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.

 

 

 

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