Aug 24, 2016
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I am a third year who was Navy HPSP. I've been informed that the Navy medical review board has decided to discharge me for a h/o PE with a subsequent finding of slightly low Protein C levels that my doctor stated shouldn't be a worry. It is documented that the PE was caused by an injury that occurred after getting commissioned. I was told the Navy will recoup the funding I have received because they paid for a product that they won't get. The appeal process is apparently next to impossible. Can someone guide me through this process?

Thanks in advance.
 

Cooperd0g

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I cannot guide you through the process, but of the military separates you for medical reasons that occurred after joining it isn't like you quit Med school. They won't come gunning for the money.
 

pawprint

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See if you can get your hands on a copy of the actual contract you signed. I'm not sure where I put my copy at the moment, but there is a contract on the HPSP accessions site for another program HPLRP that has this line in it:

"In addition to the alternative obligations specified in paragraphs (1) through (3) above, if I am relieved of my ADO by reason of separation because of a physical disability, the Secretary may give me a Service obligation as a civilian employed as a health care professional in a facility of any of the Uniformed Services for a period of time equal to my remaining ADO. "

I'm not sure if this line was in the contract we signed for HPSP, and I'm not sure if this would get you out of repayment, but to me it seems like its saying instead of repayment they will just use you in the service but as a civilian employee. If they try to recoup the money I'd get a lawyer just to make sure there isn't something in there that can get you out of repayment. The student handbook (which isn't our contract) states that you can be disenrolled involuntarily for medical reasons but does not specify recoupment. It says its evaluated on a case by case basis.
 

pgg

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I am a third year who was Navy HPSP. I've been informed that the Navy medical review board has decided to discharge me for a h/o PE with a subsequent finding of slightly low Protein C levels that my doctor stated shouldn't be a worry. It is documented that the PE was caused by an injury that occurred after getting commissioned. I was told the Navy will recoup the funding I have received because they paid for a product that they won't get. The appeal process is apparently next to impossible. Can someone guide me through this process?

Thanks in advance.
It's surprising that they would seek recoupment for a medical problem that began after commissioning.

If the medical problem is a consequence of an injury that was related to misconduct ... or if care for the injury revealed a pre-existing condition that further investigation proved the member knew about prior to commissioning but failed to disclose ... the landscape changes.

You need an attorney.
 
OP
A
Aug 24, 2016
2
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Medical Student
See if you can get your hands on a copy of the actual contract you signed. I'm not sure where I put my copy at the moment, but there is a contract on the HPSP accessions site for another program HPLRP that has this line in it:

"In addition to the alternative obligations specified in paragraphs (1) through (3) above, if I am relieved of my ADO by reason of separation because of a physical disability, the Secretary may give me a Service obligation as a civilian employed as a health care professional in a facility of any of the Uniformed Services for a period of time equal to my remaining ADO. "

I'm not sure if this line was in the contract we signed for HPSP, and I'm not sure if this would get you out of repayment, but to me it seems like its saying instead of repayment they will just use you in the service but as a civilian employee. If they try to recoup the money I'd get a lawyer just to make sure there isn't something in there that can get you out of repayment. The student handbook (which isn't our contract) states that you can be disenrolled involuntarily for medical reasons but does not specify recoupment. It says its evaluated on a case by case basis.

Thank you all for your responses. I will try to get a copy of the contract that I signed. @pawprint @USArmyHPSP @pgg @Cooperd0g
 

Former Navy

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Jul 25, 2017
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I was a Navy HSCP student and was just discharged from the program for being prescribed and SSRI by my Physician. As you know, school can be stressful by itself, then I had a series of family problems. The worst is that my Dad lived 1000+ miles away and was hospitalized for bacterial meningitis and nearly died. The MD said this would cause anxiety with anyone and prescribed me an SSRI.

The Navy found out about this and discharged me (I had no idea this prescription was out of regs). I had ~5 years of prior service and fought to stay in but was not granted a serious appeal. They gave me about 5 days notice that I was being discharged. I am not a risk to the military, there are so many people in the military that have anxiety and self-medicate with alcohol, poor performance, or violence. I effectively dealt with the problem and have seen Sailors that don't; it is sad to see the military help people with alcohol abuse but treat me like a criminal for an SSRI prescription.

So, most students in Med school have some sort of anxiety. If you possibly suffer from anxiety and are unsure about your commitment you can consider having your MD prescribe you an SSRI for the anxiety that most med students likely experience.

Why am I posting this for the world to see? I desperately want the military to change its policy and if they start actively discharging more people towards the end of school after spending $240k on them then they might change. An attorney could not help me :( I wanted to continue to serve and will try again after school.
 

backrow

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I was a Navy HSCP student and was just discharged from the program for being prescribed and SSRI by my Physician. As you know, school can be stressful by itself, then I had a series of family problems. The worst is that my Dad lived 1000+ miles away and was hospitalized for bacterial meningitis and nearly died. The MD said this would cause anxiety with anyone and prescribed me an SSRI.

The Navy found out about this and discharged me (I had no idea this prescription was out of regs). I had ~5 years of prior service and fought to stay in but was not granted a serious appeal. They gave me about 5 days notice that I was being discharged. I am not a risk to the military, there are so many people in the military that have anxiety and self-medicate with alcohol, poor performance, or violence. I effectively dealt with the problem and have seen Sailors that don't; it is sad to see the military help people with alcohol abuse but treat me like a criminal for an SSRI prescription.

So, most students in Med school have some sort of anxiety. If you possibly suffer from anxiety and are unsure about your commitment you can consider having your MD prescribe you an SSRI for the anxiety that most med students likely experience.

Why am I posting this for the world to see? I desperately want the military to change its policy and if they start actively discharging more people towards the end of school after spending $240k on them then they might change. An attorney could not help me :( I wanted to continue to serve and will try again after school.
HSCP...you were active duty. You didn't have a Med Board? I would have thought you would need a med board to be separated, but maybe not since it's considered an accession program.


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Former Navy

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HSCP...you were active duty. You didn't have a Med Board? I would have thought you would need a med board to be separated, but maybe not since it's considered an accession program.


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No Med board. My lawyer tried to force a med board with no luck; they did not give me enough warning time to put up a meaningful resistance.

Then I tried to force a clause in my contract that said if I were medically separated I would return to my old rank with no luck either.
 

HooahDOc

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Probably trying to utilize the low Protein C level as evidence of a pre-existing condition.
 

Former Navy

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Sounds like congressional time. OTOH, it's very nice to be out.
I am trying to believe that it is nice to be out and there definitely are a lot of benefits. But 3 years is not a big commitment, and the Navy really can be a great culture.
 

BetaAlpha89

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I'm sorry you went through that. With the assistance of Navy JAG, could you be reinstated? There is precedent for active duty physicians on SSRIs, and Navy interns I know who were taking SSRIs. Alternatively, you could go to a psychiatrist if the MD that prescribed you the SSRI was primary care, and say that you were misdiagnosed (bereavement instead of anxiety/ MDD depressive episode). Are they having you pay back tuition?
 

backrow

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There is precedent for active duty physicians on SSRIs, and Navy interns I know who were taking SSRIs.
That's the difference between accession standards and retention standards. Accession standards are much stricter than retention and that's why you see active duty with issues that would never come close to passing the standards for joining. The difference for me is that I would have thought since he was already on active duty the retention standards would have applied until they went for their commissioning physicals at which time it would have likely become an issue.

I have a feeling there is a significant chunk of the timeline missing from this story though because nothing in the Navy gets done in 5 days.


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BetaAlpha89

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That's the difference between accession standards and retention standards. Accession standards are much stricter than retention and that's why you see active duty with issues that would never come close to passing the standards for joining. The difference for me is that I would have thought since he was already on active duty the retention standards would have applied until they went for their commissioning physicals at which time it would have likely become an issue.

I have a feeling there is a significant chunk of the timeline missing from this story though because nothing in the Navy gets done in 5 days.


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Oh that makes sense. I'm less familiar with HSCP verse HPSP. But also true about the nothing gets done in 5 days.
 
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Former Navy

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That's the difference between accession standards and retention standards. Accession standards are much stricter than retention and that's why you see active duty with issues that would never come close to passing the standards for joining. The difference for me is that I would have thought since he was already on active duty the retention standards would have applied until they went for their commissioning physicals at which time it would have likely become an issue.

I have a feeling there is a significant chunk of the timeline missing from this story though because nothing in the Navy gets done in 5 days.


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There is no timeline missing; at least not that I am aware of, there may have been stuff happening at HQ that they were not telling me about.

How does the Military not waste a bunch of money and lose a lot of PA/MD/DDS/PharmD people since it is so likely that a lot of people will get prescriptions over the course of 2-4 years?

The military really needs to change their policy, 0 tolerance = 0 common sense. There has to be some allowance for critical thinking when making these decisions.

It is easy to say that there is more to this story because it seems so illogical, but that is why it is so frustrating.
 
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IlDestriero

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As noted above, it's easier to stay in than get in. And that's absolutely by design. Your cost is a rounding error. The cost of dumping all the recruits that fail to meet strict standards is nothing to get worked up about. The pain of having people not deployable or non functional in the field is real.


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Il Destriero
 

j4pac

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As noted above, it's easier to stay in than get in. And that's absolutely by design. Your cost is a rounding error. The cost of dumping all the recruits that fail to meet strict standards is nothing to get worked up about. The pain of having people not deployable or non functional in the field is real.


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Il Destriero
Bingo. It certainly sucks for quite a few people...but the answer to the question "why?" in every possible situation is money.
 
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StarboardMD

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That's the difference between accession standards and retention standards. Accession standards are much stricter than retention and that's why you see active duty with issues that would never come close to passing the standards for joining. The difference for me is that I would have thought since he was already on active duty the retention standards would have applied until they went for their commissioning physicals at which time it would have likely become an issue.
Maybe it's because I'm not familiar with HSCP, but I know with certainty that there were HPSP students who had a much more significant psych history during med school than mere SSRIs who had no issues remaining on AD, promoting, getting required waivers for flight surgeon, etc. Or maybe it's an Army/Navy difference? This seems a little extreme...and fishy. And I simply can't imagine you having to pay back money after being discharged for a medical condition. Get a lawyer.
 

Former Navy

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Maybe it's because I'm not familiar with HSCP, but I know with certainty that there were HPSP students who had a much more significant psych history during med school than mere SSRIs who had no issues remaining on AD, promoting, getting required waivers for flight surgeon, etc. Or maybe it's an Army/Navy difference? This seems a little extreme...and fishy. And I simply can't imagine you having to pay back money after being discharged for a medical condition. Get a lawyer.
Do not have to pay anything back.

Are you in Army medicine? Is there any hope to join Army medicine after being discharged from the Navy for an SSRI (No longer taking SSRI).

I know that the military falls back to their generic statement, "what if you experience anxiety in the middle of combat." However, this argument has huge holes; how many 18 and 22 year olds have experienced stressful situations that have tested their threshold for anxiety? There are many people that have taken an SSRI that are fit for any career in the military. Med school with a family of 5 will push the majority of military personnel to the point that an SSRI might help. The MD I am rotating with told me that he has military personnel see him and pay in cash so the military will never find out about their psych history.

But, I do have to thank the Navy for the free money and the opportunity to work in an exciting specialty as a civilian.
 

Mt Kilimanjaro

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Yikes.

I'd start here: Military Personnel: Better Debt Management Procedures and Resolution of Stipend Recoupment Issues Are Needed for Improved Collection of Medical Education Debts and your service's contract/student handbook that outlines specific procedures and policies.

"apparently next to impossible" is based on what? Dealing with complex bureaucracy always seems daunting, but have patience and be dogged and you can likely reach a desirable outcome.
I would be shocked if the military could actually/legally recoup money from someone who was involuntarily medically discharged. if they:
1. Discharge was involuntary
2. Making successful academic progress
3. Disclosed new medical conditions on every Monthly Evaluation Report.

HPSP has a clause in the contract that the military can try to recoup money but HSCP does not (for medical discharge).
The huge, huge, huge, hole in the military contract/regulations is that absolutely every condition is disqualifying. Honestly, in the regulation "contact dermatitis" is disqualifying. Almost everyone in America breaks out in a rash due to poison ivy. This language is far too broad.

Plus. the military discharges people with honorable discharges (HSCP) and doesn't try to get money back.

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Oct 17, 2018
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Hey all, I'm a HPSP student with a recent joint re-injury (the military already knows about the first injury I had to this joint). I'm nervous about submitting the annual heath form for fear that I will be discharged. How does the annual health submission form work? Does the Navy access my medical records whether or not I submit the form?
 

Gastrapathy

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Not submitting will get their attention. No one can say what will happen but you just have to go through the process. Good luck