FAA Medical with Past Anxiety       

  • ON May 05, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Obtaining your FAA medical with past anxiety is not impossible. If you are like a lot of people, you may have had anxiety at one point or another in your life. If your history of anxiety was limited to a short period of time, achieving medical certification with the FAA may be relatively straight forward. If your anxiety involved a more involved clinical presentation, medical certification is still not out of the question. Typically, whether you can obtain your FAA medical with past anxiety comes down to the level of risk for recurrence of symptoms.

If your anxiety was limited in time, you responded well to medication treatment (if any), and medication was discontinued, the required elements for treatment may be relatively simple. The FAA will likely want to review your previous treatment records, as well as a letter from your current physician regarding your status. Many times, a psychiatric evaluation can help alleviate any concerns the FAA may have regarding your current status and even facilitate a faster disposition regarding your medical certification. Be careful submitting medical records to the FAA! Always make sure you know everything that is in your records and how that information may affect the FAA’s review of your file.

A history of anxiety, when mixed with other clinical concerns, such as panic attacks, psychiatric hospitalizations, and/or other diagnoses such as major depressive disorder, will almost always warrant an evaluation by a psychiatrist. A psychiatric evaluation can give the FAA better insight as to whether the clinical picture presented in your treatment records will present a risk for recurrence of symptoms now or in the future. Ultimately, the more severe your symptoms were at the time of treatment, the more concerned the FAA will be relative to the risk for recurrence of symptoms. With a psychiatric evaluation, and in some cases, a neuropsychological evaluation, you have the ability to provide the FAA with a better perspective on the aeromedical significance of your past anxiety, as well as your current, aeromedical risk.

Why involve a FAA attorney in your FAA medical application? Despite what you may hear from your AME, the medical certification process is more so a legal process than a medical process. Ensuring that your doctor is developing the proper documentation regarding your past anxiety, as needed, can be a difficult task. To that end, everything that is submitted to the FAA (i.e. records, statements, evaluations, etc.) goes into your airman medical file. This file is what the FAA then utilizes to evaluate whether you are eligible to hold a medical certificate. If you are later denied and wish to appeal that denial, your airman medical file becomes “Exhibit A” before the NTSB or upon reconsideration by the Federal Air Surgeon. So, a FAA attorney can evaluate your records, prepare a plan for best presentation of your case to the AME or FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal. Furthermore, if your medical documentation is as strong as possible upon initial submission, in doing so, hopefully, you will avoid unnecessary delay. Also, if you have failed to report your past anxiety on your FAA medical application, a FAA attorney can give you counsel on how to rectify your omission.

If you are concerned about reporting your past anxiety to the FAA, call the FAA attorneys at The Ison Law Firm. We are happy to evaluate your case and discuss with you a plan for presenting your case to your AME or the FAA. Aviation law is all we do. Nothing else.

 

FAA Medical and VA Disability Benefits

  • ON Jan 17, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Do you have questions regarding your FAA medical and VA disability benefits? A frequent question asked of our firm is whether an applicant for FAA medical certification needs to report his or her receipt of VA disability benefits to the FAA. There seems to be a good deal of confusion, somewhat caused by the Department of Veteran’s Affairs, as to whether disability benefits are reportable. Question 18y., which specifically asks whether in the applicant’s lifetime he or she has received “medical disability benefits,” can be a bit confusing. Many veterans consider their VA disability benefits to be compensation for their service, rather than a disability.  The FAA’s position, however, is that VA disability benefits are reportable on question 18y. on Form 8500-8, the application for airman medical certification.

Reporting your VA disability benefits on your FAA medical application does not have to result in the denial of your application. Some, if not most, medical conditions for which veterans receive compensation are not conditions which are aeromedically significant. Whereas some conditions, such as post-traumatic stress disorder (“PTSD”), traumatic brain injury (“TBI”), and obstructive sleep apnea (“OSA”), may warrant further evaluation by the FAA, even those conditions, in many situations, can be overcome to establish an airman’s eligibility for FAA medical certification.

If you have failed to report your VA disability benefits on your FAA medical application, you need to act immediately. In the event the FAA or the VA discovers your failure to report your VA benefits, as required, the FAA could take action to revoke your airman certificate(s), as well as your medical certificate. In rarer cases, there may be criminal action which can be pursued against you for failure to appropriately report your VA disability benefits on your FAA medical application. Fortunately, the FAA’s sanction guidelines provide an opportunity to take corrective action, which frequently avoids action for alleged “intentional falsification” and limits the FAA’s inquiry to your eligibility to hold a medical certificate.

Why involve a FAA attorney in your FAA medical application? Despite what you may hear from your AME, the medical certification process is more so a legal process than a medical process. Ensuring that your doctor is developing the proper documentation regarding your VA disability benefits, as needed, can be a difficult task. To that end, everything that is submitted to the FAA (i.e. records, statements, evaluations, etc.) goes into your airman medical file. This file is what the FAA then utilizes to evaluate whether you are eligible to hold a medical certificate. If you are later denied and wish to appeal that denial, your airman medical file becomes “Exhibit A” before the NTSB or upon reconsideration by the Federal Air Surgeon. So, a FAA attorney can evaluate your records, prepare a plan for best presentation of your case to the AME or FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal. Furthermore, if your medical documentation is as strong as possible upon initial submission, in doing so, hopefully, you will avoid unnecessary delay. Also, if you have failed to report your VA disability benefits on your FAA medical application, a FAA attorney can give you counsel on how to rectify your omission.

If you are concerned about your FAA medical and VA disability benefits, call the FAA attorneys at The Ison Law Firm. We are happy to evaluate your case and discuss with you a plan for presenting your case to your AME or the FAA. Aviation law is all we do. Nothing else.

FAA Medical Certificate and Benign Prostatic Hyperplasia

Do you have questions regarding your FAA medical certificate and benign prostatic hyperplasia? Benign prostatic hyperplasia, or enlargement of the prostate, is a common condition that airmen experience. Fortunately, benign prostatic hyperplasia does not have to be a roadblock to your FAA medical certificate. Specifically, the FAA has identified a relatively straightforward process for achieving FAA medical certification following a diagnosis and treatment for benign prostatic hyperplasia.

If you are reporting benign prostatic hyperplasia on your FAA medical application, your Aviation Medical Examiner (“AME”) is authorized to issue you a medical certificate, without the need to defer your application, if you have findings consistent with uncomplicated benign prostatic hyperplasia and there is no evidence of prostate cancer. Most treatments for benign prostatic hyperplasia, such as alpha blockers, are not disqualifying and your AME should issue your certificate if you are found to be otherwise qualified. Medications for benign prostatic hyperplasia are disqualifying if you are taking them for any other condition such as pulmonary arterial hypertension. Furthermore, nitrates are disqualifying. Medications such as Cialis, Levitra, Staxyn, Stendra, and Viagra are approved by the FAA for treatment of benign prostatic hyperplasia, with certain mandatory wait times before flying.

Why involve a FAA attorney in your FAA medical application? Despite what you may hear from your AME, the medical certification process is more so a legal process than a medical process. Ensuring that your doctor is developing the proper documentation regarding your history of benign prostatic hyperplasia, as well as your treatment, if any, can be a delicate process. To that end, everything that is submitted to the FAA (i.e. records, statements, evaluations, etc.) goes into your airman medical file. This file is what the FAA then utilizes to evaluate whether you are eligible to hold a medical certificate. If you are later denied and wish to appeal that denial, your airman medical file becomes “Exhibit A” before the NTSB or upon reconsideration by the Federal Air Surgeon. So, a FAA attorney can evaluate your records, prepare a plan for best presentation of your case to the AME or FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal. Furthermore, if your medical documentation is as strong as possible upon initial submission, in doing so, hopefully, you will avoid unnecessary delay.

If you are concerned about your FAA medical and benign prostatic hyperplasia, call the FAA attorneys at The Ison Law Firm. We are happy to evaluate your case and discuss with you a plan for presenting your case to your AME or the FAA. Aviation law is all we do. Nothing else.

 

FAA Medical and Prostate Cancer

  • ON Jan 14, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Do you have questions regarding your FAA medical and prostate cancer? The process to obtain or re-obtain your FAA medical certificate following prostate cancer will depend upon the status of your condition, as well as whether the cancer was/is metastatic or recurring. Fortunately, there are many pathways to FAA medical certification following prostate cancer, some easier than others, but most can be successful. Here, we will walk you through the various pathways the FAA concerns for prostate cancer.

First, there must be a discussion between the difference of a regularly issued, FAA medical certificate, a FAA medical certificate subject to a CACI review, and a FAA medical certificate subject to a special issuance authorization.

Regularly Issued FAA Medical Certificate: this is the type of FAA medical certificate that everyone hopes to achieve. A regularly issued FAA medical certificate is where your Aviation Medical Examiner (“AME”) issues you your certificate in the office, following routine examination. This type of medical certificate requires very little effort from you, as far as gathering records and letter(s) from your doctor.

FAA Medical Certificate Subject to a CACI Review: “CACI” stands for Conditions AME Can Issue. CACI conditions are certain conditions which the FAA has identified as being less aeromedically significant, in that FAA authorizes the AME to evaluate certain criteria to determine whether issuance is acceptable. If the AME evaluates the criteria outlined for the relevant condition and feels that you do not meet the criteria outlined by the FAA, the AME must defer the application to the FAA for a decision. A medical certificate can even be issued under the CACI program even on your first application for the qualifying, CACI condition.

FAA Medical Certificate Subject to a Special Issuance Authorization: a special issuance authorization essentially works as a waiver. When the FAA finds that you are not eligible to hold a medical certificate, the Federal Air Surgeon (or his/her agents) may still consider you “safe to fly” pending you demonstrate ongoing stability with your condition. Once a special issuance is authorized by the Federal Air Surgeon, your AME may issue you a medical certificate. If your situation dictates the need for a special issuance authorization, your file will unfortunately undertake a time-consuming review by the FAA.

Now, where does prostate cancer fold into all of this? Prostate cancer is a condition which can result in one of these three outcomes (perhaps a fourth if you consider straight-out denial of your application). As to which category your FAA medical will fall and what you will have to demonstrate to the FAA will depend upon your case history and current status. The following outlines what you can expect, based on your history.

Prostate Cancer, Non-Metastatic, Treatment Completed 5 or More Years Ago: if your prostate cancer was not metastatic (meaning the cancer spread from the prostate to another part of your body) and you completed treatment 5 or more years ago, your AME will discuss with you whether you have had recurrence of the cancer and whether you are undertaking ongoing treatment. If you have had no recurrence of the cancer and are not undertaking treatment, the AME is authorized by the FAA to proceed with a regularly issued medical certificate.

Prostate Cancer, Non-Metastatic, Treatment Completed Less Than 5 Years Ago: if your prostate cancer was not metastatic and your treatment was completed less than 5 years ago, your AME must evaluate you for a CACI issuance. In order for you to be successful with a CACI evaluation for prostate cancer, the AME must see a current status report from your treating physician (or primary care physician) and the results of a PSA test from within the past 6-months. In order to be CACI qualified, you must be experiencing no symptoms and the only treatment that can be ongoing is either active surveillance or watchful waiting or brachytherapy. Note that ongoing treatment such as radiation is CACI disqualifying. The FAA publishes their CACI criteria and worksheet on their website. Take note that your AME may still defer your application even if you are CACI qualified.

Prostate Cancer, Currently Metastatic Or Metastatic At Any Point In The Past: if the prostate cancer you experienced or are experiencing is metastatic now or has been metastatic, the FAA is going to consider you for a special issuance authorization. To be considered for a special issuance authorization, the FAA will require a status report from your oncologist regarding your treatment plan, stability of your condition, and prognosis. The FAA will want a list of your medications and a discussion from your physician regarding side effects. Be careful to understand that some medications are aeromedically disqualifying. The FAA will also want a copy of your treatment records, operative notes and discharge summary, pathology report(s), and the results of any MRI/CT/PET scan reports. Ultimately, if you can establish for the FAA that you do not present with any risk to aviation safety and that you are not using aeromedically disqualifying medication, you can expect the FAA to want to monitor your condition in order to achieve continued certification. It is possible, however, that the FAA’s review of this documentation will warrant denial of your medical application, as well as consideration for special issuance authorization.

Prostate Cancer, Recurrent, And/Or Biochemical Recurrence after Prostatectomy: if your prostate cancer was ever recurrent or resulted in a biochemical recurrence after the removal of your prostate, the FAA will consider you for a special issuance authorization. The same information which is required for metastatic prostate cancer, above, must be submitted to the FAA for consideration.

Typically, the FAA will not consider certification (regular, CACI, or special issuance) at any point during ongoing treatment.

Why involve a FAA attorney in your FAA medical application? Despite what you may hear from your AME, the medical certification process is more so a legal process than a medical process. Ensuring that your doctor is developing the proper documentation regarding your history of prostate cancer, as well as your treatment, can be a delicate process. To that end, everything that is submitted to the FAA (i.e. records, statements, evaluations, etc.) goes into your airman medical file. This file is what the FAA then utilizes to evaluate whether you are eligible to hold a medical certificate. If you are later denied and wish to appeal that denial, your airman medical file becomes “Exhibit A” before the NTSB or upon reconsideration by the Federal Air Surgeon. So, a FAA attorney can evaluate your records, prepare a plan for best presentation of your case to the AME or FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal. Furthermore, if your medical documentation is as strong as possible upon initial submission, in doing so, hopefully, you will avoid unnecessary delay.

If you are concerned about your FAA medical and prostate cancer, call the FAA attorneys at The Ison Law Firm. We are happy to evaluate your case and discuss with you a plan for presenting your case to your AME or the FAA. Aviation law is all we do. Nothing else.

FAA Medical Denied Because Of Depression?

  • ON Jan 12, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Is your FAA medical denied because of depression? Fortunately, depression is not a condition which is specifically identified by the Federal Aviation Regulations (14 CFR Part 67) as being a disqualifying medical condition. Instead, however, the FAA has identified depression as a condition which warrants evaluation regarding its aeromedical significance for any given airmen. As is authorized by Part 67 (the body of regulations which speaks to medical certification standards), the Federal Air Surgeon can deny an airman medical certification for a history of a mental condition which either makes the airman unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or may reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges. See 14 C.F.R. Sec. 67.107(c), 67.207(c), and 67.307(c). In other words, the Federal Air Surgeon can deny you a medical certificate if your history is significant for depressive symptoms which may manifest in an aeromedically significant fashion.

In our practice, we have found that the FAA’s primary concern when evaluating an individual’s history of depression is whether the individual’s case history suggests a risk for recurrence of symptoms. Typically, this assessment manifests through the FAA doctors’ review of your medical records. As you may be aware, when you report a history of depression on your medical application, the FAA’s first response is usually to request that you send all of your medical records relative to your history of depression for their review. Within that review, the FAA is typically looking at whether you have had multiple recurrences of depressive symptoms, whether you are using a disqualifying medication to treat your depressive symptoms, whether treatment has been successful in the past, and what your risk for recurrence of symptoms may be. If this assessment of your medical records (and current evaluations, if available) renders a risk for recurrence of depressive symptoms, the FAA will typically deny your application.

As with all certification matters, the element of proper presentation of evidence is relevant in cases dealing with depression. The key question is: what can you do to sufficiently satisfy the FAA’s concerns that risk is mitigated in light of your history of depression? Sometimes, the answer is consideration of treatment with a SSRI and seeking a special issuance authorization, or maybe it is appropriate to challenge whether your diagnosis of depression was accurate in the first place. No matter the approach, the FAA needs to see that risk is sufficiently mitigated, despite your medical history.

Why involve a FAA attorney in your FAA medical application? Despite what you may hear from your AME, the medical certification process is more so a legal process than a medical process. As with denials for the use of a disqualifying medication, ensuring that your doctor is developing the proper documentation regarding your discontinuation of the medication, as well as the status of your underlying condition, can be a delicate process. To that end, everything that is submitted to the FAA (i.e. records, statements, evaluations, etc.) goes into your airman medical file. This file is what the FAA then utilizes to evaluate whether you are eligible to hold a medical certificate. If you are later denied and wish to appeal that denial, your airman medical file becomes “Exhibit A” before the NTSB or upon reconsideration by the Federal Air Surgeon. So, a FAA attorney can evaluate your records, prepare a plan for best presentation of your case to the FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal.

Is your FAA medical denied because of depression? Call the FAA attorneys at The Ison Law Firm. We are happy to evaluate your case and discuss with you a plan for presenting your case for consideration by the Federal Air Surgeon. Aviation law is all we do. Nothing else.

 

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