It’s harder to get into the military than stay there—at least by the different medical standards set by the Defense Department. By making them match, the Pentagon could widen its recruiting pool without undermining the force.
Here’s an example. In 2022, following advancements in medicine and treatment, defense leaders decided that current servicemembers would no longer be automatically discharged due to HIV status. Yet potential recruits living with asymptomatic HIV were disqualified from joining the military until August, when a U.S. District Court judge in Virginia ended that ban.
That’s far from the only difference in the medical standards that govern who can join and who can stay. Moreover, some of these conditions are increasing in the general population, meaning that they are reducing the pool of candidates eligible to join the military.
Take depression and anxiety, which are reason to dismiss current servicemembers only if they become unable to complete their duties. But the conditions are disqualifying for potential recruits who have sought treatment in the past 36 months, have seen a counselor or therapist for more than a year, or have ever had a reoccurrence of symptoms. That covers a growing segment of the population. Diagnoses of depression and anxiety in children aged 6-17 have almost doubled since 2003, due in part to increased acceptance of and access to mental health treatment. The COVID-19 pandemic exacerbated this trend, especially among youth.
To be sure, potential recruits can request a waiver to get around some of the disqualifying conditions, and they do so increasingly frequently. The number of waivers requested by recruits jumped 70 percent from 2018 to 2022. In the latter year, the Navy approved nearly two-thirds of their waivers, of which nearly 90 percent were medical.
But heavy reliance on waivers is hardly a cure-all. For one thing, not everyone is told that requesting a waiver is even possible. For another, waivers are taking longer to process, thanks to lack of sufficient medical personnel at Military Entrance Processing Stations and the increased availability of comprehensive medical records through Military Health System GENESIS.
If the standards for recruiting and retention were made to match, it could reduce the requirement for waivers for up to 3.6 million candidates annually, as 7% (or 2.3 million) of all potential candidates are currently disqualified for a single medical or physical issue, and another 4% (or 1.3 million) for mental health. That would make a big difference to the military’s recruiters, who have been targeting a shrinking pool. Only 23 percent of youth 17 to 24 years old are qualified to serve without a waiver. Just 10 percent express interest in military service.
Some might argue that aligning the standards would mean lowering the recruiting bar. But many of the assumptions that undergird the recruiting standards are outdated or simply wrong. Asthma can disqualify a potential military recruit, yet a recent study reported that 16.5 percent of Olympic athletes have asthma. Champion sprinter Noah Lyles proves that even major respiratory conditions do not preclude athletic success.
Neurodivergence is another area where reality belies the military’s assumptions. A potential recruit with attention-deficit/hyperactivity disorder (ADHD) will find it difficult to obtain a waiver; autism spectrum disorder is automatically disqualifying. Yet neither appears in the retention standards at all. Moreover, traits common among neurodivergent individuals like attention to detail and rules-based logic make them heavily sought out in STEM and intelligence fields. A 2023 RAND report highlighted how the Israeli, Australian, and British armed services actively recruit neurodivergent individuals.
Standards exist for a reason, but excluding people who could thrive in the military unnecessarily impairs readiness. As warfighting becomes more technological and the military requires more people with non-traditional combat skills, a broader base of qualified recruits may benefit the services. Further, not every service member is expected to serve on the front lines. Many units and career fields are either “deployed in place” from the continental U.S. or serve in combat support roles.
The authors are hardly the first to call for such reforms. The lawmakers who drew up the FY2024 National Defense Authorization Act mandated a review of the current medical standards, screening processes, and waivers for accessions as a means of addressing recruitment shortfalls. It is fully within the control of the services to correct these issues by ensuring parity of medical standards. Among the concrete steps that could be taken promptly: Waivers should not be required for conditions like anxiety or depression unless the condition was diagnosed with the last year or is considered uncontrolled by the recruit’s medical provider. Streamlined waivers should be available for recruits with diagnoses such as HIV, ADHD, or respiratory/skin disorders who can demonstrate that they are asymptomatic or well controlled with medication for at least a year.
Doing so would foster good will with critical Congressional stakeholders—and more importantly, improve the U.S. military’s ability to make use of America’s best and brightest.
Lt. Col. Kareen Hart is a Department of the Air Force Senior Military Fellow at the Center for a New American Security.
Taren Sylvester is a research assistant for the Military, Veterans, and Society Program at the Center for a New American Security.
The views expressed in this article represent the personal views of the authors and are not necessarily the views of the Department of Defense, the Department of the Air Force, or The Air University.
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