CLASSIFICATION: UNCLASSIFIED//
ROUTINE
R 231846Z JAN 25 MID120001699830U
FM CNO WASHINGTON DC
TO NAVADMIN
INFO CNO WASHINGTON DC
BT
UNCLAS
 
NAVADMIN 013/25
 
PASS TO OFFICE CODES:
FM CNO WASHINGTON DC//N093//
INFO CNO WASHINGTON DC//N093//

MSGID/GENADMIN/CNO WASHINGTON DC/N093//

SUBJ/CORRECTED COPY CHANGES TO SPECIAL DUTY WAIVER PROCESSING//

REF/A/MANUAL OF THE MEDICAL DEPARTMENT (MANMED), NAVMED P-117 OF 21 APR 23//

AMPN/REF A IS MANMED, NAVMED P-117 UPDATED ON 21 APR 23.

RMKS/1.  The Chief of Bureau of Medicine and Surgery (BUMED) convened a 
Critical Action Process Improvement Team (CAPIT) to support Naval Service 
Training Command in making immediate and long-term improvements to Special 
Duty Waiver
(SDW) processes and eliminate the backlog of medical holds in the future 
fleet at Recruit Training Command, and at any other accession point (i.e. U.S 
Naval Academy, Reserve Officer Training Corps, etc.).  This memo addresses 
SDW processes for those communities that fall within undersea medicine.  
Aviation special duty waiver processes are being reviewed and will be 
provided by separate message.

2.This NAVADMIN implements changes to processes to improve timeliness and 
maximize resources in support of SDW process.

3.Procedures for all Undersea Medical Officers (UMO), Undersea Medical 
Examiners (UME) performing accession physicals for special duty.
a.  UMO, UME examine the applicant in accordance with MANMED Chapter 15 and 
make a determination of "Physically Qualified (PQ)" or "Not Physically 
Qualified (NPQ)".
(1) In the case of conditions approved for a General Duty Waiver (GDW) by an 
appropriate waiver authority which do not meet NPQ criteria for Special Duty, 
no SDW is required.  The reviewing UMO/UME should document on the DD2808 the 
date and serial of the GDW letter, statement of evidence, and notation of 
"Physically Qualified" or "PQ".  Appropriate records keeping supporting 
continuous process improvement and quality assurance efforts should be 
maintained to update practice standards.
(2) Through appropriate and full medical review of GDW package, UMO/UME may 
find accession candidates physically qualified if they meet the following 
criteria SDW submission and/or evaluation by a mental health provider is not 
required in these situations:
(a) Attention Deficit Hyperactivity Disorder diagnosed prior to age 14 in 
absence of ongoing treatment/support for at least the last 12 months and no 
co-morbid
mental health diagnoses.   Must have confirmation from most recent academic
institution attended that no accommodations were provided.
(b) Unipolar depression or anxiety disorder for less than 12 months with no 
symptoms or treatment in the previous 36 months and absent a history of 
suicidal ideation or psychiatric hospitalization.
(c) Learning disorder diagnosis in absence of academic or behavioral concerns 
in the prior two years.  Must have confirmation from most recent academic 
institution attended that no accommodations were provided for at least the 
last 12 months.
(3) The following diagnoses, listed by each special duty category, are not 
appropriate for waivers. If, after careful record review, the UMO/UME 
substantiates any of these diagnoses among accession candidates, no further 
workup of other preexisting conditions is required and the candidate should 
be deemed NPQ for the associated Special Duty.  UME/UMO will generate 
abbreviated DQ package with
SF600 which references this message and sends directly to the appropriate 
BUPERS code for final determination (do not send through BUMED).  These 
criteria were developed by BUMED N10F2 in coordination with the appropriate 
TYCOMS and communities.
(a) Dive Duty:
1 Chronic eustachian tube dysfunction or inability to equalize middle ear 
pressure
2 Active or unresolved asthma
3 Cystic or cavitary disease of the lungs
4 Inability to correct vision to at least 20/25 in one eye
5 Hypertrophic cardiomyopathy
6 Hereditary disorders of coagulation
7 Chronic immune suppression
8 Current seizure disorder or 2 or more atraumatic seizures after the age of 
6
9 Chronic or recurrent alcoholism
10 Illicit drug abuse (non-cannabinoid)
11 History of psychosis to include schizophrenia
12 Recurrent syncope including secondary to vagal disorder
13 Prior suicide attempt with lethal means (i.e. involving a noose or 
firearms or cutting wrists or ingesting poison or overdosing with an 
extremely large quantity of medication [e.g. >30 pills of acetaminophen]
(b) Special Operations Duty:
1 Abnormalities preventing use of required equipment (i.e. facial deformities 
and use of mask, regulator, etc.)
2 Depth perception out of standards
3 Current asthma
4 History of spontaneous pneumothorax
5 Hypertrophic cardiomyopathy
6 Hereditary disorders of coagulation
7 Chronic inflammatory gastrointestinal disease, such as Crohn's disease, 
ulcerative colitis, celiac sprue
8 History of bariatric surgery
9 History of diverticulitis
10 Chronic or active hepatitis
11 Any history of diabetes mellitus
12 Chronic use of corticosteroids
13 History of suicide attempt (any)
14 Current seizure disorder or 2 or more atraumatic seizures after the age of 
6
15 Cerebrovascular disease
16 Chronic virus (except skin, e.g., herpes simplex)
17 Chronic immune insufficiency of any cause, chronic anemia, abnormal 
hemoglobin with anemia (excludes sickle cell trait, alpha thalassemia trait 
or beta thalassemia trait), and defects of platelet function or coagulability 
are disqualifying
18 Chronic or recurrent alcoholism
19 Drug abuse
20 History of psychosis including schizophrenia
21 Recurrent syncope including secondary to vagal disorder
22 Food allergy with anaphylaxis
(c) Submarine Duty:
1 Food allergy resulting in anaphylaxis
2 Cholelithiasis confirmed with radiologic study
3 Insulin dependent diabetes mellitus
4 Non-insulin dependent diabetes mellitus requiring more than 2 meds for 
control
5 Symptomatic diverticular disease, uncorrected
6 Eosinophilic esophagitis with abnormal biopsy results after treatment
7 History of retinal detachment
8 Color blindness unless designated for YN, CS, HM, or LN rates (as per 
MANMED Chapter 15 Section 106)
9 Complicated peptic ulcer disease
10 Recurrent urolithiasis with retained stones
11 Prior suicide attempt with lethal means (i.e. involving a noose or 
firearms or cutting wrists or ingesting poison or overdosing with an 
extremely large quantity of medication [e.g. >30 pills of acetaminophen]
12 Recurrent or refractory suicidality
13 Major depressive disorder currently on medications started in past 12 
months
14 History of major depressive disorder associated with an inpatient 
psychiatric hospitalization in the past 3 years
15 Confirmed bipolar disorder (any)
16 Confirmed personality disorders
17 Asthma: other than mild intermittent
18 History of spontaneous pneumothorax
19 Chronic or recurrent alcoholism
20 Any illicit drug abuse (non-cannabinoid)
21 History of psychosis including schizophrenia or major depressive disorder 
with psychotic features
(d) Nuclear Field Duty:
1 Color blindness (as per MANMED Chapter 15 Section 103)
2 Prior suicide attempt with lethal means (i.e. involving a noose or firearms 
or cutting wrists or ingesting poison or overdosing with an extremely large 
quantity of medication [e.g. >30 pills of acetaminophen]
3 Recurrent or refractory suicidality
4 Major depressive disorder currently on medications started in past 12 
months
5 History of major depressive disorder associated with an inpatient 
psychiatric hospitalization in the past 3 years
6 Confirmed bipolar disorder (any)
7 Confirmed personality disorders
8 Chronic or recurrent alcoholism
9 Any illicit drug abuse (non-cannabinoid)
10 History of psychosis including schizophrenia or major depressive disorder 
with psychotic features

4.  BUMED primary point of contact is CAPT Richard Schreckengaust at (703) 
681-9286 or via email at Richard.h.schreckengaust.mil@health.mil.

5.  Released by Rear Admiral Darin K. Via, N093, Surgeon General of the 
Navy.//

BT
#0001
NNNN
CLASSIFICATION: UNCLASSIFIED//