controllers/directors, combat controllers and Aerospace Control and Warning Systems (1C5X1), Tactical Air Control Party (1C4X1), Air Liaison Officer (13LX) and RPA sensor operators (1U0X1). Conditions in Chapter 5, Continued Military Service (Retention Standards) or WWD standards also apply. For conditions listed in Chapter 5, ensure an MEB has been performed and final disposition made prior to submission of a waiver request.
In addition to the standards in Section 6I, Combat Controllers must also meet the relevant Section 6K categories. Air Battle Managers, Air Weapons Controllers/Directors, required to perform frequent and regular aerial flights must also meet Flying Class III standards in Section 6G. Pararescuemen must also meet standards in Section 6K.
The medical conditions listed in Chapter 5, Section 6G and relevant Section 6K categories are cause to reject an examinee for initial controller duty or continued duty unless a waiver is
granted. Acute medical problems, injuries, or their appropriate therapy are cause for withholding certification of initial training or temporarily restricting the individual from controller duties until the problem is resolved. These standards are not all inclusive, and other diseases, or defects, can be cause for rejection based upon the medical judgment of the examining flight surgeon. Acute conditions which impair safe and effective performance of duty are cause for temporary removal from controlling duties using AF Form 1042, Medical Recommendation for Flying or Special Operational Duty, IAW Section 6C. Note: These standards do not apply to: Small unmanned aircraft systems operators (SUAS-Os). (See Section 6K 6.48.11.).
6.46.1. Ear, Nose, and Throat.
6.46.1.1. Symptomatic allergic rhinitis, seasonal or perennial not controlled by use of a single approved medication.
6.46.1.2. Any disease or malformation of the nose, mouth, pharynx or larynx that might interfere with enunciation or clear voice communication.
6.46.1.3. Any disturbance of equilibrium.
6.46.1.4. Obstructions of the nose from any cause which prevent nasal respiration. 6.46.2. Hearing.
6.46.2.1. Hearing loss greater than that specified for H-1 profile for initial selection. Hearing loss greater than that specified for H-2 profile for continued controller duty. 6.46.2.2. Use of hearing aid.
6.46.3. Eye.
6.46.3.1. Monocularity. 6.46.3.2. Intraocular pressure.
6.46.3.2.1. Glaucoma, as evidenced by pressure of 30 mmHg or greater, or the secondary changes in the optic disc or visual field associated with glaucoma.
6.46.3.2.2. Ocular hypertension (preglaucoma). Two or more determinations of 22 mmHg or greater but less than 30 mmHg, or a difference of 4 mmHg or greater between the two eyes.
6.46.3.3. Nystagmus, except on versional end points.
6.46.3.4. Contact lenses that correct near visual acuity only or that are bifocal, or that are fit with the monovision techniques.
6.46.3.5. Diplopia in any field of gaze, either constant or intermittent, including history of.
6.46.3.6. History of approved keratorefractive surgery procedures, including PRK, LASEK, epi-LASIK, and LASIK accomplished to modify the refractive power of the cornea are disqualifying if the surgical outcome results in the member’s inability to meet established vision standards or interferes with the member’s ability to perform his/her duties. All other lamellar keratoplasty (LK), penetrating keratoplasty (PK), and RK procedures are disqualifying, regardless of visual outcome.
6.46.3.7. Extraocular muscle paralysis or paresis with loss of ocular motility in any direction.
6.46.3.8. Absence of conjugate alignment in any quadrant. 6.46.4. Vision.
6.46.4.1. Distant uncorrected, worse than 20/400 each eye.
6.46.4.2. Distant or near vision that is not correctable to 20/20 each eye.
6.46.4.3. Near uncorrected, no standard. Note: Stabilized visual acuity below the above level is disqualifying; this includes following refractive surgery. Refractive surgical outcomes that interfere with the member’s ability to perform his/her duties are also disqualifying. Some occupations, such as combat controllers, must also meet flying class III standards; therefore, approved refractive surgery procedures require waiver processing because these procedures are disqualifying for the AASD career fields.
6.46.5. Heterotropias and Heterophorias. 6.46.5.1. Any heterotropia.
6.46.5.2. Heterophorias. More than 1.5 prism diopter of hyperphoria, 10 prism diopters of esophoria, or 6 prism diopters of exophoria requires a thorough evaluation for other eye pathology motor and sensory abnormalities, by an optometrist or ophthalmologist. Section 6G, 6.44.11 applies.
6.46.6. Defective Color Vision. Color vision testing must be performed annually and recorded monocularly under approved and standardized illuminant (i.e., MacBeth easel lamp with a 100 watt light bulb or a True Daylight AE lamp from Richmond Products). Three or more incorrect responses in either eye (including failure to make responses in the allowed time interval (no more than 5 seconds), using either the Dvorine or Ishihara (14 test plate version) PIP I, is considered a failure. The same testing conditions and time intervals apply for the PIP II. The minimum passing score on the PIP II is no more than one incorrect response. No other PIP versions, such as Richmond PIP, or Beck Engraving versions, or other PIP tests for color vision are authorized. The FALANT is not authorized.
Note: All other ground based aircraft controllers who were previously qualified for controlling duties based on the previous 10/14 PIP I and fail the new 12/14 PIP I standard will be considered for waiver in their current weapon system or AFSC after appropriate evaluation. A formal
ophthalmologic evaluation must be accomplished to determine the type and degree of color vision defect.
6.46.7. Depth Perception. No standard except for career fields below:
6.46.7.1. Tactical Air Control Party (1C4X1), Air Liaison Officer (13LX). Failure of either the Vision Test Apparatus (VTA-DP), or its newer replacement, the OVT is considered disqualifying if the failure occurs with best corrected visual acuity regardless of level of uncorrected visual acuity.
6.46.7.2. Failure of the VTA or OVT stereopsis testing requires completion of a local preliminary ocular motility and macular examination by an ophthalmologist or optometrist, and review by both AETC and the ACS. The testing must be accomplished as listed in 6.44.11.1.1
6.46.8. Visual Fields. Any visual field defect.
6.46.9. Night Vision. Unsatisfactory night vision as determined by history for initial controller duty. In trained controllers, this history is confirmed, when clinically required, by the appropriate electrophysiological tests requested by the Aeromedical Consultation Service ophthalmologists.
6.46.10. Cardiovascular System.
6.46.10.1. History of myocardial infarction, angina pectoris, or other evidence of coronary heart disease including silent ischemia.
6.46.10.2. History of dysrhythmia with symptoms of hemodynamic compromise.
6.46.10.3. Symptomatic valvular heart disease or asymptomatic moderate to severe valvular disease associated with hypertrophy, chamber enlargement, or ventricular dysfunction (see Chapter 5).
6.46.10.4. Aneurysm or AV fistula of a major vessel.
6.46.10.5. Hypertension, or history of hypertension on antihypertensive medication. Hypertension is evidenced by average systolic blood pressure greater than 140 mmHg or average diastolic blood pressure greater than 90 mmHg. Patients may be followed initially as in 6.44.17
6.46.10.7. ECG evidence of significant conduction defects, to include Wolff-Parkinson- White syndrome.
6.46.11. Blood, Blood-forming Tissues, and Immune System. 6.46.11.1. Anemia of any etiology.
6.46.11.2. Blood donation (including plasma and platelet donation): 8 hr restriction from controller duty (formal flight surgeon restriction not required).
6.46.12. Abdomen and Gastrointestinal System.
6.46.12.1. Gastrointestinal hemorrhage or history of, regardless of cause.
6.46.12.2. Peptic ulcer disease or any complication of peptic ulcer disease. An uncomplicated ulcer that has been inactive for 3 months and does not require medication (except the occasional use of antacids) is not disqualifying.
6.46.12.3. Cholelithiasis that is symptomatic or requires ongoing therapy. 6.46.13. Genitourinary System.
6.46.13.1. History of recurrent or bilateral renal calculus. 6.46.13.2. Retained renal calculus, except parenchymal. 6.46.13.3. Cystostomy.
6.46.13.4. Neurogenic bladder. 6.46.13.5. Renal transplant. 6.46.14. Neurological Disorders.
6.46.14.1. History of any medically unexplained disturbance of consciousness or where surgical intervention was necessary to correct the precipitating cause.
6.46.14.2. History of any of the following types of headaches:
6.46.14.2.1. Recurrent headaches of the vascular, migraine, or cluster (Horton’s cephalgia or histamine headache) type.
6.46.14.2.2. A single incapacitating headache of any type (e.g., loss of consciousness, aphasia, ataxia, vertigo or mental confusion).
6.46.14.2.3. Headaches of any type which are of sufficient severity to likely interfere with controlling duties.
6.46.14.2.4. Acephalgic migraines.
6.46.14.3. History of recurrent vertigo or dysequilibrium disorders.
6.46.14.4. Cerebrovascular disease to include transient ischemic attack (TIA), cerebral infarction, thrombotic or embolic, or transient global amnesia.
6.46.14.5. Demyelinating and autoimmune diseases.
6.46.14.6. Extrapyramidal, hereditary, and degenerative diseases of the nervous system. 6.46.14.7. Infections of the nervous system.
6.46.15. Psychiatric Disorders. (Reference most current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), American Psychiatric Association.)
6.46.15.1. Substance use disorder or any disease the proximate cause of which is substance use. Waiver may be considered when all of the requirements in 6.44.24.1.5 are met and documented.
6.46.15.2. Unsatisfactory adaptability rating for GBC duties.
6.46.15.3. Anxiety disorders. Note: Fear of controlling which does not meet the DSM criteria for a disorder is handled administratively.
6.46.15.4. History of attempted suicide or suicidal behavior.
6.46.15.5. Mood disorders including bipolar disorder, major depression, dysthymia and depression not otherwise specified.
6.46.15.6. All organic mental disorders.
6.46.15.7. Any personality disorder, or mental condition that may render the individual unable to safely perform controller duties. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts disqualifies the individual from controller duties. Also, see 5.3.12.3.2.
6.46.16. Musculoskeletal, Spine, and Extremities. Any disease, condition, or deformity of the musculoskeletal system, which may impair duty performance or access to control facilities, is likely to progress, or which requires frequent use of analgesic or anti- inflammatory medication for control.
6.46.17. Endocrine and Metabolic. 6.46.17.1. Diabetes insipidus.
6.46.17.2. Hypoglycemia, whether functional or a result of pancreatic tumor. 6.46.17.3. Thyroid disorders.
6.46.17.4. Other endocrine or metabolic disorders which preclude satisfactory performance of controller duties.
6.46.18. Medication.
6.46.18.1. Use of any medication whose known actions may affect alertness, judgment, cognition, special sensory function, mood, or coordination. See ―Official Air Force Approved Aircrew Medication‖, updated periodically by AFMSA (approved by AF/SG3P) for list of approved medications.
6.46.19. Miscellaneous.
6.46.19.1. Exacerbation of any medical condition for which a waiver has been granted. 6.46.19.2. HIV antibody testing is required for all applicants for initial controller duty. Record the results of cholesterol, high-density lipoprotein (HDL), and triglycerides in item 19F or item 42, SF 88 or appropriate block in DD Form 2808.
6.46.19.3. An AR-GBC and a reading aloud test (RAT) is required on all applicants for initial controller duty. Record the results in item 41, SF 88 or item 72a, DD Form 2808. The RAT and instructions are in AFJI 36-2018, Medical Examination of Applicants for United States Service Academies, Reserve Officer Training Corps (ROTC) Scholarship Programs, Including Two and Three-Year College Scholarship Programs (CSP), and the Uniformed Services University of Health Sciences (USUHS).
Section 6J— Space and Missile Operations Duty (SMOD)
6.47. Space and Missile Operations Duty (SMOD) Standards. The medical conditions listed