My Flight Surgeon
Sr. Aviation Medical Examiner
This is from the AOPA web site and is a very nice explanation of what the Special Issuance letter means and what you have to do to remain medically certified. My comments are in BLUE and the AOPA's comments are in RED. If you get one of these letters and go to an AME other than the one who performed the flight physical, you need to take a copy of the letter to the new AME.
Dear Mr. Member: PI# 100111
I have reviewed the information submitted by you in support of your request for an airman medical certificate. The medical evidence reveals a history of myocardial infarction and coronary artery disease requiring coronary artery bypass surgery. You are ineligible for third-class medical certification under Section 67.111(a) (1) (3), 67.211(a) (c), and 67.311(a) (c) of the Federal Aviation Regulations (FARs).
The letter must state the medical history presented to the FAA. Because of the disqualifying conditions, the medical regulation that makes the condition disqualifying must also be stated. Section 67.111 details the requirements for a first class medical, 67.211 for second class, and 67.311 for third. The parenthetical numbers refer to the specific medical condition, in this case, myocardial infarction and coronary heart disease.
However, based on the complete review of the available medical evidence, I have determined that you may be granted authorization for special issuance of Third-class airman medical certification under Section 67.401 of the FARs.
Your Aviation Medical Examiner is authorized by this letter to issue you a third-class medical certificate bearing the limitation "NOT VALID FOR ANY CLASS AFTER APRIL 30, 2007" provided you are found to be otherwise qualified.
Despite your disqualifying condition, the federal air surgeon has found that your current medical condition does not put you at an unacceptable risk that would endanger public safety during the time the authorization will be in effect (April 14, 2006, through April 30, 2007). For our purposes, assume this pilot's last FAA medical examination was more than two years ago, and he will be reapplying for a new medical with his AME this month. It is usually best to undergo a current FAA flight physical at the same time you are providing the FAA with medical records in support of a special issuance request. That way, the periodic reexamination (usually at yearly intervals) will come in the same month that your regular FAA medical examination is due according to FAR 61.23.
This Authorization expires on April 30, 2007.
Only the authorization expires one year from now. The FAA physical examination done by your AME is still valid for 24 or 36 months as specified in 61.23, so you will not need to go back to your AME until April 2008. (Assume also that this pilot is over age 40 and requires a new medical application every 24 months.)
Consideration for a new Authorization will be contingent upon the following, performed in accordance with the enclosed specifications:
On or about March 2008:
In order to avoid a lapse in certification, the necessary testing should be completed near the date noted above THIS IS VERY IMPORTANT and forwarded in one package to the following office.
Aerospace Medical Certification Division (AAM-300)
FAA Civil Aerospace Medical Institute
6700 South MacArthur Blvd.
Oklahoma City, OK 73169
Telephone 800/350-5286, 405/954-4821
The FAA will allow you to send your renewal information up to 90 days prior to the expiration date of the authorization. Even though the letter indicates 60 days is enough lead time, we suggest you take the full 90 days to allow for delays in getting testing done, receiving final reports from the doctor's office, and other last-minute delays that always seem to pop up. Make copies of everything for your own files in case something gets lost, which does happen occasionally. Either address will work, but the best way to send information is by overnight or express mail to the S. MacArthur Blvd. address. Regular first class can go to the P.O. box number.
Many of the Special Issuances are for a longer period of time but require you provide the AME with documentation ( letter from your doctor and/or test results) as outlined in the FAA's letter to you in order for the AME to issue your medical certificate. The AME is then required to forward these documents to the FAA along with the 8500-8 original copy.
You must promptly report any adverse changes in your medical condition to the FAA Medical Appeals Branch, AAM 320.
Remember, FAR 61.53 kicks in here.
FAR 61.53: Prohibition on Operations During Medical Deficiency
Use of the above reference number and your full name on any reports or correspondence will aid us in locating your file and expediting a reply to you.
Always use the PI# when contacting the FAA. It is the easiest way for them to access your data.
Sincerely,
Warren S. Silberman, D.O.
Manager, Aeromedical Certification Division
Civil Aeromedical Institute
Remember, when the FAA asks for specific information and/or tests they want exactly what they asked for, not what your doc thinks they need. Be specific with you doctor and provide exactly what the FAA wants. If you do not do so, it will delay the entire process another 2-4 weeks (GROUNDED
). If one looks at the FAA's data, about 1% of medical applications are ulimately denied. Those that do not meet standards most often receive a Special Issuance. 80% of the problems with delays or denials are in the airman not providing the requested information to the FAA. My experience is that I rarely have someone outright denied. The denials we see are because the pilot does not get the testing done or just decides to quit trying.
One last comment: The FAA asks for documantetion of what is the Standard of Medical Care for the condition they are reviewing. So what they ask for is what you and your doctor should be doing anyway if you are receiving First Class Medical Care.
I hope this information helps those of you who may have a Special Issuance now or in the future.
One last thing, 50% of AME's perform fewer than 25 flight physicals a year. So, if you have a Special Issuance problem and your AME seems to not know the ropes with the FAA, consider contacting the folks at www.aviationmedicine.com or www.leftseat.com for help and for $$$. There are many AME's who perform 50-200 exams a month and these folks should be able to help you without the need to spend extra money with the resources noted in the above links. Ask around to see who is experienced and who has helped other pilots through the "system". Not all AME's are interested in the beaurocratic role they have to play to do this for pilots so if an AME is not interested, find someone who is willing to help you.
Dear Mr. Member: PI# 100111
I have reviewed the information submitted by you in support of your request for an airman medical certificate. The medical evidence reveals a history of myocardial infarction and coronary artery disease requiring coronary artery bypass surgery. You are ineligible for third-class medical certification under Section 67.111(a) (1) (3), 67.211(a) (c), and 67.311(a) (c) of the Federal Aviation Regulations (FARs).
The letter must state the medical history presented to the FAA. Because of the disqualifying conditions, the medical regulation that makes the condition disqualifying must also be stated. Section 67.111 details the requirements for a first class medical, 67.211 for second class, and 67.311 for third. The parenthetical numbers refer to the specific medical condition, in this case, myocardial infarction and coronary heart disease.
However, based on the complete review of the available medical evidence, I have determined that you may be granted authorization for special issuance of Third-class airman medical certification under Section 67.401 of the FARs.
Your Aviation Medical Examiner is authorized by this letter to issue you a third-class medical certificate bearing the limitation "NOT VALID FOR ANY CLASS AFTER APRIL 30, 2007" provided you are found to be otherwise qualified.
Despite your disqualifying condition, the federal air surgeon has found that your current medical condition does not put you at an unacceptable risk that would endanger public safety during the time the authorization will be in effect (April 14, 2006, through April 30, 2007). For our purposes, assume this pilot's last FAA medical examination was more than two years ago, and he will be reapplying for a new medical with his AME this month. It is usually best to undergo a current FAA flight physical at the same time you are providing the FAA with medical records in support of a special issuance request. That way, the periodic reexamination (usually at yearly intervals) will come in the same month that your regular FAA medical examination is due according to FAR 61.23.
This Authorization expires on April 30, 2007.
Only the authorization expires one year from now. The FAA physical examination done by your AME is still valid for 24 or 36 months as specified in 61.23, so you will not need to go back to your AME until April 2008. (Assume also that this pilot is over age 40 and requires a new medical application every 24 months.)
Consideration for a new Authorization will be contingent upon the following, performed in accordance with the enclosed specifications:
On or about March 2008:
- A current cardiovascular evaluation and current lab work.
- A current radionuclide scintigraphy exercise stress test.
In order to avoid a lapse in certification, the necessary testing should be completed near the date noted above THIS IS VERY IMPORTANT and forwarded in one package to the following office.
Aerospace Medical Certification Division (AAM-300)
FAA Civil Aerospace Medical Institute
6700 South MacArthur Blvd.
Oklahoma City, OK 73169
Telephone 800/350-5286, 405/954-4821
The FAA will allow you to send your renewal information up to 90 days prior to the expiration date of the authorization. Even though the letter indicates 60 days is enough lead time, we suggest you take the full 90 days to allow for delays in getting testing done, receiving final reports from the doctor's office, and other last-minute delays that always seem to pop up. Make copies of everything for your own files in case something gets lost, which does happen occasionally. Either address will work, but the best way to send information is by overnight or express mail to the S. MacArthur Blvd. address. Regular first class can go to the P.O. box number.
Many of the Special Issuances are for a longer period of time but require you provide the AME with documentation ( letter from your doctor and/or test results) as outlined in the FAA's letter to you in order for the AME to issue your medical certificate. The AME is then required to forward these documents to the FAA along with the 8500-8 original copy.
You must promptly report any adverse changes in your medical condition to the FAA Medical Appeals Branch, AAM 320.
Remember, FAR 61.53 kicks in here.
FAR 61.53: Prohibition on Operations During Medical Deficiency
- Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required flight crewmember while that person:
- Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or
- Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.
- Operations that do not require a medical certificate. For operations provided for in FAR 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required flight crew member, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.
Use of the above reference number and your full name on any reports or correspondence will aid us in locating your file and expediting a reply to you.
Always use the PI# when contacting the FAA. It is the easiest way for them to access your data.
Sincerely,
Warren S. Silberman, D.O.
Manager, Aeromedical Certification Division
Civil Aeromedical Institute
Remember, when the FAA asks for specific information and/or tests they want exactly what they asked for, not what your doc thinks they need. Be specific with you doctor and provide exactly what the FAA wants. If you do not do so, it will delay the entire process another 2-4 weeks (GROUNDED
). If one looks at the FAA's data, about 1% of medical applications are ulimately denied. Those that do not meet standards most often receive a Special Issuance. 80% of the problems with delays or denials are in the airman not providing the requested information to the FAA. My experience is that I rarely have someone outright denied. The denials we see are because the pilot does not get the testing done or just decides to quit trying.One last comment: The FAA asks for documantetion of what is the Standard of Medical Care for the condition they are reviewing. So what they ask for is what you and your doctor should be doing anyway if you are receiving First Class Medical Care.
I hope this information helps those of you who may have a Special Issuance now or in the future.
One last thing, 50% of AME's perform fewer than 25 flight physicals a year. So, if you have a Special Issuance problem and your AME seems to not know the ropes with the FAA, consider contacting the folks at www.aviationmedicine.com or www.leftseat.com for help and for $$$. There are many AME's who perform 50-200 exams a month and these folks should be able to help you without the need to spend extra money with the resources noted in the above links. Ask around to see who is experienced and who has helped other pilots through the "system". Not all AME's are interested in the beaurocratic role they have to play to do this for pilots so if an AME is not interested, find someone who is willing to help you.
