This is very hard . . . this post won't make it any easier, but may explain some things to some about what the situation is . . .
Approximately 10,000-12,000 applicants complete their applications to the "Big 3" SAs each year (USAFA, USMA & USNA). About 4,000 receive a Congressional Nomination. About 2,400 of those are considered "qualified academically and in physical aptitude (CFA)" by the SA. (Check out the Class Profiles from the SAs on line for the most current numbers) There are 1200 slots at each of the Big 3 each year. About 500 of those go to the Principal Noms . . . about 200 go to those with LOAs/recruits/prep school . . . that leaves about 500 slots and about 1700 candidates . . . The SA will select from the 1700 those that best meet the SA's need to compile a "Class" that best represents the make up of our society and our military. Gender, ethnic and geographic diversity is required and the Admissions office does its best to meet the guidance it has received. You have to understand that if you made it into that final bunch of about 2400, you have attained some pretty rarified air . . . the SA would like to have all of you, but they can only take 1200 . . . that does NOT mean they have ranked ordered those remaining 1700 and picked the top 500 . . . all of the remaining 1700 are "qualified academically and in physical aptitude" . . . some will also need a medical waiver. The effort on the medical waiver first goes to the 500 Principal Noms and the LOAs/recruits/prep school that may need a medical waiver. The medical waiver effort next goes to those the SA selects from the 1700 to fill the 500 slots. Not everybody that is considered for a medical waiver gets it and sometimes the time does run out . . . Having said all that, make sure you have a good "Plan B" in place and focus on that . . . hopefully you have applied for a ROTC scholarship and have a great civilian University or Senior Military College (Citadel, UNG, Norwich, Texas A&M, VA Tech or VMI) in mind . . . if the SA appointment comes through, then that is AWESOME . . . if it doesn't . . . you've got another great path to attain your commission . . . do NOT feel you are second rate if the SA appointment doesn't come through. . . for instance . . .
People are sometimes under the incorrect impression that those selected to go to an SA are "superior" to those that earn a 4 yr (or 3 yr) national ROTC scholarship. To get a 4 yr (or 3 yr) national ROTC scholarship today, it typically takes a "SA-quality" record with all the same varsity letter sports achievements, team captain, club officer, other leadership, physical fitness, good grades and high SAT/ACT test scores. In some cases it is harder to get the ROTC scholarship than the SA appointment. In recent years, the AF was only awarding 300 AFROTC scholarships each year (a mix of 3 and 4 year) while USAFA was still making 1200 appointments each year. For the Army, they usually only award about 600 4 yr scholarships each year while USMA still makes 1200 appointments each year. (Total Army ROTC national scholarships has been around 2500 each year with 600 being 4 yr and 1900 being 3 yr.) I don't have any experience with the Navy.
An SA candidate from a very competitive area like NoVa will earn only one of the 10 nominations from a MOC, but be ranked low on the MOC's slate because of all the great candidates (NoVa will have 200-300 applicants to each senator and each NoVa Representative -- typically 50 get interviews and 10 are seletected by each MOC usually with no duplication). A candidate from a not-so-competive region will get one or more nominations and be ranked high on the MOC's slate. The candidate that is ranked low from the very competitive region will have a record that is way better than the candidate from the not-so-competitive region. In the end, the candiate from the not-so-competitive region will get the SA appointment, and the candidate from the very competitive region will not get an SA appointment, even though they have a better record. Every year there are SA candidates that get an SA appointment, but don't qualify for a national ROTC scholarship -- nationally, they were not competitive -- they "won their MOC's slate" for the SA appointment, but compared to the national pool, they didn't make the cut (this is the geographic diversity factor) -- and every year there are great SA candidates that don't get the SA appointment (because they didn't win their MOC's slate in a very competitive region) but do earn a 4 yr (or 3 yr) national ROTC scholarship because they did compete well within the national pool.
When we went through it, DS was being offered an early appt to USAFA, but was denied entry by the USAFA docs because of a medical issue. We found out very early in the process and he switched everything over to USMA and AROTC because we discovered the Army gave waivers for his condition. He got one of the Congressional Noms from NoVa to USMA, but it wasn't a Principal Nom. He also was awarded a 4 yr AROTC scholarship to VMI and AROTC granted him a medical waiver. USMA never put him forward for the waiver, and he did not receive an appointment to USMA. USMA did keep him on their "almost list" right up to the very end (late April/early May) before they sent the TWE . . . by that time he was already focused for VMI and AROTC . . . He is completing his junior year and will graduate and commission summer 2019 . . .
Best wishes to you all and thank you for your willingness to serve