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Guest Editorial: Reach out

The office of aerospace medicine and you

By Susan Northrup, Federal Air Surgeon

I recently saw a social media post in which an airman complained about how difficult it was to get a special medical authorization in 2007 (yes, 13.5 years ago), which he subsequently never renewed.

In 2017, he resumed flying under BasicMed and now believes he deserves an apology from the FAA for making things so hard.

Sadly, he grounded himself for nine years when he had options.

I have communicated with thousands of aviators during my career at the FAA—whether in person at fly-in events, or by phone or email. Regardless of the forum, I always listen. I understand it can be particularly challenging to get the special authorization, especially if you have never done it before. Depending on the conditions, subsequent renewals can be equally difficult, although it typically gets easier.

Regardless of your situation, you can take a few steps to help yourself:

  • Get smart about the requirements. The FAA’s Guide for Aviation Medical Examiners is on
  • Review your medical documentation closely to make sure the information is thorough and accurate. We read everything closely.
  • Make sure every page is legible and contains at least your name and a date. All letters from health care providers must be signed. Clinical notes may be attached without signatures.
  • Ensure that each item we asked for is in the package you send to the FAA.
  • Make sure your contact details are correct in our system and on your paperwork. I can’t begin to tell you how many times I could have solved an issue with a phone call but was forced to write a letter because the phone number on file for the airman was no good.
  • Keep a copy of everything you send. Mail and even FedEx packages can go astray or be misdelivered.
  • Finally, consider enlisting the services of AOPA, the Experimental Aircraft Association, an aviation medical examiner, or other pilot advocate if you have a complicated case. Should you need a limited extension, contact the Airman Medical Certification Division or your regional flight surgeon’s office.

The FAA’s Office of Aerospace Medicine has changed for the better in the past decade, and we aren’t finished yet. We met with external stakeholders, including AOPA, in November 2020 to seek input on additional ways to better serve the aviation community. All the participants agreed that better communication is vital.

We recently published the Federal Air Surgeon’s Medical Bulletin, the first in a couple of years, and we are developing microlearning for airmen that will discuss various items of interest in minute-long segments. We are rewriting our letter templates to more clearly tell airmen what we need to address their cases, and we are developing an electronic method for submitting medical documentation directly and securely.

Meanwhile, we reduced the scanning backlog to less than a week. Hopefully, this will reduce the incidence of letters crossing in the mail. We continue to evaluate additional conditions suitable for an AME Assisted Special Issuance (AASI) or Condition an AME Can Issue (CACI). Finally, we are working on a system that eventually will enable each applicant to track the progress of a case electronically.

What about the airman I mentioned at the beginning of this column? I looked him up. He was appropriately deferred by his AME under the policy in place in 2007. However, he was ultimately granted an AASI after he provided a lab value and a clinical summary from his doctor. We would have released him from the AASI in 2012 if nothing had changed. (In 2013, the airman’s condition became one of those that AMEs can now issue without FAA review.)

The unfortunate part of this whole event is that the airman apparently never sought assistance from AOPA, EAA, or several other organizations that could have helped him. The result: He grounded himself unnecessarily for years.

Don’t let this happen to you. Of the typical 385,000 applications for airman medical certificates per year (2020 was down slightly), only 10 percent end up with a special issuance. One percent encounter an initial denial, most for failure to provide information or self-removal from consideration. Less than 0.1 percent of all cases result in a final denial once all requested materials are provided.

Reach out.

The FAA’s Office of Aerospace Medicine is committed to public outreach and education, including columns like this. You can expect to hear from us more regularly.

Fly safe!

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