Expert: MARK A. HOWELL - 9/25/2009

Question
QUESTION: Colonel Howell,

Just a quick question -- I was recently selected for accession in the Air Force JAG Corps and went to MEPS to have my physical completed.  Everything went well except that my blood pressure readings were not favorable (my lowest was 140/88 but because it was the final reading it was averaged and the overall average was too high).  When I had my interview with the MEPS doctor she stated she's seen alot of people with high BP get waivers and that there is a good chance a waiver would be approved (though she did admit she deals mostly with enlistees).

I have spoken with my recruiter in Washington D.C. and he will be pursuing a waiver on my behalf, but I will either have to have 5 days worth of consecutive blood pressure readings or go to a cardio-pulmonary specialist to ensure nothing's wrong with my heart / vascular system.  I'm leaning towards the latter option simply because I have "white coat syndrome" and I don't know if having the 5 readings done will take care of the issue.

Do you have any thoughts?  I know that the waiver process is not scientific, but any thoughts you have would help.  I was really proud to be selected and hope I can ultimately get commissioned.

Thank you,

Josh

ANSWER: Josh,
Congratulations on being selected for accession in the Air Force JAG career field.  That's not easy to do and is a big accomplishment.

I agree with you that going to a cardio-pulmonary specialist is the best way.  If you have White Coat Syndrome then all five of your BP readings may continue being high.  The military doesn't like a BP reading higher than 140/90.

I have seen waivers like this all the time.  Just a few months ago I had an Airman trying to enter OTS and she also had White Coat Syndrome.  She received a waiver and is well on her way to becoming a pilot.

I don't think you'll have any problem.
See you around the AFB.
Colonel H

---------- FOLLOW-UP ----------

QUESTION: Colonel Howell,

Thanks for the response.  One other question -- Generally, what kind of documentation / test results would a cardiologist have to provide in order to satisfy the waiver authority?  Is this up to the private physician or does the Air Force have guidelines requiring what has to be submitted (I ask because blood pressure readings themselves will likely not be submitted given my issue, so I assume the doctor has to confirm in writing that there really isn't anything wrong with my heart / vascular system and that would be sufficient?)

Again -- thanks for your input I appreciate it.

Regards,

Josh

Answer
Josh,
Your assumptions are correct.  The physician will likely perform some tests, and then dictate a letter stating his opinion of your health, what test he conducted, and what the results were.  Remind him to conclude his letter with a statement saying you're fit for military service.

His medical transcriber will later type it up and send it to you.

Good luck.
Colonel H