FAA Medical with Past Anxiety       

  • ON May 05, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Obtaining your FAA medical with past anxiety is not impossible. If you are like a lot of people, you may have had anxiety at one point or another in your life. If your history of anxiety was limited to a short period of time, achieving medical certification with the FAA may be relatively straight forward. If your anxiety involved a more involved clinical presentation, medical certification is still not out of the question. Typically, whether you can obtain your FAA medical with past anxiety comes down to the level of risk for recurrence of symptoms.

If your anxiety was limited in time, you responded well to medication treatment (if any), and medication was discontinued, the required elements for treatment may be relatively simple. The FAA will likely want to review your previous treatment records, as well as a letter from your current physician regarding your status. Many times, a psychiatric evaluation can help alleviate any concerns the FAA may have regarding your current status and even facilitate a faster disposition regarding your medical certification. Be careful submitting medical records to the FAA! Always make sure you know everything that is in your records and how that information may affect the FAA’s review of your file.

A history of anxiety, when mixed with other clinical concerns, such as panic attacks, psychiatric hospitalizations, and/or other diagnoses such as major depressive disorder, will almost always warrant an evaluation by a psychiatrist. A psychiatric evaluation can give the FAA better insight as to whether the clinical picture presented in your treatment records will present a risk for recurrence of symptoms now or in the future. Ultimately, the more severe your symptoms were at the time of treatment, the more concerned the FAA will be relative to the risk for recurrence of symptoms. With a psychiatric evaluation, and in some cases, a neuropsychological evaluation, you have the ability to provide the FAA with a better perspective on the aeromedical significance of your past anxiety, as well as your current, aeromedical risk.

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 past anxiety, as needed, can be a difficult task. 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. Also, if you have failed to report your past anxiety on your FAA medical application, a FAA attorney can give you counsel on how to rectify your omission.

If you are concerned about reporting your past anxiety to the FAA, 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.

 

FAA Medical and VA Disability Benefits

  • ON Jan 17, 2022
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  • BY Anthony Ison
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  • IN Pilot Law

Do you have questions regarding your FAA medical and VA disability benefits? A frequent question asked of our firm is whether an applicant for FAA medical certification needs to report his or her receipt of VA disability benefits to the FAA. There seems to be a good deal of confusion, somewhat caused by the Department of Veteran’s Affairs, as to whether disability benefits are reportable. Question 18y., which specifically asks whether in the applicant’s lifetime he or she has received “medical disability benefits,” can be a bit confusing. Many veterans consider their VA disability benefits to be compensation for their service, rather than a disability.  The FAA’s position, however, is that VA disability benefits are reportable on question 18y. on Form 8500-8, the application for airman medical certification.

Reporting your VA disability benefits on your FAA medical application does not have to result in the denial of your application. Some, if not most, medical conditions for which veterans receive compensation are not conditions which are aeromedically significant. Whereas some conditions, such as post-traumatic stress disorder (“PTSD”), traumatic brain injury (“TBI”), and obstructive sleep apnea (“OSA”), may warrant further evaluation by the FAA, even those conditions, in many situations, can be overcome to establish an airman’s eligibility for FAA medical certification.

If you have failed to report your VA disability benefits on your FAA medical application, you need to act immediately. In the event the FAA or the VA discovers your failure to report your VA benefits, as required, the FAA could take action to revoke your airman certificate(s), as well as your medical certificate. In rarer cases, there may be criminal action which can be pursued against you for failure to appropriately report your VA disability benefits on your FAA medical application. Fortunately, the FAA’s sanction guidelines provide an opportunity to take corrective action, which frequently avoids action for alleged “intentional falsification” and limits the FAA’s inquiry to your eligibility to hold a medical certificate.

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 VA disability benefits, as needed, can be a difficult task. 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. Also, if you have failed to report your VA disability benefits on your FAA medical application, a FAA attorney can give you counsel on how to rectify your omission.

If you are concerned about your FAA medical and VA disability benefits, 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.

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.

FAA Medical Denied Because of Adderall?

  • ON Aug 25, 2021
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  • BY Anthony Ison
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  • IN Pilot Law

FAA medical denied because of Adderall? Adderall, as well as all other amphetamines and dextroamphetamines, is a disqualifying medication for the purpose of airman medical certification with the FAA. What does this mean? If you are taking Adderall, your application for medical certification will be denied. You will not be issued a medical certificate while you are taking Adderall. If you submit an application for medical certification and identify Adderall as a medication that you are currently using, your Aviation Medical Examiner will automatically defer your application. Thereafter, the FAA will send you a letter (approximately one to two months after your exam) and likely ask for any combination of treatment records, a current status letter from your treating physician, 12-months of pharmacy records, and/or a neuropsychological evaluation with a HIMS-trained psychologist or neuropsychologist.

Is there a better way? Yes! You should never submit a medical application to the FAA during the time in which you are currently using Adderall. Instead, prior to your application you should talk with your doctor about the possibility of discontinuing your use of the medication. This discontinuation should be properly documented and monitored by your treating physician. Following 90 days or more of discontinuation, then it would be appropriate to submit an application to the FAA for medical certification. At the time of application, you should be able to provide documentation regarding discontinuation of the Adderall, as well as treatment records, a current status letter from your doctor, and pharmacy records (demonstrating that you have not filled any prescriptions for Adderall within 90 days).

Will discontinuing the medication prevent a deferral? No! Unfortunately, you will still need to say “yes” to question 18m. on the medical application due to your history of ADD/ADHD and/or condition for which you have been using the Adderall. This underlying condition will warrant deferral by your Aviation Medical Examiner.

The good news, however, is that it is possible that if you have properly documented discontinuation of the Adderall and if you can demonstrate stability, you may be able to prevent the costly and risky neuropsychological evaluation. While not guaranteed, circumstances may warrant the FAA allowing an individual to be issued a special issuance authorization, without the requirement for cognitive testing. While these cases tend to be reserved for airmen who have long discontinued Adderall and have exhibited no ongoing, cognitive deficiencies, every case is different. Whether you anticipate a deferral or have been denied, consultation with a FAA medical attorney regarding how to best present your history is crucial.

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 with denials for the use of a disqualifying medication, ensuring that your doctor is developing the proper documentation regarding your discontinuation of the medication, as well as the status of your underlying condition, 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 FAA, and best argue your medical eligibility to the Federal Air Surgeon, with an eye for potential, future appeal.

FAA medical denied because Adderall? 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.

Aviation Lawyer For My FAA Medical Certificate?

  • ON Jun 08, 2021
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  • BY Anthony Ison
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  • IN Pilot Law

Often, we are asked by prospective clients, “do I need an aviation lawyer for my FAA medical certificate?” This question usually comes from airmen who have spoken with an Aviation Medical Examiner (“AME”) before calling The Ison Law Firm. Without naming names, there are a handful of AMEs that constantly question why an airman would ever consider hiring a lawyer to address a medical concern with the Federal Aviation Administration (“FAA”).

The aviation attorneys at The Ison Law Firm are an invaluable resource for combating the FAA’s Aerospace Medical Division when applying for medical certification. As much as an AME would like to think that his or her medical prowess can affect the outcome of an airman’s medical application, the fact remains that an AME’s role in the FAA medical certification process is limited to a small part. And while this small part may be useful downstream in the process, an airman will likely need the representation of a seasoned aviation medical certification lawyer should the airman’s medical application be deferred by the AME or denied by the FAA.

Whether you are a seasoned airman or are just beginning your journey in aviation, most airmen understand that the privilege of operating an aircraft comes with the responsibility of understanding countless Federal Aviation Regulations (“FARs”). In fact, interoffice jokes around the watercooler sometimes will fixate on how a pilot thinks he or she is a based on the shear volume of FARs that are required to be read and comprehended in order to fly. To that end, most airmen are aware that medical certification standards for the operation of aircraft are found at 14 C.F.R. Part 67. What is often lost in the nuance of the FARs, and certainly on some AMEs, is that the certification of airmen under 14 C.F.R. Part 67 is not entirely premised on just the practice of medicine. To the contrary, the certification of airman under Part 67 is first based upon regulation which, by its very nature, suggests the eventual application of law to facts. And this is where FAA medical lawyers are needed!

In a perfect world, an airman goes to an AME and the AME immediately issues the airman a medical certificate. However, in situations where the airman has a history of certain disqualifying conditions under Part 67, the AME will have to defer the airman’s medical application to the FAA. After deferring an application to the FAA, the AME has little control over the outcome of the matter. The airman will likely be left to navigate the nebulous and vague requests made by the FAA for additional information, costly testing, and possible denial, depending upon the specific disqualifying issue. What is an airman to do at that point? If this was just a medical process, the AME would be able to assist. However, by this point, it should be evident that the airman will need a FAA medical certification lawyer to navigate the FARs precluding his or her ability to obtain a medical certificate.

The aviation medical certification lawyers at The Ison Law Firm are experienced in handling all types of medical certification matters before the FAA after an AME defers an airman’s medical application. The AMEs that belittle the use of lawyers fail to appreciate the process beyond the flight physical. If an airman’s medical application is denied, then that airman will ultimately have the option to appeal the Federal Air Surgeon’s final denial to the National Transportation Board of Safety (“NTSB”). At the NTSB level, 49 U.S. Code § 44703 requires the airman to present evidence by a preponderance of the evidence, in accordance with the Federal Rules of Evidence. To that end, the litigation process leading up to the hearing will require the airman to understand the various Federal Rules of Civil Procedure as the airman engages in the discovery process and exchanges discovery with the Administrator, as well as the volumes of governing NTSB opinions.

So, why would an airman ever consider hiring an aviation attorney for a medical application? For starters, the documentation provided to the FAA and the statements made by an airman and the airman’s medical providers will form the basis for the evidence to be presented at a hearing in support of that airman’s qualifications to hold a medical certificate. In other words, knowing what to provide, when to provide it, and how to frame it, before litigation even begins, is incredibly important in the medical certification process. These are techniques and strategies best left to competent legal professionals, and not to be trusted to AMEs that think they know the law just because they are doctors that practice within the realm of aviation regulation.

If your AME questions why you would hire a lawyer for your medical application with the FAA or if you are asking yourself “do I need an aviation lawyer for my FAA medical certificate,” first call the lawyers 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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