Medical waiver experience at U.S. Air Force Special Operations Command, 1992-2003.

Introduction: Strict physical standards are applied to military applicants and service members, but these standards can be waived on a case-by-case basis when a member is felt to be capable of continued service in spite of their infirmity. Knowledge of the waiver experience at the unit or major command (MAJCOM) level could yield important operational risk management insight. The present study examined the waiver experience at Air Force Special Operations Command (AFSOC) from 1992 through 2003. Methods: A dataset reflecting the accumulated waiver experience at AFSOC from 1992 to 2003 was reviewed. Diagnostic groups and occupations were tallied, and waiver rates determined for each. Results: There were 1042 individuals considered for waivers of 1270 medical conditions. Combat controllers made up the largest occupational group, and were statistically more likely to seek waiver consideration than would be expected in the general AFSOC population. The five most commonly encountered diagnostic groups were: otorhinolaryngologic, 26.9%; musculoskeletal, 17.6%; ophthalmologic, 10.9%; cardiovascular, 7.2%; and gastrointestinal, 7.9%. Waivers were granted to 83.9% of the group. Pilots and navigators were more likely to receive a waiver, and aerial gunners were less likely to receive a waiver. Discussion: The five most commonly encountered diagnostic groups accounted for 69% of waiver requests, and the overall waiver rate of 83.9% exceeded that reported in other studies. This MAJCOM-specific data could serve as a valuable resource for comparison to waiver data obtained from other MAJCOMs, and could aid in the development of targeted operational risk management activities.