5.1. General Information.
This chapter covers the medical requirements for contracting a cadet (enlistment) and commissioning into the Air Force. Medical examinations can be obtained through the Department of Defense Medical Examination Review Board (DoDMERB), a Military Entrance Processing Station (MEPS), or military treatment facilities (MTF). For additional information refer to the AETC/SGPS ROTC Cadet Medical Processing Guide (CMPG). The OPR for this chapter is HQ AFROTC/RRF.
5.2. DoDMERB Physicals.
DoDMERB is the centralized certifying authority for entry (scholarship) physicals and a DoDMERB physical is required for scholarship activations. Certified DoDMERB physicals are good for scholarship activation, field training attendance, POC entry and commissioning (non-rated and non-specialty only). DoDMERB physicals are scheduled through their website at https://dodmets.com, and a user guide is available on this website. HQ AETC/SGPS serves as the action office following initial DoDMERB certification, regardless of medical action addressed, and will accomplish all subsequent recertification. The initial DoDMERB determination of "MEETS" or "DOES NOT MEET" medical accession standards is based on DoDI 6130.3, Medical Standards for Appointment, Enlistment, and Induction into the Armed Forces. If the DoDMERB determination is "DOES NOT MEET" medical accession standards, then a medical waiver is normally considered by AETC/SGP automatically based on AFI 48-123, Medical Examinations and Standards, unless the cadet requests not to pursue the waiver. The CMPG provides additional information on the AETC/SGP case review process.
5.3. MEPS Physicals.
5.3.1. MEPS is a certifying authority for POC entry physicals (non-scholarship), field training attendance, and commissioning physicals (commission certification ONLY). MEPS physicals are scheduled by detachment personnel through the local MEPS unit. When requesting a MEPS physical, detachments should request a commissioning physical. Check with the MEPS facility for any local policies or procedures that the cadets must follow. Common medical forms used by MEPS include DD Forms 2807-2, Medical Prescreen of Report of Medical History, 2807-1, Report of Medical History, and 2808, Report of Medical Examination. MEPS will require medical records for any illness listed by the cadet on medical forms. Physicals certified by MEPS are annotated "Qualified" for commissioning in item 74a, page 3 of DD Form 2808 (NOT stamped).
5.3.2. Commissioning physicals accomplished and "qualified" at MEPS are considered certified for commissioning purposes for any cadet requiring a "commission-only" certified physical. Do not forward to AETC/SGPS for certification.
5.3.3. MEPS is not the certifying authority for changes in a cadet/applicant's medical status following initial MEPS qualification. Once initially qualified by MEPS, HQ AETC/SGPS becomes the reviewing and certifying authority for any subsequent medical condition/illness.
5.4. Initial Flying Class/Medical Flight Screening (IFC/MFS) Physicals. IFC/MFS physicals are for pilot, RPA, and top pilot alternate candidates. These cadets will receive an IFC/MFS examination conducted by the USAF School of Aerospace Medicine (USAFSAM) located at Wright-Patterson AFB, OH. IFC/MFS physicals are scheduled by the detachment through WINGS. AETC/SGP certifies IFC/MFS physicals.
5.5. Military Treatment Facility (MTF) Physicals.
5.5.1. MTFs may provide entrance physicals for ECP cadets and will perform commissioning physicals for cadets selected into non-IFC/MFS rated physicals (FCIA, FCIII, ABM, etc.) and non-rated (13XX) positions. Cadets must be categorized/selected for the position prior to requesting a physical examination appointment with the MTF. Cadets will hand-carry any supporting medical documents maintained at the detachment so they may be available for review by the MTF personnel and copies uploaded into the Physical Exams Processing Program (PEPP) as required. This will ensure all the documents needed for review and certification by HQ AETC/SGPS are available.
5.5.2. Non-IFC/MFS rated physicals. Detachments will schedule the appointment at the MTF and request that all cadets receive an Adaptability Rating Medical Assessment (ARMA) for ATC, MOD, as well as for flying. This will save time if the cadet is re- categorized after the physical is completed and certified by SGPS.
5.5.3. Non-rated (13XX) physicals. Detachments will schedule the appointment at the MTF and request Adaptability Rating for Space and Missile Operations Duty (ARMOD) evaluation, RAT and color vision included for certification. Air Traffic Control AFSCs must have a RAT and Adaptability Rating for Air Traffic Control (AR-ATC), and Depth Perception results on the SF88 prior to certification. Cadets selected for missile career field must have a certified commissioning physical with a Missile Crew Duty certification. ARMOD and RAT test results must be annotated on the DD Form 2808, Medical Record – Report of Medical Examination, prior to certification by HQ AETC/SGPS. Cadets selected for ABM must receive a certified FCIII physical stamped "ABM." If the applicant is found disqualified or requires a medical waiver, ensure the MTF enters the case into the Aeromedical Information Management Waiver Tracking System (AIMWTS).
5.6. Validity Periods.
5.6.1. Physicals are valid for a limited period of time depending on the purpose of the exam.
5.6.2. Accession Physicals (for enlistment purposes). IAW AFI 48-123, DoDMERB, MEPS, and MTF physicals are valid for 24 months from the date of exam for accession. This applies to all cadets contracting. In addition, contracting cannot occur until the examination has been certified by DoDMERB, MEPS, or AETC/SG (waivers or MTF exams). Update the physical exam expiration date in WINGS to 24 months from the date of exam and then, after a cadet enlists, adjust the expiration date to 48 months from the certification date.
5.6.2.1. ECP cadets must be enlisted within 24 months of the date on their AF Form 422, Physical Profile Serial Report.
5.6.2.2. Field Training (FT). To attend FT, the cadet must have certified, qualified DoDMERB, MTF, or MEPS physical stamped with a date of exam within 48 months (regardless of contract status) of the FT start date. NOTE: ECP cadets may use the AF Form 422 for FT attendance.
5.6.3. Commissioning Physicals. After enlistment, AETC/SGPS automatically extends accession physical validity to 48 months from the certification date for DoDMERB, MEPS or MTF physicals. Accession physicals remain valid until, and may be used for, commissioning unless there is a change in medical status or a specialized examination is required for an AFSC. An extension certification or stamp is not required, it is automatic if there is no break in service. Exception: If a cadet is disenrolled and returns/continues, a new physical will be required for FT attendance and/or POC entry if the exam is more than 48 months old.
- 5.6.3.1. For commissioning purposes, FCIII, ATC and MOD medical examinations are valid for 24 months from the date of examination (as annotated in item 6 of DD Form 2808, Report of Medical Examination). FCI/IA/IIU (pilot, combat systems officer, RPA) commissioning medical examinations are valid for 48 months from the date of examination. Schedule the individual for the highest level of physical examination commensurate with the individual's category (AFSC).
5.7. Detachment Responsibilities.
5.7.1. Ensure cadets have the properly certified physicals for contracting or commissioning.
5.7.2. Limit contact with DoDMERB and HQ AETC/SGPS. Detachments are authorized to contact DoDMERB and HQ AETC/SGPS only when a significant problem or question exists. Routine telephone calls hamper timely processing of physicals. Routine status checks can be made by accessing the DoDMERB web site at https://DoDMERB.tricare.osd.mil. Detachments will follow the chain of command using guidance in the CMPG to contact AETC/SGPS.
5.7.3. Schedule cadets or applicants for a physical as soon as the commander believes the individual is a viable candidate for the program. NOTE: Cadets must not be scheduled for a physical until they have completed the AF Form 2030. See Attachment 16 for general physical exam timelines. Allow at least 60-90 days from the date of examination for processing.
5.7.4. Obtain medical examinations directly from DoDMERB for applicants who have completed a physical within the last 24 months for another program. In such cases, forward a request via email to DoDMERB requesting the information.
5.7.5. Counsel cadets via AFROTC Form 16. All cadets who have had a physical administered must be counseled on their responsibility to report changes in medical status. Specifically, cadets must report any medical treatment (to include prescription medication other than birth control), illness, injury, or other change in medical status, including pregnancy. Process all reported changes in medical status as specified in paragraphs 5.12 and 5.13. For additional information refer to the CMPG. NOTE: Failure by a cadet to report a change in medical status will be considered a civil involvement with military authorities and handled in accordance with paragraph 4.5.
5.7.6. Update all certified medical physicals in WINGS.
5.8. Preparation of Cadets for Physicals.
5.8.1. Some physicals require cadets to take action prior to their exams. Cadets should refer to their NCOs and treatment facilities for guidelines. Specific requirements for commissioning physicals include:
5.8.1.1. Dental Treatment. All active orthodontic treatment must be completed before a cadet can be medically certified for commissioning. Ensure orthodontic appliances are removed prior to a cadet's commissioning examination. FCI/IA/IIU physical examinations will not be submitted with dental cavities until a statement from the dentist that corrections have been made has been received. Pilot, RPA, and CSO cadets who require correction of dental cavities must have this condition corrected within 2 months of notification (notification from dentist) or risk loss of rated categorization. NOTE: Cadets failing to meet this requirement should be issued a CE for Failure to Maintain Military Retention Standards (FTMMRS). Upon issuing the CE, contact HQ AFROTC/RRF to determine if the rated allocation will be removed.
5.8.1.2. Contact Lenses. Cadets scheduled for FCI/IA/IIU/FCIII physicals are restricted from wearing hard lenses 90 days before the examination and soft lenses 30 days before the examination. To permit an accurate refraction evaluation, cadets who fail to remove contact lenses within these timeframes will be sent home from WPAFB and will be issued a CE for FTMMRS. NOTE: Upon issuing the CE, contact AFROTC/RRFA to determine if the rated allocation will be removed.
5.9. Potentially Qualified for Rated Duty
5.9.1. Potentially Pilot Qualified (PPQ), Potentially RPA Qualified (PRPQ), Potentially CSO Qualified (PCQ), Potentially ABM Qualified (PAQ).
5.9.2. For rated categorization nomination purposes, cadets are required to have their current physical screened using WINGS. Follow the procedures in the WINGS User Guide. It is important that detachments update this at least 12 months from categorization to identify any cadets who may require corneal refractive surgery (CRS) in order to qualify. Optimal time frame for CRS is immediately after entering the POC. See CMPG on CRS procedures. A physical screened as PPQ/PRPQ/PCQ/PAQ applies for rated categorization and only indicates the "potential" of a rated certification. Cadets are still required to receive an appropriate certified flying class physical prior to commissioning. NOTE: Detachments must verify appropriate qualification/certification is present on a "Final FCI/IA/II/IIU/III" commissioning physical prior to commissioning a Pilot, RPA, CSO, or ABM cadet.
5.10. Medical Commissioning Requirements.
5.10.1. All cadets must receive a commissioning physical performed by a medical officer. Schedule the commissioning physical NET 15 months, NLT 13 months prior to the cadet's DOC. This is to ensure there is an appropriately certified "commissioning" physical on-hand at time of commissioning. If a previously completed "commissioning" physical with the required tests (e.g., Reading Aloud Test (RAT), etc.) exists and the validity period has not expired, the physical may be used to satisfy this requirement. Commissioning physicals must be certified by MEPS ("Commission" certified ONLY) or AETC/SGPS (all others) prior to commissioning. A "qualified" and "valid" MEPS examination does not require AETC/SGPS certification. The following paragraphs outline additional commissioning physical requirements:
5.10.1.1. AECP/NECP/ASCP/SOAR. Physical requirements for AECP/NECP students are contained in AFI 36-2013, Officer Training School (OTS) and Enlisted Commissioning Programs (ECPS), and Chapter 13. ASCP/SOAR cadets must meet the same commissioning physical requirements as AFROTC cadets.
5.10.1.2. Specialty Career Fields. A currently rated or designated flight surgeon must accomplish commissioning physicals for all Pilot, RPA, combat systems officer, and non- rated/rated operations (to include ATC, ABM and MOD). Please note that there are specific requirements for Special Tactics and Combat Rescue Officer (STO/CRO) Duty. Contact the local MTF for further guidance.
5.10.1.3. IFC/MFS. All IFC/MFS physicals for pilot, RPA, and top pilot alternate candidates are accomplished by USAFSAM at Wright-Patterson AFB. Detachments will schedule the appointment through WINGS as soon as a cadet is classified and follow AFROTC/RR instructions located on the Holm Center restricted webpage at: https://hq.afoats.af.mil/AFOATSOp/Mission/RR/Enrolldisenroll.asp#MedicalInformation
5.11. Medical Waiver Requests.
HQ AETC/SGPS serves as medical waiver authority for cadets in all categories and year groups with one exception. The waiver authority for space/missile operations duty is AFSPC/SGP. If a waiver is approved, medical conditions must remain static for it to continue in effect. Waivers previously granted are reevaluated each time a cadet is examined. If a waiver is denied and an applicant feels that there is new evidence that shows the defect has been resolved or challenges the original determination, then a medical disqualification rebuttal request can be submitted. The process will be provided in the disqualification letter. If the rebuttal request is denied, then an Exception to Policy (ETP) request can be submitted following the guidelines in Attachment 48.
5.12. Medical Recheck Status (MRS) (Contracted Cadets only).
5.12.1. When a change in medical status occurs, the previously certified physical is temporarily no longer considered a "qualified/certified" physical. MRS allows a cadet temporarily not medically qualified to continue receiving monetary benefits while healing. Contracted Cadets who have a change in medical status must be evaluated for placement on MRS. Immediately upon notification of a change in a cadet's medical status, forward a request for MRS to AETC/SGPS via email. The cadet will remain on MRS until released by AETC/SGPS. NOTE: Cadets cannot commission while on MRS.
5.12.2. If the condition is considered to be minor in nature, the Detachment Commander may place the cadet on a 30-day temporary medical deferral by counseling via AFROTC Form 16. The detachment must monitor the cadet's condition. During the deferral, the cadet must be excused from the PFA. If the condition persists beyond 30 days, forward a request to HQ AETC/SGPS for placement in MRS. A copy of the Detachment Commander's temporary medical deferral must accompany the request for further MRS action (reference CMPG and AFI 48-123).
5.12.3. A cadet in/or pending MRS is excused from PT until the cadet's medical condition is reviewed and the cadet is released from MRS. Once released from MRS, the cadet will enter a 45-day reconditioning period, during which time he or she may participate in PT. Counsel the cadet in writing via AFROTC Form 16 that he or she must pass the PFA no later than the 60th calendar day after removal from MRS. If the 60th day occurs during a break between terms, the MRS waives the requirement to successfully complete the PFA for the previous term. Schedule the cadet to take the first PFA of the next term. Achieving a passing score on this PFA will fulfill both the current and previous term requirements.
5.12.3.1. While a cadet cannot be forced to take the PFA during the 45-day reconditioning period, he or she may elect to take the PFA at any time after release from MRS. If the cadet waives the reconditioning period, the PFA will be official and documented as such. Counsel the cadet via AFROTC Form 16 that the PFA will be recorded as official.
5.12.3.2. MRS for administrative-type procedures does not excuse cadets from PFA requirements. For example, a cadet may be in MRS for 12 months awaiting final certification for Photorefractive Keratectomy (PRK) or Laser-Assisted In-Situ Keratomileusis (LASIK) surgery. Once they are cleared for full activity by the operating doctor, they are expected to participate in PT and PFA in spite of MRS.
5.12.3.3. Send changes in medical status directly to AETC/SGPS via email for evaluation with any medical documentation scanned and attached in PDF format for AETC/SGPS review. The email must include full name, SSAN, date contracted, medical condition warranting MRS and detachment information (phone/fax number and detachment). Faxes must be pre-authorized by AETC/SGPS.
5.12.4. AETC/SGPS may direct a period of MRS not to exceed 6 months. EXCEPTION: MRS due to pregnancy or eye surgery will exceed the normal 6 months. AETC/SGPS will specify via return email the length of time contract cadets will remain in MRS and will advise the detachment of any required actions to remove the MRS status and reevaluate the physical. Counsel the cadet via AFROTC Form 16 that he or she has been placed in MRS and that he or she has 10 calendar days to provide medical documentation or the scholarship will be temporarily inactivated until documentation has been provided. Cadets may be deferred from fitness testing (weight checks) for the period of MRS (reference AFI 36-2905, AFROTC Sup). NOTE: Ensure MRS data is updated in WINGS.
5.12.4.1. MRS extensions beyond the 6-month point must be requested from AFROTC/RRFA via AFROTC Form 22. The request must be initiated prior to the expiration of the MRS. Granting the extension beyond the six month point will not occur except in rare cases. If an extension is granted, it will not exceed an additional 3 months. The request for the extension MUST include a prognosis/diagnosis from the attending physician and a get-well date within the 3-month period. If the get-well date extends beyond the 3-month period, do not submit the waiver request and initiate a medical disenrollment. If a cadet requires another extension after the previously granted 3-month extension, initiate a medical disenrollment. NOTE: MRS extensions may be denied and the physical is then stamped disqualified due to prolonged illness/injury.
5.12.4.2. Contract Cadets may compete for PSP but cannot attend FT or participate in AFROTC physical activities while in MRS. EXCEPTION: Cadets in MRS due to CRS may attend once the treating physician clears the cadet for full unrestricted duty (reference CMPG). Contact AFROTC/RRFA for field training deferral due to change in medical status. If change in medical status occurs after field training and before POC entry and enlistment, the cadet cannot be enlisted and may be placed in pursuing status. An AFROTC Form 22 must be submitted to AFROTC/RRFA for an applicant to pursue more than one academic term (reference Chapter 3 for scholarship designees who cannot enlist due to a change in medical status prior to scholarship activation).
5.12.5. Submission to AETC/SGPS for Removal of MRS. At the conclusion of the prescribed MRS period or upon presentation of medical evidence that the condition is corrected, the detachment will forward, by email (with scanned documents attached in PDF format) or mail, the physician's statement returning the cadet to "full and unrestricted activity" and all medical documentation outlining the diagnosis, treatment and prognosis and any other forms or reports requested (in the initial email that placed the cadet in medical recheck status) to AETC/SGPS. If mailed, attach the required documentation to the AFROTC Form 46. AETC/SGPS will recertify, disqualify, or return to detachment for forwarding to AFROTC/RRFP for additional period of MRS.
- 5.12.5.1. If HQ AETC/SGPS removes the cadet from MRS, cadets in pursuing status and scholarship designees are eligible to enlist, provided they meet all other enlistment standards. Counsel via AFROTC Form 16 to remove contract cadets from medical recheck status. Update WINGS. If AETC/SGPS disqualifies the medical examination, initiate a medical disenrollment for contract cadets. Counsel cadet via AFROTC Form 16 on medical disqualification.
5.13. Change in Medical Status (Non-Contract Cadets).
5.13.1. AETC/SGPS must reevaluate non-contract cadets who have been medically qualified or certified who have a change in medical status prior to contracting once medical situation has been resolved. When a change in medical status occurs, the physical is no longer a "qualified/certified" physical until reevaluation is complete and the physical is recertified. Counsel cadet via AFROTC Form 16. Questionable conditions should be submitted via email with full name and SSAN to AETC/SGPS to determine if they warrant evaluation.
5.13.2. Send changes in medical status directly to AETC/SGPS via email for evaluation with any medical documentation scanned in and attached in PDF Format for AETC/SGPS review. The email will include cadet's full name, SSAN, medical condition warranting evaluation, and detachment information (phone/fax number and detachment). Faxes must be pre- authorized by AETC/SGPS.
5.13.3. Once recertified (either Qualified or Disqualified), attach documentation to the original examination and file in cadet UPRG. Counsel cadet via AFROTC Form 16 regarding outcome of evaluation.
5.13.4. Non-contract AS200/250 cadets will follow guidance similar to contract cadets placed in MRS. Non-contract AS200 cadets who cannot attend FT due to a medical issue which has lasted longer than six months will lose their EA, but may, if they desire, become AS500 (with appropriate DOC/DOG) and compete in PSP the following year if their medical problem is resolved. These procedures apply to a single type medical problem, (e.g., broken bone). It is possible to have 2 separate medical problems which extend beyond the 6-month limitation. For example, broken ankle for 4 months then 4-month shoulder separation a month after recovering from the ankle injury. These events would be handled as two separate events. On the other hand, a shoulder separation for 4 months followed by a shoulder instability for 4 months would be considered a medical problem exceeding 6 months. Contact AFROTC/RRFA for field training deferral due to change in medical status. If change in medical status occurs after field training and before POC entry and enlistment, the cadet cannot be enlisted and may be placed in pursuing status. An AFROTC Form 22 must be submitted to AFROTC/RRFA for an applicant to pursue more than one academic term (reference Chapter 3 for scholarship designees who cannot enlist due to a change in medical status prior to scholarship activation).
5.14. Upgrading Medical Examinations.
5.14.1. Cadets who have a certified physical at one level of qualification may have their physical examinations upgraded by AETC/SGPS to a higher level of qualification (e.g., from commission qualified to non-rated operations, CSO, or pilot). Cadet examinations cannot be upgraded to FCI/IA prior to categorization and selection. EXCEPTION: A cadet selected for CSO duty can be scheduled for an FCI exam to ensure overall qualification in the event of category upgrade to pilot by AFROTC/RR if the host base can support the request.
5.14.2. The requirement to upgrade physicals can be minimized by ensuring all scholarship, POC, and commissioning cadets receive a physical commensurate with the position designated by AFROTC/RR and the needs of the Air Force. Provided there is reasonable expectation that an individual can qualify for another category, an appropriate medical examination may be requested.
- 5.14.2.1. Review the individual's most recent examination or medical documents to determine if the physical warrants consideration. If medically certified for the new category by AETC/SGPS, send AFROTC Form 22 to AFROTC/RRFA requesting re- categorization and attach one copy of the certification.