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Chances of Appealing a Headache Waiver Denial?

#1
This is gonna be a little long-- sorry about that!

I'm a firstie at USNA and will be commissioning almost exactly one month from now. I was elated to service select NFO and be one step closer to being a WSO. However, no one ever told me that it was career suicide to use the word migraine (which I used to think was synonymous with headache) or go see the doc for headache meds until it was too late.. I was told after service selection that I needed to get a waiver. I went to see a neurologist O-6 and he gave me a glowing AHLTA note (I do not have migraines and the problem has been resolved by not staying up for 24 hrs at a time), but NAMI still denied the waiver. However, they denied me due to having "migraine (G43) with presence of aura", which is completely incorrect. All of these headaches (five total over four years, with the most recent being over eight months ago) were very mild, were treatable with OTC meds, and were due to major sleep deprivation/all-nighters. Not to mention that this past summer I successfully soloed (validated IFS) and worked with a USAF weather recon squadron flying 12-hr missions inside Hurricane Irma with no headaches whatsoever. My neuro guy was confident that the waiver would get approved and is now helping me fight it (he is actually friends with the NAMI neurologist, so that's good I guess). I want to believe that I have a fighting chance, but I know headaches are bad juju and the pipeline is already so backed up due to the recent T-6 issues at P-cola. Regardless, this is my dream job and I'm going to fight for it until every door gets slammed in my face. You guys have way more experience than me, so I'd appreciate any advice you can give me!
 

Beans

*1. Loins... GIRD
pilot
#2
Yeah so Aura is disqualifying, and your waiver request probably didn't address it, because you didn't have a diagnosis of Aura (inferring from your post). You'll probably need them to resubmit the waiver, clarifying that you did not have a diagnosis of Aura.

MORE DETAIL AND MANMED NERDERY TO FOLLOW:
Your two favorite websites are:
http://www.med.navy.mil/sites/nmotc/nami/arwg/Documents/WaiverGuide/MANMED_P117_Change_150.pdf (look to page 15-62 for Aura points)
http://www.med.navy.mil/sites/nmotc/nami/arwg/Documents/WaiverGuide/10_Neurology.pdf (page 6)

In the MANMED, Pages 15-43 and 15-63 combine to explain the rules (for you) on migraines.... Page 43 (disqualifying conditions for commissioning in to any designator): "(5) History of recurrent headaches (784.0) to include migraines (346) and tension headaches (307.81) that interfere with normal function, in the past 3 years or of such severity to require prescription medications, are disqualifying."
The or here is probably what drives your need for a waiver.
The section on aviation duty is actually more vague. "[Disqualifying if...] History of headaches or facial pain if frequently recurrent, disabling, requiring prescription medication, or associated with transient neurological impairments." if you did not need prescription meds and they were not documented as above, you should be ok. In fact, if so, then it's not even disqualifying and you shouldn't even

You need to sit down with the doc supporting you on this and go through these documents making sure your record is clear about your condition and doesn't accidentally trip any CD/WNR (that's condition for disqualification, waiver not recommended) landmines.
You, as the person who cares most about this (your doc, NAMI ppl, your Company officer... all move on w/ their day when you get the final answer. You get a new direction in your career/life.), need to understand the MANMED and ARWG as well as you can (given your lack of med knowledge). The MANMED works in layers. First it's conditions for any service. Then specific types of duty (aviation, diving, special stuff, nuke stuff). Within Aviation there are general aviation rules, and then specific rules by class of aviation duty. You may have to read 3 separate sections to get the whole understanding of how a condition impacts your suitability for specific duty. Have fun and don't stay up too late with that. The ARWG then only applies if you have a disqualifying condition per the MANMED.

And of course, lying for a waiver only puts you, your shipmates, and Navy equipment at risk for personal selfish gain. Don't do that.

Background of poster: I dealt with med qualifications for an NROTC unit for a tour. Time to get back to my real job.
 
#3
Thanks so much for the detailed response, Beans-- that was all extremely helpful! I'm going to thoroughly look over both documents tonight and discuss with my doc this weekend.

The only tripping point right now is that a doc at the Academy once prescribed me Fioricet instead of the Motrin they always gave me (the only reason I ever went in for headaches in the first place is because OTC meds are free and I didn't want to pay for it at the store, but I should have realized they would document the appointments). I'm guessing he prescribed me that because I stupidly walked in saying that I had a migraine and wanted meds. I realized the mistake at the pharmacy counter and didn't take the Fioricet from them, but I feel like it looks really bad from NAMI's perspective.. so that's the thing I'm worried about most right now. I put myself in this situation by being cheap and going in to get meds for minor headaches, so I'll be really kicking myself if I can't get this overturned-- if I had just paid the ten bucks for a bottle of Motrin at the store, I wouldn't be in this situation.

In other news, my neurologist discussed my case with the NAMI neuro guy yesterday and he is going to review my case next week when he's back in Pensacola. Fingers crossed for some good news!