Army Medical Standards 40-501, Chapter 2
Army Medical Standards for
Enlistment,
Appointment, and Induction
As Revised -- 1 February 2005
40-501, Chapter 2
Physical Standards for Enlistment, Appointment, and Induction
2–1. General
This chapter implements DOD Directive 6130.3, Physical Standards for Appointment, Enlistment, and Induction, December 15, 2000, and DOD Instruction 6130.4, Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces, December 14, 2000.
2–2. Application and responsibilities
a. Purpose.
The purpose of the standards contained in this chapter is to ensure that individuals medically qualified are—
(1) Free of contagious diseases that would likely endanger the health of other personnel.
(2) Free of medical conditions
or physical defects that would require excessive time lost from duty for
necessary treatment or hospitalization or would likely result in separation from
the Army for medical
unfitness.
(3) Medically capable of satisfactorily completing required training.
(4) Medically adaptable to the military environment without the necessity of geographical area limitations.
(5) Medically capable of performing duties without aggravation of existing
physical defects or medical
conditions.
b. Application.
This chapter prescribes the medical conditions and physical defects that are
causes for rejection for
appointment, enlistment, and induction into military
service. Other standards may be prescribed by DOD in
the event of mobilization
or a national emergency. Those individuals found medically qualified based on
the
medical standards of chapter 2 that were in effect prior to this publication
will not be disqualified solely on
the basis of the new standards. The
designated waiver authorities may grant waivers for selection or
continuation in
the programs described below, provided the individual meets the retention
standards of
chapter 3. However, the standard in paragraph 2–35l will not
be waived regardless of whether chapter 2 or
chapter 3 standards are applied.
c. Scope.
The standards of chapter 2 apply to—
(1) Applicants for appointment
as commissioned or warrant officers in the Active Army and RCs, including
appointment as a soldier in the USAR or the Army National Guard of the United
States
(ARNG/ARNGUS). This includes enlisted soldier applicants for appointment
as commissioned or
warrant officers. (However, for officers of the ARNG/ARNGUS
or USAR who apply for appointment in
the Active Army, the standards of chap 3
are applicable.)
(2) Applicants for enlistment in the Regular Army. For medical conditions or physical defects predating
original
enlistment, these standards are applicable for enlistees’ first 6 months of
active duty.
(However, for enlisted soldiers of the ARNG/ARNGUS or USAR who
apply for enlistment in the
Regular Army or who re-enter active duty for
training (ADT) under the “split-training” option, the
standards of chapter 3 are
applicable.)
(a)
Enlisted soldiers identified within the first 6
months of active duty with a condition that existed prior
to service that does
not meet the standards of chapter 2 may be separated (or receive a waiver to
remain on active duty) following an evaluation by an Entrance Physical Standards
Board, in
accordance with AR 635–200, chapter 5, with the exception as noted in
(b) below.
(b)
Enlisted soldiers identified within the first 6
months of active duty with a condition that existed prior
to service that does
not meet the standards of chapter 2 or chapter 3 must be evaluated by a
medical
evaluation board (MEB). The soldier will then be
referred to a physical evaluation board
(PEB) unless the soldier waives his or
her right to the PEB in accordance with AR 635–40.
(3) Applicants for enlistment in
the RC and federally recognized units or organizations of the
ARNG/ARNGUS. For
medical conditions or physical defects predating original enlistment, these
standards are applicable during the enlistees’ initial period of ADT.
(4) Applicants for reenlistment
in the Active Army, RC, and ARNG/ARNGUS after a period of more than
6 months has
elapsed since discharge.
(5) Applicants (civilian
applicants or enlisted soldier applicants) for the USMA, Scholarship or
Advanced
Course ROTC, USUHS, Health Professions Scholarship Program (HPSP), Officer
Candidate School (OCS), Warrant Officer Candidate School, and all other Army
special officer
personnel procurement programs. (See chap 3 for retention of
students in HPSP and USUHS
programs.)
(6) Retention of cadets and
midshipmen at the United States Armed Forces academies and students
enrolled in
ROTC. (However, the Commander, ROTC Cadet Command or the Superintendent,
USMA
has the authority to grant medical waivers for continuation in these programs,
provided the
cadet meets the retention standards of chap 3.)
(7) All individuals being inducted into the Army.
d. Responsibilities.
The Secretary of the Army shall—
(1) Revise Army policies to
conform with the standards contained in DOD Directive 6130.3 and DOD
Instruction
6130.4.
(2) Ensure uniformity of application and implementation of DOD Instruction 6130.4.
(3) Have authority to grant a
waiver of the standards in individual cases for applicable reasons and ensure
uniformity of waiver determinations. Delegated waiver authorities are noted in
chapter 1.
(4) Have authority to change
Army-specific visual standards (particularly for officer-accession programs)
and
establish other standards for special programs. Notification of any proposed
changes in standards
will be provided to the ASD(HA) 60 days before their
implementation.
(5) Ensure that accurate
International Classification of Disease (ICD) Codes are assigned to all medical
conditions resulting in a personnel action such as medical waiver or medical
separation.
(6) Eliminate inconsistencies
and inequities based on race, sex, or examination location in the application
of
the standards.
e. Medical conditions.
The disqualifying medical
conditions are listed in paragraphs 2–3 through 2–37 below. (The ICD codes are
listed in parentheses following each standard in chap 2.)
2–3. Abdominal organs and gastrointestinal system
The causes for rejection for appointment, enlistment, and induction are an authenticated history of:
a. Esophagus. Ulceration, varices, fistula, achalasia, or other dismotility disorders; chronic or recurrent
esophagitis if confirmed by appropriate x-ray or endoscopic examination (530).
b. Stomach and duodenum.
(1) Gastritis. Chronic hypertrophic, or severe (535).
(2) Active ulcer of the stomach or duodenum confirmed by x-ray or endoscopy (533).
(3) Congenital abnormalities of
the stomach or duodenum causing symptoms or requiring surgical
treatment (751),
except a history of surgical correction of hypertrophic pyloric stenosis of
infancy.
c. Small and large intestine.
(1) Inflammatory bowel disease. Regional enteritis (555), ulcerative colitis (556), ulcerative proctitis (556).
(2) Duodenal diverticula with symptoms or sequelae (hemorrhage, perforation, etc.) (562.02).
(3) Intestinal malabsorption syndromes, including postsurgical and idiopathic (579).
(4) Congenital (751). Condition,
to include Meckel’s diverticulum or functional (564) abnormalities,
persisting
or symptomatic within the past 2 years.
d.
Gastrointestinal bleeding. History of, unless the
cause has been corrected, and is not otherwise
disqualifying (578).
e. Hepato-pancreatic-biliary tract.
(1) Viral hepatitis (070), or
unspecified hepatitis (570), within the preceding 6 months or persistence of
symptoms after 6 months, or objective evidence of impairment of liver function,
chronic hepatitis, and
hepatitis B carriers (070). (Individuals who are
known to have tested positive for hepatitis C virus
(HCV) infection require
confirmatory testing. If positive, individuals should be clinically
evaluated for
objective evidence of liver function impairment. If evaluation
reveals no signs or symptoms of disease,
the applicant meets the standards.)
(2) Cirrhosis (571), hepatic cysts and abscess (572), and sequelae of chronic liver disease (572).
(3) Cholecystitis, acute or
chronic, with or without cholelithiasis (574), and other disorders of the
gallbladder including post-cholecystectomy syndrome (575), and biliary system
(576).
Note.
Cholecystectomy is not disqualifying 60 days
postsurgery (or 30 days post-laproscopic surgery),
providing there are no
disqualifying residuals from treatment.
(4) Pancreatitis. Acute (577.0) and chronic (577.1).
f. Anorectal.
(1) Anal fissure if persistent, or anal fistula (565).
(2) Anal or rectal polyp (569.0), prolapse (569.1), stricture (569.2), or incontinence (787.6).
(3) Hemorrhoids, internal or external, when large, symptomatic, or history of bleeding (455).
g. Spleen.
(1) Splenomegaly, if persistent (789.2).
(2) Splenectomy (P41.5), except
when accomplished for trauma, or conditions unrelated to the spleen, or
for
hereditary spherocytosis (282.0).
h. Abdominal wall.
(1) Hernia, including inguinal (550), and other abdominal (553), except for small, asymptomatic umbilical
or asymptomatic hiatal.
(2) History of abdominal surgery
within the preceding 60 days (P54), except that individuals post-
laparoscopic cholecystectomy may be qualified after 30 days.
i. Other.
(1) Gastrointestinal bypass (P43) or stomach stapling (P44) for control of obesity.
(2) Persons with artificial openings (V44).
2–4. Blood and blood-forming tissue diseases
The causes for rejection for appointment, enlistment, and induction are an authenticated history of:
a.
Anemia. Any hereditary (282), acquired (283), aplastic (284), or unspecified (285) anemia that has not
permanently corrected
with therapy.
b.
Hemorrhagic disorders. Any congenital (286) or
acquired (287) tendency to bleed due to a platelet or
coagulation disorder.
c. Leukopenia. Chronic or recurrent (288), based upon available norms for ethnic background.
d. Immunodeficiency (279).
2–5. Dental
The causes for rejection are for appointment, enlistment, and induction are:
a.
Diseases of the jaw or associated tissues which are
not easily remediable, and will incapacitate the
individual or otherwise prevent
the satisfactory performance of duty. This includes temporomandibular
disorders
(524.6) and/or myofascial pain dysfunction that is not easily corrected or has
the potential for
significant future problems with pain and function.
b.
Severe malocclusion (524) that interferes with normal
mastication or requires early and protracted
treatment; or relationship between
mandible and maxilla that prevents satisfactory future prosthodontic
replacement.
c.
Insufficient natural healthy teeth (521) or lack of a
serviceable prosthesis, preventing adequate mastication
and incision of a normal
diet. This includes complex (multiple fixture) dental implant systems that have
associated complications that severely limit assignments and adversely affect
performance of world–wide
duty. Dental implants systems must be successfully osseointegrated and completed.
d.
Orthodontic appliances for continued treatment
(V53.4) (attached or removable). Retainer appliances are
permissible, provided
all active orthodontic treatment has been satisfactorily completed.
2–6. Ears
The causes for rejection for appointment, enlistment, and induction are:
a.
External ear. Atresia or severe microtia (744),
acquired stenosis (380.5), severe chronic or acute otitis
externa (380.2), or
severe traumatic deformity (738.7).
b.
Mastoids. Mastoiditis (383), residual of mastoid
operation with fistula (383.81), or marked external
deformity that prevents or
interferes with wearing a protective mask or helmet (383.3).
c. Meniere’s Syndrome. Or other diseases of the vestibular system (386).
d.
Middle and inner ear. Acute or chronic otitis media
(382), cholesteatoma (385.3), or history of any inner
(P20) or middle (P19) ear
surgery excluding myringotomy or successful tympanoplasty.
e.
Tympanic membrane. Any perforation of the tympanic
membrane (384), or surgery to correct perforation
within 120 days of examination
(P19).
2–7. Hearing
The cause for rejection for appointment, enlistment, and induction is a hearing threshold level greater than that described in paragraph c below.
a.
Audiometers, calibrated to standards of the
International Standards Organization (ISO 1964) or the
American National
Standards Institute (ANSI 1996), will be used to test the hearing of all
applicants.
b.
All audiometric tracings or audiometric readings
recorded on reports of medical examination or other
medical records will be
clearly identified.
c. Acceptable audiometric hearing levels (both ears) are:
(1) Pure tone at 500, 1000, and
2000 cycles per second of not more than 30 decibels (dB) on the average
(each
ear), with no individual level greater than 35dB at these frequencies.
(2) Pure tone level not more
than 45 dB at 3000 cycles per second each ear, and 55 dB at 4000 cycles
per
second each ear.
2–8. Endocrine and metabolic disorders
The causes for rejection for appointment, enlistment, and induction are an authenticated history of:
a. Adrenal dysfunction (255) of any degree.
b. Diabetes mellitus (250) of any type.
c. Glycosuria. Persistent, when associated with impaired glucose tolerance (250) or renal tubular defects
(271.4).
d. Acromegaly. Gigantism or other disorder of pituitary function (253).
e. Gout (274).
f. Hyperinsulinism (251.1).
g. Hyperparathyroidism (252.0) and hypoparathyroidism (252.1).
h. Thyroid disorders.
(1) Goiter, persistent or untreated (240).
(2) Hypothyroidism, uncontrolled by medication (244).
(3) Cretinism (243).
(4) Hyperthyroidism (242).
(5) Thyroiditis (245).
i. Nutritional deficiency diseases. Such diseases include beriberi (265), pellagra (265.2), and scurvy (267).
j.
Other endocrine or metabolic disorders such as cystic
fibrosis (277), porphyria (277.1), and amyloidosis
(277.3) that obviously
prevent satisfactory performance of duty or require frequent or prolonged
treatment.
2–9. Upper extremities
(See also para 2–11.) The causes for rejection for appointment, enlistment, and induction are:
a. Limitation of motion. An individual will be considered unacceptable if the joint ranges of motion are less
than the measurements listed below. Methods of measurement appear in TC 8–640.
(1) Shoulder (726.1):
(a) Forward elevation to 90 degrees.
(b) Abduction to 90 degrees.
(2) Elbow (726.3):
(a) Flexion to 100 degrees.
(b) Extension to 15 degrees.
(3) Wrist (726.4): a total range
of 60 degrees (extension plus flexion) or radial and ulnar deviation
combined
arc 30 degrees.
(4) Hand (726.4):
(a) Pronation to 45 degrees.
(b) Supination to 45 degrees.
(5) Fingers and thumb (726.4):
inability to clench fist, pick up a pin, grasp an object, or touch tips of at
least three fingers with thumb.
b. Hand and fingers.
(1) Absence of the distal phalanx of either thumb (885).
(2) Absence of distal and middle
phalanx of an index, middle, or ring finger of either hand, irrespective of
the
absence or loss of little finger (886).
(3) Absence of more than the
distal phalanx of any two of the following fingers: index, middle finger, or
ring
finger of either hand (886).
(4) Absence of hand or any portion thereof (887) except for fingers as noted above.
(5) Polydactyly (755).
(6) Scars and deformities of the
fingers or hand (905.2) that are symptomatic or that impair normal
function to
such a degree as to interfere with the satisfactory performance of military
duty.
(7) Intrinsic paralysis or
weakness, including nerve palsy (354) sufficient to produce physical findings in
the
hand such as muscle atrophy or weakness.
(8) Wrist, forearm, elbow, arm,
or shoulder. Recovery from disease or injury with residual weakness or
symptoms
such as to preclude satisfactory performance of duty (905.2), or grip strength
of less than 75
percent of predicted normal when injured hand is compared with
the normal hand (non-dominant is 80
percent of dominant grip).
2–10. Lower extremities
(See also para 2–11.) The causes for rejection for appointment, enlistment, and induction are:
a.
Limitation of motion.
An individual will be considered unacceptable if the joint ranges of motion are
less
that the measurements listed below. Methods of measurement appear in TC
8–640.
(1) Hip (due to disease (726.5), injury (905.2)):
(a) Flexion to 90 degrees.
(b) No demonstrable flexion contracture.
(c) Extension to 10 degrees (beyond 0 degrees).
(d) Abduction to 45 degrees.
(e) Rotation of 60 degrees (internal and external combined).
(2) Knee (due to disease (726.6), injury (905.4)):
(a) Full extension compared with contralateral.
(b) Flexion to 90 degrees.
(3) Ankle (due to disease (726.7), injury (905.4)):
(a) Dorsiflexion to 10 degrees.
(b) Planter flexion to 30 degrees.
(4) Subtalar (due to disease (726.7) or injury (905.4)): eversion and inversion (total to 5 degrees).
b. Foot and ankle.
(1) Absences of one or more
small toes (895) if function of the foot is poor or running or jumping is
prevented; absence of a foot (896) or any portion thereof except for toes.
(2) Absence of great toe(s) (895); loss of dorsal/plantar flexion if function of the foot is impaired (905.4).
(3) Deformities of the toes,
either acquired (735) or congenital (755.66), including polydactyly (755.02),
that prevent wearing military footwear or impair walking, marching, running, or
jumping. This includes
hallux valgus (735).
(4) Clubfoot or Pes Cavus
(754.5), if stiffness or deformity prevents foot function or wearing military
footwear.
(5) Symptomatic pes planus,
acquired (734) or congenital (754.6) or pronounced cases, with absence of
subtalar motion.
(6) Ingrown toenails (703), if severe.
(7) Planter fascitis (728.7), persistent.
(8) Neuroma
(355.6), confirmed condition and refractory to
medical treatment or will impair function of the
foot.
c. Leg, knee, thigh, and hip.
(1) Loose or foreign bodies within the knee joint (717.6).
(2) Physical findings of an
unstable or internally deranged joint (717.9). History of uncorrected anterior
(717.83) or posterior (717.84) cruciate ligament injury.
(3) Surgical correction of any knee ligaments if symptomatic or unstable (P81).
(4) History of congenital
dislocation of the hip (754.3), osteochondritis of the hip (Legg-Perthes
disease)
(732.1), or slipped femoral epiphysis of the hip (732.2).
(5) Hip dislocation (835) within 2 years before examination.
(6) Osteochondritis of the tibial tuberosity (Osgood-Schlatter disease) (732.4), if symptomatic.
d. General.
(1) Deformities (905.4), disease
or chronic pain (719.4) of one or both lower extremities that have
interfered
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, or weight bearing, or the
satisfactory completion of
prescribed training or military duty.
(2) Shortening of a lower extremity (736.81) resulting in a noticeable limp or scoliosis.
2–11. Miscellaneous conditions of the extremities
(See also paras 2–9 and 2–10.) The causes for rejection for appointment, enlistment, and induction are an authenticated history of:
a. Arthritis.
(1) Active, subacute, or chronic arthritis (716).
(2) Chronic osteoarthritis
(715.3) or traumatic arthritis (716.1) of isolated joints of more than a minimal
degree, which has interfered with the following of a physically active vocation
in civilian life or that
prevents the satisfactory performance of military duty.
b. Chronic Retro Patellar Knee Pain Syndrome with or without confirmatory arthroscopic evaluation (717.7).
c.
Dislocation if unreduced, or recurrent dislocations
of any major joint such as shoulder (831), hip (835),
elbow (832), or knee
(836); or instability of any major joint such as shoulder (718.1), elbow
(718.3), or hip
(718.5).
d. Fractures.
(1) Malunion or non-union of any fracture (733.8), except ulnar styloid process.
(2) Orthopedic hardware
(733.99), including plates, pins, rods, wires, or screws used for fixation and
left in
place; except that a pin, wire, or screw not subject to easy trauma is
not disqualifying.
e.
Injury of a bone or joint of more than a minor
nature, with or without fracture or dislocation, that occurred
within the
preceding 6 weeks: upper extremity (923), lower extremity (924), ribs and
clavicle (922).
f. Joint replacement (V43.6).
g.
Muscular paralysis, contracture, or atrophy (728), if
progressive or of sufficient degree to interfere with
military service and
muscular dystrophies (359).
h. Osteochondritis dessicans (732.7).
i. Osteochondromatosis or Multiple Cartilaginous Exostoses (727.82).
j. Osteoporosis (733).
k. Osteomyelitis (730), active or recurrent.
l.
Scars (709.2), extensive, deep, or adherent to the
skin and soft tissues that interfere with muscular
movements.
m. Implants, silastic or other devices implanted to correct orthopedic abnormalities (V43).
2–12. Eyes
The causes for rejection for appointment, enlistment, and induction are:
a. Lids.
(1) Blepharitis (373), chronic, of more than mild degree.
(2) Blepharospasm (333.81).
(3) Dacryocystitis, acute or chronic (375.3).
(4) Deformity of the lids
(374.4), complete or extensive, sufficient to interfere with vision or impair
protection of the eye from exposure.
b. Conjunctiva.
(1) Conjunctivitis, chronic (372.1), including trachoma (076) and allergic conjunctivitis (372.13).
(2) Pterygium, (372.4), if
encroaching on the cornea in excess of 3 millimeters (mm), interfering with
vision, progressive (372.42), or recurring after two operative procedures
(372.45).
(3) Xerophthalmia (372.53).
c. Cornea.
(1) Dystrophy, corneal, of any type (371.5), including keratoconus (371.6) of any degree.
(2) Keratorefractive surgery,
history of lamellar (P11.7) and/or penetrating keratoplasty (P11.6). Laser
surgery or appliance utilized to reconfigure the cornea is also disqualifying.
(3) Keratitis (370), acute or
chronic, which includes recurrent corneal ulcers, erosions (abrasions), or
herpetic ulcers (054.42).
(4) Vascularization (370.6) or
opacification (371) of the cornea from any cause that is progressive or
reduces
vision below the standards prescribed in paragraph 2–13 below.
d. Uveitis (364) or iridocyclitis.
e. Retina.
(1) Angiomatosis (759.6), or
other congenitohereditary retinal dystrophy (362.7) that impairs visual
function.
(2) Chorioretinitis or
inflammation of the retina (363), including histoplasmosis, toxoplasmosis, or
vascular
conditions of the eye to include Coats’ disease, Eales’ disease, and
retinitis proliferans, unless a
single episode of known cause that has healed
and does not interfere with vision.
(3) Congenital or degenerative changes of any part of the retina (362).
(4) Detachment of the retina
(361), history of surgery for same, or peripheral retinal injury or degeneration
that may cause retinal detachment.
f. Optic nerve.
(1) Optic neuritis (377.3),
neuroretinitis, secondary optic atrophy, or documented history of attacks of
retrobulbar neuritis.
(2) Optic atrophy (377.1), or cortical blindness (377.7).
(3) Papilledema (377.0).
g. Lens.
(1) Aphakia (379.3), lens implant, or dislocation of a lens.
(2) Opacities of the lens (366) that interfere with vision or that are considered to be progressive.
h. Ocular mobility and motility.
(1) Diplopia (386.2), documented, constant or intermittent.
(2) Nystagmus (379.5).
(3) Strabismus (378), uncorrectable by lenses to less than 40 diopters or accompanied by diplopia.
(4) Strabismus, surgery (P15) for the correction of, within the preceding 6 months.
(5) For entrance into the USMA
or ROTC programs, the following conditions are also disqualifying:
esotropia of
over 15 prism diopters; exotropia of over 10 prism diopters; hypertropia of over
5 prism
diopters.
i. Miscellaneous defects and conditions.
(1) Abnormal visual fields due
to disease of the eye or central nervous system (368.4), or trauma (368.9).
Meridianspecific visual field minimums are as follows:
(a) Temporal, 85 degrees.
(b) Superior-temporal, 55 degrees.
(c) Superior, 45 degrees.
(d) Superior nasal, 55 degrees.
(e) Nasal, 60 degrees.
(f) Inferior nasal, 50 degrees.
(g) Inferior, 65 degrees.
(h)
Inferior-temporal, 85 degrees.
(2) Absence of an eye, congenital (743) or acquired (360.8).
(3) Asthenopia (368.13), severe.
(4) Exophthalmos (376), unilateral or bilateral, non–familial.
(5) Glaucoma (365), primary, or
secondary, or pre-glaucoma as evidenced by intraocular pressure above
21
millimeters of mercury (mmHg), or the secondary changes in the optic disc or
visual field loss
associated with glaucoma.
(6) Loss of normal pupillary
reflex reactions to accommodation (367.5) or light (379.4), including Adie’s
syndrome.
(7) Night blindness (368.6).
(8) Retained intraocular foreign body (360).
(9) Growth or tumors of the
eyelid, other than small basal cell tumors which can be cured by treatment, and
small nonprogressive asymptomatic benign lesions.
(10) Any organic disease of the
eye (360) or adnexa (376) not specified above, that threatens vision or
visual
function.
2–13. Vision
The causes for rejection for appointment, enlistment, and induction are:
a.
Distant visual acuity
of any degree that does not correct with spectacle lenses to at least one of the
following (367):
(1) 20/40 in one eye and 20/70 in the other eye.
(2) 20/30 in one eye and 20/100 in the other eye.
(3) 20/20 in one eye and 20/400
in the other eye. However, for entrance into USMA or ROTC, distant
visual acuity
that does not correct to 20/20 in one eye and 20/40 in the other eye is
disqualifying. For
entrance into OCS, distant visual acuity that does not
correct to 20/20 in one eye and 20/100 in the
other eye is disqualifying.
b. Near visual acuity (367) of any degree that does not correct to 20/40 in the better eye.
c.
Refractive error
(hyperopia (367.0), myopia (367.1), astigmatism (367.2)), in any spherical
equivalent of
worse than –8.00 or +8.00 diopters; if ordinary spectacles cause
discomfort by reason of ghost images or
prismatic displacement; or if corrected
by orthokeratology or keratorefractive surgery. However, for
entrance into USMA
or Army ROTC programs, the following conditions are disqualifying:
(1) Astigmatism, all types over 3 diopters.
(2) Hyperopia over 8.00 diopters spherical equivalent.
(3) Myopia over 8 diopters spherical equivalent.
(4) Refractive error corrected by orthokeratology or keratorefractive surgery.
d.
Contact lenses.
Complicated cases requiring contact lenses for adequate correction of vision,
such as
corneal scars (371) and irregular astigmatism (367.2).
e.
Color vision
(368.5). Although there is no standard, color vision will be tested because
adequate color
vision is a prerequisite for entry into many military
specialties. However, for entrance into the USMA or
Army ROTC or OCS programs,
the inability 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 disqualifying.
2–14. Genitalia
The causes for rejection for appointment, enlistment, and induction are:
a. Female genitalia.
(1) Abnormal uterine bleeding (626.2), including menorrhagia, metrorrhagia, or polymenorrhea.
(2) Amenorrhea (626.0), unexplained.
(3) Dysmenorrhea (625.3),
incapacitating to a degree recurrently necessitating absences of more than a
few
hours from routine activities.
(4) Endometriosis (617).
(5) Hermaphroditism (752.7).
(6) Menopausal syndrome (627),
if manifested by more than mild constitutional or mental symptoms, or
artificial
menopause if less than 1 year’s duration.
(7) Ovarian cysts (620), persistent, clinically significant.
(8) Pelvic inflammatory disease (614), acute or chronic.
(9) Pregnancy (V22).
(10) Uterus, congenital absence of (752.3), or enlargement due to any cause (621.2).
(11) Vulvar or vaginal
ulceration (616.5), including herpes genitalia (054.11) and condyloma acuminatum
(078.11), acute or chronic, not amenable to treatment. Such treatment must be
given and
demonstrated effective prior to accession.
(12) Abnormal Papanicolaou’s
test (Pap smear) (795) graded LGSIL or higher severity, or any smear in
which
the descriptive terms carcinoma-in-situ, invasive cancer, condyloma acuminatum,
human
papilloma virus, or dysplasia are used.
(13) Major abnormalities and
defects of the genitalia such as a change of sex (P64.5). A history thereof, or
dysfunctional residuals from surgical correction of these conditions.
b. Male genitalia.
(1) Absence of both testicles,
either congenital (752.8), or acquired (878.2), or unexplained absence of a
testicle.
(2) Epispadias or Hypospadias
(752.6), when accompanied by evidence of infection of the urinary tract,
or if
clothing is soiled when voiding.
(3) Undiagnosed enlargement or mass of testicle or epididymis (608.9).
(4) Undescended testicle(s) (752.5).
(5) Orchitis (604), acute or chronic epididymitis.
(6) Penis, amputation of (878), if the resulting stump is insufficient to permit normal micturition.
(7) Penile infectious lesions,
including herpes genitalis (054.1) and condyloma acuminata (078.11), acute
or
chronic, not amenable to treatment. Such treatment must be given and
demonstrated effective prior
to accession.
(8) Prostatitis (601), acute or chronic.
(9) Hydrocele (603.9). Left varicocele, if painful, or any right varicocele (456.4).
c.
Major abnormalities and defects of the genitalia,
such as a change of sex (P64.5), a history
thereof, or dysfunctional residuals from surgical correction of these
conditions.
2–15. Urinary system
(See para 2–8.) The causes for rejection for appointment, enlistment, and induction are:
a. Cystitis (595).
b. Urethritis (597).
c. Enuresis (788.3) or incontinence of urine beyond age 12. (See also para 2–29.)
d. Hematuria, pyuria, or other findings indicative of renal tract disease (599).
e. Urethral stricture (598) or fistula (599.1).
f. Kidney.
(1) Absence of one kidney, congenital (753.0) or acquired (593.89).
(2) Infections, acute or chronic (590).
(3) Polycystic kidney (753.1), confirmed history of.
(4) Horseshoe kidney (753.3).
(5) Hydronephrosis (591).
(6) Nephritis, acute (580) or chronic (582).
g.
Proteinuria
(791) under normal activity (at least 48 hours after strenuous exercise) greater
than 200
milligrams (mg)/24 hours, or a protein to creatinine ratio greater than
0.2 in a random urine sample, unless
nephrologic consultation determines the
condition to be benign orthostatic proteinuria.
h.
Renal calculus
(592) within the previous 12 months, recurrent calculus, nephrocalcinosis, or
bilateral renal
calculi at any time.
2–16. Head
The causes for rejection for appointment, enlistment, and induction are:
a.
Injuries, including severe contusions and other
wounds of the scalp (920) and cerebral concussion (850),
until a period of 3
months has elapsed. (See para 2–26.)
b.
Deformities of the skull, face, or jaw (754.0) of a
degree that would prevent the individual from wearing a
protective mask or
military headgear.
c.
Defects (756.0), loss or congenital absence of
the bony substance of the skull not successfully corrected
by reconstructive
materials, or leaving residual defect in excess of 1 square inch (6.45
centimeter (cm)2)
or the size of a 25 cent piece.
2–17. Neck
The causes for rejection for appointment, enlistment, and induction are:
a. Cervical ribs (756.2), if symptomatic or so obvious that they are found on routine physical examination.
(Detection based primarily on x-rays is not considered to meet this criterion.)
b.
Congenital cysts (744.4) of branchial cleft origin or
those developing from remnants of the thyroglossal
duct, with or without
fistulous tracts.
c.
Contraction (723.8) of the muscles of the neck,
spastic or non–spastic, or cicatricial contracture of the
neck to the extent
that it interferes with wearing a uniform or military equipment or is so
disfiguring as to
impair military bearing.
2–18. Heart
The causes for rejection for appointment, enlistment, and induction are:
a.
All valvular heart diseases, congenital (746) or
acquired (394), including those improved by surgery
except mitral valve prolapse
and bicuspid aortic valve. These latter two conditions are not reasons for
rejection unless there is associated tachyarrhythmia, mitral regurgitation,
aortic stenosis, insufficiency,
or cardiomegaly.
b. Coronary heart disease (410).
c. Symptomatic arrhythmia (or electrocardiographic evidence of arrhythmia), history of.
(1) Supraventricular tachycardia
(427.0), or any dysrhythmia originating from the atrium or sinoatrial node,
such
as atrial flutter, and atrial fibrillation, unless there has been no recurrence
during the preceding 2
years while off all medications. Premature atrial or
ventricular contractions are disqualifying when
sufficiently symptomatic to
require treatment or result in physical or psychological impairment.
(2) Ventricular arrhythmias
(427.1), including ventricular fibrillation, tachycardia, and multifocal
premature
ventricular contractions. Occasional asymptomatic premature
ventricular contractions are not
disqualifying.
(3) Ventricular conduction
disorders, left bundle branch block (426.2), Mobitz type II second degree
atrioventricular (AV) block (426.12), and third degree AV block (426.0).
Wolff-Parkinson-White
Syndrome (426.7) and Lown-Ganong-Levine-Syndrome (426.81)
associated with an arrhythmia are
also disqualifying.
(4) Conduction disturbances such
as first degree AV block (426.11), left anterior hemiblock (426.2), right
bundle
branch block (426.4), or Mobitz type I second degree AV block (426.13) are
disqualifying when
symptomatic or associated with underlying cardiovascular
disease.
d. Hypertrophy or dilatation of the heart (429.3).
e.
Cardiomyopathy (425), including myocarditis (422), or
history of congestive heart failure (428) even
though currently compensated.
f. Pericarditis (420).
g. Persistent tachycardia (785) (resting pulse rate of 100 or greater).
h. Congenital anomalies of heart and great vessels (746), except for corrected patent ductus arteriosus.
2–19. Vascular system
The causes for rejection for appointment, enlistment, and induction are:
a.
Abnormalities of the arteries and blood vessels
(447), including aneurysms (442), even if repaired,
atherosclerosis (440), or arteritis (446).
b.
Hypertensive vascular disease (401), evidenced by the
average of three consecutive diastolic blood
pressure measurements greater than
90 mmHg or three consecutive systolic pressure measurements
greater than 140
mmHg. High blood pressure requiring
medication or a history of treatment including
dietary restriction.
c. Pulmonary (415) or systemic embolization (444).
d. Peripheral vascular disease, including Raynaud’s phenomenon (443).
e.
Vein diseases, recurrent thrombophlebitis (451),
thrombophlebitis during the preceding year, or any
evidence of venous
incompetence, such as large or symptomatic varicose veins, edema, or skin
ulceration (454).
2–20. Height
The causes for rejection for appointment, enlistment, and induction are:
a. Men: Height below 60 inches or over 80 inches.
b. Women: Height below 58 inches or over 80 inches.
2–21. Weight
a.
Army applicants for initial appointment as
commissioned officers (to include appointment as
commissioned warrant officers)
must meet the standards of AR 600–9. Body fat composition is used as
the final
determinant in evaluating an applicant’s acceptability when the weight exceeds
the weight tables.
b.
All other applicants must meet the standards of
tables 2–l and 2–2. Body fat composition is used as the
final determinant in
evaluating an applicant’s acceptability when the weight exceeds the weight
tables.
2–22. Body build
The cause for rejection for appointment, enlistment, and induction is deficient muscular development that would interfere with the completion of required training.
2–23. Lungs, chest wall, pleura, and mediastinum
The causes for rejection for appointment, enlistment, and induction are:
a. Abnormal elevation of the diaphragm (793.2), either side.
b. Abscess of the lung (513).
c. Acute infectious processes of the lung (518), until cured.
d. Asthma (493), including reactive airway disease, exercise-induced bronchospasm or asthmatic
bronchitis, reliably diagnosed and
symptomatic after the 13th birthday. Reliable diagnostic criteria may
include
any of the following: substantiated history of cough, wheeze, chest tightness,
and/or dyspnea which
persists or recurs over a prolonged period of time,
generally more than 12 months.
e. Bronchitis (490), chronic, symptoms over 3 months occurring at least twice a year.
f. Bronchiectasis (494).
g. Bronchopleural fistula (510).
h. Bullous or generalized pulmonary emphysema (492).
i. Chronic mycotic diseases (117) of the lung including coccidioidomycosis.
j. Chest wall malformation (754) or fracture (807) that interferes with vigorous physical exertion.
k. Empyema (510), including residual pleural effusion (511.9) or unhealed sinuses of chest wall (510).
l. Extensive pulmonary fibrosis (515).
m. Foreign body in lung, trachea, or bronchus (934).
n. Lobectomy, with residual pulmonary disease or removal of more than one lobe (P32.4).
o. Pleurisy with effusion (511.9), within the previous 2 years if known or unknown origin.
p.
Pneumothorax (512) during the year preceding
examination if due to a simple trauma or surgery; during
the 3 years preceding
examination from spontaneous origin. Recurrent spontaneous pneumothorax after
surgical correction or pleural sclerosis.
q. Sarcoidosis (135). (See para 2–34.)
r .
Silicone breast implants, encapsulated (85.53) if
less than 9 months since surgery or with symptomatic
complications.
s. Tuberculous lesions. (See para 2–34.)
2–24. Mouth
The causes for rejection for appointment, enlistment, and induction are:
a. Cleft lip or palate defects (749), unless satisfactorily repaired by surgery.
b. Leukoplakia (528.6).
2–25. Nose, sinuses, and larynx
The causes for rejection for appointment, enlistment, and induction are:
a. Allergic manifestations.
(1) Allergic or vasomotor
rhinitis (477), if moderate or severe and not controlled by oral medications,
desensitization, or topical corticosteroid medication.
(2) Atrophic rhinitis (472).
(3) Vocal cord paralysis (478.3), or symptomatic disease of the larynx (478.7).
b. Anosmia or parosmia (352).
c. Epistaxis (784.7), recurrent.
d. Nasal polyps (471), unless surgery was performed at least 1 year before examination.
e. Perforation of nasal septum (478.1), if symptomatic or progressive.
f. Sinusitis (461), acute.
g.
Sinusitis, chronic (473), when evidenced by chronic
purulent nasal discharge, hyperplastic changes of the
nasal tissue, symptoms
requiring frequent medical attention, or x–ray findings.
h. Larynx ulceration, polyps, granulated tissue, or chronic laryngitis (476).
i. Tracheostomy (V44) or tracheal fistula.
j.
Deformities or conditions (750.9) of the mouth,
tongue, palate throat, pharynx, larynx, and nose that
interfere with chewing,
swallowing, speech, or breathing.
k. Pharyngitis (462) and nasopharyngitis (472.2), chronic.
2–26. Neurological disorders
The causes for rejection for appointment, enlistment, and induction are:
a.
Cerebrovascular conditions, any history of
subarachnoid (430) or intracerebral (431) hemorrhage,
vascular insufficiency,
aneurysm, or arteriovenous malformation (437).
b.
Congenital malformations (742), if associated with
neurological manifestations or if known to be
progressive; meningocele (741),
even if uncomplicated.
c.
Degenerative and hereditodegenerative disorders
affecting the cerebrum (330), basal ganglia (333),
cerebellum (334), spinal cord
(335), and peripheral nerves, or muscles (337).
d.
Recurrent headaches (784) of all types if they are of
sufficient severity or frequency to interfere with normal
function within 3
years.
e. Head injury (854).
(1) Applicants with a history of head injury with—
(a) Late post-traumatic epilepsy (occurring more than l week after injury).
(b) Permanent motor or sensory deficits.
(c) Impairment of intellectual function.
(d) Alteration of personality.
(e) Central nervous system shunt.
(2) Applicants with a history of
severe head injury are unfit for a period of at least 5 years, after which they
may be considered fit if complete neurological and neurophysical evaluation
shows no residual
dysfunction or complications. Applicants with a history
of severe penetrating head injury are unfit for a
period of at least 10 years
after the injury. After 10 years they may be considered fit if complete
neurological and neuropsychological evaluation shows no residuals dysfunction or
complications.
Severe head injuries are defined
by one or more of the following:
(a) Unconsciousness or amnesia, alone or in combination, of 24 hours duration or longer.
(b) Depressed skull fracture.
(c) Laceration or contusion of dura or brain.
(d) Epidural, subdural, subarachnoid, or intracerebral hematoma.
(e) Associated abscess or meningitis.
(f) Cerebrospinal fluid rhinorrhea or otorrhea persisting more than 7 days.
(g) Focal neurologic signs.
(h) Radiographic evidence of retained metallic or bony fragments.
(i) Leptomeningeal cysts or arteriovenous fistula.
(j) Early post-traumatic seizure(s) occurring within 1 week of injury but more than 30 minutes after injury.
(3) Applicants with a history of
moderate head injury are unfit for a period of at least 2 years after injury,
after which they may be considered fit if complete neurological evaluation shows
no residual
dysfunction or complications. Moderate head injuries are
defined by unconsciousness or amnesia,
alone or in combination of 1 to 24 hours
duration or linear skull fracture.
(4) Applicants with a history of
mild head injury, as defined by a period of unconsciousness or amnesia,
alone or
in combination, of 1 hour or less, are unfit for at least 1 month after injury;
after which they may
be acceptable if neurological evaluation shows no residual
dysfunction or complications.
(5) Persistent post-traumatic
sequelae, as manifested by headache, vomiting, disorientation, spatial
disequilibrium, personality changes, impaired memory, poor mental concentration,
shortened attention
span, dizziness, altered sleep patterns, or any findings
consistent with organic brain syndrome are
disqualifying until full recovery has
been confirmed by complete neurological and neuropsychological
evaluation.
f. Infectious diseases.
(1) Meningitis (322),
encephalitis (323), or poliomyelitis (045) within 1 year before examination, or
if there
are residual neurological defects.
(2) Neurosyphilis (094) of any form, general paresis, tabes dorsalis meningovascular syphilis.
g. Narcolepsy (347), sleep apnea syndrome (780.57).
h. Paralysis, weakness, lack of coordination, pain, sensory disturbance (344).
i. Epilepsy (345),
beyond the age of 5 unless the applicant has been free of seizures for a period
of 5 years
while taking no medication for seizure control, and has a normal
electroencephalogram (EEG). All such
applicants will have a
current neurology consultation with current EEG results. EEG may be requested by
the reviewing authority.
j. Chronic disorders such as myasthenia gravis (358) and multiple sclerosis (340).
k. Central nervous system shunts of all kinds (V45.2).
2–27. Disorders with psychotic features
The causes for rejection for appointment, enlistment, and induction are disorders with psychotic features (295).
2–28. Neurotic, anxiety, mood, somatoform, dissociative, or factitious disorders
The causes for rejection for appointment, enlistment, and induction are a history of such disorders (300) resulting in any or all of the below:
a. Admission to a hospital or residential facility.
b. Care by a physician or other mental health professional for more than 6 months.
c. Symptoms or behavior of a repeated nature that impaired social, school, or work efficiency.
2–29. Personality, conduct, and behavior disorders
The causes for rejection for appointment, enlistment, and induction are:
a.
Personality (301), conduct (312), or behavior
disorders (313) as evidenced by frequent encounters with
law enforcement
agencies, antisocial attitudes or behavior, which, while not sufficient cause
for
administrative rejection, are tangible evidence of impaired capacity to
adapt to military service.
b.
Personality (301), conduct (312), or behavior (313)
disorders where it is evident by history, interview, or
psychological testing
that the degree of immaturity, instability, personality inadequacy,
impulsiveness, or
dependency will seriously interfere with adjustment in the
Army as demonstrated by repeated inability to
maintain reasonable adjustment in
school, with employers and fellow workers, and with other social
groups.
c.
Other behavior disorders including but not limited to
conditions such as authenticated evidence of
functional enuresis (307.6) or encopresis (307.7), sleepwalking (307.6), or eating disorders that are
habitual
or persistent (307.1 or 307.5) occurring beyond age 12, or stammering (307.0) of
such a degree
that the individual is normally unable to express himself or
herself clearly or to repeat commands.
d. Attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) (314), or
perceptual/learning disorder(s)
(315) unless applicant can demonstrate passing academic performance
and there
has been no use of medication(s) in the previous 12 months.
e. Suicide, history of attempted or suicidal behavior (300.9).
2–30. Psychosexual conditions
The causes for rejection for appointment, enlistment, and induction are transsexualism, exhibitionism, transvestitism, voyeurism, and other paraphilias (302).
2–31. Substance misuse
The causes for rejection for appointment, enlistment, and induction are:
a. Alcohol dependence (303).
b. Drug dependence (304).
c. Non–dependent use of drugs characterized by—
(1) The evidence of use of any
controlled hallucinogenic, or other intoxicating substance at time of
examination (305), when the use cannot be accounted for as the result of a
prescription of a physician.
(2) Documented misuse or abuse
of any controlled substance (including cannabinoids or anabolic
steroids)
requiring professional care (305).
(3) The repeated
self-procurement and self-administration of any drug or chemical substance,
including
cannabinoids or anabolic steroids, with such frequency that it appears
that the applicant has accepted
the use of or reliance on these substances as
part of his or her pattern of behavior (305).
d. The use of LSD (305.3) within a 2-year period of the examination.
e.
Alcohol abuse (305), use of alcoholic beverages that
leads to misconduct, unacceptable social behavior,
poor work or academic
performance, impaired physical or mental health, lack of financial
responsibility, or
a disrupted personal relationship.
2–32. Skin and cellular tissues
The causes for rejection for appointment, enlistment, and induction are:
a.
Acne (706), severe, or when extensive involvement of
the neck, shoulders, chest, or back would be
aggravated by or interfere with the
wearing of military equipment, and would not be amenable to
treatment. Patients
under treatment with isotretinoin (Accutane) are medically unacceptable until 8
weeks after completion of course of therapy.
b.
Atopic dermatitis (691) or eczema (692), with active
or residual lesions in characteristic areas (face,
neck, antecubital, and
or/popliteal fossae, occasionally wrists and hands), or documented history
thereof after the age of 8.
c.
Contact dermatitis (692.4), especially involving
rubber or other materials used in any type of required
protective equipment.
d. Cysts.
(1) Cysts (706.2), other than
pilonidal, of such a size or location as to interfere with the normal wearing of
military equipment.
(2) Pilonidal cysts (685), if
evidenced by the presence of a tumor mass or a discharging sinus. History of
pilonidal cystectomy within 6 months before examination is disqualifying.
e. Dermatitis factitia (698.4).
f. Bullous dermatoses (694), such as Dermatitis Herpetiformis, pemphigus, and epidermolysis bullosa.
g. Chronic Lymphedema (457).
h. Fungus infections (117), systemic or superficial types, if extensive and not amenable to treatment.
i. Furunculosis (680), extensive recurrent, or chronic.
j. Hyperhidrosis of hands or feet (780.8), chronic or severe.
k.
Ichthyosis, or other congenital (757) or acquired
(216) anomalies of the skin such as nevi or vascular
tumors that interfere with
function or are exposed to constant irritation.
l. Keloid formation (701.4), if the tendency is marked or interferes with the wearing of military equipment.
m. Leprosy (030.9), any type.
n. Lichen planus (697.0).
o. Neurofibromatosis (von Recklinghausen’s disease) (237.7).
p.
Photosensitivity (692.72), any primary sun-sensitive
condition, such as polymorphous light eruption or
solar urticaria; any
dermatosis aggravated by sunlight such as lupus erythematosus.
q.
Psoriasis (696.1), unless mild by degree, not
involving nail pitting, and not interfering with wearing military
equipment or
clothing.
r. Radiodermatitis (692.82).
s.
Scars (709.2) that are so extensive, deep, or
adherent that they may interfere with the wearing of military
clothing or
equipment, exhibit a tendency to ulcerate, or interfere with function. Includes
scars at skin graft
donor or recipient sites if the area is susceptible to
trauma.
t. Scleroderma (710.1).
u.
Tattoos (709.9) that will significantly limit
effective performance of military service or that are otherwise
prohibited under
AR 670–1.
v. Urticaria (708.8), chronic.
w. Warts, plantar (078.19), symptomatic.
x. Xanthoma (272.2), if disabling or accompanied by hyperlipemia.
y.
Any other chronic skin disorder of a degree or
nature, such as Dysplastic Nevi Syndrome (448.1), which
requires frequent
outpatient treatment or hospitalization, or interferes with the satisfactory
performance of
duty.
2–33. Spine and sacroiliac joints
(See also para 2–11.) The causes for rejection for appointment, enlistment, and induction are:
a. Arthritis (720). (See para 2–11a.)
b.
Complaint of a disease or injury of the spine or
sacroiliac joints with or without objective signs that has
prevented the
individual from successfully following a physically active vocation in civilian
life (724) or that
is associated with pain referred to the lower extremities,
muscular spasm, postural deformities, or
limitation of motion.
c. Deviation or curvature of spine (737) from normal alignment, structure, or function if—
(1) It prevents the individual from following a physically active vocation in civilian life.
(2) It interferes with wearing a uniform or military equipment.
(3) It is symptomatic and associated with positive physical finding(s) and demonstrable by x-ray.
(4) There is lumbar scoliosis
greater than 20 degrees, thoracic scoliosis greater than 30 degrees, and
kyphosis or lordosis greater than 55 degrees when measured by the Cobb method.
d.
Fusion, congenital (756.15), involving more than two
vertebrae. Any surgical fusion (81.0P) is
disqualifying.
e.
Healed fractures or dislocations of the vertebrae
(805). A compression fracture, involving less than 25
percent of a single
vertebra is not disqualifying if the injury occurred more than 1 year before
examination
and the applicant is asymptomatic. A history of fractures of the
transverse or spinous processes is not
disqualifying if the applicant is
asymptomatic.
f. Juvenile epiphysitis (732.6) with any degree of residual change indicated by x-ray or kyphosis.
g. Ruptured nucleus pulposus (722), herniation of intervertebral disk or history of operation for this condition.
h.
Spina bifida (741) when symptomatic or if there is
more than one vertebra involved, dimpling of the
overlying skin, or a history of
surgical repair.
i. Spondylolysis (756.1) and spondylolisthesis (738.4).
j.
Weak or painful back (724) requiring external support
such as a corset or brace; recurrent sprains or
strains requiring limitation of
physical activity or frequent treatment.
2–34. Systemic diseases
The causes for rejection for appointment, enlistment, and induction are:
a. Amyloidosis (277.3).
b. Ankylosing spondylitis (720).
c.
Eosinophilic granuloma (277.8) when occurring as a
single localized bony lesion and not associated with
soft tissue or other
involvement should not be a cause for rejection once healing has occurred. All
other
forms of the Histiocytosis X spectrum should be rejected.
d. Lupus erythematosus (710) and mixed connective tissue disease.
e. Polymyositis/dermatomyositis complex (710).
f.
Progressive Systemic Sclerosis (710), including
calcinosis, Raynaud’s phenomenon, sclerodactyly, and
telangiectasis variant. A
single plaque of localized scleroderma (morphea) that has been stable for at
least
2 years is not disqualifying.
g. Reiter’s Disease (099.3).
h. Rheumatoid arthritis (714).
i. Rhabdomyolysis (728.9).
j.
Sarcoidosis (135), unless there is substantiated
evidence of a complete spontaneous remission of at least
2 years duration.
k. Sjogren’s Syndrome (710.2).
l. Tuberculosis (010).
(1) Active tuberculosis in any form or location, or history of active tuberculosis within the previous 2 years.
(2) One or more reactivations.
(3) Residual physical or mental
defects from past tuberculosis that would preclude the satisfactory
performance
of duty.
(4) Individuals with a past
history of active tuberculosis MORE than 2 years prior to enlistment, induction
and appointment are QUALIFIED IF they have received a complete course of
standard chemotherapy
for tuberculosis. In addition, individuals with a
tuberculin reaction 10 mm or greater and without
evidence of residual disease
are qualified once they have been treated with chemoprophylaxis.
(5) Vasculitis (446) such as Bechet’s, Wegener’s granulomatosis, polyarteritis nodosa.
2–35. General and miscellaneous conditions and defects
The causes for rejection for appointment, enlistment, and induction are:
a.
Allergic manifestations (995.0). A reliable history
of anaphylaxis to stinging insects. Reliable history of a
moderate to severe
reaction to common foods, spices, or food additives.
b.
Any acute pathological condition, including acute
communicable diseases, until recovery has occurred
without sequelae.
c. Chronic metallic poisoning with lead, arsenic, or silver (985), or beryllium or manganese (985).
d.
Cold injury (991), residuals of, such as: frostbite,
chilblain, immersion foot, trench foot, deep–seated ache,
paresthesia,
hyperhidrosis, easily traumatized skin, cyanosis, amputation of any digit, or
ankylosis.
e. Cold urticaria (708.2) and angioedema, hereditary angioedema (277.6).
f.
Filariasis (125), trypanosomiasis (086),
schistosomiasis (120), uncinariasis (126.9), or other parasitic
conditions, if
symptomatic or carrier states.
g.
Heat pyrexia, heatstroke, or sunstroke (992).
Documented evidence of a predisposition (including
disorders of sweat mechanism
and a previous serious episode), recurrent episodes requiring medical
attention,
or residual injury (especially cardiac, cerebral, hepatic, and renal); malignant
hyperthermia
(995.89).
h. Industrial solvent and other chemical intoxication (982).
i.
Motion sickness (994.6). An authenticated history of
frequent incapacitating motion sickness after the 12th
birthday.
j. Mycotic (114) infection of internal organs.
k. Organ transplant recipient (V42).
l. Presence of human immunodeficiency virus (HIV–I) or antibody (042). Presence is confirmed by
repeatedly reactive enzyme-linked
immunoassay serological test and positive immunoelectrophoresis
(Western Blot
test, or other DOD-approved confirmatory test.
m.
Reactive tests for syphilis (093) such as the rapid
plasma reagin (RPR) test or venereal disease
research laboratory (VDRL) followed
by a reactive, confirmatory Fluorescent Treponemal Antibody
Absorption (FTA–ABS)
test unless there is a documented history of adequately treated syphilis. In
the
absence of clinical findings, the presence of reactive RPR or VDRL followed by a
negative
FTA–ABS test is not disqualifying if a cause for the false positive
reaction can be identified and is
not otherwise disqualifying.
n.
Residual of tropical fevers, such as malaria (084)
and various parasitic or protozoal infestations that
prevent the satisfactory
performance of military duty.
o.
Rheumatic fever (390) during the previous 2 years, or
any history of recurrent attacks; Sydenham’s chorea
at any age.
p. Sleep apnea (780.57).
2–36. Tumors and malignant diseases
The causes for rejection for appointment, enlistment, and induction are:
a.
Benign tumors (M8000) that interfere with function,
prevent wearing the uniform or protective equipment,
would require frequent
specialized attention, or have a high malignant potential.
b.
Malignant tumors (V10), exception for basal cell
carcinoma, removed with no residual. In addition, the
following cases should be
qualified if on careful review they meet the following criteria: individuals who
have a history of childhood cancer who have not received any surgical or medical
cancer therapy for 5
years and are free of cancer; individuals with a history of Wilm’s tumor and germ cell tumors of the testis
treated surgically and/or with
chemotherapy after a 2-year disease-free interval off all treatment;
individuals
with a history of Hodgkin’s disease treated with radiation therapy and/or
chemotherapy and
disease free off treatment for 5 years; individuals with a
history of large cell lymphoma after a 2-year
disease-free interval off all
therapy.
2–37. Miscellaneous
Any condition that in the opinion of the examining medical officer will significantly interfere with the successful performance of military duty or training (796) may be a cause for rejection for appointment, enlistment, and induction.
Table 2–1
Military acceptable weight (in pounds) as related to age and height for males
Initial Army procurement
Minimum
Height Weight
in (Pounds) Maximum weight (in pounds) by years of age
inches Any age 17–20 21–27 28–39 40 and over
60 100 139 141 143 146
61 102 144 146 148 151
62 103 148 150 153 156
63 104 153 155 158 161
64 105 158 160 163 166
65 106 163 165 168 171
66 107 168 170 173 177
67 111 174 176 179 182
68 115 179 181 184 187
69 119 184 186 189 193
70 123 189 192 195 199
71 127 194 197 201 204
72 131 200 203 206 210
73 135 205 208 212 216
74 139 211 214 218 222
75 143 217 220 224 228
76 147 223 226 230 234
77 151 229 232 236 240
78 153 235 238 242 247
79 159 241 244 248 253
80 166 247 250 255 259
Maximum body fat by years of age: 17–20 21–27 28–39 40 and over
24% 26% 28% 30%
Notes:
1 If a male exceeds these
weights, percent body fat will be measured by the method described in
AR 600–9.
2 If a male also exceeds this body fat, he will be rejected for service.
Table 2–2
Military acceptable weight (in pounds) as related to age and height for females
Initial Army procurement
Minimum
Height Weight
in (Pounds) Maximum weight (in pounds) by years of age
inches Any age 17–20 21–27 28–39 40 and over
58 90 112 115 119 122
59 92 116 119 123 126
60 94 120 123 127 130
61 96 124 127 131 135
62 98 129 132 137 139
63 100 133 137 141 144
64 102 137 141 145 148
65 104 141 145 149 153
66 106 146 150 154 158
67 109 149 154 159 162
68 112 154 159 164 167
69 115 158 163 168 172
70 118 163 168 173 177
71 122 167 172 177 182
72 125 172 177 183 188
73 128 177 182 188 193
74 130 183 189 194 198
75 133 188 194 200 204
76 136 194 200 206 209
77 139 199 205 211 215
78 141 204 210 216 220
79 144 209 215 222 226
80 147 214 220 227 232
Maximum body fat by years of age: 17–20 21–27 28–39 40 and over
30% 32% 34% 36%
Notes:
1 If a female exceeds these
weights, percent body fat will be measured by the method described in
AR 600–9.
2 If a female also exceeds this body fat, she will be rejected for service.