FAA Medical Archives - The Pilot Lawyer

FAA Medical with a Possession Conviction

ON Mar 11, 2023
/
BY Anthony Ison
/
IN Pilot Law

Can you get a FAA medical with a possession conviction on your record? It is possible to get a FAA medical with a possession conviction on your record. Of course, every situation is different; however, if you were convicted of a misdemeanor charge of “possession of paraphernalia” or “possession of marijuana” or the like, the FAA will require that you provide a “yes” response to question 18w. on your application for airman medical certificate. When you say “yes” to question 18w., it is likely that your Aviation Medical Examiner will defer your application to the FAA for further review. Upon review of your application, the FAA will likely ask for more information regarding the possession conviction. The information the FAA will require regarding the possession conviction will include a copy of the narrative police report, final court disposition documentation, a copy of your 10-year driving record, and a statement from you regarding past, present, and future plans for substance use. The FAA may also require that you provide a drug test result.

Typically, a possession conviction will give the FAA cause for concern as to whether you meet criteria for “substance abuse” or “substance dependence” under Part 67 of the Federal Aviation Regulations. Typically, the first thing you should look at is when was your possession conviction. If your possession conviction was greater than two years before your application for airman medical certification with the FAA, you may be able to argue to the FAA that you do not meet criteria for “substance abuse,” as “substance abuse” only has a two year lookback. Be careful, however, because if you indicate a concern for “substance dependence” to the FAA in your statement regarding substance use, you may actually trigger an inquiry for “substance dependence,” which is a lifetime lookback. If there has been no ongoing use of a substance, the possession conviction is greater than two years prior to application, and you do not trigger a concern for “substance dependence,” the FAA will typically issue you a medical certificate if you are otherwise qualified. It is important to remember that a possession conviction does not establish proof of substance use for the FAA. The regulation which defines “substance abuse” under the Federal Aviation Regulations requires use not just possession.

Why involve a FAA attorney in your FAA medical application when you have a possession conviction? 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 possession conviction, 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, despite your possession conviction. 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 possession conviction on your FAA medical application, a FAA medical attorney can give you counsel on how to rectify your omission.

If you are concerned about your FAA medical and a possession conviction, 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.

Assessment for Sleep Apnea During Your FAA Medical

ON Dec 29, 2022
/
BY Anthony Ison
/
IN Pilot Law

Did you know that your AME conducts an assessment for sleep apnea during your FAA medical examination? In 2015, the FAA made it a requirement that your Aviation Medical Examiner (“AME”) conduct a risk assessment for obstructive sleep apnea (“sleep apnea”) on every airman being examined for FAA medical certification. The FAA encourages AMEs to use their own clinical judgment in assessing an airman’s risk for sleep apnea. Nevertheless, the FAA has noted in the Guide for Aviation Medical Examiners that the following items may put an airman at a higher risk for sleep apnea: retrograde mandible, large tongue or tonsils, neuromuscular disorders, connective tissue anomalies, and airmen with a body mass index (“BMI”) of 40 or greater. The FAA also identifies that airmen with the following conditions may be at a greater risk for having sleep apnea: refractory hypertension requiring more than two medications for control, diabetes mellitus, and atrial fibrillation. Of course, there may be additional items which the AME and/or the FAA believe puts any given airman at greater risk for sleep apnea.

What happens when your AME determines that you are at risk for sleep apnea during a FAA medical examination? Generally, even if the AME thinks you are at an increased risk for sleep apnea, you can still be issued a FAA medical certificate. You may need to jump through a few hoops to satisfy the FAA in the long run, but this is usually satisfied by establishing proof of effective treatment of the underlying sleep apnea. During the FAA medical exam, however, the FAA requires that the AME make a decision as to your risk for sleep apnea. Specifically, the AME will need to identify one of six options to the FAA on your FAA medical application.

For those airmen who have previously been assessed, the AME can select one of the following:

[Applicant] has [sleep apnea] diagnosis and is on Special Issuance. Reports to follow.
[Applicant] has [sleep apnea] diagnosis and is currently being treated OR has previous [sleep apnea] assessment. NOT on Special Issuance. Reports to follow.

If you are an airman the falls into this category, you either already have a special issuance authorization for sleep apnea or you are reporting your diagnosis of sleep apnea to the FAA for the first time on this exam. In this context, the AME’s assessment of your sleep apnea is largely immaterial, as your treating physician would have already diagnosed the condition and (hopefully) initiated an effective treatment.

For those airmen who have previously been assessed the AME can select one of the following:

[Applicant] determined to NOT be at Risk for [sleep apnea] at this examination.

If you are an airman that falls into this category, you are in the clear. Your AME will issue your medical certificate, if you are otherwise qualified.

For those airmen who may not have a prior diagnosis of sleep apnea, but the AME believes to be at risk for sleep apnea:

Discuss [sleep apnea] risks with airman and provide education material.
At risk for [sleep apnea]. AASM sleep apnea assessment required. Reports to follow.

If you are an airman that falls into this category, your AME either believes you should be cautious about sleep apnea becoming a problem or the AME believes that you have sleep apnea and need to be assessed clinically. If your AME selects one of these boxes on the FAA medical application, there is still a good chance you can be issued a medical certificate by your AME, if you are otherwise qualified. Following issuance, however, you can expect to receive a letter from the FAA, requesting more information about your risk for sleep apnea. Typically, this will require you to undergo a clinic sleep study, as well as consult with a sleep specialist about the severity of your sleep apnea, if any, as well as provide the FAA with evidence of any potential treatment.

For those airmen who may not have a prior diagnosis of sleep apnea, but the AME believes to be at a high risk for severe sleep apnea:

Immediate safety risk. AASM sleep apnea assessment required. Reports to follow.

If you are an airman that falls into this category, your AME believes you are not safe to be issued an airman medical certificate. You will not leave your AME’s office with a medical certificate if your AME selects this box. You can expect to receive a letter from the FAA, requesting more information about your risk for sleep apnea. In our experience, it is rare for an AME to trigger box 6, but if you do, it is wise to consider an evaluation with a sleep specialist as soon as possible, FAA notwithstanding.

In any situation where the AME checks a box that includes “reports to follow,” the FAA will require documentation regarding the existence and severity of sleep apnea, your treatment of sleep apnea, and a status report from your treating physician regarding the severity of your sleep apnea. Typically, thereafter, the FAA will place you on a special issuance authorization, in an effort to monitor the status of your sleep apnea. It is always a good idea to have an understanding of your risk of sleep apnea before you sit for your FAA medical examination. Having a good awareness of your risk for sleep apnea can allow you to streamline the process and provide all necessary documentation to your AME at the time of exam.

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 sleep apnea, 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 sleep apnea on your FAA medical application, a FAA medical attorney can give you counsel on how to rectify your omission.

If you are concerned about your FAA medical and the assessment for sleep apnea during your FAA medical exam, 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 Depression?

ON Jan 12, 2022
/
BY Anthony Ison
/
IN Pilot Law

Is your FAA medical denied because of depression? Fortunately, depression is not a condition which is specifically identified by the Federal Aviation Regulations (14 CFR Part 67) as being a disqualifying medical condition. Instead, however, the FAA has identified depression as a condition which warrants evaluation regarding its aeromedical significance for any given airmen. As is authorized by Part 67 (the body of regulations which speaks to medical certification standards), the Federal Air Surgeon can deny an airman medical certification for a history of a mental condition which either makes the airman unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or 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. See 14 C.F.R. Sec. 67.107(c), 67.207(c), and 67.307(c). In other words, the Federal Air Surgeon can deny you a medical certificate if your history is significant for depressive symptoms which may manifest in an aeromedically significant fashion.

In our practice, we have found that the FAA’s primary concern when evaluating an individual’s history of depression is whether the individual’s case history suggests a risk for recurrence of symptoms. Typically, this assessment manifests through the FAA doctors’ review of your medical records. As you may be aware, when you report a history of depression on your medical application, the FAA’s first response is usually to request that you send all of your medical records relative to your history of depression for their review. Within that review, the FAA is typically looking at whether you have had multiple recurrences of depressive symptoms, whether you are using a disqualifying medication to treat your depressive symptoms, whether treatment has been successful in the past, and what your risk for recurrence of symptoms may be. If this assessment of your medical records (and current evaluations, if available) renders a risk for recurrence of depressive symptoms, the FAA will typically deny your application.

As with all certification matters, the element of proper presentation of evidence is relevant in cases dealing with depression. The key question is: what can you do to sufficiently satisfy the FAA’s concerns that risk is mitigated in light of your history of depression? Sometimes, the answer is consideration of treatment with a SSRI and seeking a special issuance authorization, or maybe it is appropriate to challenge whether your diagnosis of depression was accurate in the first place. No matter the approach, the FAA needs to see that risk is sufficiently mitigated, despite your medical history.

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 of depression? 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
/
BY Anthony Ison
/
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
/
BY Anthony Ison
/
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.

Tag: FAA Medical

FAA Medical with a Possession Conviction

Assessment for Sleep Apnea During Your FAA Medical

FAA Medical Denied Because Of Depression?

FAA Medical Denied Because of Coronary Artery Disease?

FAA Medical Denied Because of a Colostomy Bag

Recent Posts

Recent Comments

Archives

Categories

Contact The Pilot Lawyer for a confidential case review.