Is it possible to get a FAA medical certificate with sleep apnea? Yes! It is possible to be issued a FAA medical certificate with obstructive sleep apnea (“sleep apnea”), but you will also need to be granted a special issuance authorization. A special issuance authorization can be better understood as a “waiver.” When an airman has been issued a special issuance authorization, the FAA essentially wants to monitor the status of the airman’s condition and the on-going compliance with and effectiveness of treatment. Certain criteria have been identified by the FAA as prerequisites to being issued a special issuance authorization for sleep apnea. While the process may seem daunting, preparing a successful submission to the FAA, supporting your eligibility for FAA medical certification with sleep apnea, can be successful.

The National Transportation Safety Board (“NTSB”) directed the FAA to consider screening airmen for obstructive sleep apnea, as they had done in the trucking industry. In screening surveys, the NTSB found it was not infrequent that airmen were falling asleep in the cockpit, and in one rather infamous scenario both crewmembers succumbed to the effects of sleep apnea. In that case, an aircraft was flying from the Island of Oahu to Hilo, where both crew members fell asleep. One crewmember was found to have severe sleep apnea and the other crewmember had shift work fatigue. The crew overflew their destination by 22 miles before they were finally awakened and returned, with only twenty minutes of fuel left in the aircraft.

Even still, the risks of sleep apnea, if undiagnosed, include causing repeated hypoxic or low oxygen injury to the heart and brain. In turn, sleep apnea presents a four-fold increase for a heart attack or stroke, as well as a seven-fold increase of having a motor vehicle type of accident. As a result, in our experience, it has been the FAA’s position that airmen must be screened for sleep apnea and appropriately diagnosed, and if sleep apnea is present, that it be accurately treated and mitigated. In doing so, the FAA believes that risk of fatigue and/or further morbidity is being mitigated.

In order to establish your eligibility for FAA medical certification with a history of sleep apnea, you will need to provide the following documentation to the FAA: a copy of the FAA’s “OSA Status Report – Initial” or a clinical note (with ALL required information) from your physician; a copy of your most recent sleep study (used for diagnosis); and compliance data from PAP device representing 30 days if new diagnosis (may consider minimum of 2 weeks if data verifies excellent compliance, effective treatment, and resolved symptoms) OR 365 days if previously diagnosed and treated. It should also be noted that the FAA will also consider an airman for medical certification in cases where sleep apnea is being treated with a dental device, as well as other types of 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 sleep apnea, 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 sleep apnea on your FAA medical application, a FAA medical attorney can give you counsel on how to rectify your omission.

If you are concerned about your FAA medical and sleep apnea, 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.