federal aviation certification updates
TRANSCRIPT
Federal AviationAdministration
CertificationUpdates:
Warren S. Silberman, DO
Aerospace Medical Education Division
September 2017
Federal Aviation AdministrationAME Updates
Structure Changes to Guide• 3 columns (was 4)• Moved the “class” to top of page• Look for “Updated” dates• USE THE DISPO TABLES---to help a/m
collect the info we will ask for
Federal AviationAdministration
AME Updates
Updates---how to find changes
Last Wed of themonth: AME guide“archives section”with links
www.faa.gov/go/ame
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AME Updates
Structure Changes -- AME aids• Disposition table updates• CACIs• Status Reports• AME Checklist• Certification Aids• Airman Questionnaires• Pharmaceutical sections
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Federal AviationAdministration
AME Updates
Disposition tables• Start here• Many conditions can now be cleared by the
AME at this step• Need block 60 notes
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Federal AviationAdministration
AME Updates
CACIs---4/9/2013• Allows AME to issue from the office without
calling the FAA.• Start with the Disposition Table first• If CACI is needed--Follow the worksheet• If NOT CACI qualified—most likely will AASI
or SI
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Federal AviationAdministration
AME Updates
CACIs• AME can issue if the
worksheet criteriaare met
• Worksheets Do NOTneed to besubmitted to FAA
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Federal AviationAdministration
AME Updates
If NOT CACI qualified
• See what info tosubmit
• Middle column• Possible AASI or SI
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Federal AviationAdministration
AME Updates
CACI vs Special IssuanceCACI Special issuance
Where to find info to submit Dispo table first, then CACI Dispo table
Initial presentation AME can issue if conditions aremet
AME must defer
Follow up AME can issue if conditions aremet
AME can issue follow up withvalid Authorization Letter
Reports are due 1st and 2nd—annually3rd class—at each exam (2 or 5years)
Per Authorization letter (mostare annual)
If not qualified May be special issuance Defer for FAA decision
Reports submitted to FAA No—keep in your records Yes
Time limited cert NO Yes
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AME Updates
CACI-- Pearls• See if CACI is even needed (dispo tables)• Review the required documents• Block 60 notes
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Federal AviationAdministration
AME Updates
CACI block 60• Previously:
– “Airman meets certification criteria for hypothyroidism”• NOW
– CACI qualified hypothyroidism
• Working on a CACI button• If no block 60 notes—it is an AME error
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AME Updates
Status Reports• Must be signed and dated• Can take the place of clinic
notes• Must be submitted to FAA
• Current:– Diabetes– Gender Dysphoria
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Federal AviationAdministration
AME Updates
AME Checklist• Must be signed and dated• Does NOT take the place of
clinic notes– Allows AME to issue a follow up
if criteria met
• Must be submitted to FAA
• Current:– SSRI recert– HIMS recert
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AME Updates
Certification Aids• Designed to treating
providers• Does NOT need to be
submitted• Must be submitted to
FAA• Current:
– SSRI recert– HIMS recert
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AME Updates
Airman Questionnaires• Designed to collect history
from the airman• Must be submitted to FAA• Only used for specific
conditions
• Current:– Seizure history
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AME Updates
Pharmaceutical section• Designed to identify
meds allowed/notallowed/wait time
• Only used forspecific conditions– Do Not Issue –Do
Not Fly list– Pharmaceuticals
table
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Federal Aviation AdministrationAME Updates
Changes since 3/2015– Seizure history sheet added– SSRI and HIMS standardization– Remove ATCs (x color vision)– Student Pilot combined cert
remove 4/1/16– Mitral valve repair– Gender Dysphoria– Chronic Kidney Disease– HTN medication section expanded,
CACI updated, 7 days, new AASI,FAQ
– Kidney stones---big changes,CACI, AASI
– Renal cancer CACI– PC and TC have CACI worksheets– ED/BPH meds– Bladder cancer CACI– HIV prophylaxis meds– Hypothyroid 1 year TSH is ok– Diabetes. IDDM—3rd class send to
AMCD/RFS. 1st/2nd class decisionreview at HQ, DM form, metformin14 days
– CACI wording changes
Federal AviationAdministration
AME Updates
SSRI Program Changes• Initial
– 6 months on meds (was 12) to consider for initial Authorization– AME must defer– Worked at HQ
• Recerts– Can be issued by HIMS AMEs in some cases– Must now see face to face every 6 months– Checklist
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Federal AviationAdministration
AME Updates
SSRI and HIMS—AME pearls• Current auth letter is ok to use• Will get new auth letter saying 6 months
• AME phone calls/complaints---HQ• AME questions—send to AAM-220• SEE HANDOUT (checklist and cert aid)
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Federal Aviation AdministrationAME Updates
Student Pilot changes 4/1/16• Removal of the COMBINED student pilot
certificate and medical certificate• AMEs—continue to perform AME medical
exams.• Student need a medical prior to solo
Federal AviationAdministration
AME Updates
Student Pilot – AME pearls• 1) MFT needed---AME should defer• 2) Restrictions eliminated
• Valid for MFT only• VSPPO—valid for student pilot purposes only• Not valid until (mm/dd/yy) age 16
• 3) Language requirement—FSDO• 4) Transmit all w/in 14 days
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AME Updates
Student Pilot – where AMEs arehaving trouble• Think they cannot do the medical if they
are a student• Places to go for help• www.faa.gov.go/ame
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AME Updates
Mitral Valve Repair• Followed indefinitely• Previously all Special Issuance• Now 5 or more years out—possible CACI
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AME Updates
Mitral Valve—not CACI qualified• Mitral Valve REPLACEMENT• Any other valve• Any other additional valve• Any of the Co-morbid conditions
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AME Updates
Mitral Vale Repair–AME Pearls• If 5 or more years out---- New CACI
– see if CACI qualified– What’s NOT a CACI
• Other valves• Other cardiac conditions• Co-morbid conditions
– Echo results—use the CACI worksheet• If not—may qualify for AASI (annual c/s and
echo)39
Federal AviationAdministration
AME Updates
Gender Dysphoria• The AME may ISSUE (no further information is needed), if the
airman:• Was evaluated for or diagnosed with Gender Dysphoria and
has never undergone treatment (counseling or support groupfor GD does not require information);
• Has no history of other mental health diagnoses or treatment;and
• Is otherwise qualified
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AME Updates
Gender Dysphoria–AME Pearls• 5 or more years stable on meds—AME may be able
to issue• Change in status may reset 5 year clock
• Use the AME Gender Dysphoria Status Report• If airman has shaded answers---send in addition
info
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Federal AviationAdministration
AME Updates
CKD – AME Pearls• New CACI• New AASI
– New info in the guide– eGRF – if other testing was done, have the airman
submit
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Federal AviationAdministration
AME Updates
Latest CACI: COLON Cancer
• The 17th CACI is Colon Cancer– Need Current Status Report– Note Chemo TX or XRTx would not qualify– Positive margins or Metastasis also a “no go”– No Recurrence for CACI– CEA at Dx must be < 5 ng/ml– Cannot have HgB less than 11 (done within 90 days)
Federal AviationAdministration
AME Updates
HTN- AME Pearls• CACI is based on # of component meds
– Lisinopril/HCTZ is 2
– 7 days no fly when starting meds– (was 14 day no fly)
– New AASI if 4 or more meds
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AME Updates
Kidney Stones – AME Pearls• 5 or more years ago---AME may issue• If retained stones
– No complications– Possible CACI– If complications---possible AASI– Size and number no longer requirement. Urologist
needs to state if treatment is needed.
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AME Updates
Hypothyroid• TSH within the last year for CACI (was 90 days)
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AME Updates
Diabetes• B-blockers and insulin• B-blockers and sulfonylurea• ALLOWED
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AME Updates
Diabetes---IDDM• 3rd class---as before• 3rd class who wants to upgrade---ok to issue
3rd class if qualified and a/m wants in themeantime (per auth letter) while HQ workson the upgrade
• 1st/2nd – worked at HQ
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Federal Aviation AdministrationAME Updates
Summary• Condition Changes• Updates
– Dispo tables– CACI– New AASIs– AME & treating physician tools
• What’s next
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