SC Regulation 40- 501 A-1

APPENDIX A

RESPONSIBILITIES

1. Commander, USSOUTHCOM is responsible for the Force Health Protection (FHP) 

of all forces deployed to USSOUTHCOM AOR IAW USSOUTHCOM FHP Guidance 

(Attachment D). In accordance with DODI 6490.07, the CCDR serves as the medical 

waiver authority for all SMs in the AOR. This authority has been delegated in writing to 

the USSOUTHCOM Command Surgeon, who has further delegated this authority to the 

respective Service Component surgeons. 

2. Command Surgeon (SCSG) will:

a. Monitor and report compliance with this policy.

b. Integrate medical guidelines into the orders process for all operations in the 

AOR.

c. Ensure Service and component specific procedures are maintained for 

appropriate reference.

d. On request, provide Medical Capability Reports from the TRICARE Overseas 

Program (TOP) contractor outlining the medical care environment with specificity of 

conditions that may not be adequately covered in the host nation. 

3. Component Commanders will: 

a. Publish and enforce medical suitability screening procedures, congruent with this 

regulation for their commands as applicable.

b. Ensure personnel in paragraph 4b above are medically screened IAW this 

regulation.

c. Ensure personnel offices validate IAW respective service policies, medical 

suitability for Permanent Change of Station (PCS) personnel being assigned to the 

AOR. PCS personnel will coordinate with their respective service component medical 

elements for screening who will in turn comply with service guidance and this policy.

d. Ensure medical guidelines are incorporated into the orders process ICW 

USSOUTHCOM Directives

e. Ensure DOD contracts include USSOUTHCOM medical requirements to screen 

contract personnel entering the USSOUTHCOM AOR. In the event of a conflict 

between this policy and the language of a particular contract requiring activities in the 

USSOUTHCOM AOR, the language contained in the contract will have precedence. As 

a result, it is incumbent on contracting activities in the USSOUTHCOM AOR to ensure 

contracts reflect the requirements of this policy, DODI 3020.41, and the applicable part 

of the Defense Federal Acquisition Regulation (DFAR) to conserve DOD resources.
SC Regulation 40- 501 A-2 

f. Ensure all civilian contractors are provided suitability screening at no cost to the 

government to provide mentally and physically qualified contingency contractor 

personnel to perform duties in applicable contingency operations as outlined in the 

contract.

4. Component Surgeons will:

a. Receive, review and log subordinate elements' waiver requests. Provide 

instructions for subordinate elements to submit waivers. 

b. Review waiver requests within 15 business days and reply to the requestor 

based on sound medical judgment and knowledge of potential operational and/or 

component specific limitations.

c. Utilize available resources and Subject Matter Experts to appropriately 

disposition medical waiver requests. Conversation can also include the 

USSOUTHCOM Command Surgeon and/or JTF Surgeon responsible for the AOR.

d. Provide USSOUTHCOM Command Surgeon a copy of all adjudicated 

waivers, via email: southcom.miami.sc-cc.mbx.southcom-waivers@mail.mil

e. Ensure dissemination of this policy to sourcing units and medical commands/ 

Medical Treatment Facilities (MTFs) responsible for conducting medical screening of 

applicable personnel tasked to operate in the USSOUTHCOM AOR.

 

f. When available, serve as the appellate authority for the medical waiver process 

(Attachment C). The Component Surgeon is the final approval authority for all waivers. 

USSOUTHCOM delegates waiver authority to Service Components. 

g. Coordinate waiver requests with JTF and Component Surgeons for continuity and 

consistency. 

h. Log all waiver requests.

5. Contracting Officer’s Representatives (COR) will: 

a. Comply with USSOUTHCOM Policy Memorandum 1-12, Synchronized Predeployment, and Operational Tracker (SPOT) in the USSOUTHCOM AOR, ensuring all 

contractors are in the SPOT database and obtain theater clearance via APACs IAW 

DODI 3020.41 and the applicable part of the Defense Federal Acquisition Regulation 

(DFAR).

b. Ensure employees are provided a medical suitability screening prior to entering 

the SC AOR. Ensure employees have the appropriate level of health care coverage that 

will provide for hospital care OCONUS and patient movement/medical evacuation back 

to their country of origin or nearest medical center of excellence as required. 
SC Regulation 40- 501 A-3 

c. Ensure a SPOT generated Letter of Authorization (LOA) is issued by the 

contracting officer or otherwise designated by the CCDR. The contract shall require 

that all contingency contractor personnel who are issued an LOA will always carry the 

LOA with them. 

d. All contracts with DoD shall include requirements to screen personnel entering 

the USSOUTHCOM AOR for Medical Suitability, in accordance with SC published 

guidance.

e. Contracting companies must maintain medical documentation throughout 

contract employment and two years after termination of employment. Companies will 

also ensure screenings are conducted by licensed medical providers. Any disqualifying 

medical conditions will be immediately reported to the responsible contracting officer 

with a recommendation that the contractor does not hire or immediately replace the 

individual at no cost to the government.

6. The Defense Health Agency through the Dwight D. Eisenhower Medical Center will 

delegate screening responsibilities to the SOUTHCOM health clinic for personnel 

assigned to USSOUTHCOM HQ.

7. Director for Manpower, Personnel, and Administration (SCJ1) will: 

a. Review service specific policies and regulations governing medical clearance of

personnel assigned to the AOR. Coordinate with service components to provide

guidance on obtaining waivers to meet medical clearance requirements.

b. Upon receipt of notification from members reassigned within the AOR for longer

than 30 days, provide notification to the Command Surgeon’s office. This notification 

will provide oversight for the SCSG to account for the possible degradation of medical 

care at the gaining location.

c. Civilian personnel (SCJ14) in conjunction with Civilian Personnel Advisory 

Center (CPAC) will monitor, as a condition of employment, members who receive 

medical screening prior to hiring. Civilian personnel will ensure personnel accepting 

positions overseas with authorized dependents on their orders complete the Exceptional 

Family Member Program Information Sheet (DA FORM 5863). 

8. Security Cooperation Offices (SCO) will:

a. Notify SCSG in the event there is a degradation or significant change in available 

medical care in country that could negatively affect healthcare for service members, 

civilian employees and/or dependents. Advise inbound personnel and dependents of 

available care through sponsors and appropriate POCs prior to arrival.

9. Member assigned to the AOR will:
SC Regulation 40- 501 A-4

a. Ensure completion of medical screening requirements prior to PCS, TCS, or 

TDY. For DTS orders, members must add a remark stating, “Medical suitability 

screening and briefings for travel have been completed IAW USSOUTHCOM REG 40-

501.”

b. Notify SCJ1 services desk(s) of any pending movement within the AOR spanning 

periods of 30 days or greater.

10. All Offices will maintain records generated by the implementation of this regulation, 

in accordance with CJCS Manual 5760.01, Joint Staff and Combatant Command 

Records Management Manual, Volumes I and II.
SC Regulation 40-501 B-1 

APPENDIX B

PROCEDURES

1. General. DoD guidance and attachment B of this regulation will be used to screen 

all persons entering the USSOUTHCOM AOR. Component or Service specific 

guidance may have more stringent requirements to meet specific service needs. Any 

Component with differing requirements will provide USSOUTHCOM Command Surgeon 

a copy of the Component policy for approval. Pre-employment and annual medical 

screenings of contractors will not be performed in military treatment facilities or by U.S. 

military personnel unless authorized by the contracting officer and respective MTF. 

Minimal standards are outlined below. In general, individuals with the following 

conditions shall not deploy:

a. Conditions affecting Force Health Protection. Conditions that prohibit 

immunizations or the use of Force Health Protection prescription products (FHPPs) 

required for the specific deployment. Depending on the applicable threat assessment, 

required FHPPs may include atropine, epinephrine, certain antimicrobials and antimalarials. 

b. Unresolved health conditions (to include behavioral health) requiring frequent 

clinical visits and/or affecting the individual’s ability to perform their duties in a 

satisfactory manner. Any unresolved acute or chronic illness or injury that would impair 

duty performance in a deployed environment during the duration of the deployment. 

This includes conditions that require routine evacuation out of theater continuing 

diagnostics or acute exacerbations of a physical or mental health condition that could 

significantly affect duty performance. 

c. Condition that could cause sudden incapacitation. Recurrent loss of 

consciousness for any reason or any medical condition that could result in sudden 

incapacitation to include history of stroke or MI within the last 12 months, uncontrolled 

vertiginous disorders, seizure disorders and diabetes mellitus I or II treated with insulin. 

These conditions are NON-WAIVERABLE.

d. Infectious disease. Active tuberculosis or known blood-borne diseases that may 

be transmitted to others in a deployed environment. Any request for waiver must have 

complete lab work including viral load and specialist recommendation. 

e. Mental Health Disorders. Behavioral health conditions that require ongoing 

treatment with antipsychotics, lithium or anticonvulsants are NON-WAIVERABLE. 

Any history of psychiatric/mental health/behavioral health hospitalization, including 

substance abuse, illicit drug use, and alcohol dependency/ abuse must be thoroughly 

assessed with behavioral health consultation. Any behavioral health condition requiring 

medication must demonstrate a minimum of three months stability on medication 

without any change of medication in those three months to be considered for a waiver. 

Psychiatric disorders newly diagnosed during deployments may require evacuation out 

of theater and must be replaced through the normal personnel process (see Attachment 
SC Regulation 40-501 B-2 

B, for guidance on newly diagnosed conditions as not all require waiver or 

redeployment).

2. Medical examiners will use Attachment B as the governing document for deployment 

screening. The following exceptions will be considered on a case-by-case basis with a 

waiver approval by the respective Surgeon and will be reviewed by the SCSG Office: 

a. Conditions outlined in Paragraph 1 above. Component Surgeon Approval.

b. Injectable Medications. Component Surgeon Approval 

c. Opioids for chronic use. Component Surgeon Approval 

d. Immunosuppressants. Component Surgeon Approval 

e. Conditions that require surgery. Component Surgeon Approval 

f. Conditions requiring Durable Medical Equipment. Component Surgeon Approval. 

3. Local National (LN)/Third Country Nationals (TCN). All local national and third 

country national employees whose job requires close or frequent contact with nonLN/TCN personnel (i.e., dining facility workers, interpreters etc.) must be screened for 

tuberculosis (TB). LN and TCN employees involved in food service, including water and 

ice production must be screened annually for signs and symptoms of infectious 

diseases. Contractors must ensure LN/TCN employees receive Typhoid and Hepatitis 

A vaccinations and ensure documentation in the employees’ medical record. Vision 

readiness standards, hearing standards must be IAW service policy/guidance for all 

LNs/TCNs. LNs/TCNs must have a current dental exam in his/her medical record.

4. Waivers. 

a. If a medical waiver is indicated, prepare, and submit a medical waiver request 

form (Attachment A) with appropriate supporting documentation to the specific 

USSOUTHCOM Component Surgeon based on component guidance (Attachment C). 

Ensure to encrypt all emails. 

b. If the individual does not meet minimal medical suitability requirements, the 

screening health care provider (MD/DO, PA/NP, PhD/PsyD or LCSW) should either 

initiate a permanent profile or recommend for SM for separation. 

c. Medical examiners must consider climate, altitude, billeting options, duty 

assignment and duration, and health support services available in theater when 

deciding whether an individual with a specific medical condition is deployable.

d. Contractors are responsible for requesting medical waivers for employment 

consideration from the contracting officer. Contracting officers will forward the waiver 
SC Regulation 40-501 B-3 

request to the responsible Component Surgeon (see Attachment C) for review and 

approval. Responsible Component Surgeon will provide a copy of approved waiver of 

contracting officer, contract company, employee medical record and the SCSG IAW this 

regulation. 

e. For visits of less than 30 days (TDY), the responsible unit or MTF medical 

personnel will determine medical suitability screening based on the anticipated medical 

risks and the individual's medical condition. No medical waiver is required. 

f. An adequate healthcare support system must be validated by the component 

Surgeon prior to approving waivers for any condition requiring ongoing health care or 

use of medications. Medications must be available or accessible to the individual 

through existing pharmacy resources, within the military health system or through mail 

order supply and have no special handling, storage, or other requirements. 

g. If a person is found deployed with a listed condition and without a waiver for that 

condition, a waiver request form must be initiated by the JTF or Component Surgeon if 

they believe a waiver is warranted. If the waiver is denied, the individual will be 

redeployed as soon as possible, and the personnel process will be used to replace the 

individual as needed. 

 h. The list of conditions is not intended to be all-inclusive. A list of all possible 

diagnoses, which could result in potential non-deployability, would be too extensive. It 

is the intent of this Medical Suitability Standard to provide a framework for healthcare 

providers to make informed decisions and to outline the process for addressing medical 

conditions which could adversely affect the individual or the mission while OCONUS in 

theater.
SC Regulation 40-501 C-1

APPENDIX C

ABBREVIATIONS AND ACRONYMS

CCDR - Combatant Commander 

DFAR - Defense Federal Acquisition Regulation 

DO – Doctor of Osteopathy

EFMP - Exceptional Family Member Program 

GCC – Geographic Combatant Command

HBV - Hepatitis B Virus

HCV - Hepatitis C Virus

HIV - Human Immunodeficiency Virus

IMR - Individual Medical Record

FHP - Force Health Protection 

LCSW – Licensed Clinical Social Worker 

LN - Local National 

MI – Myocardial Infarction

MD – Medical Doctor 

MTF - Military Treatment Facility

NP - Nurse Practitioner

PA - Physician Assistant 

PsyD – Doctor of Psychology

SCSG- SOUTHCOM Surgeon 

SPOT - Synchronized Pre-deployment and Operational Tracker 

TB - Tuberculosis 

TCN - Third Country National 
SC Regulation 40-501 AA-1

ATTACHMENTS

ATTACHMENT A

USSOUTHCOM Medical Waiver Request Form

Attachment 

A_Medical Waiver Re 

ATTACHMENT B 

MOD 3 USSOUTHCOM Amplification of the Minimal Standards of Fitness

Attachment B_MOD 

3 AMPLIFICATION O 

ATTACHMENT C 

USSOUTHCOM Medical Waiver Process

Attachment 

C_Medical Waiver Pr 

ATTACHMENT D 

USSOUTHCOM Force Health Protection Guidance 

Attachement D_SC 

Policy Memo 15-21 F 

ATTACHMENT E 

MOD 16 USCENTCOM Amplification of the Minimal Standards of Fitness 

Attachment 

E_CENTCOM MOD 1

ATTACHMENT F 

USSOUTHCOM Policy Memorandum, Service Component Reporting of Potentially 

Concussive Events (PCE), JULY 2022

Attachment F_Policy 

Memorandum 04-22