Commissioned Corps Management Information Site

How long should I wait to submit my medical waiver if I do not have a diagnosis and/or all the supporting labs/testing? And what should I do if I cannot see a specialist to complete the waiver for my medical concern?

Your medical waiver should be submitted as soon as documentation can be completed by a primary care provider reporting the symptoms that prevent you from deploying or completing other required activities. It should include the date or timeline expected for you to see a specialist or receive results concerning diagnostic testing/lab work. Please note that this initial waiver allowing you time to see a specialist may be short term and may need to be renewed once more information is known. Once the specialist assesses you, the specialist will determine if more time is needed for treatment at which time you must submit a new waiver request with the appropriate updates.

What type of healthcare provider can provide medical documentation for a medical waiver (e.g. MD, PA, NP, PT, LCSW)?

Any provider actively managing your medical condition may provide waiver documentation. Instructions for providers are included with the request for Medical Waivers form.

Where can an officer find the "Active Duty and Reserve Corps Medical Waiver Request" form?

A link to the waiver request form (which now includes a provider instructions memo) can be found on the Medical Waiver Program page under Medical Affairs tab on the CCMIS website. It can also be found under Forms/Medical on the CCMIS website and can be accessed using the following link: /ccmis/PDF_docs/Medical%20Waiver%20Request%20Form%20and%20Instructions.pdf

What information must my provider include in the medical documentation attached to the waiver request form?

A provider instruction memo is now attached to the waiver request form.

Your provider must include medical documentation supporting the waiver request including:

What are your specific disabling medical diagnoses, condition(s) or disabling symptoms?
- A final diagnosis is not required to request a waiver. If a diagnosis is unknown, please report the symptoms you are experiencing or working diagnosis with the associated evaluation, follow-up and treatment plan.
How does the condition(s) prohibit you from completing readiness requirements including deployments?
What is the current management of your conditions or symptoms, to include diagnostic and/or treatment plan(s)?
How long do they expect the medical condition to prevent you from deploying or meeting readiness requirements or when is the next reevaluation date, not to exceed 6 months?

For Annual Physical Fitness Testing (APFT) waiver requests, the medical documentation must include justification for each section that you are requesting to waive.

For Pregnancy waivers, an estimated delivery date and laboratory or ultrasound confirmation of the pregnancy must be included.

What waivers are included in a “pregnancy waiver?”

Pregnancy: Pregnancy waivers temporarily waives deployment, requirements of all sections of APFT, Weight Standards, and live virus vaccinations. The waiver ends 12 months after anticipated delivery date. Approval requires documentation which includes laboratory or ultrasound confirmation of pregnancy and estimated date of delivery (EDD)

Documentation Requirements:

Your Primary Care provider should provide an estimated delivery date based on the Last Menstrual Period (LMP) to the best of their knowledge, and laboratory confirmation (final confirmation is the responsibility of the clinician providing obstetric care).

Readiness Requirements:

The readiness requirements of the annual Periodic Health Update (PHU) and annual seasonal Influenza immunization are NOT waived by the Pregnancy waiver.
If an officer’s pregnancy ends prior to 20 weeks gestation, the officer should inform Medical Affairs within 30 days by uploading a new Waiver request form and the date the pregnancy ended.

Newest Updates to the Pregnancy Waiver accommodations:

As of January 15, 2021, there are significant changes in what is included in a Pregnancy waiver which are summarized below:

Length of Pregnancy	Waiver	Waiver requested January 15, 2021 or prior	Waiver requested after January 16, 2021
≥ 20 weeks	Deployment, APFT, BLS, Live virus immunizations	Expires 6 months after estimated date of delivery	Expires 12 months after estimated date of delivery. NO BLS WAIVER INCLUDED
	Weight Standards	Expires 6 months after estimated date of delivery with an option for an additional 3 months	Expires 12 months after estimated date of delivery
	Breastfeeding	Additional 6 months after expiration of Pregnancy waiver (12 months after child’s birthday)	Included in pregnancy waiver, expires 12 months after estimated date of delivery
< 20 weeks	Deployment, APFT, BLS, Live virus immunizations, Weight standards	Not in Policy	Expires 6 months after termination of pregnancy. NO BLS WAIVER INCLUDED

Do I need to request a breastfeeding waiver? Can I extend breastfeeding past the expiration of my pregnancy waiver?

After expiration of the Pregnancy waiver (12 months after anticipated delivery date) officers should be prepared to deploy. When the Pregnancy waiver expires, you should submit a breastfeeding waiver (no earlier than one week before expiration of the Pregnancy waiver) with an attached personal statement indicating that breastfeeding is still occurring. You do not need a note from your provider. Breastfeeding waivers ensure additional lactation needs and resources are available when deployed or in a training environment (e.g., regular breaks electricity, refrigeration). Breastfeeding waivers will be provided for 5-month intervals, with ability to extend as needed.

I was approved for a breastfeeding waiver. What can I do to ensure additional resources are available to me when deployed or in a training environment? What should I do if they are not?

MAB will assist in communicating your needs to RDB once your breastfeeding waiver is approved. Officers with this waiver will only be rostered for deployment or training in an environment with the additional resources to support lactation. Officers who feel that their needs are not met should reach out to MAB (Phsmacchq@hhs.gov) and RDB Deployment (PHSDeployment@hhs.gov) to assist in addressing the concern.

Is there guidance available on how I can transport my breastmilk?

Per Joint Travel Regulations effective 07 April 2022, “the cost of shipping breast milk may be reimbursed as a travel accommodation for a special need during temporary duty (TDY) travel. Expenses may include reasonable commercial shipping fees, excess baggage, disposable storage bags or non-durable containers, cold shipping packages, refrigeration, and transport. Expenses will be reimbursed up to a maximum of $1,000 when authorized.”

Please seek individual guidance from sponsoring agency Federal Agency Travel Administrators (FATA) on how to seek reimbursement.

How do I know I my waiver was rejected or if I was granted a modification instead?

Updates regarding waiver status are generally seen in approximately 3 business days

Waivers that are rejected or modified are communicated to the officer (either by standard email for format deviations, or via eCMCS for waiver modifications). For details on reason for waiver rejection or modification not containing PHI refer to the comments section of the standard email. The officer should also check their spam folder for waiver updates.

How do I know if my waiver was granted and when it expires?

MAB no longer sends confirmations of waivers being granted. An officer can check their waiver status by going to the Officer Secure Area of the CCMIS website. Please follow the instructions below.

Log into the officer secure area of CCMIS.
Click “RDB Self Service” in the lower left blue panel of the screen.
1. Click the “Self Service” tab à click “Readiness Information”
Click “Waivers” under number 3 to review your waiver status and expiration

Please note that no email notification is available at this time to inform officers when their waiver is pending expiration or has already expired. It is the responsibility of the officer to ensure waiver renewals are submitted at least 72hrs before the previous one is expired to maintain Basic Readiness requirements.

For more information, please contact Medical Affairs at: PHSMACCHQ@hhs.gov

Why was a waiver granted only for three months?

If the officer’s provider did not designate the length of time that the waiver should be granted, the waiver will be granted for three months. In addition, the time could be shortened at the reviewer’s discretion, if in their clinical judgement, an update is needed sooner. This does not apply to pregnancy waivers that has a standard waiver period.

Can I get a waiver for an elective procedure?

Officers should request the necessary waivers (with medical documentation) for an elective procedure to include recovery time. Waivers should be requested for deployment and any other readiness requirement that they are unable to complete. Officers are strongly encouraged not to schedule elective procedures during their on-call month or the month preceding.

Are waivers provided for readiness requirements? How long does an officer have to complete readiness requirements that were not done while the officer had a waiver?

Waivers can be provided for the following readiness requirements if the officer provides adequate documentation to approve the waiver.

Deployment
APFT
BLS
Immunization
Weight

Waivers are NOT provided for the Periodic Health Update

The officer has until the end of the month of waiver expiration to complete all required readiness components that were not done during the waiver period. In general, MAB ends waiver periods early in the month to give the officer maximum time to complete requirements.

What are MRCs and how does my waiver affect them?

Medical Readiness Categories (MRC)

MAB uses MRCs to communicate internally to Readiness and Deployment Branch (RDB) about an officer’s medical deployment status without disclosing protected health information. There are four categories:

MRC-1: Fully deployable without limitation(s).
MRC-2: Deployable with limitations or specific needs.
MRC-3: Non-deployable, usually requiring a medical waiver.
MRC-4: Critical information pending; currently non-deployable. Usually related to a medical/dental issue requiring immediate attention, preventing deployment.

Officers are assigned an MRC after review of medical documentation by MAB. The assigned category is transmitted digitally to RDB without disclosing any protected health information.

MRC-1 assignment indicates that the officer is fully deployable and without medical conditions preventing or limiting their ability and range of deployment opportunities.

MRC-2 assignment is usually associated with the submission of a medical waiver request. This MRC allows an officer to deploy with certain limitations.

For example, an officer needs a reliable source of electricity to operate a medical device and requests a deployment waiver. MAB may assign the officer an MRC-2, “requires reliable electricity.” RDB is now obliged to ensure that the officer’s need is met wherever the officer is deployed.
Another officer has medical conditions that will put the officer at risk for serious infections and asks for a deployment waiver. If appropriate, rather than grant the waiver, MAB will assign the officer to MRC-2, “No exposure to severe infections.” RDB will then only deploy that officer if that deployment role does not require the officer to have potential contact with serious infections.
Since being able to deploy is a condition of service, assigning an officer an MRC-2 allows the officer to be deployable while ensuring that the officer’s limitations or needs are considered. RDB is aware of the MRC status but is unable to see the specific medical conditions of the officer.

MRC-3 assignments are usually submitted with a medical waiver and result in an officer being deemed non-deployable for a period of time.

Acceptance of the medical waiver you submit is strongly dependent on how clearly your condition is described and how it effects your ability to deploy. Final approval of the medical waiver is up to the discretion of the Chief Medical Officer (or their designee).

Please see this link for more information prior to requesting a medical waiver.

MRC-4 assignments are reserved for officers that are currently non-deployable due to a medical/dental issue requiring immediate attention, preventing deployment.

This information can be obtained from your PHU (DD-2813, DD-2807, DD-2808) and/or a waiver request. The length of these waivers and/or accommodations are impacted by the information provided by your provider and are left to the discretion of the Senior Dental or Medical Evaluations Officer of Medical Affairs.

Unfortunately, Officers cannot yet see their assigned MRC on their Readiness dashboard. We hope that will be possible in the future.

For more information, please contact Medical Affairs at: PHSMACCHQ@hhs.gov

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