My Flight Surgeon
Sr. Aviation Medical Examiner
This is the third of a series of threads regarding the history portion of the FAA Form 8500-8 that you complete every time you get a flight physical. For the vast majority of you, this will be just informational and you will not be affected. As with many of the conditions discussed here and elsewhere in these threads, there is a requirement for the pilot to provide medical records and physician documentation regarding the medical condition being reported. I would suggest that if you are unsure of how to answer these questions in Item 18, you discuss them with your AME before you complete the form. Some things may not be significant while others will require explanation.
Item18c. Unconsciousness for any reason
Unconsciousness occurs often. It may be rather benign such as having way too much to drink (not pilots:nana2: ), passing out while at attention during military ceremonies, or having one’s “bell rung” :banghead: in a sporting event. These are usually not significant and if they occur only once there is no real problem with the episode of unconsciousness. Discuss these episodes with the AME before you check the box 18c on the medical history form if you are unsure of whether it was significant or not.
The real problem arises when there has been more than one episode of unconsciousness, have been seizures associated with the episode(s) or the unconsciousness lasted for more than a minute. This is when you should describe the event(s) to determine the primary organ system responsible for the episode, witness statements, initial treatment, and evidence of recurrence or prior episode. Although the regulation states, “an unexplained disturbance of consciousness is disqualifying,” it does not mean to imply that the applicant can be certificated if the etiology (cause) is identified, because the etiology may also be disqualifying in and of itself. It is these underlying causes that the FAA wants to review. Some of the diseases (this is not an all-inclusive list) that can cause incapacitation include: stroke, brain tumor, post-traumatic head injury (concussion), meningitis or encephalitis, seizures, loss of consciousness without explanation, skull fracture, and unconsciousness or disorientation of more than 1 hour following injury. The difficulty with many of these conditions is the potential of physical incapacitation they represent.
When a history of any of these occurs, a medical report needs to be submitted to the FAA via the AME. These should include hospital records, consultation reports, and appropriate laboratory and imaging studies, if available. The AME may be able to review the data and determine that the episode is easily explained and does not require FAA review. If review is required, the AME may wish to call the FAA and talk directly to the duty officer. Frequently, if all the data is available, the duty officer will authorize issuance of the medical certificate and ask the AME to forward all of the supporting documents to the FAA for review and filing. Be sure to take copies of these documents to you flight physical with you!
The important take home points regarding unconsciousness include: 1) simple episodes like having your bell rung do not lead to disqualification, 2) full recovery with a good medical evaluation allows one to fly after head injury, and 3) there are neurological conditions that are disqualifying, such as epilepsy.
Item18c. Unconsciousness for any reason
Unconsciousness
Unconsciousness occurs often. It may be rather benign such as having way too much to drink (not pilots:nana2: ), passing out while at attention during military ceremonies, or having one’s “bell rung” :banghead: in a sporting event. These are usually not significant and if they occur only once there is no real problem with the episode of unconsciousness. Discuss these episodes with the AME before you check the box 18c on the medical history form if you are unsure of whether it was significant or not.
The real problem arises when there has been more than one episode of unconsciousness, have been seizures associated with the episode(s) or the unconsciousness lasted for more than a minute. This is when you should describe the event(s) to determine the primary organ system responsible for the episode, witness statements, initial treatment, and evidence of recurrence or prior episode. Although the regulation states, “an unexplained disturbance of consciousness is disqualifying,” it does not mean to imply that the applicant can be certificated if the etiology (cause) is identified, because the etiology may also be disqualifying in and of itself. It is these underlying causes that the FAA wants to review. Some of the diseases (this is not an all-inclusive list) that can cause incapacitation include: stroke, brain tumor, post-traumatic head injury (concussion), meningitis or encephalitis, seizures, loss of consciousness without explanation, skull fracture, and unconsciousness or disorientation of more than 1 hour following injury. The difficulty with many of these conditions is the potential of physical incapacitation they represent.
When a history of any of these occurs, a medical report needs to be submitted to the FAA via the AME. These should include hospital records, consultation reports, and appropriate laboratory and imaging studies, if available. The AME may be able to review the data and determine that the episode is easily explained and does not require FAA review. If review is required, the AME may wish to call the FAA and talk directly to the duty officer. Frequently, if all the data is available, the duty officer will authorize issuance of the medical certificate and ask the AME to forward all of the supporting documents to the FAA for review and filing. Be sure to take copies of these documents to you flight physical with you!
The important take home points regarding unconsciousness include: 1) simple episodes like having your bell rung do not lead to disqualification, 2) full recovery with a good medical evaluation allows one to fly after head injury, and 3) there are neurological conditions that are disqualifying, such as epilepsy.
There are a number of statutes where the prosecution must prove what someone knew ahead of time, like perjury or fraud, and that's considered very difficult. In those cases, having plausible deniability can be an advantage. But I'd have to know the FAA enforcement history and pertinent NTSB rulings to know in this instance whether pleading ignorance would help.