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A medical hardship waiver is almost always for a sixth year of eligibility.
The two are not the same...
Medical Hardship is asking for a season that you played games in to not count toward the 4 years of eligibility you are allowed.
6th year extension is to add an additional year to the 5 you are allotted to use your 4 years of eligibility.
Medical Hardship waivers have no bearing on you getting a 6th year of eligibility unless you have two or more Hardship waivers. If you don't play for a year and it wasn't due to injury or some other compelling reason... you're most likely not going to get a 6th year extension regardless of a Hardship waiver being granted. IE, you get redshirted your Freshman year because you're just not good enough to make the game field and the next year you have a season ending injury in game 1. You can apply for a medical hardship waiver and would be granted that waiver; however, you'd still only have 3 years remaining to play 4 years of eligibility... you'd need to apply for a 6th year extension so you'd be left with 4 to play 4. Unfortunately, because you have a non-injury related redshirt year (your freshman year), the odds of getting the extension are slim. If, however, your freshman year can be claimed as a medical hardship along with your other medical hardship the odds of getting that 6th year extension are very good.
Here is a good read in case you're interested (unfortunately it's from a aTm compliance source)...
http://grfx.cstv.com/photos/schools/tam/genrel/auto_pdf/comp101-3-five-year-clock-ext.pdf
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