FAA Madical Help
Votes
Answered By AOPA
In 2013 at the age of 20 I was in the process of getting my pilots license and went to get a third class medical card. I was denied by the AME since I listed on the form that I had two collapsed lungs (same lung different times) and my info was sent off to the FAA for further review. Long story short I had fallen off of the roof of a building and landed striking my chest on a object roughly a year and a half before I applied for FAA medical. I did not puncture anything or seek medical attention at the time I just had light bruising and soreness but was fine within a few days. When doing some heavy underwater swimming in a pool a few months later I experienced a odd sensation in my chest and days later after visiting the doctor I was told I had a partial pneumothorax and was given oxygen to treat it. the next year the same thing happened again when swimming and holding my breath again and it was treated the same way. The FAA wanted me to have a surgery to glue my lungs to the inside of my chest and at the time I decided not to have it.

Fast forward to 2019 I am trying to get all this sorted out so I can get my private pilots license. The FAA once again denied me but said moving forward they wanted me to have a pulmonary stress test and CAT scan so I did. I then had a consultation and review buy a pulmonologist who gave me a clean bill of health as well as recommended that the FAA grant me a medical certificate since he saw no reason I couldn't fly. All of this information was sent to the FAA and after a long wait they once again denied me and stated that there was no foreseeable outcome for change. The re occurrence pneumococcus were due to blebs that had ruptured in the past but upon review of my CT scan the pulmonologist stated that the blebs had scared over and were not a problem any longer.

In my recent communication with the FAA they have stated that they would reconsider if I was to have a aeromedical surgeon review my medical files and contradict the FAA's findings. I currently am working on getting a appointment set up with a Head pulmonologist of a major hospital but wanted to see if anyone else could help or give any insight.

The FAA also has not given me a definitive reason as to why they're denying me so I have sent in a letter requesting their findings and I'm waiting for that currently. I am not opposed to having the surgery, but don't see any reason for a perfectly healthy 26 year old to have a surgery to glue both of his lungs into his chest if he does not need it. In the last two years I have also flown in both pressurized and non-pressurized planes as well as scuba dove with no issues. I understand the FAA's concern four planes falling out of the sky due to medical concerns and the fact that they want proof that I am not going to have a pneumothorax in flight but what do I have to do to prove it to them? The only reason the FAA knows I am at risk is because I fell off of a roof causing a bleeb to rupture. My point being if I didn't fall off the roof they will never known any different between myself or any other individual flying a personal aircraft and being that I have had CT scans, pulmonary function test and other medical exams to prove my airworthiness what else do I have to do? Also it is my understanding that when getting a medical they only look back 3 years in to your history so what is the difference between me not having any issues in the last three years and never getting a medical before and trying to get one now without any medical concerns in the last three years?
7 Replies
Votes
AOPA Staff Answer
From our experience, once that second pneumothorax happens, FAA policy requires corrective surgery to adhere to lung to the chest wall to "minimize" for aeromedical certification purposes the likelihood of a subsequent pneumo.  This is long standing policy and considering the direction the FAA has moved in recent years, I would expect that policy to remain in place for the foreseeable future.  You can certainly continue to play with the FAA with back and forth dialog, but I suspect you 're not going to get anywhere UNLESS the FAA has a very open-minded pulmonary consultant who wants to rock the FAA policy boat--- which probably isn't the case.  The FAA hand picks their consultants with a "conservative is better" frame of mind. Bruce, would you agree? 
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William Flaugher:
Also it is my understanding that when getting a medical they only look back 3 years in to your history


Your understanding is incorrect. For the portion of the application asking about visits to medical practitioners, you are asked only to report visits within the last three years. However, in Block 18 about your medical history, it's "have you ever...", and that means "any time in your life". So you were indeed obligated to report that injury even though it was more than three years before you applied for a medical certificate. As for the rest, wait for Dr. Bruce Chien to show up here later tonight. He really is the expert on difficult medical certifications, but even Bruce isn't a miracle worker, so be prepared to be told "You have to do what the FAA says." The only alternative after that would be to hire an attorney who specializes in aeromedical cases and appeal the FAA's decision to an Administrative Law Judge at DoT or maybe beyond that to the full NTSB, and maybe all the way to the US Court of Appeals -- very expensive, and very low probability of success.
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Something doesn’t smell right. My approach would be to totally review your FAA BLUE Ribbon record and figure it out from there.....
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As Ron said, the three year look back only applies to health professional visits. You would still have to report the condition on the MedXPress. The option for reconsideration through the Federal Air Surgeon is not unusual for more complicated or complex conditions. There are pilots out there who have gotten medicals after having a lung collapse but it would depend on current testing. You could try calling the Regional Flight Surgeon ( https://www.faa.gov/licenses_certificates/medical_certification/rfs/ ) to see if they can tell you what in your testing was the reason for denial. Or as Bruce said you could request your medical records through the FAA.
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William, "in the eyes of the FAA you are NOT perfectly healthy".  You have to understand that in their eyes you are beating on your chest: "but I am perfectly fine".

I have had a few approved after double pneumothorax but only after extensive documentation.  If you continue with "but I am perfectly fine" you will not accomplish the goal:
"Hoops to jump through".
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Thanks everyone for the replies. So if I was to have the procedure done how do I know I will be given a Medical? I do not want to have the procedure done for the FAA to say I still cant fly. I am working on getting a appointment with a cardiothoracic surgeon to see what its going to take.
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After successful surgery and a ninety day wait, + chest Xray, reapproval is pretty routine.