Is your FAA medical denied because of coronary artery disease? The Federal Aviation Regulations relevant to standards for airman medical certification are found in Part 67 of the Code of Federal Regulations. Therein, the FAA has identified 15 specific conditions which are disqualifying; other conditions not specifically stated therein may be disqualifying at the Federal Air Surgeon’s discretion. One such specifically disqualifying condition, however, is “coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant.” As you can see, there is some nuance to this regulation, such that your case may be arguable as to whether you have “required treatment” or if your case has been “symptomatic or clinically significant.” What is “treatment?” What are “symptoms?” What is “clinical significance?”

Many times, airmen are denied a medical certificate because of coronary artery disease following treatment with a stent or bypass surgery. The FAA has a protocol for certification following such surgical intervention. The tests associated with that protocol sometimes reveal a discrepancy, however, between what your treating physician feels is medically acceptable risk, versus what the FAA feels is an acceptable risk for the purposes of aviation safety. Oftentimes, in practice, our firm handles cases where a treating physician opted not to treat an occlusion with a stent, but rather treated the occlusion with medication. This less invasive approach may be medically acceptable. The FAA may look at this information, however, and suggest that the level of plaque buildup left behind presents a risk which is not sufficiently mitigated. In those circumstances, for example, the FAA will suggest that that this is “untreated” coronary artery disease which is “clinically significant.” Arguing your physician’s position of sufficiently mitigated risk may be the key to certification.

There are many ways that your arteries may get on the FAA’s radar (i.e. ischemia on a stress test, concerns on an echocardiogram, etc.). The key, however, is first understanding what the FAA’s concerns are (not always a simple task) and then pinpointing an argument as to why any disease is either not “significant” or no longer presenting with symptoms. Reversing a denial because of coronary artery disease (or being issued a special issuance authorization) means methodically going through the data and arguing to the FAA why you do not pose a risk to aviation safety and/or why any risk is appropriately mitigated with medication and observation.

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 you can see with denials for coronary artery disease, presentation of medical data to the FAA for such a condition is a delicate application of fact to law (i.e. why does your situation not meet the level of “clinical significance”)? Furthermore, 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 coronary artery disease? 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.