How much authority does a leader have to mandate when a soldier can make medical appointments? Can they order them to miss/cancel it?

SPC Private RallyPoint Member — Wed, 27 Mar 2019 10:52:18 -0400

I work shift work in a hospital. So everyone’s work schedule is irregular and all over the place.

At the beginning of the year the floor NCOIC informed us that we are not allowed to make appointments on days that we work and that if we do, for what ever reason, will be ordered to cancel/miss it?

We are allowed to swap two shifts a month and can request days off (RDO), so long as they are requested 6-8 weeks in advance. Clinics only schedule 8 weeks in advance.

This make scheduling an appointment extremely difficult or impossible. We have to try and schedule in that two week gap from the clinics availability and the RDO deadline or we can’t make an appointment at all if a) no one will swap, b) our schedule is published, or c) if the clinic isn’t making appointments for that time frame yet.

I understand why the floor requires that due to laws regulating patient-to-staff ratio and I believe that people should be mindful of their work schedule when making an appointment.

The floor NCOIC has not been sympathetic to people who try to talk to him about it either. Its a figure it out or your not going situation.

At the same time what are service members to do when nothing is available to them? Do they forego treatment? Does “patient care comes first” not apply to people are both employees and patients at the same facility?

Does the NCOIC or anyone for that matter have the authority to deny someone a medical appointment? Can you be ordered to cancel/miss your appointment?

An example of this is; I’m having to forego a good chunk of Physical Therapy’s recommendations because my schedule is already out until May and I work majority of the days PT wants me to attend a specific rehab class for my shoulder.

Response by SSgt Private RallyPoint Member made Mar 27 at 2019 10:55 AM

SSgt Private RallyPoint Member — Wed, 27 Mar 2019 10:55:26 -0400

No one can do that, leaderwise. It is wrong! Esp if it is an emergency.

Response by SFC Private RallyPoint Member made Mar 27 at 2019 11:21 AM

SFC Private RallyPoint Member — Wed, 27 Mar 2019 11:21:21 -0400

If he’s not willing to accommodate and his answer is just always a flat out “No”, he has a boss too. Go there. Your health needs to be your number one concern and the health of his soldiers should be pretty high on his list. Doesn’t seem that it is.

Response by SFC Casey O'Mally made Mar 27 at 2019 11:21 AM

SFC Casey O'Mally — Wed, 27 Mar 2019 11:21:30 -0400

The Commander can do pretty much anything (s)he wants regarding your medical appointments, and is held responsible for the results, both good and bad. Floor NCOIC is not the Commander. Unless the Commander has specifically delegated the authority to cancel your appointment, the floor NCOIC cannot cancel them himself. He CAN put in place a policy regarding appointments and availability, however if that policy effectively prevents you from obtaining full and proper medical treatment, than his policy is not viable and needs to be re-worked.

But it is entirely possible his policy is workable. You have to request days off 6 weeks in advance - when is the schedule published? If it is published 5 weeks out, then you have all but one week of scheduling availability. If it is published 2 weeks out, ask (respectfully) why you have to submit 6 weeks out when the schedule won't be published for a month, explaining (tactfully) the problem this creates with trying to take care of yourself (as you are supposed to do within the Soldier's Creed - you aren't slacking, you are fulfilling your responsibilities). Then ask if there is any leeway, or you can get a regularized schedule so that you can better plan medical appointments.

Try to make this a collaborative effort, where you are working to fulfill your NCOIC's needs (work your shifts) and he is fulfilling yours (availability for appointments and ability to schedule).

If none of that works, then go above him to the next higher step in the CoC and explain the situation. Work your way up to 1SG and CO, if necessary. But at the CO, it stops, because (s)he is the one who ultimately has that authority and responsibility.

Also, make SURE that as you work up the chain, it is a "seek guidance"/ "ask for help with ME" conversation and NOT a "tattle" / "ask for help with that mean NCO" conversation. The former will get leaders invested, the latter gets shut down real quick, in most cases. Tact and respect (to include respect for your Floor NCOIC) go a LONG way here.

Response by SGM Erik Marquez made Mar 27 at 2019 11:24 AM

SGM Erik Marquez — Wed, 27 Mar 2019 11:24:55 -0400

Yes, no, kind of.

Your leadership can absolutely direct you to schedule appointments that are deconflicted with work. At the same time, as happens often, if the only available appointment time conflicts with work the leadership should absolutely make a exception to the policy.

The secret to making that work, Honesty and communication.

The SM has to honestly try and get a deconflicted appointment time, and communicate to the leader that no deconflicted appointment time slots were available.

The Leader should honestly listen and evaluate the impact of the SM being gone from place of duty for the appointment time and if manageable, allow it, even it makes things difficult.

With low density MOS's and short filled UMR's that can be a challenge at times.
If your the only Radiology Tech in the Peds unit this week, it would not be ok to have you gone to a appointment this week. And the policy of no appointments during scheduled work time would be upheld. If as the leader I was able to borrow an Xray Tech from another department to cover your appointment time I would make the exception and happily send you on your way.

Response by PVT Mark Zehner made Mar 27 at 2019 11:29 AM

PVT Mark Zehner — Wed, 27 Mar 2019 11:29:45 -0400

Yes up to if it's an emergency or it's the only slot available

Response by LT Brad McInnis made Mar 27 at 2019 12:31 PM

LT Brad McInnis — Wed, 27 Mar 2019 12:31:15 -0400

Was JOC XO at CENTCOM where I worked nights, and our policy was to 1) sked any appointments on off time, and 2) if that was impossible, then get a relief. If neither of those are possible, then work to get a schedule change. We had no extra bodies, and so it was really incumbent on the SM's figuring it out within the confines of policy. It may mean you pull some extra shifts to get someone to cover your appts...

On the other hand, not sure what your shoulder injury is, but I dislocated both of mine and tore rotator cuffs. Best read is surgical tubing exercises they give you, and Australian Dream Cream. Nothing else really helped. Best of luck!

Response by SFC Private RallyPoint Member made Mar 27 at 2019 12:33 PM

SFC Private RallyPoint Member — Wed, 27 Mar 2019 12:33:00 -0400

The key is deconfliction. Of course, you have to show a genuine attempt at deconfliction before you go over the head of your NCOIC.
Ask for a printout of all the appointments available for you over the next 2 to 4 weeks. Take that to the ncoic and ask him which ones are okay. Ask for schedule of the class your physical therapist wants you to attend and run that by your ncyc as well.
Your ncoic cannot deny you seeking medical treatment. He should be capable of arranging the schedule several weeks ahead to accommodate your classes. If he refuses to oh, at that point you have two options.
Option one, make the appointments provide him with the appointment slips and even send an email calendar invite. If possible, find someone who is willing and capable I'm switching your shift. If the ncoic brings this to his Commander in order to push for Article 15, you have plenty of proof to show that you made all allowances possible for your leadership to accommodate your medical needs, and that you were being denied medical treatment.
Option 2, ask your ncoic to place the denial in writing for you. Then, take that denial to your company Commander with your grievance. At the same time, you could also take that to IG and explain that you have made all attempts to work with your leadership for medical treatment, but you are being denied medical treatment

Response by SPC Brian Mason made Mar 27 at 2019 2:00 PM

SPC Brian Mason — Wed, 27 Mar 2019 14:00:25 -0400

It's not that simple. As a Medic, I can attest that part of this is true.
Our work schedule is planned out well in advance. Immunizations are set on a schedule so that we can get the MR and vaccinations can be ordered. Usually, there will be one day for each company and will fill an entire week maybe more.
Depending on the soldier's needs and how far in advance then making appointments is fine. Find out what the schedule is far enough in advance and THEN tell your CoC how to best plan it. We did volunteer but we're not mindless robots. I had an accident during work hours which sent me to the TMC for a back X-ray(long story). Lost 2 days of work while at home on some good pain meds and mostly sleeping. An eval checkup a week from the date of injury then puts me on 3 weeks of Low Physical Activity, a back brace, AND more meds. Even after that, I had to get more check-ups to test mobility, blood flow, pain, and muscle testing to ensure there wasn't permanent damage.
Depending on the unit and that company, your platoon may be understaffed. Maybe your MOS and position is narrow and even one person being out slows things down significantly. Hospitals and clinics are no less immune to this since seeing patients and treatment is not a fixed thing.

Response by MSgt Denise Smith made Mar 27 at 2019 7:49 PM

MSgt Denise Smith — Wed, 27 Mar 2019 19:49:52 -0400

This is a issue to take up with your unit senior enlisted leader and your doctor. Since a doctor or a physician assistant out ranks your NCOIC it sounds like he/she is just being a jerk.

Response by SSG Dave Johnston made Mar 27 at 2019 9:18 PM

SSG Dave Johnston — Wed, 27 Mar 2019 21:18:58 -0400

Specialist, you and your NCOIC are going to come to loggerheads over this one... You'll need to go to the Command suite and discuss this with either the Chief of Nursing, or the SGM; Sorry. I do find it interesting that your NCOIC was unable or unwilling to move you to nights so you could get with Physical Therapy since that clinic is a "Day shift" only and Your NCOIC must be aware of it. So, arm your self with a copy of the posted duty roster for your floor, your PT referral from your PCM and if; I say IF, your NCOIC posted written instructions concerning 'Medical Appointments" take that with you as well. And be prepared to be transferred to a different Ward, Medical Hold, or possibly over to Division...

And stay calm, respectful, don't loose it, and ask if there is a facility off post that can accommodate the hours you're assigned to work. since you are unable to use the PT clinic "in house per NCOIC's instructions and have the Ortho Clinic set it up.