Virtual Flight Systems eases medical mysteries

Aviation International News » August 2003
August 4, 2008, 11:02 AM

If you get the feeling you’re just a number when it comes to getting your medical, you may be interested to know that the FAA issues 453,000 airman medicals every year. According to an FAA spokesman, the agency also processes 5,700 special issuances, responds to 87,600 written inquiries, answers 95,000 telephone inquiries and conducts 155,000 full reviews of medical records. But don’t be too quick to assume they’re an uncaring lot.

“I think the FAA has a bad name, and that’s unfortunate,” suggested W. Keith Martin, M.D., of Aurora, Colo.-based Virtual Flight Surgeons. “Most of the people who work in [the aeromedical division] of the FAA are very dedicated. They want you to be able to fly, but what you have to understand is that they need the proper documentation.”

Martin points out that pilots need two certificates to fly–a pilot certificate and a medical certificate. “Aviation departments invest significant time and expense in maintaining their crews’ pilot certificates, with training costs that can exceed $30,000 per pilot annually, but what are flight departments doing to maintain their pilots’ medical certificates?” he asked. For many flight departments, the answer is nothing. Typically a pilot’s medical is left up to the pilot, who in turn visits an AME only as often as is required to renew the medical. For everything else he uses a family physician.

Martin said the average physician doesn’t understand the requirements of aviation, and that can be trouble for a pilot. “Let’s be realistic,” he said. “What’s OK for an accountant isn’t necessarily good for a pilot, but once the FAA gets all of the information it needs, it’s very supportive.”

He recalled that, historically, if a pilot had a heart attack, his flying career was over. “That’s not true any more. In fact, pilots with a history of drug problems, alcohol problems and even seizures have eventually been granted waivers when their individual situations warranted it,” Martin said. “The trick is to know the ins and outs of the regulations and what you need to do for the FAA to consider giving you a waiver.” He used color blindness as an example.

“Three to 5 percent of all males have some abnormality in their color vision,” Martin said. “It used to be that for a first-class medical the applicant was required to have ‘normal color vision.’ Now the requirement is for the applicant to have the ‘ability to perceive those colors necessary for safe performance of airman duties.’ The problem is that when the FAA’s doctors changed the standard they didn’t make allowances for how to prove it.”

Martin said one option is for the applicant to take a control-tower lightgun test. If you pass it you get a statement of demonstrated ability (SODA), but Martin said many pilots are uncomfortable with a SODA because they think it’s still seen as a stigma. “Many applicants don’t understand that they can provide documentation to the FAA proving they can pass an alternate color vision test,” he explained. “You might not be able to pass the one type of test your AME happens to have in his office, and if you don’t he has no choice but to fail you. There are many different types of color test. The trick is, if you know you have a color-blindness issue, you should take an alternate test somewhere, have it documented and submit it to the aerospace medical certification division of the FAA in Oklahoma City. They, in turn, will send you a letter of proficiency stating you meet the necessary standards. Take that letter to your AME when you go for your medical, and you will get an unrestricted medical certificate. The key is taking an alternative test before going to the AME.”

Psychological issues are another area rife with substantial misconceptions. “It is true that current FAA policy prohibits you from flying while taking antidepressant medication such as Prozac, Zoloft and Paxil,” Martin said. “That has led to all sorts of misconceptions. For example, someone needs medication and they elect not to use it for fear they’ll never be allowed to fly again, and they end up flying without proper medical treatment. You have got to do what’s best for your health first.

“Unfortunately, many pilots believe that if they take that type of medication they can never fly again, but that’s not true. Once they’re off the medication they can go back to flying and continue to see someone in therapy at the same time. People have this notion that if they see a psychiatrist or counselor they’ll never fly again. Nothing could be further from the truth. It’s an unfounded rumor.”

The medical process is simple and straightforward until an applicant runs into a problem and requests a waiver. It can easily take months, even a year or more, to obtain such a waiver.

According to Martin, a lot of individuals going for their first medical walk away from the AME thinking they can’t be a pilot because they’ve been rejected for some reason, such as color blindness. “What we do at our company is act as a liaison between the clinician, the pilot and the FAA,” Martin said. The company also has a Web site (www.aviationmedicine.com) dedicated to helping people understand the process.

“The reason it takes so long for a waiver to be issued is because the FAA doesn’t always get all the information it needs to make a decision. Making matters even worse, Oklahoma City isn’t sufficiently staffed to allow it simply to call a pilot and tell him what it needs,” Martin explained. “So the FAA sends a letter to the pilot, who then has to follow up. We don’t have anything magical at Virtual Flight Surgeons, but when we prepare a package for the FAA we know what’s needed to complete it properly and give the FAA everything it needs to make the decision the first time.”

Bizav Program

Virtual Flight Systems’ corporate aeromedical services program includes unlimited e-mail and telephone physician consultation; an electronic newsletter; FAA waiver advocacy and case preparation; expert-witness legal review, testimony and travel; flight-department operations manager/chief pilot consultations; corporate flight physiology and medical procedures/programs review; and a review of company drug- and alcohol-testing programs, among other benefits.

Depending on the number of pilots in a flight department, the annual fee per pilot, based on a three-year contract, is $599 for departments with two to 24 pilots. There is also a program for individual pilots. The question is whether or not the program is worth the investment.

David Hale, executive director of Pilot Medical Solutions of Oklahoma City, believes that it pays to have a professional guide an applicant through the process. “It is important to note that the process is somewhat bureaucratic, not just medical,” he said. “Many think it’s a matter of just being medically fit, but it’s not that simple. U.S. regulations are actually pretty liberal compared with those of other countries, so the bottom line is that anyone who really should be allowed to fly can do so. But it’s a matter of having the right documentation in sufficient detail to satisfy the FAA’s criteria,” Hale emphasized. “The majority of pilots who come to us are looking for waivers, so by definition they’re looking to depart from the FARs. It’s important to note that the federal air surgeon can certify anyone he believes is fit to fly; you just have to make your case in the proper manner,” Hale said.

Pilot Medical Solutions has comprehensive aeromedical information via its Web site (www.leftseat.com). The site has a list of AMEs who are actually pilots (being a pilot isn’t a requirement for AME certification) and the “largest list of FAA-approved medications.”

Finding the Right AME

While many AMEs may not have a lot of experience in seeking waivers, there are some that do. Ruth Martens, M.D., is a senior AME in private practice in Wheaton, Ill. Some years ago Martens, a pilot herself, had difficulty getting her medical because of a past but stable medical condition. “I found the process to be grueling,” she said. “And I was surprised at how few female AMEs there are, so I decided to become an AME to make it easier for others.”

Martens recommends that if an applicant has, or has reason to believe he might have, any potentially disqualifying issue he should call the AME first and discuss it before going for the medical. “It is very important to find an AME who is willing to talk to you about your condition in advance,” she said. “Some are willing to do that; some aren’t. If they’re not helpful, call your FAA regional office. They have a pilot line where you can ask questions about a specific condition, what testing has to be done and so on. They will tell you what to expect. Believe me, the FAA is not trying to nail people to the wall. If you are safe to fly, the agency’s job is to guide the paperwork so you can get it done in a timely manner.”

The reason for calling the AME before going for a medical is that once you start the medical process, the clock starts ticking. If you’re applying for a first-class medical and it takes eight months to get a waiver approved, the medical time period expires before you ever get the waiver and you’re back to square one.

“But more than anything the hardest thing for me is when people call and tell me about one problem, then show up and have another problem in addition to it,” she said. “You should look up disqualifying conditions in advance and tell the AME everything that’s wrong before going for the medical. It’s important to understand that disqualifying conditions don’t always mean you can never fly again.”

Dr. Erwin Samuelson echoed this sentiment.“You have to tell the brutal truth,” said Samuelson, a senior AME. “An AME can’t help you get a medical if you withhold information. The FAA is very professional, and you have to do things right. For example, on the medical the FAA asks you to indicate every medical issue, including alcohol and recreational drug use, that has occurred in your life. Any administrative actions or convictions related to alcohol must also be reported to the security division of the FAA within 60 days. It is definitely in your best interest to tell the truth. The FAA checks your driving record each time you apply for a medical and publishes a toll-free hotline number so that anyone can anonymously report you. If you falsify the form you’re liable for a $250,000 fine, five years in jail and the loss of your airman certificates. If the AME lies for you, he’ll get tapped for a $250,000 fine, five years in jail and lose his AME status.”

Samuelson, who has an office in Redondo Beach, Calif., issues more than 1,000 FAA medicals a year and has been an AME for more than 25 years. Through his Web site (www.leftseat.com/drerwin) he offers the requirements for a medical, disqualifying conditions and waivers and links to other related sites.

“The truth is, very few people can’t obtain FAA medical certification,” he said. “The initial determination is made by the AME; however, the aerospace medical certification division of the FAA in Oklahoma City makes the final decision. Any decision can be appealed. Providing medical documentation that demonstrates flight fitness leads to the most successful appeals. Rarely will an FAA decision be reversed without some medical evidence.” He said the odds aren’t good for legal appeals, since the process takes a long time and can be expensive.

“Most pilots who are refused medical certification are actually eligible but haven’t provided proper documentation to the FAA,” concluded Samuelson.

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