12 Tips for Taking Your Medical Exam

Health Watch

By Dr. Quay Snyder, ALPA Aeromedical Advisor

1. Establish a long-term relationship with an aviation medical examiner (AME)

An AME who knows your medical history and will make the effort to help you keep your certificate may save you a lot of time and anxiety. The AME will also have records from your previous exams and copies of FAA correspondence. Canadian pilots will see a civil aviation medical examiner (CAME) designated by Transport Canada.

2. Select an AME/CAME who you’re comfortable using

The AME/CAME should be willing to work with you, your physicians, and the FAA or Transport Canada to help you retain your medical certificate. An AME/CAME who makes a phone call to the regulator for you may save you weeks or months in certification determinations. If you’re comfortable discussing any medical concerns with your AME/CAME, they can potentially serve as your primary care physician as well.

If you’re hesitant in raising medical concerns with your AME/CAME, find a different doctor to provide your primary care. Your well-being is too important to withhold information from a medical professional who can help optimize your health.

3. Understand the three possible outcomes of an FAA medical exam

Most FAA exams result in the AME issuing the certificate. If you clearly don’t meet FAA medical standards, the AME may give you a denial letter revoking your current certificate. The AME must then forward that information to the FAA Aeromedical Certification Division (AMCD).

Denials are rare and not necessarily permanent. If you document that the medical condition has been resolved or is being treated in an aeromedically safe manner, the FAA may reissue your medical certificate.

With a deferral, the AME notes a questionable medical condition and sends the application to the FAA regional flight surgeon or AMCD. With the AME’s permission, you may fly until your current medical certificate lapses. Obtaining an FAA response to a deferral can take several months. Submitting complete information to the FAA is critical to timely certification.

The FAA recently added a new feature to MedXPress that makes the status of medical applications available to pilots and AMEs online. This change will reduce the administrative burden on the FAA and greatly help pilots understand where their medical certification is in the certification process.

Transport Canada is currently experiencing significant delays in processing exams that require additional information to make a determination.

4. Take your physical exam early in the month that it’s due

Don’t wait until shortly before your medical lapses to schedule another physical. If a medical condition arises that requires you to provide additional information, obtaining that information may take several days or weeks. An AME may only hold a medical application for 14 days from the date of the exam before issuing or deferring the application to the FAA. If more information is required, a pilot may continue to fly on the current medical certificate for the duration of its validity while awaiting a certification determination on the new application unless the AME specifically grounds the pilot.

5. Don’t have a physical exam if you’re not medically qualified

If you have a disqualifying condition or are using nonallowed medications when your next physical is due, you should let your medical certificate lapse. When the condition has been resolved, take documentation from your treating physician to your exam, give it to your AME/CAME, and note the treatment on your application. Expect to walk out with a new certificate. There’s no harm in allowing a medical certificate to lapse other than not being able to fly until the condition is resolved and a new medical certificate is issued.

6. Take appropriate documentation

If you’ve had visits to health professionals since your last exam, call the AME/CAME or ALPA’s Aeromedical Office to confirm what documents will be required to submit with the application.

An FAA program, AME Assisted Special Issuances (AASI), allows AMEs to renew special issuance medical certificates for 30 specific medical conditions for all classes of medical certificates. The FAA also has 20 “Conditions AMEs Can Issue” (CACIs).

With both AASIs and CACIs, be sure to bring all the required documentation from the worksheets so that the AME will be able to issue a new medical certificate if all information is favorable and the documentation is complete.

7. Take glasses, contact lenses, or hearing aids, if required

You must meet the vision and hearing standards to qualify for a new medical certificate. The use of glasses and hearing aids is allowed and encouraged if needed to meet the standards. If glasses or hearing aids are required to meet certification standards, the AME will place a limitation on the medical certificate. Examples include “Holder shall wear corrective lenses” or “Valid only with the use of hearing amplification.”

8. Prepare physically for the exam

Be well rested and avoid caffeine, tobacco, and stimulant medications (e.g., decongestants) before your physical exam—especially before an electrocardiogram. These substances may elevate your heart rate. Meals high in sugar may cause an erroneous urinalysis result, which raises a suspicion of diabetes. If you’re an endurance athlete, running a flight or two of stairs before the ECG will help you get your heart rate above 50.

9. Understand reporting responsibilities on your medical application

List all visits to health-care providers (except FAA exams and routine dental/eye exams) or risk revocation of your medical certificate and all airman certificates for as long as one year.

Remember to list all disability benefits (including full or partial veterans benefits) if you’ve ever received them in the past or are currently receiving them.

Also be sure to list any prescription or nonprescription medications you currently use. Contact AMAS with any questions about reporting medications for which you have a current or open prescription.

If you’ve checked “Yes” to any of the questions up to Question 18 in the past, you must continue to check Yes to those questions in all future exams. If you haven’t sought care for those conditions since your previous exam, you can indicate “Previously Reported, No Change.”

ALPA’s Aeromedical Office strongly advises you to print a copy of the secure electronic version of Form 8500-8 prior to electronically submitting information to your AME and retain it for your records. If any new events occur between the electronic submission and your exam, the AME can assist you in making additions or corrections.

10. Remember to check the blocks regarding drug and alcohol offenses and other legal encounters

Your signature on Form 8500-8 authorizes the FAA to search the National Driver Registry for violations. Falsifying a medical application can lead to five years in prison, a $250,000 fine, and revocation of airman certificates and ratings. Read the attached instructions carefully and call ALPA’s Aeromedical Office with questions.

11. Be prepared to send additional information to the FAA upon request

The FAA usually gives pilots 60 days from the date of the letter to submit requested information. If you can’t meet this deadline, call AMCD Customer Service at 405-954-4821 and ask for a 30-day extension.

Don’t call until near the end of the original 60 days, as the FAA grants the extension from the day of the request. You may continue to fly with a current, valid medical certificate issued by the AME pending a final determination from the FAA.

12. Contact an aviation medicine specialist early if you have questions

ALPA members in good standing can get free, confidential consultations and assistance regarding aeromedical certification by calling ALPA’s Aeromedical Office at 303-341-4435, Monday–Friday, 8:30 a.m. to 4:00 p.m. mountain time. Information regarding FAA policies, medical conditions, and medications is available at AviationMedicine.com.

For more information on aeromedical issues, go to alpa.org/aeromedical.

This article was originally published in the April 2022 issue of Air Line Pilot.

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