Getting a FAA medical certificate with vertigo or a history of vertigo is possible. The Guide for Aviation Medical Examiners provides guidance for airmen applying for a FAA medical certificate with vertigo. Specifically, the FAA’s guidance for benign paroxysmal positional vertigo or “BPPV” identifies three categories of the condition: 1) vertigo which is resolved and symptoms lasted 1 year or less in total; 2) vertigo which occurred in multiple episodes during which the combined time of sickness was 1 year or more; and 3) severe/persistent recurrent/refractory to treatment or which required surgery at any time. Depending upon which category of disease your vertigo or history of vertigo can be identified will make a difference when it comes time to get your FAA medical certificate.
Vertigo Which is Resolved/Symptoms Lasting 1 Year or Less
If your history of vertigo falls within the category of disease in which your vertigo has been resolved and you only experienced symptoms, whether it was multiple episodes or a single episode, lasting 1 year or less, it is likely that your Aviation Medical Examiner (“AME”) will be able to issue your medical certificate. In order to issue your FAA medical certificate with a history of vertigo, your AME must be able to determine that your condition has fully resolved without complications. This will be verified by your AME via “favorable” notes from either your primary care physician, an emergency room physician, or an ENT. The AME must also be able to determine that you currently have no symptoms or problems which would interfere with flight duties, that you are not taking any medication(s) for vertigo, and that you have had no hearing loss as the result of the vertigo.
The AME should note that vertigo falling into this category should only have been brief, mild, not disabling, and should have responded to repositioning. History of disease falling outside of these criteria could result in your case being triaged into one of the other two categories of vertigo identified by the FAA.
Vertigo With Combined Sickness of 1 Year or More
Vertigo which resulted in a combined period of sickness for 1 year or more will result in your AME deferring your application to the FAA’s Office of Aerospace Medicine for review and consideration of your application. Disease falling within this category, for an example, would include a situation in which an airman may have been sick with vertigo for six months with symptoms having resolved and then 1 year later, the airman having vertigo symptoms again, lasting 8 months. This is an example of the combined period of symptoms occurring 1 year or more.
If your history of vertigo falls into this category, the FAA will require that you provide a current, detailed clinical progress note generated from a clinic visit with your treating otolaryngologist or primary care physician. The physician must make notes relative to the history of your condition, your current use of medication, findings upon physical exam, the results of any testing performed, the assessment and plan for your condition, and, importantly, notation relative to the underlying cause of your vertigo. The FAA will also require copies of additional tests which may have been conducted by your doctor, to include any ECOG, VEMP, MRI with Gadolinium of the cerebellopontine angle [CPA], etc.
Severe Vertigo or Vertigo Requiring Surgery
If your vertigo is severe, ongoing, and/or has required surgery, your application will get deferred by your AME to the FAA’s Office of Aerospace Medicine for further review. In these cases, the FAA will require that you provide a detailed, clinical progress note similar to the one referenced above, but the report must be from an ENT. The FAA would prefer that the ENT be a subspecialist in neurotology. The FAA will also want all records relative to your surgery, if you had surgery.
We recommend that you consider the following when applying for a FAA medical certificate with vertigo, especially when applying for the first time with this issue:
- The FAA’s primary concerns relative to vertigo will include duration and severity of symptoms. Furthermore, the FAA will be interested in the etiology of your vertigo. Discuss with your physician whether the underlying cause of your vertigo could be something serious or otherwise aeromedically significant (i.e. coronary artery disease, side effect to medication, tumor, etc).
- In cases where your symptoms lasted 1 year or less, consider obtaining a detailed, clinical progress note from your treating physician (although not required), as providing same could go a long way toward assuaging any concerns your AME (and the FAA) may have regarding your history.
- If you provide your AME with a detailed clinical progress note from your treating physician, keep in mind that the AME (and FAA) will scrutinize the entirety of that record. If there is any additional information on this report which indicates an otherwise aeromedically significant concern (even if related to a different condition, symptom, or social habit), the FAA or your AME may require more information regarding that concern.
- Your application for airman medical certification (FAA 8500-8) or MedXPress, should identify any history of vertigo or dizzy spells at question 18b., which asks if in your lifetime you have ever been diagnosed with, had, or whether you presently have a history of “dizziness or fainting spell.” This is one of the limited conditions which the FAA specifically identifies on the FAA medical application.
- In cases of recurrent vertigo in which there is no known etiology or cause, the FAA will typically require that you remain asymptomatic for 2 years before you can be considered eligible for a FAA medical certificate.
- Start your FAA medical certification process as soon as possible. Having your documentation and supporting evidence prepared and submitted before your AME examination can potentially save you months of processing time in some cases where a deferral is necessary.
- If you would like to learn more about this topic, listen to our episode about FAA Medical with Vertigo on The Pilot Lawyer Podcast!
If you are trying to get your FAA medical certificate with vertigo, consider a consultation with a FAA medical defense attorney at The Ison Law Firm before applying for a FAA medical certificate. 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.