*Supersedes SC Regulation 40-501, dated 22 April 2013 

20 February 2019 SC Regulation 40-501 

MEDICAL SUITABILITY SCREENING 

TABLE OF CONTENTS 

 Paragraph Page 

References ................................................................ 1 1 

Purpose ................................................................. 2 1 

Applicability............................................................. 3 1 

Summary................................................................... 4 2 

Appendices. 

A. Responsibilities A-1

B. Procedures B-1 

C. Glossary C-1 

Attachments. AA-1 

A. USSOUTHCOM Medical Waiver 

B. USSOUTHCOM Amplification Standards 

C. Waiver Request Flow Chart 

D. SOUTHCOM Force Health Protection Guidance 

1. References. 

a. DODI 1400.32, DOD Civilian Workforce Contingency and Emergency Planning 

Guidelines and Procedures, April 24, 1995. 

b. DODI 3020.32, Continuation of DOD Contractor Services During Crisis, 

November 6, 1990 

c. DODI 3020.41, Operational Contract Support, December 20, 2011 

d. DOD Instruction 6025.19, “Individual Medical Readiness (IMR),” June 9, 2014 

e. DOD Directive 6200.04, “Force Health Protection (FHP),” October 9, 2004 

f. DODI 6485.01, Human Immunodeficiency Virus(HIV) in Military Service 

Members, October 26, 2006 

g. DODI 6490.03, Deployment Health, August 11, 2006 

h. DODI 6490.07, Deployment-Limiting Medical Conditions for Service Members 

and DoD Civilian Employees, February 5, 2010. 

i. DoD Instruction 6490.13, “Comprehensive Policy on Traumatic Brain InjuryRelated Neurocognitive Assessments by the Military Services,” September 11, 2015, as 

amended 

j. Assistant Secretary of Defense for Health Affairs Memorandum, “Clinical 

Practice Guidance for Deployment-Limiting Mental Disorders and Psychotropic 

Medications,” October 7, 2013 

DEPARTMENT OF DEFENSE 

UNITED STATES SOUTHERN COMMAND 

9301 NW 33rd STREET 

DORAL, FL 33172-1202 
SC Regulation 40-501 2 

k. DTM: Directive-type Memorandum 17-004, “Department of Defense Civilian 

Expeditionary Workforce,” January 25, 2017 

l. USSOUTHCOM Policy Memorandum 1-12, Synchronized Predeployment and 

Operational Tracker (SPOT) in the USSOUTHCOM AOR, February 15, 2012 

m. SOUTHCOM Force Health Protection Guidance, September 23, 2018, as 

amended 

n. MOD Thirteen to US CENTCOM Individual Protection and Individual Unit 

Deployment Policy, March 23, 2017 

2. Purpose. This regulation prescribes policy, responsibilities, and procedures for 

medical suitability screening when entering the United States Southern Command 

(USSOUTHCOM) Area of Responsibility (AOR). 

3. Applicability. This regulation is provided to all Department of Defense (DOD) 

personnel and contractors on behalf of DoD, entering the USSOUTHCOM AOR or 

employed within the USSOUTHCOM AOR. United States Government (USG) 

Interagency partners under DoD command and control will be obligated to follow DoD 

guidelines unless the agency prescribes equally adequate standards for medical 

suitability screening for their own personnel. This regulation applies to subordinate 

commands (i.e., Air Force South, Army South, Marine Force South, Navy South, and 

Special Operations Command South) and joint task forces (i.e., JTF-Bravo, JTFGuantanamo, and Joint Interagency Task Force South); hereafter referred to as 

components. This regulation applies to subordinate directorates, special staff offices, 

and security cooperation organizations, hereafter referred to as elements. Components 

and elements may require more or less stringent screening requirements to meet 

specific Service needs or to address interagency and non-governmental organizations 

(NGOs) coordination that are in direct support of DoD missions. Any Component with 

differing requirements will provide USSOUTHCOM Command Surgeon a copy of the 

Component policy for approval. Family members on accompanied tours will be 

regulated by the Service Members’ (SM) parent service policies for screening. 

4. Summary: 

a. It is USSOUTHCOM’s policy that all uniformed service members permanently 

assigned to the AOR (PCS personnel), command-sponsored dependents of uniformed 

service members assigned to the AOR, uniformed servicemembers scheduled to 

perform temporary duty in the AOR for a period greater than 30 days (TDY personnel), 

DoD personnel deploying to a contingency operation within the AOR, and contractors 

entering the USSOUTHCOM AOR will be medically screened prior to entering the 

theater and meet minimum medical suitability standards to ensure force health 

protection (FHP) and accomplishment of the mission. 

b. Persons in paragraph 4a. above, not meeting the minimum medical standards 

may be granted a waiver based on the professional opinion of a medical provider that 

considers: (1) how the medical condition might impact an individual's ability to perform 

occupational responsibilities; (2) how the medical condition might be affected by 
SC Regulation 40-501 3 

variables such as environment, altered sleep cycle, operational stress, etc.; and (3) 

available health service depending on the location and nature of operations before 

submitting a medical waiver. 

c. It is policy of USOUTHCOM that all DoD civilian employees permanently 

assigned to the AOR receive a notice of medical services available in the country for 

which he or she will be assigned. The notice will be provided to the civilian employee 

upon offer of employment, and he or she will affirmatively acknowledge receipt of the 

information. The civilian employee will also provide a statement of understanding that 

he or she may be fiduciarily responsible for any Government expenditures that result 

from medical care received by the employee or family members at Government 

expense, to include MEDEVAC. 

d. This policy is a collaborative effort with USCENTCOM and Secretary of DefenseHealth Affairs to streamline deployment criteria common to all AORs. USSOUTHCOM 

Medical Limiting Conditions Guidelines are reflective of USCENTCOM Mod13- Tab A 

with the USSOUTHCOM noted exceptions outlined in this policy. 

5. Records Management. Records generated by the implementation of this regulation 

will be maintained in accordance with (IAW) CJCSM 5760.01, Joint Staff Records 

Schedule and DODI 6040.45, "DoD Health Record Life Cycle Management", November 

16, 2015, as amended. 

6. Point of contact for this regulation the office of the Command Surgeon (SCSG) at 

COMM: 305-437-1327, or DSN 567-1327. 

The proponent agency of this regulation is the US Southern Command. Users are 

invited to send comments and suggested improvements to: HQ USSOUTHCOM ATTN: 

SCSG, 9301 NW 33rd St., Doral, FL, 33172-1202. 

FOR THE COMMANDER 

 

PATRICIA M. ANSLOW 

 Major General, USA 

 Chief of Staff 

DISTRIBUTION 

D 

 
 SC Regulation 40- 501 A-1 

APPENDIX A 

RESPONSIBILITIES 

1. Commander US Southern Command is responsible for the Force Health Protection 

(FHP) of all forces deployed to USSOUTHCOM AOR IAW SOUTHCOM FHP Guidance 

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

waiver authority for all SMs in the AOR. He has delegated this authority 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. Acts as the appellate authority for the waivers process (Attachment C). The 

USSOUTHCOM Command Surgeon is the final approval authority for all waivers. The 

Command Surgeon has delegated authority to Component Surgeons but retains final 

approval authority for any appeals 

e. Log all waiver requests. Ensure that all requests are acted on in a timely manner. 

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

and consistency. 

g. 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. 

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

this regulation. Ensure all USSOUTHCOM TDY/TAD travel orders greater than 30 days 

for countries within the AOR are informed of the medical requirements to enter the 

theater and that a SOUTHCOM Travel Worksheet is contained in DTS confirming 

medical screening. 

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

suitability for Permanent Change of Station (PCS) personnel being assigned to the 
 SC Regulation 40- 501 A-2 

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 

USSOUTCHOM 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) in order to conserve DOD 

resources. 

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

government in order to provide medically 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 7 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 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. 

5. Contracting Officer’s Representatives 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 
 SC Regulation 40- 501 A-3 

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. 

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 a LOA will carry the LOA with them 

at all times. 

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

the USOUTCHOM 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 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 in order 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 SG in order 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 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 will: 
 SC Regulation 40- 501 A-4 

 a. Notify SOUTHCOM SG in the event there is a degradation or significant change 

in available medical care in country that could negatively impact 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: 

 a. Ensure completion of medical screening requirements prior to PCS 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 USSOUTHCOM amplification of minimal standards will 

be used to screen all persons that require screening pursuant to this regulation prior to 

entering the SOUTHCOM AOR(See Attachment B). Component or Service specific 

guidance may have more stringent requirements in order 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 FHPPPs may include atropine, epinephrine, certain antimicrobials and antimalarials. 

b. Unresolved health conditions 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 24 months, heat stroke, 

uncontrolled vertiginous disorders, recurrent syncope, 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. The 

SOUTHCOM Command Surgeon shall be consulted in all instances of HIV and 

HBV/HCV seropositivity before medical clearance is granted for deployment. 

e. Mental Health Disorders. Chronic or medical 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. 
SC Regulation 40-501 B-2 

Psychiatric disorders newly diagnosed during deployments require evacuation out of 

theater and must be replaced through the normal personnel process. 

2. USSOUTHCOM Amplification of minimal standards. 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 SOUTHCOM SG 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 

(Attachment A) with appropriate supporting documentation to the specific 

USSOUTHCOM Component Surgeon based on component guidance. Ensure to 

encrypt your email. 

b. If the individual does not meet medical suitability requirements to enter the 

theater, the screening health care provider (MD, PA, and NP) should consider the 

individual's job duties, medical condition, and duration of assignment in the theater, 

available health service support and other variables depending on the location and 

nature of operations before submitting a medical waiver. 
SC Regulation 40-501 B-3 

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 

request to the responsible MTF for review and approval. Responsible MTF will provide a 

copy of approved waiver of contracting officer, contract company, employee medical 

record and the Command Surgeon IAW this regulation. 

e. For visits of less than 30 days, 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 mailorder 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 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 

ASAP 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 

diagnosis 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 

GLOSSARY 

SECTION I – ABBREVIATIONS AND ACRONYMS 

CCDR - Combatant Commander 

DFAR - Defense Federal Acquisition Regulation 

EFMP - Exceptional Family Member Program 

HBV - Hepatitis B Virus 

HCV - Hepatitis C Virus 

HIV - Human Immunodeficiency Virus 

IMR - Individual Medical Record 

FHP - Force Health Protection 

LN - Local National 

MI – Myocardial Infarction 

MD – Medical doctor 

MTF - Military Treatment Facility 

NP - Nurse Practitioner 

PA - Physician Assistant 

SCSG- SOUTHCOM Surgeon 

SPOT - Synchronized Pre-deployment and Operational Tracker 

TB - Tuberculosis 

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

ATTACHMENT A 

USSOUTHCOM MEDICAL WAIVER REQUEST 

SOUTHCOM-ATTAC

HMENT A - WAIVER 

ATTACHMENT B 

USSOUTHCOM Amplification of Minimal Standards 

USSOUTHCOM - 

ATTACHMENT B- AM

ATTACHMENT C 

WAIVER REQUEST FLOW CHART 

 

Attachment 

C_Waiver request.pu

ATTACHMENT D 

SOUTHCOM FORCE HEALTH PROTECTION GUIDANCE 

 

USOUTHCOM Force 

Health Protection Gu