If your Aviation Medical Examiner (AME) deferred your application, that FAA medical deferral means the FAA must review your case before deciding whether to issue your medical certificate. The decision is pending, not denied, and a deferral does not automatically mean you cannot obtain certification.
For pilots, mechanics, and other FAA certificate holders dealing with a deferred or denied medical—or trying to head off an aeromedical issue before it disrupts training, work, or flying privileges—knowing what happens next matters. This guide explains why the FAA defers applications, how long review can take, what medical records and supporting documentation the FAA may require, how mental health conditions and medications can affect the process, whether you can keep flying during a deferral, when reapplication is possible, what a denial can mean, and when legal help may be worth involving.
Why Was Your First Medical Application Deferred?
An examiner may be required to defer because a condition needs agency review, supporting information is missing, or a finding needs further evaluation. Deferral can also happen when there is uncertainty about a medication or its effects.
Potential issues include:
- A current or past condition requiring additional evaluation.
- Missing treatment notes, test results, or specialist reports.
- Medication use, dosage changes, or adverse reactions.
- Medical history that needs clarification.
- A condition requiring an initial special issuance decision.
Even a complete application may need higher-level review. Your examiner should explain what prompted the deferral and whether additional information was identified during the examination.
How Long Does a Deferred Medical Application Take?
Allow for a review that may extend from weeks into months, particularly when additional testing or specialist input is needed. This is a planning consideration, not a guaranteed turnaround or a current agency average. Published pilot guidance has documented lengthy waits, while the FAA explains that when it is unable to establish your medical eligibility, each new submission requires further review.
Several separate stages affect the timeline:
| Stage | What affects the wait |
|---|---|
| Examination submission | Examinations must be transmitted within 14 days. This is not an approval deadline. |
| Initial agency review | The review queue, case complexity, and information already submitted. |
| Your response | Appointment availability, testing, and how quickly doctors prepare the requested reports. |
| Further review | Whether the response answers every question or more information is needed. |
The MedXPress user guide describes a warning when review has not begun within 60 days after transmission. That does not mean a decision is guaranteed within 60 days. Follow the inquiry instructions displayed in your account if the stated review window passes.
What to Do After Your Examination Is Deferred
1. Confirm What Your Examiner Submitted
Ask when your examination was transmitted, what supporting material accompanied it, and whether anything remains outstanding. Retain a copy of your application and relevant correspondence.
If you have been advised to obtain additional evaluations, clarify the requirements before scheduling them. Some tests are expensive, and the report must address the specific certification question.
2. Check Your Application Status
Use MedXPress to follow your application through the system. An online status can help you understand its position in the review process, but it does not replace the instructions in official correspondence.
Keep a simple log of submissions, calls, and documents received. When making an inquiry, have your identifying information and examination date available. Ask a specific question, such as whether the requested material has been received or whether something remains missing.
3. Read Each Request Carefully
The FAA may send a letter identifying additional information needed to determine your eligibility. After reviewing your response, it may ask follow-up questions or communicate a certification decision, and future changes to the FAA medical deferral process may affect whether you first receive an information request or an initial denial. There is no identical sequence for every applicant.
Identify the requested items, submission instructions, and response deadline. Share the full request with the doctors preparing your reports. If you are unable to meet the deadline, ask about an extension before it expires and confirm whether it has been granted.
4. Submit a Complete, Organized Response
Match each requested item to the document that answers it. Check for missing pages, outdated results, or reports that do not address the question asked.
The agency recommends having your examiner upload the required information or forwarding it together in one package. Keep copies and proof of submission. A complete response can prevent avoidable follow-up requests, although it cannot guarantee approval or a particular decision date.
What Medical Documentation Matters?
The required documentation depends on your condition, treatment, and the class of certificate sought. Follow the specific request and applicable guidance.
Useful information may include (for example, after a significant event such as an FAA medical after a heart attack evaluation):
- Treatment history: Relevant past diagnoses, symptoms, procedures, and follow-up care.
- Current clinical findings: A detailed assessment of your condition and its present status.
- Medication information: What you are taking, the dosage, treatment changes, effectiveness, and any reported reactions or side effects.
- Testing and specialist evaluations: Reports addressing the requirements identified for your case.
For some conditions, current clinical notes or tests must meet particular date requirements. A general statement that you are doing well may not satisfy a request for specific findings. Confirm what is needed before asking your physician to prepare a report.
Mental Health, Depression, SSRI Pathway, and Medication Reviews
A mental health history does not automatically require a denial. Some anxiety or depression histories may qualify for issuance by an examiner when the applicable criteria are met; others require further review.
If you are taking an antidepressant, you may encounter references to an “SSRI pathway.” The FAA now uses the broader name Antidepressant Protocol, which encompasses conditionally approved medications and specific evaluation requirements. Depending on your circumstances, a HIMS-trained examiner may need to participate.
Do not change or stop prescribed medication on your own to influence certification. Discuss treatment with your prescribing clinician and certification requirements with your examiner. Taking a different drug or discontinuing treatment does not itself establish eligibility.
Can You Fly While Your Application Is Deferred?
A deferred application does not provide a new medical certificate. If this is your first medical, you have not yet received the certificate needed for operations requiring one.
If you already hold a certificate, do not assume that an unexpired date settles the question. Your condition, medication, applicable privileges, and the restrictions on operating during a medical deficiency under 14 C.F.R. § 61.53 also matter. Confirm your individual circumstances before flying.
Should You Reapply or See Another Examiner?
Before attempting to reapply, clarify the status of your existing application. A new appointment should not be treated as a way to bypass an unresolved review.
Changing examiners does not erase your past medical history or earlier disclosures. Ask how any new evaluation would fit into the pending matter and what information should be coordinated with the existing file.
What If the Review Results in a Denial?
A denial is a different stage from a pending deferral. If correspondence states that your application has been denied, review it promptly because response rights and deadlines may apply, including the option to seek reconsideration of an FAA medical denial.
Our FAA medical denial and special issuance page explains those options. Do not assume that instructions for responding to an information request also apply to a denial.
When Should You Seek Legal Help?
Legal advice may be useful when the reason for a request is unclear, past disclosures appear inconsistent, a deadline is approaching, or repeated submissions have not resolved the issue.
The Ison Law Firm can review your correspondence, identify documentation gaps, and help coordinate a response with your medical professionals. Our FAA medical attorneys explain the legal questions affecting your case and the options available.
Contact our firm for a confidential consultation or call 855-322-1215.
