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The below disqualifying conditions are in addition to the disqualifying conditions listed in the Military Medical Accessions Medical Guide. Unlike medical waivers to join the military, medical waivers for aviation duty are much harder to come by.

The causes for medical unfitness for flying duty Classes 1/1A/2/2F/2S/3 are:

a. History of electroencephalographic abnormalities of any kind; to include spike–wave complexes, spikes, or sharp waves.

b. History of any type of vascular headache; to include migraine and cluster types.

c. History of neuritis, neuralgia, neuropathy, or radiculopathy until reviewed by the Aviation Medicine Approving Authority.

d. History of decompression sickness (Type II) or an air embolism with neurologic involvement.

e. History of disturbances in consciousness, single episode or recurrent; to include nontraumatic loss of consciousness, narcolepsy, cataplexy, all forms of paroxysmal convulsive disorders, or single convulsive seizures of any type, except—

(1) Single episode of documented vasovagal syncope such as syncope with venipuncture or immunizations.

(2) Single episode of documented postural or parade-rest syncope, not otherwise disqualifying.

(3) Febrile seizures before the age of 5 with a normal EEG.

f. Central nervous system infections.

(1) Classes 1/1A. Within 1 year prior to examination, except 6 years for encephalitis, or if there are residual neurological deficits or other sequelae.

(2) Classes 2/2F/2S/3. Until complete recovery without residual neurological deficits or other sequelae.

g. History of organic mental syndromes; developmental, learning, or sensory processing disorders; or toxic or metabolic central nervous system disorders, until reviewed by the Aviation Medicine Approving Authority.

h. History of intracranial embolism, vascular insufficiency, thrombosis, hemorrhage, arteriovenous malformation, or aneurysm.

i. History of degenerative or demyelinating process, such as multiple sclerosis, dementia, Alzheimer’s disease, Parkinson’s disease, or basal ganglia disease.

j. For Classes 1/1A, personal or family history of hereditary diseases with neurologic sequelae, such as hepatolen­ticular degeneration, neurofibromatosis, acute intermittent porphyria, or familial periodic paralysis. A strong family history of such syndromes indicating an hereditary predilection for the disease will be cause for disqualification, even if there are no current signs or symptoms.

k. History of benign or malignant neoplasms of the brain, pituitary gland, spinal cord, or their coverings.

l. History of diagnostic or therapeutic craniotomy, or any procedure involving penetration of the dura mater or the brain substance, including ventriculo-peritoneal shunts, evacuation of hematomas, and brain biopsy.

m. Any defect in the bony substance of the skull, regardless of cause.

n. History of any head injury associated with the following will be cause for permanent disqualification for aviation duty for all Classes.

(1) Intracranial hemorrhage or hematoma, to include epidural, subdural, intracerebral, or subarachnoid hemorrhage.

(2) Any penetration of the dura mater or brain substance.

(3) Radiographic or other evidence of retained intracranial foreign bodies or bony fragments.

(4) Transient or persistent neurological deficits indicative of parenchymal central nervous system injury, such as hemiparesis or cranial neuropathy.

(5) Persistent focal or diffuse abnormalities of the EEG reasonably assumed to be a result of an accident.

(6) Depressed skull fracture with or without dural penetration.

(7) Linear or basilar skull fracture with or without dural penetration.

(8) Posttraumatic syndrome as manifested by changes in personality, impairment of higher intellectual functions, anxiety, headaches, or disturbances of equilibrium that does not resolve within 6 weeks after injury.

(9) Unconsciousness exceeding 24 hours.

(10) Cerebrospinal fluid rhinorrhea or otorrhea persisting more than 7 days.

o. History of head injury associated with any of the following will be cause for permanent disqualification for flying duties for Classes 1/1A; and termination of aviation service for a minimum of 2 years for Classes 2/2F/2S/3.

(1) Linear or basilar skull fracture with loss of consciousness for more than 15 minutes but less than 2 hours.

(2) Posttraumatic syndrome, as manifested by changes in personality, impairment of higher intellectual functions, anxiety, headaches, or disturbances of equilibrium, that persists for more than 2 weeks, but resolves within 6 weeks of the injury.

(3) Amnesia (posttraumatic and retrograde, patchy or complete), delirium, disorientation, or impairment of judgment that exceeds 24 hours.

(4) Unconsciousness for a period of greater than 2 hours, but less than 24 hours.

p. History of head injury associated with any of the following will be cause for a 2-year disqualification for Classes 1/1A; and temporary medical suspension from aviation duty for 3 months for Classes 2/2F/2S/3.

(1) Linear or basilar skull fracture with loss of consciousness for less than 15 minutes.

(2) Posttraumatic syndrome, as manifested by changes in personality, impairment of higher intellectual functions, anxiety, headaches, or disturbances of equilibrium, that persists for more than 48 hours but resolves within 14 days of the injury.

(3) Posttraumatic headaches alone that persist more than 14 days after injury, but resolve within 1 month.

(4) Amnesia (posttraumatic and retrograde, patchy and complete), delirium, or disorientation that lasts less than 24 hours, but more than 12 hours after injury.

(5) Unconsciousness for more than 15 minutes but less than 2 hours.

(6) Cerebrospinal fluid rhinorrhea or otorrhea that clears within 7 days of injury, provided there is no evidence of cranial nerve palsy.

q. History of head injury associated with any of the following will be cause for a 3-month disqualification for Classes 1/1A, and temporary medical suspension from aviation duty for 1 month for Classes 2/2F/2S/3.

(1) Posttraumatic syndrome, as manifested by changes in personality, impairment of higher intellectual functions, anxiety, headaches, or disturbances of equilibrium, that resolves within 48 hours of the injury.

(2) Posttraumatic headaches alone that resolves within 14 days after injury.

(3) Amnesia (posttraumatic and retrograde, patchy and complete), delirium, or disorientation that lasts less than 12 hours after injury.

(4) Unconsciousness less than 15 minutes.

Flight Classes

Specific Flight Class Medical Examinations are:

Class 1 - Warrant Officer Aviation Duty Applicants
Class 1A - Commissioned Officer Aviation Duty Applicants
Class 2 - Current Aviators, Current Student Aviators, and Previous Aviators Returning to Aviation Service
Class 2F - Flight Surgeons, Including Those in Flight Surgeon Training
Class 2S - MOS 13F, Assigned to Aerial Fire Support Observer Duty
Class 3 - Non Rated Soldiers who Participate in Regular Flights (Crew Chiefs, Gunners, UAV Operators, etc.)
Class 4 - Air Traffic Control

Derived from Army Regulation 40-501, Standards of Medical Fitness