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Medical Conditions that Result in Automatic Denial

 
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Home > Info for Patients & Community > Overseas Screening > Medical Conditions that Result in Automatic Denial
 

Okinawa Overseas Screening
 

Medical Conditions That Will Result in Automatic Denial
For Overseas Screening Assignment

  1. USN family Members with EFMP Category 4 Assignment or equivalent conditions with other services
  2. USNH family members with EFMP Category 5 or 6 assignment or equivalent conditions with other services.
    • USN family Members with EFMP Category 6 Assignments should have resolution of condition and be re-evaluated and given new category.
  3. Medical Conditions
    • Family members with tracheostomies and/or home ventilators have medical needs that cannot be met here
    • Home oxygen (difficulty obtaining equipment, no oxygen concentrators, equipment not delivered)
    • G-Tube/Feeding tube (difficulty obtaining equipment)
    • Wheelchair/Walkers (difficulty obtaining parts, supplies and/or repair service, no housing modifications, no vehicle modifications)
    • Family members with ventriculoperitoneal shunts for treatment/management of hydrocephalus have medical/surgical needs that cannot be met here
    • Amputation of major limb within he past 2 years
    • Dialysis
    • Family members with asthma who have had 2 or more ICU admissions in past 2 years
    • Medical conditions which require follow-up by specialty services not available at Naval Hospital Okinawa
      • Such as Cardiology, Gastroenterology, Endocrinology, Rheumatology or any other sub-specialties not available at Naval Hospital Okinawa
      • Such as facility limitations, i.e. as the capabilities of specialty services continue to grow there are and there will become certain facility limitations at Naval Hospital Okinawa that will result in automatic disapproval (e.g. Bowel or bladder rehabilitation services)
    • Medical condition which have a high probability of resulting in ICU admissions, e.g., Brittle/Labile Type I Insulin-Dependent Diabetes (Insulin Depending Diabetic Mellitus)
    • Status Post Gastric By-Pass for morbid obesity or any related subsequent complications due to the surgery or the related morbid obesity with-in the past 3 years
  4. Psychiatric Conditions
    • Which have required 1 or more inpatient hospitalizations in past 10 years
    • Psychiatric conditions in which there is a history of admission to or recommendation for “Day Hospital” or “Partial Hospital” in past 10 years
    • Psychiatric conditions where there is a history of admission to or recommendation for “Residential Treatment” in past 10 years
    • Mental Health Conditions which required on-going individual/family therapy
    • Aggressive, destructive and/or illegal behaviors
    • Active or substantiated family advocacy case within the past 2 years
    • Psychiatric conditions where the patient is on antipsychotic medications
    • Substance abuse/dependence over past 10 years (multiple addictive substances are prevalent on Okinawa)
    • Schizophrenia
    • Bipolar Disorder
    • Dementia
    • Suicide attempt/gesture within past 2 years
    • Dissociative disorder
    • Sexual Addiction (specialist not available)
    • Eating disorder (specialist no available)
    • DSM diagnosis and/or requiring psychotropic medications who are not sable for at least one year prior to moving overseas
  5. Orthopedic Conditions:
    • Any limb amputation requiring prosthesis
    • Scoliosis undergoing surgical or brace treatment, or being followed by Pediatric Orthopedics
    • Cerebral Palsy requiring orthopedic surgery or bracing
    • Children being treated for limb length inequality
    • Patients with anticipated need for joint replacement surgery
       

Pediatric Conditions

Pediatric Conditions that result in automatic disapproval

  1. Any Navy/USMC dependent child assigned EFMP 4 (major medical INCONUS) or higher, or equivalent assignment in other services.
  2. Any child with asthma that:
    • Is diagnosed, or treated, as moderate or severe persistent
    • Has required 2 or more hospitalizations in the last 3 years
  3. Need for wheelchairs, walkers, AFOs, and/or other orthotic devices.
  4. Hearing impairment
  5. G-tube/Feeding tubes
  6. ventriculoperitoneal shunts
  7. Type I diabetes mellitus
  8. Congenital heart defects that have required, or are likely to require, significant surgical intervention
  9. Cystic fibrosis or currently being evaluated for possible cystic fibrosis. Approval will not be considered until after workup is completed
  10. Allergic conditions requiring immunotherapy (allergy shots)
  11. History of leukemia or other pediatric cancer
  12. Any condition that requires regular follow-up by a pediatric subspecialist (such as pulmonology, cardiology, endocrinology, hematology, oncology, GI). Only general pediatrics and developmental pediatrics are available here.
  13. Mental health/behavioral conditions:
    • psychotic, bipolar, or eating disorder
    • required any kind of inpatient treatment in the last 3 years
    • history of recent or chronic suicidal ideation or behavior, self-harm, self injurious behavior, or suicide attempts
    • that have required multiple emergency room visits
    • Aggressive, destructive, and/or illegal behaviors
    • Any history of juvenile convictions or parole
    • History of substance abuse
    • Any foster care placement in the last 3 years

Pediatric conditions that require more information or are likely result in disapproval

  1. Any Navy/USMC dependent child assigned EFMP category 3 (no overseas assignment), or equivalent categories in other services.
  2. Minor congenital heart defects that require annual, or less than annual, pediatric cardiology follow-up.
  3. Autistic spectrum diagnoses will only be considered on a case-by-case basis. However, strongly discourage autism spectrum disorders due to lack of community resources and mental health services.
  4. Mental health/behavioral conditions:
    • conduct disorder, ODD, intermittent explosive disorder, or disruptive behavior disorder
    • require ongoing individual and/or family therapy
    • required any type of inpatient treatment in the last 5 years
    • require treatment with anti-psychotic medications (will consider if stable for 2 years on current regimen)
    • has required more than once-a-month treatment in the last year
    • any foster care placement in the last 5 years
    • placement in reform school or alternative school
  5. Chronic ear or sinus conditions requiring follow-up with ENT (otorhinolaryngology).
  6. Stable medical conditions that have been followed by a pediatric subspecialist but do not require follow-up during the duration of sponsor’s tour (e.g, hypothyroidism stable on medications)
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