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Were military surgeons or civilian doctors responsible for certifying bone spur deferments during the Vietnam draft?

Checked on November 21, 2025
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Executive summary

Contemporary reporting and historical summaries show that medical deferments during the Vietnam era—such as “bone spur” exemptions—were usually documented by civilian physicians and then processed by local Selective Service/local draft boards; military surgeons did not routinely issue initial civilian draft medical certifications (not explicitly stated in all sources) [1] [2]. Coverage of high-profile cases (e.g., Donald Trump) focuses on civilian podiatrists who wrote letters claiming heel spurs that led draft boards to change classifications, while broader Selective Service procedures and record gaps complicate firm, universal statements [1] [2].

1. How draft medical exemptions were triggered: civilian doctors provided the paperwork

Contemporary news reporting about draft exemptions emphasizes that civilian physicians supplied the medical letters or certificates that plaintiffs then submitted to their local draft boards; for example, reporting on Donald Trump’s bone-spur deferment centers on letters from podiatrists in civilian practice that led the Jamaica, Queens board to reclassify him [1]. Snopes’ review likewise describes Trump’s classification as stemming from a medical deferment for heel spurs and notes that details remain unclear in part because most draft-era medical records were not preserved—underscoring that civilian medical notes were the documentary basis forwarded to Selective Service [2].

2. Local draft boards, not military hospitals, made the call on fitness for service

The Selective Service System’s local boards handled classification decisions based on registrant records, including physician letters and Selective Service medical examinations; historical summaries explain that local boards classified registrants (for example 1-A, 1-Y or 2-S) and that the system was administered through local Selective Service machinery rather than being a military-hospital certification process [3]. News accounts of specific bone-spur deferments describe board reclassification following civilian doctors’ letters, indicating the practical flow: civilian physician → board review → draft classification [1] [2].

3. High-profile “bone spur” cases highlight civilian involvement and record gaps

Multiple outlets detail that “bone spur” exemptions often traced to civilian podiatrists or physicians who wrote statements for registrants; Newsweek recounts two podiatrists who penned letters in Trump’s case, and investigative pieces note that the documentation was submitted to the draft board [1]. Yet retrospective investigations and testimony (e.g., Michael Cohen’s claims and later reporting) also stress the lack of preserved medical files from the era, so many specifics about who evaluated what and when cannot be independently verified today [4] [2].

4. Why critics say the system was vulnerable to abuse—economic and access differences

Commentators and veterans pointed to unequal access to sympathetic physicians and to lawyers who could navigate local boards as a feature that advantaged wealthier men in avoiding service; Sen. John McCain’s criticism specifically singled out “highest income” Americans who found doctors to certify bone spurs as a draft-avoidance route, reflecting how civilian physician letters could be leveraged to obtain deferments [5]. Historical context from the Selective Service shows local-board discretion played a large role in fairness concerns long discussed in the Nixon-era reforms [3].

5. What sources do and don’t say: limits of the record

Available sources document civilian physicians writing the letters that led to reclassification and local Selective Service boards making classification decisions, and multiple news outlets and fact checks repeat that pattern [1] [2]. However, none of the provided sources lays out a comprehensive, statutory step-by-step rule that “only civilian doctors” certified deferments in every case or describes routine involvement of military surgeons for draft medical exemptions; therefore, definitive claims about universal procedures or rare exceptions are not found in current reporting [3] [2].

6. Bottom line for the question asked

The evidence in these sources shows that civilian doctors commonly supplied the medical documentation (letters from podiatrists or physicians) that led local draft boards to grant bone-spur or similar deferments, and draft boards administered classification decisions—not front-line military surgeons—according to the reporting and Selective Service history cited here [1] [3] [2]. Because many Vietnam-era medical records were not preserved, some individual cases remain disputed and unverifiable in the public record [2] [4].

Want to dive deeper?
How did the Selective Service define and document bone spur medical deferments during the Vietnam draft?
What role did military medical boards versus civilian physicians play in granting draft classifications (1-A, 1-O, 4-F) for musculoskeletal conditions?
Were there notable cases or scandals involving fraudulent or preferential bone spur deferments during the Vietnam War?
How did appeals and reclassifications work if the draft board or military doctors contested a civilian doctor’s assessment?
Did socioeconomic status, race, or political connections influence who received bone spur deferments in the Vietnam-era draft?