Wasted time

The AMCD listed two paragraphs of requests that ranged from copies of surgical records to a disability evaluation by an orthopedic specialist. All this for a “partial finger amputation.”

I wrote an email to Dr. Susan Northrup, the federal air surgeon for the FAA, incensed by this apparent overreaction. Well, not so quick. Northrup investigated the file and found that although the pilot noted the injury on his medical, his aviation medical examiner (AME) did not comment on it. This major screw-up by the AME cost the airman and the FAA unnecessary time and expense.

A partial finger amputation is usually not a significant factor for flying an aircraft. However, if the thumb is the affected finger, it may be. The thumb is critical for opposition in the hand which can affect the ability to control certain aspects of an aircraft. It is not unreasonable for the FAA to want to know about the injury. However, since the AME did not explain the injury or comment on any possible disability, the airman was subject to unnecessary questioning and the FAA wasted its time. Had the AME just stated something like “amputation of distal phalanx of index finger of non-dominant hand with no disability, injury from using unfamiliar table saw,” the issue would have been over.

Unfortunately, this is not a one-off problem. Many times, simple explanations by the AME of issues on a pilot’s medical form can prevent follow-up questions from the FAA about medical status. For instance, if a pilot checks that he has allergies, does the pilot take medication not listed on the form? If he takes a medication, is it “approved” (non-sedating)? If the pilot checks the allergy box and the AME does not comment, the FAA will ask for clarification.

Another common problem that drives the FAA crazy (and me when I hear about it) is when a pilot’s medical is deferred unnecessarily. Currently there are 20 conditions AMEs can issue (CACIs) a medical certificate for that do not require special issuance or approval from the FAA. CACIs range from asthma to testicular cancer and the pilot just needs to provide documentation to the AME that is listed on the FAA website. If the listed criteria are met, the AME can issue the medical on the spot. If the AME is not paying attention, misses that the pilot’s condition is a CACI, and sends in the medical as a deferral, all involved lose in the process.

Although mistakes like this happen more frequently with AMEs who do a minimal number of exams per year, missteps can happen to anyone. AMEs are required to undergo recurrent training every three years but remembering the intricacies of pilot medical applications may not be top priority in a busy medical practice.

For the pilot, knowledge helps and if a condition arises between medicals that may be an issue for the FAA, knowing if it is a CACI may help “remind” the AME the medical can be issued. The FAA’s Guide for Aviation Medical Examiners, which has all the rules, is available to everyone online.

A gentle statement to the AME to make sure and comment on benign conditions like a “partial finger amputation” could help prevent problems created by omitting simple data on the medical form. If the AME is unsure of what to document or to defer, asking him to call the regional flight surgeon or the Oklahoma City main office can provide clarity.

Performance data is kept on every AME, including information like medicals issued that should not have been and medicals deferred that could have been granted. AMEs have access to their records online. The regional flight surgeons are responsible for AME performance in their regions and if multiple or recurrent mistakes are made, the regional flight surgeon may recommend revocation of an AME’s designation. Revocation does not happen often, but it does happen.

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