SlowItDownCKD

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Best Six Kidney Disease Blogs of 2016 & 2017; winner Top 75 Nephrology Blogs

Clarification

This past Friday was Independence Day here in the United States. Despite the despairing political climate at this time, our armed forces have never failed us. I’ve written about their policies for people with kidney disease before, but Dan Holmes has the insider’s perspective. I’ve asked him to explain it to us from the military member’s point of view… and he certainly has. Read it for yourself:

Mission Interrupted: How CKD Impacts Military Readiness

In the military, the word deployment carries weight. For some, it means stepping into danger. For others, it’s the culmination of years of training and a chance to prove themselves. Deployments can also bring financial relief, tax-free pay, bonuses, an opportunity to make rank, or just a break from the realities of home.

For many service members, there comes a moment when they’re told they can’t go. They’ve become non-deployable. That single designation, often assigned through a routine medical appointment or unexpected health event can trigger a chain reaction that reshapes careers, relationships, mental health, and identity.

What Does “Non-Deployable” Actually Mean?

At its core, non-deployable status means a service member is not currently cleared to perform duties in an operational environment, whether that’s aboard a ship, in a combat zone, or at a remote overseas location. This can be temporary, such as after surgery, injury, or pregnancy. Or it can become indefinite, depending on the medical condition, recovery outlook, or risk factors involved.

The Department of Defense Instruction (DoDI 1332.45) outlines a key policy: If a service member remains non-deployable for 12 consecutive months, they may be referred for administrative separation, medical evaluation, or other retention decisions. The clock starts ticking and with every month a member stays non-deployable, their future in uniform becomes less certain.

Reasons for Non-Deployability

Non-deployable status can be triggered by a wide range of issues, many of which are not visible to those around the service member:

• Pregnancy

• Mental health diagnoses (e.g., PTSD, anxiety, depression)

• Chronic illnesses (e.g., diabetes, autoimmune disorders, kidney disease) [Gail here: my bolding]

• Medication requirements that cannot be supported in deployed environments

Some of these conditions come with well-understood timelines and procedures. Some examples may be:

• Pregnancy, has established rules: Navy guidance requires pregnant sailors to be moved to shore duty no later than the 20th week.

• Under Army Regulation 40-501, any service member with a glomerular filtration rate (eGFR) below 60 is flagged as medically “non-deployable.” The eGRF is the term used to track the function of your kidneys. Depending on the severity and progression of your condition, you may remain in a support capacity, or you may be medically separated altogether. [Gail here: I bolded this information for obvious reasons.]

There are checklists, assigned support systems, and structured protections. Other conditions, especially chronic or invisible illnesses exist in a gray zone. There may be no clear roadmap, no command-level awareness, and no obvious support structure. That’s when the real struggle begins.

The Emotional and Professional Impact

Being labeled non-deployable doesn’t just affect a service member’s duty status, it often affects their sense of worth. In a culture where readiness and reliability are deeply tied to identity, non-deployability can feel like failure. One may no longer be on the roster, billet might be reassigned, not be included in training evolutions. Promotions and special assignments can quietly disappear.

Even more challenging is the mental toll:

• The feeling of being left behind

• Personnel are often assigned to a demoralizing unit that cleans trash off the side of the street or some non-career-oriented tasks, usually tedious in nature. Often these units are full of negative military personnel, the malingerers who fake injury or the personnel that have gotten into trouble for some UCMJ law violation. Many times, this is also a unit where others could not continue training after they have quit like a Special Operations candidate who doesn’t make it through the process.

• Guilt, shame, the fear of being labeled “broken” are all present at the same time.

• Service members questioning their self-value, feeling part of something bigger than yourself is an important feeling to maintain.

Many of the conditions that trigger non-deployable status aren’t physically visible. The struggle is often misunderstood. There’s no cast. No crutches. Just a profile in your medical record and a silence in your chain of command.

The Deployment Disconnect

From the outside, civilians often think “non-deployable” means relief. You’re safe. You’re home. You’re lucky. Inside the military it is the opposite.

Deployments provide various benefits:

• Builds camaraderie

• Earn opportunities to advance in rank and

responsibility

• Pay checks become tax free

• Depending on location, and job duty, there are other financial incentives to deployment, like hazard pay, flight pay, combat pay, etc.

• They’re seen as the ultimate test of readiness. Many jobs train harder than the real job, so deployment can mean a break from training and a chance to relax and go operational.

When someone is told they can’t go, especially without warning, it cuts deep. It creates a disconnect that few are prepared for.

The System Isn’t Always Equipped

In some cases, there is a clear path forward: rehab, recovery, return to duty. In others, the path is foggy. The member waits, month after month, for clearance, for clarity, for a decision. Meanwhile, the military’s administrative machine keeps moving, and the member can feel forgotten and stuck in limbo. Many times, being away from your unit means you’re not actively involved in your rated job duties, and this may disqualify you from taking promotional exams. This also may cause you to be evaluated at your job by someone who doesn’t understand your job as these non-deployable units are often made up of many different personnel job profiles.

In many cases, there’s no one to help them navigate this stage. No briefing. No mentor. No playbook. Just paperwork, wait times, and unanswered questions.

This Is Where the Conversation Needs to Change

Too often, there’s no one to guide service members through the experience of becoming non-deployable. No roadmap. No voice explaining that they’re not broken, just navigating a different kind of mission. Let alone the struggle of dealing with whatever landed them on non-deployable status, something like being diagnosed with chronic kidney disease. Understanding what non-deployable status really means and how it affects the mental, emotional, and professional lives of service members is long overdue.

The system still has work to do. But so do we. We need leaders, advocates, and fellow warriors who can help others navigate the gray zone. We need to normalize conversations about chronic illness, invisible wounds, and the quiet struggles happening behind the scenes of every formation. Because deployment status doesn’t define a warrior—resilience does.

The Author

Daniel Holmes is a U.S. Navy Special Operations veteran and kidney disease patient advocate. He is the Founder and CEO of the Enlisted Kidney Foundation, where he is making real change for veterans and patients living with chronic illnesses, through education, action, and advocacy.

Learn more at EnlistedKidneyFoundation.org

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