FAA Medical Denied Because Of... Archives

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.

Is Your FAA Medical Denied Because You Use Lexapro?

ON Nov 21, 2021
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BY ThePilotLawyer
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IN Pilot Law

Is your FAA medical denied because you use Lexapro? If you are reporting a history of using Lexapro (generic being Escitalopram) on your FAA medical application, your medical application will be deferred by your Aviation Medical Examiner (“AME”). Thereafter, the FAA’s Office of Aerospace Medicine will send you correspondence, likely requesting copies of your medical records relevant to your history of treatment with Lexapro. Don’t let this correspondence give you any false hope, as the FAA is likely to deny your application if you are currently using Lexapro because Lexapro is a disqualifying medication for airman medical certification. Even though you may be denied, you can still get a medical certificate if you are currently using Lexapro. Lexapro is one of four selective serotonin reuptake inhibitors (“SSRI”) medications which can be approved for use under a special issuance authorization.

If you opt to continue using Lexapro, you will need to apply for a SSRI special issuance. In doing so, the FAA will require you will to jump through various “hoops” to establish your ongoing stability on the medication. The process of obtaining a special issuance authorization for Lexapro use can be difficult and subject to nuanced consideration for your history. The FAA calls this SSRI Decision Path – II: SSRI Decision Path – II (faa.gov)

If you do not opt to pursue a SSRI special issuance authorization, your only other option is to consider, with your doctor, discontinuing the Lexapro. If you opt to discontinue your Lexapro, with your doctor’s approval and supervision, the question for the FAA then becomes whether your underlying medical condition, for which you were being treated with Lexapro, is stable and/or presents a risk for recurrence. There are some conditions, such as Major Depressive Disorder, Recurrent, which typically carry with them a higher level of concern by the FAA for recurrence, if left untreated. So, if you decide to follow the pathway of discontinuing Lexapro, the burden will be upon you to demonstrate that you do not have an underlying condition that poses a risk for recurrent symptoms. In other words, just because you discontinue using Lexapro does not mean that the FAA will automatically issue to you a medical certificate. The FAA calls this SSRI Decision Path – I: SSRI Decision Path – I (faa.gov)

Why involve a FAA medical attorney when you are using Lexapro? 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. Whether you opt to discontinue your use of Lexapro (with your doctor’s approval) or pursue a special issuance authorization, the FAA attorneys at The Ison Law Firm are here to guide you through the process.

Is your FAA medical denied because you use Lexapro? 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 You Use Gabapentin?

ON Jun 15, 2021
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BY Anthony Ison
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IN Pilot Law

Is your FAA medical denied because you use Gabapentin? Our firm has handled many cases where an airman was treated with Gabapentin (common brands include Horizant, Gralise, and Neuraptine). Typically, Gabapentin is prescribed by your treating physician to relieve various conditions in the nervous system. We typically see airmen being treated with Gabapentin for conditions like neuropathy and restless leg syndrome. Gabapentin is also identified as an anticonvulsant medication and is used to treat some forms of epilepsy. While you may not be taking Gabapentin for seizures or epilepsy, it really does not matter. The FAA does not accept the use of anti-epileptic or anti-seizure medications as treatment for any medical conditions. Outside of the concern that your use of Gabapentin could be seizure related, the FAA has found that the side effects of this medication may be incompatible with aviation safety.

What should you do if your FAA medical was denied because you use Gabapentin? If you are taking Gabapentin for a non-seizure related issue, the easiest way to achieve certification is to talk with your doctor about discontinuing the medication. If your doctor believes it is safe for you to come off of the medication, have him or her properly document your discontinuation. Following discontinuation for 60-days, your doctor should prepare a letter or progress note, indicating that you have successfully weaned off of the medication and that your underlying condition is stable with no functional impairment. This documentation can then be presented to the FAA for reconsideration.

If you are taking Gabapentin for seizure prevention or for epilepsy, the FAA’s inquiry will extend beyond your use of the medication. To that end, the FAA will likely deny your application for medical certification, as epilepsy is a specifically disqualifying condition, as found in Part 67 of the Code of Federal Regulations.

The FAA does have the regulatory discretion to deny your application for medical certification based on your use of a “disqualifying” medication. That regulation can be found at 14 C.F.R. 67.113 (c), 67.213 (c), and 67.313 (c). Nevertheless, if you are denied because you use a disqualifying medication, such as Gabapentin, there are usually solutions to discussing medication modification with your doctor or giving the FAA assurances regarding your proper use of the medication.

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.

Is your FAA medical denied because you use Gabapentin? 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 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.

Tag: FAA Medical Denied Because Of…

FAA Medical and VA Disability Benefits

FAA Medical and Prostate Cancer

Is Your FAA Medical Denied Because You Use Lexapro?

FAA Medical Denied Because You Use Gabapentin?

FAA Medical Denied Because of Coronary Artery Disease?

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