There is a difference; being able to get a waiver and commission and a condition that is waivered and that person is not commissionable. Tons of folks get waivers. For someone who is a recruited athlete it even raises the spidey senses more because it makes it sound like medical standards were compromised for the sake of the sport. I doubt West Point did that. We don't know the whole story. Tons of folks get waivers every year. Very few do not commission after 4 years. They are generally extreme cases and stuff that develops during the 4 years at a SA: type 1, Chrones, cancer, extreme depression, an major ortho injury.