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Answers for Pilots: Airman Medical Certification - What's Changed?

Perhaps you’ve held an airman medical certificate for a couple of decades, but you haven’t been flying lately and your medical certificate lapsed several years ago. However, your daughter has caught the flying bug and her excitement is contagious! As you talk with her about flying, the conversation turns to obtaining a medical certificate. You describe the form and the process as you remember it. She tells you it’s all different now and shows you the MedXpress Web site, catching you by surprise. The paper form is no longer used – all airmen must apply online now. That’s not all that’s changed over recent years. In addition to MedXpress, there is now CACI (Conditions an AME Can Issue), a new schedule for medication dosing, and movement on third class medical reform. Here’s the scoop.

MedXpress replaced the paper 8500-8 form on October 1, 2012. You are not the only one with a lapsed medical certificate who has been caught by surprise! All applications for airman medical certification must be completed online using this system. There are no exceptions, no workarounds, no other ways to apply. The form, itself, though digital rather than paper, is identical to the previous application. Once you have created an account with the FAA, you complete the 8500-8 online and answer the questions in the same way as you completed it on paper in years past. The FAA provides a good user guide on its web site, which is very helpful for first time users. It walks you through the entire application process, explaining each of the steps. You can save the form during the process if you are interrupted or need to gather some information, and come back to it at a later time. When you’ve finished the application,  click the “Submit” button and your application is filed. Once that is done, find the “Exam Summary” button and click to print a copy of the application – your confirmation number is at the bottom of that page. Take that hard copy with you to your AME appointment. The confirmation number is all the AME will need to access your medical application in the system and complete the process.

CACI – “Conditions AMEs Can Issue” –is a relatively new procedure that will allow your aviation medical examiner (AME) to issue your medical certificate in the office for certain medical conditions that previously required a special issuance authorization. The CACI conditions are arthritis, asthma, glaucoma, chronic hepatitis C, hypothyroidism, migraine and chronic headache, pre-diabetes conditions, and renal cancer. These conditions are now considered low-risk and AMEs have a specific medical evaluation worksheet that you must have completed by your treating physician and bring to the AME at the time of your medical exam. If all the requirements specified in the worksheet are met, the AME may issue you a medical certificate without calling the FAA for verbal or written permission. Links to the worksheets are provided on AOPA’s web site on the pages discussing the CACI conditions.

Medication Dosing
While the Federal Aviation Regulations (FARs) do not maintain a list of disqualified medications, the guidance is clear that medication usage cannot result in the person being unable to meet the requirements of the medical certificate he or she holds or affect the person in any way contrary to safety. AOPA has developed a sizeable database of drugs – both allowed and disqualified – that is based on the most current information provided by the FAA. For those medications that are acceptable, the dosing interval has changed recently. While the dosing interval used to be two or three times the interval, pilots are now required to wait five times the interval after the last dose before flying. For example, if the dosing instructions say, “Take every four hours for pain,” pilots must wait 20 hours after the last dose before flying. This allows enough time for the drug to reach its expected half-life, the time after ingestion when a medication’s effectiveness is reduced by 50%.

3rd Class Medical Reform Update
The FAA has sent a proposal to reform the third class medical certification process to the Department of Transportation for review, according to a recent announcement made by FAA Administrator Michael Huerta at EAA’s AirVenture. Huerta said the FAA has heard the general aviation community “loud and clear” on the need for reform. The proposed rulemaking must be vetted by both the Department of Transportation and the White House Office of Management and Budget before details of the rule can be revealed and opened for public comment. AOPA is continuing to work daily with Congress on moving the General Aviation Pilot Protection Act (GAPPA) forward.  There are currently 129 House and 17 Senate co-sponsors of the GAPPA legislation. AOPA advocacy staff will continue to leverage every available opportunity to keep pressure on the FAA and will not let up until rulemaking is completed or the legislation is signed into law.

AOPA President Mark Baker weighed in with comments. “While we acknowledge that rulemaking is moving through the normal FAA process, the path toward reform has been far too slow,” he said. “We have 10 years of data proving that pilots can fly safely without going through the costly and time-consuming process of getting a third class medical certificate. AOPA will continue working closely with Congress to keep up the pressure and get this done. This issue is too important to our members and the entire aviation community to let it get bogged down in bureaucracy.”

Look for additional information on airman medical certification in an upcoming webinar, a short video, and a podcast – all brought to you by AOPA Pilot Protection Services. And, feel free to give the aviation medical specialists a call, Monday through Friday, 8:30 a.m. to 6:00 p.m. Eastern Time, 800-USA-AOPA (872-2672).

Kathy Dondzila
Kathleen Dondzila King
Manager, Technical Communications, Pilot Information Center
Technical Communications Manager, Kathleen Dondzila King, joined AOPA in 1990 and is an instrument-rated private pilot.
Topics: Pilot Health and Medical Certification, Advocacy, Pilot Protection Services

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