SEPTEMBER/OCTOBER 2009VOLUME 4 • ISSUE 4

1 Tips for Complyingwith ReportingRequirements onFAA MedicalApplications

6 What are myreportingresponsibilities . . . ?

8 The 12 Tips forTaking Your FAAMedical Exam

Tips for Complying withReporting Requirements onFAA Medical Applications

By Quay Snyder, MD, MSPHAssociate ALPA Aeromedical Advisor

Recent actions by the FAA against pilots who have allegedly failed to report medicalconditions on periodic FAA medical applications have raised concerns among pilots.The ALPA Aeromedical Office has developed guidelines for ALPA members in complyingwith FAA reporting requirements and maintaining their medical certification. Theseguidelines should encourage optimization of pilot health, preserve careers, and protectaviation safety. Failure to comply with FAA reporting requirements may result inrevocation of all FAA certificates, ratings, and designations.

BackgroundThe Application for Airman Medical Certificate (FAA Form 8500-8) is used by the FAAOffice of Aerospace Medicine and Designated Aviation Medical Examiners (AMEs) forperiodic medical examinations of pilots to determine initial and continued medicalqualification for duty. The medical qualification process relies on both the historicalinformation provided by the pilot and the results of the examination by the AME.

ALPA Aeromedical is currently engaging the FAA on appropriate methods for pilots tocorrect previously completed medical applications, while protecting them from adversecertificate actions as a result of these corrections. At the time of this writing, no

This edition of the Aeromedical Flyer has two great articles written by Dr. Quay Snyder of the ALPA AeromedicalOffice concerning your AME visit and your reporting requirements to the FAA.

There has been a great deal of confusion in regard to drug- and alcohol-reporting responsibilities. Remember, U.S.pilots are required to make two reports to the FAA. First, you have 60 days to report drug/alcohol “motor vehicleactions” (which include convictions and/or administration actions) to the FAA under FAR 61.15. Second, at yournext AME medical exam, you must report on the FAA Form 8500-8 any drug/alcohol arrests and administrativeactions—which are defined more inclusively than under 61.15.

The important point is that there are two separate reporting requirements, neither fulfilled by the other. Pilotsfailing to complete either reporting requirement are in serious jeopardy of having action taken against their pilot andmedical certificates. If you have further questions, do not hesitate to contact ALPA’s Aeromedical Office.

Fly Safe! Be Healthy! Captain R. A. SolikAeromedical Chairman

2

procedure exists for correcting erroneously completed medical records that guaran-tees protection from adverse action. Please direct any questions to the ALPA Aero-medical Office or ALPA Legal Department.

Form 8500-8Form 8500-8 requires the pilot to complete and sign the front side of the form (page3). The AME reports the results of the medical examination, makes any comments,and signs on the back side of the form (page 4). The AME’s office then inputs theapplicant’s responses on the front of the form and its findings on the back of theform electronically to a database maintained by the FAA Office of Aerospace Medi-cine. The pilot’s responses are to be entered verbatim.

The FAA has developed an online version of the Form 8500-8 that can be completedby the pilot prior to meeting with an aviation medical examiner. The medical appli-cation is termed MedXPress and is accessed at https://medxpress.faa.gov/. Pilotsusing MedXPress will have a unique log-in and password. Following completion ofthe online application, a confirmation number will be e-mailed to the pilot. For theAME to access the application, the pilot must provide the confirmation number. TheFAA encourages the use of MedXPress for all pilots.

Form 8500-8 is a four-page form, with three copies of the third and fourth pages.The first page of the form includes the Privacy Act statement and the PaperworkReduction Act Statement. Under the Privacy Act statement section, there is anexplanation of the FAA’s right to request any information about the applicant fromthe National Driver Register. Access to this information is authorized by theapplicant’s signature on the bottom of the front side (page 3) of the form.

The second page of the form is titled “Instructions for Completion of the Applicationfor Airman Medical Certificate.” Read this page carefully. If not provided with a copyof the instructions, request that information be provided to you before signing theform. The note at the bottom of the instructions page indicates, “If more space isrequired to respond to ‘yes’ answers for numbers 17, 18, or 19, use a plain sheet ofpaper bearing the information, your signature, and the date signed.” Each of theseareas is explained in detail below.

The third page of the form is completed by the pilot. This includes the identificationinformation, a listing of medications, a self-reporting history of medical conditions,alcohol- and drug-related driving actions, misdemeanors or felonies, and explana-tions of visits to health professionals. Because this page is completed in triplicate, acopy should be made available to each pilot at the end of the examination. Werecommend that each pilot insist on receiving a copy of each application. Retainevery copy for your personal records.

The fourth page of the form is for the AME to report the results of each medical exami-nation. Each area of the body examined is marked as “Normal” or “Abnormal.” Abnormalfindings require explanation. Vision, hearing, blood pressure, ECG, and urinalysis resultsare recorded. Note: The urine test is not a drug test but simply requires an evaluation ofblood or sugar in the urine indicating the possibility of other medical conditions. Anyitems listed by the pilot on the front side of the form that are considered medicallysignificant also require an explanation by the AME. A copy of this portion of the form isnot routinely available to the pilot. Many AMEs will provide a photocopy on request.

Completion of Question 17 –Do You Currently Use Any Medication?Three lines are provided to list current medications. Additional medications, dos-ages, and frequency should be listed on a separate piece of paper as noted above.If the medication has been reported on a previous Form 8500-8, indicate so bychecking the box “Yes.” If not previously reported on the form (even if it has beenreported to the Flight Surgeon’s Office between examinations), check the “No” box.

The urinetest is not a

drug test butsimply

requires anevaluation of

blood orsugar in the

urineindicating

thepossibility of

othermedical

conditions.

3

Pilots will be expected to provide dosage information, reason for use of the medica-tion, and a comment about the presence or absence of side effects in the “Explana-tions” section under Part 18 or on a separate sheet of paper.

Note that both prescription and nonprescription medicine use must be reported. The keyissue from a safety perspective usually is not the medication but the reason the medica-tion is being used. Only medication that is currently being used is required to be re-ported in this section. Although the FAA discourages the use of “nutritional supplements”obtained over the counter, there is no requirement to report their use. Nutritionalsupplements are not regulated by the FDA nor restricted by the FAA. They include herbalpreparations, performance enhancers, vitamins, minerals, and many other unregulatedsubstances. Examples include echinacea, creatine, vitamin C megadoses, and calciumtablets. If a health-care professional recommended the nutritional supplement, the visitto the health-care professional is reportable under question 19.

Completion of Question 18 – Medical HistoryThis section requires significant care in completing. The instructions specify “Haveyou ever in your life been diagnosed with, had, or do you presently have any of thefollowing . . . (conditions)?” The critical and ambiguous term “condition” is notdefined anywhere on Form 8500-8. Every condition on which you check “yes” musthave an explanation in the blank space below or on a separate blank sheet of paper.If the condition has been previously reported on a Form 8500-8 and no interimtreatment for the condition has occurred, the pilot should indicate the letter of theaffirmatively answered question (e.g., “18.e”) and write “Previously reported, nochange.” Once an answer has been checked “Yes” on a Form 8500-8, it shouldalways be checked “Yes” on every subsequent form.

Question 18.x lists “Other illnesses, disability, or surgery.” This is obviously a verybroad question. The AME and regional flight surgeon are not interested in mostchildhood illnesses or surgeries or other insignificant events. Carried to an extreme,this question would require reporting colds, mumps, stitches, hemorrhoids, brokentoes, and other trivial medical items from a safety perspective. An ever increasinglist of conditions may be attached to the form if this question is interpreted literally.

In the fall of 2008 the FAA added item 18.y, which requires reporting if you haveever received “medical disability benefits.” If you have received benefits, simplyprovide details of the benefit, such as military separation disability, and note thatyou have no current significant physical limitation. The FAA may request a currentevaluation of the disability.

Given the current actions by organizations outside the Federal Air Surgeon’s Office, it isdifficult to advise pilots on what to omit. A call to the ALPA Aeromedical Office may helpclarify reporting requirements and wording. Neither the AME, the Aeromedical Certifica-tion Division, nor the Regional Flight Surgeons’ offices are interested in the increasedworkload and documentation requirements associated with an exhaustive list of medicalconditions from every pilot. Certainly those conditions that a pilot seeks medical evalua-tion or care for should be reported. Often, attaching a summary from the treatingprovider will minimize requirements to provide further information at a later date.

Question 18.v –Alcohol- and Drug-Related Motor Vehicle ActionsQuestion 18.v asks about a history of “arrests or convictions involving driving whileintoxicated by, while impaired by, or while under the influence of alcohol or a drug.”This would include arrests or convictions for offenses that were reduced to a loweroffense, such as careless driving. This also includes offenses that were expungedby the courts after a certain time period. Pilots who have been ticketed for operat-ing under the influence while driving a golf cart or a boat have also been requiredto report these offenses. Remember, your signature on the form authorizes the FAAto search the National Driver Register.

Have youever in

your lifebeen

diagnosedwith . . .

4

Question 18.v also asks about “history of arrests or convictions(s) or administrativeaction(s) involving offense(s) which resulted in the denial, suspension, cancellation,or revocation of driving privileges or which resulted in attendance at an educationalor a rehabilitation program.” As above, the FAA interprets this very broadly. Theissuance of a temporary driver’s license following a citation, even if the person waslater acquitted, constitutes an administrative action in the FAA’s eyes. If drivingprivileges were suspended in a state in which the person does not hold a license(California, most often), this will appear on the National Driver Register, even if theperson did not lose the state driver’s license s/he holds. Attendance at a three-hoursafety seminar is another example of a reportable event.

Note that in the fall of 2008 the FAA changed the verbiage of the application to include“arrests” in item 18.v. The FAA understands this will require some to report remoteevents not previously reported (e.g., arrests that may have been subsequently adjudi-cated without official action taken on the driver’s license). The FAA will handle suchreporting on a case-by-case basis, looking at the events of the arrest.

The instructions on page two of the form contain detailed explanations of thereporting requirements. If in doubt about a reporting requirement, insist on readingthe instructions. When reading the instructions, think in terms of an FAA represen-tative interpreting the requirement rather than trying to justify not reporting anevent. It is safer.

Do not fail to report any offense in this area. Positive responses may or may nottrigger a requirement for a substance-abuse evaluation. False responses may resultin serious administrative consequences.

Question 19 –Visits to Health Professionals Within the Last Three YearsQuestion 19 has been the most common source of adverse actions against pilots. Asabove, this area can be interpreted very broadly. The only exemptions from report-ing in this area are “Routine dental, eye, and FAA periodic medical examinations.”Also, “consultations with your employer-sponsored employee assistance program(EAP) may be excluded unless the consultations were for your substance abuse orunless the consultations resulted in referral for psychiatric evaluation or treatment.”

Counseling does not have to be reported if it was strictly related to family or maritalcounseling that does not result in a personal psychiatric diagnosis. Examples includejoint sessions for families with difficult-to-manage teenagers, trauma to a familymember, and relationship counseling. If the counseling results in a personal psychi-atric diagnosis requiring individual therapy or medication, it is reportable. Individualsessions done in conjunction with joint marital therapy are generally not reportable.

What else should be reported? Everything else. Routine medical examinations byyour private physician, GYN exams, oral surgery, discussion of laboratory work—even visits for minor colds and coughs are not excluded, according to the instruc-tions. Obviously, more serious conditions require reporting. If a pilot has multiplevisits to one health professional for the same reason, simply list a range of datesfor all visits in a single line. Use a blank sheet of paper to report the visits if there isnot enough room on the form. When submitting an extra sheet to report visits,write on the explanations section of question 18 “see attached supplemental re-ports.” This will offer some protection to the pilot if the separate paper is lost ornot forwarded to the FAA by the AME.

How should visits be reported? Report the final diagnosis, not the symptom, as thereason for the visit. For example, visit(s) to a doctor triggered by burning chestdiscomfort after eating that resolves with an antacid or “purple pill” should not belisted as a visit for “chest pain.” That would result in requirements for more medicalinformation and possible costly medical evaluations. The correct technique forlisting the visit(s) may be “reflux, treated and resolved.” Other common listings

Routinemedical

examinationsby yourprivate

physician . . .are not

excluded,according

to theinstructions.

5

include “routine examination, normal” and “blood pressure check-up.” Calling theALPA Aeromedical Office may help a pilot in honestly responding to a questionwithout causing unnecessary alarm.

Who is a health professional? Again, no definition or guidance is provided. Inaddition to the obvious doctors, osteopaths, dentists, nurse practitioners, andphysician assistants, included are psychologists, counselors, social workers, sub-stance-abuse specialists, naturopaths, physical therapists, and chiropractors. Thislist is not exhaustive. Persons not included are clergy who may provide counselingand peer counselors as part of a critical incident response program.

What if my AME tells me not to report something? You are the person signing theform and attesting that “all statements and answers provided by me are completeand true to the best of my knowledge.” If the FAA ever has reason to question yourcompletion of Form 8500-8, you are the one responsible for its accuracy. Even if theAME who told you not to list a condition, visit, or medication on the form was willingto attest to that in court (unlikely, as it would probably result in revocation of theAME designation), the investigator or FAA attorney is unlikely to view this as anacceptable excuse. You have worked too hard on achieving all your ratings andcertificates to jeopardize them for a momentary convenience.

Signing the FormThe notice at the bottom of page 2 states, “Whoever in any manner within thejurisdiction of any department or agency of the United States knowingly and will-ingly falsifies, conceals, or covers by any trick, scheme, or device a material fact, orwho makes any false, fictitious, or fraudulent statements or representations, orentry may be fined up to $250,000 or imprisoned not more than 5 years, or both.” Arecent sting operation resulted in several dozen felony convictions of pilots underthis statute who were defrauding the government in disability claims. Recently, thegovernment seems to be taking a much more aggressive stance against pilots itdeems to have falsified the form.

Signing the form includes two declarations. The first declaration constitutes an authori-zation for a single access to the NDR to verify information provided in question 18.v. Thesecond declaration certifies the completeness and truthfulness of the medical applica-tion. The declaration section must be signed and dated by the pilot to be valid.

Asking for AssistanceThe staff of the ALPA Aeromedical Office is available to advise all pilots on correctlyreporting medical conditions, medications, and health-care provider visits on theirmedical applications. Please contact the office well before your next scheduled FAAmedical examination for assistance. The Aeromedical staff may be reached at 303-341-4435 on workdays from 8:30 a.m. through 4:00 p.m. mountain time.

Final Points• Keep a list of health-care visits, and bring it to your FAA exam.

• Read the instruction sheet carefully.

• Consult ALPA Aeromedical if in doubt about how to or whether to report.

• Once you check “Yes” to an answer in question 18, always check “Yes.”

• Keep a copy of every application.

• Protect yourself. “When in doubt, write it out!”

THIS

COMMUNICATION

IS ADVISORY ONLY

AND IS NOT

INTENDED TO

EXPRESS A LEGAL,

MEDICAL, OR

OTHER OPINION

WITH RESPECT TO

EITHER ITS

CONTENTS OR THE

FAA’S FORM 8500-8. Fly Safely,Stay Healthy!

6

In addition to reporting the offense on your next FAA Application for Airman MedicalCertification, you must report to the FAA Civil Aviation Security Division as outlinedin the following regulation:

FAR Part 61.15 – Offenses involving alcohol or drugs.a. A conviction for the violation of any Federal or State statute relating to the

growing, processing, manufacture, sale, disposition, possession, transportation,or importation of narcotic drugs, marijuana, or depressant or stimulant drugs orsubstances is grounds for:

1. Denial of an application for any certificate, rating, or authorizationissued under this part for a period of up to 1 year after the date of finalconviction; or

2. Suspension or revocation of any certificate, rating, or authorizationissued under this part.

b. Committing an act prohibited by Sec. 91.17(a) or Sec. 91.19(a) of this chapteris grounds for:

1. Denial of an application for a certificate, rating, or authorization issuedunder this part for a period of up to 1 year after the date of that act; or

2. Suspension or revocation of any certificate, rating, or authorizationissued under this part.

c. For the purposes of paragraphs (d), (e), and (f) of this section, a motor vehicleaction means:

A conviction after November 29, 1990, for the violation of any Federal or Statestatute relating to the operation of a motor vehicle while intoxicated by alcoholor a drug, while impaired by alcohol or a drug, or while under the influence ofalcohol or a drug;

The cancellation, suspension, or revocation of a license to operate a motorvehicle after November 29, 1990, for a cause related to the operation of amotor vehicle while intoxicated by alcohol or a drug, while impaired by alcoholor a drug, or while under the influence of alcohol or a drug; or the denial afterNovember 29, 1990, of an application for a license to operate a motor vehiclefor a cause related to the operation of a motor vehicle while intoxicated byalcohol or a drug, while impaired by alcohol or a drug, or while under theinfluence of alcohol or a drug.

d. Except for a motor vehicle action that results from the same incident or arisesout of the same factual circumstances, a motor vehicle action occurring within 3years of a previous motor vehicle action is grounds for:

Denial of an application for any certificate, rating, or authorization issued underthis part for a period of up to 1 year after the date of the last motor vehicleaction; or

Suspension or revocation of any certificate, rating, or authorization issuedunder this part.

What are my reporting responsibilities under theFARs regarding drug/alcohol-related offenses?

7

e. Each person holding a certificate issued under this part shall provide a writtenreport of each motor vehicle action to the

FAA, Civil Aviation Security Division (AMC-700)P.O. BoxOklahoma City, OK 73125

not later than 60 days after the motor vehicle action. The report must include:

1. The person’s name, address, date of birth, and airman certificatenumber;

2. The type of violation that resulted in the conviction or the administrativeaction;

3. The date of the conviction or administrative action;

4. The State that holds the record of conviction or administrative action;and

5. A statement of whether the motor vehicle action resulted from the sameincident or arose out of the same factual circumstances related to apreviously reported motor vehicle action.

(Download FAA DUI Reporting Form Letter)

f. Failure to comply with paragraph (e) of this section is grounds for:

1. Denial of an application for any certificate, rating, or authorizationissued under this part for a period of up to 1 year after the date of themotor vehicle action; or

2. Suspension or revocation of any certificate, rating, or authorizationissued under this part.

Contact FAA directly for more info at FAA DUI/DWI home page.

Anyone involved with a driving offense related to alcohol/drugs may want to contactVirtual Flight Surgeons (www.AviationMedicine.com or 720-857-6117) for assistance.We can assist in attempting to prevent such delays at the time of the pilot’s nextFAA medical exam. Remember, every situation is different.

Send comments to:Bob.Solik@alpa.org

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By Quay Snyder, MD, MSPH,Associate ALPA Aeromedical Advisor

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

An AME who knows you and your medical history well and who is also willing tomake the extra effort to help you keep your medical certificate is an invaluableresource. Many times, the convenience of scheduling an appointment for a physicalon short notice will save you time or missed flying days. Medical problems that havebeen previously addressed will be familiar to this AME and not be a source ofanxiety for you or your AME when you report them on your physical. Additionally,the AME will have a file of all correspondence to and from the FAA regarding yourmedical certificate. An AME who knows you well is more likely to answer questionsfor you over the phone about your use of medications, medical conditions, andflying. Of course, pilots and AMEs are always welcome to contact the AerospaceMedicine physicians of Virtual Flight Surgeons through the secure and anonymousconfidential questionnaire. ALPA pilots are entitled to free services by calling theALPA Aeromedical Office at 303-341-4435.

2. Select an AME that you and other pilots arecomfortable using.

The AME should be knowledgeable about aviation medicine and willing to work withthe pilot, the pilot’s treating physicians, and the FAA regional and national offices, ifnecessary, to help you retain your medical certificate. Many AMEs do relatively fewexaminations each year and have a very busy office practice. The pace of theirpractice may not allow them to take the time to make a phone call to the regionalflight surgeon or the Aeromedical Certification Division at Oklahoma City if a ques-tion arises about your medical qualifications. Those AMEs who do make the time fora phone call may save you weeks of administrative time, versus those who do nottake the time but instead defer a medical certificate to the Regional Office orOklahoma City for a decision. Some AMEs do hundreds or even thousands of FAAphysicals each year and are extremely familiar with the nuances of the FAA admin-istrative process. They are very comfortable working within the system, knowledge-able about the regulations, and capable of assisting the pilot with rapiddeterminations of eligibility. We recommend using these AMEs, many of whom aremembers of the Civil Aviation Medicine Association.

3. Understand the three possible outcomes of an FAAmedical examination.

First, the expected outcome for a physical examination is that the medical certifi-cate will be issued. In this circumstance, the pilot completes FAA Form 8500-8,Application for Medical Certification, at the time of the physical examination and,assuming he or she meets all the standards, walks out of the AME’s office with anew medical certificate in hand. The overwhelming majority of physical exams havethis result.

The 12 Tips for Taking Your FAA Medical Exam

ALPA pilotsare entitled to

free servicesby callingthe ALPA

AeromedicalOffice at

303-341-4435.

9

A second result is a denial of the medical certificate. If pilots clearly do not meetFAA medical standards, particularly if they have conditions that are specificallygrounding in Part 67 of the FARs or the Guide to Aviation Medical Examiners, theaviation medical examiner may issue a denial letter to the pilot revoking the pilot’scurrent medical privileges. That information is forwarded to the FAA AeromedicalCertification Division, which will then issue a formal denial letter and request returnof the current airman’s medical certificate. Denials are not necessarily permanent.If the pilot can present information that the disqualifying medical condition hasresolved or is being treated in an aeromedically safe manner, the FAA may reissuethe airman’s medical certificate. A denial of an application is extremely rare.

The third possible outcome is an intermediate decision termed a deferral. In thissituation, the AME notes a medical condition that is questionable with regard toeligibility for medical certification. The pilot takes the physical examination, but ratherthan issue the medical certificate or give the pilot a denial letter, the AME defers theapplication and medical certificate to the regional flight surgeon or the AeromedicalCertification Division (AMCD) in Oklahoma City. With the AME’s permission, the pilotmay continue to fly on his or her current medical certificate until it lapses.

Unfortunately, deferrals often take up to several months to obtain a response fromthe FAA. The FAA response letters frequently request that the pilot provide addi-tional medical information to support the application. A 30-day suspension from thedate of the FAA letter on this reporting requirement is common. If no information isreceived at the end of the period, the FAA may deny the airman’s medical certifi-cate. The pilot is not eligible to use the older medical certificate. Instead, the pilotmust await the arrival of the previously deferred certificate to be returned from theFAA office to which the AME forwarded it. If additional information is required bythe FAA, this process may take several additional months. Submission of completeinformation to the FAA is critical to timely certification decisions.

Savvy pilots can see the advantage in this situation of having the AME call the FAAregional office or AMCD to get an answer immediately rather than using the mail tohandle a deferred medical application. Also see “Documentation” section in tip #6 below.

4. Take your physical examination early in the month thatit is due.

Pilots often wait until the last several days before their medical certificate lapses toschedule another physical examination. Sometimes an examination cannot bescheduled prior to the lapse of the pilot’s previous medical certificate. If a medicalcondition arises that requires additional information, obtaining that information maytake several days. Often, the aviation medical examiner will hold the certificate forseveral days pending receipt of additional information in hopes of issuing a medicalcertificate to the pilot. The maximum time an AME may hold a medical applicationbefore electronically submitting it to the FAA is 14 days. If the physical is scheduledearly in the month, the pilot has sufficient time to gather that information and takeit to the AME for subsequent issuance of a new medical certificate prior to expira-tion of his/her previous medical certificate.

5. Do not take a physical examination if you are notmedically qualified.

There are no adverse consequences from the FAA Aeromedical Certification Divisionof allowing your medical certificate to lapse. As long as you are not operating anaircraft without the appropriate class of medical certificate, the FAA AMCD is notconcerned with the currency of your medical certificate. If you do take a physicaland have a disqualifying condition, the AME is obligated to deny or defer your

The thirdpossibleoutcome

is anintermediate

decisiontermed adeferral.

10

application. This can result in significant administrative delays even if your medicalcondition resolves while awaiting a letter from the FAA.

If you have a disqualifying medical condition when your next physical is due, it is usuallybetter to allow your medical certificate to lapse. When the condition has resolved, bringappropriate documentation from your treating physician to your physical and present itto your AME after noting the treatment on the front of the application. You may thenexpect to leave the office with a new medical certificate in hand.

6. Bring appropriate documentation.If you have had medical evaluations or treatment since your last FAA physicalexamination, bring documentation of the treatment and the resolution of the condi-tion to your FAA medical examination. This may help avoid any delays in issuing anew medical certificate if all aeromedically relevant questions are answered. Forexample, if you have had surgery on a knee or an appendix removed or werehospitalized for an infection, then the hospital discharge summary and a signed,dated follow-up note from your treating physician indicating you can return to fullactivity is usually sufficient.

Some conditions, such as cancer, heart disease, and neurologic and psychiatricconditions requiring hospitalization, require additional documentation and review bythe FAA. In general, the more documentation available, the easier it is to make afavorable certification decision. Again, submission of complete information to theFAA is critical to timely certification decisions.

A program instituted by the FAA in 2002 termed AME Assisted Special Issuances(AASI) allows AMEs to renew Special Issuance medical certificates of all classes for25 medical conditions designated by the FAA. Two additional conditions, coronaryartery disease and cardiac valve replacements/repair, are eligible for AASI for third-class certification only. To be eligible, airmen must bring specific documentationfrom their treating physicians with a copy of their Special Issuance Authorizationletter. If the documentation reflects they have had no adverse change in theirmedical condition, the AME may renew the Special Issuance and submit the docu-mentation to the FAA.

7. Bring glasses, contact lenses, or hearing aids, ifrequired.

An aviation medical examiner is not authorized to issue a new medical certificate ifa pilot does not meet the standards listed in FAR Part 67 and the Guide to AviationMedical Examiners. Pilots using glasses or contact lenses should bring them to thephysical examination to optimize their chances of passing those respective tests.Likewise, pilots using hearing aids (which are authorized during flying with alimitation on the medical certificate) should bring them to the exam.

8. Prepare physically for the examination.Pilots who have a medical examination should be well rested and avoid high-sugarmeals, caffeine, tobacco, and stimulant-type medications before their physicalexamination. Meals high in sugar may cause an erroneous result in the urinalysisthat raises a suspicion of diabetes. Complex carbohydrates and proteins before anexamination will stabilize blood sugars and decrease the risk of an abnormal urineresult in individuals. Fasting is not necessary, however.

For those pilots requiring electrocardiograms (first physical examination after age35 and annually after age 40 for First Class certification), being well rested andavoiding caffeine, tobacco, and stimulant medications such as decongestantsdecreases the risk of abnormalities on the ECG. Although in most cases these

Pilots usingglasses or

contact lensesshould bring

them to thephysical

examination . . .

11

abnormalities are shown to be not clinically significant, the time and expense, not tomention the anxiety, associated with obtaining the required evaluation can beavoided by simple preparation.

9. Understand reporting responsibilities on your FAAmedical application.

The medical application requires pilots to report all medicines, prescription andnonprescription, that the pilot is using on question 17 of the FAA medical applica-tion. If this is your first time reporting the use of a medication, be sure to include astatement about the absence of any side effects, if true. Over-the-counter “nutri-tional supplements” do not require reporting.

Likewise, the pilot is required to report all visits to health-care providers within thelast three years, along with the provider’s name and address and reason for visit. If apilot has or has ever had conditions listed on question 18, a check mark in the“Yes” block is required. If this information has been previously reported to the FAA, anannotation in the remarks section, “previously reported, no change” is acceptable ifthere has been no significant change in the medical condition. The pilot may list a“PI#” referencing the condition if one has been assigned to the pilot by the FAA. Ifthis is a new condition or there has been a change, bringing the appropriate docu-mentation as mentioned above will alleviate most questions regarding certification.

The FAA has recently amended Form 8500-8. It now includes a new question 18.ythat asks about receiving disability benefits. Pilots who have received Social Secu-rity, state, military, Veterans Administration, or insurance disability benefits shouldcheck “Yes” to this question. Receiving disability benefits is not generally disqualify-ing but does require submission of information as to the nature of the benefits.Often a VA form listing the benefits is adequate. Other more serious conditionsrequire more detailed information. Many conditions should have already beenreported under one of the other questions on Form 8500-8.

The FAA is very concerned with omission and falsification of medical conditions andevaluations on Questions 18 and 19 on the medical application, Form 8500-8. Donot forget to list all visits to health-care providers (except FAA exams and routinedental/eye exams) on your application. Failure to do so may result in revocation ofboth medical certificates and all pilot certificates and ratings for up to one year.

Pilots may use an electronic version of Form 8500-8, termed MedXPress and foundat https://medxpress.faa.gov/, to submit their information to the AME electronicallywithin 30 days of or at the time of their examination. After submission of theelectronic application, pilots are given a confirmation number. Access to the applica-tions is restricted to the AME to whom the pilot provides a confirmation number. Ouroffice encourages the use of MedXPress.

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

Many applications are returned to airmen because they fail to check any answer onquestions 18.v (convictions or administrative actions related to driving under theinfluence of alcohol or drugs) and 18.w (history of other convictions). This results inthe medical application being returned to the pilot for completion. As above, thisquestion not only includes events since your last FAA medical exam but also re-quires a “Yes” response if you ever have had a conviction or administrative action.

The newest version of the FAA medical application, Form 8500-8, now asks if anapplicant has ever been arrested for an offense involving drugs or alcohol whiledriving (18.v). Previously, only convictions required a “Yes” response. For pilots who

Manyapplicationsare returned

to airmenbecause theyfail to check

any answer onquestions 18.v. . . and 18.w.

12

are now required to respond affirmatively, an explanation of the circumstances andpolice/driving records may be required.

Concealing a moving violation involving the use of alcohol or illegal drugs is foolish.The pilot’s signature at the bottom of the application authorizes the FAA to searchthe National Driver Register for any violations. Not only will concealment of anoffense trigger a medical evaluation, but the Securities Division of the FAA maypursue enforcement action against your pilot certificate. Falsification of a medicalapplication is subject to up to five years in prison, a $250,000 fine, and revocationof pilot certificates and ratings. Please see articles in several issues of the VirtualFlight Surgeons Aeromedical Newsletter regarding the legal implications associatedwith inaccurate completion of the Airman’s Medical Application, FAA Form 8500-8.

11. Be prepared to send further information to the FAAupon request.

Occasionally, pilots will receive a letter from the FAA after they have been issued amedical certificate by their AME. The letter states that the FAA is unable to deter-mine their eligibility for an airman medical certificate based on incomplete informa-tion regarding some medical condition. The FAA specifically requests informationand/or further studies to be submitted prior to an eligibility determination.

Usually, there is a 30-day suspension from the date of the letter on this submissionrequirement. Attempt to comply with this timeline and submit all requested informa-tion. If it is impossible to complete this requirement prior to the 30-day extension, acall to the FAA requesting another 30-day extension is all that is needed. The FAAAMCD Customer Service number to call for an extension is 405-954-4821. Do notrequest an extension until near the end of the original 30-day suspension, as the FAAgrants an extension of 30 days from the day of the request, not sequentially with thefirst suspension date. The pilot may continue to operate an aircraft with a currentmedical certificate issued by the AME pending a final determination from the FAA.

Denial letters from the FAA come via certified mail and specifically request a returnof the medical certificate.

12. Contact an aviation medicine specialist early for anyquestions you may have.

Many AMEs are very knowledgeable and have assisted many pilots. Most questionscan be addressed with a simple phone call, which avoids administrative delaysand anxieties at a later date. If AMEs are not certain about the appropriate action,they will contact the FAA regional flight surgeon or the FAA Aeromedical Certifica-tion Division for advice. ALPA pilots are entitled to free consultations and assis-tance with FAA reporting by calling the ALPA Aeromedical Office at 303-341-4435.Pilots who are not eligible for the free services of the ALPA Aeromedical Officeare always welcome to contact the Aerospace Medicine physicians of Virtual FlightSurgeons through the secure and anonymous confidential questionnaire atwww.AviationMedicine.com or by phone at 720-857-6117.

Stay Healthy,Ask Questions Early.

Fly Safely—

The FAAAMCD

CustomerService number

to call for anextension is

405-954-4821.