The armed forces have strict standards for enlistment, such as good general health and sufficient physical fitness. As such, many people with asthma may be disqualified from joining the military.
Most people living with asthma are disqualified from joining any branch of the military in the United States. However, depending on their medical history, their general outlook, and the severity of their condition, a person may obtain a waiver that allows them to enlist.
Asthma is a chronic respiratory condition that affects the airways, making it difficult to breathe. Many factors, such as changes in the weather and vigorous physical activity, can trigger symptoms. In the U.S., about 20 million adults have the condition.
According to the Department of Defense’s 2018 Medical Standards for Military Service: Appointment, Enlistment, or Induction, people who have asthma beyond their 13th birthday are disqualified from joining the military services. However, those who have not experienced asthma or received treatment for the condition by this age are allowed to enlist.
People who currently have symptoms of asthma are immediately disqualified. According to the Army Medical Department, an asthma evaluation will look for evidence of persistent cough, wheezing, chest tightness, or shortness of breath that persists for more than 12 months.
People who have asthma beyond the age of 13 years may still be allowed to enlist, but a medical waiver will be required. The granting of a waiver depends on the period when a person last had symptoms or received treatment, the severity of their asthma, and their general outlook.
Although the standards are the same for all branches of the military, each differs in how it handles the medical waiver process. The steps for potentially obtaining a medical waiver include:
- Submit a complete medical prescreen form to the recruiter, who forwards it to the Military Entrance Processing Station (MEPS).
- A doctor at MEPS reviews the form. They can disqualify a person on the spot or schedule them for a medical examination appointment.
- During their visit to MEPS, a person may only be required to submit a signed statement confirming that they have not had asthma or received treatment for it after their 13th birthday. Those who have had asthma beyond their 13th birthday will need to submit their complete medical documentation, including hospital and outpatient treatment records.
- In addition to submitting their medical records, a person will undergo tests, including a physical examination and a pulmonary function test (PFT). After the exam, the doctor will either deem the person medically qualified or temporarily or permanently disqualify them.
- MEPS will send the records and medical recommendation for anyone who has received a permanent disqualification to the recruiting commander or representative of the service. This individual will decide whether to request a waiver or not.
- If the recruiting commander asks for a waiver, the waiver request will undergo an approval process from military medical officials representing several layers of the organization. They will give their approval or disapproval until the request reaches a high ranking doctor who will make the final decision.
Previously, any person with a history of asthma was immediately disqualified from joining the military regardless of age. However, in 2014, the Department of Defense revised its policy and only disqualified those who still have asthma beyond the age of 13 years.
An older study from 2008 proved that people with a childhood history of asthma did not contribute significantly to military attrition or hospitalizations due to asthma.
Although the requirements for waiver application are the same for all branches, below are some specific guidelines that each branch has set.
Army
Similar to the general requirement, only people who do not have asthma after their 13th birthday can enlist. In addition, the army will not deploy current soldiers if any of the following apply:
- the inability to wear protective gear
- a recent visit to the emergency room
- repetitive intake of oral corticosteroids
Air Force
In 2017, the Air Force announced its decision to process candidates with a questionable history of asthma for a waiver if they successfully pass the methacholine challenge, a type of test that shows whether a person’s airway is prone to spasms.
Navy
According to the Navy’s Aeromedical Reference and Waiver Guide (ARWG), any history of asthma, even a mild case, can disqualify a candidate for aviation training and duties. However, they can receive a waiver if they fulfill all of the following requirements:
- currently has no symptoms and has had no symptoms and no medication for at least 5 years
- normal PFT within 1 year of the waiver application
- normal methacholine challenge within 1 year of the waiver application
- an accomplished ARWG worksheet
Marines
The Marines Corps uphold the same standards as above for health waiver applications. As the branch is known as the most elite U.S. military branch, it must always adhere to its high standards.
Coast Guard
According to the Coast Guard, people whom MEPS has approved do not require further review. However, recruiters who believe that an applicant received an erroneous disqualification can forward any necessary documentation to the commander for review.
Many myths surround the military, not only in relation to health. Below, we debunk some of these.
Military personnel who develop asthma while on duty will be discharged.
According to the military’s Medical Standards for Retention, the armed forces will only not retain a person if their condition persists even with treatment and hinders them from adequately performing their duties. However, some people may get a different assignment that is less likely to trigger asthma.
People join the military because they have a low income.
A 2020 study found that the military “no longer primarily recruits individuals from the most disadvantaged socioeconomic backgrounds.”
Less talented people join the military.
The same 2020 study found that most recruits had average or slightly-above-average cognitive skills. Although there is an assumption that advanced technology requires less skilled individuals, researchers argue that people with higher skill levels are better placed to work with complex and sophisticated technology.
Women find it difficult to enter the military.
Women represent approximately one-fifth of the officers in every branch except the marines, where they only account for 8%. Moreover, in most branches, the ratio of women officers was higher than that for those who were enlisted.
People who go to the military out of high school do not get the chance to study at college level.
Members in service are eligible for tuition assistance from the Military Tuition Assistance Program, which pays up to 100% of the tuition and school expenses, depending on the limits that the Department of Defense has established.
Other “top-up” programs such as the Montgomery GI Bill Active Duty and the Post-9/11 GI Bill pay the fees that the tuition assistance does not cover.
The ASVAB is not necessary.
A person’s Armed Services Vocational Aptitude Battery (ASVAB) determines their eligibility to join the U.S. military. Moreover, a strong score in certain ASVAB sections is essential to qualify for specialist military roles.
As asthma is chronic, people with a history of the condition can develop symptoms again at an older age. In addition, those who currently have asthma can find that their symptoms worsen over time.
A 2018 longitudinal study found that personnel deployed with combat experience had a 24–30% higher likelihood of developing asthma than those not deployed.
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In line with this, the Military Health System (MHS) ensures that all active duty and reserve personnel are healthy and ready to meet their responsibilities. The MHS also provides medical benefits and care for its members and beneficiaries, such as family members and retirees.
The military does not permit people with active asthma to enlist. However, those who have a history of asthma but have had no symptoms after the age of 13 years may plead eligibility by requesting a medical waiver.
Approval for a medical waiver occurs on a case-to-case basis. It depends on various factors, such as the age at which the person last had symptoms and the severity of the condition.
Moreover, the U.S. military has strict medical standards for enlistment, and each specific branch may have additional or different requirements. It is best for people who want to enlist to review the conditions to ensure that they are eligible.