The FAA denied 75 first-class
medicals in 1997, according to Warren Silberman, M.D., manager of the Aeromedical
Certification Division of the FAA in Oklahoma City. That represents less than one
percent of the 185,894 first-class medical applications received that year. But it
represents the loss of livelihood for those 75 individuals. The statistics also
don't tell the story of those pilots snatched from the jaws of rejection or jeopardy due
to a special issuance of a medical certificate despite a disqualifying condition.
The most prevalent disqualifying conditions among the 75
denials in 1997 were (in the order of most frequent to least:: coronary heart disease,
certain psychiatric conditions requiring medication, high blood pressure/on medication,
various forms of neurosis and alcohol-related offenses. Some pilots have more than
one disqualifying condition, Dr. Silberman said.
But no matter how final it sounds, a rejection letter from
the FAA does not have to mean the end of your career as a pilot. If you have been
disqualified for a medical certificate, you have two courses of action: (1) prove that you
do not have the medical condition with which you've been diagnoses or (2) apply for
In other words, don't give up. Lots of support is
available from experts who want to get pilots back into the air.
Special Issuance of Medical Certificates
Part 67.401 of the medical regulations (paragraph 67.401),
called "Special Issuance of Medical Certificates" gives the Federal Air Surgeon
the authority to certify essentially every medical problem- even mandatory denials -
"if it can be proven with factual medical data that the pilot is safe to fly in the
type of aircraft and position for which the pilot is applying.
If you can prove that your medical disorder is an
acceptable risk now and in the next six to 12 months, then no matter what the problem is,
the Federal Air Surgeon can consider certifying you. But the responsibility of
proving you are fit to fly is yours.
You must take the initiative and appeal the denial of your
medical and pursue special issuance from the Federal Air Surgeon in Washington, D.C.
You will have to collect medical records and documentation so that your case can be
reviewed for special issuance or reconsideration by the Federal Air Surgeon or by the
FAA's doctors in Oklahoma City.
In 1997, the agency authorized 6,867 special issuance
medicals-993 after initial request or appeal and 5,874 by recertification....
...Helpers Along the Way
The road to a special issuance can be smoothed by the AME
and several of the aviation trade associations that offer consultative or preventive pilot
advocate services. Federal Air Surgeon Jon L. Jordan, M.D., J.D. feels such services
"are good for the agency as well as the airman." He explained that when a
pilot's medical is in jeopardy, a good pilot advocate can cut down on communication
barriers. "Effective advocates are timesavers for the agency and the pilot, and
have improved our relationship with the pilot community."
When we asked Dr. Jordan if pilot advocates should have
special credentials, he said they should have knowledge of aviation medicine and FAA
policies and practices. "They don't all have to be AME's," he advised. He
noted that a pilot could choose someone who specializes in a particular medical problem
and knows how to work with the FAA regarding that medical problem...
Practice for Your Medical
Mandatory Initial Denials
FAA will deny medical certification if a pilot has one of the following medical
conditions (However, if you do have one or more of these conditions, you may still may be
eligible for an FAA special issuance medical certificate.):
(1) Severe personality disorder.
(3) A bipolar disorder.
(4) Substance dependence (alcoholism or other chemical dependency).
(5) Substance abuse.
of consciousness without satisfactory medical explanation of the cause.
(8) Transient loss of control of the nervous system function
without satisfactory medical explanation of the cause.
(9) Myocardial infarction.
(10) Angina pectoris.
(11) Coronary heart disease.
(12) Cardiac valve replacement.
(13) Permanent cardiac pacemaker implantation.
(14) Heart replacement.
Just as rehearsals are good for show business, they also
can be valuable in the medical certification process. Pilot Medical
Solutions of Tulsa has a new medical protection program that pre-qualifies pilots
before they apply for their medical certificates. "Our program is confidential
and preventive," said David Hale, the director of the company, who is also a pilot.
By allowing pilots to take a practice FAA medical, "it virtually eliminates
premature applications often containing negative data that AME's are required to forward
to the FAA for a pilot's permanent record."
A Medical Protection membership from Pilot Medical
Solutions costs $75 per year. A discounted retainer arrangement-not to
exceed $450-is available for members who have a disqualifying medical condition and want
Hale to consult with them on resolving the paperwork.
What happens if you don't pass the pre-qualification
test? Hale works with your primary physician first, and he will "coach"
you by providing you with a regimen for success, often including an exercise or nutrition
prescription. "Most pilots who fail the pre-test will qualify by finding a
medication the FAA will approve of by making lifestyle changes," Hale explained.
In addition to the preventive part of the business, Pilot
Medical Solutions has been offering a Flight Fitness Program since 1996 for
special issuance clients. To expedite FAA approval, the company retrieves, reviews,
organizes and submits pilot records. Neil Hauft, an ATP who lives near Los Angeles,
credits the company with pulling his medical out of the fire. "Most important to me
was Hale's knowledge of FAA/AME evaluation protocols. That was invaluable."
After Hauft had five-way bypass surgery, Hale developed a comprehensive cardiac
strengthening program for him. Hauft worked up from a walking program to running
five to six days a week.
"With Hale's assistance, I aced the examination and
presented the FAA with all the required test data, lab results and medical records,"
he said. Then, 18 days after submitting the data, "I received the FAA's
unrestricted clearance and a new medical certificate."
Pilot Medical Solutions consulting fees
are $500 at the onset as a retainer and $500 when certification is assured. Call
The Final Word on Advocates
Some AME's advertise as advocates, Dr. Jordan said, and the
agency has no problem with that "as long as everybody is above board and provides
complete disclosure of their findings. Problems will arise only if they try to
circumvent the FAA." So, grab all the qualified help you can get.-BCA