A few days ago, I received a call from a pilot who was being seen by a physician in the emergency room. Did he want a second opinion? No, he wanted to know if the condition affected his medical certificate!
The greatest fear among pilots is losing their medical certificate. Unfortunately, some choose to lie on their medical; if they’re discovered, they can get into serious trouble. It doesn’t happen often, but it does happen.
The purpose of the medical certificate is to prove to the FAA that a person is medically fit to fly an aircraft and has little risk of sudden incapacitation during the certificate’s duration. Certificates expire sooner for people who work for hire, e.g., pilots of scheduled airlines, than for private or LSA pilots who fly purely for their own benefit. After all, the main difference between the different classes of exams is the vision requirement, and I’ve never heard anyone say that there are more vision-related accidents for third-class pilots than for first- or second-class aviators.
It’s extremely important for pilots to know how to handle a change in their medical status between exams, and how to best prepare for an upcoming medical after a change. There are definitely right ways and wrong ways to handle these situations, and some of the wrong ways will generate unneeded paperwork and lost time, jeopardizing the ability to fly.
Under CFR 61.53 (“Pilot Self-Grounding Requirements”), pilots are supposed to ground themselves and report any changes in condition to the FAA before they can fly again. These conditions are defined as “unable to meet the requirements for the medical certificate,” which is intentionally vague. As listed in the Guide for Aviation Medical Examiners, there are several absolutes that require grounding and FAA notification. For instance, cancer isn’t on this list, but it generally requires a special issuance. Does this mean that pilots who are diagnosed with a superficial skin cancer need to ground themselves and report to the FAA before flying again? It’s difficult to get a consistent answer from different FAA representatives. Some say yes, some say no, and some say to use common sense.
My take is to call an aviation medical examiner (AME). They’re under no obligation to report your change in condition to the FAA, as long as you don’t fill out an 8500-8 medical form. If the AME says that you’re not grounded, I would keep a note about the phone call with a time and date, and continue to fly. If the AME says you have to ground yourself and report it before flying again, then you need to make a decision. Note that you don’t need to report a change in condition unless you want to operate an aircraft. CFR 61.53 has no reporting requirement. This is important to remember because if you develop a disqualifying condition that isn’t amenable to special issuance—say, for example, epilepsy and report it, the FAA will ask for your medical to be surrendered. That eliminates the right to fly.
|Lying On Your Medical: The Consequences|
Sixteen months in jail was the sentence Ronald Crews received on March 20, 2008, for lying on his pilot medical application. Crews pleaded guilty to not reporting insulin-dependent diabetes on his first-class medical. Prosecution of this case is the exception, however; the only reason it came to light was because Crews suffered a diabetic seizure during an air taxi flight in which a student pilot, who just happened to be on board, had to land the aircraft.
Another case of egregious lying on a medical was discovered in July 2005 in California, where the Department of Transportation Inspector General compared the Social Security numbers of people who were on Social Security disability with the Social Security numbers of pilots. The inspector found more than 3,200 pilots who claimed Social Security disability for conditions never reported on their pilot medical forms. This generated a House Transportation and Infrastructure Committee oversight report that asked the FAA to screen all pilot medicals for fraud. In addition, the committee found that 10% of pilots involved in fatal accidents had positive postmortem drug tests for prescription drugs of which only 10% had been reported to the FAA.
There are more than 700,000 pilots in the United States, and the FAA’s Civil Aerospace Medical Institute in Oklahoma City, Okla., barely has staff to keep up with the pilots who report their medical conditions, much less chase after ones who lie. The system relies on people being honest on their medical forms, as well as AMEs who look for signs of fraud at the time of the exam.
The penalty for lying is stiff—fines up to $250,000, up to five years imprisonment, and revocation of all pilot medicals and certificates. Although some pilots lie, some just don’t get medicals. The downside for the latter is not only breaking the FARs, but also chancing that insurance won’t pay in the event of an accident. The system must be working since only one half of one percent of all aviation accidents have a medical factor involve
The greatest fear among pilots is losing their medical certificate. unfortunately, some choose to lie on their medical; if they’re discovered, they can get into serious trouble.
What should you do if you need to report your change in medical condition, or are getting ready to report it on your next AME checkup? The most important thing is to collect all your medical records. This mainly includes all dictated reports and test results. Consult the FAA’s website (www.faa.gov), which lists disease protocols and includes all the information and current testing required for certification. Because there are time limitations, remember to check this site before beginning any required testing. For instance, testing can’t be done prior to six months since a cardiac event (not one day sooner), and follow-up testing (usually) needs to be within 90 days of the application. There are also certain requirements for the type of testing and how the tests are performed. Also, the FAA generally wants the actual tracings or film (CD or DVD) of tests—not just the interpretation by local doctors. Again, check with the FAA first.
Most times, the FAA will require a letter from the treating doctor for a summary of the pilot’s current condition; this letter is critical. It’s reasonable to have your physician write a draft letter, then show it to the AME to see if it contains the right information and proper wording. Sometimes the wording, which may seem innocuous in the “normal” medical world, can send up warning flares at the FAA. Probably the most important sentence a physician can write in the referral letter is the statement, “This patient is no more likely to be suddenly incapacitated than someone from the general population.” This wording is welcomed by the FAA.
Always send in all your paperwork together via a signed courier like UPS or FedEx. Make a copy of everything you send and note the date it was sent. (Keeping a copy of the delivery confirmation is helpful.) With pilots for whom I do Special Issuance medicals, I’ll send the required paperwork with the 8500-8 medical form (just to keep everything together for the FAA). If you send the 8500-8 separately, a letter may be generated asking for more information, and you won’t know whether that’s because the records haven’t reached the FAA or just because the documents got crossed in the mail.
Another important consideration is your choice of AME. As a general rule, you should choose AMEs who are pilots and have a reputation for helping other aviators with medical problems. Generally, AMEs who aren’t pilots don’t seem to work as hard to keep pilots in the air. Nothing can be worse than an AME who defers a medical exam for further consideration when the person could have issued the medical on the spot had he or she just made a phone call to the Regional Flight Surgeon or the FAA’s Civil Aerospace Medical Institute in Oklahoma City, Okla.
AMEs can also provide consultation (some will do it by phone) before the medical exam to discuss any potentially problematic conditions and how to present them to the FAA. A few pilots will come in for a “mock” exam without any paperwork being filled out, just to see if they would pass the real thing. Without an 8500-8 form being filled out, the worse-case scenario is the cost of the exam. Nothing can be sent to the FAA without the medical form being filled out.
One problem that pilots can experience is erroneous diagnosis and improper treatment by private physicians. An incredible number of pilots get put on medications “willy-nilly,” which can have serious, adverse consequences for their medical certification. Depression is an example. For instance, a pilot who’s experiencing bad feelings during a divorce may be prescribed antidepressants by his or her doctor. Not only are these drugs not very useful for short-duration, situational depression, but they also cause a world of cost and paperwork for pilots who must now demonstrate to the FAA that they don’t suffer from serious depression. Before starting any medication, don’t hesitate to call your AME or check online sites like AOPA (www.aopa.org) to see if it might jeopardize your medical certification.
As one experienced AME use to say, “We all are only one medical away from being an ultralight pilot!”
|Lying On Your Medical: The Consequences|
• Angina pectoris
|• Heart replacement
• Myocardial infarction
• Permanent cardiac pacemaker
• Personality disorder that’s severe enough to have repeatedly manifested itself by overt acts
• Substance abuse and dependence
• Transient loss of control of nervous system function(s) without satisfactory medical explanation of cause
|(Source: Guide for Aviation Medical Examiners, last update November 26, 2007)|