. 2. These conditions will still require clearance and supporting documentation for a waiver to be considered. 3. Comment: Removal of these conditions from non-waiverable status does not change their quali?cation or disquali?cation status as per 6130.03, Medical Standards for Appointment, Enlistment, or Induction in the Military Services. They do not impact clinical documentation or decision making as to whether or not an applicant meets accession medical standards. The Supplemental Guidance to UM 17-070 is highlighted as follows: 1. The removal of self-mutilation, non-isolated mood disorders, and drug and alcohol abuse from ?never waiver/suspended? status only means that a waiver may now be ?considered.? 2. ?Appropriate documentation? to support waiver consideration for a self~ mutilation disquali?cation (DQ) will include: a. A detailed statement from the applicant b. Supporting medical records c. Evidence from an employer if the injury was job-related d. Photographs (submitted by the recruiter) e. evaluation and ?clearance? 3. The evaluation may be accomplished through USMEPCOM but ?civilian? evaluation may also be required. 4. ?For all waivers, the burden of proof is on the applicant to provide a clear and meritorious case for why a waiver should be considered.? 5 . Comments: a. Neither UM 17-070 (Attachment 1) nor the Supplemental Guidance (Attachment 2) state that the MEPS are now required to order consults on all cases disquali?ed for self-mutilation. However, since self-mutilation may now be considered for a waiver, the Service Medical Waiver Review Authority (SMWRA) may request a consultation after they review the disquali?ed applicant?s packet. This is no different from the current process, for example, a request for an orthopedic consult for an applicant disquali?ed for a shoulder dislocation or a request for a methacholine challenge test for an applicant disquali?ed for a history of asthma. b. Each SMWRA request for a consultation will continue to be reviewed by the CMO on a case-by-case basis. The CMO should consider a request for a consult as they would any other request by the SMWRA and continue to follow guidance in UMR 40-1, 11-3.c., SMWRA Consultation/Ancillary Services Requests. If issues arise at any point during this process, contact or submit a MOC ticket. c. As there is now a chance that an applicant with a history of self- mutilation, mood disorder, or substance abuse may be granted a waiver, it is not unreasonable to get a consult to evaluate the applicant for current mood or personality disorder/instability and/or current substance use disorder. d. The purpose of the consult would not be to con?rm or refute the self?mutilation, mood disorder, or substance abuse, nor would it be to ?clear? the applicant for military service. The purpose would be to assess the applicant?s current mental status/stability and prognosis. e. USMEPCOM?designated physicians are the medical authority for determining if an applicant processing with USMEPCOM meets the requirements of Title 10 to be quali?ed, effective, and able-bodied prior to enlistment (UMR40-1, 1-1). Only the MEPS physician, not the consultant, can decide if the applicant is medically quali?ed under accession medicine standards. The MEPS physician should make their decision based on their careful physical exam, their understanding of self-mutilation, and DSM5 criteria for mood and substance-related disorders. i. A Self-mutilation Assessment tutorial PowerPoint presentation is available on SPEAR under the -7/Standardized medical Processing tab if needed for reference. ii. Most MEPS have a hard copy of the DSM5 available for reference. Online access to the DSM5 is available through the AMEDD Virtual Library (AVL) license. Please contact -7 if you need assistance obtaining online access. f. UMR 40?1, 3-13 is still in effect re: photographing medical conditions. No photographing of medical conditions by MEPS personnel is permitted. Any photographs submitted in accordance with (IAW) UM 17-070 must be submitted by the Services following the instructions that have been provided to them in the Supplemental Guidance to UM 17-070. g. consult may be interpreted as either or consult, depending on the resources available to the individual MEPS. If the SMWRA requests the applicant obtain a ?civilian? consult, this must be done at the applicant?s own expense on the applicant?s own time. The MEPS are not to arrange these for the applicant nor are they to pay for them. h. As the Supplemental Guidance to UM 17-070 makes clear, ?For all waivers, the burden of proof is on the applicant to provide a clear and meritorious case for why a waiver should be considered.? POCs are: 0 Dr. Alexia Gordon, J- (847) 688- 3680, ext7130, e- -mail 0 Mr. Kelvin Rama, (847) 688- 3680, ext7l33, mail kelvi11,ram a.c1y@ madam! 0 Ms. Lorene Roth, (847) 688-3680, ext 7134, e-mail e1 ?1 imp 1 ml 0 Mr. Derrick Scott, (847) 688- 3680, ext 7147, e- ~mail ck 1 I 0 Mr. T..J Sternemann, J- (847) 688- 3680, ext7l35, e- -mail 11 (7 1 i CLASSIFICATION: UNCLASSIFIED Attachment 1 (UM 161600 August 2017 (EST) USAREC MESSAGE 17?070 From: Headquarters USAREC To: A11 Recruiting Personne1 Remova1 of Suspended Waivers for Regu1ar Army (RA) and Army Reserve AR . NOTE: Current open and c1osed_categories are avai1ab1e at: and are a1so pub1ished dai1y on the Mission Accomp1ishment Report. 1. Suspension of en1istment waivers has been updated. 2. Operationa1 change to AR 601?210: a. Chapter 4?13c: Added a waiting period of 90 days and changed waiver authority 1eve1 to from CG USAREC to Recruiting Bn Commander. Change 4?13c to read, ?If app1icant was separated from any component of the U.S. Armed Forces for any reason 1isted in this paragraph, a waiver may not be submitted unti1 a 90?day waiting period has e1apsed after the date of separation. The waiver authority is the Recruiting Batta1ion Commander for RA and b. Chapter 1) Positive marijuana and a1coho1 waiting period has changed from "6 months? to ?45 days". 2) $011ow chapter 4?18 for waiting periods for other positive drug resu ts. 3. Current waiver restrictions has changed. a. Nonwaiverab1e conditions/separations: see AR 601-210, chapter 4?7d, 4?22, and 4?23. b. A11 conduct waivers wi11 be considered under the who1e?person concept and based on the overa11 merit of the app1ication. 4. Operationa1 change to UR 601?210, a. Remove Se1f?muti1ation, Non?iso1ated mood disorders, and Drug and a1coho1 abuse. b. A1though these_medica1 conditions were removed from the nonwaiverab1e status, these conditions w111 st111 require appropriate c1earance and supporting documents. 5. POC through the chain of command is EEPD waivers Branch, at (800) 688-9203, Option 5 6. References: a. AR 601?210, Regu1ar Army and Reserve components En1istment Program, dated 31 August 2016. b. Memorandum For Record from Director, Mi1itary Personne1 Management (DMPM) Subject: Adjustment of En1istment Waiver Authority, 16 AUG 2017. c. UR 601-210, En1istment and Accessions Processing, dated 1 March 2015 W1th Rapid Action Revision Issue Date 3 January 2017. James H. Jensen, COL, AR, Assistant Chief of Staff, 6?3 Page 1 Attachment 1 (UM For OfficiaT Use 0n1y (FOUO) Page 2 Subject: FLASH SUPPLEMENTAL GUIDANCE FOR UM Sent: Thursday August 17, 2017, 2017 12:34 PM BDE Ops, Please disseminate to the lowest level. 1) The purpose ofthis message is to clarify certain aspects of UM 17-070. In paragraph 2, the only change was to chapter 4-13c (not the entire 4-13). 4-13a and 4-13b remain HQ-level waivers. 2) Paragraph 3a lists areas of the regulation where you can find waivers that remain suspended. In other words, follow the regulation to determine ifa waiver can be processed or is nonwaiverable. 3b is simply a reminder thatjust because a category is open, there still must be a meritorious case, and the waiver must make sense for the Army. 3) Paragraph 4a and 4b. It is true these conditions were removed from a "never waiver/suspended" status. All this means, is they can now be considered. "ApprOpriate documentation" to overcome a self- mutilation D0 will include a detailed statement from the applicant, supporting medical records and/or evidence from employer that it was job-related (if applicable), photographs, and evaluation and clearance. When uploading photos, they must be clearly labeled with the area of body outside area of right forearm or inside portion of left wrist), applicant's name and and the date/time the photo was taken. Do not take/provide any photographs of intimate areas. In many cases, a consult will be accomplished through USMEPCOM, but civilian clearance may also be required. For all waivers, the burden of proof is on the applicant to provide a clear and meritorious case for why a waiver should be considered. USAREC Message 17-021 has been rescinded. The UM 17-070 has been updated to reflect this. Point of contact for this is the undersigned, through your chain of command. Troy TROY D. HQ, USAREC GB (EEPD) Waivers Branch Chief (502) 626-5422