Applying for RMO Role - Made TMU - How Strong is my Case?

KJames

Midshipman
First time posting here as the Royal Marines own forums appears to be shutting down. I am applying for the role of Royal Marine officer. I passed my initial interview and sent off my paperwork to Capita. I would be grateful to have some feedback. on the strengths of my case (I understand medically there is not much people can say). I was made TMU on 22 April 2021 for the three following reasons: 1. A fractured left wrist (age 10), 2. Aspergers/ASD, 3. Depression.

1. Fractured Left Wrist

I thought I was Tarzan at a soft play area and missed a monkey bar swing and fell and landed on my wrist. Fully healed and recovered. No further issues.

2. Aspergers/ASD

I was diagnosed with Autism/ASD when I was three-years old. In February, however, I had a private reassessment done. I have a 35-page report which I had privately done via a Chartered Clinical Psychologist (BSc (Hons) PhD C.Psychol CSci AFBPsS) which expressly states the diagnosis of ASD is something I no longer fit as an adult. I quote from the letter the psychologist wrote to accompany the report as follows:

Results from all the standardized autism measures employed during this assessment – the AQ, EQ, AAA and ADOS2 – were negative for autism. Had [redacted] presented to this service as an adult he would not have received a diagnosis... It is difficult to say whether [redacted] has progressed such that he no longer meets criteria, or whether his presentation in childhood was similar to autism but was underpinned by something else and that he was not actually autistic, but either way his current presentation is such that an autism diagnosis would not be warranted. The lack of any family history of autism, either then or now, also reduces the possible ‘risk’ for autism as a diagnosis.... Recent research has indicated that around 7-13% of young children diagnosed with autism no longer meet the diagnostic criteria when older (e.g., Shulman et al., 2019; Anderson et al., 2014; Blumberg et al., 2016), and that this is particularly true when the child is under 4 years of age at diagnosis… It is not possible to know which reason underpins [redacted]'s situation, but the key thing is that he is no longer meets the diagnostic criteria, and as such should no longer be defined as being on the autistic spectrum. I would recommend… that it is made clear that he does not present with autism in adulthood.

3. Depression

This could potentially be the biggest of the hurdles. Back in December of 2017 I had started University and was feeling pressure with deadlines, adjusting to the University experience and also had some angst regarding relationships and dating (a bad breakup happened around this time as well). My parents (and in particular my mother) pressured me into going to the doctor to see if I could get some antidepressants (which I regret, but ultimately I was over 18 and so the decision is mine to bear responsibility for). In the paperwork that I had to fill in for my medical I saw that "Depression or low mood in last two years" is one of the conditions that may make a person unsuitable for entry to the Naval Service. I did some digging and found these statements within the JSP 950:

4. "It is important to differentiate between conditions representing understandable emotional and behavioural responses to significant life events (eg parental divorce, bereavement) and those disorders with a hereditary or complex aetiology (eg depression). Whilst the former may settle within acceptable time frames and with no psychiatric input, the latter are more likely to have a significant effect on function and greater risk of relapse. Candidates with a diagnosis made during adolescence require particular scrutiny. This is to ensure that individuals who have presented at a time of normal and understandable emotional turmoil are not unnecessarily declared UNFIT if they are symptom free and have developed coping strategies adequate for Service life."

18. "Candidates with a diagnosis of a single episode of mild or moderate depression (F32.0, 32.1) with a clear precipitating stressor may be graded FIT provided that all treatment, including medication, has been completed and the individual must be free from symptoms and off medication for 1 year."

19. "A diagnosis of a single episode of severe depression without psychosis (F32.2) suggests a greater impact on functioning, a requirement for more extensive therapy and higher risk of relapse. To be graded FIT, all treatment (including medication) must be completed and the candidate must be free from symptoms and off medication for 2 years. The episode of depression itself and the treatment pathway should not be more than 24 months in total."
  • From the date of my diagnosis (December 2017) to the date of my last prescription (April-May 2019) the period that elapsed comes to 17 months - well within the 24 month limit. I've had no counselling or further medication since then.
  • There were clear precipitating stressors - multiple of them in fact, which I have stated above.
I have had a letter of support written by a Psychiatrist I was seeing in 2018, and in it he has stated the following:

I first met [redacted] in April 2018. He had been prescribed Fluoxetine for low mood by his GP. He had also received a diagnosis of Asperger’s Syndrome in the past. He was previously diagnosed with Asperger’s syndrome and throughout my time with him I didn’t see enough signs or symptoms of an ASD to justify that diagnosis. I concur with his recent ASD assessment by Dr [redacted] which indicates this diagnosis is no longer accurate. I do not think he suffered depression now or at that time, because his mood varied too much, as did his energy, interest and enjoyment. His mood was not pervasively low… He was particularly interested in exercise and personal development. He was attending the gym and exploring Brazilian Jujitsu. He had a wider range of interests and his concentration was good. There was no evidence of social phobia, panic disorder or any anxiety disorders. There was no evidence of any psychotic phenomenology. He did have low self-confidence at times. In my view, rather than depression, [redacted] had issues around self-esteem, perfectionism and high personal standards. He had high expectations of himself and when he failed to meet those his mood deteriorated temporarily. He was health focussed and believed in a healthy mind and a healthy body.... We had a number of interesting philosophical discussions and he was always open to new information and new ideas. He was widely read and I found him an impressive character. I was struck in particular, by his high moral code and clear moral standards. I was struck by his impressive self-discipline both academically and physically. His intermittent low mood came from those high standards which led to disappointment when he failed to meet them.

However, [redacted] was far from a stiff or an impersonal stickler… His receptiveness to new information and people was impressive. I found him polite and engaging. His GP had diagnosed depression before I saw him… I decided to continue the medication to avoid any deterioration or unforeseen consequences of cessation, although explicitly stated in my notes and letters that I did not think he suffered from depression... These certainly did not reach diagnostic criteria for obsessive compulsive disorder and we rarely talked about them… We met for approximately 8-10 sessions of therapeutic support, but these always took the form of broad philosophical discussions, leaning on cognitive behavioural therapy, and wider therapeutic approaches. [redacted] found that the Fluoxetine was not doing anything for him anyway (not surprising since he was not anxious or depressed) and he stopped it... [redacted] does not have a mental illness in my view, and nor did he ever. His low mood was an understandable response to his circumstances, and his normal process of identity development. [redacted] is a young man with excellent self-discipline. He is physically fit and intellectually very capable. He has high standards and an excellent moral compass. In my opinion, he would make an excellent leader and I would have no concerns about him joining the forces or becoming an officer in the Royal Marines. I think he would be a very fine candidate...

In addition to this evidence, I have a GP letter that I have sent off that states the following:

I would like to add further clarification to help in your assessment of [redacted] with regard to his application to join the Royal Marines. I understand that he is awaiting his medical. [redacted] has a prior history of depression from December 2017 to May 2019. My understanding is that a lot of his previous depressed mood was secondary to reactive pressures and stresses such as examinations and university deadlines. In any case it did seem that he responded well to Fluoxetine medication and we prescribed this at the general practice from December 2017 through to June 2019. [redacted] does tell me that he last used Fluoxetine in May 2019 and did not need the last prescription for Fluoxetine. Looking at his records I can confirm that his mood has been stable and has not needed any medication for his mental health since May 2019. He has learnt to manage his mood through lifestyle interventions such as doing more exercise, getting outside and setting himself goals. He very seldomly drinks and at the weekend only and likes to maintain his fitness. I would be grateful if you would take this into consideration with regards to his upcoming assessment.

All in all, taking all of that into account, what would you ladies and gents reading this say about my chances of successfully passing the medical stage? I understand this has been one long post. Thank you.
 

huwshpis

War Hero
Unfortunately, there is no-one regularly on here who can offer a valid opinion. @Ninja_Stoker and @soleil may be able to offer some help, but remember that this is an UNOFFICIAL forum. Most of us have been out of uniform for too long to have relevant information or experience.
 

fishhead

War Hero
@KJames Most of us old pharts who inhabit these boards have learnt that taking a guess at what the Capita staff will do in response to certain medical questions is a very dodgy pastime. In the fullness of time you will get an answer and be told that you are either TMU(Temporary Unfit) where they will require clarity on certain matters or more seriously PMU(permanently unfit). The latter decision can be appealed and this is the time to produce your proof that past diagnoses no longer apply.
Good luck with your application and don't give up without a fight.
 

KJames

Midshipman
@KJames Most of us old pharts who inhabit these boards have learnt that taking a guess at what the Capita staff will do in response to certain medical questions is a very dodgy pastime. In the fullness of time you will get an answer and be told that you are either TMU(Temporary Unfit) where they will require clarity on certain matters or more seriously PMU(permanently unfit). The latter decision can be appealed and this is the time to produce your proof that past diagnoses no longer apply.
Good luck with your application and don't give up without a fight.
Understood mate. I suppose what I was angling for was some feedback on the quality and strength of the evidence and arguments I have put forward. I could have phrased things better. I appreciate the well-wishes. I'll post an update as and when one is known!
 

Martnet

Midshipman
Understood mate. I suppose what I was angling for was some feedback on the quality and strength of the evidence and arguments I have put forward. I could have phrased things better. I appreciate the well-wishes. I'll post an update as and when one is known!
Being made TMU just means they have to seek out more information from your medical records. If your records give enough specifics to land you back within the parameters of JSP 950, they'll tell you that after a paper review and pass you on to the next phase of the application. If you get made PMU, you can appeal...but be aware: having relatively recently appealed and won a PMU status, I can say that what the SMOSE is looking for is for you to provide specific evidence that either a) presents new information that gives reason to overturn the decision, or b) presents more specific information that brings the case back within the guidelines of JSP 950. I couldn't possibly advise you on your case, but if you have to go down the road of appealing a PMU decision, I can say it helps to know exactly what the JSP 950 guidelines are (as you have already researched) and then make sure you have evidence (preferably from a specialist/GP) that proves you fall within those guidelines. It doesn't help your case to make an appeal just because you think the decision was unfair.

Hope that helps. Good luck with the application.
 

canouanislander

Midshipman
My son, just got his start date, went through the medical and was TMU'd for a variety of things which initially looked terrifying and he would never get past.

But actually it was just a process. Some were just a one sentence answer - it healed, no symptoms or problems since. Our doctor was really proactive and answered all the requests within a couple of days, sent to us and we then sent to Capita to avoid delays. The list was full of stupid things - cut to head aged 7, stitch in arm aged 11 and the like.

For the 2 issues that were more serious in their mind (physical, not mental health) we immediately sought a professional diagnosis, had a report done and ensured, and this was key, that the report was based on the PULHEEMS ENTRY requirements for all applicants. The reports confirmed that my son absolutely passed those in the view of the specialists and we forwarded that directly to Capita. Once received by Capita he was deemed fit. Both things were not what anyone would ever think would stop a very healthy and fit lad getting in the navy, or indeed affecting his navy life moving forwards, but had to have a robust answer to for Capita.

I cant advise on if you'll get through but get an up to date report and diagnosis asap, pay and get it done asap, and print off the PULHEEMS ENTRY requirements for the RN and ask the specialist to focus the review and report around that, quoting the requirements and their findings.

Hope that helps.
 
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KJames

Midshipman
Being made TMU just means they have to seek out more information from your medical records. If your records give enough specifics to land you back within the parameters of JSP 950, they'll tell you that after a paper review and pass you on to the next phase of the application. If you get made PMU, you can appeal...but be aware: having relatively recently appealed and won a PMU status, I can say that what the SMOSE is looking for is for you to provide specific evidence that either a) presents new information that gives reason to overturn the decision, or b) presents more specific information that brings the case back within the guidelines of JSP 950. I couldn't possibly advise you on your case, but if you have to go down the road of appealing a PMU decision, I can say it helps to know exactly what the JSP 950 guidelines are (as you have already researched) and then make sure you have evidence (preferably from a specialist/GP) that proves you fall within those guidelines. It doesn't help your case to make an appeal just because you think the decision was unfair.

Hope that helps. Good luck with the application.
Thank you for taking the time to respond buddy. All the specialist evidence I have (aside from the 35-page ASD reassessment) I included in my post. Done all I can at this point.
 

KJames

Midshipman
My son, just got his start date, went through the medical and was TMU'd for a variety of things which initially looked terrifying and he would never get past.

But actually it was just a process. Some were just a one sentence answer - it healed, no symptoms or problems since. Our doctor was really proactive and answered all the requests within a couple of days, sent to us and we then sent to Capita to avoid delays. The list was full of stupid things - cut to head aged 7, stitch in arm aged 11 and the like.

For the 2 issues that were more serious in their mind (physical, not mental health) we immediately sought a professional diagnosis, had a report done and ensured, and this was key, that the report was based on the PULHEEMS ENTRY requirements for all applicants. The reports confirmed that my son absolutely passed those in the view of the specialists and we forwarded that directly to Capita. Once received by Capita he was deemed fit. Both things were not what anyone would ever think would stop a very healthy and fit lad getting in the navy, or indeed affecting his navy life moving forwards, but had to have a robust answer to for Capita.

I cant advise on if you'll get through but get an up to date report and diagnosis asap, pay and get it done asap, and print off the PULHEEMS ENTRY requirements for the RN and ask the specialist to focus the review and report around that, quoting the requirements and their findings.

Hope that helps.
Appreciate that mate. Even though Capita were the ones who put together the letter to send to the GP, it turns out that they'd either a) not sent the letter yet or b) it had been lost in transit, as when I called my GP last week they'd not received anything whatsoever for the doctor to fill in. Thankfully I had a lightbulb moment where I thought 'Hey, if the nurse at Capita has sent me the exact same copy of the letter my doctor needs to fill in... why not just send that to the GP instead via email?' Honestly, I could have kicked myself - would have been so much better to have done that originally, but I made the mistake of trusting Capita in that instance. I mean, I have no idea if what I ended up doing there was what I was supposed to do in the first place - I was operating on the understanding that Capita were going to send a letter/forms to my GP of their own initiative.
 

canouanislander

Midshipman
Appreciate that mate. Even though Capita were the ones who put together the letter to send to the GP, it turns out that they'd either a) not sent the letter yet or b) it had been lost in transit, as when I called my GP last week they'd not received anything whatsoever for the doctor to fill in. Thankfully I had a lightbulb moment where I thought 'Hey, if the nurse at Capita has sent me the exact same copy of the letter my doctor needs to fill in... why not just send that to the GP instead via email?' Honestly, I could have kicked myself - would have been so much better to have done that originally, but I made the mistake of trusting Capita in that instance. I mean, I have no idea if what I ended up doing there was what I was supposed to do in the first place - I was operating on the understanding that Capita were going to send a letter/forms to my GP of their own initiative.
Cut Capita out - take what letters they send to you saying they are sending them to the GP and send them yourself via email. Same for the GP on the way back - they ask for the GP's letter sent in the post then miraculously never receive it or lose it. Just get your GP to send you the letter and you email it to Capita requesting Read receipt. ITs quicker and they cant deny getting it!
 

KJames

Midshipman
Cut Capita out - take what letters they send to you saying they are sending them to the GP and send them yourself via email. Same for the GP on the way back - they ask for the GP's letter sent in the post then miraculously never receive it or lose it. Just get your GP to send you the letter and you email it to Capita requesting Read receipt. ITs quicker and they cant deny getting it!
100% agreed; didn't think they could muck up sending a letter they had already fully written and addressed, but there's a reason they have a certain nickname. I have already set it up so my GP sends me an email/give me a courtesy call to inform me when it's been completed. I will also have a copy of what is sent off to them sent to me also, and forward it to them on my own initiative.
 

Martnet

Midshipman
100% agreed; didn't think they could muck up sending a letter they had already fully written and addressed, but there's a reason they have a certain nickname. I have already set it up so my GP sends me an email/give me a courtesy call to inform me when it's been completed. I will also have a copy of what is sent off to them sent to me also, and forward it to them on my own initiative.
Absolutely. I've been dealing with Capita back and forth for over a year now, with several different requests "sent off" to my GP. My GP has never once received a letter sent by Capita, and Capita have more than once claimed they never received letters/reports sent back to them. My SOP now is to email and take a hard copy of any Capita request to my GP, ask for a copy of anything my GP sends to them, and then immediately send at least one copy of my own of any GP report to Capita (signed for, recorded, all of that) as a back-up. It saves a lot of time to just automatically send an extra copy that's signed for rather than wait three or four weeks to find out they don't have the original (when I've emailed to ask for confirmation they've received anything, the quickest response I got was three weeks later)
 

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