Military Medical Standards — CNS, Head Injuries, Skin Conditions

There are many ailments that will disqualify a person from military service, and issues involving the central nervous system, head injuries, and skin conditions are high on the list.

Not physically qualified (NPQ) is the label the military gives to those who do not medically qualify for certain professions in the military or for entering the service at all.

Here's what you need to know about the more common disqualifications for recruits seeking military service.

Central Nervous System Disqualification Factors

The military disqualifies candidates who have the following medical issues involving the central nervous system:

• A history of neurological conditions
• A history of cerebrovascular conditions, including but not limited to:
  • Subarachnoid or intracerebral hemorrhage
  • Vascular insufficiency
  • Aneurysm
  • Arteriorvenous malformation
• A history of disorders of meningocele or meninges, including but not limited to:
  • Cysts, in the following scenarios:
    • They have a size and location that interferes with the proper wearing of military equipment
    • They are indicative of an underlying condition that would interfere with military duties
    • They would result in constant irritation that would inhibit one's ability to complete one's responsibilities
  • Degenerative and heredodegenerative disorders (affecting the cerebrum, basal ganglia, cerebellum, spinal cord, or peripheral nerves(
  • Migraines and tension headaches that interfere with normal function in the past three years, or of such severity to require prescription medications

Head Injury Disqualification Factors

Those with a history of head injury will be disqualifying if the injury is associated with any of the following:

• Post-traumatic seizure(s) occurring more than 30 minutes after injury
• Persistent motor or sensory deficits
• Impairment of intellectual function
• Alteration of personality
• Unconsciousness, amnesia, or disorientation of person, place, or time of 24-hours duration or longer post-injury
• Multiple fractures involving skull or face
• Cerebral laceration or contusion
• History of epidural, subdural, subarachnoid, or intercerebral hematoma
• Associated abscess or meningitis
• Cerebrospinal fluid rhinorrhea or otorrhea persisting more than 7 days.
• Focal neurologic signs
• Radiographic evidence of retained foreign body or bone fragments secondary to the trauma and/or operative procedure in the brain
• Leptomeningeal cysts or arteriovenous fistula

Those with a history of moderate head injury will also be disqualified.

Two years after the injruy, applicants may be qualified if neurological consultation shows no residual dysfunction or complications. Moderate head injuries are defined as unconsciousness, amnesia, or disorientation of person, place, or time alone or in combination, of more than one and less than 24 hours duration post-injury, or linear skull fracture.

A mild head injury can be disqualifying, too. However, applicants can be qualified if a neurological evaluation at least a month after the injury shows no residual dysfunction or complications. Mild head injuries are defined as a period of unconsciousness, amnesia, or disorientation of person, place, or time, alone or in combination of one hour or less post-injury.

Those with post-traumatic symptoms that interfere with normal activities are disqualified. Symptoms include headache, vomiting, disorientation, spatial disequilibrium, impaired memory, poor mental concentration, shortened attention span, dizziness, or altered sleep patterns.

Infectious Diseases of the Central Nervous System

Candidates with infectious diseases of the CNS may also find that they are disqualified in the following situations:

• A history of acute infectious processes of the central nervous system, including, but not limited to:
  • Meningitis
  • Encephalitis
  • Brain abscess
• A history of neurosyphilis of any form, including but not limited to:
  • General paresis
  • Tabes dorsalis
  • Meningovascular syphilis
• A history or narcolepsy, cataplexy, paralysis, weakness, lack of coordination, chronic pain, sensory disturbance, or other specified paralytic syndromes
• Epilepsy occurring after the sixth birthday, unless the applicant has been free of seizures for a period of five years while taking no medication for seizure control, and has a normal electroencephalogram (EEG)
• Chronic nervous system disorders, including but not limited to:
  • Myasthenia gravis multiple sclerosis
  • Tic disorders (for example, Tourette's)
  • Retained central nervous system shunts

Skin Disqualification Factors

Skin is considered the biggest organ of the body, and there are many ailments that occur on the skin that can be disqualifying for military service.

From tattoos on certain body parts to major burns to dermatitis and psoriasis, skin conditions have been preventing people from serving throughout history. Typically, any ailment on the skin or otherwise that prevents the use and proper wearing of safety equipment (hazardous materials, helmet, body armor, etc) will result in disqualification from service.

Acne. Severe acne can also prevent a candidate from becoming a solider. If extensive acne of the neck, shoulders, chest, or back is present or would be aggravated by or interfere with the proper wearing of military equipment, the individual would be disqualified. Applicants under treatment with system retinoids, including Accutane, are disqualified until eight weeks after completion of therapy.

Dermatitis. Dermatitis, also known as eczema, is an inflammation of the skin that results in a visible rash and itchiness. A history of atopic dermatitis or eczema after the ninth birthday is disqualifying. A history of contact dermatitis, especially involving materials used in any type of required protective equipment, is disqualifying as well.

Tattoos. The Army has a strict policy when it comes to tattoos. Violation of that policy could be disqualifying.

Scars and Burns Disqualification Factors

One of the main reasons that the preceding conditions are disqualifying is they prevent the proper wearing of military equipment or interfere with the performance of duties, and that is no different in the case of scars and burns.

A candidate will be disqualified if he or she has current scars or any other chronic skin disorder of a degree or nature that requires frequent outpatient treatment or hospitalization. A certifying authority may decide that this condition affects thermoregulatory function, or will interfere with the wearing of military clothing or equipment, or which exhibit a tendency to ulcerate, or interfere with the satisfactory performance of duty.

Scars at skin graft donor or recipient sites will include an evaluation of not only the relative total size of the burn wound but also the measurable effects of the wound, the location of the wound, and the risk of subsequent injury related to the wound itself.

Prior burn injuries involving more than 40 percent of total body surface area are disqualifying, while those covering less than 40 percent total body surface area that results in a loss or degradation of thermoregulatory function is also disqualifying. An examination will focus on the depth of the burn, anatomic location (extensive burns on the torso will most significantly impair heat dissipation), and destruction of sweat glands.

Any prior burn injury that is susceptible to trauma or functional impairment may be disqualifying as well.