Defense Secretary Pete Hegseth signed a memorandum, April 24, 2025, directing a comprehensive review of medical conditions that disqualify individuals from joining the military.
The memo, addressed to senior Pentagon leadership, ensures recruits meet the high physical and mental standards required for service. This initiative responds to concerns about current medical waiver policies and their impact on military readiness, prompting a 30-day evaluation to refine enlistment criteria.
Titled "Review of Medical Conditions Disqualifying for Accession into the Military," the memo targets Department of Defense Instruction 6130.03, Volume 1, which outlines medical standards for enlistment, appointment or induction. It notes that waivers are currently permitted for conditions such as schizophrenia, paraphilic disorders, congestive heart failure and chronic oxygen use.
Hegseth emphasized that while the desire to serve is admirable, individuals with such conditions are often unable to complete initial training or their first term of service, potentially compromising mission success and the safety of service members.
"Applicants for military service … must be physically and mentally able to perform their duties under the harshest of conditions without risk to themselves or others," he said in a video posted on Defense Department social media accounts.
The memo tasks the undersecretary of defense for personnel and readiness with identifying conditions that should be ineligible for waivers and those requiring approval from a military department secretary. Proposed updates to the instruction will be submitted for the secretary's approval within 30 days.
In his recorded statement, Hegseth spoke about the memo's intent. He highlighted the need for "clear, high, and uncompromising medical and mental standards" to ensure readiness.
"Service members need to be medically ready to fight," he said, underscoring the goal to align standards with operational demands.
The reason for the review is rooted in recent trends and research. Data shows a rise in medical waivers, with approximately 17% of 2022 recruits receiving them, which is up from 12% in 2013, according to a DOD inspector general review.
The Navy alone issued 15,900 medical waivers in 2022, a significant increase from prior years. The surge, partly due to the health record system flagging more issues, has raised concerns about readiness.
Studies indicate conditions like schizophrenia can worsen under military stress. Heart conditions like hypertension and congestive heart failure limit physical performance, especially in deployment settings. Chronic oxygen use — often linked to severe respiratory issues — undermines service in high altitude or physically demanding roles.
The review also aligns with broader efforts to balance recruitment needs with operational effectiveness. By tightening waiver criteria, the department aims to ensure new service members can withstand the rigors of service, enhancing safety and mission success.
Hegseth's memorandum is nested in the department's focus on maintaining high standards, readiness and lethality. The forthcoming review provides a clearer framework for accession, ensuring only fully capable applicants join the military services.
"High standards equal lethality," Hegseth explained. "[Under President Donald J. Trump] we've … seen a huge surge of Americans who want to join … a military with high, clear standards."