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HPSP Medical discharge and payback?

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chordaetendineae

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I am an HPSP medical student. I was diagnosed about a year ago with a health condition (after starting medical school and HPSP). Since then, it has been progressively getting worse, and I now believe it will affect my ability to serve active duty. There is no cure. (It's not HIV). My question is, if I ask for a medical discharge, would I be required to pay back everything? The policy handbook states that I may be held financially responsible, but it's ambiguous. It does state specifically the HIV patients are exempt.

I know my ability to serve active duty is compromised, but I'd rather hide my health condition than have to pay back money I do not have.

Can anyone advise? What usually happens in these medical cases?
 
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68PGunner

Unless your worsening medical condition stops you from graduating from med school and becoming a BC physician, you will serve your obligated years in middle-of-nowhere dumps or war zones. Good luck!
 
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Slevin

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Not sure what branch you are but each has their own standards of medical fitness. In the army it's AR 40-501. You can check to see if your medical condition is listed
 

chordaetendineae

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Thanks for your responses. I am in the army, and my condition is listed in AR 40-501. I do not meet the standards.

Given that I developed this condition after I signed up for HPSP and started medical school, would I have to pay everything back? Obviously if I do, I'll keep my mouth shut.

Should I find a lawyer who is knowledgeable about military law?
 

Slevin

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I don't have much info in this area but if it developed after you signed the paperwork then they should allow you to separate without having to pay anything back. But I'm not sure. There is probably a regulation about it in either the wording of the HPSP contract or possibility under the medical separations regulation.
 
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68PGunner

Thanks for your responses. I am in the army, and my condition is listed in AR 40-501. I do not meet the standards.

Given that I developed this condition after I signed up for HPSP and started medical school, would I have to pay everything back? Obviously if I do, I'll keep my mouth shut.

Should I find a lawyer who is knowledgeable about military law?

What is your problem that's keeping you from being a physician for the Army?

I'm going to make this simple and sweet for you. Unless you have a diagnosed condition that stops you from being a physician for the Army, you will be found fit by MEB/PEB regardless of retention standards. Retention standards for a physician are different than retention standards for enlisted soldiers and line officers.

For example, you might have herniated discs with radiculopathy. However, since your symptoms can be controlled by drugs, you will stay on to become a physician for the Army. Naturally, an enlisted soldier or line officer will be MEB because they can't shoot, move, and communicate effectively. As a physician, you're not a real soldier.

So, unless your condition stops you from becoming a BC physician in the civilian world, you will pay back your obligated years at Ft Polk or Ft Drum. You're welcome to get a military lawyer, but you won't get out of your contract.
 

jabreal00

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Thanks for your responses. I am in the army, and my condition is listed in AR 40-501. I do not meet the standards.

Given that I developed this condition after I signed up for HPSP and started medical school, would I have to pay everything back? Obviously if I do, I'll keep my mouth shut.

Should I find a lawyer who is knowledgeable about military law?

You are unique as a physician. Much of what is in AR 40-501 may not apply to you. AR 40-501 is geared more towards the line soldiers who's job is to deploy or train for deployment year round. If you are able to still practice as a physician despite your medical condition the Army will keep you. They'd use you as a physician stateside even if your condition precludes you from deploying. If your medical condition is life threatening and/or would interfere with you practicing medicine then then you'd likely get discharged. If it is not a pre-existing condition and you cannot practice medicine they'd cut their loses while you are a medical student. There could be precedent for your loans to be forgiven in that scenario (you'd probably have to pay tax on the loan amount.
 

notdeadyet

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Thanks for your responses. I am in the army, and my condition is listed in AR 40-501. I do not meet the standards.
If it's DM, do not expect immediate discharge.

Agree with the others on this. The AR 40-501 standards that will get SGT Snuffy discharged are different from those for a physician, who they will bend over backwards to keep.

You can consult a lawyer with experience with military law, and they will be HAPPY to take your money, but unless they've had experience on cases of folks trying to leave prior to HPSP payback due to medical reasons, they likely will not be able to shed any light on the subject. The language is such that the military can ask you to pay back HPSP payouts if you are not able to fulfill your service obligation. Any other outcome will really be decided case by case.
 

Homunculus

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just let the med board do its thing. if they keep you, they keep you. to answer your original question though if you do get medboarded out and this truly developed after you joined i highly doubt you will pay back anything. it's the risk they take with these programs- but like health insurance most of us make it through fine, and like previous people have said the bar is set much higher for physicians. i know of docs who have everything ranging from being s/p colectomy (with an ostomy) to crohn's disease to retinal detachments to myasthenia gravis to multiple sclerosis, etc. you may be surprised.

--your friendly neighborhood otherwise healthy in NAD caveman
 
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chordaetendineae

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Thank you everybody for your input. Everything you say makes sense. However, I have seen several posts on this forum from people who have been medically discharged for benign conditions, such as developing asthma or accidentally getting Lasik (w/o complications).

My condition does keep me from getting deployed. However, it does not keep me from practicing medicine.

My options are:
1) Tell the army about my condition.
a) They keep me in HPSP and have me serve state-side.
b) They discharge me and make me pay back a few hundred grand.
c) They discharge me without asking me to pay anything back.
2) Don't tell the army about my condition. If they try to deploy me in the future, I will have no choice but to tell them about my condition. However, they may say that I was committing fraud by hiding it from them. I am not sure what the implications of that would be.

Any thoughts which course of action is best? Thanks!
 

TheEarDoc

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Thank you everybody for your input. Everything you say makes sense. However, I have seen several posts on this forum from people who have been medically discharged for benign conditions, such as developing asthma or accidentally getting Lasik (w/o complications).

My condition does keep me from getting deployed. However, it does not keep me from practicing medicine.

My options are:
1) Tell the army about my condition.
a) They keep me in HPSP and have me serve state-side.
b) They discharge me and make me pay back a few hundred grand.
c) They discharge me without asking me to pay anything back.
2) Don't tell the army about my condition. If they try to deploy me in the future, I will have no choice but to tell them about my condition. However, they may say that I was committing fraud by hiding it from them. I am not sure what the implications of that would be.

Any thoughts which course of action is best? Thanks!

Most of the people discussing such medical discharges are not medical officers and are usually either line officers or enlisted or committed fraudulent enlistment and got busted for it.

If your condition is that serious that it would truly make you non-deployable as a med officer (this would have be something horrible to meet this) then you need to let the Army know this before you end up in some gutter on the other side of the globe and have a health crisis! As others have said if it was not a pre-existing condition and they feel they need to med board you out then they will do that process which usually takes a long time. My guess as others have said is if your condition is so bad you wouldn't be of use to the Army in some form or fashion then they would med board you out and you wouldn't owe anything is my guess.

If you stay quiet about it and then it comes up right before you are to be deployed that's going to be a problem for a few reasons:
1. They might truly question if you have the condition and then how long you've had it
2. Then they might start digging and wonder how long you've had it without reporting it - big no no and if they think you knew about it prior to signing up then you could be in a whole heap of trouble! That could range from dishonorable discharge to fines to jail time and felony record depending on how far they wanted to take it. Not something I personally would want to risk. You have to remember you are an officer and they are often held to a higher standard than enlisted and you might get that unsavory person who decides to make an example out of you

I would say go talk to them and report your condition. Get checked out. Get it documented. Let the Army the decide what they want to do with you. Honesty now will be better than cover up and explanation later.
 
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jonb12997

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I agree with theeardoc. Just bring it forward and let the meb process do it's thing. Are you checking chapter 3 retention standards? Or The "get in" standards. As I've learned the bar to get in is high but the bar to stay in is much lower...
 
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Tell them what's going on with your health. See where it goes. They will likely let you stay in and give you a waiver, even make you non deployable. Unless it's something debilitating where you might progress to non functional, like MS, etc. That they might cut loose.
I don't think they will drop you and come after you for tuition unless they believe you concealed the condition and had a fraudulent enlistment or whatever they call that for officers.
 
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asdf123g

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Could OP collect a disability check or build disability rating or whatever its called?
In the hypothetical situation where the army does cut OP, would he be required to pay all future tuition going forward?
 

pgg

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You're anonymous here. You could consider telling us what the condition is, to get better information.


If you conceal the condition that you know you have from the military, while continuing to collect benefits (tuition etc), then there is a good chance the military will want its money back when it finds out you've been withholding that information.

If you disclose the condition, the worst case is that the military will stop paying for your education. They won't demand a refund ... unless perhaps if your condition is the direct result of criminal activity ... eg, if you just became a paraplegic because a cop shot you in the spine while you were robbing a gas station, or because or you DUI'd yourself through a farmer's market and crashed your car into a kindergarten.


You should let the service paying your tuition know that you have concerns that you will be medically unqualified to serve out your commitment. If you act in good faith and do the right thing, it'll work out.

1) Tell the army about my condition.
a) They keep me in HPSP and have me serve state-side.
Probable.

b) They discharge me and make me pay back a few hundred grand.
Won't happen if you disclose the problem now.

c) They discharge me without asking me to pay anything back.
Possible.

2) Don't tell the army about my condition. If they try to deploy me in the future, I will have no choice but to tell them about my condition. However, they may say that I was committing fraud by hiding it from them. I am not sure what the implications of that would be.
Terrible idea. They'll burn you at the stake when they find out, and we'll roast marshmallows at the burning because you'll deserve it.
 
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68PGunner

Could OP collect a disability check or build disability rating or whatever its called?
In the hypothetical situation where the army does cut OP, would he be required to pay all future tuition going forward?

No, you have to prove that your disability is service related. It means that your condition is aggravated by active duty time.
 

notdeadyet

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Could OP collect a disability check or build disability rating or whatever its called?
In the hypothetical situation where the army does cut OP, would he be required to pay all future tuition going forward?
He could if this issue (whatever it is) started during his active duty years and was exacerbated by service. HPSP is not active duty time.
 
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deleted480308

No, you have to prove that your disability is service related. It means that your condition is aggravated by active duty time.
I know it's an evidence level on par with wiki but the implication there isn't 100% true if they are active. I think they said reservist which has a higher proof level but in active it's decisively easier.

Similarly, genetic and hereditary conditions are conditions that will develop in a person’s life no matter what. Some develop before service and are thus considered EPTS. Others may develop later in life. If a genetic condition develops while a service member is in the military, then it is automatically considered service-aggravated unless it can be clearly proven that the condition would have developed at the same time and to the same degree whether or not the service member was in the military. If this can be proven, then it is not considered service-aggravated.

All EPTS, genetic, and hereditary conditions are considered fully service-connected if the service member is on active duty for 8 years or more.
http://www.militarydisabilitymadeeasy.com/service-connected.html
 
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68PGunner

I know it's an evidence level on par with wiki but the implication there isn't 100% true if they are active. I think they said reservist which has a higher proof level but in active it's decisively easier.

Similarly, genetic and hereditary conditions are conditions that will develop in a person’s life no matter what. Some develop before service and are thus considered EPTS. Others may develop later in life. If a genetic condition develops while a service member is in the military, then it is automatically considered service-aggravated unless it can be clearly proven that the condition would have developed at the same time and to the same degree whether or not the service member was in the military. If this can be proven, then it is not considered service-aggravated.

All EPTS, genetic, and hereditary conditions are considered fully service-connected if the service member is on active duty for 8 years or more.
http://www.militarydisabilitymadeeasy.com/service-connected.html

Dude, having combed through the regulations, your chance of proving service connected is zero while on HPSP. Reservists can prove service connection due to monthly drill, annual FTX, and deployment every 2-3 years.
 

idq1i

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I am an HPSP medical student. I was diagnosed about a year ago with a health condition (after starting medical school and HPSP). Since then, it has been progressively getting worse, and I now believe it will affect my ability to serve active duty. There is no cure. (It's not HIV). My question is, if I ask for a medical discharge, would I be required to pay back everything? The policy handbook states that I may be held financially responsible, but it's ambiguous. It does state specifically the HIV patients are exempt.

I know my ability to serve active duty is compromised, but I'd rather hide my health condition than have to pay back money I do not have.

Can anyone advise? What usually happens in these medical cases?

My condition does keep me from getting deployed. However, it does not keep me from practicing medicine.
3–13. Special rules applicable to general and medical corps officers
a.
General officers and medical corps (MC) officers will not be found to be unfit by reason of physical disability if
they can be expected to perform satisfactorily in an assignment appropriate to their grade, qualifications, and
experience.

Particularly as you said you COULD STILL practice medicine, you WILL be retained. Guaranteed. Tell the army. You will get med boarded, then the informal PEB will retain you based on the rule quoted above
 
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jonb12997

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3–13. Special rules applicable to general and medical corps officers
a.
General officers and medical corps (MC) officers will not be found to be unfit by reason of physical disability if
they can be expected to perform satisfactorily in an assignment appropriate to their grade, qualifications, and
experience.

Particularly as you said you COULD STILL practice medicine, you WILL be retained. Guaranteed. Tell the army. You will get med boarded, then the informal PEB will retain you based on the rule quoted above

Strong work! Can I ask which ar this came from? I can't find anything in 40-501 like this in my quick review....
 

pgg

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3–13. Special rules applicable to general and medical corps officers
a.
General officers and medical corps (MC) officers will not be found to be unfit by reason of physical disability if
they can be expected to perform satisfactorily in an assignment appropriate to their grade, qualifications, and
experience.

Particularly as you said you COULD STILL practice medicine, you WILL be retained. Guaranteed. Tell the army. You will get med boarded, then the informal PEB will retain you based on the rule quoted above

Are Army students in the medical corps while in medical school?

I have some vague memory in the back of my head that my Army classmates at USUHS were medical service corps or something while in school, and when they got promoted to O3 at graduation, they move to the medical corps. I could be completely imagining that though.
 
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jonb12997

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Yep. I was medical service Corp as a 01 and 02 during med school. I was recommissioned into the medical Corp as an 03. My date of rank was the day of my med school graduation.
 

idq1i

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Are Army students in the medical corps while in medical school?

I have some vague memory in the back of my head that my Army classmates at USUHS were medical service corps or something while in school, and when they got promoted to O3 at graduation, they move to the medical corps. I could be completely imagining that though.
I guess med students are technically MSC. I suppose it's possible that the OP may slide on this technicality, but I doubt it. Personal experience.
 
6

68PGunner

3–13. Special rules applicable to general and medical corps officers
a.
General officers and medical corps (MC) officers will not be found to be unfit by reason of physical disability if
they can be expected to perform satisfactorily in an assignment appropriate to their grade, qualifications, and
experience.

Particularly as you said you COULD STILL practice medicine, you WILL be retained. Guaranteed. Tell the army. You will get med boarded, then the informal PEB will retain you based on the rule quoted above

LOL, I knew that there was a regulation like this somewhere. Someone needs to educate OP on the scenic beauties available at Ft Polk.
 
D

deleted480308

I guess a larger question here is also motivation. Does OP want out? Are they hoping this will be their ticket? Or are they afraid this will cost them the chance to serve their end of the deal and they'll have to pay it instead?
 

narcusprince

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Another potential issue if they disclose the medical condition to the army it will likely effect residency placement. Likely the person will be relegated to gmo land. This road is a tough one.
 
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There's worse things in the world than buffing your golf game and leadership bullets in GMO land preparing for a civilian residency, particularly if they deem the OP undeployable. He might come out financially ahead as well, depending on his ultimate specialty, particularly if he moonlights in some evening minute clinic type arrangement.
 
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pgg

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Another potential issue if they disclose the medical condition to the army it will likely effect residency placement. Likely the person will be relegated to gmo land. This road is a tough one.
How do you figure? JSGME board doesn't get copies of medical records.

The only thing they get is a CO endorsement which comments on whether or not the applicant is within physical standards and eligible for PCS.
 

narcusprince

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How do you figure? JSGME board doesn't get copies of medical records.

The only thing they get is a CO endorsement which comments on whether or not the applicant is within physical standards and eligible for PCS.
Correct me if I am wrong. But in order to obtain a residency post intern year you have to be fully medically ready. In this case if the service member cannot pass the prt or comply with army standards they are not eligble for residency placement. Also in the navy contracts can be terminated due to physical standards.
 
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TheEarDoc

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Could OP collect a disability check or build disability rating or whatever its called?
In the hypothetical situation where the army does cut OP, would he be required to pay all future tuition going forward?

Yes if there was no record of the condition existing before signing up then yes he could file a claim for it and be service connected for it. Depending on the % for the rating would probably determine if he would be on the line for any payments. My guess is if he still isn't done the military isn't going to keep paying for him to go to school, but many states have programs for "disabled" veterans who are a certain % to assist with school.
 

TheEarDoc

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Dude, having combed through the regulations, your chance of proving service connected is zero while on HPSP. Reservists can prove service connection due to monthly drill, annual FTX, and deployment every 2-3 years.
usually requires an LOD report for said condition or a med boarding finding. If he has no drill time at all and is straight in school with no time in the military except for the scholarship with no drill then yeah he's most likely SOL.
 

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Those medical students who are in the Army HPSP are not MS (like USUHS). They are branch unassigned, assigned to Control Group Obligated Active Duty Officer, with the identifier 00E (student). Second, to not tell the Army though the PHA process that there has been a change in the medical condition is a direct violation of the HPSP service agreement (paragraph 4).

In the recent past when a medical condition has precluded someone from entering active duty per the PEB, the recommendation forwarded to Sec Army has been based on the ability to use the degree. Meaning if someone gets dropped in their fourth year because they can’t pass the PT test but still can do a civilian internship and go onto residency and make a living doing XYZ, the recommendation is for recoupment. If someone is diagnosed with stage 4 breast CA in their fourth year, the recommendation is discharge without recoupment. Of course, this is an over-simplification but you get the idea.

In all cases, even though someone is not medically qualified the Secretary of the Service is the only authority that can waive the obligation.
 
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Miller123

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Hello everyone, my best mate was recently diagnosed with HIV. He is an HPSP student and is in the process of notifying the military. He has been emotionally unstable because he is not sure what the outcomes are. I told him that I will do some research for him and I ran across this threat. Does anyone know what the military does with HPSP students who test positive for HIV?
 

WernickeDO

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Hello everyone, my best mate was recently diagnosed with HIV. He is an HPSP student and is in the process of notifying the military. He has been emotionally unstable because he is not sure what the outcomes are. I told him that I will do some research for him and I ran across this threat. Does anyone know what the military does with HPSP students who test positive for HIV?
I assume they would be separated under AR 635-200, Chp 5-11. http://www.ansbach.army.mil/documents/RetVetAR635-200EnlSep.pdf
 

Slevin

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Hello everyone, my best mate was recently diagnosed with HIV. He is an HPSP student and is in the process of notifying the military. He has been emotionally unstable because he is not sure what the outcomes are. I told him that I will do some research for him and I ran across this threat. Does anyone know what the military does with HPSP students who test positive for HIV?

HIV isn't grounds for automatic separation. Recently I had the unfortunate duty of informing a young soldier that they were HIV positive. They are allowed to remain in active duty but never allowed to serve OCONUS.

Although since your friend isn't on active duty not sure what effect this will have on their contract with the military
 

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Hello everyone, my best mate was recently diagnosed with HIV. He is an HPSP student and is in the process of notifying the military. He has been emotionally unstable because he is not sure what the outcomes are. I told him that I will do some research for him and I ran across this threat. Does anyone know what the military does with HPSP students who test positive for HIV?
AR 600-110 Identification, Surveillance, and Administration of Personnel Infected with Human Immunodeficiency Virus

This resource is not official for the regulation but I could not bring it up on the APD website. http://asktop.net/wp/download/3/r600_110.pdf

Keep up the positive support. The outcomes will be similar to those previously advised and it will be addressed with respect.
 

hello1234!

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so, I didn't read the entire thread, but I think you're saying u may want to keep on collecting HPSP even after u know u may have a disqualifying condition. That sounds like fraud....

I am not sure what you should do as I have zero military experience, but my advise is please don't commit fraud.
 

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so, I didn't read the entire thread, but I think you're saying u may want to keep on collecting HPSP even after u know u may have a disqualifying condition. That sounds like fraud....

I am not sure what you should do as I have zero military experience, but my advise is please don't commit fraud.
hello - the OP hasn't posted in a long time. That issue is likely resolved. The only recent responses are to Miller123 that is asking about HIV as an HPSP participant. I haven't interpreted any of this as 'fraud'. You probably should have read it all.
 

hello1234!

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well, one of the OP's original suggestions of continuing to collect HPSP even if he knew he may not qualify sounds kinds like fraud..
 

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So is it or is it not grounds for separation?

No, it is not. HIV, in and of itself, is not grounds for separation (administrative or medical). But HPSP is different than active duty or even being in a reserve component, so I can make no guarantees about how it affects medical school finances. Your friend should a) get medical and psychological help as it relates to the new diagnosis and b) discuss with HPSP office as it might affect his military career.

If he continues with HPSP, which I assume he will, the diagnosis does limit assignments, but for a physician that shouldn't be a tremendous issue in the way that limiting sea-billets could be for advancement for certain enlisted rates/line officers.
 

Armyhealth

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What happens if I fail the physical examination?
(HPSP Handbook 6-3)

Students who are medically disqualified upon initial evaluation for retention shall have their physical examinations reviewed by the Directorate of Health Policy, Office of the Surgeon General (OTSG), for medical waiver consideration. Those who are not granted a medical waiver are considered for an alternative service obligation (i.e. working as a civilian in a treatment facility). Those whose medical disqualification is based solely on failure to meet weight standards are granted an administrative waiver and called to active duty.
 
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Onefellswoop87

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What happens if I fail the physical examination?
(HPSP Handbook 6-3)

Students who are medically disqualified upon initial evaluation for retention shall have their physical examinations reviewed by the Directorate of Health Policy, Office of the Surgeon General (OTSG), for medical waiver consideration. Those who are not granted a medical waiver are considered for an alternative service obligation (i.e. working as a civilian in a treatment facility). Those whose medical disqualification is based solely on failure to meet weight standards are granted an administrative waiver and called to active duty.

http://www.med.navy.mil/sites/nmcph...ogy/SECNAVINST-5300.30E-HIV-and-Hepatitis.pdf

"4. c. (4) Commissioned officers in professional education programs leading to appointment in a military professional specialty (including, but not limited to medical, dental, chaplain, and legal and or judge advocate) shall not be disenrolled from the program at the end of the academic term in which HIV positive status is identified, or in which diagnosed with chronic HBV or HCV infection."

Per Navy policy (I can only assume the same is true for USA and USAF) HIV infection is not a medical disqualification for retention, only initial accession. See specifically sections 9, 10, and 11 of the link.
 

Armyhealth

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What happens if I test positive for HIV or AIDS?
(HPSP Handbook 6-1e)

Students found to be HIV positive or diagnosed with acquired immune deficiency syndrome (AIDS) shall be placed on medical leave of absence upon receipt of confirmation of the medical condition from the Commander, Army Human Resources Command (AHRC). Following confirmation of positive results, the student’s scholarship and obligation will be terminated at the end of the academic semester
This is from the Army Handbook, also your post from the Navy talks about academic programs. We are talking about Medical school...think about it would you want a HIV positive Doctor working on you in the battlefield. Blood to blood contact...
 

Helpful Troll

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http://www.med.navy.mil/sites/nmcph...ogy/SECNAVINST-5300.30E-HIV-and-Hepatitis.pdf

"4. c. (4) Commissioned officers in professional education programs leading to appointment in a military professional specialty (including, but not limited to medical, dental, chaplain, and legal and or judge advocate) shall not be disenrolled from the program at the end of the academic term in which HIV positive status is identified, or in which diagnosed with chronic HBV or HCV infection."

Per Navy policy (I can only assume the same is true for USA and USAF) HIV infection is not a medical disqualification for retention, only initial accession. See specifically sections 9, 10, and 11 of the link.
Fluffhead - that same paragraph you quoted in 5300.30E goes on to say "Reserve officers on inactive duty who are commissioned for the purpose of participation in such programs shall be discharged. Except as specifically prohibited by statute, any additional service obligation incurred by participation in such program shall be waived, and financial assistance received in these programs shall not be subject to recoupment."

Wow - the guidance in all services is clear as mud.
 

Onefellswoop87

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Fluffhead - that same paragraph you quoted in 5300.30E goes on to say "Reserve officers on inactive duty who are commissioned for the purpose of participation in such programs shall be discharged. Except as specifically prohibited by statute, any additional service obligation incurred by participation in such program shall be waived, and financial assistance received in these programs shall not be subject to recoupment."

Wow - the guidance in all services is clear as mud.

Yeah, clear as mud is right. Guess I focused too much on the opening part of that paragraph. Looks like, if he's USN, HPSP office could keep or separate him and either way be supported by sections of that instruction.
 
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