Being an Informed Reserve Citizen Patient

  • Published
  • By Lt. Col. Amy Hansen, 940 ARW Inspector General
  • 940th Air Refueling Wing

“Medical put me on no pay, no points status!” is a phrase I commonly hear when attempting to resolve complaints as the Inspector General at the 940th Air Refueling Wing.  For Reservists who have served our nation selflessly for two, 12, or even 18 years, “no pay, no points” seems like a phrase equal to being kicked out of the Air Force and brings up many negative emotions.  So I decided to do a little digging to see what “no pay, no points” really means for the average Reserve Citizen Airman.

I began with two very helpful medical technicians at the 940th Aerospace Medicine Squadron, Staff Sgt.’s Kimheak Ly and Cathy Saetern.  They explained that the goal of the squadron is to ensure Citizen Airmen are medically safe to perform duty, which protects both the Reservist and the Air Force Reserve (AFI 48-123).  If a Citizen Airman has a potentially unsafe medical condition, the 940th AMDS recommends no pay, no points status (AFI 36-2254 V1) until the medical condition is resolved or a waiver can be obtained from the Air Force Reserve Command’s Surgeon General.  In no pay, no points status, Reservists are not allowed to participate in duty and are excused from drill weekends.

My next question was how Citizen Airmen should know what a “potentially unsafe” medical condition is. The Air Force publishes fitness standards so we all have clear expectations for our fitness tests, so why isn’t there a list of medical conditions and medications that are considered unsafe for duty?

It turns out there is a list of medical conditions and medications, called the Medical Standards Directory, which is used across the Air Force medical community to determine which medical conditions are disqualifying, and for which career fields.  The MSD is a long, complicated document which is updated at least every year, which is likely one reason it isn’t readily available to Airmen.  But more importantly, the Air Force doesn’t want its members to avoid getting needed medical attention due to the fear of being kicked out of the military.

I whole heartedly agree with this.  If you have a clear medical condition, get the help you need without regard to the consequences to your military career.  Your health and safety comes first, and as a reservist, you likely know there is more to life than your military job. 

According to Saetern, some examples of conditions that will trigger a no pay, no points status immediately include diabetes, asthma, sleep apnea, pacemakers, chronic pain, and progressive cancer.  However, even many of these conditions can qualify for a waiver under certain circumstances, said Ly.

Many common conditions don’t fall into the clearly disqualifying (without a waiver) category, and aren’t life and death diagnoses.  This is where being an informed Reserve Citizen patient can reduce your susceptibility to being put on a no pay, no points status. 

Here are some tips:

1.  When seeing your civilian provider, make sure to inform that person of your Air Force Reserve service so you can thoroughly discuss all diagnosis and treatment options before making a decision.  Ensure any diagnosis is as accurate as possible to streamline the waiver process.

2.  Reservists on flying status should contact the flight surgeon about the approved medication list.

3.  Ensure your provider does not put a preliminary diagnosis in your records simply for ease of billing. 

4.  Discuss all your medication options with your physician.  If possible, select medications without side effects that will prevent you from doing your Air Force Reserve job.  For example, drugs like Norco, Percocet, and Flexeril cause drowsiness and may cause impaired driving.

5.  There are often good options to try before using prescription medication.  Therapies like acupuncture, chiropractic care, physical therapy, and cognitive-behavioral therapy can be useful for resolving many common conditions without medication.

6.  Consult the 940th AMDS prior to any elective surgery to discuss the potential impact to your Air Force Reserve duty.

7.  Know that all injuries and serious illnesses, including pregnancy, need to be reported to the 940th AMDS within 72 hours (AFI 48-123).  Any illnesses or injuries that prevent a Citizen Airman from running 100 yards or lifting, pulling, and pushing 40 pounds, or a condition which requires a medical device like crutches, may result in a mobility restriction which can trigger a temporary no pay, no points status.

8. As of spring 2017, the 940th AMDS can view most civilian medical records, to include Veteran’s Administration claims, so do not try to hide conditions or medications.  The 940th AMDS will work with you to get the appropriate waivers.

9. If you get ill or hurt on duty, don’t wait! Address any immediate medical needs first, and then call the 940th AMDS to discuss your options.  You may be entitled to reimbursement for medical care for injuries which occur on duty.

10.  Program the phone number of the 940th AMDS into your phone: (530) 634-1710.  Call up your friendly medical technicians if you have any questions about medical readiness.

 After my conversation with the 940th AMDS, it is clear that even though no pay, no points status can make members nervous, it is by no means the end of a career. 

“The 940 AMDS is the military member’s advocate, and we attempt to provide guidance and expedite the application of the medical guidelines to minimize any interruption,” said Lt. Col. Will Lucas, 940th AMDS commander.

The numbers are hopeful.  The 940th AMDS medical technicians estimate out of 13 people who went on no pay, no points status last year, about 10 received waivers to continue participating. 

“Members can be afraid to let us see all medical records, but the more we can see, the more we can help. There is nothing to hide,” said Ly.

In my experience, she is right.  Bad news doesn’t get better with time, and the Air Force Reserve medical process has many opportunities for waivers and appeals if a Reservist is actually fit for duty. 

The bottom line is you can help yourself and your career by being an informed Reserve Citizen patient.