The Most Common Disqualifying Medical Conditions in Army Aviators, 2016–2020

INTRODUCTION: Military aviators have long undergone enhanced medical screening to minimize accidents and deaths. U.S. Army aviators undergo a rigorous initial screening process followed by annual medical evaluations governed by published standards of medical fitness which are updated periodically. An aeromedical summary is submitted for disqualifying conditions, resulting in either a waiver of the standard or suspension of flight status. This study aimed to identify the most common disqualifying medical conditions in U.S. Army aviators in recent years and analyze trends over time.

METHODS: A retrospective observational study was performed using 5 yr of data from the U.S. Army’s Aeromedical Epidemiological Data Repository. Incidence rates for the 10 most common disqualifying conditions, and the waiver approval rate for those conditions, were calculated. Annual incidence was calculated for hypertension aeromedical summary submissions.

RESULTS: Lumbar and cervical spinal disorders (101.55 and 39.26 per 10,000 aviator-years, 81.6% and 79.1% waived, respectively), obstructive sleep apnea (62.00 per 10,000 aviator-years, 93.4% waived), hearing loss (27.96 per 10,000 aviator-years, 98.0% waived), and hypertension (26.13 per 10,000 aviator-years, 97.3% waived) were the most common conditions submitted. Psychological diagnoses were also common, with post-traumatic stress disorder, anxiety and phobias, adjustment disorder, and mood disorders having a cumulative incidence of 44.20 per 10,000 aviator-years and a waiver rate of 45.4%. Submissions for hypertension substantially decreased starting in 2019.

DISCUSSION: Spine disorders are among the leading disqualifying conditions in U.S. Army aviators and metabolic conditions were submitted less often than previously reported, likely due to changes in aeromedical policy with respect to hypertension.

Simmons EA, Lee A, Kelley A. The most common disqualifying medical conditions in Army aviators, 2016–2020. Aerosp Med Hum Perform. 2025; 96(6):490–495.