Based on a flight physical, aviators are assigned to three groups as follows: Service Group I.-Aviators under 45 years of age-they may be assigned to flight duties of an unlimited or unrestricted nature.

Service Group II.-Aviators under 45 years of age who do not meet the visual standards for Service Group I-such officers are restricted from flying from carriers, except in helicopters.

Service Group III.-Aviators 45 years of age and over or those aviators under 45 years of age who are (1) recovering from illness of injury or who (2) meet only the physical standards for Service Group III. These officers will normally operate only aircraft equipped with dual controls and be accompanied on all flights by a pilot or a co-pilot of Service Group I or II qualified in the model aircraft operated.

Summary.-Navy and Marine aviators must meet rigid physical standards. They are placed in one of three service groups depending upon their age and their ability to meet these standards and their flying assignments are contingent upon the service group to which they are assigned. All aviators may be restricted from any flying whatsoever because of illness or injury as determined by a qualified flight surgeon. Once "downed", they may only fly when certified to be physically qualified by a flight surgeon.

A copy of the applicable articles in the Manual of the Medical Department is attached.

15-61. Policies on Service Groups for Naval Aviators

(1) Assignment. The following policies shall, in general, be followed in the assignment of aviators to flight duties:

(a) Service Group I.-Aviators under 45 years of age who meet the physical standards for service group I. These aviators may be assigned to flight duties of an unlimited or unrestricted nature.

(b) Service Group II.-Aviators under 45 years of age who meet the physical standards for service group II, and aviators of service group I who temporarily meet only the physical standards of service group II. Aviators of service group II are restricted from carrier operations except in helicopter.

(c) Service Group III-Aviators 45 years of age and over who meet the physical standards of service group I, II, or III and those aviators under 45 years of age who (1) are recovering from illness or injury or (2) meet the standards of service group III but are not physically qualified for the other service groups when the needs of the service and the individual's flying experience specifically justify their employment in such a limited status. Those aviators assigned because of temporary physical defects shall be retained in service group III for a period of up to 6 months, at the end of which time they shall be reexamined for classification. Should the temporary disability warrant a longer period in order to fully recuperate, they can be retained in this group for additional 6month periods before final classification is effected. Those aviators assigned for the need of the service shall be retained in service group III for only as long as the need exists. The Chief of Naval Personnel, or the Commandant of the Marine Corps in the case of Marine Corps personnel, will effect appropriate redesignation as needs of the service require.

(1) Service group III aviators shall normally operate only aircraft equipped with dual controls and be accompanied on all flights by a pilot or co-pilot of service group I or II qualified in model aircraft operated.

(2) With the approval of the Deputy Chief of Naval Operation (Air), or Commandant of the Marine Corps in the case of Marine Corps personnel, aviators in service group III who meet the physical standards for service group I or II may solo such aircraft as is commensurate with physical and service qualifications of each aviator. Requests for solo/pilot in command waiver shall be submitted in accordance with OPNAVINST 3710.7 series or MCO 3710.1 series.

(3) Aviators in this group are authorized to maintain an instrument card provided all other requirements are met.

(2) Physical Standards and Disposition.-(a) The physical standards for aviation personnel in each of the foregoing service groups are set forth in articles 15-62, 15-63, and 15-64.

(b) Should any aviator fail to meet the prescribed physical standards for flying of his service group, and the physical defect which caused such failure is expected to exist longer than 30 days, such failure shall be recorded br completing Standard Form SS, and the report shall be forwarded to BUMED with a specific recommendation by the flight surgeon. BUMED will then submit its recommendation to the Chief of Naval Personnel or to the Commandant of

the Marine Corps in the case of Marine Corps personnel. In general, one of the following dispositions will apply:

(1) Permitted to continued unrestricted flight status of his service group subject to waiver of the standards by the Chief of Naval Personnel, or the Commandant of the Marine Corps in the case of Marine Corps personnel.

(2) Restricted to flight duties of next service group; that is, from I to II, or II to III.

(3) Restricted to flight duties of lessened tempo commensurate with present temporary physical condition (limited to aviators recuperating from injuries or illness).

(4) Restricted to flight duties of service group III, requiring the presence of a pilot or copilot qualified in service group I or II.

(5) Restricted from all duties involving flying with statement concerning whether a disqualifying defect is considered temporary or permanent.

(c) In those cases where an aviator fails to meet the standards or qualifications for flying in an appropriate service group, for flying in any capacity or where a decision cannot be made by the examining flight surgeon, consideration shall be given to the appearance of the aviator before an appropriate board of flight surgeons. See article 15-72.

(d) In cases where recommendation is made to terminate flight status, the Chief of Naval Personnel, or the Commandant of the Marine Corps in the case of Marine Corps personnel, will determine if the individual shall be retained within the aeronautical organization or assigned to duty outside the aeronautical organization.

15–62. Examination and Standards for Class 1, Service Group I

(1) General Examination.—Except as modified by addition of the provisions of this article, the basic physical examination and basic physical standards for first acceptance in service group I shall be the same as those prescribed for commission. Continuation in service group I will be determined by the provisions set forth in this article and article 15-59 (3) (a).

(2) History.-History of any of the following shall be considered as disqualifying: seizures, isolated or repetitive (grand mal, petit mal, psychomotor or Jacksonian), narcolepsy or cataplexy, head injury complicated by unconsciousness in excess of 24 hours or post traumatic amnesia or impaired judgment exceeding 48 hours, repeated attacks of acute allergy, hay fever, allergic rhinitis, gastric or duodenal ulcer with or without hemorrhage, repeated use of hallucinatory drugs or narcotics, herniated nucleus pulposus with or without surgical treatment, ulcerative colitis or proctitis, psychosis, psychoneurosis, personality disorders (arts. 15–21 (2), (3), and (4) refer), recent attacks of malaria, paroxysmal tachycardia, any organic heart disease, heart surgery, recurrent attacks of any of the rheumatic group, recent renal calculus, encephalitis lethargica or any illness accompanied by diplopia and lethargy, or recurrent pneumothorax. For persons already in the Navy, a complete review of the examinee's Health Records is most important. Flight surgeons are authorized to postpone the examination of persons who fail to present their Health Record at the time of examination. In exercising this prerogative, due consideration must be made in cases where access to the individual's Health Record is administratively impracticable. In such cases the examinee shall be required to complete Standard Form 93. When Standard Form 93 is employed as part of a physical examination (mandatory for all candidates) some comment must be made by the flight surgeon when any significant item is checked by the examinee.

(3) Therapeutics and General Fitness.-A notation shall be recorded on the Standard Form 88 on individuals receiving medication or other therapeutic procedures within 24 hours of a flight physical examination. In general, individuals requiring therapeutics or who have observed lowering of general fitness (dietary. rest. emotional, etc.) which might affect their flying proficiency shall not be found qualified for duty involving flying. See article 15-70 and OPNAV Instruetion 3740 series.

(4) Height and Weight.

(a) Height.-The minimum height is 64 inches. The maximum height is 78 inches. Providing:

(1) The sitting height is not less than 32 inches nor more than 41 inches. Record in parentheses in item 51 of the Standard Form 88.

(2) The buttock-leg length is not less than 36 inches nor more than 50 inches. Record in margin above item 51 of the Standard Form 88 as: BLL=

(3) These measurements shall be obtained on all class I personnel and naval flight officers and recorded to the nearest tenth of an inch in accordance with article 16-38 (2) (u). Also see article 16-74, illustration 2A.

(b) Weight.-Minimum and maximum weights shall be in accordance with the weight standards for aviation personnel, article 15-17(2), table 2. Even though an individual's weight is within the maximum standards, he shall be reported as not physically qualified when the examining physician considers that the weight in relation to the body structure and musculature constitutes obesity of such a degree as to interfere with the satisfactory performance of his duty involving flying.

(5) Chest.-Any condition that serves to impair respiratory function may be cause for rejection. The examinee, if an average-sized individual, should normally have not less than 3 inches of chest expansion. A variation of 1⁄2 inch is allowable if the individual is otherwise acceptable. Pulmonary function tests are recommended in borderline cases.

(6) Cardiovascular System.-Cardiac arrhythmia, or heart murmur, or other evidence of cardiac abnormality shall be the cause of careful study, to include appropriate consultations and electrocardiographic studies. Evidence of organic heart disease shall be cause for rejection. Also see article 15-62 (7).

(7) Blood Pressure and Pulse Rate.-The neurocirculatory efficiency test (Schneider Index) is no longer required. There is no objection in determining or recording the index, however it shall not be used in determining qualification for duty involving flying.

(a) Blood pressure.-Shall be determined first after the examinee has been supine at least 5 minutes and secondly after standing motionless for 3 minutes. preferably employing a mercurial sphygmomanometer. Prolonged bed rest shall not precede the determination of the blood pressure; however, due regard must be given to the age of the examinee and to physiological causes such as excitement, recent exercise, illness and digestion. No examinee shall be rejected as the result of a single determination. When the blood pressure determination at the first examination is regarded as abnormal, the above procedure shall be repeated twice daily (in the morning and in the afternoon) for a sufficient number of days to enable the examiner to arrive at a definite conclusion. The first determination shall be recorded in item 57 (B & C) and the repeat determination in item 73 of the Standard Form 88. Blood pressure determinations shall be made in accordance with the recommendations of the American Heart Association. The systolic reading shall be taken at the first ausculatory sound. The diastolic reading shall be taken when the ausculatory sound disappears.

(b) Interpretation of Blood Pressure Determinations.-In examinees under 35 years of age, a persistent systolic blood pressure of 140 mm. or more is disqualifying. In examinees over 35 years of age the persistent systolic blood pressure of 150 mm. or more is disqualifying. A persistent diastolic blood pressure of 90 mm. or more is disqualifying. When changing from the recumbent to the standing position and remaining in that position for 3 minutes, if the systolic or diastolic blood pressure is found to be persistently more than 10 mm. below that of the recumbent position, it is disqualifying. Systolic blood pressure persistently less than 96 mm. is disqualifying unless a complete evaluation shows no cardiovascular or other abnormalities.

(c) Pulse Rate.-Shall be determined first after the examinee has been recumbent at least 5 minutes and then after standing motionless for 3 minutes (both determinations to coincide with the recording of the blood pressure). In the presence of a relevant history, arrhythmia or a pulse of less than 50 or over 110, an electrocardiogram shall be obtained.

(d) Interpretation of Pulse Rate.-Resting pulse shall not persistently exceed 100. Standing pulse shall not persistently exceed 110. Pulse rate of 50 or under in the presence of a negative cardiac history and the absence of abnormal physical or electrocardiographic finding shall not in itself be considered disqualifying. (8) Teeth.-Any dental defect which would react adversely to sudden changes in the barometric pressure or produce indistinct speech by direct voice or radio transmission is disqualifying.

(9) Psychiatric Examination. Following the completion of the general examination, the examiner shall make a careful study of the examinee's family history for evidence of insanity, familial traits of psychoneurotic manifestations. degenerations, and inherited deficiencies. A candidate's personal history shall be searched for significant factors which relate to the formative years that affect his personality trend. The infantile period shall be searched for evidence of

retardation. Consideration shall be given to examination of the family life, play life, school life, sex life and a careful search for epileptic equivalents. Determine the family attitude toward flying and the examinee's reaction to the stresses of life and his general emotional response and control. The object of the examination shall be to determine the individual's basic stability, motivation, and capacity to react favorably to the special stresses encountered in flying. Although this phase of the examination shall be performed routinely only on candidates for flight training who are otherwise physically qualified, it may, at the discretion of the flight surgeon be made a part of the examination of any aviation personnel. Any significant personality change in an experienced aviator should be reported when the examiner knows the pilot well enough to note such a change.

(10) Neurological Examination.-A careful neurological examination shall be made, attention being given to the following examinations and report of findings. (a) Pupils.-Regular, irregular, equal, unequal, do or do not react to light and accommodation.

(b) Deep Sense (Romberg).—Negative, slightly positive or pronouncedly positive. (c) Deep Reflexes: Patellar, Bicepts, etc.-Absent (o), diminished (−), normal (+), hyperactive (++) and exaggerated (+++).

(d) Superficial Reflex-Abdominal, Crecasteric, etc.—Any abormalities found. (e) Sensory Disturbances.-Any abnormalities found.

(f) Motor Disturbances.-Evidence of muscle weakness, paresis, or any other abnormality.

(g) Trophic Disturbances.-Evidence of atrophy, compensatory hypertrophies, or any other abnormality.

(h) Tremors.-State whether fine or coarse, and name parts affected.

(i) Tics. Specify parts affected. State whether they are considered to be permanent or due to fatigue or nervous tension.

(j) Cranial Nerves.-Examine carefully for evidence of impaired function or paresis. It should be remembered that some of the cranial nerves are subject to frequent involvement in a number of important diseases, such as syphilis, meningitis, encephalitis lethargica, and injuries to the cranium.

(k) Psychomotor Tension.-Ability to relax voluntarily. This shall be tested by having the examinee rest his forearm upon palm of examiner and then testing the tendon reflexes of the forearm with a percussion hammer. The flight surgeon should also keep himself informed regarding all indications of staleness in order to recognize the earliest manifestations of that condition.

(1) Peripheral Circulation.-Examine for flushing, mottling and cyanosis of face, trunk and extremities. Question as to the presence of localized sweating (armpits and palm) and cold extremities. Any abnormalities disclosed on the neurological examination should be carefully studied and an opinion expressed as to their cause and significance and whether they are sufficient cause for rejection.

(11) Visual Acuity.-(a) Methodology.-Because of the extreme importance of accuracy, uniformity, and objectivity in performing this test, the examiner should be thoroughly familiar with article 15-86. Visual acuity may also be determined with the Armed Forces Vision Tester (AFVT). See article 15-87A for instructions.

(b) Interpretation of Findings.-Visual acuity shall be not less than 20/50 for each eye and if less than 20/20 must be correctable to 20/20 each eye with standard lenses. When the visual acuity of either eye is less than 20/30, each eye shall be corrected to 20/20 and that correction shall be worn at all times while flying.

(c) The corrected visual acuity obtained with the glasses worn while flying will be reported in item 59 and their prescription entered in item 60 of the SF SS. (d) Corrective lenses shall be mounted in aviation frames. When required, prescription sunglasses may be supplied. The wearing of contact lenses is prohibited.

(12) Depth Perception.—(a) Methodology. The AFVT is to be used to determine depth perception in accordance with the instructions in article 15-87A. When this instrument is not available the test may be accomplished on the Verhoeff stereopter and shall be conducted as directed in article 15-87B. When any correction is required to correct distant visual acuity, this correction must be worn while testing depth perception. In such cases the results obtained shall be entered in the lower half of item 65 on SF 88.

(b) Interpretation of Findings.-(1) The AFVT is the preferred testing device. In problem cases, the results obtained by this method shall be considered final.

However, qualifying results obtained by either method (AFVT or Verhoeff) are acceptable.

(2) AFVT: An error in group B, C, or D is disqualifying.

(3) Verhoeff: Failure to correctly report eight out of eight in two or three trials is disqualifying.

(c) Reporting.-(1) Record name of test used in left-hand portion of item 65 of SF 88.

(2) AFVT: In appropriate space of right hand portion of item 65, record the letter designation of the highest group passed; example: Passed F.

(3) Verhoeff: In appropriate space of right-hand portion of item 65, record perfect score as 16/16.

(13) Oculomotor Balance.—(a) Methodology.-The vertical and lateral phorias may be tested for with the phorometer (see art. 15-S7) or with the AFVT (see art. 15-87A).

(b) Interpretation of Findings.-(1) Esophoria greater than 10 prism diopters is disqualifying.

(2) Exophoria greater than 10 prism diopters is disqualifying.

(3) Hyperphoria greater than 1.5 prism diopters is disqualifying.

(4) Prism divergence at 20 feet and 13 inches is optional and required only on candidates and on entering preflight. These tests shall be accomplished, however, on designated naval aviators who have sustained significant head injury, central nervous system disease, or who have demonstrated a change in their phorias.

(14) Red Lens Test.-Conduct only if indicated.

(a) Apparatus.--A spectacle trial frame, a red lens from the trial lens case, a small light such as an opthalmoscope with head removed, and metric rule or tape shall be used.

(b) Procedure. The examinee is seated in the darkroom facing the dark wall or tangent curtain at 75 cm. distance. The spectacle trial frame is adjusted into position and the red lens from the trial lens case is placed in one cell of the trial frame. With the examinee's head in a fixed position, the small lamp is held directly before the center of the dark wall or tangent curtain at 75 cm. distance from the eyes. The presence or absence of diplopia in this position (primary) is noted. The light is then slowly moved from the central position toward the right for a distance of 50 cm. in the horizontal plane. In the same manner, the light is moved in the remaining five cardinal directions, up and to the right, up and to the left, to the left. down and to the left, and down and to the right. The presence or absence of diplopia in any of these positions should be noted. Normally diplopia should not occur in any meridian within 50 cm. of the primary position. In the presence of diplopia, notation should be made as to whether it is crossed, homonymous, or vertical and the distance in centimeters from the central position at which diplopia first occurs should be recorded. When diplopia is suspected and the examinee has been coached to deny its presence, a prism of 3 or 4 D. may be placed, either base up or base down, in one cell of the trial frame. If diplopia is still denied, the statement is obviously untrue.

(c) Precautions.-The head of the examinee must remain fixed and the movement of the light followed only by the eyes. No tilting or rotation of the face shall be permitted.

(d) Interpretation of Findings.-Diplopia first occurring within 50 cm. of the primary position, in any meridian, disqualifies.

(15) Inspection of the eyes.—(a) Procedure.-Whenever possible, the eves are inspected by bright daylight. Every pathologic condition and congenital anomaly is recorded. The following conditions may be found by this procedure: (1) Lids.-Ptosis, blepharitis. trichiasis, entropion, ectropion, and chalazion. (2) Tear Sacs.-Imperfect drainage.

(3) Lower Puncta.-Failure of contact with bulbar conjunctiva.

(4) Conjunctivae.-Trachoma and old scars.

(5) Corneas.-Sears, pannus and ptreygium. The wearing of contact lenses should be disclosed at this stage of the examination.

(6) Pupils.-Unequal size, irregular shape, and failure to react to light or accommodation.

(b) Interpretation of Findings.-Any pathologic condition which may become worse or interfere with the proper functioning of the eyes under the fatigue and exposure of flying disqualifies.

(16) Test for Accommodation.-(a) Procedure.-The flat side of the Prince rule is placed against the side of the examinee's nose with the end of the rule