FAA eases burden for many pilots with ADHD history

The new guidance from the FAA to aviation medical examiners now identifies certain histories of ADHD diagnosis and/or medication usage for which AMEs can issue medical certificates. Virtually all applications for a medical certificate (FAA Form 8500-8, also known as MedXPress) that included any ADHD history previously required an extensive, expensive, and time-consuming review process typically handled by FAA staff in Washington, D.C.

AOPA for many years has advocated for a more practical and reasonable approach to medical certification, including ADHD reform and also with BasicMed. More than 80,000 pilots have now qualified for BasicMed privileges since the program's inception in 2017. AOPA also continues to educate pilots about the medical certification process, providing pilots with information and advice that can reduce the waiting time for a medical certificate to be issued.

The new FAA guidance to AMEs recognizes that not all applicants who report a history of ADHD diagnosis or treatment with medications necessarily require the extensive evaluation that previously applied to anyone reporting that history on the medical certificate application. This is the result of a comprehensive review of literature by the FAA as well as case history experience from the large number of applications submitted to the FAA over the past few years.

The guidance also includes key documents to assist the applicant and the AME in determining if a medical certificate can be issued at the time of examination rather than being deferred to the FAA for further review. The key elements include all of the following:

• No treatment or use of ADHD meds for any reason in the past four years.
• No symptoms in the past four years.
• Detailed records showing no instability in academic, occupational, or social functioning within the past four years, and no other psychiatric conditions or diagnosis.

If an applicant doesn’t meet those specific criteria, the case will still be deferred by the AME to the FAA for evaluation using the existing protocol that requires psychological and neuropsychological evaluation to identify the presence of “aeromedically significant” ADHD. For the standard track, ADHD medications must be discontinued for 90 days prior to the required evaluations that include evaluation by a Human Intervention Motivation Study psychologist or HIMS neuropsychologist. These reviews will take months as most cases are evaluated by the FAA in Washington.

With the new procedures in place, many applicants who meet the qualifications for the immediate issuance will save thousands of dollars and many months of waiting for a response. This change represents the FAA’s ongoing commitment to finding the proper balance between aviation safety and providing as many people as possible the opportunity to fly. The process is bureaucratic to be sure, and it does take time and money in many situations, but persistence and patience will pay off in the majority of cases.