APFT profile, not being given recovery time

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DD214_DOC

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So here's an interesting situation. Was flagged for PT, put on profile. To keep this as anonymous as possible, now I'm being told by those outside of my MTF command that I have to pass a record APFT either while still on profile or during recovery phase lest I won't progress to the next PGY level.

I thought it was army policy that you cannot be forced to take an APFT while in recovery phase, let alone while still on the active profile?

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Dude, you're a psychiatry intern. Dig deep, suck it up and find a way to run 2 miles in less than 16:36. This isn't rocket surgery. If I recall you're profiled for some vague systemic issues. I've got guys in my outfit with asthma, full ACL tears who still go out and get it done.

If you ever get out to a real unit trust me, they won't be nearly as forgiving as your current MEDCEN "command."


-61N
 
My experiences with this kind of stuff have only been as a doc at an AF base, but the essential principle seems similar.

Airman wants to re-train to a better career field, go to a training academy, sweet TDY, or whatever, but flunks his PT test for some after the fact reason. It's always something like they missed their situp count by a couple of situps because over the weekend they tweaked their back helping their buddy move. They thought they'd be OK and they weren't, now they need a profile because now their cookie is being taken away 'cause they flunked.

I end up telling them this: I can give them a profile, but it won't make their cookie come back. That's up to their commander. Sure they're not "supposed to" re-take their PT test while on a profile or during the recovery period, but their commander is also under absolutely NO obligation to return their cookie to them just because they got a piece of paper after they went crying to the doc after they effed up.

Long story short, a doctor's note doesn't trump a commander's decision. Your commander can't FORCE you to re-take your PT test while you're on profile or in the recovery period, but he CAN take away your cookie (i.e., your PGY-2) year until you show him a passed PT test. Your commander isn't forcing you to do anything, he's simply offering you a choice: waive your profile/recovery period and bust out a pass on your PT test now (the regs do allow members to waive their profile/recovery period), or remain a PGY-1 until you do so.
 
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Was flagged for PT, put on profile. To keep this as anonymous as possible, now I'm being told by those outside of my MTF command that I have to pass a record APFT either while still on profile or during recovery phase lest I won't progress to the next PGY level.
It seems like the situation hasn't changed when you created a thread about this seven weeks ago, right? Have you made any progress in the last 7 weeks towards a passing APFT? Did they come up with a diagnosis or is it more an issue of conditioning/recovery at this point?

And out of curiosity, have you never had a passing APFT on record? I'd be a little surprised if the Army flat out wouldn't allow folks on profile to progress from PGY-1 to PGY-2. But I wouldn't be surprised at all if the Army wouldn't move someone out of intern year if they had no history of demonstrating an ability to pass an APFT.
I thought it was army policy that you cannot be forced to take an APFT while in recovery phase, let alone while still on the active profile?
You can't be forced to take an APFT on profile. But they can't be forced to progress you to PGY-2 if you don't have a record of ever passing an APFT.

Why doesn't the military require folks to pass APFTs prior to transitioning active in intern year? Can folks make it through med school with no physical requirements other than height/weight? Seems if you required a passing APFT to START intern year, you'd have less issues with folks who haven't done a sit-up or push up or any running in 2 or 3 years. Even in the Guard we have to pass a record APFT twice a year or there's he!! to pay.
 
You guys are missing the point. Ive been on profile and told not to exert myself until medically cleared. Now im told to take and pass an apft without any recovery period to train to what is necessary. Believe it or not, not everyone makes **** up just to get a profile. I had issues that concerned me, went to my pcm (who wanted tbe profile I did not ask for it), and now am told to pass without time to train or face punitive action from somrone not even in my local coc overriding what they want to do.
 
So here's an interesting situation. Was flagged for PT, put on profile. To keep this as anonymous as possible, now I'm being told by those outside of my MTF command that I have to pass a record APFT either while still on profile or during recovery phase lest I won't progress to the next PGY level.

I thought it was army policy that you cannot be forced to take an APFT while in recovery phase, let alone while still on the active profile?

Here a hypothetical situation: I had one doctor who was sick and did not take the board exam. He lost the board exam fee and did not get paid for board exam pay for whole year.

You have a good reason, but if your department policy to have current APFT passing score to progress to PGY II then you need to comply. You can talk to higher chain of command if you want to get a waiver to policy given unique situation.
 
If you are a psych intern as stated above, you should have plenty of time to be able to knock out 40 pushups, 50 situps and find an event run, swim or bike.

The guys above are right, if it is the GME policy, then either you get an exception to policy or you take the PT test. The purpose of "recovery" time isn't to be sitting and doing nothing. You should be engaging in an appropriate exercise. I tell this to all of my soldiers that i put on profile. A profile doesn't mean not to exercise, it serves as guidelines to their command of what they can do.

Talk to your command, GME office and program director. See what you can work out. But you better start getting ready for a PT test. You are in the Army and this is part of the deal.

PT is just part of the Army. Ever since the AMEDD came under fire for the jihaddist psychiatrist at Ft Hood, they have been cranking up the pressure on not turning a blind eye to these things. That guy failed multiple PT tests, yet was still promoted and graduated.
 
Long story short, a doctor's note doesn't trump a commander's decision. Your commander can't FORCE you to re-take your PT test while you're on profile or in the recovery period, but he CAN take away your cookie (i.e., your PGY-2) year until you show him a passed PT test. Your commander isn't forcing you to do anything, he's simply offering you a choice: waive your profile/recovery period and bust out a pass on your PT test now (the regs do allow members to waive their profile/recovery period), or remain a PGY-1 until you do so.

Sounds like this is exactly what's going on.

HooahDoc: It sounds like your command doesn't believe that you're deserving of a profile, regardless of the fact that you got an official one from a physician. And so they're trying to call your bluff.

Whether or not their disbelief is justified is hard to say, not knowing you and your personal situation.

What exactly is your profile for anyway? You may think it's not important (a profile is a profile), but it is. Along with any profile comes a perception; a profile for fibromyalgia might draw more scrutiny than one for a torn ACL. You might as well lay out all your cards here to get more specific advice. And don't worry about your anonymity; it's already been compromised, Dr-PGY1-Psych-Army-Tripler-onProfile.
 
So I took a diagnostic today and passed with room to spare. Taking a record in a week or two.
Good stuff. You shouldn't have any problem with the record. Congrats, that has to be a load off...
Regardless, I still think the whole situation is lame and needs to be addressed.
What situation?

Are you someone with passed record APFTs on file and you've recently been put on profile, with your command not moving you on to PGY-2? That seems fishy...

Or are you someone who has NEVER passed a record APFT and the Army does not want to put you into a PGY-2 spot? That seems legit...

Which are you? If you're the latter, it makes sense that the Army might have concerns about the fact that they've put someone through medical school and internship and have not yet been offered any assurances that the individual can pass the basic health standards required of all soldiers. Our commission is contingent upon our ability to make height/weight and pass the physical twice a year. Failing to do so can make us ineligible for promotion and further training (such as post-internship residency). This should not be a surprise.

I would think you couldn't fall in the latter category though. After 4 years of HPSP with ADTs and 1 year of full-time active duty as an intern, you'd have had to take the APFT at least once for record, no?
 
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So I took a diagnostic today and passed with room to spare. Taking a record in a week or two. Regardless, I still think the whole situation is lame and needs to be addressed.

It is being addressed; you're taking the PT test.

Lol, I had one hardass boss who had to deal with all the people who wrote big letters or memorandums about how they should be exempted from their PT test or why they failed their last one. Her system was this: the member and usually their supervisor would come in with their big file and long letter documenting their woes.

Before they could begin their huge speech on why they sucked, she would hold up her hand and ask, how many hours did you spend putting all of this together this week?

The supervisor and the member would look at each other and toss out a number. Usually like 5-10 hours.

Then she would ask, how much time did you spend doing PT this week? Invariably, the member would hem and haw. This was why my boss made the member bring their supervisor; because the supervisor would know or be able to get the truth, so the member knew that they couldn't lie. Finally the member would say something like they jogged to the fridge three days ago or something like that.

My boss would then dramatically hold up the member's thick file and say, "if you spent HALF as much time working out and doing what you're supposed to instead of drafting letters explaining why you can't to cover your rapidly-expanding backside, then we wouldn't be having this conversation!" Then she would look at the member's supervisor, and ask what their plan was to get the member back on track. Within a couple of months, the member had either passed their PT test or was out of the Air Force entirely.

It was a sad day when she left. People got more touchy-feely and the base got a lot fatter.
 
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Well, just to correct something mentioned earlier, I have not yet been in my recovery phase, but still on active profile. Despite the profile, I had been training because I figured something like this would happen.

Ultimately, I had to take an aPFT while on an active profile to avoid the reprecussions. It isn't over and done yet, but as long as I don't somehow screw up the record and everything else goes ok it should be a non-issue.
 
I think the takeaway from all this is that the Army should require a passing APFT prior to starting internship. It looks like that would avoided all the drama HooahDOc is going through. Folks are on active orders starting internship, so they should be required to pass the same physical every other soldier does who draws a paycheck.

Passing an APFT is really not hard, but passing your first one definitely can be, particularly if you're out of shape or were never in shape. Fourth year medical school is an excellent time to correct this. Intern year, not so much.
 
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I see no reason to overhaul the manner in which interns, specifically those who are new to active duty, take their APFTs. As I recall, this all started because the OP took and failed a record APFT while being injured or ill. It was that injury/illness that prompted the profile that this thread now references. I think the real learning point here is to not take a record APFT if you have a legitimate cause that would prevent you from performing up to standards. Profiles are a pain, but they exist for a reason. If the OP would have gotten his profile before the APFT, then it's reasonable to believe that he would have recovered and trained appropriately so that he could pass following the expiration of his profile but well before the end of his internship. His reported performance on a diagnostic APFT speaks to that.
 
I see no reason to overhaul the manner in which interns, specifically those who are new to active duty, take their APFTs. As I recall, this all started because the OP took and failed a record APFT while being injured or ill. It was that injury/illness that prompted the profile that this thread now references. I think the real learning point here is to not take a record APFT if you have a legitimate cause that would prevent you from performing up to standards. Profiles are a pain, but they exist for a reason. If the OP would have gotten his profile before the APFT, then it's reasonable to believe that he would have recovered and trained appropriately so that he could pass following the expiration of his profile but well before the end of his internship. His reported performance on a diagnostic APFT speaks to that.

Thank goodness someone finally said this. Please, everyone remember this: if you fail a record PT test, you are flagged. This means no positive personnel action (which is the OP's problem). I have several friends who have missed promotions and citations for failing weight/PT. Getting a profile AFTER being flagged does nothing to remove the flag. The only thing it would potentially save you from is remedial PT. Until you get the flagged lifted, you are doomed. It's too bad the OP took a diagnostic PT test the other day rather than for record. Frankly, I can see no benefit for taking a diagnostic after you are flagged.

I think the big confusion here is believing that getting flagged and being on profile have anything to do with each other, they really don't. Totally separate regulations. Take home point as said above: get the profile before the PT test.

By the way OP, you need to clear your profile before you take the PT test.

Ed
 
Thank goodness someone finally said this. Please, everyone remember this: if you fail a record PT test, you are flagged. This means no positive personnel action (which is the OP's problem). I have several friends who have missed promotions and citations for failing weight/PT. Getting a profile AFTER being flagged does nothing to remove the flag. The only thing it would potentially save you from is remedial PT. Until you get the flagged lifted, you are doomed. It's too bad the OP took a diagnostic PT test the other day rather than for record. Frankly, I can see no benefit for taking a diagnostic after you are flagged.

I think the big confusion here is believing that getting flagged and being on profile have anything to do with each other, they really don't. Totally separate regulations. Take home point as said above: get the profile before the PT test.

By the way OP, you need to clear your profile before you take the PT test.

Ed



This is a great point. Let me expand on the last point. I think OP cannot take the record APFT on temporary profile. That explains why he took the diag. PT. This needs to be permanent profile > 3 months. I wonder if a soldier can get a consecutive temporary profile for same condition and take it. Please also remember that the profile is a recommendation made by a doctor. It can also be ignored by a commander.:eek:
 
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I think a SM may elect to do whatever he wants regardless of profile status.

I think you are mistaken.

FM 21-20 states under section 14-20, "A soldier with a temporary profile
must take the regular three-event APFT after the profile has expired."

My personal experience jives with this as well.
 
I think a SM may elect to do whatever he wants regardless of profile status.
Not quite - you actually have to abide by the limitations on the profile - if a profile says "no running" for example and the soldier chooses to run - he/she can be disciplined for breaking the profile.
The profile system is designed to allow the soldier to heal and protect the soldier from the Command but also expects the soldier to follow the guidance.
 
I think you are mistaken.

FM 21-20 states under section 14-20, "A soldier with a temporary profile
must take the regular three-event APFT after the profile has expired."

My personal experience jives with this as well.
I lifted this from TC 3-22.20 (Army PT document)

Once a profile is lifted, the Soldier
must be given twice the time of the temporary profile (but not more than 90 days) to train for the APFT.


It doesn't say you have to take the recovery time just that you must be given it. In the OP's situation it is far better to take and pass it so not affecting the opportunity to progress to R2 year.
 
You guys are missing the point. Ive been on profile and told not to exert myself until medically cleared. Now im told to take and pass an apft without any recovery period to train to what is necessary. Believe it or not, not everyone makes **** up just to get a profile. I had issues that concerned me, went to my pcm (who wanted tbe profile I did not ask for it), and now am told to pass without time to train or face punitive action from somrone not even in my local coc overriding what they want to do.

The person who put you on the profile should intervene on your behalf. If an orthopedic surgeon put you on a no exercise restriction, that physician should speak with your chain of command to resolve the conflict rather than you directly. The restriction should come directly from a competent medical authority to your command rather than through you.
 
s an aside, my echo and gxt had some nonspecific findings and I have no idea what, if anything, they mean? (hyperdynamic ejection fraction (85%-90% on echo), mild mitral regurgitation, 32-point drop in SBP during increased physical activity; During peak exercise, I went from 146/x to around 114/x and felt dizzy and had to stop. My SBP actually started to decline as I further exerted myself. For some reason the cardiologist read it as, "normal". I know I'm an intern and all but I don't remember that being normal during exercise)
 
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So, now I'm kind of stuck. He either approves an alternate event or I have to violate the profile to move on to PGY2 and hope nothing becomes of it...

The decision rests with the cardiologist(?) who put you on a profile. Are you fit for duty or not? Are you fit to take the PFT or not? These are medical questions. The cardiologist or other physician should advocate on your behalf, speak directly to your command and resolve the conflict. I think your commander or cardiologist(?) could waive a portion of the PFT. So you could do sit-ups, push-ups but not cardio.

One concern I have is if you are found physically unqualified you could end up with a release from the military and a bill for all your HPSP expenses.
 
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). As an aside, my echo and gxt had some nonspecific findings and I have no idea what, if anything, they mean? (hyperdynamic ejection fraction (85%-90% on echo), mild mitral regurgitation, 32-point drop in SBP during increased physical activity; During peak exercise, I went from 146/x to around 114/x and felt dizzy and had to stop. My SBP actually started to decline as I further exerted myself. For some reason the cardiologist read it as, "normal". I know I'm an intern and all but I don't remember that being normal during exercise)

Any suggestions?

If your BP dropped DURING exercise this may indicate heart disease. Any arrhythmias? Although I do not know the indication for your specific stress test it is not unreasonable to obtain cardiac cath to eval for obstructive CAD. Had this happend to older patients I would be worry about left main disease. In my opinion you are not cleared to perform any exercise at this point.
 
If your BP dropped DURING exercise this may indicate heart disease. Any arrhythmias? Although I do not know the indication for your specific stress test it is not unreasonable to obtain cardiac cath to eval for obstructive CAD. Had this happend to older patients I would be worry about left main disease. In my opinion you are not cleared to perform any exercise at this point.

Yeah, it was during peak exercise, which is typically when the symptoms occur. No arrythmias or anything noted, just an IRBBB. Nonspecific junctional ST-T wave stuff in resting EKG. Could be an anomolous coronary or something too? I had a nuclear profusion study before every joining the military for this stuff which was normal. ????
 
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Yeah, it was during peak exercise, which is typically when the symptoms occur. No arrythmias or anything noted, just an IRBBB. Nonspecific junctional ST-T wave stuff in resting EKG. Could be an anomolous coronary or something too? I had a nuclear profusion study before every joining the military for this stuff which was normal. ????

So now you understand my frustration. My concerns and profile are legitimate, but I'm still SOL.

Given the serious nature of your profile, your command should be doing whatever it can to help you out. The fact that they're not, and the fact that they're dangling PGY2 like a carrot above your head is very concerning, especially given the need for trained psychiatrists in the Army. It's hard to say why your chain is being so difficult; I've only seen such lack of support when the member in question has been a sht bag or done something to really piss someone off. Is that the case with you, you think?

In any case, I don't mean to beat the JAG drum, but it might be prudent for you to seek some legal counsel, if you think you're being unduly hassled (I'm sure there's several JAG officers out there that have dealt with profile-related issues, not unlike your current one.) You don't have to tell anyone that you've gone to a JAG, nor do you have to officially recruit one as your representation. You can just have a conversation, they may provide good advice. Good luck . . .
 
A resident in my training program was diagnosed with cancer. He was put on limited duty, had surgery and radiation treatment. Everyone went out of his way to help him and it worked out. As I recall he resumed his residency a year later and has been in remission since.
 
If your BP dropped DURING exercise this may indicate heart disease. Any arrhythmias? Although I do not know the indication for your specific stress test it is not unreasonable to obtain cardiac cath to eval for obstructive CAD. Had this happend to older patients I would be worry about left main disease. In my opinion you are not cleared to perform any exercise at this point.
Haujun,
Are you really giving medical advice on a public website without interviewing or examing th patient? Irresponsible

OP - probably a good idea to keep things a little closer to the vest. In all likelihood there are people on the forum who work at your facility.
 
Haujun,
Are you really giving medical advice on a public website without interviewing or examing th patient? Irresponsible

OP - probably a good idea to keep things a little closer to the vest. In all likelihood there are people on the forum who work at your facility.

A doctor ordered GXT based on hx and exam. Even if he had unremarkable hx or physical exam it does not change the fact that drop in his blood pressure dropped during exertion which may indicate heart disease. This is not common occurence. I think it would be irresponsible to stay quiet because I did not interview or exam this patient.
 
I think this whole thread is a good example of how your military employer treats people.
 
I think the poster deserves our support. Internship is stressful enough without having to worry about a medical concern or whether you could continue to PGY2 because of a paperwork issue. Please keep us updated as to your progress!
 
Okay, here is the bottom line. Whenever the military makes a policy that might seem unfair, keep in mind that you can thank those before you that have abused the system.

In the past, I have seen individuals that on the day they pin on 0-4, figure out that they will have an ETS date before they would ever be considered for an 0-5 promotion, thus, at that point in time, they decide to get nice and fat and REFUSE to ever go do an APFT again. If that lead to a below the center of mass OER or ugly ORB, they didn't care, because they new that in a very short time they were getting out and taking a job that would pay them 2.5X as much as the military.

I have also seen individuals that NEVER passed an APFT throughout their entire GME training, thus, NEVER passed one whenever they were post-grad, thus never getting promoted to 0-4, but also dodging deployments due to this.

As a prior posted pointed out, there are also lists of individuals that fall into this category and still somehow get awareded fellowship, promotions, etc?

At this time, at least on the Army side of the house, they are sick of this crap and are trimming the fat, so to speak and have made this "if you don't pass by the end of your PGY-1 year" rule.

Now, for a guy like you that perhaps has a legitimate profile and medical condition, well, that is unfortunate. But again, thank all of those before you that ruined it for you. My advice, do whatever it takes to get through that PGY-1 AFPT and get it out of the way!! Whether its fair or not.

I do not expect you to share your medical history with any of us and would advise against doing so. But, if you do have some sort of condition that would hinder APFT performance, you may face an MEB. Because you are a doctor, you may also be retained and placed on a permanent profile and never deployed as a result of this.

I wish you well in your training. If you are an intern in psych (as others have suggested), then I would recommend paying back your committment and exiting at your earliest chance and go on in life and be the best doc you can.
 
Oh, forgot to tell my experience. My first AD year, I passed my AFPT. I had a 36inch abdomen. BMI was 26 so I wasn't fat. the next year, while awaiting surgery to remove my 4+ tonsils (so I could breathe while exercising), I was forced to do the AFPT.
I asked to allow post-poning so I could do the test straight up. Denied.
I only was allowed abd taping. Unbekwonst to me, that a 36 inch abd gives you 72% points. Fail. I was then enrolled into a program which mandated 5 workouts a week (the classes clash with clinic hours--go figure), and have work out instructors sign my work out form. like a 5th grader. I had to endure this for 45 days before I was allowed to test again (and pass). Once, a teenage instructor refused to sign my form because I was 5 minutes late (due to finishing up a code), apparently that isn't sufficient reason.
We had only 1 car, so my wife (and 1 year old) had to drive me to classes since it is miles across base and the temperature and weather do not allow biking. because I missed some signatures, i got a letter of counseling.
I will never allow my children nor my friends make the same mistake I made: signing to serve my country as a "professional"
 
Oh, forgot to tell my experience. My first AD year, I passed my AFPT. I had a 36inch abdomen. BMI was 26 so I wasn't fat. the next year, while awaiting surgery to remove my 4+ tonsils (so I could breathe while exercising), I was forced to do the AFPT.
I asked to allow post-poning so I could do the test straight up. Denied.
I only was allowed abd taping. Unbekwonst to me, that a 36 inch abd gives you 72% points. Fail. I was then enrolled into a program which mandated 5 workouts a week (the classes clash with clinic hours--go figure), and have work out instructors sign my work out form. like a 5th grader. I had to endure this for 45 days before I was allowed to test again (and pass). Once, a teenage instructor refused to sign my form because I was 5 minutes late (due to finishing up a code), apparently that isn't sufficient reason.
We had only 1 car, so my wife (and 1 year old) had to drive me to classes since it is miles across base and the temperature and weather do not allow biking. because I missed some signatures, i got a letter of counseling.
I will never allow my children nor my friends make the same mistake I made: signing to serve my country as a "professional"
which service?
 
I have a question along these lines. I never passed an APFT, at OBLC I was fine on situps and pushups but a minute over on my run. I had never run before in my life, and starting the summer before medschool I began training on my own, a tenth of a mile at first, then working up to the full two miles, then trying to trim down my time. I wasn't too upset by the fail, I figured I'd keep working and get up to speed before graduation. But since then I have developed a problem with my knee. I don't recall a specific moment of trauma that caused it, but I have a meniscal tear that hasn't responded to conservative treatment. About a year ago, the injury became a persistent problem, with swelling and a fluid effusion within hours of every run. I tried staying off of it a while, then got frustrated and decided to run on it anyway--because it wasn't that painful. That was 8 months ago, and since then it has never gotten better, pops/clicks with every step, has a constant effusion, aches all day long, even first thing in the morning, etc. I've stayed off of it since then, tried the brace, tried elevation and babying it, but to no avail. Ever since the day I decided to run on it while it was bothering me, it worsened and never healed.

I've been thinking of getting an MRI and an official diagnosis this month, and mentioned this to another HPSP student. He seemed to think this is a bad idea. In fact, he's been having unilateral headaches and has refused to seek medical treatment for fear of involuntary separation from the military. He seemed to think I should avoid any diagnosis whatsoever, because if I got one I would have to report it to the military, and this will impact me negatively.

My question is, should I get an MRI to confirm the meniscal tear and report this to the military now, before being flagged for failing an APFT? I would hate to fail another APFT, get flagged, and then be accused of scrounging up the diagnosis to avoid the physical fitness requirements. That isn't all the case; I am quite motivated to meet the requirements and have been frustrated by the limits my knee has put on my ability to exercise. The stationary bike isn't even working at this point, bc any flexion irritates the injury.

Someone else suggested for me to get the imaging and the treatment and never mention it to the military but this seems risky. If it doesn't heal before I need to take an APFT, and then my medical record shows that I had the diagnosis for a while and did not report it--well, I just don't know the ramifications of that.

Thanks in advance.
 
They're not going to separate you for something like a meniscal tear. You may end up with a permanent profile depending upon how you recover, but it's not a diagnosis that would exclude you from continued military service. In fact, there are only a few medical diagnosis that require a medical board and separation.
 
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