Fly Well: Denied

But like many risks in aviation, there are mitigating steps one can take to reduce one’s chances of walking out of the AME’s office without a medical certificate in hand. To put things in perspective, out of 450,000 annual medical applications, fewer than 400 are denied and 98 percent of those are ultimately granted.

Each time I visit a doctor or other health care provider, I keep a note on my smartphone and back it up in the cloud, noting who saw me, when, why, and what was done. I also obtain any documents I might need. For instance, when I saw an ophthalmologist for a “floater” I made sure I had the FAA Eye Form 8500-7 all signed, sealed, and delivered, ready to hand over. Failure to have papers to hand causes numerous unnecessary delays. Complete the FAA MedXPress application ahead of time and prepare any necessary documentation for reported conditions.

Should my doctor find a squawk, it would be good to have time to fix it before my medical expires, so I don’t make the appointment at the end of the month my medical expires. If you have your own airplane, you may time its annual at the same time as your own inspection to minimize time lost aloft.

You may also help yourself by having your blood pressure checked twice a year and staying on top of any screening tests such as colonoscopy; preemptive interventions are far less likely to interfere with your flying than waiting for disease to declare itself. Prior to your visit have an eye exam, and you can even take proactive steps such as checking your hearing with an online test, and buying urine dipsticks to ensure there is no mischief lurking in your kidneys, ureter, bladder, or elsewhere. Achieving and maintaining a healthy weight, exercising, and eating good food minimize many health conditions that could endanger your flying and your life.

If your AME issues a certificate but the FAA follows up with a request for “additional information,” under no circumstances ignore that letter. If you do, your application will be denied and the FAA will request that you surrender your medical certificate because of your failure to provide requested information within the time frame specified. Only send what the FAA asks for, but send everything it asks for, and, of course, if you are having problems pulling information together, inform the FAA as it might grant an extension.

The most common reasons for a denial are quite predictable: heart attacks or other cardiac disease, stroke or transient ischemic attacks, two manifestations of disturbed blood flow to the brain. However, after recovery, a suitable and safe time interval, submission of important documentation, and review, one can return to the left seat after resolution of the administrative reason for denial. Less easy to understand are denials because of taking nonallowed medications. It astounds me that this last reason continues to be a problem given how often we write about it and the wide availability of resources to advise pilots and their doctors about which drugs to avoid.

We receive a lot of communication about this topic. Helping aviators deal with aeromedical issues is a prime directive of Pilot Protection Services, so you may want to consider joining. I am a member.

Inefficiency of this area of the FAA is one of the main reasons AOPA has fought so hard for third class medical reform. Delays in processing deferred medical applications may actually create a more serious safety issue than the medical condition the FAA is reviewing, as time while grounded erodes pilot proficiency and competency. If you are experiencing tardiness obtaining responses from the FAA, you might try your regional FAA medical office as staff there are often able to pull your case from the queue and work it locally if it is not too complicated. You can locate the contact information for your region online (http://tinyurl.com/FAAmedoffices).

A denial of a medical certificate based upon an application that indicates a disqualifying condition is not final in the eyes of the FAA. If at any time in the future you can provide sufficient medical information about your condition to the FAA, your case can be reevaluated and, if found eligible, a medical can be issued under a special issuance authorization. Stay well, plan your medical well, and fly well.

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Dr. Jonathan Sackier answers AOPA members’ medical questions through the AOPA Pilot Protection Services program.