Nearly all branches of the military are undermanned. The services have increased their recruiting efforts, but under current regulations, many young adults are not eligible to serve. However, deciding who is eligible is within the discretion of the service. Perhaps it is time to revisit the physical, medical, and mental health standards to see if some potential recruits who are fit, ready, and capable are being unnecessarily excluded from military service.
Eligibility and Availability
The Department of Defense 2020 Qualified Military Available (QMA) Study found only 23 percent of the country’s young adults, ages 17 to 24, meet the eligibility requirements for military service without a waiver.1 Of this small segment, nearly half are enrolled in college. Therefore, the number of young adults who are eligible and available to join the military is about 1 in 10.
The study does not show how many young adults are actually interested in joining the military, but it is certainly less than the number who are eligible and available.
This puts recruiters in a difficult situation. When a recruiter connects with a young adult, there is a high probability that individual will not qualify for military service.
Disqualifiers
Potential recruits can be disqualified for a variety of reasons, including drug use, weight, aptitude, conduct, and dependency. Additional factors such as age and citizenship can disqualify someone from specific entry programs, such as Officer Candidate School. According to the QMA study, 11 percent of young adults are disqualified solely because of a medical/physical or mental health condition.
This begs the following questions: What are disqualifying medical/physical and mental health conditions? Given access to quality health care, could someone realistically serve with one of those conditions?
The Department of Defense instruction governing medical standards for entering military service includes 42 pages of disqualifying conditions.2 Most clearly limit an individual’s ability to meet the standards’ five goals:
1. Prevent contagious diseases from endangering the health of others.
2. Avoid excessive lost of time due to treatment or hospitalization.
3. Ensure completion of required training.
4. Adapt to the military environment without geographical limitations.
5. Perform duties without worsening existing conditions.
However, for a number of conditions, disqualification may not be the only means to achieve these five goals. Somewhat surprisingly, past conditions (e.g., not chronic and for which the individual has been cured) and conditions that can be controlled with medication still can result in an interested young adult being disqualified from military service. See examples in Tables 1 and 2.
Better Access to Health Care and Medicine
The expansions of public and private healthcare programs has led to historically high levels of access to care. As a result, more young adults are going to have longer, more thorough medical histories documented in their healthcare records—and more documentation of disqualifying medical conditions.
But increased access to medical services and medicine also makes living with chronic conditions more manageable. For example, some injectable psoriasis medications can be administered monthly at home. If a young adult can manage conditions such as psoriasis with medication as a civilian, what limits them from being able to do that in the military?
One concern could be access to medications, especially ones that require refrigeration or special storage. But while not every duty location has the same facilities, the list of those that have the needed facilities is more than likely longer than the list of those that do not. Developing a workable care plan for a service member should be doable, not a barrier to entry.
Mental Health Standards: More Harm Than Help?
Current eligibility standards could discourage young adults from seeking mental health care. Some of the disqualifying conditions do not always present noticeable symptoms or can be masked or disguised. It is possible that individuals interested in military service might avoid seeking help to keep their records clear of disqualifying conditions. Worse, their conditions might remain hidden until after they enter the military, delaying treatment and putting them and those with whom they serve at risk.
In addition, telling a potential recruit they are not fit to serve because they sought treatment for an eating disorder earlier in life or spoke to a therapist could put that individual at further
risk. Recent events—the isolation and challenges of the COVID-19 pandemic, in particular—have been taxing for many people.
The military encourages mental health treatment for service members, and people who have sought mental health care could serve as examples for others. They also may be willing to share their stories, helping to eliminate any stigma associated with mental illness. Many mental health conditions can be helped with treatment or medication. Telemedicine and mental health applications on mobile devices have expanded access to mental health resources to almost anywhere at any time.
In addition, some disqualifying conditions are surprisingly broad. A young adult who had a headache and skipped a social activity more than once in a year is subject to disqualification. Really?
What Should Be Done?
The services should revisit the list of disqualifying medical, physical, and mental heath conditions and ask whether a condition reasonably should prevent someone from serving in the armed forces. Some standards could be modified or eliminated, and any condition that has been cured or is treatable with medicine should be strongly considered for a waiver.
Such revisions would increase the number of young adults eligible and available to serve in the military, increasing national security by ensuring the services have the manpower to meet global missions.
1. Department of Defense, 2020 Qualified Military Available (QMA) Study key findings, prod-media.asvabprogram.com/CEP_PDF_Contents/Qualified_Military_Available.pdf.
2. DoD Instruction 6130.03, vol. 1, “Medical Standards for Military Service: Appointment, Enlistment, or Induction” (effective 16 November 2022).