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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

ADULTS (18 years of age and older) 

  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
    • Home oxygen (difficulty obtaining equipment, no oxygen concentrators, equipment not delivered)
    • Tube Feeding (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 
    •  Amputation of major limb within the 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 Dependent Diabetes 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
    • Hearing loss requiring hearing aids (cannot repair items on island and hearing aids are susceptible to breakdown given the high humidity of the island), BAHA’s or cochlear implants.
  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 require 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 not available)
    • DSM diagnosis and/or requiring psychotropic medications who are not stable for at least one year prior to moving overseas
  5. Orthopedic Conditions:
    • Any limb amputation requiring prosthesis
    • Patients with anticipated need for joint replacement surgery


Pediatric (0-18 years of life)

Pediatric Conditions that result in automatic disapproval 

  • Any Navy/USMC dependent child assigned EFMP 4 (major medical INCONUS) or higher, or equivalent assignment in other services.
  • Any child that is not fully vaccinated with age appropriate required vaccinations.
  • Any child with asthma that:
    • Actively diagnosed with or is treated as moderate or severe persistent asthma
    • Has required 2 or more hospitalizations in the last 3 years
    • Okinawa lacks a Pediatric ICU or Pediatric Pulmonologist to manage moderate to severe asthma
  • Need for wheelchairs, walkers, AFOs, and/or other orthotic devices (limited abilities to maintain the equipment)
  • Hearing loss requiring hearing aids (cannot repair items on island and hearing aids are susceptible to breakdown given the high humidity of the island), BAHA’s or cochlear implants.
  • Tube feeding (difficulty accessing equipment)
  • Ventriculo-peritoneal Shunts (lack of equipment and specialty care)
  • Type I diabetes mellitus
  • Congenital heart defects that have required, or are likely to require, significant surgical intervention; medications to moderate heart function, or the regular need to see a pediatric cardiologist. 
  • Cystic fibrosis or currently being evaluated for possible cystic fibrosis. Approval will not be considered until after workup is completed and negative.
  • Allergic conditions requiring immunotherapy (including allergy shots).
  • Failure to thrive (current diagnosis or recent history).
  • Feeding disorders or severe feeding difficulties
  • History of leukemia or other pediatric cancer
  • Any condition that requires or is likely to require regular follow-up by a pediatric subspecialist (such as, Cardiology, Cleft Palate Team, Endocrinology, Hematology/Oncology, Gastroenterology, Nephrology, Neurology, Neurosurgery, Otorhinolaryngology (excluding annual follow-up for PETs), Pulmonology, Ophthalmology, Orthopedics, Surgery or Urology Neurosurgery). Only general pediatrics and developmental pediatrics are available here.
  • The active need for private medical therapy, to include:
    •  Applied Behavior Analysis (ABA) or any other therapies specific for Autism Spectrum Disorder (services not available from school or privately)
    • Hippotherapy (therapeutic horseback riding)
    • Occupational Therapy
    • Physical Therapy
    • Sensory Integration/Processing Disorder
    • Speech Language Pathology
  1. Mental health/behavioral conditions:
    • Psychotic disorders
    • Bipolar / Manic Depressive Disorders
    • Eating disorders (all types)
    • Oppositional Defiant Disorder
    • Disruptive Behavior Disorder
    • Behaviors which include aggression, destruction and/or legal behaviors
    • Any kind of inpatient treatment in the last 3 years
    • Any kind of intensive full day outpatient treatment in the past two years
    • History of recent or chronic suicidal ideation or behavior, self-harm, self-injurious behavior, or suicide attempts
    • Have required multiple emergency room visits
    • Any history of juvenile convictions or parole
    • History of substance abuse
    • History of sexual abuse
  2. Scoliosis undergoing surgical or brace treatment, or being followed by spine specialist
  3. Cerebral Palsy requiring orthopedic surgery or bracing
  4. Children being treated for limb length inequality
  5. Any foster care placement in the last 3 years

Pediatric conditions that require more information or are likely to 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, given lack of community resources, private therapy services and mental health services, most children with Autism Spectrum Disorders cannot have their needs met here.
  4. Mental health/behavioral conditions:
    • 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)


Updated: 11-Mar-2015




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