Medical Pickle
Answered By AOPA

Good evening everyone!

I was really hopeful, like most, that I'd get my medical however after a bit of back and forth I was denied. Citing hyper mobility syndrome, IBS, and a visual acuity. Through this back and forth I provided many reports from my doctors at the time disproving a mobility syndrome is a factor (Rheumatologist's interpretation of a genetic exam stating no genetic markers), IBS (nothing of importance other than “won't affect anything"), visual acuity (I need another exam and a new pair of glasses anyways).

Even though this was a denied medical I called and eventually received a letter saying that whenever I have the following tests/new information they'd reconsider. The test seem very invasive, expensive, and I no longer have access to these specialists.

  1. Current clinical examination for hyper mobility (performed within the previous 90 days) from your reading physician. Exam must address history/symptoms/diagnosis/dates/etc 
  2. 2-Dimensional, M-Model and Doppler echocardiogram with an interpretive report
  3. MRA of my brain that includes a neurologists interpretation and discussion of the significance of the genetic mutation test results with regard to your current and future neuromuscular health
  4. Clinical exam and progress notes from your treating ophthalmologist
  5. Current clinical exam and progresss notes from your treating IBS physician (not something I've had in years)


Is my best course of action going forth with these exams? Find a new AME? Or any other suggestions would be helpful. 

2 Replies
AOPA Staff Answer

@Christian Decker

Hi Christian, I agree with Ron, you can either take the path of resistance which is to appeal with the NTSB or provide what the FAA is requesting and then ask them to reconsider their decision to deny a medical certificate. To take the NTSB approach would be a long and arduous task, and in the end the Medical Certification department at the FAA will likely still require the same testing. 

If you want to be able to fly as pilot in command, the only course of action is to have the requested testing performed, submit to the FAA. As frustrating as this process is, the FAA has a great responsibility to ensure that every pilot that is issued a medical certificate is indeed fit to fly. And the only way to do that is with solid medical documentation to prove that they are. 

Now that a denial has been issued, there is no time limit as to when to ask for reconsideration. You can wait until such time as you are prepared to have the testing done and then submit it to the FAA. OF course be sure that these items are not older than 90 days old when submitted. 

If you have any questions at all, feel free to reach out to the Medical Certification Specialists at AOPA for guidance. We are happy to help.

1629 Posts

@Christian Decker
Since you've been denied, your ONLY viable course of action is to give the FAA what they want, and even then there's no guarantee you'll be issued.   Having applied and been denied, the Basic Med and Sport (based on driver"s license) options are both closed to you.  And unless you bring all the documentation the FAA requested in that letter of denial, going to another AME won't help, as they'd be bound by the FAA's ruling.

There is, of course, the option of appealing the denial to an Administrative Law Judge and potentially the full NTSB, demonstrating that you do not actually have the conditions listed, but based on what you've said, that doesn't seem viable.  If that is still the path you want to take, you need to consult an aviation attorney who works medical certification cases right away,  because you have only a very limited time to appeal after you receive the denial letter.

The visual acuity issue seems the easiest.  If you can get new corrective lenses and then pass the necessary eye test, that part's easy – just get your eye doc to document your sufficiently corrected vision on an FAA Form 8500-7.

For the IBS, see this worksheet for what you'd need to show to get issued - up to your physician to fill it out and sign it.  If you do NOT meet all the criteria on that worksheet, it gets much tougher.

Finally, for your mobility syndrome (is that “joint hypermobility syndrome” aka Ehlers-Danlos?) I can't find anything  in the way of FAA guidance on that condition.  All you can do is what the FAA said.

As for your concern about not having the previous specialists available to you, the harsh truth is that the FAA doesn't care.  The unshakable rule is that it's up to you to prove your medical fitness to fly, and to do so at your own expense, no matter what it costs.

If there's a lesson in this story, it's that you should never, ever show up for an FAA medical certification exam with an AME if you have even the slightest doubt that you'll pass unless you first do your homework with an AME or other aviation-savvy medical specialist and have all the necessary documentation with you when you show up at the AME's office for the exam.  Otherwise, do NOT apply for the medical certificate, and accept that your only remaining option to fly airplanes is the Sport Pilot path based on your US driver's license.

For more advice, contact the AOPA Medical Help Desk or an expert in difficult medical certification like Dr. Bruce Chien (www.aeromedical