Coalition asks FAA to stay new medical certification policy

The FAA began briefing industry groups weeks before the new policy is set to take effect January 1. AOPA joined a coalition including airline and charter pilot unions that wrote a December 13 letter asking Federal Air Surgeon Dr. Susan Northrup to stay the implementation of the policy, which stands to shift the practice of deferring medical certificate applications deemed incomplete to denying those applications pending reconsideration.

"The FAA’s use of denials, in lieu of the currently used deferral, as a routine part of the medical application process will significantly increase unneeded confusion for applicants and introduce unintended consequences for those under initial denial," the groups wrote. "These initial denials will also be reportable on future medical applications and other applications the industry uses, such as employment applications, which ask whether a pilot has had a previous medical denial. The ramifications of an increase in airmen receiving and reporting medical denials on these applications and the need to educate hiring managers about this change are significant and will take considerable time."

The FAA has long struggled with a backlog of medical certificate applications, particularly those that are deferred pending receipt of medical details, such as documentation of procedures, exam reports, or test results. Pilots recovering from cardiac events are among those with complex medical histories that may require detailed evaluation by the FAA, and that has often led to lengthy back-and-forth communications between the pilot and the agency's medical staff.

If the new policy goes into effect as planned on January 1, that back-and-forth will be conducted after the fact of a denial, not while an application (for an initial certificate or renewal) is pending. The agency will issue a prompt denial of any applications deemed incomplete following the aviation medical exam.

Northrup briefed aviation medical examiners (AMEs) on the pending change in a December 4 "Grand Rounds" webinar, explaining that the new policy is driven by an "unacceptably long" backlog of deferred medical certificate applications.

Northrup said about 5 percent of roughly 450,000 medical certificate applications filed annually are deferred by the FAA pending receipt of additional information—which amounts to about 22,500 applications that require additional staff time for the FAA to determine whether the medical certificate will be issued. Northrop said applications filed by AMEs with complete documentation, excluding cardiac appeals, have typically been reviewed within 20 days of receipt in recent months.

"If they touch it in 20 days and you have everything uploaded that the airman is going to need, they're going to act on it," Northrup said of the FAA medical staff during the webinar. "If we don't have everything that we need, instead of sending a letter, an information request letter, we're going to send a denial, with a reconsideration letter."

Pilots denied a medical certificate are not eligible to fly under BasicMed, the use of which has significantly reduced the volume of medical certificate applications that would otherwise have been filed.

The coalition expressed support for the FAA's effort to improve the medical certification system overall, if not the policy:

"We support your office's desire to promote the submission of complete information at the time of initial medical application," the coalition of pilot advocacy groups and unions wrote in the December 13 letter. "In addition to reducing application time, it dramatically reduces the administrative burden on your staff and allows them to focus on evaluating submitted data."

The signatories noted that modernization of the medical certification system, including implementation of Aeromedical Working Group recommendations required by Congress in the 2024 FAA reauthorization, stands to address the concerns that drove the policy change.

"These changes and your authorization to bring on more AMEs and medical specialists will go a long way to helping the FAA and the pilots the agency serves. We are very willing to help bring these improvements to reality."

AOPA medical certification specialists routinely advise members with complicated medical situations. Pilots may be able to consult their AME, in advance of the exam, for advice on what documentation the FAA may require in their particular circumstances, Northrup said. (Pilots may also want to reference the agency's online Guide for Aviation Medical Examiners to learn what additional documentation the AME or the FAA might ultimately require.)

In addition to losing the privileges associated with a medical certificate directly, denial also makes the pilot ineligible to fly under BasicMed, or as a sport pilot with a driver's license. While the denial may be reversed after the pilot submits additional documentation, and an adverse decision at that stage can be appealed to the FAA Aerospace Medical Certification Division, and ultimately to the NTSB, denial (as opposed to deferral) leaves an applicant with an existing medical certificate unable to serve as a pilot or controller during the process.

The December 13 letter was signed by AOPA; the Air Line Pilots Association; the Allied Pilots Association; the Coalition of Airline Pilots Associations; the Experimental Aircraft Association; the Flight School Association of North America; the Independent Pilots Association; the International Brotherhood of Teamsters, Airline Division; NATA (formerly the National Air Transportation Association); the National Business Aviation Association; the National Flight Training Alliance; the NetJets Association of Shared Aircraft Pilots; the Southwest Airlines Pilots Association; and Vertical Aviation International. The FAA has yet to respond.