Did anyone else notice that the TSA sprung this on the citizenry while Congress was in recess?
From what we read, some people are more successful than others with a medical opt-out. I've never tried it, but will do it if the NOS becomes mandatory for real. I realize that you are subject to the whims and reasoning ability of the particular group of clerks you encounter on a given day, but there must be a way to publish a checklist or of exact things to say or not say when doing a medical opt-out. "Prefer not" versus "I cannot" are good examples.
Then, there are the best practices for basic acting skills. You don't want to show up with your arm in a sling, be successful, and then proceed to throw your bag over your shoulder when you take it from the rollers. I think a successful medical opt out is a combination of saying the right things and winning an Academy award.