Several reasons for the U.S. military’s recruiting crisis are largely out of its control. But there is one problem that is squarely within the Pentagon’s ability to fix: the process by which potential recruits are evaluated—and far too often rejected—for their medical ability to serve. I propose two common-sense changes to overly bureaucratic processes and stringent standards, which would enable the military to access thousands more service members per year.
Having been medically rejected three times before ultimately receiving a medical waiver to join the Air National Guard in 2018, I know firsthand how illogical and infuriating this process can be. But, it was through my efforts advising over 400 similarly rejected applicants that I realized that larger-scale change is needed. By my calculations, over 15,000 applicants are medically rejected each year without applying for a waiver, with even more denied at the recruiter’s door or self-selecting out from applying at all. At a time when the military is facing a recruiting crisis, shouldn’t it be doing everything it can to bring in applicants who are ready and willing but currently unable to serve?
More than 15,000 applicants per year rejected without a waiver appeal
How many potential recruits is the military missing out on? According to a 2022 Accession Medical Standards Analysis and Research Activity report, 1.35 million applicants received a physical at MEPS from 2016-2020. Of that population, 13-16% were medically disqualified, yet only 47-66% of disqualified applicants applied for a medical waiver. By my calculations, from 2016-2020, as many as 85,000 applicants were rejected and did not apply for a medical waiver.
Why would an applicant not request a waiver? The answer comes down to incentives — and who actually does the paperwork. For most applicants, recruiters determine whether or not to submit for a waiver review. However, recruiters are evaluated by the total number of recruits they bring in, often based on monthly or yearly quotas. This disincentivizes them from prioritizing applicants who require waivers, which require more work, take more time, and may ultimately result in rejection. Additionally, recruiters are neither medical professionals nor empowered to evaluate an applicant holistically, which, in fact, is the intent of the waiver process. So, recruiters are unfortunately being put in the position of effectively making waiver decisions when they decide not to submit an applicant at all.
Let’s take 2020 as a case study, when the military services saw the following numbers of applicants, disqualifications, and waivers based on AMSARA’s 2022 Annual Report:
- Army: 120,500 applicants, 14% disqualified (16,750), 8,500 did not apply for waiver.
- Navy: 46,300 applicants, 16% disqualified (7,400), 3,100 did not apply for waiver.
- Air Force: 39,500 applicants, 16% disqualified (6,200), 2,500 did not apply for waiver.
- Marine Corps: 42,500 applicants, 14% disqualified (5,700), 1,800 did not apply for waiver.
So, in 2020 alone, 36,000 potential service members were rejected and 16,000 did not apply for a waiver. When you consider the previous four years as well, 192,000 applicants were medically rejected and 85,000 did not apply for a waiver.
It is important to note that these numbers are an underestimation of total applicants, since recruiters often exercise a “pocket veto” that prevents applicants from processing at MEPS or appealing for a waiver. Additionally, these disqualification statistics do not include the increased rate of disqualifications under MHS Genesis, an electronic health records system launched in 2023, which automatically flags civilian medical and prescription records. This forced disclosure of any and all potentially relevant medical records — which may be outdated, inaccurate, and irrelevant to an applicant’s ability to serve — will now cause only more hurdles.
The question remains: how many of these rejected applicants might be able to serve if given the opportunity to apply for a waiver?
Automatically push all applicants for a waiver
In the near term, a simple fix to this problem would be to automatically push all disqualified applicants for a waiver review. This would immediately double the number of applicants receiving waiver reviews and consequently increase the number of waivers approved. It would end the pocket veto of recruiters, who can slow roll or prevent applicants from applying for waivers. And it would give all applicants a chance to be evaluated holistically as to whether the potential risks they pose are outweighed by the value they bring to the military despite their medical conditions.
Waiver approval rates are currently 60-70%. How many of the 85,000 applicants currently rejected without a waiver might receive one if given the opportunity? There is no way to know for sure. But if we assume, for example, that 25% might be waived, the military could have received 21,000 additional recruits in the past five years. While this would not solve the entire military recruitment crisis, this improvement would result in a significant step towards improving the military recruitment crisis and is wholly within the military’s control.
Tailor medical requirements to job requirements
Requiring all applicants to apply for waivers is only a band-aid solution. Given current qualification standards prevent 77% of American youth from being eligible to serve, changing these standards would increase the supply of potential applicants to much more than just 23% of American youth. The long term solution, therefore, is to tailor military medical standards to military roles (i.e. MOS/AFSC). The military already exercises more waiver flexibility for jobs which are not physically demanding, such as chaplains, lawyers, and doctors, and has increased medical requirements for physically demanding jobs, such as fighter pilots and special forces. Why not expand this practice to all career fields?
Today, many military roles such as intelligence, logistics, or cyber, while critically important, are no more physically taxing than their civilian equivalents. Shouldn’t these roles have lower medical barriers to entry? Each Service could grade each MOS/AFSC as high, medium, or low risk from a physical and medical perspective and update standards and waiver recommendations accordingly. Just like applicants are currently waived for a specific branch, in the future they could be waived for specific jobs. If they wanted to switch, their medical status would need to be taken into consideration.
The needs of the military
Some will argue that tailoring medical standards and waiver guidelines is tantamount to “lowering standards.” I agree that not all conditions should be eligible for a waiver and that neither fitness standards nor job requirements be lowered. Deployability should be considered as well, yet deployability for support functions often means working on an established base or even deployment in place. Overall, the point is that medical standards should match the job, not be needlessly strict and standardized.
At the end of the day, the needs of the military come before any individual applicant. But what, exactly, are the needs of the military? Right now, the military needs to recruit thousands more qualified, competent, and fit individuals per year. The military can make simple changes to eligibility right now to open the floodgates of applicants who are already ready and willing to serve. The question remains whether the Department of Defense will choose to do so.
Joe Schuman is an Air National Guard officer and has published multiple articles on military recruitment issues as well as advised over 400 applicants on navigating the military medical waiver process. The views and opinions expressed in this article are solely those of the author and do not reflect the official position of the U.S. Department of Defense. He can be reached at joeschuman1234@gmail.com.
