You may have a “history or diagnosis” of one of those
specific disqualifying conditions or otherwise fail to meet Part 67 standards
but now present no special risk. Perhaps you had a heart attack but then
underwent heart surgery, quit smoking, went on a low cholesterol diet, and are
following a good exercise regimen so that you are now no more likely to have
another heart attack than anyone else of your age. Maybe you were able to beat
an alcohol or drug habit. Maybe the history or diagnosis was erroneous (doctors
are human and sometimes make mistakes too). Or perhaps the Federal Air Surgeon
has disqualified you because in his opinion your condition, medication, or
current course of treatment is incompatible with safe flying. Your treating
physicians may strongly disagree with the Federal Air Surgeon’s opinion.
Shouldn’t you be free to fly? Yes, and if you can convince the FAA that despite
your medical history you are now fit to fly, you can.
Statement of
Demonstrated Ability (SODA)
Pilots who have a static disability that is not expected to
worsen may be certified through a process referred to as a Statement of
Demonstrated Ability (SODA).
Let’s start with the easiest ones: vision and hearing
problems. If your vision doesn’t meet FAA standards without eyeglasses or
contact lenses but does with these lenses, all that may be required is for your
AME to add this limitation to your medical certificate: “Holder shall wear
correcting lenses while exercising the privileges of his/her airman
certificate.”
If you failed the color vision test, you may be able to get
your medical certificate by arranging a test to determine whether you are able
to distinguish between the red, green, and white of the control tower light gun
that would give you directions in the event of a radio failure. If you can, you
get your medical certificate even if your color vision isn’t perfect. If your
hearing is below standards but you can demonstrate that you can still hear and understand
ATC instructions and flight deck conversation, you should be able to get your
medical certificate, although it may have a limitation on it requiring you to
use a noise-canceling headset while flying.
If you have a below-the-knee amputation of a leg, but have a
prosthetic limb which generally enables you to function normally, and your AME
is of the opinion that this would present no problem with operating the aircraft’s
controls, she has authority to issue you a student pilot certificate with the
limitation “For Student Pilot Purposes Only” to enable you to take a checkride
with an FAA examiner. If you pass the checkride by demonstrating that you are
in fact able to operate all of the aircraft’s controls despite your disability,
you will be issued a SODA.
Special Issuance
If your problem is a history or diagnosis of one of the
specific disqualifying conditions listed above, but you can prove that in spite
of that history you are unlikely to become suddenly incapacitated while flying
(or to fly irresponsibly), you may obtain an FAA medical certificate by
“special issuance.” The burden will be on you and your doctors to convince the
Federal Air Surgeon that you are now an acceptable risk to flight safety. If
you succeed, the Federal Air Surgeon has the discretionary authority to issue
you any class of medical certificate by special issuance, even though you don’t
meet the letter of the law. Long a tedious, time-consuming, and frustrating
bureaucratic process, the Federal Air Surgeon has delegated special issuance
authority for certain medical conditions to the AME under new published
guidelines called “Certificates an AME Can Issue (CACI).” This allows an AME
the discretion to issue a medical certificate to applicants with arthritis,
asthma, glaucoma, chronic hepatitis C, hypertension, hypothyroidism, migraine
and chronic headache, pre-diabetes and renal (kidney) cancer. This delegation
has simplified and expedited certification for many airmen, and this list is
likely to continue to expand.
One exception to the possibility of certification through
the special issuance process is the diabetic who requires insulin injections to
control the disease. The FAA long considered insulin-treated diabetes mellitus (ITDM)
absolutely disqualifying for any class of medical certificate. No special
issuance medical certificates of any class were granted to individuals with
ITDM. In response to a petition from the American Diabetes Association, the FAA
has opened third-class aviation medical certification by special issuance to
individuals with IDTM who haven’t experienced any further complications, such
as heart or kidney disease, neurological abnormalities, or vision problems. The
conditions for special issuance to individuals with ITDM, which include stringent
monitoring requirements, are available on the FAA’s website. This change has
opened up the joy and freedom of personal flying (under a student, recreational
or private pilot certificate) to hundreds of such individuals, at this writing.
Flight operations by these individuals are, however, limited to the United
States, as ICAO has yet to adopt comparable rules. It continues to be the FAA’s
position that individuals with ITDM still pose too great a risk of sudden
incapacitation to allow first or second-class medical certification as would
allow them to carry passengers for hire.
Periodic renewal of medical certificates issued under this
special issuance process, once as slow and cumbersome as getting the first
special issuance, is now being expedited under the FAA’s “Quick-Cert” program.
This program is part of the Federal Air Surgeon’s goal to
provide “same-day medical certification” to qualified applicants.
According to the NTSB, medical causes are a factor in only
about 2.5 percent of civil aviation accidents in the United States. The safety
record of pilots operating under specially issued medical certificates has
proven every bit as good as that of the general pilot population over the
years, so this increasingly enlightened and humane process of personalized
evaluation is likely to remain a feature of aviation medical certification.
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