Story ID: 
AINsight: FAA Letters, Part 2
By: Robert Sancetta
Caption: There is no time for pilots to delay action if they receive a letter from the FAA asking for additional medical intervention. Act immediately!
Word Count: 1158
In part two of this series, I want to discuss a particular type of letter that pilots sometimes receive from the FAA that requires their immediate attention.
I previously discussed some of the reasons why the FAA might send letters. Some are simply to acknowledge the report of a specific medical condition, while occasionally there is the rare denial of the pilot’s medical certificate based on a medical condition that might adversely affect aeromedical safety.
Very commonly, however, letters are sent by the FAA to a pilot asking for additional information about a specific medical condition. This is one version of the “nastygrams” that I referred to previously.
The FAA always maintains the right to ask for additional medical information as its mandate is to ensure aeromedical safety. Therefore, simply asking for additional medical information is not a violation of a pilot’s rights.
There are times when a pilot—often with the help of their AME or other consulting aeromedical services—has already submitted required data, yet the FAA then comes back with yet another request for additional information. This can be frustrating to the pilot and their treating physician, but FAA requests for additional medical information are not optional, even if the treating physician does not feel that such testing is necessary.
The purpose of discussing this particular type of FAA letter in this submission is primarily to emphasize some important logistical timing considerations.
Most of the requests for additional information do not “deny” the pilot’s medical certificate. These letters typically have verbiage that the FAA is “unable to determine the pilot’s eligibility,” hence the request for additional information.
These letters typically give the pilot 60 days to submit the information. On the surface, that seems reasonable. While the treating physician often does not have time on the schedule to fit in the pilot immediately, more often than not testing can be accomplished within 60 days.
If, however, a pilot simply ignores the FAA request for additional data, the FAA will eventually deny that pilot’s medical certificate.
That said, the rub is in the actual timing and processing of these letters. Recently, it has been taking anywhere from two to four weeks for the pilot to receive the letter from the date that it was originally processed at the FAA.
The AME usually receives a copy of these letters, and I recently received a copy of a letter that was dated a full five weeks previously. Many such letters are sent both by regular and certified mail, so tracking when the pilot received the letter is more feasible.
Upon receipt of the letter, the pilot is sometimes halfway through the 60-day submission requirement stated in the FAA letter.
Once the pilot and the treating physician scramble to obtain the additional testing, it is then sent to the FAA for review. Another rub in this process is that it often takes yet another one to two weeks for the data to be logged into the system for scanning, after receipt at the appropriate FAA office. And, you guessed it, the FAA does not consider the data as having been received until it is logged in for the scanning process.
Therefore, a pretty good chunk of the 60-day requirement can be eaten up purely in the logistics. So if you—as a pilot—receive a letter asking for additional information, get on it immediately.
While the FAA does try to be a bit reasonable about this, I have argued that the timing of the receipt of FAA letters and logging in the additional testing is a bit unwieldy and unfair. A pilot can call the FAA at (405) 954-4821 for a one-time, 30-day extension.
The FAA is supposed to send a letter confirming that extension, so if no such letter is received, then the pilot needs to call again. The pilot should ask for the name of the person spoken with to request the extension and write down the date and time. To be fair, the people who answer these kinds of telephone calls from pilots are outside contractors and they are typically polite and motivated.  
A situation that involved one of my patients recently is as follows: this pilot is followed for a cardiac condition and has been maintained on a first-class medical certificate through the special issuance process.
As per the existing special issuance authorization, the cardiologist provided the “usual” data and was pleased with the pilot’s stability. I sent in the data after approving the medical certificate—the authorization permitted the AME to issue at the time of examination if the data appeared favorable.
However, a few months later the pilot received a nastygram requesting additional data—again, this is not optional and is at the discretion of the FAA physician who reviewed the initial information sent per the special issuance authorization. The letter was dated about a month prior to its actual receipt. The pilot’s consulting cardiologist is very busy and could not get him into the office for the additional testing for several weeks.
So the pilot called the FAA for a 30-day extension. When receiving the next letter from the FAA, it was not the confirmation of the 30-day extension; instead, it was a “failure to provide” denial letter since the 60-days had, by then, been exceeded.
That pilot was then officially grounded, and in a small corporate flight department that caused some immediate staffing challenges. In this case, there was a breakdown in the system, as the request for the 30-day extension was never properly entered.
Fortunately, the requested additional data was indeed reviewed shortly thereafter and the pilot’s first-class medical certificate was reinstated. But, as you can imagine, it was a very stressful and frustrating time for both the pilot and myself as his AME.
While I will discuss more of the individual types and rationale of other letters and their formats in future submissions, the point I want to stress today is to never dilly-dally when receiving an FAA letter asking for submission of additional medical data.
Make a very clear note of the date on the FAA letter, the date it was actually received, and contact your treating physician immediately to try to get the additional testing scheduled. If necessary, call the FAA for a 30-day extension and work with your AME or an outside aeromedical consulting service for assistance.
Opinions expressed in this column are those of the author and not necessarily endorsed by AIN Media Group.