Russia’s Defense Ministry is quietly making it even harder to get a medical exemption from military service

Avoiding conscription or getting out of the Russian army is about to become even harder. The Defense Ministry has quietly moved to change military medical regulations, narrowing the list of health conditions that grant exemptions. Under the new rules, even some severe mental health disorders will no longer disqualify recruits. Here’s what we know so far about the upcoming changes.

Russia’s Defense Ministry has proposed changes to the government’s Regulations on Military Medical Examinations that would make it harder for servicemen and conscripts to be deemed unfit for duty, the Movement of Conscientious Objectors reported.

“Getting an exemption from compulsory military service or a medical discharge will become much more difficult,” the organization said, warning that if the changes are approved, they will “significantly worsen conditions for both servicemen and conscripts in terms of medical evaluations.”

According to the Movement of Conscientious Objectors, the ministry is preparing major revisions to the Schedule of Illnesses — the official list of medical conditions that disqualify individuals from military service. This schedule is used by draft boards to classify individuals based on their fitness for duty.

An explanatory note states that the proposed changes aim to “improve the system of medical examinations for servicemen, drawing on experience from the special military operation,” as well as to refine health requirements for conscripts, contract soldiers, mobilized personnel, reservists, and applicants to military academies.

The Movement of Conscientious Objectors highlighted several key changes proposed by the Defense Ministry:

• The fitness category for conscripts with primary, secondary, or latent syphilis will change from C to B-4.
• The fitness category for conscripts with stage 1 hypertension will change from C to B-3.
• Contract soldiers and mobilized personnel with moderately severe, transient endogenous psychoses, as well as “severe neurotic disorders” associated with stress, somatic symptom disorder, and mood disorders will now be classified as C instead of E, allowing them to remain in the ranks of the Russian army.
• The definitions of “widespread” and “limited” forms of dermatoses will be updated. Psoriasis or eczema will be classified as “widespread” if it affects more than 10 percent of the body. For chronic urticaria (hives), a lack of treatment effectiveness must be documented over a period of four weeks.

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The Defense Ministry published the draft resolution on December 17, 2024, but Russian media did not report on it. Public discussion closed on January 4. The document’s description notes that Deputy Defense Minister Anna Tsivileva “decided against posting a notification” on October 22, though it’s unclear what notification this refers to.

Back in December 2023, Russia’s Defense Ministry drafted a proposal to revise the medical examination process for individuals with conditions that “do not significantly affect” their ability to fulfill “military service duties.” However, the ministry did not specify what changes it planned to introduce.

According to the Movement of Conscientious Objectors, the proposal received more than 800 negative responses during public hearings. The Defense Ministry was expected to publish the full text of the amendments, but that never happened, and the document was never approved.

Human rights advocates believe the new proposal is similar in intent.

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