Expectations for Waiver Packages - angsg/peripheral-brain GitHub Wiki

The State Air Surgeons are cranky and old school. We have definite expectations for waiver packages, some of which are reviewed here.

• A waiver is a big deal. Remember, the member has been found medically unfit to perform flying or special operational duty. By granting a waiver, we are going to say that we are smarter than the regulations... not a boast to be made cavalierly. So we view every waiver as a detailed examination.

• The waiver narrative should tell the full story of the patient. That is why they always start with describing the member's current military status and what is being sought (initial waiver, waiver renewal, waiver retirement, etc.). We expect that the squadron physician will talk to the member -- cutting and pasting from outside documentation is not sufficient. Civilian physicians are not trained to make the special assessments that determine military unfitness or fitness.

• Waivers from outside the USAF system don't count for anything. That is, non-USAF waivers are part of the past medical history, and nothing more.

• The waiver narrative should summarize the attachments. Do not expect the reviewing authorities to dive deep into the attachments, especially if there are 20 pages of them. The squadron flight surgeon has the responsibility of performing the chart review, just as a resident does on a teaching service. We expect you to have reviewed all documentation submitted by the member, and then choose the pertinent documentation to submit as part of the waiver package.

• The USAF Waiver Guide is your friend. The reviewing authorities will look at the waiver guide to see what medical information is required to be submitted. If the package omits something, the waiver will be sent back reflexively.

• The squadron physician will perform a physical examination in all cases. Quoting another physician's exam is not adequate. If it were, we wouldn't need you.

• We tremendously value your opinion. You have seen the patient, we have not. We want you to tell us not only what you think, but why. Put yourself in the mind of the reviewing authority and think not just about now, but also how the disorder might play out over the next several years, and put that into your discussion.

• Initial waiver requests always require a letter from the member's commander. Your front office has the template for that. Waiver renewals do not require a commander's letter, but you should feel free to include one if it illuminates the case.

The State Air Surgeons are always happy to talk about our expectations for waiver packages.