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Guide for Aviation Medical Examiners | Chapter 1, Page 1
GENERAL INFORMATION This chapter provides general information that is important in helping an Examiner efficiently and effectively perform his or her duties. It also describes Examiner responsibilities as the Federal Aviation Administration's (FAA) representative in medical certification matters and as the link between airmen and the FAA. 1. LEGAL RESPONSIBILITIES OF DESIGNATED AVIATION MEDICAL EXAMINERS Title 49, United States Code (U.S.C.) (Transportation), sections 109(9), 40113(a), 4701-44703, and 44709 (1994) formerly codified in the Federal Aviation Act of 1958, as amended, authorizes the FAA Administrator to delegate to qualified private persons; i.e. designated Aviation Medical Examiners (AME), matters related to the examination, testing, and inspection necessary to issue a certificate under the U.S.C. and to issue the certificate. Designated Examiners are delegated the Administrator's authority to examine applicants for airman medical certificates and to issue or deny issuance of certificates. Approximately 460,000 applications for airman medical certification are received and processed each year. The vast majority of medical examinations conducted in connection with these applications are performed by physicians in private practice who have been designated to represent the FAA for this purpose. An Examiner is a designated representative of the FAA Administrator with important duties and responsibilities. It is essential that Examiners recognize the responsibility associated with their appointment.The consequences of a negligent or wrongful certification, which would permit an unqualified person to take the controls of an aircraft, can be serious for the public, for the Government, and for the Examiner. If the examination is cursory and the Examiner fails to find a disqualifying defect that should have been discovered in the course of a thorough and careful examination, a safety hazard may be created and the Examiner may bear the responsibility for the results of such action. Of equal concern is the situation in which an Examiner deliberately fails to report a disqualifying condition either observed in the course of the examination or otherwise known to exist. In this situation, both the applicant and the Examiner in completing the application and medical report form, may be found to have committed a violation of Federal criminal law which provides that — Guide for Aviation Medical Examiners | Page 2
Cases of falsification may be subject to criminal prosecution by the Department of Justice. This is true whether the false statement is made by the applicant, the Examiner, or both. In view of the pressures sometimes placed on Examiners by their regular patients to ignore a disqualifying physical defect that the physician knows to exist, it is important that all Examiners be aware of possible consequences of such conduct. In addition, when an airman has been issued a medical certificate that should not have been issued, it is frequently necessary for the FAA to begin a legal revocation or suspension action to recover the certificate. This procedure is time consuming and costly. Furthermore, until the legal process is completed, the airman may continue to exercise the privileges of the certificate, thereby compromising aviation safety. 2. AUTHORITY OF AVIATION MEDICAL EXAMINERS The Examiner is delegated authority to:
A medical certificate issued by an Examiner is considered to be affirmed as issued unless, within 60 days after date of issuance (date of examination), it is reversed by the Federal Air Surgeon, a Regional Flight Surgeon, or the Manager, Aeromedical Certification Division, Civil Aeromedical Institute. However, if the FAA requests additional information from the applicant within 60 days after the issuance, the above-named officials have 60 days after receipt of the additional information to reverse the issuance. Guide for Aviation Medical Examiners | Page 3 3. MEDICAL CERTIFICATION DECISION MAKING After reviewing the medical history and completing the examination, the Examiner must:
The Examiner may issue a medical certificate only if the applicant meets all medical standards, including those pertaining to medical history. The Examiner may not issue a medical certificate if the applicant fails to meet specified minimum standards or demonstrates any of the findings or diagnoses described in this Guide as "disqualifying" unless the condition is unchanged or improved and the applicant presents written documentation that the FAA has evaluated the condition, found the applicant eligible for certification, and authorized Examiners to issue certificates. The Examiner must be aware that an established medical history or clinical diagnosis of any of the following is disqualifying:
An airman who is medically disqualified for any reason may be considered by the FAA for grant of an Authorization for Special Issuance of a Medical Certificate (Authorization). For medical defects, which are static or nonprogressive in nature, a Statement of Demonstrated Ability (SODA), may be granted in lieu of an Authorization. (See Item 23). Guide for Aviation Medical Examiners | Page 4 The Examiner always may defer the application to the FAA for action. In the interests of the applicant and of a responsive certification system, however, deferral is appropriate only if the standards are not met; if there is an unresolved question about the history, the findings, the standards, or agency policy; if the examination is incomplete; if further evaluation is necessary; or, if directed by the FAA. The Examiner may deny certification only when the applicant clearly does not meet the standards. 4. PRIVACY OF MEDICAL INFORMATION Within the FAA, access to an individual's medical information is strictly on a "need-to-know" basis. The safeguards of the Privacy Act apply to the application for airman medical certification and to other medical files in the FAA's possession. The FAA does not release medical information without an order from a court of competent jurisdiction, written permission from the individual to whom it applies, or, with the individual's knowledge, during litigation of matters related to certification. The FAA does, however, on request, disclose the fact that an individual holds an airman medical certificate and its class, and it may provide medical information regarding a pilot involved in an accident to the National Transportation Safety Board (NTSB) (or to a physician of the appropriate medical discipline who is retained by the NTSB) for use in aircraft accident investigation. The Examiner, as a representative of the FAA, should treat the applicant's medical certification information in accordance with the requirements of the Privacy Act. Therefore, information should not be released without the written consent of the applicant or an order from a court of competent jurisdiction. In order to ensure that release of information is proper, whenever a court order or subpoena is received by the Examiner, the appropriate Regional Flight Surgeon (see Appendix C), or the Aeromedical Certification Division, AAM-300 (see address below), should be contacted. Similarly, unless the applicant's written consent for release is of a routine nature; e.g., accompanying a standard insurance company request, advice should be sought from the FAA before releasing any information. In all cases, copies of all released information should be retained. 5. RELEASE OF INFORMATION Except in compliance with an order of a court of competent jurisdiction, or upon an applicant's written request, Examiners will not divulge or release copies of any reports prepared in connection with the examination to anyone other than the applicant or the FAA. A copy of the examination may be released to the applicant upon request. Upon receipt of a court subpoena or order, the Examiner shall notify the appropriate Regional Flight Surgeon. Other Guide for Aviation Medical Examiners | Page 5 requests for information will be referred to: MANAGER, AEROMEDICAL 6. NO "ALTERNATE" EXAMINERS DESIGNATED The Examiner is to conduct all medical examinations in the Examiner's regular office. An Examiner is not permitted to conduct examinations at a temporary address and is not permitted to name an alternate Examiner. During an Examiner's absence from the permanent office, applicants for airman medical certification shall be referred to another Examiner in the area. 7. WHO MAY BE CERTIFIED a. Age Requirements There is no age restriction or aviation experience requirements for medical certification. Any applicant who qualifies medically may be issued a Medical Certificate, FAA Form 8500-9 (white), regardless of age. Examiners also have been delegated authority to issue the combined Medical Certificate and Student Pilot Certificate, FAA Form 8420-2 (yellow), which is age restricted because it is an airman medical and student pilot certificate (student license and medical certificate). For issuance of the combined certificate, the applicant must have reached his or her 16th birthday. Minimum age requirements for the various airman certificates (i.e., pilot license certificates) are defined in 14 CFR Part 61, Certification: Pilots and Flight Instructors, as follows:
b. Language Requirements An applicant for an Airman Medical and Student Pilot Certificate must be able to read, speak, write, and understand the English language. If the Examiner believes that an applicant applying for a Medical Certificate and Student Pilot Certificate, FAA Form 8420-2 (yellow), cannot read, speak, write, and understand the English language, the applicant shall be referred to the nearest Flight Standards District Office (FSDO) for a determination of eligibility for the Student Pilot Certificate. (See Appendix E for FSDO addresses). Under these circumstances, the Guide for Aviation Medical Examiners | Page 6 Examiner may issue only a Medical Certificate, FAA Form 8500-9 (white), and the applicant must present that certificate to the FSDO when applying for a Student Pilot Certificate. 8. CLASSES OF MEDICAL CERTIFICATES The class of medical certificate for which an individual applies will be issued if the applicant possesses the required medical qualifications. Regardless of whether an applicant holds an airman certificate that permits the exercise of a high level of airman duties, it is only necessary for the applicant to have a medical certificate of a class appropriate to the airman privileges exercised. For example, an airman who holds an ATP certificate may pilot aircraft while holding only a third-class medical certificate as long as flying activities are limited to those authorized for private pilots. Also, an applicant need not hold an ATP airman certificate to be eligible for a first-class medical certificate. Listed below are the three classes of airman medical certificates and, with each, the categories of airmen requiring such a medical certificate in order to exercise their privileges. First-Class — Airline Transport Pilot. Second-Class — Commercial Pilot; Flight Engineer; Flight Navigator; or Air Traffic Control Specialist (ATCS). (Note: This category of ATCS's does not include FAA employee ATCS's.) Third-Class — Private Pilot, Recreational Pilot, or Student Pilot. Glider and Free Balloon Pilots are not required to hold a medical certificate of any class. To be issued Glider or Free Balloon Airman Certificates, the applicant must certify that he or she has no known physical defect that makes him or her unable to pilot a glider or free balloon. 9. VALIDITY OF MEDICAL CERTIFICATES A. First-Class Medical Certificate:
plus
plus
plus
plus
B. Second-Class Medical Certificate:
plus
plus
plus
C. Third-Class Medical Certificate:
plus
plus
Each medical certificate must bear the same date as the date of medical examination regardless of the date the certificate is actually issued.
10. TITLE 14 CFR § 61.53, PROHIBITION ON OPERATIONS DURING MEDICAL DEFICIENCY. ***(a) Operations that require a medical certificate. Except as Guide for Aviation Medical Examiners | Page 8 provided for in paragraph (b) of this section, a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person: (1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or (2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation. (b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner. 11. REEXAMINATION OF AN AIRMAN A medical certificate holder may be required to undergo a reexamination at any time if, in the opinion of the Federal Air Surgeon or authorized representative within the FAA, there is a reasonable basis to question the airman's ability to meet the medical standards. An Examiner may NOT order such reexamination. 12. EXAMINATION FEES The FAA does not establish fees to be charged by Examiners for the medical examination of persons applying for airman medical certification. It is recommended that the fee be the usual and customary fee established by other physicians in the same general locality for similar services. 13. REPLACEMENT OF MEDICAL CERTIFICATES Medical certificates that are lost or accidentally destroyed may be replaced upon proper application provided such certificates have not expired. The request should be sent to: MANAGER, AEROMEDICAL The airman's request for replacement must be accompanied by a remittance of two dollars ($2) made payable to the FAA. This request must include:
The replacement certificate will be prepared in the same manner as the missing certificate and will bear the same date of examination regardless of when it is issued. In an emergency, contact the Manager, Aeromedical Certification Division, AAM-300, at above address or by facsimile at 405-954-3231 for certification verification only. 14. DISPOSITION OF APPLICATIONS AND MEDICAL EXAMINATIONS All completed applications and medical examinations, unless otherwise directed by the FAA, must be transmitted electronically in a timely manner to the Aeromedical Certification Division. In addition, the FAA/Original Copy must be mailed to: MANAGER, AEROMEDICAL These may be batch mailed at monthly intervals. All incomplete applications and medical examinations must be mailed immediately to the above address. The AME Work Copy must be retained as the file copy. The Applicant's Copy (last page) must be given to the applicant along with the Information for Applicant and the instruction sheet. Examiners not required to use the AMCS; e.g., International AME's, must forward the typed, completed FAA/Original Copy to the above address. Applications awaiting additional information prior to submission to the FAA should not be held by the Examiner for more than 2 weeks. 15. PROTECTION AND DESTRUCTION OF FORMS Examiners are cautioned to provide adequate security for blank medical application and certificate forms to ensure that they do not become available for illegal use. When the FAA issues new or revised medical forms and certificates, the FAA will advise Examiners of the disposition of the old forms and certificates. The serial numbers of FAA Form 8500-8 assigned to each Examiner are recorded at the Civil Aeromedical Institute in Oklahoma City. If asked, the Examiner should be prepared to account for the forms. Forms should not be shared with other Examiners. Guide for Aviation Medical Examiners | Page 10 16. QUESTIONS OR REQUESTS FOR ASSISTANCE When an Examiner has a question or needs assistance in carrying out responsibilities, the Examiner should contact one of the following individuals:
These inquiries should be made to: MANAGER, AEROMEDICAL c. Manager, Aeromedical Education Division, AAM-400
These inquiries should be made to: MANAGER, AEROMEDICAL Guide for Aviation Medical Examiners | Page 11 17. AIRMAN APPEALS a. Request for Reconsideration An Examiner's denial of a medical certificate is not a final FAA denial. An applicant may ask for reconsideration of an Examiner's denial by submitting a request in writing to: FEDERAL AIR SURGEON The Manager of the Aeromedical Certification Division will provide initial reconsideration. Some cases may be referred to the appropriate Regional Flight Surgeon for action. If the Manager of the Aeromedical Certification Division or a Regional Flight Surgeon finds that the applicant is not qualified, the applicant is denied and advised of further reconsideration and appeal procedures. These may include reconsideration by the Federal Air Surgeon and/or petition for NTSB review.
At the discretion of the Federal Air Surgeon, an Authorization for Special Issuance of a Medical Certificate (Authorization); i.e., a waiver, valid for a specified period, may be granted to a person who does not meet the established medical standards if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force. The Federal Air Surgeon may authorize a special medical flight test, practical test, or medical evaluation for this purpose. A medical certificate of the appropriate class may be issued to a person who does not meet the established medical standards if that person possesses a valid Authorization and is otherwise eligible. An airman medical certificate issued in accordance with the special issuance section of Part 67 (14 CFR 67.401), shall expire no later than the end of the validity period or upon the withdrawal of the Authorization upon which it is based. At the end of its specified validity period, for grant of a new Authorization, the person must again show to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force. In granting an Authorization, the Federal Air Surgeon may consider the person's operational experience and any medical facts that may affect the ability of the person to perform airman duties including:
In granting an Authorization the Federal Air Surgeon specifies the class of medical certificate authorized to be issued and may do any or all of the following:
An Authorization granted to a person who does not meet the applicable medical standards of Part 67 may be withdrawn, at the discretion of the Federal Air Surgeon, at any time if:
A person who has been granted an Authorization under the special issuance section of Part 67 (14 CFR 67.401), based on a special medical flight or practical test, need not take the test again during later medical examinations unless the Federal Air Surgeon determines or has reason to believe that the Guide for Aviation Medical Examiners | Page 13 physical deficiency has or may have degraded to a degree to require another special medical flight test or practical test. The authority of the Federal Air Surgeon under the special issuance section of Part 67 (14 CFR 67.401) is also exercised by the Manager, Aeromedical Certification Division, and each Regional Flight Surgeon. If an Authorization is withdrawn at any time, the following procedures apply:
c. Statement of Demonstrated Ability (SODA) At the discretion of the Federal Air Surgeon, a Statement of Demonstrated Ability (SODA); i.e., a waiver, may be granted, instead of an Authorization, to a person whose disqualifying condition is static or nonprogressive and who has been found capable of performing airman duties without endangering public safety. A SODA does not expire and authorizes a designated Examiner to issue a medical certificate of a specified class if the Examiner finds that the condition described on the SODA has not adversely changed. In granting a SODA, the Federal Air Surgeon may consider the person's operational experience and any medical facts that may affect the ability of the person to perform airman duties including:
In granting a SODA under the special issuance section of Part 67 (14 CFR 67.401), the Federal Air Surgeon specifies the class of medical certificate authorized to be issued and may do any of the following: Guide for Aviation Medical Examiners | Page 14
A SODA granted to a person who does not meet the applicable standards of Part 67 may be withdrawn, at the discretion of the Federal Air Surgeon, at any time if:
The authority of the Federal Air Surgeon under the special issuance section of Part 67 (14 CFR 67.401) is also exercised by the Manager, Aeromedical Certification Division, and each Regional Flight Surgeon. Guide for Aviation Medical Examiners | Page 15 If a SODA is withdrawn at any time, the following procedures apply:
Within 60 days after a final FAA denial of a medical certificate, an airman may petition the NTSB for a review. A petition for NTSB review must be submitted in writing to: NATIONAL TRANSPORTATION The NTSB is an independent agency of the Federal Government that has the authority to review on appeal the suspension, amendment, modification, revocation, or denial of any certificate or license issued by the FAA Administrator. An Administrative Law Judge (ALJ) for the NTSB may hold a formal hearing at which the FAA will present documentary evidence and testimony by medical specialists supporting the denial decision. The petitioner will also be given an opportunity to present evidence and testimony at the hearing. The ALJ's decision is subject to review by the full NTSB. END OF CHAPTER 1 | AME GUIDE AME GUIDE Table of Contents | Index | Chapter 1 2 3 4
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