Fly Safe! Be Healthy!

Transcription

1 This edition of the Aeromedical Flyer has two great articles written by Dr. Quay Snyder of the ALPA Aeromedical Office 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 vehicle actions (which include convictions and/or administration actions) to the FAA under FAR Second, at your next AME medical exam, you must report on the FAA Form any drug/alcohol arrests and administrative actions which are defined more inclusively than under The important point is that there are two separate reporting requirements, neither fulfilled by the other. Pilots failing to complete either reporting requirement are in serious jeopardy of having action taken against their pilot and medical certificates. If you have further questions, do not hesitate to contact ALPA s Aeromedical Office. Fly Safe! Be Healthy! Captain R. A. Solik Aeromedical Chairman Tips for Complying with Reporting Requirements on FAA Medical Applications By Quay Snyder, MD, MSPH Associate ALPA Aeromedical Advisor Recent actions by the FAA against pilots who have allegedly failed to report medical conditions on periodic FAA medical applications have raised concerns among pilots. The ALPA Aeromedical Office has developed guidelines for ALPA members in complying with FAA reporting requirements and maintaining their medical certification. These guidelines should encourage optimization of pilot health, preserve careers, and protect aviation safety. Failure to comply with FAA reporting requirements may result in revocation of all FAA certificates, ratings, and designations. Background The Application for Airman Medical Certificate (FAA Form ) is used by the FAA Office of Aerospace Medicine and Designated Aviation Medical Examiners (AMEs) for periodic medical examinations of pilots to determine initial and continued medical qualification for duty. The medical qualification process relies on both the historical information 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 to correct previously completed medical applications, while protecting them from adverse certificate actions as a result of these corrections. At the time of this writing, no SEPTEMBER/OCTOBER 2009 VOLUME 4 ISSUE 4 1 Tips for Complying with Reporting Requirements on FAA Medical Applications 6 What are my reporting responsibilities...? 8 The 12 Tips for Taking Your FAA Medical Exam

2 procedure exists for correcting erroneously completed medical records that guarantees protection from adverse action. Please direct any questions to the ALPA Aeromedical Office or ALPA Legal Department. The urine test is not a drug test but simply requires an evaluation of blood or sugar in the urine indicating the possibility of other medical conditions. 2 Form Form requires the pilot to complete and sign the front side of the form (page 3). 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 the applicant s responses on the front of the form and its findings on the back of the form electronically to a database maintained by the FAA Office of Aerospace Medicine. The pilot s responses are to be entered verbatim. The FAA has developed an online version of the Form that can be completed by the pilot prior to meeting with an aviation medical examiner. The medical application is termed MedXPress and is accessed at Pilots using MedXPress will have a unique log-in and password. Following completion of the online application, a confirmation number will be ed to the pilot. For the AME to access the application, the pilot must provide the confirmation number. The FAA encourages the use of MedXPress for all pilots. Form 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 Paperwork Reduction Act Statement. Under the Privacy Act statement section, there is an explanation of the FAA s right to request any information about the applicant from the National Driver Register. Access to this information is authorized by the applicant 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 Application for Airman Medical Certificate. Read this page carefully. If not provided with a copy of the instructions, request that information be provided to you before signing the form. The note at the bottom of the instructions page indicates, If more space is required to respond to yes answers for numbers 17, 18, or 19, use a plain sheet of paper bearing the information, your signature, and the date signed. Each of these areas is explained in detail below. The third page of the form is completed by the pilot. This includes the identification information, a listing of medications, a self-reporting history of medical conditions, alcohol- and drug-related driving actions, misdemeanors or felonies, and explanations of visits to health professionals. Because this page is completed in triplicate, a copy should be made available to each pilot at the end of the examination. We recommend that each pilot insist on receiving a copy of each application. Retain every copy for your personal records. The fourth page of the form is for the AME to report the results of each medical examination. Each area of the body examined is marked as Normal or Abnormal. Abnormal findings require explanation. Vision, hearing, blood pressure, ECG, and urinalysis results are recorded. Note: The urine test is not a drug test but simply requires an evaluation of blood or sugar in the urine indicating the possibility of other medical conditions. Any items listed by the pilot on the front side of the form that are considered medically significant also require an explanation by the AME. A copy of this portion of the form is not 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, dosages, and frequency should be listed on a separate piece of paper as noted above. If the medication has been reported on a previous Form , indicate so by checking the box Yes. If not previously reported on the form (even if it has been reported to the Flight Surgeon s Office between examinations), check the No box.

3 Pilots will be expected to provide dosage information, reason for use of the medication, and a comment about the presence or absence of side effects in the Explanations section under Part 18 or on a separate sheet of paper. Note that both prescription and nonprescription medicine use must be reported. The key issue from a safety perspective usually is not the medication but the reason the medication is being used. Only medication that is currently being used is required to be reported in this section. Although the FAA discourages the use of nutritional supplements obtained over the counter, there is no requirement to report their use. Nutritional supplements are not regulated by the FDA nor restricted by the FAA. They include herbal preparations, performance enhancers, vitamins, minerals, and many other unregulated substances. Examples include echinacea, creatine, vitamin C megadoses, and calcium tablets. If a health-care professional recommended the nutritional supplement, the visit to the health-care professional is reportable under question 19. Completion of Question 18 Medical History This section requires significant care in completing. The instructions specify Have you ever in your life been diagnosed with, had, or do you presently have any of the following... (conditions)? The critical and ambiguous term condition is not defined anywhere on Form Every condition on which you check yes must have 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 and no interim treatment for the condition has occurred, the pilot should indicate the letter of the affirmatively answered question (e.g., 18.e ) and write Previously reported, no change. Once an answer has been checked Yes on a Form , it should always be checked Yes on every subsequent form. Have you ever in your life been diagnosed with... Question 18.x lists Other illnesses, disability, or surgery. This is obviously a very broad question. The AME and regional flight surgeon are not interested in most childhood illnesses or surgeries or other insignificant events. Carried to an extreme, this question would require reporting colds, mumps, stitches, hemorrhoids, broken toes, and other trivial medical items from a safety perspective. An ever increasing list 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 have ever received medical disability benefits. If you have received benefits, simply provide details of the benefit, such as military separation disability, and note that you have no current significant physical limitation. The FAA may request a current evaluation of the disability. Given the current actions by organizations outside the Federal Air Surgeon s Office, it is difficult to advise pilots on what to omit. A call to the ALPA Aeromedical Office may help clarify reporting requirements and wording. Neither the AME, the Aeromedical Certification Division, nor the Regional Flight Surgeons offices are interested in the increased workload and documentation requirements associated with an exhaustive list of medical conditions from every pilot. Certainly those conditions that a pilot seeks medical evaluation or care for should be reported. Often, attaching a summary from the treating provider will minimize requirements to provide further information at a later date. 3 Question 18.v Alcohol- and Drug-Related Motor Vehicle Actions Question 18.v asks about a history of arrests or convictions involving driving while intoxicated 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 lower offense, such as careless driving. This also includes offenses that were expunged by the courts after a certain time period. Pilots who have been ticketed for operating under the influence while driving a golf cart or a boat have also been required to report these offenses. Remember, your signature on the form authorizes the FAA to search the National Driver Register.

4 Question 18.v also asks about history of arrests or convictions(s) or administrative action(s) involving offense(s) which resulted in the denial, suspension, cancellation, or revocation of driving privileges or which resulted in attendance at an educational or a rehabilitation program. As above, the FAA interprets this very broadly. The issuance of a temporary driver s license following a citation, even if the person was later acquitted, constitutes an administrative action in the FAA s eyes. If driving privileges 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 the person did not lose the state driver s license s/he holds. Attendance at a three-hour safety 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 remote events not previously reported (e.g., arrests that may have been subsequently adjudicated without official action taken on the driver s license). The FAA will handle such reporting 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 the reporting requirements. If in doubt about a reporting requirement, insist on reading the instructions. When reading the instructions, think in terms of an FAA representative interpreting the requirement rather than trying to justify not reporting an event. It is safer. Do not fail to report any offense in this area. Positive responses may or may not trigger a requirement for a substance-abuse evaluation. False responses may result in serious administrative consequences. Routine medical examinations by your private physician... are not excluded, according to the instructions. 4 Question 19 Visits to Health Professionals Within the Last Three Years Question 19 has been the most common source of adverse actions against pilots. As above, this area can be interpreted very broadly. The only exemptions from reporting 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 or unless 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 marital counseling that does not result in a personal psychiatric diagnosis. Examples include joint sessions for families with difficult-to-manage teenagers, trauma to a family member, and relationship counseling. If the counseling results in a personal psychiatric diagnosis requiring individual therapy or medication, it is reportable. Individual sessions done in conjunction with joint marital therapy are generally not reportable. What else should be reported? Everything else. Routine medical examinations by your private physician, GYN exams, oral surgery, discussion of laboratory work even visits for minor colds and coughs are not excluded, according to the instructions. Obviously, more serious conditions require reporting. If a pilot has multiple visits to one health professional for the same reason, simply list a range of dates for all visits in a single line. Use a blank sheet of paper to report the visits if there is not enough room on the form. When submitting an extra sheet to report visits, write on the explanations section of question 18 see attached supplemental reports. This will offer some protection to the pilot if the separate paper is lost or not forwarded to the FAA by the AME. How should visits be reported? Report the final diagnosis, not the symptom, as the reason for the visit. For example, visit(s) to a doctor triggered by burning chest discomfort after eating that resolves with an antacid or purple pill should not be listed as a visit for chest pain. That would result in requirements for more medical information and possible costly medical evaluations. The correct technique for listing the visit(s) may be reflux, treated and resolved. Other common listings

5 include routine examination, normal and blood pressure check-up. Calling the ALPA Aeromedical Office may help a pilot in honestly responding to a question without causing unnecessary alarm. Who is a health professional? Again, no definition or guidance is provided. In addition to the obvious doctors, osteopaths, dentists, nurse practitioners, and physician assistants, included are psychologists, counselors, social workers, substance-abuse specialists, naturopaths, physical therapists, and chiropractors. This list is not exhaustive. Persons not included are clergy who may provide counseling and 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 the form and attesting that all statements and answers provided by me are complete and true to the best of my knowledge. If the FAA ever has reason to question your completion of Form , you are the one responsible for its accuracy. Even if the AME who told you not to list a condition, visit, or medication on the form was willing to attest to that in court (unlikely, as it would probably result in revocation of the AME designation), the investigator or FAA attorney is unlikely to view this as an acceptable excuse. You have worked too hard on achieving all your ratings and certificates to jeopardize them for a momentary convenience. Signing the Form The notice at the bottom of page 2 states, Whoever in any manner within the jurisdiction of any department or agency of the United States knowingly and willingly falsifies, conceals, or covers by any trick, scheme, or device a material fact, or who makes any false, fictitious, or fraudulent statements or representations, or entry may be fined up to $250,000 or imprisoned not more than 5 years, or both. A recent sting operation resulted in several dozen felony convictions of pilots under this statute who were defrauding the government in disability claims. Recently, the government seems to be taking a much more aggressive stance against pilots it deems to have falsified the form. 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 Signing the form includes two declarations. The first declaration constitutes an authorization for a single access to the NDR to verify information provided in question 18.v. The second declaration certifies the completeness and truthfulness of the medical application. The declaration section must be signed and dated by the pilot to be valid. Asking for Assistance The staff of the ALPA Aeromedical Office is available to advise all pilots on correctly reporting medical conditions, medications, and health-care provider visits on their medical applications. Please contact the office well before your next scheduled FAA medical examination for assistance. The Aeromedical staff may be reached at 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! Fly Safely, Stay Healthy!

6 What are my reporting responsibilities under the FARs regarding drug/alcohol-related offenses? In addition to reporting the offense on your next FAA Application for Airman Medical Certification, you must report to the FAA Civil Aviation Security Division as outlined in the following regulation: 6 FAR Part 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 or substances is grounds for: 1. Denial of an application for any certificate, rating, or authorization issued under this part for a period of up to 1 year after the date of final conviction; or 2. Suspension or revocation of any certificate, rating, or authorization issued under this part. b. Committing an act prohibited by Sec (a) or Sec (a) of this chapter is grounds for: 1. Denial of an application for a certificate, rating, or authorization issued under 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 authorization issued under this part. c. For the purposes of paragraphs (d), (e), and (f) of this section, a motor vehicle action means: A conviction after November 29, 1990, for the violation of any Federal or State statute relating to the operation of a motor vehicle while intoxicated by alcohol or a drug, while impaired by alcohol or a drug, or while under the influence of alcohol or a drug; The cancellation, suspension, or revocation of a license to operate a motor vehicle after November 29, 1990, for a cause related to the operation of a motor vehicle while intoxicated by alcohol or a drug, while impaired by alcohol or a drug, or while under the influence of alcohol or a drug; or the denial after November 29, 1990, of an application for a license to operate a motor vehicle for a cause related to the operation of a motor vehicle while intoxicated by alcohol or a drug, while impaired by alcohol or a drug, or while under the influence of alcohol or a drug. d. Except for a motor vehicle action that results from the same incident or arises out of the same factual circumstances, a motor vehicle action occurring within 3 years of a previous motor vehicle action is grounds for: Denial of an application for any certificate, rating, or authorization issued under this part for a period of up to 1 year after the date of the last motor vehicle action; or Suspension or revocation of any certificate, rating, or authorization issued under this part.

7 e. Each person holding a certificate issued under this part shall provide a written report of each motor vehicle action to the FAA, Civil Aviation Security Division (AMC-700) P.O. Box Oklahoma City, OK 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 certificate number; 2. The type of violation that resulted in the conviction or the administrative action; 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 same incident or arose out of the same factual circumstances related to a previously 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 authorization issued under this part for a period of up to 1 year after the date of the motor vehicle action; or 2. Suspension or revocation of any certificate, rating, or authorization issued 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 contact Virtual Flight Surgeons ( or ) for assistance. We can assist in attempting to prevent such delays at the time of the pilot s next FAA medical exam. Remember, every situation is different. Send comments to: Bob.Solik@alpa.org 7

8 The 12 Tips for Taking Your FAA Medical Exam By Quay Snyder, MD, MSPH, Associate ALPA Aeromedical Advisor ALPA pilots are entitled to free services by calling the ALPA Aeromedical Office at Establish a long-term relationship with an aviation medical examiner (AME). An AME who knows you and your medical history well and who is also willing to make the extra effort to help you keep your medical certificate is an invaluable resource. Many times, the convenience of scheduling an appointment for a physical on short notice will save you time or missed flying days. Medical problems that have been previously addressed will be familiar to this AME and not be a source of anxiety 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 your medical certificate. An AME who knows you well is more likely to answer questions for you over the phone about your use of medications, medical conditions, and flying. Of course, pilots and AMEs are always welcome to contact the Aerospace Medicine physicians of Virtual Flight Surgeons through the secure and anonymous confidential questionnaire. ALPA pilots are entitled to free services by calling the ALPA Aeromedical Office at Select an AME that you and other pilots are comfortable using. The AME should be knowledgeable about aviation medicine and willing to work with the pilot, the pilot s treating physicians, and the FAA regional and national offices, if necessary, to help you retain your medical certificate. Many AMEs do relatively few examinations each year and have a very busy office practice. The pace of their practice may not allow them to take the time to make a phone call to the regional flight surgeon or the Aeromedical Certification Division at Oklahoma City if a question arises about your medical qualifications. Those AMEs who do make the time for a phone call may save you weeks of administrative time, versus those who do not take the time but instead defer a medical certificate to the Regional Office or Oklahoma City for a decision. Some AMEs do hundreds or even thousands of FAA physicals each year and are extremely familiar with the nuances of the FAA administrative process. They are very comfortable working within the system, knowledgeable about the regulations, and capable of assisting the pilot with rapid determinations of eligibility. We recommend using these AMEs, many of whom are members of the Civil Aviation Medicine Association. 3. Understand the three possible outcomes of an FAA medical examination. First, the expected outcome for a physical examination is that the medical certificate will be issued. In this circumstance, the pilot completes FAA Form , 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 a new medical certificate in hand. The overwhelming majority of physical exams have this result. 8

9 A second result is a denial of the medical certificate. If pilots clearly do not meet FAA medical standards, particularly if they have conditions that are specifically grounding in Part 67 of the FARs or the Guide to Aviation Medical Examiners, the aviation medical examiner may issue a denial letter to the pilot revoking the pilot s current medical privileges. That information is forwarded to the FAA Aeromedical Certification Division, which will then issue a formal denial letter and request return of the current airman s medical certificate. Denials are not necessarily permanent. If the pilot can present information that the disqualifying medical condition has resolved or is being treated in an aeromedically safe manner, the FAA may reissue the airman s medical certificate. A denial of an application is extremely rare. The third possible outcome is an intermediate decision termed a deferral. In this situation, the AME notes a medical condition that is questionable with regard to eligibility for medical certification. The pilot takes the physical examination, but rather than issue the medical certificate or give the pilot a denial letter, the AME defers the application and medical certificate to the regional flight surgeon or the Aeromedical Certification Division (AMCD) in Oklahoma City. With the AME s permission, the pilot may continue to fly on his or her current medical certificate until it lapses. The third possible outcome is an intermediate decision termed a deferral. Unfortunately, deferrals often take up to several months to obtain a response from the FAA. The FAA response letters frequently request that the pilot provide additional medical information to support the application. A 30-day suspension from the date of the FAA letter on this reporting requirement is common. If no information is received at the end of the period, the FAA may deny the airman s medical certificate. The pilot is not eligible to use the older medical certificate. Instead, the pilot must await the arrival of the previously deferred certificate to be returned from the FAA office to which the AME forwarded it. If additional information is required by the FAA, this process may take several additional months. Submission of complete information to the FAA is critical to timely certification decisions. Savvy pilots can see the advantage in this situation of having the AME call the FAA regional office or AMCD to get an answer immediately rather than using the mail to handle a deferred medical application. Also see Documentation section in tip #6 below. 4. Take your physical examination early in the month that it is due. Pilots often wait until the last several days before their medical certificate lapses to schedule another physical examination. Sometimes an examination cannot be scheduled prior to the lapse of the pilot s previous medical certificate. If a medical condition arises that requires additional information, obtaining that information may take several days. Often, the aviation medical examiner will hold the certificate for several days pending receipt of additional information in hopes of issuing a medical certificate to the pilot. The maximum time an AME may hold a medical application before electronically submitting it to the FAA is 14 days. If the physical is scheduled early in the month, the pilot has sufficient time to gather that information and take it to the AME for subsequent issuance of a new medical certificate prior to expiration of his/her previous medical certificate. 5. Do not take a physical examination if you are not medically qualified. There are no adverse consequences from the FAA Aeromedical Certification Division of allowing your medical certificate to lapse. As long as you are not operating an aircraft without the appropriate class of medical certificate, the FAA AMCD is not concerned with the currency of your medical certificate. If you do take a physical and have a disqualifying condition, the AME is obligated to deny or defer your 9

10 application. This can result in significant administrative delays even if your medical condition resolves while awaiting a letter from the FAA. If you have a disqualifying medical condition when your next physical is due, it is usually better to allow your medical certificate to lapse. When the condition has resolved, bring appropriate documentation from your treating physician to your physical and present it to your AME after noting the treatment on the front of the application. You may then expect to leave the office with a new medical certificate in hand. Pilots using glasses or contact lenses should bring them to the physical examination Bring appropriate documentation. If you have had medical evaluations or treatment since your last FAA physical examination, bring documentation of the treatment and the resolution of the condition to your FAA medical examination. This may help avoid any delays in issuing a new medical certificate if all aeromedically relevant questions are answered. For example, if you have had surgery on a knee or an appendix removed or were hospitalized for an infection, then the hospital discharge summary and a signed, dated follow-up note from your treating physician indicating you can return to full activity is usually sufficient. Some conditions, such as cancer, heart disease, and neurologic and psychiatric conditions requiring hospitalization, require additional documentation and review by the FAA. In general, the more documentation available, the easier it is to make a favorable certification decision. Again, submission of complete information to the FAA 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 for 25 medical conditions designated by the FAA. Two additional conditions, coronary artery disease and cardiac valve replacements/repair, are eligible for AASI for thirdclass certification only. To be eligible, airmen must bring specific documentation from their treating physicians with a copy of their Special Issuance Authorization letter. If the documentation reflects they have had no adverse change in their medical condition, the AME may renew the Special Issuance and submit the documentation to the FAA. 7. Bring glasses, contact lenses, or hearing aids, if required. An aviation medical examiner is not authorized to issue a new medical certificate if a pilot does not meet the standards listed in FAR Part 67 and the Guide to Aviation Medical Examiners. Pilots using glasses or contact lenses should bring them to the physical examination to optimize their chances of passing those respective tests. Likewise, pilots using hearing aids (which are authorized during flying with a limitation 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-sugar meals, caffeine, tobacco, and stimulant-type medications before their physical examination. Meals high in sugar may cause an erroneous result in the urinalysis that raises a suspicion of diabetes. Complex carbohydrates and proteins before an examination will stabilize blood sugars and decrease the risk of an abnormal urine result in individuals. Fasting is not necessary, however. 10 For those pilots requiring electrocardiograms (first physical examination after age 35 and annually after age 40 for First Class certification), being well rested and avoiding caffeine, tobacco, and stimulant medications such as decongestants decreases the risk of abnormalities on the ECG. Although in most cases these

11 abnormalities are shown to be not clinically significant, the time and expense, not to mention the anxiety, associated with obtaining the required evaluation can be avoided by simple preparation. 9. Understand reporting responsibilities on your FAA medical application. The medical application requires pilots to report all medicines, prescription and nonprescription, that the pilot is using on question 17 of the FAA medical application. If this is your first time reporting the use of a medication, be sure to include a statement about the absence of any side effects, if true. Over-the-counter nutritional supplements do not require reporting. Many applications are returned to airmen because they fail to check any answer on questions 18.v... and 18.w. Likewise, the pilot is required to report all visits to health-care providers within the last three years, along with the provider s name and address and reason for visit. If a pilot 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, an annotation in the remarks section, previously reported, no change is acceptable if there 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. If this is a new condition or there has been a change, bringing the appropriate documentation as mentioned above will alleviate most questions regarding certification. The FAA has recently amended Form It now includes a new question 18.y that asks about receiving disability benefits. Pilots who have received Social Security, state, military, Veterans Administration, or insurance disability benefits should check Yes to this question. Receiving disability benefits is not generally disqualifying 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 conditions require more detailed information. Many conditions should have already been reported under one of the other questions on Form The FAA is very concerned with omission and falsification of medical conditions and evaluations on Questions 18 and 19 on the medical application, Form Do not forget to list all visits to health-care providers (except FAA exams and routine dental/eye exams) on your application. Failure to do so may result in revocation of both medical certificates and all pilot certificates and ratings for up to one year. Pilots may use an electronic version of Form , termed MedXPress and found at to submit their information to the AME electronically within 30 days of or at the time of their examination. After submission of the electronic application, pilots are given a confirmation number. Access to the applications is restricted to the AME to whom the pilot provides a confirmation number. Our office encourages the use of MedXPress. 10. Remember to check the blocks regarding drug and alcohol offenses and other legal encounters. Many applications are returned to airmen because they fail to check any answer on questions 18.v (convictions or administrative actions related to driving under the influence of alcohol or drugs) and 18.w (history of other convictions). This results in the medical application being returned to the pilot for completion. As above, this question not only includes events since your last FAA medical exam but also requires a Yes response if you ever have had a conviction or administrative action. The newest version of the FAA medical application, Form , now asks if an applicant has ever been arrested for an offense involving drugs or alcohol while driving (18.v). Previously, only convictions required a Yes response. For pilots who 11

12 are now required to respond affirmatively, an explanation of the circumstances and police/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 search the National Driver Register for any violations. Not only will concealment of an offense trigger a medical evaluation, but the Securities Division of the FAA may pursue enforcement action against your pilot certificate. Falsification of a medical application is subject to up to five years in prison, a $250,000 fine, and revocation of pilot certificates and ratings. Please see articles in several issues of the Virtual Flight Surgeons Aeromedical Newsletter regarding the legal implications associated with inaccurate completion of the Airman s Medical Application, FAA Form Be prepared to send further information to the FAA upon request. Occasionally, pilots will receive a letter from the FAA after they have been issued a medical certificate by their AME. The letter states that the FAA is unable to determine their eligibility for an airman medical certificate based on incomplete information regarding some medical condition. The FAA specifically requests information and/or further studies to be submitted prior to an eligibility determination. The FAA AMCD Customer Service number to call for an extension is Usually, there is a 30-day suspension from the date of the letter on this submission requirement. Attempt to comply with this timeline and submit all requested information. If it is impossible to complete this requirement prior to the 30-day extension, a call to the FAA requesting another 30-day extension is all that is needed. The FAA AMCD Customer Service number to call for an extension is Do not request an extension until near the end of the original 30-day suspension, as the FAA grants an extension of 30 days from the day of the request, not sequentially with the first suspension date. The pilot may continue to operate an aircraft with a current medical 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 return of the medical certificate. 12. Contact an aviation medicine specialist early for any questions you may have. Many AMEs are very knowledgeable and have assisted many pilots. Most questions can be addressed with a simple phone call, which avoids administrative delays and 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 Certification Division for advice. ALPA pilots are entitled to free consultations and assistance with FAA reporting by calling the ALPA Aeromedical Office at Pilots who are not eligible for the free services of the ALPA Aeromedical Office are always welcome to contact the Aerospace Medicine physicians of Virtual Flight Surgeons through the secure and anonymous confidential questionnaire at or by phone at Fly Safely Stay Healthy, Ask Questions Early.