Does your chain of command need to know about your medical history?

2015-09-09T09:28:27-04:00

At my previous command, we were never asked what our appointments were for. I had a great department that trusted us that we weren't misusing their trust, so we didn't. However, and my new command, I constantly get asked what my appointments are for, from different levels of my chain of command. I'm not comfortable telling them, because quite frankly, it's none of their business. I just simply tell them that it's at the hospital. I'm not lying, I really do go to my appointments. But it's getting uncomfortable, and I feel like they know better.

Response by MSG Private RallyPoint Member made Sep 9 at 2015 9:42 AM

2015-09-09T09:42:42-04:00

Sounds like your new command had (or has) a serious problem with people BSing about appointments and need to ensure accountability.

Response by 1SG Private RallyPoint Member made Sep 9 at 2015 9:59 AM

2015-09-09T09:59:19-04:00

Your commander and a select number of personnel folks have a duty and responsibility to know what ongoing medical issues that you may have, insofar as it affects your readiness and fitness for duty. Beyond that, your medical records are personal and protected by HIPPA laws.
A good example would be treatment for an STD (just an example, don't get mad) when you are married. It needs to get fixed and you might get a profile (I think the Navy calls them Limited Duty Chits), but answering too many questions could land one in hot water.
I for one don't want to go on any witch hunts, but I do want to know if I have a troop that is hurt and can't perform certain duties.

Without saying too much, do you feel that you have a reason to conceal your medical status, PO2 Private RallyPoint Member?

Response by PO1 Private RallyPoint Member made Sep 9 at 2015 10:21 AM

2015-09-09T10:21:32-04:00

PO2 Private RallyPoint Member I have dealt with this issue both from a personal side as well as the leadership side. If you are having a lot of medical appointments every week, this is going to flag a concern on the leadership side (e.g. anywhere from one-three appointments a week, every week). Now if you are doing a good job of spacing them out or able to schedule them to not interfere with your work schedule then I do not see this being as much of an issue. However, perception is key and I think from a leadership position this inquiry is two-fold.

First, if someone is always gone at appointments then their fellow co-workers are having to take on their job/responsibilities. This can often leave disgruntlement in the work place and coworkers can begin to complain.

Second, if someone is always gone at appointments then this gives the perception that either (1) something serious may be going on with the member or (2) the member is misusing this opportunity to get out of work. If it is serious the CoC is going to want to make sure that they are aware of it. If it is not serious then the CoC is going to want to know why you are gone all the time and correct the perception.

Response by SSgt Private RallyPoint Member made Sep 9 at 2015 10:22 AM

2015-09-09T10:22:34-04:00

When my supervisor comes up to me and asks me any appts I may have, I look at it as he cares. I have no problem discussing them with him (though I may leave out some details, as I don't want him to know everything about my personal life). Some people are not as open as I am, I get that. Unfortunately there are a lot of people that do BS about appts just to get out of work. I've seen it way to much.

Something I have found that your supervisor can do, is to call the clinic and ask them if you were seen if they really believe you are lying about them. The clinic cannot disclose who you saw, or what is what for, though can state rather you were seen that day or not.

As for others in your command questioning you, this part I do not understand. If your supervisor is doing their job with accountability, your chain should trust them and they should not be coming to you about things like this. This part seems like horrible mico-management to me.

Response by COL Vincent Stoneking made Sep 9 at 2015 10:23 AM

2015-09-09T10:23:58-04:00

They have an absolute right to know. This is one area where the military command relationship is NOT like an employer-employee relationship. Contrary to popular belief, commands fully have the ability - and the right - to go directly to providers to get information about your conditions as well. Not necessarily all the treatment details (and only general outlines where psych is concerned), but at least the broad outlines. "But HIPPA...." is not relevant, because they have an actual need to know the information. (see below on discretion)

It is more nuanced than that, but I am not a lawyer, nor do I want to play one on the internet.

Three reasons come to mind in order or importance:

Your command is responsible for your health and welfare, which requires them to be informed about.... your health and welfare. This is the same reason they can do barracks inspections (and technically could do off-post housing inspections, though that is pretty much never done). Again the command is RESPONSIBLE for this. It is their job to be informed. They have some discretion as to HOW informed. (see below)

Your command is responsible for unit readiness. Your medical condition(s) can directly impact that readiness. As such, they NEED to be informed about anything that could impact readiness. They have some discretion as to HOW informed. (see below)

Your command has a responsibility to both ensure resources aren't being wasted and that service members are not shirking. See MSG Private RallyPoint Member 's response. (and see below)

Discretion:
Again, as stated above, commands have the right (and the affirmative obligation) to be informed where your health & welfare is concerned. They also have a large amount of discretion on how to go about doing that. They could go the over the top (in my mind) route of requiring you to take a battle buddy with you for accountability and an AAR upon your return. They could go to the other extreme and pretend to not even be aware that you go to medical appointments (dereliction on their part, in my mind).

Generally commands are going to go more towards the less oversight end of the spectrum based on respect for privacy (something that I personally think is overdone), belief in treating people like adults until they prove otherwise (something I support), frankly not wanting to know, and a childlike faith that their people will let them know if there is anything relevant that needs to be known.

Personally, when I was in command - and if I were to be in command again - I tended to take the "OK, great. When will you be back, and is there anything I need to be aware of?" approach. But I would not criticize someone else in different circumstances taking a more hands-on approach, at least not without knowing all the relevant facts, to include the local culture and their past experiences. My suspicion is that MSG Private RallyPoint Member nailed it.

Response by LCDR Rabbah Rona Matlow made Sep 9 at 2015 11:18 AM

2015-09-09T11:18:37-04:00

MC3 - it sounds like you are working for a bunch of micro-managers. As a Third Class, it can be tough. Junior enlisted are often not trusted as much as they should be when they are away during work hours.

I would suggest you find a supportive woman who is senior (enlisted or officer) in your command, and talk to her about it. Clearly your command needs to learn about HIPAA laws, and in addition, male supervisors don't need to know about female health issues...

Response by CDR Michael Goldschmidt made Sep 9 at 2015 11:20 AM

2015-09-09T11:20:48-04:00

I disagree that your medical conditions are none of their business. The Navy is not the civilian world. Your medical condition affects your readiness and the command's. including its ability to deploy. Sailors and civilians do not have equal rights to privacy.

Response by MAJ Ken Landgren made Sep 9 at 2015 11:31 AM

2015-09-09T11:31:30-04:00

To a degree if you are MED Boarding.

Response by PO2 Private RallyPoint Member made Sep 9 at 2015 11:35 AM

2015-09-09T11:35:20-04:00

I guess I should have added in the start, that it has nothing to do with female wellness.

Response by CPT Mark Gonzalez made Sep 9 at 2015 11:59 AM

2015-09-09T11:59:04-04:00

Your individual supervisor's have a limited right to know, but to save time I would tell them what is necessary for accountability. The appointment times and places is completely reasonable. You do not have to disclose your medical condition or specifics of the treatment plan to your supervisors, but if it impacts your ability to deploy or is duty limiting the commander is going to know or can easily find out.

Response by PO1 Private RallyPoint Member made Sep 9 at 2015 1:52 PM

2015-09-09T13:52:49-04:00

In a direct response to the question - does the COC need to know about your medical history - NO. It's none of their damned business. However, at the top of the COC - your Commanding Officer and XO, they have the authority and need to know what medical issues affect their personnel regarding fitness for duty and readiness. A lot of folks that have been onboard ship know about what's often called the "binnacle list" - the corpman's daily report to the CO/XO on personnel and health issues. What happens ashore is a bit different - unless there is an issue that requires hospitalization, quarantine, etc., there are no such lists provided, so the XO often (and I only speak from the ships/commands I have been on) is tasked to find out what is going on with someone who has multiple appointments. As a result, the XO may task a Department Head, who tasks a Division Officer, who may task a Division Chief, who may task a Leading Petty Officer, etc, etc, etc. In my book, the tasking should have stopped at the Department Head - but that's a leadership style discussion and not germane.

Additionally, folks, let's get real - yeah, you have appointments and we often don't get to set those dates/times. The more open and honest we are with our COC, the better everyone can manage expectations. Not everything you need to discuss with your COC is something everyone will feel comfortable with. But, if you're smart, you'll broach the subject with someone in that COC so you are not perceived as the "loafer" - but rather as someone taking charge of their health in order to be fully fit for duty and ready to deploy.

The harsh reality is this - you can manage the expectations of your COC by selecting someone within that COC to discuss the situation fully or you can ignore that opportunity (to manage expectations). Select someone in the COC known for discretion - in the Navy it doesn't take long to figure out who that is. If you don't feel comfortable with your COC, then find the CMC (Command Master Chief for you landlubbers) and approach them - the CMC is supposed to be the voice of the enlisted personnel.

Are there exceptions to every scenario? Damn skippy there is! Yet, understanding that your health and fitness for duty affects not only yourself and your family -- it also affects the people around you at work that rely on your ability to do your job 110%. If you're not able to do your job, then someone has to take up the slack.

Trust me. There's not one thing that's happening to you regarding your health that hasn't happened before to some other sailor.

Response by PO1 Glenn Boucher made Sep 9 at 2015 3:12 PM

2015-09-09T15:12:50-04:00

The only time as a LPO or supervisor I questioned appointments is if they became excessive to the point of interfering with normal duties.
I know many people won't like this either but in food service in the military we need to know if any of the food service personal have contracted an STD. I would reassign that person to non food handling duties until cleared by medical, its all we can do to prevent the potential spread of any diseases.
Sometimes people have medical issues which can seem excessive, but its really medicals call on the appointments. And if you have to see specialists then it can get even more complicated.
But only your LPO, CPO's and Divo really need to stay up to date on what is going on.

Response by Sgt Private RallyPoint Member made Sep 9 at 2015 3:19 PM

2015-09-09T15:19:01-04:00

Yes and No. there are certain things that they should know; past injuries and such. they should know that you have been to mental health and if you still go, but not the reasons.
So I'd say they need to know the basics of your medical history just so they know what to expect when a certain situation pops up. like he has cronic knee problems so after the hike allow him time to recover or go to medical.

Response by PO1 Private RallyPoint Member made Sep 10 at 2015 11:38 AM

2015-09-10T11:38:49-04:00

If your medical history will effect readiness they definitely should know. If it is something insignificant or won't cause problems there shouldn't be any need to tell them.

Response by GySgt Moses Lozano made Sep 11 at 2015 8:57 PM

2015-09-11T20:57:31-04:00

Request Mast to your Commanding Officer and inform him or her that your HIPPA rights are being violated. If that doen't work then file an equal opportunity complaint of the grounds of a hostile working environment.

Response by PO3 Private RallyPoint Member made Sep 12 at 2015 10:22 PM

2015-09-12T22:22:34-04:00

My chain doesn't really ask for what it is about, I have a paper copy of the appointments and what it is for. I guess a lot of kids keep saying they have appointments when they really don't and that's probably why now the Chain's ask what it is about.

Response by PO1 Russell Henson made Sep 16 at 2015 12:06 AM

2015-09-16T00:06:26-04:00

Different times. More sailors having real problems that may lead to medical separation

Response by PO2 Nick Burke made Sep 22 at 2015 6:23 PM

2015-09-22T18:23:30-04:00

There may be some privacy issues. You are not required to discuss your medical situation.

Response by SSgt Alex Robinson made Sep 24 at 2015 6:52 PM

2015-09-24T18:52:20-04:00

You only need to inform them of your appointment. It is a violation of your privacy for them to ask why or what medical condition you may have...

Response by MAJ Ken Landgren made Sep 25 at 2015 2:21 PM

2015-09-25T14:21:17-04:00

I know of a soldier who was effing up and the leadership contemplated chaptering until they found out he had an acute case of PTSD. So instead going COA A they went with COA B. It is a double edged sword sometimes.

Response by SSG Richard Reilly made Sep 25 at 2015 3:12 PM

2015-09-25T15:12:23-04:00

Yes they do and should ask. If it has a potential to effect the mission and your readiness they deserve to know. Obviously some limitation should occur where you can give them the minimum information but still keep them informed.

Response by PO2 Private RallyPoint Member made Sep 26 at 2015 1:27 AM

2015-09-26T01:27:13-04:00

It's none of their business. Tell them the time of your appointment and where it is. If the issue affects readiness your CO will be informed by your DOC. Otherwise your privacy is covered under HIPAA. If you don't want them to know they don't have the right to.

Response by SFC Private RallyPoint Member made Apr 21 at 2016 2:53 PM

2016-04-21T14:53:38-04:00

When I have appointments, I will let whoever needs to know that I will be at whatever treatment facility. I don't go into detail unless it is absolutely necessary. Because of the nature of my job and the fact that we have 6 people, I try to limit them to either before work call, during lunch, or late in the day. I hate leaving them with my work load as well as theirs. If I know that I will miss significant time out of the office because of appointments, I will usually come in earlier or work thru lunch to "make" up the time missed.
Now, if a person is constantly going on appointments to the point that they are getting more treatment done than work, then yeah, we might have to dig a little deeper. If it's to the point that a person is gone that much, then maybe they need to be in a WTU so that their sole purpose is to get the medical attention they need so that they can become healthy and mission capable.
Personally, if I had a number of appointments, I would volunteer my appointment printout just to alleviate any guess work. But no one needs to know why I am going to whatever appointment it is. It would be more for accountability than anything else.

Response by CPL Wesley Keyser made Jul 1 at 2016 3:44 PM

2016-07-01T15:44:50-04:00

As a Health care provider I will weigh in here. Do they need to know thing that affect readiness etc.? Yes. Do they need to know you have a UTI, fecal impaction, a cold, pharyngitis, jock itch, athletes foot, an STD, absolutely not. Try to make friends with some independent duty corpsmen, physicians assistants etc, see them for run of the mill stuff as much as possible instead of the docs. They usually are, or used to be, enlisted and will be glad to give your command what for. When you need specific special care, get copies of the follow up sheets and so on to give to command. Most health care providers will redact private health care info off of the sheet.

Response by SSG Stephan Pendarvis made Aug 6 at 2016 11:52 AM

2016-08-06T11:52:19-04:00

I would say so but to an extent. We all know that when you raise your right hand you belong to Uncle Sam. It seems for the next remaining years we try to ignore this fact. I believe they (The COC) should know because you are part of a unit and they are as strong as their weakest link. I don't think they need to know everything...there is HIPAA and Dr./ Patient confidentiality. Everything is case by case. If they are asking to see if a Joe is shamming that is one thing. Soldiers will try the system just to try and be individuals. And if a Joe is having too many appointments then he is not contributing to the unit. I have been on both sides and the leadership side always sucks because you have to answer and be accountable for a soldier at all times. Younger soldiers do not realize this at all. You have to give an accountability for soldiers...they cannot just be out there doing what they want without commo checks with their first line. If a soldier just communicates with his first line this would alleviate many problems. But back to the medical history...it is case by case...I guess it depends on the Command an what is going on with the soldier.