No pilot looks forward to their medical certificate application with an Aviation Medical Examiner (AME). Flight physicals are inherently stressful, but after you have completed your first one, at least you know what to expect in future. Once you have cataloged your entire medical history on a MedXPress application and successfully qualified for a FAA medical certificate, your future applications should look almost exactly the same and your experience at your AME appointment should be predictable – at least until your medical history changes.
Don’t fly when you shouldn’t
Every FAA medical certificate is printed with a reminder to abide by 14 CFR 61.53 which prohibits operating an aircraft during a “medical deficiency”. Many times, abiding by that provision is intuitive. With acute illnesses like a cold or the flu, most pilots have the common sense to stay on the ground until they recover. The same is true for acute injuries like sprained joins and broken bones.
On the other end of the spectrum, if you have recovered from a major head injury or heart attack, the FAA needs to know that before you get back in the cockpit. Between these extremes, there are hundreds of subtleties and unique situations, but some general guidelines hold.
Report self-limited conditions next time you visit at AME
For self-limited medical conditions that do not require ongoing treatment, there is no reason to make any special effort to notify the FAA between flight physicals. Just use good judgment and follow your doctor’s advice. When you both agree that you are ready to resume your normal activities, you can start flying again too. You should report the condition on your next MedXPress application, but you can do that on the same schedule as you normally would.
Common colds, orthopedic injuries, and even some hospitalizations fall into this category. If you have completely recovered, require no on-going treatment or medical follow-up, and you are not at increased risk for relapse compared to the general population, there is a good chance you can just add the condition on your next MedXPress application.
Discuss more serious conditions with an expert
For more serious conditions or ones that require ongoing treatment, it gets more complicated. You do not necessarily need to immediately report every new medication prescription or every new diagnosis. However, you should review the FAA’s list of approved medications any time you receive a new prescription and discuss any new diagnosis with someone familiar with the FAA’s medical certification process.
Using high blood pressure as one common example that many pilots will encounter, the likelihood is that you can wait until your next regularly scheduled AME appointment before you formally disclose it to the FAA. The same can be true when you start new medications for conditions the FAA already knows about or receive a new diagnosis that has little associated aviation risk.
As a general rule of thumb, if the FAA has published clear guidance to AMEs about when they can issue certificates for pilots with a given disease AND you meet those criteria, you may be able delay reporting your condition until your routine flight physical. Conditions AMEs Can Issue (CACIs) provide the most convenient examples, but there are others.
Make sure your condition falls into this category before you decide to keep flying. When in doubt, you can always schedule an AME appointment to officially add your new condition to the record and get a fresh certificate. Unless you schedule an appointment within three months of your previous exam, your AME will be able to issue your certificate. Even if you can legally wait until closer to your certificate expiration, disclosing it earlier may provide some piece of mind.
Schedule a new flight physical for more serious conditions
For anything that does not neatly fit into one of the categories above, you will need to tell the FAA about your new condition by scheduling an AME appointment. Consulting companies like Wingman Med, experienced AMEs, and AOPA may be able to provide advice, but the only way to continue flying with most chronic medical conditions is by telling the FAA about it and receiving their approval in the form of a special issuance or letter of eligibility. Flying under the sport pilot rule or Basic Med may provide some exceptions to that statement, but you can rapidly find yourself in some legal and ethical gray areas if you stray from the established rules.
The good news is that you can qualify for a medical certificate with most well controlled medical conditions. This is particularly true for pilots who have received a medical certificate in the past and develop a new condition. Unless you are diagnosed with a serious mental health condition or seizure disorder, chances are that you can still qualify for a medical certificate.
Ideally, you should schedule an AME appointment as soon as you can fly safely with your condition and have collected the right medical documentation to demonstrate that to the FAA. With the right preparation, your AME may be able to request special permission to issue you certificate directly or, if your application must be deferred to the FAA, the review process may take three months or less.
Horror stories about healthy pilots who spend 12 months or more arguing with the FAA about their medical certification are generally told by pilots who either should not be flying or have not done the due diligence to show that their medical condition is under control.
Getting back to flying as soon as possible
Even with newly diagnosed medical conditions, medical certification delay usually has much more to do with AMEs and pilots who do not know how to navigate the FAA’s medical certification process well. Many AMEs know the FAA medical standards, but do not know how to guide pilots who have a potentially disqualifying condition.
If you have a new medical condition, a free consultation with Wingman Med could help you avoid months of medical certification delay. Find out how we can keep you flying.