The roadmap to quick certification
We have previously discussed how to fill out your MedXPress to reduce the amount of questions your AME may want to ask. However, there are many times when you will still need a note from your doctor about your medical conditions. Because the FAA doesn’t see you in person and doesn’t have access to your entire medical history, that note is critical. Providing a Current Detailed Clinical Progress Note that meets the FAA’s rigorous quality and content standards is vital to your speedy medical certification.
But what do you do when your doctor won’t write the note the way the FAA would like? Or what if your doctor already wrote a note and you need it updated to meet the FAA requirements and they won’t do it? Why would this happen?
Why won’t my doctor write a Current Detailed Clinical Progress Note?
We briefly discussed this in our article about Direct Primary Care Physicians. It pretty much boils down to motivation. If they have already written a note, especially one that meets the insurance payment criteria, you are asking them to do more work for no more compensation. For a very busy doctor, this can be difficult to overcome.
Even if you provide the physician with the criteria in advance, they may feel that the level of information required is not necessary. That is because they are looking at it from their point of view rather than the point of view of an independent reviewer in the FAA’s Aerospace Medical Certification Division (AMCD). From that point of view, they aren’t wrong. Not every patient encounter note needs the level of detail the FAA expects. But not every note needs to support your ability to obtain an FAA medical certificate. In these cases, if the doctor is willing to discuss the issue with us, we can usually help them understand the importance to the pilot.
What to do when your doctor won’t write the note you need for the FAA
Sometimes pilots may hit a brick wall with their physician. That doesn’t mean it is over, but it might mean it is over between you and that particular doctor. When it comes to primary care physicians, which can cover the vast majority of issues you may be dealing with, this is where we think making the switch to a Direct Primary Care (DPC) physician may be beneficial. They work directly for you and are not beholden to the insurance companies for their reimbursement. That is exactly what you need. If you think this will be a good option for you, then use the Direct Primary Care Coalition’s website to find one near you.
If you aren’t ready to make a change to primary care and you just need a one time evaluation, or your situation requires a specialist then you still have options. Independent Medical Examiners (IMEs) are physicians of varying specialties who conduct, well, independent medical exams. They have training in reviewing records and writing complete notes along with giving their medical opinion based on the combination of the records and their own exam. That can be very useful to a pilot facing a challenging FAA medical certification.
There is a downside though. Sometimes the FAA requires things that are not covered by insurance. While the FAA wants them to evaluate you, they may not be medically indicated from a treatment perspective. That generally means that insurance won’t pay for those things. Another thing that insurance won’t pay for is an independent medical exam. Rates will vary by specialty, location, and for how long it will take. If you want to find and IME you can check SEAK’s National Directory of Independent Medical Examiners and Independent Medical Examiners Directory.
If you commit to the process, you’ll likely succeed
Most of the time when a pilot’s medical certificate is denied it is because the FAA never received the information that was requested. If you are safe to fly then it is a matter of having the right documentation. Don’t let one physician who is unwilling to help be the thing that stops you from getting back in the air. We can help.