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.