Frequently  Asked Questions

Q: I have always held a third class FAA medical certificate. I would like to fly under the new rules for BasicMed. Do you perform exams under BasicMed?

 

A: Dr. Schrack does not perform exams under BasicMed. BasicMed falls under 14 CFR part 68. An AME performs exams under the authority of 14 CFR part 67. BasicMed is a process whereby the airman's treating physician who knows their medical history well may complete a comprehensive medical exam checklist (CMEC). It is the pilots responsibility to understand the requirements of the new rules and also the physician completing the BasicMed CMEC must attest that they are familiar with FAA medical certification standards. Further information is available at https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/

 

Q: What is the difference between a First (I), Second (II), and Third (III) Class physical examination?

 

A: For First Class if the applicant is under the age of 40 at the time of the exam, the certificate is valid for one year and if over the age of 40 it is valid for six months.  A First class pilot needs to be able to have 20/20 vision in each eye with correction for distant vision, 20/40 intermediate vision (if over age 50), as well as 20/40 near vision acuity.  For pilots over the age of 35, an EKG is required at the initial exam and then annually after age 40.  Applicant must also demonstrate adequate depth perception and pass a minimum conversational voice test and color vision. 

 

For Second Class, the certificate is valid for one year no matter the age of the applicant.  Second Class applicants also need 20/20 vision in each eye with correction for distant vision, 20/40 intermediate vision (if over age 50), as well as 20/40 near vision acuity.  Applicant must also demonstrate adequate depth perception and pass a minimum conversational voice test and color vision test. 

For Third Class, if the applicant is under the age of 40 at the time of the exam, the certificate is valid for five years and if over the age of 40 it is valid for two years.  Third Class applicants must demonstrate 20/40 vision in both eyes with correction for distant and near vision. Applicant must also pass a minimum conversational voice test and color vision test. 

 

For all classes at Central PA AME, applicants receive a professional vision screening.

 

Q: How much does an FAA medical examination cost and how may I pay?

A: Our fee is $145 for First, Second, and Third Class airmen medical examinations.  A requested EKG submitted electronically to the FAA is $50.  Our fee for AME Assisted Special Issuance review and issuance of an interim certificate is $75. Additional work required for a Special Issuance will be invoiced at an hourly rate.  We accept cash, personal checks, Visa, MasterCard, and Discover.

Q: Does medical insurance cover my FAA examination?

 

A: FAA examinations are a third party requested examination and are not covered by any medical insurance.  However, pilots have been successful in using a Health Savings Account for payment.  

 

Q: I need a CDL medical exam or camp physical form completed.  Can that be done at the time of my appointment?

A: Unfortunately we are not authorized to perform CDL medical exams for the FMCA.,

Q: Should my AME also be my personal physician?

 

A: Unfortunately, this would not apply to Central PA AME since the practice is limited to FAA medical examinations.  The Aviation Medical Examiner (AME) is a designee of the FAA and is empowered to determine if a medical certificate can safely be granted for aviation duty.  Therefore, no doctor/patient relationship exists and the AME is not serving in the capacity of a personal physician.  There is no duty of confidentiality.  Any information about the applicant is required to be disclosed to the FAA.

 

Q: I lost my medical certificate.  How can I get a replacement?

 

A: We are not allowed to make a copy of the medical certificate. Pilots should contact the FAA and request a duplicate medical certificate.  In the FORMS page on this website there is a copy of the request to be sent to the FAA.  Remember to include $2.00.

 

Q: How should I prepare in advance of scheduling an examination?

 

A: The FAA Medical itself is an uncomplicated physical exam that's meant to assess a pilot's health history and overall fitness for flight. Most people who are in reasonably good health will have no problem passing an FAA Medical, provided that they do not suffer from a disqualifying condition which primarily comprises health issues affecting the heart and nervous system, as well as issues of mental stability and substance abuse.  Anyone concerned about not passing the flight physical because of a known health problem should contact an examiner before scheduling an appointment. Obtaining required tests or consultations in advance of the flight physical can save considerable time. If you routinely or frequently take a medication, we need to know the brand name or generic name, the dosage, and how often you take it.  The FAA will not approve the use of any medicine which can affect mental status. We need to know the name, address and dates of all physician visits within the past 3 years. You do not need to bring your pilot logbook to your exam.  Estimates of total flying time are acceptable.  All of this information will be required when you complete your MedXpress application online and the information will be reviewed with you at the time of your examination.

 

Q:  What is included in my physical examination? 

 

A: The physical examination consists of a height and weight measurement, blood pressure and heart rate, hearing screeningc, color vision testing, vision screening utilizing a sophisticated screening device, urine testing (glucose and protein), and EKG if required for first-class examinees.  The physical portion does not require or include examination of the breasts, genitalia, or rectum. Contact lenses do not need to be removed. A typical exam is a stress-free experience and takes no more than 60 minutes.

 

Q:  What are the disqualifying medical conditions?

 

A: The following medical conditions are specifically disqualifying under 14 CFR part 67. However, the FAA may exercise discretionary authority under the provisions of Authorization of Special Issuance, to issue an airman medical certificate. Unless otherwise directed by the FAA, the Examiner must deny or defer if the applicant has a history of: (1) Diabetes mellitus requiring hypoglycemic medication; (2) Angina pectoris; (3) Coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant; (4) Myocardial infarction; (5) Cardiac valve replacement; (6) Permanent cardiac pacemaker; (7) Heart replacement; (8) Psychosis; (9) Bipolar disorder; (10) Personality disorder that is severe enough to have repeatedly manifested itself by overt acts; (11) Substance dependence; (12) Substance abuse; (13) Epilepsy; (14) Disturbance of consciousness and without satisfactory explanation of cause, and (15) Transient loss of control of nervous system function(s) without satisfactory explanation of cause.

 

Q:  Because of a medical condition I am worried that I might not be able to pass my physical examination.  I understand I can fly an airplane under the Sport Pilot Rule.  Should I apply for a third class medical or should I go the Sport Pilot Route? 

 

A: You should discuss this with your AME, but it may be in your best interest to not apply for a medical certificate as a denial will prevent you from flying under Sport Pilot category unless you pursue getting certified under Special Issuance.  Although the FAA requires only a valid driver’s license as proof of medical suitability for the Sport Pilot category, it does exclude individuals who have had a previous denial of their medical certificate.  Unfortunately, this appears to be a catch 22 or double standard.  Honestly, it does not make any sense if a pilot should not be flying with a known medical condition that is a risk to flight safety that they should be allowed to fly under the Sport Pilot Rule just because they hold a driver’s license.  I think it would also be important to understand that aircraft owners insurance or renters insurance policies may require the pilot to hold a FAA medical certificate.

 

Q: What is Special Issuance?

 

A: Special Issuance is a category of medical certification for pilots with certain medical conditions which are stable and the FAA has previously determined they are qualified or if a new medical condition has developed which may be temporarily disqualifying the applicant may apply for a special issuance. This category generally is issued a time-limited certificate (usually one year) and requires careful monitoring of the medical condition requiring status reports from the treating physician to be forwarded to the FAA before a new medical certificate can be issued.  When a pilot receives a Special Issuance they will receive an Authorization Letter which describes requirements that pilots must meet prior to the next required examination.  It is imperative that the applicant follow the directions in the Authorization Letter explicitly and bring the required records to the office for all follow-up examinations.  If required medical documentation is missing it may lead to a delay in processing their medical certification. 

 

Q: What is a SODA?

A: A Statement of Demonstrated Ability (SODA) is a determination that a pilot can fly safely with a fixed physical deficiency, such as the loss of an eye or a limb. The pilot must demonstrate to an FAA examiner that he or she can safely fly with any handicap and there have been no changes since the determination was first issued.  Restrictions may be applied, an example being the use of hand controls.  Any pilot who already has been issued a SODA and is coming for a medical examination should always bring a copy of the SODA with him to the office.

Q:  What are medical conditions that the AME can issue? 

 

A: These are conditions that are not deemed to be disqualifying, so they do not require a Special Issuance Authorization. They are relatively common and mild enough that they may be issued by the AME as long as the current medical status report from the treating physician documents stability according to the FAA specifications.

Some require “pre-approval” under an initial Special Issuance, others do not.  The important thing is that the AME can issue the certificate as long as the medical reports are complete and fulfill the FAA’s requirements. Some previous Special Issuance conditions are now in this category (see below) making things much easier. Furthermore, these conditions do not carry any shortened expiration dates. Here is the list of the currently approved conditions: 

• Arthritis
• Asthma
• Bladder Cancer
• Breast Cancer
• Chronic Immune Thrombocytopenia
• Chronic Kidney Disease
• Colitis
• Colon Cancer
• Essential Tremor
• Glaucoma
• Hepatitis C - Chronic
• Hypertension
• Hypothyroidism
• Retained Kidney Stones
• Migraine and Chronic Headache
• Mitral Valve Repair
• Pre-Diabetes
• Prostate Cancer
• Renal Cancer
• Thrombocytopenia
• Testicular Cancer

Q: Is there an approved medication list published by the FAA?

 

A: The FAA has recently posted very helpful guidance to pharmaceuticals in the AME Guide.  Click the following link:

 

http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/

 

Q: How does the FAA handle DUI’s or other legal problems?

 

A: The FAA takes any form of substance abuse or dependence very seriously. The FAA computers access national databases containing anything of public record and such facts cannot be hidden. If a pilot is arrested for a DUI, he or she must report this to the security division of the FAA within 60 days of a conviction. Any arrest (even without conviction) must also be reported on the next flight physical application. The AME is then required to assess whether the pilot might have a problem with alcohol or recurring legal issues.  This includes obtaining the arrest and court records from the jurisdiction where the infraction occurred.  If this is an isolated incident the AME may be able to issue the medical certificate if evidence supports this unless the following is true:

• Blood alcohol concentration (BAC) of 0.15 or higher
• History of two DUI arrests within 10 years
• Lifetime history of three or more DUI arrests

If any of the above three criteria are met, the FAA will require the applicant to undergo a quality Substance Abuse Evaluation before further consideration can be undertaken. If you have a problem in this area, please email us for further comments so we can assist you to the best of our ability even if it requires deferral for FAA consideration. 

 

Q: Can I fly if I have been diagnosed with ADD?

 

A: If this diagnosis occurred during childhood and the applicant no longer takes medication and no longer has current evidence of Attention Deficit Disorder, then the answer may be “yes”, with documentation and a thorough explanation by the applicant’s treating physician, as long as ADD medications have not been used for a long time. However, if the diagnosis is ongoing, the applicant will need to be off all ADD medications and undergo a rigorous cognitive evaluation by a board-certified clinical neuropsychologist.  The applicant should consult with an AME before undergoing such testing to make sure it follows the FAA standards. 

 

Q:  What is the new FAA policy concerning diagnosis and treatment of depression?

 

A:  A new policy concerning "situational depression" was instituted in May 2022 that any AME can issue. The AME should gather information regarding the diagnosis, severity, treatment, symptoms, and address ALL of the questions on the Situational Depression Decision Tool for the AME. If 5 or more years ago; treatment was not more than 6 months from the resolution of the stressor; there is no history of self-harm, psychiatric hospitalization, or persisting symptoms - the FAA will accept the AME history. If the single episode was LESS than 5 years ago, the AME must review a current, detailed Clinical Progress Note and actual clinical record(s) from the treating provider to verify the diagnosis.

 

The policy regarding medical certification of airmen with a history of depression treated with selective serotonin reuptake inhibitor (SSRI) anti-depressant medication went into effect on April 5, 2010.  Applicants will be followed by HIMS (Human Intervention Motivation Study) trained aviation medical examiners who are familiar with the initial evaluation and monitoring process that will be utilized for the SSRIs because the new policy is modeled on the process used for airmen with substance abuse and dependence diagnoses.  They also have training and experience in evaluating airmen from a psychological perspective.

 

The FAA Office of Aerospace Medicine will consider Special Issuance medical certification for airmen who are being treated for mild to moderate depressive disorders, such as major depressive disorder (mild to moderate), either single episode or recurrent episode; dysthymic disorder; and adjustment disorder with depressed mood.  Also, the following single agent medications may be utilized:  Fluoxetine (Prozac), Sertraline (Zoloft), citalopram (Celexa), and Escitalopram (Lexapro). The following are specifically unacceptable diagnoses and or symptoms: psychosis, suicidal ideation, history of electro convulsive therapy (ECT), treatment with multiple antidepressant medications concurrently, and a history of multiage drug protocol use (prior use of other psychiatric drugs in conjunction with antidepressant medications).

 

To be certified the applicant must demonstrate the following status: All symptoms of the psychiatric condition for which treatment is indicated must be ameliorated by the single medication, and the condition must be stable with no change in or exacerbation of symptoms for 12 months prior to certification; airman must be on a stable dosage of medication for a minimum of 6 months prior to certification; airman must have no aeromedically significant side effects of prescribed medication(s).

 

The following are required reports and consultations for initial consideration:

 

• Current status report from treating psychiatrist attesting to diagnosis, length of treatment, and presence of any side effects.
• Written statement from airman regarding his status.
• Letter from airline management (Chief pilot or designee) attesting to pilot’s observed mood on medication, if previously not flying, and in pilot’s admitting previous non-disclosure, a report on prior competence, crew interaction, and mood while on medication (only for first- and second-class medical certificate holders flying under FAR Parts 121 or 135).
• Report of results of neurocognitive psychological tests and provision of raw test data: include but not be limited to — COGSCREEN AE, Trails A/B; Stroop Test; CCPT, PASAT, Wisconsin Card Sorting Test.
• Evaluation and written report from HIMS-trained AME as to current psychiatric status of airman, treatment, and recommendation for Special Issuance certificate.

 

Process for Special Issuance certification:

 

• Records package sent through Aerospace Medical Certification Division (AMCD) in Oklahoma City, Okla. to AAM-200 (Washington, D.C.) for review of first-time application and approval for Special Issuance of 6 month or 12-month time-limited medical certificate, depending on age of applicant(reviewed by Chief Psychiatrist) for first-class medical certificates and pilots flying under FAR Parts 121 or 135, 12-month time-limited medical Certificate (reviewed by Chief Psychiatrist) for second and third-class medical certificates.
• Subsequent Special Issuance medical certificate issued directly by HIMS trained AME if all required documentation is considered acceptable or deferred to AAM-200, Chief FAA Psychiatrist, if there are concerns.
• 8500-8 will be transmitted to the AMCD, and follow-up report with recommendation from the HIMS-trained AME will also be forwarded to the AMCD (as per the current HIMS model for substance dependence Special Issuance).

 

Follow-up evaluation requirements (all classes of medical certificate) include forwarding the following materials to the HIMS trained AME:

 

• Current status report from treating physician at the time of application for Special Issuance medical certificate.
• Psychiatric consultation status report every 6 months for all classes of medical certificate holders.
• Letter from airline management every 3 months for first and second-class medical certificate holders flying under FAR Parts 121 or135, forwarded to the HIMS AME.
• After initial Special Issuance Authorization, psychometric testing will be required; annually for first and second class medical certificate holders flying under FAR Parts 121 or 135; and every two years for third class medical certificate holders.

 

 

Q: I received a letter requiring me to contact a HIMS AME. What does that entail?

 

A: It depends what the situation is, whether it's for alcohol, drug, or mental health issue. The letter usually specifies some of the requirments to obtain a Special Issuance. HIMS engagement is a complicated issue and it would be better to contact Dr. Schrack through the Contact Us page at the top of the website.