1. 

Q: If I have to take blood pressure medications, will I lose my medical?

A: Of course not! this is one of the most common medical problems pilots face, and is one of the easiest to handle with the FAA. All the usually prescribed anti-hypertension medications in current use are approved by the FAA. The first flight physical after being placed on blood pressure medications requires forwarding a brief cardiovascular status report by your treating physician, including mention of the medications used, their dosages, and whether there are any adverse effects. Routine lab tests and an electrocardiogram (ECG) are also required the first time; as is documentation of stable pressures by demonstrating 3 blood pressure readings (below 155/95). Brief mention of any complications of the hypertension itself is also ncessary. A follow-up current status report is required at the time of renewal of the next medical for Class III pilots, and annually for Class I and II pilots. The follow-up reports do not require any further ECG's, and lab tests are only required if taking a potassium depleting diuretic (water pill). In reality, these reports are no more than what a good doctor should be doing anyway! Of course, it is best if the pilot presents these reports to the AME at the time of the examination, in order to avoid any hold-up in issuing the certificate.

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2. 

Q: What is the difference between a Class I, II, and III physical examination?

A: Class III examinations are required every 3 years if the applicant is under the age of 40 at the time of examination, otherwise every 2 years. Class II exams are valid only for one year, and Class I for 6 months. For pilots over 35, an ECG is required for Class I, and then annually after the age of 40, and these must be performed at the AME's office and transmitted to the FAA electronically. Vision standards are also different between private and commercial categories. For example, a Class I and II pilot need to be able to see 20/20 in each eye (corrected if needed) for distant vision, while a private pilot can get by with 20/40 vision. Commercial pilots over the age of 50 are required to demonstrate intermediate vision of at least 20/40, in addition to the near vision requirements, which are the same (20/40) for all classes. Commercial pilots also must demonstrate reasonable depth perception by measuring eye alignment.

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3. 

Q: What is a SODA?

A: A Statement Of Demonstrated Ability (SODA) is a determination that a pilot can fly safely with a fixed physical deficiency, such as the loss of an eye or a limb. The pilot must demonstrate to an FAA examiner that he or she can safely fly with this handicap, and a waiver, called a SODA, will be issued for this particular physical deficiency. There may be some restrictions placed on this waiver, for example, the need for hand controls, if the pilot is paralyzed in the lower extremities.

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4. 

Q: Can I fly commercially if I am color blind?

A: That depends on the severity of the color vision deficiency. If mild enough to pass a Color Signal Test or Farnsworth Lantern Test, the pilot would be issued a letter by the FAA that "waives" the color vision test requirement. However, if the pilot cannot pass, a limitation will be placed on the medical certificate that states "Not valid for night flight or by color signal." Under such circumstances, it is doubtful that an airline would hire such a pilot for commercial flying.

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5. 

Q: How does the FAA handle DUI's?

A: The FAA takes any form of substance abuse or dependence very seriously. If a pilot is arrested for a DUI, he or she must report this to the security division of the FAA within 60 days of a conviction. This must also be reported on the next flight physical application. The AME is then required to assess the pilot for alcoholism. If the AME determines that the DUI was of a one-time nature and there is little concern that the applicant truly has trouble with alcohol, then the AME may issue the certificate. However, if the AME feels otherwise, particularly if there is more than one alcohol-related offense involved, the AME may not issue the certificate and defer judgment to the FAA. In such a case, it is helpful if the applicant gathers all court records and obtains a Substance Abuse Evaluation, all to be forwarded to the FAA for determination of eligibility.

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6. 

Q: I have been diagnosed with Adult Onset Diabetes. How does this affect my medical?

A: If it can be determined that your diabetes is well controlled by diet and exercise alone, then only a report from your physician is required and the airman can receive an unlimited medical certificate from the AME. However, if medications are necessary, the pilot must be considered under Special Issuance, as diabetes requiring medications is a disqualifying medical condition. Class I and II pilots are not allowed to use insulin. Class III requirements for insulin-dependent diabetics are quite stringent, emphasizing the absense of any hypoglycemic events. For diabetics requiring only oral medications, annual reports from the treating physician are required. These reports must show that the pilot is under adequate control with medications by virtue of a hemoglobin A1C below 10, that there are no adverse effects from the medication, and that there are no complications to other organ systems from the diabetes itself. Under this circumstance, the medical certificate would be limited to one year, with further certificates contingent upon favorable reports from the treating physician. If a pilot is diagnosed with diabetes on his or her FAA examination, a minimum waiting period of 60 days is required to determine effectiveness of oral medication.

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7. 

Q: If I had a childhood illness or surgery, do I have to continue reporting it on the application?

A: Technically, yes. Section 18 of the application requires disclosure of your entire life's medical history. However, anything previously reported does not need to be re-explained each time. It is alright to mark the question "yes" and state "previously reported, no change" in the explanations box.

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8. 

Q: I see my physician several times per year for my medical condition. Do I have to report each and every visit?

A: In box 19 of the application, it asks about visits to health professionals in the last 3 years, the date, name and address of the physician, and the reason for the visit. If there are several visits for the same type of medical condition, it is not necessary to list each episode. Aggregating them, for example, to the last visit, is perfectly acceptable. It is also not necessary to remember the exact dates of the visits. These questions have more to do with prompting the AME to understand your medical situation and to perhaps request medical records, than to exercise your detailed memory of your medical appointments. Routine preventive health check-ups are not included, unless these examinations result in treatment of an illness. Your FAA flight physical examinations are also not required to be listed here. Please not that "previously reported" is not an option for this category!

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9. 

Q: I see my physician several times per year for my medical condition. Do I have to report each and every visit?

A: In box 19 of the application, it asks about visits to health professionals in the last 3 years, the date, name and address of the physician, and the reason for the visit. If there are several visits for the same type of medical condition, it is not necessary to list each episode. Aggregating them, for example, to the last visit, is perfectly acceptable. It is also not necessary to remember the exact dates of the visits. These questions have more to do with prompting the AME to understand your medical situation and to perhaps request medical records, than to exercise your detailed memory of your medical appointments. Routine preventive health check-ups are not included, unless these examinations result in treatment of an illness. Your FAA flight physical examinations are also not required to be listed here. Please not that "previously reported" is not an option for this category!

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10. 

Q: Is there an approved medication list published by the FAA?

A: No, as this list is constantly updated (it would be impossible for them to produce and maintain). However, there is a good information on medications that are allowed and disapproved on the web site of the ALPA aeromedical physicians, click here. Or ask your AME or Regional Flight Surgeon's office.

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11. 

Q: Can I fly if I have been diagnosed with ADD?

A: If this was a "soft" diagnosis in childhood, and it can be determined that no medications are needed and the applicant has no current evidence of Attention Deficit Disorder, then the answer is probably yes. however, if there is reason to believe that true ADD exists, the pilot will probably be found ineligible. After all, would you want to fly with someone who can't pay attention?

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12. 

Q: What about a diagnosis of depression?

A: There are basically two different kinds of depression. Situational depression occurs to normal and mentally healthy people, when they find themselves in depressing situations. As long as the individual has resolved their depression and is no longer requiring medicatiosn after a "reasonable" period of time, the FAA will likely certify, based on a favorable current psychiatric evaluation. However, if an individual has recurrent, cyclical depression due to abnormal brain chemistry, the FAA will not certify. Sometimes it is difficult to tell the difference, and a "reasonable" period of time must lapse after the first episode resolves, in order to determine that it is not likely to recur. It is important to emphasize that all anti-depressant medications, whether used for depression or other conditions, are considered disqualifying by the FAA.

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13. 

Q: What about sleeping pills?

A: All over-the-counter (OTC) sleeping aides are actually antihistamines, have a very long half life, and should be avoided for at least 12-24 hours after ingestion. In some people, cognitive effects can last even longer. The FAA has approved two short-acting prescription sleep aides, but with two important restrictions. First, they should not be used more than 1-2 times per week. as habituation can easily occur. Secondly, there are required waiting periods between ingestion and flight. Ambien has a 24 hour waiting period, and Lunesta has a 12 hour waiting period. Of course, individual variations can occur, and pilots should "ground test" them before using them prior to a planned flight.

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14. 

Q: Do I have to disclose medications I occasionally take, if not currently taking at the time of the examination?

A: This depends on the type of medication and the reason. For example, if an individual took an antibiotic some time ago for a few days for an infection that is not a chronic condition, then that does not need to be reported. However, if a medication, even an OTC drug, is periodically used for a chronic medical condition, this should be reported, even if not being taken at the time of examination. Anti-inflammatories such as Advil come to mind, for example, for an individual with arthritis who takes it only when needed. If not sure, this is a good question to ask of the AME at the time of the examination.

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15. 

Q: Can I fly if I have had a kidney stone?

A: Yes, if it can be domonstrated by an imaging technique (X ray, CT scan) that the stone has passed. The question becomes more complicated for pilots who have recurrent stone formation, as these can be unpredictable and the pain quite incapacitating when new stones form in the urinary tract. These individuals should be carefully evaluated by a specialist for determining the cause of the recurrent stone formation, so that preventive techniques, if any, can be utilized.

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16. 

Q: I was recently treated for prostate cancer. how long do I have to wait before I can fly again?

A: As soon as it can be determined that you are cancer free and your treatment is concluded, you can be eligible again under Special Issuance. Because prostate cancer can often be eradicated before the cancer has spread beyond the prostate capsule, pilots with successful treatment of this form of cancer can frequently return to flying immediately after their therapy is finished. This is not necessarily the case of other cancers, such as breast cancer, which can spread to othe rbody areas, by virtue of only a single cancer cell escaping and lodging elsewhere in the body. Many other cancers require waiting periods to determine a cancer-free state.

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17. 

Q: I am worried that I might not pass my next medical due to a heart condition. I would be satisified to fly an airplane that qualifies under Sport Pilot rule. Should I try to get my medical anyway?

A: Probably not. Although the FAA requires only a valid driver's license as proof of medical suitability for the Sport Pilot category, it does exclude individuals who have had a previous denial of their medical certificate. To me, this makes no sense, as it creates a double standard. Having said that, if you knowingly have a medical condition that is a risk to flight safety, you should not fly under the Sport Pilot rule, even if you do hold a drivers' license!

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18. 

Q: What is Special Issuance?

A: Special Issuance is a category of medical certification for pilots with certain disqualifying medical conditions. Many pilots fly with conditions that are technically disqualifying, but are stable enough that they can be issued a time-limited certificate under careful medical monitoring. Medical conditions such as well-controlled diabetes or slowly developing neurological conditions such as Parkinson's come to mind. Even people with coronary artery disease often can return to flying, as long as their disease is well managed and they are not at significant risk for having an adverse medical event due to their condition. These Special Issuance certificates are time limited, often to a year, requiring status reports from the treating physician to be forwarded to the FAA before a new medical certificate can be issued. The requirements for future consideration are spelled out in the Special Issuance Authorization Letter. Often the tests that the FAA requires are more than what the treating physician feels is necessary to monitor the condition or disease. It can therefore be challenging for the pilot to convince their doctor, much less their insurance company, of the need for this additional testing. For pilots facing Special Issuance, it is highly recommended that they consult with their AME before making the appointment for the FAA physical examination. This will allow the pilot to have all the required medical records in hand, so that their medical certification process is not held up by waiting for the required documentation.

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19. 

Q: the FAA sent me a letter requirng more medical information within 30 days, otherwise I might ahve my medical certificate revoked. I am not able to obtain these records within that period of time. What should I do?

A: It is important tha tyou at least respond to the FAA in writing within 30 days, and let them know that you are attempting to gather the necessary documents. They will give you a 30 day extension if you request this, but be prepared to give them everything they need as soon as possible.

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20. 

Q: I had surgery a couple weeks ago, and during this time, I did not fly. Do I need to forward a report from my surgeon to the FAA to indicate that I am fully recovered?

A: Unless the surgery was for a disqualifying condition, you do not need to report anything to the FAA until your next FAA medical examination. As long as you did not fly during your incapacitation, you did not violate any FAA regulations. As soon as you have recovered and are no longer taking disqualifying medications, you are good to get back into the airplane. If you are not sure whether or not the reason for the surgery is diqualifying, please check with your AME or Regional Flight Surgeon.

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21. 

Q: Should my AME also be my personal physician?

A: There is a difference of opinion on that. Some pilots prefer their AME and their personal doctor to be one and the same, with the idea tha their doctor will more easily catch medical conditions that are potentially problematic for the FAA. Others feel they can be more honest about their health concerns if their personal physician is not also their AME. Interestingly enough, the FAA takes the latter position, even though they have no regulations on this matter.

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