FAA Medical Denied Because of Coronary Artery Disease?

  • ON Jun 14, 2021
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  • BY Anthony Ison
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  • IN Pilot Law

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.

FAA Medical Denied Because of a Colostomy Bag

  • ON Jun 07, 2021
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  • BY Anthony Ison
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  • IN Pilot Law

Is your FAA medical denied because of a colostomy bag? Having a history of ileostomy or colostomy may not necessarily mean you are ineligible for a Federal Aviation Administration medical certificate. An applicant with an ileostomy or colostomy may receive FAA consideration in some circumstances and qualify for aeromedical certification.

In situations where the airman has a history of colon cancer, the Guide for Aviation Medical Examiners specifically enumerates various situations and stages in which the disease/condition should affect the AME’s decision making process for issuance of a medical certification. For example, if the airman has non metastatic colon cancer and treatment completed five (5) or more years prior, and there has been no recurrence or ongoing treatment, the AME may issue a medical certificate. To that end, if the airman had a pedunculated cancerous polyp (adenocarcinoma) that was removed by colonoscopy less that five (5) years prior to the flight physical, the AME may issue a medical certificate if a status report shows that there was only a local lesion (TNM stage 0 or I), complete resection with no additional treatment needed, follow up is annual or less frequent, and there are no clinical concerns.

The attorneys at The Ison Law Firm are well versed in the Guide for Aviation Medical Examiners, as well as the applicable Federal Aviation Regulations under Part 67. While 14 CFR Part 67 does not specifically speak to airmen with a history of colostomy, the Guide for Aviation Medical Examiners does briefly discuss these matters. For those airmen that have successfully recovered from a history of cancer but require ileostomy or colostomy, the FAA will require a report from the airman’s physician to confirm that the applicant has fully recovered from the surgery and is completely asymptomatic.  Oftentimes, however, the FAA will require additional information on the underlying cause for the airman’s usage of a colostomy bag.

Is your FAA medical denied because of a colostomy bag or the underlying reasons thereof, 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.

FAA Medical Denied Because of Previous Suicide Attempts

  • ON Jun 06, 2021
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  • BY Anthony Ison
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  • IN Pilot Law

Is your FAA medical denied because of previous suicide attempts? Having a history of suicide attempts is not one of the specifically disqualifying conditions found in 14 C.F.R. Part 67. In other words, you will not find a specific provision within the Federal Aviation Regulations which specifically states that if you have had a history of suicide attempts, that you do not qualify for an airman medical certificate (no matter whether you are applying for a first-, second-, or third-class certificate). Instead, the FAA typically relies upon a “catch all” regulation to support a potential denial for an application with a history of previous suicide attempts. That regulation is 14 C.F.R. 67.107 (for first-class certificates), 14 C.F.R. 67.207 (for second-class certificates), and 14 C.F.R. 67.307 (for third-class certificates. Across all classes of certificates, the wording of the regulation is the same: “[the applicant must not have] a personality disorder, neurosis, or other mental condition that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds – (1) makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or (2) may reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.”

Typically, the analysis becomes a question of whether a history of previous suicide attempts rises to the level of a “mental health condition,” which the Federal Air Surgeon can find makes you unable to safely operate within the National Airspace System. Consequently, the task then becomes presenting an argument to the Federal Air Surgeon that based upon all of your relevant medical records, evaluation by qualified physicians, and assessment for future risk, that you are qualified to exercise the privileges of an airman.

With a history of previous suicide attempts, the presentation to the FAA may be multi-faceted, in that there will be several issues to sort through: was your suicide attempt(s) the results of an underlying medical condition (such as major recurrent depression, anxiety, bipolar disorder, etc.), were you hospitalized for the suicide attempt(s), were you treated with any medication (also, are you still taking medication), what is your current status (how long ago was your suicide attempt(s))? Ultimately, the task will be to present an appropriate argument to the FAA, if able, that your suicide attempts were the result of an underlying situation, which is now either in sufficient remission, without risk for future recurrence, or, that perhaps that your history of previous suicide attempt(s) has been exaggerated in your medical records. Each underlying condition and element will have to be appropriately addressed with the Federal Air Surgeon, however, so that you do not invite a denial for the underlying condition (such as depression).

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. Specifically, 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 previous suicide attempts? 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.

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