In prior blogs, I have spoken about techniques and recommendations for being prepared for your FAA medical exam. These discussions have included considerations for proper medical records documentation (when required), getting the MedXpress application filled out in advance of the exam, and disclosing to the aviation medical examiner (AME) proactively if there have been new medical conditions that arose in the time between scheduled FAA medical exams.
One thing you have heard me say more than once is to “tell the AME” about new medical conditions. If there have been new surgeries, other significant medical events, prescription medications (that are expected to be ongoing, such as for high blood pressure), and, heaven forbid, a new DUI, let the AME know in advance of your next FAA medical exam.
Once being informed of the new medical circumstances, the AME can usually give pilots some guidance for any documentation that might be needed and how to best report the new conditions on the MedXpress application. To prevent any disappointing surprises, the AME can also let pilots know if they will or will not be receiving a new medical certificate at the time of the next exam.
It is never fun for the AME to have to give a pilot either bad news or a laundry list of documentation that might be required. While the additional work to comply with the AME’s request is a burden on the pilot, this also then becomes a burden on the AME. However, when telling a pilot about the ramifications of the new medical condition and the documentation that will be required, I remind them that I am making this seem difficult only in my efforts to act as their advocate, not adversary.
The sooner the AME can get the proverbial ball rolling on documentation—and any potential new evaluations that might be required—the more likely it is that a pilot will either be able to walk out of the AME’s office with a new medical certificate in hand or, if a certificate can’t be issued at the time of exam, that any potential time being grounded may be reduced. Hence, the value of telling the AME in advance if a potentially complicating medical situation arose in the time period after the pilot’s last medical exam.
All of that said, please also respect the AME’s time. I spend several hours every day just answering questions for pilots who do not have exams scheduled with me on that day. This is time that cannot be used for routine FAA exams, which are paid for at the time of the exam.
And, to be frank, much of my “advice” time goes unreimbursed. Any lengthy consultation, of course, must be billed for (no different than asking for the expert legal advice of an attorney). So when asking the AME to give advice about the ramifications of a new medical condition, try to be prepared to give a complete history, but to be able to do it succinctly.
Also, try not to express anger and frustration at the AME, who is just giving advice based on FAA precedent and protocol, even if the answers are not the ones you were hoping for. Again, the AME is acting as your advocate in these kinds of situations.
Given that my AME practice is largely for pilots with complicated medical conditions often requiring a special issuance authorization, I accept that I will be answering lots of questions. That’s part of the deal that I accept and understood full well going into the special issuance game nearly 30 years ago. But it’s also very rewarding to help pilots get back in the air, especially when they wondered if their careers were over. While this is time-consuming and stressful work for the AME, it is usually well worth the effort.
These kinds of rewarding success stories are part of why I also participate in the Human Intervention Motivation Study (HIMS) program, which has returned more than 7,000 pilots who have a diagnosis of alcohol and/or other substance abuse or dependence back to the cockpit since the program’s inception in the 1970s. In previous blogs, I covered alcohol- and substance-related issues and the HIMS program.
Regarding alcohol-reporting requirements, an important point to remember is that in addition to reporting any alcohol (or drug) motor vehicle arrest at the time of the next FAA medical exam (in item 18v on the MedXpress application), there is also a separate reporting requirement per FAR 61.15. A pilot must make a separate report to the agency’s security and investigations division for a history of any license suspension, conviction, etc., that resulted from an alcohol- or drug-related motor vehicle action. This must be done within 60 days of the action.
The FAA has a DUI/DWI webpage with further information, including a more complete reference to all reportable events and/or administrative actions. I recommend doing this kind of report from a computer that has a printer attached so that you can print your notification letter at the time it is submitted to the FAA. Keep copies of the notification letter itself, the automatic email from the FAA that your notification was received, and later for any letters that the FAA sends to you.
And, of course, if you are in the unfortunate position of having to make such a report, contact your AME for guidance regarding the documentation that will be required at (or possibly prior to) your next FAA exam. In addition to a formal response by letter from Security and Investigations, you may also get a letter from the Aerospace Medical Certification Division (AMCD) asking for data once the Security and Investigations Division notifies the AMCD of the FAR 61.15 report.
Calling your AME proactively will give you a head-start on the data that will be required anyway, as will ultimately be noted in any letter you eventually receive from the AMCD.
A final word regarding the MedXpress application process. The system does still go down periodically, so please don’t wait until the very last minute to fill it out. Additionally, the system often asks pilots to update their passwords, with increasingly tedious parameters that must be followed.
Please try to do all of this at least several days before your upcoming visit with the AME. Remember to have your MedXpress confirmation number with you, and, if possible, print your application. In any case, simply having the confirmation number readily available will be very useful for the AME.
While it is advisable to inform the AME of new medical conditions that might complicate issuance of your next medical certificate, please remember to treat urgent medical conditions urgently. Do not wait to hear from your AME in the middle of a medical crisis, which only delays necessary treatments. Please get urgent or emergent care in a timely manner, and you can interface with the AME later.