Retirement tax questions

That screen doesn't appear for me.  As soon I finish the screen that has the 1099R info on it I get these two screens:

The medical part doesn't look like it's the right method anyway since this isn't a medical cost exemption.  It's simply the fact we had twins and qualify for the exemption. In spite of it saying it'll check for exemptions, it never asks or gives me the opportunity to enter it.  I've called Vanguard twice and got the same answer both times.  They say they can't fix it and I'm supposed to add a form 5329 to my taxes to get it waved.