Master Your Medical

Of all our routine encounters with the FAA, perhaps medical certification is the most intimidating. A little knowledge goes a long way…


Maybe it’s time to renew your medical certificate or even obtain your first. The first step is to complete the online application at Benign as it may appear, it can cause unneeded misery if not completed accurately. Here are some angles, tips, and things to bear in mind as you weave your way toward that essential bit of paper.

Think positive. The FAA’s Aviation Medical Certification Division (AMCD) devotes itself to helping pilots earn and keep their medical certificates. Pilots fly with diabetes, missing limbs, cancer, treated depression, one eye, even Parkinson’s disease. AMCD has pretty much seen it all and has developed protocols to approve many medical conditions.

Each year the FAA issues around 385,000 medical certificates. About one in 3000 results in an initial denial, often approved after further inquiry. Only about 400 applicants per year have conditions the FAA will never approve unless they prove their diagnosis was wrong. There’s about a 95 percent chance your AME will issue your certificate on the spot.

Be Smart

Pilots who manage their health set themselves up for success. Set your priorities: Living is more important than flying; remember that next time you’re tempted to push the boundaries. Let the FAA become part of your health regimen.

Know what to expect. Medical Standards and Certification rules are in Part 67, where Subparts B through D offer specifics for each certificate class. Read the AME Guide by searching for it at Then scroll down to the AME Guide search tool to find what you want.

AMEs expect apprehension. Some pilots sweat their blood pressure. Well, the AME Guide permits a maximum blood pressure of 155/95, much higher than average. To dial down the stress, check it a few times in advance, say at a local drug store, to see what’s normal for you. If it remains high, the Guide offers remedial suggestions.

Help yourself further with a well-prepared MedXPress form. Some answers require details and sound judgment.

MedXPress fills in your contact information if available. Make sure it’s correct. Each section offers help by clicking the square box in the upper left corner.

Your application expires 31 days after creation if not submitted. After submission, it’s saved for 60 days, then deleted if no examination occurs. If completed, it’s retained indefinitely.

You can log out before completing the form. Save your work first to prevent losing it. You must correct errors before you can save. MedXPress warns your session is about to expire after 15 minutes of inactivity and logs you out after 20 minutes.

Once submitted, save and print the application and summary sheet with its all-important confirmation number to bring to your AME. They require this number to retrieve your application. Your AME can correct the information you provide but you should complete the form as best you’re able.

Current Medications

Three areas on the form cause the most trouble. The first is Current Medications, the second is Medical History, and the third is Health Visits.

Despite the title, the biggest mistake is to list medications you no longer take, which needlessly raises flags to the FAA. You need to enter only the medication’s correct name. The remaining boxes are optional but filling them in looks better. You can remove a drug if you make a mistake.

Medications include prescription and non-prescription drugs. Most doctors don’t care whether a drug they prescribe is FAA-approved; that’s up to you. An alternate approved medication might suffice as a substitute for a forbidden one.

The FAA doesn’t publish a list of approved or non-approved medications, but you can find AOPA’s list of about 1200 drugs online. Controlled substances like sleeping pills and tranquilizers are unapproved, as are psychiatric medications. The lone exception is four specific medications to treat depression.

One recent concern is cannabidiol or CBD. The FDA does not regulate CBD, so there’s no way to know what’s in the merchandise. Improperly processed, the hallucinogenic component of marijuana can sneak into a CBD product. That’s illegal, and a pilot would fail a drug test. CBD is not FAA-approved for any treatment.

Several studies published by the FAA Toxicology Laboratory indicated the presence of illicit drugs, prescription, or over-the-counter medications in 42 percent of subjects tested. Many allergy and sleep aid medications are sedating antihistamines, such as diphenhydramine (e.g., Benadryl). It’s the most detected medication in fatal accidents and can even void your insurance coverage.

Medical History

Question 18 asks broadly: “Have you ever in your life been diagnosed with, had, or do you presently have any of the following?”

If a pilot voluntarily discloses something they recall after submitting the form, it’s generally considered mitigating because there was no deceptive intent.

If an applicant falsely answers a direct question, it leads to deeper scrutiny. If the information or falsification is discovered during an investigation or after an aircraft incident or accident, that invites FAA legal action.

Consistency is important. Once you list a condition, you must list it on every subsequent application. This is but one reason to save previous applications.

If you receive medical disability payments, say so. The FAA has spot-checked this item with the Social Security Administration and the VA in past years.

Last, it’s better to over-report than under-report to avoid the FAA calling you out on it later.

Visits to Health Professionals

If you read the directions associated with question 19, you’ll see it pertains to a specific set of professionals seen within the last three years, including mental health professionals. Answering yes here is not an automatic deal-killer. According to Dr. Susan Northrup, the Federal Air Surgeon, “Some pilots perceive that if they’ve had a mental health issue of any sort, they’ll never fly again, and that is simply not true.”

Be Honest

The whole system depends on applicants’ honesty. The FAA knows most pilots are honest. At the end, you certify the information is complete and true to the best of your knowledge. You’re not expected to be perfect.

You also authorize the FAA to look once in the DOT’s National Driver Register to verify information regarding your driving history. You have the right to see, review and comment if they do.

Don’t let the form intimidate you. Be as truthful as you can. Since virtually all applicants become certified, dishonesty is a pointless risk.

Summing Up

Some fatal accidents reveal the pilot had no medical certificate or had an unreported but known disqualifying medical condition. Insurance coverage might be rejected, and their estate could be exposed to a lawsuit. Others had conditions eligible for Special Issuances, which might have avoided the accident. The Special Issuance process offers a time-limited certificate with periodic checks to ensure recipients stay within safe limits.

This enormous bureaucracy exists primarily to weed out the few hundred people annually who should not be flying. And all of us are bound to observe the health envelope consistent with our medical certificates.

In Dr. Northrup’s words, “the medical is really a bet that the pilot is not going to become subtly or suddenly incapacitated for the duration of the certificate.” Indeed, the rate is vanishingly low. It takes an enormous bureaucracy to achieve it, but who wants to share the sky with unfit pilots?


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