Heel spurs and stammers: What kept people from military service?

Story highlights

  • Donald Trump said heel spurs kept him out of Vietnam
  • There's a complicated history behind the list of conditions that exempt people from military service

(CNN)On the heels of Donald Trump facing scrutiny over his multiple US military deferments during the Vietnam War, many Americans are questioning what exactly qualifies as a draft exemption -- especially from a medical perspective.

The New York Times reported Monday that the Republican presidential nominee dodged the draft due to four student deferments and a medical deferment after he was diagnosed with heel spurs, calcium deposits that cause bony protrusions on the bottom of the heel.
    Classification records shared with CNN by the federal government's Selective Service System confirm that Trump received a student deferment and was later found "disqualified for military service" in 1968 after he underwent a physical exam.

    No 'habitual drunkenness' or 'masturbation' allowed

    Regulations determining which diseases and ailments disqualify a registered man from being drafted for military service can be traced to the Civil War, according to a digital copy of an 1863 regulation manual in the National Library of Medicine that spans 100 pages.
    Consider just a few of the many medical conditions that could have disqualified someone from military service, if found to be severe or detrimental, in 1863:
    • Insanity or mania
    • Scrofula or constitutional syphilis
    • Cancer
    • Habitual drunkenness
    • Acne rosacea
    • Masturbation may result in rejection or discharge of service
    • Minimum stature of 5-foot-3, and possibly maximum height of 6-foot-3
    • A greater weight than 220 pounds, unless accompanied by corresponding height and muscular sufficiency
    • Deafness
    • Hernia and stomach ulcers
    • Contagious skin diseases
    • Club feet, splay feet, flat feet
    However, "a national bureaucracy for managing conscription did not emerge until after the passage of the Selective Service Act of 1917 -- although even this relied on the contributions of approximately 4,000 local draft boards, which retained the prerogative of granting exemptions," said John Hall, professor of military history at the University of Wisconsin-Madison.
    "In 1940, as European and Asian war clouds darkened America's skies, the United States implemented 'peacetime' conscription for the first time -- but the world was already at war," he said. "The real break from American tradition came in 1948 when the United States for the first time employed the draft as a routine element of defense manpower policy, whether or not the United States was at war."
    Around that same time, physical and mental standards for Selective Service registrants were developed.
    In 1942, the list of medical conditions that could have disqualified someone from military service, if found to be severe or detrimental, looked a little different. Among dozens of other conditions, it included:
    • Brain tumors
    • Epilepsy
    • Sexual perversions
    • Stammering to such a degree that the registrant is unable to express himself clearly or repeat commands
    • Psychopathic personalities
    • Chronic alcoholism and drug addiction
    • Multiple sclerosis
    • Cerebrospinal syphilis
    "When Richard Nixon took office in 1969, he realized that the draft was undermining rather than sustaining the war effort in Vietnam, so he initiated a transition to an exclusive reliance on volunteers, which culminated in 1973," Hall said. "Partly because of the scarring experience of Vietnam, the United States is very unlikely to resort ever again to the draft."

    Modern standards of health

    Currently, each branch of the military -- from the Navy to the Air Force -- has its own medical or fitness assessment for applicants.
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    "They do have guidelines on what is disqualifying and what is qualifying and, in some cases, what can be waived and what cannot be waived," said Jim Dower, who formerly worked in both Selective Service and the military. He retired in 1994 and now resides in Sarasota, Florida.
    "You're psychologically screened, you're physically screened in the normal things you would take a physical for, and your history is taken," Dower said. "If there's any questions, they go out and get consultations for whatever is required."
    For instance, the standards of medical fitness for the United States Army were last updated in 2011 (PDF), when the "don't ask, don't tell" policy was repealed.
    By then, some of the dozens of medical conditions that could disqualify someone from serving in the US Army, if found to be severe or detrimental, included:
    • Cleft lip defects
    • Stomach ulcers and stomach bleeding
    • Heel spur syndrome and hammertoe result in referral to a medical evaluation board
    • Current or history of coronary heart disease
    • Current absence of one or both testicles
    • Plantar flexion of the foot must meet 30 degrees
    • Women below 58 inches or over 80 inches tall do not meet standards
    • Men below 60 inches or over 80 inches tall do not meet standards
    "Although there has not been a draft in over 40 years, men 18 [years old] are still required to register with the Selective Service System. It's a law and civic duty," said Matthew Tittmann, a spokesman for the agency.
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    "At 26, they become too old to register, but failure to register can carry lifelong consequences, and non-registrants risk being disqualified from access to federal college loans and grants, job training programs, all federal jobs and many state and municipal jobs," he added. "All documented and undocumented immigrants must register, as well. Otherwise they risk losing the aforementioned benefits and could delay their citizenship process."