Pilot's Guide to Medical Certification


When pilots complete an application for a new medical certificate, many find themselves on the receiving end of a letter from the FAA that arrives months after the medical examination. The content of the letter may be confusing and just a little intimidating, and it's then that we might begin to wonder just how the FAA medical certification process really works.

The FAA Act of 1958 charges the federal government with promoting aviation and maintaining aviation safety standards. The FAA Office of Aviation Medicine regulates, among other things, airman medical certification standards and structures certification policies and processes to reflect medical technology advancements. There are ongoing problems in the administration of the system that result in some lengthy delays in processing medical applications. A major overhaul of the system is underway now. The process takes time, however, and it will be at least two years before the transition is completed. Those delays notwithstanding, the U.S. FAA has the most progressive civil aviation medical certification standards in the world.

The Airman Medical Standards and Certification Procedures, FAR Part 67, is a maze of medical and legal language that is, in some respects, clear and concise, in others, general and vague. Certifying pilots is a bureaucratic process, devoid of purely medical considerations alone. The FAA also has to consider the prevailing political and legal climate in the course of evaluating an applicant's medical history. Aviation safety is foremost, and each medical history is evaluated on the basis of risk of incapacitation.

The airman medical standards are minimum standards. There is no practical way for all possible medical conditions to be addressed in a regulation. The standards have to be general and subject to interpretation by the FAA doctors who make the decisions. Policies are established to give the FAA aeromedical personnel guidelines for determining that an applicant is eligible to hold a medical certificate. The regulations and policies govern the review, but each case is evaluated on an individual basis.

More than two years after a Notice of Proposed Rulemaking was issued in October 1994, new medical standards took effect on September 16, 1996. The amended rule eliminated outdated language and standards, reformatted the regulation into subparts, and increased the number of disqualifying conditions.

Subpart "A" of FAR 67 is general information including certification of foreign airmen and an important authorization for access to the National Driver Register. (More on that in the question and answer section.) Subparts B, C, and D include the minimum standards for First, Second, and Third Class medical certificates. The subparts are further divided by organ group including Eye; Ear, nose, throat, and equilibrium; Mental; Neurologic; Cardiovascular; and General medical condition. Subpart E is Certification Procedures, and includes the detailed description of special issuances that are required for pilot applicants who have disqualifying medical histories.

Eye

1st and 2nd class visual acuity standards are identical and require that you be able to see 20/20 or better in each eye, with or without correction for distance. For near vision, the standard is 20/40 (at 16 inches) and, for pilots age 50 and over, a 20/40 intermediate vision (at 32 inches) is also required.

There is no uncorrected distant vision requirement. Your aviation medical examiner (AME) will probably check your uncorrected vision just to see if there have been any significant changes since your last exam. Waivers for uncorrected visual acuity are no longer valid. When you renew your next medical, ask the AME to include a note requesting that the waiver be removed from your records. If you wear eyeglasses or contact lenses to see 20/20, you meet the standards. Your certificate will include a limitation that you wear corrective lenses while exercising privileges.

For 3rd class, you need to be able to see 20/40 or better in each eye, with or without correction for distance and near vision.

The language for color vision is amended for first-class medical certificates. "Normal" color vision is no longer a requirement. The new rule applies to all classes of medicals and requires that an applicant have "…the ability to perceive those colors necessary for safe performance of airman duties." Now we don't know exactly what colors are necessary for performing airman duties; the rule doesn't tell us, but when we find out, the regulation is already there to cover it.

Practically, though, the procedure for determining that an airman meets the color vision standard hasn't changed very much despite the new language. It is still necessary to identify characters on a field of colored dots using, most commonly, the Ishihara pseudoisochromatic color plates. Pilots who don't do well with color plates in the AME's office can still be issued a medical certificate, but will be limited to no night flying or color signal control.

The FAA authorizes several alternative color perception tests. If you can pass one of these tests, you will be issued a medical certificate without the night flying restrictions. A last resort is to take a color signal light test at an FAA control tower. Passing this test will allow the issuance of a "waiver," or Statement of Demonstrated Ability (SODA), which will also remove the night flying restriction.

Ear, nose, throat, and equilibrium

The standards now require, for all classes of medical certificates, that you be able to hear a conversational voice at 6 feet, with your back turned to the examiner. If you can't meet the conversational voice test, additional testing may be needed, including audiometric speech discrimination testing or pure tone audiometric testing. Even if you wear a hearing aid, the AME can issue you a certificate if you meet the 6 feet conversational voice test. The FAA will issue a waiver when your application is processed.

Obviously, any condition that results in vertigo or any type of disequilibrium is disqualifying until the condition is diagnosed and the likelihood of recurrence of symptoms established. Ear problems that are at least temporarily disqualifying include serious infections such as those caused by labyrinthitis. Acoustic neuromas are tumors that grow in the inner ear and can cause hearing loss, ringing in the ears (tinnitus) and disequilibrium similar to vertigo. Meniere's disease is a particular problem for pilots because of the quick onset and severity of symptoms. Vertigo can come on quickly and last for up to 24 hours. Symptoms may disappear, only to recur unexpectedly months or even years later.

Mental

The new mental standards include several of the 15 specific disqualifying conditions. These include:

  1. a personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
  2. psychosis;
  3. substance dependence/abuse (defined within the regulation and includes prescription drugs, illicit drugs, and alcohol), or a verified positive DOT-mandated drug test.

Personality disorders and psychoses pose substantial challenges for certification. These diagnoses often require the use of disqualifying medications and individuals on these drugs don't always respond well to the therapy. Substances other than alcohol usually require at least 24 months of documented abstinence and recovery. Alcoholism or alcohol dependence may be reconsidered after as little as 12 months, again with good evidence of recovery and continued abstinence.

Neurologic

Neurologic cases pose some of the more difficult certification decisions for the FAA. Epilepsy and a disturbance of consciousness or transient loss of control of nervous system function without satisfactory medical explanation of the cause are disqualifying. A history of epilepsy can be considered for certification only if there has been at least a 10-year period since the last seizure, and at least 10 years since anticonvulsant medication was used. A single seizure history might be reconsidered if at least 4 years have passed since the last seizure, and there has been no anticonvulsant drug therapy for at least two years.

Some "disturbances of consciousness" may be directly related to a neurologic problem but may also be associated with an underlying cardiovascular problem or a combination of neurocardiac pathology. These cases require extensive cardiac and neurologic evaluations to arrive at a diagnosis. Sometimes a diagnosis cannot be made. When a firm diagnosis isn't made, the FAA will need to see at least one year without a recurrence of symptoms.

Strokes and transient ischemic attacks ("ministrokes") without evidence of serious neurological deficits can be reconsidered after one to two years of recovery. Transient global amnesia, an interesting phenomenon that involves a partial loss of memory of recent past events but no unconsciousness, may be a precursor for future significant neurological events. These cases also require a period of uneventful recovery and a current neurological evaluation before certificate eligibility can be established.

Cardiovascular

Heart disease and related vascular problems ground more pilots than any other disease process. Prior to the development of coronary artery bypass surgery in the 1980s, there was little medical intervention available to enable the FAA to recertify pilots who had histories of heart attacks or significant heart disease. Now, thanks to a large database of applicants who have heart disease, several thousand pilots have been approved under special issuance. The regulations currently disqualify a history of:

  1. myocardial infarction;
  2. angina pectoris (chest pain attributed to heart disease);
  3. coronary heart disease that has been treated, or, if untreated, that has been symptomatic or clinically significant;
  4. cardiac valve replacement;
  5. permanent cardiac pacemaker implantation;
  6. heart replacement.

The regulation also requires applicants for a 1st class medical, at the first examination after age 35 and annually after age 40, to have an electrocardiogram showing no evidence of myocardial infarction or other significant abnormality.

Clinically significant heart disease isn't defined in the regulation. The term refers to an abnormal treadmill stress test, sometimes characterized by a change of greater than one millimeter in what cardiologists call the "ST" segment of the electrocardiogram, an abnormal radionuclide myocardial perfusion scan (thallium or sestamibi are commonly used radioisotopes), or an angiogram indicating 50% or greater blockage of any coronary artery. With a history of heart abnormalities, the FAA will ask for all the available medical records. If test results are more than six months old, it's possible you will have to repeat some or all of them.

You may also be asked to provide a cardiovascular evaluation that includes a current exercise treadmill stress test, routine laboratory blood chemistry report, and a report of a general physical and cardiac examination. If the stress test indicates anything abnormal, a myocardial perfusion scan or exercise echocardiogram may be requested.

Additional specific tests may also be needed, depending on the findings of earlier studies. Rhythm disturbances, for example, may require a 24-hour ambulatory Holter monitor or a signal-averaged ECG. A heart murmur that might indicate a defective valve is usually studied with an echocardiogram.

General medical condition

This is the "catch-all" that applies to just about everything that hasn't been specified in the previous sections. Diabetes requiring insulin or other hypoglycemic drugs is listed here as a disqualifying medical condition. Use of oral medications to control blood glucose has been approved for many years under special issuance. In late 1996, the FAA began considering applicants who use insulin for diabetes management. The policy currently allows only 3rd class certification, but 1st and 2nd class issuance might be possible in the future. For applicants who use diet or oral medications, an initial evaluation includes reports of 3 monthly fasting blood glucose readings and a report of glycohemoglobin (A1C). Certification is possible if there is no evidence of significant organ disease and the blood glucose levels indicate good control. "Good" control to the FAA means a fasting blood glucose of no higher than 140 milligrams/deciliter (mg/dl.) and an A1C glycohemoglobin of no more than 9%.

For insulin using diabetics, the process is more complex. A comprehensive past medical history and a detailed current clinical evaluation are necessary. These reports should confirm the absence of any recent significant diabetes-related events and no evidence of significant cardiovascular, kidney, retinal, or other organ disease. After approval is granted, the special issuance guidelines require pilots to monitor blood glucose (with an approved glucometer) before the flight begins, periodically during flight, and one half hour prior to landing. Although the process is complex and time consuming, special issuance medical certificates are being issued to a small but increasing number of applicants. (Detailed information about the special issuance process for diabetes and many other medical conditions can be obtained by calling the AOPA Medical Certification Department at 800-872-2672 or by visiting AOPA's Web site.)

"No other organic, functional, or structural disease, defect, or limitation…" rounds out the regulation. The FAA considers high blood pressure to be one of these organic conditions and formulates a blood pressure certification "policy" within the regulation.

Regulations are codified in print for everyone to see and are broad in scope. Policies, though, are based on operating procedures known internally to the FAA and those outside the FAA who find out about them on their own. Policies are not necessarily secrets that only people with top security clearances know about. The FAA just doesn't routinely volunteer information about how a particular policy influences the certification decision.

If there was a regulation that mandated the 155/95 limit, the only way pilots with high blood pressure could be certified legally would be with a special issuance authorization. A special issuance is a costly and time-consuming way to achieve an end (see below), so the FAA did us a favor (if you want to call it that) by addressing hypertension by policy rather than by regulatory standard. Unfortunately, some medical examiners still aren't aware of this long-standing policy, and will defer an application even when the evaluation is provided at the time of examination. A deferral is bad news nowadays, because the review process in Oklahoma City may take up to four months before you get a response. That isn't good news for any pilot, but really bad news for a professional pilot.

The hypertension policy sets a maximum allowable blood pressure of 155 over 95. This is a change from the previous limit of 170/100, but the FAA evaluation is still the same. You'll need to have a report of a resting electrocardiogram. Blood plasma levels for glucose, cholesterol, triglycerides, potassium, and creatinine, and a summary report from your treating physician including three blood pressure reports demonstrating good control will also be needed. The FAA approves virtually all anti-hypertension medications, including alpha-adrenergic blockers, beta-adrenergic blockers, ACE-inhibitors, calcium channel blockers, direct vasodilators, and diuretics. These groups of drugs make up the majority of blood pressure medications available. As long as your doctor prescribes a drug from one of the approved categories and the medication does the job of keeping your pressure down, the FAA won't have any trouble approving your certificate.

Special Issuance

The new regulations now include 15 specific medical conditions that are disqualifying for any class of medical. The FAA doctors couldn't issue you a medical if they wanted to because the regulations prohibit it. However, the regulations also provide a remedy known as a special issuance authorization. This is a discretionary issuance granted by the Federal Air Surgeon to applicants who have disqualifying histories. (In medical jargon, a "history" is established when you have a single medical event anytime in your life. If you were knocked unconscious when you fell out of a tree as a young child, you have a history of unconsciousness.)

A special issuance is a two-sided coin. It's great that the regulations offer a mechanism to offset the disqualifying conditions. The downside is that it is a discretionary issuance and can be withdrawn anytime the FAA sees evidence of an "adverse" change in the condition. All special issuance authorizations have a time limitation (often 12 months). You may hold a certificate that appears to be valid for up to 36 calendar months in accordance with FAR 61.23. In reality, though, the certificate is valid for only as long as the authorization is in force, and that's determined by the type of medical condition and the perceived risk of incapacitation that could result from the condition.

In addition to the time limitation, reissuance of the certificate will be based on additional testing that must be submitted to the FAA prior to the expiration date of the authorization. This might be a simple status report from your treating physician or a complete reexamination with comprehensive (and expensive) diagnostic testing. Additional limitations may be placed on the operational privileges of the certificate, such as limiting a 2nd class medical holder to carrying passengers for hire only when part of a qualified two-pilot crew.

A special issuance is different from a waiver or Statement of Demonstrated Ability. Waivers are issued for static defects that are not likely to change. Medical flight tests are sometimes conducted to demonstrate that an applicant can safely operate the aircraft. Useful vision in only one eye (monocular vision) is one condition for which a medical flight test might be used. There are several hundred pilots flying with monocular vision waivers. Upper or lower limb amputees can also qualify for a SODA with a flight test. Pilots with defective color vision can also be issued a waiver after passing a color signal light test. The waiver becomes part of your medical certificate and shows that you have satisfactorily demonstrated the ability to safely perform the duties as required by the regulations.

For special issuance consideration, the FAA will ask for medical information specific to the type of condition you had. Often, that first round of records will be sufficient for the FAA to make a decision. Sometimes, though, additional information is needed, especially if the first records you send are incomplete or inconclusive, or if there are abnormal results indicated. You may get several letters over a period of months asking for more information before finally getting a decision. The doctors in Oklahoma City don't want to ask you for any more information than is necessary, but they also won't issue a certificate until there is as complete a medical picture as possible. Just be patient and expect a few bumps in the road along the way. The process is time consuming and costly to maintain because of the required follow-up medical tests. The hassle notwithstanding, more than 25,000 pilots have been certified under special issuance, including more than 1,100 at first class.

Medication

Medication usage presents numerous aeromedical concerns. The regulations do not include specific reference to disqualifying drugs, although §61.53 prohibits a medical deficiency or use of any medication that makes the person unable to meet the requirements for a medical certificate. §91.17 prohibits the use of any drug that "affects the person's faculties in any way contrary to safety." Again, FAA policy determines which drugs are acceptable, based on the medication's potential side effects and on the symptoms for which the drug is being taken. If a pilot unknowingly reports a "disqualifying" drug on the medical application, the medical examiner has to defer the application, and that will mean a lengthy delay before you receive a denial letter. That's one of the problems of not knowing the policy on a particular drug, and a very good reason to call AOPA before reporting medication usage on a medical application. Denials may be favorably reconsidered if the medication is discontinued and there is no recurrence of the symptoms which required the medication in the first place. Generally, the FAA prohibits the use of any drug that acts on the central nervous system. Stimulants, barbiturates, antidepressants (yes, Prozac and Paxil are currently disqualifying), hypnotics, muscle relaxants, sedatives, tranquilizers, and sleep aids are a few that won't be approved.

Drugs affect people differently, and the side effects can range from none at all to profound. Over-the-counter antihistamines or decongestants taken a half hour before a flight may seem innocuous until you're airborne. That's when altitude and pressure changes can cause uncomfortable side effects that could render you "unable to safely perform the duties." Drowsiness is not uncommon in many of the OTCs, yet over-the-counter remedies are frequently misused by unsuspecting flight crew members. Remember, too, that the condition for which a drug is being taken may be disqualifying under FAR 61.53. A "medical deficiency" requires that you ground yourself, so a really bad cold and sore throat, combined with self-dispensed medications, may prompt you to have second thoughts about flying that day. If you decide to fly anyway, a good rule of thumb for any medication usage is double the last dosage interval before flying. For example, if the prescription instructs you to take the medication every four hours, wait eight hours after the last dose before leaving the ground. Your pharmacist can probably answer any questions about proper usage of a medication, possible adverse side effects or drug interactions.

Contrary to popular belief, the FAA really wants to certify as many pilots as possible. Very few applicants actually are finally denied medical certification. Some of the ones who are don't pursue it after getting the initial denial letter. They just give up.

The Aeromedical Certification Division is a labor-intensive part of the federal bureaucracy and almost always has a backlog of several months. Even if you do everything absolutely right, it will still take some time to get a response to your application. If you understand how the system works, use common sense, be patient and persistent, though, you'll probably be issued a medical.

The best way to work with the FAA is to get started on the right foot. To do that, you need to call AOPA's Medical Certification Department before you see the medical examiner. We annually answer more than 20,000 calls from pilots who have heard, or expect to hear, from the FAA. We are the best source of medical certification information outside the FAA and can provide advice to members that is not available through any other aviation source. Members can access the Aviation Services Hotline at 800-872-2672, or visit AOPA Online.

FAA Medical Certification

General Information

I'm ready to start flight training, but my instructor has suggested that I get my medical before getting too involved in training. Can my family doctor give me an FAA medical?

No. The FAA designates physicians (M.D.s or D.O.s) around the country to administer flight physicals. These doctors attend initial and recurrent training seminars to maintain their eligibility to conduct FAA medical examinations. Most aviation medical examiners are family practitioners, but many other medical specialties are also represented. Your flight instructor can probably recommend a doctor who can do your physical. AOPA's Medical Certification Department can refer you to doctors in your city or county, or you can search the AME database online.

What kinds of certificates are there? How do I know the appropriate one for me?

The FAA issues three classes of medical certificates:

A first class is required for pilots who exercise Airline Transport Pilot (ATP) privileges; that is, those flying scheduled airliners and other pilots whose employers require this level of certification. A first class medical is valid for ATP privileges for six months.

Second class is required for pilots who fly commercially—in operations such as crop dusting, delivering canceled checks, or carrying passengers or cargo for hire. The second class medical is valid for commercial privileges for 12 months.

Third class is appropriate for student pilots and private pilots who fly for pleasure or personal business (but not for hire). Student pilots need only a third class/student pilot certificate which is a combination certificate and serves both as a pilot and medical certificate. A third class medical is valid for 24 months (36 months for applicants who have not reached age 40). A third class medical is valid for student, recreational, and private pilot privileges. In fact, according to FAR 61.23(a)(iv), a person can exercise flight instructor privileges with a minimum of a Third Class medical certificate, and be compensated for that instruction.

Does a third class medical examination include any type of drug testing?

No. Your AME will not be testing for illicit drugs during a flight physical. A routine part of the FAA medical exam is a urinalysis to check for sugar or protein, indicators of possible diabetes or kidney disease. Even as a commercial pilot participating in the DOT/FAA drug testing program, a drug test is done independent of an aviation medical examination. Your AME may also be a medical review officer for a drug testing company, but when conducting a flight physical, he/she will not test you for illicit drugs.

Some of the information asked for on the application is a little confusing, especially the medical history section. Can the examiner help me check answers to those questions?

You should accurately complete the front side of the form. Your signature at the bottom makes the form a legal document and tells the FAA that all information provided is correct to your best knowledge. The application asks you to report use of medications, past medical history, and visits to health professionals. These are important items that the examiner and the FAA use to identify any potential problems that could delay the issuance of your medical. Read the instruction sheet carefully before completing the application and refer to it as you fill out the form. The medical examiner can give you some general guidance, but if the FAA has any questions, they will contact you for clarification. AOPA can provide you with a copy of the medical application for you to review before completing the real one at the medical examiner's office.

Does the FAA set a standard fee for a medical examination?

The FAA does not set the fees that examiners can charge. The doctors are encouraged to keep their charges for pilots within the range of fees that other patients would be charged for similar services. A third class medical will cost approximately $40-$80, depending on the area of the country where the exam is taken.

If I see an aviation medical examiner every two years for a third class medical, can I postpone regular physicals with my family doctor?

The FAA aviation medical is not intended to be a comprehensive physical checkup. It is intended to be a screening exam to determine if you meet the minimum medical standards required by the regulations. You should continue to see your family physician for routine periodic checkups.

If I have a change in my medical status after the certificate is issued, may I still fly?

That depends upon whether or not you are in compliance with FAR 61.53. This regulation prohibits the exercising of pilot-in-command privileges while you have a known medical deficiency that prevents you from meeting the requirements of your medical certificate. The regulation does not define medical "deficiency," however. If your treating physician feels that your condition allows you to meet the medical standards and does not jeopardize aviation safety, you may continue flying and report the condition on your next medical application.

My medical was denied. Can I still fly?

Sure you can. You can't legally act as pilot in command or as a required flight crew member, but you can sit in the left seat and manipulate the controls, as long as you have a qualified pilot on board who is appropriately rated, current, and knowingly acting as pilot in command. In fact, you can LOG as pilot in command all that time that you are sole manipulator of the controls. You just can't act as PIC. There is still a possibility that the FAA will someday allow pilots who are exercising only Recreational Pilot privileges to do so without the need for a 3rd class medical.

What happens if I get caught flying without a medical?

That depends. If you hold a valid medical and just didn't have it in your possession when you flew, and can provide it to the inspector that ramp checked you, a fine and/or civil penalty will likely result. If you have been denied a medical because of a disqualifying medical condition and are caught flying, the penalty will probably be revocation of all your airman certificates and ratings. If they catch you a second time, jail time is a possibility, though a stiff fine is more likely if your certificates were revoked after the previous offense.

Special Circumstances

Although most pilots are certified without complications, there are some conditions that require extra effort before approval can be granted. Here are some situations frequently discussed with AOPA's Medical Certification Department staff.

Alcohol Use and Alcohol-Related Legal Actions

I have a "driving under the influence" (DUI) in my driving record. Is that going to be a problem?

Item 18v of the medical application asks you to report any alcohol-or drug-related motor vehicle actions. If there is only one prior DUI on your record, the FAA will not be too concerned

If you have had two alcohol-related actions within three years, or more than three in any time period, the FAA has a basis to deny your medical. You will be asked to provide copies of your driving record and any court records resulting from the driving infractions. Additional information concerning your past and current use of alcohol may also be required before your eligibility for medical certification can be determined.

Please note: Under FAR 61.15, it's required that you report alcohol-related incidents to the Civil Aviation Security Division within 60 days of each administrative action and/or conviction. This report is separate from the report on the medical application. Because each case is unique, members with questions regarding alcohol-related driving offenses are encouraged to call AOPA for information and assistance.

What happens if I don't report alcohol-related convictions on the application?

Alcohol problems are serious business to the FAA. By signing the application, you are authorizing the FAA to access the National Driver Register to cross-match your driving record against the information provided on the application. Alcohol convictions and other offenses resulting in suspension, denial, cancellation or revocation of drivers' licenses will appear on the NDR. Omitting information on the medical application can result in suspension or revocation of your airman and/or medical certificate.

Cardiovascular Problems

I fly under a special issuance medical because I had a heart valve replaced six years ago. The FAA tells me in the letters to send my records in at least 30 days prior to the expiration date to avoid a lapse. I do that, and it takes three or four months to get a new medical. What can I do to get a full year on my special issuance?

Special issuances cause a lot of delays right now because there is such a backlog in the review of these cases. Even though the letter doesn't say so, you can do your followup examination and testing up to 90 days before your current medical expires. Count back on the calendar 90 days from your expiration date and schedule your cardiology exam and testing as close to that day as possible. Once your doctor gets the reports to you, get them in the mail (preferably overnight or express mail) as soon as possible. If the FAA gets your records at least 60-75 days before expiration, you should have your new medical before the current one runs out.

Vision Problems

I didn't pass the color vision test at the examiner's office. He put a restriction on my medical that prevents me from flying at night or with color signal control. Can I get this removed?

Most aviation medical examiners use the Ishihara pseudoisochromatic color plates. People with even mild color deficiencies usually have problems passing this test. The FAA authorizes several alternative color plate tests that will substitute for the Ishihara. If you can pass one of these other tests, you meet the color vision standards and will be issued a medical certificate without any night flying restriction. Another option is to take a color signal light test at an FAA control tower. Upon successful completion of the signal light test, the FAA will issue you a waiver that will allow night flying.

My ophthalmologist has recommended a lens implant following removal of a cataract. Will I lose my certificate?

Not if the surgery enables you to again meet the vision standards for your class of medical. After the surgery, ground yourself until the ophthalmologist releases you to resume normal activities and you again meet the vision standard. Then you may return to flying. At your next medical examination, report the surgery and present a completed Report of Eye Evaluation to the AME.

My eye doctor assures me that a surgical procedure called "radial keratotomy" will enable me to throw away my "Coke bottle" lenses. What will it do to my medical?

The FAA approves refractive surgical procedures provided you have no serious complications and your visual acuity meets the medical standards for the class of medical you hold. When you are released from your doctor's care (usually 6-8 weeks after the procedure), ask your physician to complete an FAA "Report of Eye Evaluation" Form 8500-7. Take the completed form to your aviation medical examiner at your next medical exam.

Cancer

Since my last medical, I was diagnosed with cancer. How will this affect my next FAA physical?

All treatment must be completed and you should be free of any evidence of metastatic disease or in remission before attempting certification. When you go for your examination, take copies of your hospitalization records, surgical report, and discharge summary, along with a current status report from your treating physician. There are many types of cancer, and each type requires close review, but a good status report and prognosis can often result in certificate issuance.

Kidney Stones

I had a kidney stone since my last FAA exam. Will I have any problem?

A recent history of a kidney stone is disqualifying for the issuance of a medical certificate. You will need a status report from your urologist. The report should summarize your medical history, including a comment about your recent treatment for the stones. Also, a current report of either an IVP, KUB, or ultrasound indicating the absence of stones will be needed. With a favorable report, reissuance of a medical is very likely.

FAA Terminology

What is the difference between a "deferral" and a "denial"?

The medical examiner has two options if he decides not to issue your medical. If you clearly don't meet the medical standards, he can issue a denial, although most examiners prefer not to because of the paperwork required. More likely, the doctor will defer the application to Oklahoma City. The FAA will eventually issue a certificate, ask you for more information, or deny your application. If you are finally denied a medical, you should ask for reconsideration under FAR 67.409

The FAA sent me a letter stating it is "unable to establish my eligibility to hold a medical certificate." The examiner had issued my medical, so may I still use it?

The FAA is questioning something about your medical history, medications, or visits to health professionals that requires further explanation. Your medical remains valid until the FAA tells you otherwise, but you do need to provide the information requested in the letter.

The FAA has denied my application because it claims I have a "history" of angina. However, I experienced this condition only once, and that was a year ago. How can I convince the FAA that I have no "history"?

The FAA uses the term "history" to refer to any medical situation on record, regardless of the number of times experienced or the length of time since the episode(s) occurred. For example, if you check the "yes" box on the medical application because you recall one incident of "fainting" in the tenth grade, the FAA will want information about your "history" of fainting.

My medical test information was rejected because the FAA claimed it was not current. What does this mean?

The FAA usually accepts as "current" that information gathered from tests performed no more than three months before it is submitted for evaluation.


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