Lt.j.g. Marcos Correa (back center) poses with his case management and medical utilization team at the Hospital Menonita Cayey in San Juan, Puerto Rico, Sept. 1. Lt.j.g. Marcos Correa (third from left) poses with Petty Officer 2nd Class Derick Rivera, Fireman Osvaldo Martinez, and Seaman Hector Figueroa-Sanchez at a shooting range in Puerto Rico in May. Coast Guard reservists improve and streamline medical waiver processes for new accessions Story by Capt. Michael Stanley,CGRC Everyone is familiar with the recruitment crisis the armed ser- vices are facing and the Coast Guard is no stranger to this saga. One of the largest hurdles that re- cruiters face is when an applicant is medically disqualified at a Mili- tary Entrance Processing Station (MEPS). The disqualification rate significantly increased in 2021 af- ter MEPS began utilizing nation- wide electronic health informa- tion exchanges. In the past, an applicant may have failed to mention a poten- tially disqualifying event or medi- cal condition. Now, each applicant goes through a pre-screen in which their electronic health re- cords are reviewed prior to their actual physical. As a result, ap- proximately 40% of Coast Guard applicants will require a medical waiver to join. This surge in the “discovery” of potentially disqualifying condi- tions led the United States Mili- tary Entrance Processing Com- mand to launch a new program called the Medical Accession Re- view Pilot (MARP). The MARP provides time criteria that can be used to exempt an otherwise dis- qualifying condition such as At- tention-Deficit /Hyperactivity Disorder (ADHD). For example, an applicant with a diagnosis of ADHD from middle school, which they outgrew by age 14, has not utilized any medi- cation in the past two years or re- quires any special accommoda- tions in school, would get a “free pass” under the MARP. In the past, any history of ADHD at any age would have been a showstop- per. Another example is knee pain. Previously, any incidence of knee pain was disqualifying; however, under the MARP, an applicant is qualified if there has been no pain in the last three years. These new exemptions, cou- pled with the electronic back- ground health review, dramati- cally increased the workload for each branch’s service waiver au- thority. In January, there were over 400 Coast Guard waiver cas- es ready for review; a large task for a small office that relied at the time on volunteer Coast Guard Auxiliary health care profession- als to read medical records and make recommendations. Thankfully, in December 2022 Cmdr. Gail Tarlton with the U.S. Public Health Service, accepted the role in the senior medical of- ficer position at Coast Guard Re- cruiting Command. Previously, she served six years in the Medi- cal Affairs Branch of the United States Public Health Service Com- missioned Corps Headquarters evaluating officer fitness for duty. Joining her on active duty orders from the Reserve are Lt. j.g. Mar- cos Correa, a medical doctor, and myself, a physician assistant. I have been a medical officer for over 20 years and most recently was the senior medical executive at Coast Guard Training Center Cape May, New Jersey. At the end of the fiscal year 2023, the Coast Guard processed 3,000 new enlisted accessions via basic training. Supporting this ef- fort, our team analyzed and pro- vided recommendations for more than a thousand waiver requests, reading over 30,000 pages of in- formation. The team also reviews and makes approval recommen- dations for all direct commission and Officer Candidate School physicals. Despite the large vol- ume of cases that are added daily from more than 150 recruiting of- fices across the nation, applicants can now expect a decision within two or three weeks of applying. On average, 90% of waivers are approved and fewer than 5% are considered permanently disquali- fied. The path to entry into the Coast Guard isn’t always straight- forward. The process of reviewing medical waivers presents a chal- lenge between the aspirations of candidates with potential health concerns, the operational de- mands of the service and the duty of maintaining fleet safety during missions. . Lt.j.g. Marcos Correa, M.D. Story by Master Chief Petty Officer Susan Blake One of the greatest strengths of the Coast Guard Reserve is the wealth of knowledge and experience each member brings from their civilian jobs to broaden the capacity of the service. Such is the case of Dr. Marcos A. Correa, Associate Director of the Medical Care Review, Medical Utilization and Case Manager Department at Hospital Menonita Caye. Correa is also a Coast Guard Reserve enforcement officer who is currently serving in a critical role in the Coast Guard Recruiting Command Accessions Division. As Correa has been reviewing medical waiver submissions, he also is developing guides for each common medical condition that is typically submitted and required for a service medical waiver. “These guides simplify a complex medical condition for the field recruiter to understand, why it’s a medical disqualification and what would be required by the applicant to obtain in the way of medical documents to submit for waiver consideration,” said Russell Kirkham, Chief of CGRC’s Accession Division. “The use of these guides has accelerated the process, resulting in days to adjudicate a medical waiver instead of months with multiple submissions.” Eager to grow professionally, Correa is also preparing for the United States Medical Licensing Examination board, aiming to pursue a family medicine residency to make a positive impact on families in his community. Correa encourages people to pursue their dreams with fervor and guarantees that the Coast Guard will find a way to help them set sail for success. “Keep a positive mental attitude, be thankful for the good and learn from the bad,” said Correa. “The first day you put on that uniform, from that day on, you will never be alone.” . 10 Reservist . Issue 4 • 2023 Celebrating Celebrating 70 70 years of the Reservist years of the Reservist
