DEPARTMENT OF THE AIR FORCE WASHINGTON DC

1 DEPARTMENT OF THE AIR FORCE WASHINGTON DC AFI48-123_AFGM2018-02 28 January 2018 MEMORANDUM FOR ALMAJCOM/SG FROM: HQ USAF/SG 1780 Air FORCE Pentagon WASHINGTON , DC 20330-1780 SUBJECT: Guidance Memorandum Air FORCE Instruction 48-123, Medical Examinations and Standards By Order of the Secretary of the Air FORCE , this memorandum immediately implements changes to Air FORCE Instruction 48-123. This memorandum restates previous Guidance Memo (GM) AFGM 2016-01 dated 19 September 2016, which provides substantial changes to improve upon guidance regarding medical examinations and standards. It incorporates the previous Guidance Memo (GM) and also adds direction for implementing and monitoring remotely piloted aircraft (RPA) pilot standards.

2 Further, this Guidance Memo (GM) clarifies the definitions for the USAF Medical Serial Profile Annotation [Physical Profile Serial Chart (PULHES)] and incorporates recommendations for clarifying language for Duty Not Involving Flying (DNIF) procedures following a mishap. It also officially adopts the DoD equivalent to AF Form 1042, the DD Form 2992, Medical Recommendation for Flying or Special Operational Duty. Compliance with this memorandum is mandatory. To the extent its directions are inconsistent with other Air FORCE publications, the information herein prevails, in accordance with Air FORCE Instruction 33-360, Publications and Forms Management.

3 This memorandum becomes void after one year has elapsed from the date of this Memorandum, or upon publication by interim change to, or rewrite of AFI 48-123, whichever is earlier. MARK A. EDIGER Lieutenant General, USAF, MC, CFS Surgeon General Attachment: Changes to Air FORCE Instruction 48-123 (Add) Opening Paragraph. The authorities to waive wing/unit level requirements in this publication are identified with a Tier ( T-0, T-1, T-2, T-3 ) number following the compliance AFI48-123_AFGM2018-02 Changes to Air FORCE Instruction 48-123 statement. See Air FORCE Instruction 33-360, Publications and Forms Management, for a description of the authorities associated with the Tier numbers.

4 Submit requests for waivers through the chain of command to the appropriate Tier waiver approval authority, or alternately, to the Publication OPR for non-tiered compliance items. (Add) The current Medical Standards Directory is located on the Knowledge Exchange under Flight Medicine in the Medical Standards Directory folder. (Add) The Medical Standards Directory and the Official Air FORCE Medicine Approved Medications must be used in accordance with Air FORCE Instruction 48-123 and can be changed through the process noted in Air FORCE Instruction 48-123 Guidance Memo (GM) para. (Add) Medical standards and aircrew approved medications are changed through a process that includes review by the Aircrew Medical Standards Working Group (AMSWG) which includes members from Major Commands (MAJCOM), HAF/A3, and appropriate Subject Matter Experts for the specific standards.

5 Then any recommended changes by the Aircrew Medical Standards Working Group (AMSWG) are reviewed by the Flight and Operational Medicine Corporate Board whose voting members include the Major Command (MAJCOM)/SGPs. All medical standards are approved in accordance with the AF/SG s delegated authority. For retention and all special duty medical standards (including flying) the delegated authority is the AF/SG3/5P. (Add) The Chief of Physical Standards Development is the OPR for any changes and can be contacted for any recommendations. (Replace) Color Vision Testing: Pseudoisochromatic Plate (PIP) testing to determine color vision perception will be completed at accession, and the results will be recorded in member s record (T-2).

6 [Special Operational Duty (SOD) positions include but are not limited to Ground Based Controller (GBC), Survival, Evasion, Resistance, and Escape (SERE), Pararescue (PJ) and Combat Control.] If an applicant wants to apply for flying or special duty, then they must pass the Cone Contrast Test (CCT) at an Air FORCE Military Treatment Facility (MTF) or equivalent. (T-1) Exception: See section for applicants for Initial Flying Class I and Initial Flying Class II/Flight Surgeon (IFCII/FS) and remotely piloted aircraft (RPA) duties. (Replace) Disorders That Are Unsuiting. Disorders that are unsuiting for, or interfere with, military service are managed administratively through the patient s chain of command in accordance with Air FORCE Instruction 36-3206, Administrative Discharge Procedures for Commissioned Officers and Air FORCE Instruction 36-3208, Administrative Separation of Airmen.

7 Unsuiting disorders are conditions that interfere with military service and must not be confused with disorders that render a member medically unfit for duty. These conditions are not entered into the Integrated Disability Evaluation System (IDES), in accordance with DoDI , Disability Evaluation System (DES) paragraph (Add) Retraining applications will be reviewed by the primary care provider at the request of the Medical Standards Management Element (MSME). (T-1) The provider will then update the Physical Profile Serial Chart (PULHES) (see Table ) for the applicant in an AF Form 422 in accordance with Air FORCE Instruction 10-203, Duty Limiting Conditions.

8 (T-2) AFI48-123_AFGM2018-02 Changes to Air FORCE Instruction 48-123 (Add) Retraining applications will be reviewed by the Medical Standards Management Element (MSME) to ensure members are qualified for entry into the Air FORCE Specialty Codes (AFSC) for which the member is applying in accordance with Air FORCE Instruction 10-203. (T-1) Medical Standards Management Element (MSME) will ensure Physical Profile Serial Chart (PULHES) (see Table ) is updated in accordance with Air FORCE Instruction 10-203. (T-1) (Replace) Certain conditions render an individual unsuited for duty, rather than unfit, and render the service member subject to administrative separation since these conditions interfere with military service.

9 These conditions cannot be entered into the Integrated Disability Evaluation System (IDES). Consult Air FORCE Instruction 36-3206, Administrative Discharge Procedures for Commissioned Officers, Air FORCE Instruction 36-3208, Administrative Separation of Airmen, and DoDI , Disability Evaluation System (DES) for details and specific cases. (Replace) Rated officers for continued flying duty (pilots, navigators/electronic warfare officers, 12SX Special Operations Combat Systems Officer and flight surgeons). (Replace) Flying Class (FC) III qualifies individuals for aviation as indicated in the Air FORCE Officer Classification Directory (AFOCD) or the Air FORCE Enlisted Classification Directory (AFECD).

10 For United States Air FORCE Academy (USAFA) cadets participating in United States Air FORCE Academy (USAFA) cadet airmanship program, see Air FORCE Instruction 48-123 paragraph A categorical Flying Class III (FCIII) qualifies individuals for duty with certain restrictions. Granting categorical certifications and waivers does not guarantee operational utilization. Restrictions for Flying Class IIIC (FCIIIC) and Flying Class IIID (FCIIID) will be documented in the remarks section of the AF Form 1042 or DD Form 2992. (T-1) See Air FORCE Instruction 48-123 paragraph and Table for certification and waiver authority.