Trying to get your FAA medical after a stroke? A lot will depend on what kind of stroke you have had and when you had your stroke. The most important thing to remember when attempting to get your FAA medical after a stroke is that the FAA requires an observation period following a stroke. For airmen that have experienced a cortical stroke or transient ischemic attack (“TIA”), the FAA requires a 2-year observation recovery period before considering an airman’s application for FAA medical certification. For applicants which have experienced a sub-cortical stroke, the FAA requires a 1-year observation recovery period. In some cases, if you can identify for the FAA that a legitimate medical explanation exists for why a sub-cortical stroke or TIA occurred, the FAA will consider reducing the 2-year observation period, on a case-by-case basis. Such a legitimate medical explanation would be that you had a high-grade carotid stenosis which has been fully treated or that you had patent foramen ovale (“PVO”) with known acute venous clot fully treated. Of course, you would have to provide documentation of such a medical explanation and resolution of same for the FAA’s review.
Unfortunately, once your observation period has successfully elapsed, the FAA will require a fairly extensive list of evaluations and documentation in order for you to be considered, whether you are applying for a first-, second-, or third-class airman medical certification. Specifically, the FAA requires the following:
- A detailed neurological evaluation with accompanying detailed clinical progress note;
- A Brain MRI which has been performed within 12 months of submission to the FAA;
- Hospital records from the stroke/TIA event; and,
- A current cardiac monitor for TIA cases, to include 30-day monitor results. And, if an implanted loop recorder has been placed, the FAA will want 6 months of data.
The problem here is that the FAA’s stroke protocol specifically states that the airman should submit the above-referenced documentation and then to standby and wait to find out if the FAA physicians will want more evaluations. Specifically, the protocol states that the FAA physicians could request additional imaging (such as a CT scan, MRI, MRA, or carotid ultrasound), a transthoracic echocardiogram, a cardiovascular evaluation, a cardiac stress test, a Holter monitor test, a neuropsychological evaluation, and/or a comprehensive hypercoagulopathy panel after their initial review of your case. The FAA does not require airmen to provide all this documentation up front, as they don’t want airmen to have to undertake unnecessary evaluations if they don’t think it is necessary. While that may seem considerate, this usually results in airmen having to wait many months for the FAA’s initial review of the stroke history before additional testing is requested by FAA physicians.
When you are trying to get your FAA medical after a stroke, consider that the documentation being requested by the FAA is trying to establish one thing: do you present a risk to aviation safety. Therefore, all the documentation that you put in front of the FAA physicians must work to support that you are not a risk to aviation safety or to your own safety, if possible. More specifically, the relevant regulations for applicants applying for a FAA medical after a stroke are 14 C.F.R. §§67.109, 67.209, and 67.309. Therein, the regulations require that an applicant have had no seizure disorder, disturbance of consciousness, or neurologic condition that the Federal Air Surgeon would find makes the applicant essentially unable to safely operate as an airman. So, when you are presenting the above-referenced evidence to the FAA, you need to be able to generate a compelling argument that you are safe to operate as a pilot.
For individuals with a history of TIA, the regulations specifically state that no matter what class medical you are applying for, an airman may not be issued if he or she has experienced a loss of control of nervous system function(s) without satisfactory medical explanation of the cause. So, if you have experienced a TIA, be prepared to also make a clear argument to the FAA as to what caused the disturbance to your nervous system. Sometimes, this may require you to provide additional medical records to demonstrate what caused the disturbance, how it was remedied, and why the risk for a recurrent event is appropriately mitigated.
A few tips for moving forward with your FAA medical after a stroke are as follows:
- Make sure to include your history of stroke or TIA on your application for airman medical certification, FAA Form 8500-8. Specifically, question 18L. asks whether you’ve ever in your life been diagnosed with, had, or presently have any “neurological disorders, epilepsy, seizure, stroke, paralysis, etc.”
- Prepare for a deferral if you are applying for your FAA medical after a stroke for the first time. Even if you have been through the appropriate observation period, the AME will be required to defer your application for review of your history, as noted above.
- Even though your application for FAA medical certification is going to be deferred, you should present to your FAA examination with your Aviation Medical Examiner (“AME”) with the required documentation identified above. Having your documentation accompany your application, rather than waiting for the FAA to send you a letter requesting the same, could save you months in the review process.
- Although the above-referenced protocol requires that you wait for FAA physicians to request additional evaluation(s), having your case reviewed by an aviation attorney can help ascertain whether additional evaluation(s) could be expected to be requested by the FAA. Being proactive with obtaining evaluations may save you many months in the review process.
An aviation attorney can help you determine the best way to present your case to the FAA after a stroke. Again, the documentation you present to the FAA may be clinical in nature, but it is all evidence that the FAA can either use to your favor or against you. The FAA physicians are trying to determine whether the evidence presented to them supports your eligibility as stated in the above-referenced regulations. An aviation attorney can help you best present and argue your eligibility for FAA medical certification and, in some cases, argue that opportunities for monitoring through a special issuance authorization should exist.
You need both a pilot and a lawyer on your side for your aviation law needs. Don’t hesitate to contact our team from The Ison Law Firm Aviation Lawyers to schedule a confidential consultation with an experienced aviation lawyer today.
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