My Odyssey Through The FAA Medical Certification Maze

John King recounts the story of how he fought the FAA to regain his medical certificate — and prevailed.

Article appeared on the Flying Magazine website – March 9, 2017 by John King

John & Martha at a recent speaking engagement at the Wichita Aero Club.

“You gave us all quite a scare last night.”  I gradually became aware that I was in a hospital and Martha was explaining to me that I had had a lapse of consciousness. You will appreciate that the very first thing that came into my mind was concern for my aviation medical certificate.

The hospital had done extensive tests to discover that I indeed did have a brain and there wasn’t much wrong with it. I was assured I had no long-term health issues. On the other hand, it soon became clear that concern for my aviation medical certificate was certainly warranted. And as with nearly every pilot, my aviation medical and flying are a very big deal to me.

I am particularly fortunate. If I were to I lose my medical, I could still fly with Martha. It just means that for our long-distance flying we would need to trade our old Falcon 10 for a lower-performance airplane that doesn’t require two pilots. But still, that would be a great loss to us. For the last 30 years we have been flying as a two-pilot crew in airplanes for which two pilots are required. On every leg we trade seats, and captain and copilot responsibilities. We get profound satisfaction from practicing the art of crew coordination.

What was now putting our precious flying as a crew in jeopardy was thefact that while getting out of bed in the middle of the night to go to the bathroom, I had passed out. The FAA understandably takes a very dim view of any loss of consciousness.

It was off to Rochester, Minnesota, and the Mayo Clinic. The neurologists at Mayo diagnosed my event as a seizure. Next we were directed to the Mayo Clinic in Scottsdale, Arizona, where there is a world-class specialist in seizures. After multiple tests, his conclusion was that my singular seizure was provoked by a number of circumstances, including excessive coffee consumption, medications I was taking and a prostate infection. He determined I was no more likely to have another seizure than the general public.

John, as PIC, conducts a pre-flight check of the Falcon before a trip. w/ Tom Keller, King Schools VP of Technology.

With that good news, I submitted myself for my aviation medical exam. Because of my report of the seizure, my medical examiner couldn’t issue my medical certificate directly. He instead was required to defer to the Medical Certification Division at Oklahoma City. Not long afterward he learned, much to my surprise, that the FAA in Oklahoma City was going to deny my medical. As many pilots had before me, I had begun my long odyssey through the FAA’s medical certification maze.

I could no longer act as a required crewmember. Martha had to recruit and train other copilots. I was riding in the back and practicing a very difficult new skill — keeping my mouth shut and not giving unsolicited advice to the flight crew.

I then went to another neurologist who specializes in aviation neurological cases. After examining me, this neurologist likewise stated that I do not pose a risk to aviation safety and that he would “recommend medical certification at this time.” He also suggested in his report that I would be willing to accept a “with or as a copilot” restriction.

Next I made a written request to the Medical Certification Division. I asked that with this more recent supporting neurological evaluation, if they were still unable to issue my certificate, they send my case for review by the Federal Air Surgeon. After four and a half months I received a letter from the Federal Air Surgeon saying that I was “ineligible for medical certification … ” To make matters worse, the letter from the Federal Air Surgeon threw additional obstacles in my path to recertification. There were new reporting requirements dealing with things it would be hard to imagine could have an impact on the safety of flight — such as a report on my urinary tract inflammation.

We decided we needed legal help. We selected Kathy Yodice, an attorney from Frederick, Maryland, who specializes in medical certification cases. Kathy has great experience and obvious expertise at this. She first filed a petition for review by the National Transportation Safety Board. Soon thereafter she requested an informal meeting with the FAA in Washington, D.C. There I made a heartfelt request that the FAA consider a risk mitigation strategy in which I be issued a medical certificate with a restriction that it be valid only with another qualified crewmember.

We thought we had made progress with the FAA because soon afterward they requested a new set of tests from me. Most applicants actually give up at this point. Multiple tests require multiple trips to medical facilities and considerable expenses, which many people can’t afford. But I was hopeful the tests would resolve my situation and I was more than willing to do them. A little over two and a half months later I was deeply disappointed to receive my second letter of denial from the Federal Air Surgeon. It was frustrating. I had two neurologists who had examined me, and both had said I was no more likely to have a problem than the general public, while FAA physicians who had never examined me were denying my medical.

At that time I sent a letter to the FAA Associate Administrator for Safety asking that the four core values developed by the Flight Standards division of the FAA be employed by the medical certification folks:

  • Create a just culture.
  • When reaching a hurdle, try to find ways to get to “yes.”
  • Conduct risk-based decision making.
  • Treat people as individuals.

In a system based on self-reporting and voluntary compliance, these core values are critically important because they support the element of trust. When you are making yourself vulnerable with your flying future, you are placing tremendous power over yourself into the FAA’s hands. For this system to work, pilots need to feel that the FAA respects you, has your interest at heart, is predictable and plays by fair rules.

Less than a month after I sent the email to the Associate Administrator, I received my medical certificate.

Of course, I am thrilled. But my fondest hope is that this represents an embracing of those core values. And that my case represents an example of using innovation to find ways to get to “yes.” This was new territory for the FAA. I am told a restriction requiring a second pilot for a third-class medical or for a neurological issue has never been done before.

The FAA is working hard to improve the percentage of pilots who get their certificates directly from the Aviation Medical Examiner (AME). They hope it will get even better as they continue to implement an expanded list of what the AME can issue through what they call the “Conditions AMEs Can Issue” (CACI) program. The FAA medical folks are measuring their success by the improving number of pilots they are able to return to the skies with a medical certificate.

I am certainly thrilled to be one of their success stories!

29 thoughts on “My Odyssey Through The FAA Medical Certification Maze

  1. Robby Meadows

    Very happy you have the med back! I got mine back because of Basic Med. Also thanks for posting a recent picture. It is encouraging to see you both still enjoying the privilege!

    Reply
  2. Robert Collins

    Maybe this would be a new course that you make for other pilots that have had the same or similar problems.

    Reply
  3. John McCoy

    This is a bad news good news story. Thanks for pushing this to a satisfactory result. Sadly, FAA medical certification has not caught up with evidence based medicine, even when cogress has pushed them on medical certification.

    Reply
  4. dan Kennedy

    Capt John,
    Isn’t there an advocate group for older ATP pilots? (having a time finding them thought they were actually in OKC) Your article was excellent, thanks!

    Reply
  5. James L. Jones MD, PhD

    Many pilots have had an issue with Oklahoma. The FAA hires disgruntled Postal Workers.

    I got a Conditional license because I have sleep apnea. Lets ignore the fact that I’m 100% compliant with CPAP. But that and essential hypertension, a history of a DVT from being in a leg cast for 6 months..they gave me a conditional license.

    I’m quite athletic. I went on a 1500 cal/day diet and lost 40 lbs, off my BP meds.

    So many problems are related to weight, so all pilots should get near their ideal body weight to avoid medical problems that lead to “problems”.

    My MD is sending them a letter, attesting to all of this, hopefully they’ll lift the conditional clause.

    The FAA is creating an atmosphere where pilots don’t want things worked up. So many people die from Sleep Apnea, but if you have it evaluated and treated, they treat you like a Leper.
    So we don’t get the medical attention we need, and then bad things happen.

    Reply
  6. John Williams

    Hi John

    I read your comments with great interest. I am a retired captain from a major American airline and experienced an almost parallel situation in the early nineties. I jumped through all the hoops you did along the same path however the neurologist I used taught neurology classes to the FAA’s staff doctors in Oklahoma City. They ignored his recommendation and withheld certification–a somewhat better situation that your denial. However I was told to wait three years and reapply. I had fought the battle for two years at that time.

    I accepted the situation and decided to seek another vocation, the study of law. I remained on sick leave from my company and during my last semester of school I received a call from my company flight surgeon which coincided with my transition from sick leave to long term disability. I explained how my situation had progressed and he seemed genuinely interested and said he would look into it.

    A couple of weeks later my medical certificate mysteriously showed up in my mail box with no explanation other than it had been reinstated.

    Reply
  7. Jules Delaune, MD

    John,
    Your story is very similar to mine, the only difference being that after the Air Surgeon denial, including for some diagnoses that were considered but ruled out in my medical history I gave up. I could afford neither the financial or psychological costs of lawyers and continued appeals to the NTSB. In my experience the FAA showed absolutely no inclination to “get to yes”, but I hope it works out for others.

    Reply
    1. Gary Frick

      I’m a cardiologist and have had some medical problems and after I read the AME Guide I realized that the chance that The FAA may add up the special issuances and say forget it. I descided to exercise the SPORT PILOT option and fly with your drivers license. I researched every LSA available and chose the best one on the market, a Tecnam P2008 914 Rotax turbo that climbs at 1800ft/min has a 48″ cabin, Garmin G3x, autopilot, parachute. No it’s not a 172SP but it flies as fast and has more shoulder room. I went back to aviation after a 47 year absence. I’ve never been happier. The 2008 is like flying an Italian sports car, it is made in Italy. Think about an LSA, they’re a lot of fun and your flying a real plane. I hope this helps. Gary A Frick, DO,MS,RPh,FACC,FACOI

      Reply
  8. Colin Henderson

    John, thank you for sharing your experience. Several years ago while having a routine annual eye exam my doctor noted that the pressure in the right eye was a little elevated (indication: glaucoma). The concern here is that untreated, glaucoma can result in macular degeneration which causes deterioration of peripheral vision. That is a big issue for us pilots. I was put me on a daily drop of Isolol .5% solution (right eye only) and scheduled a return for further tests in six months. At the initial re-test and every six months since (8 yrs.), pressure has been normal. Vision good.

    This has gone through two Class III Medical cycles (3rd next year) with the same result you describe: Denial: “How could you even ask”, then request for more tests, submit more test, then denial again, request assistance from AOPA, then out of the blue, I get my certificate.

    All despite the fact that I practice risk management every time I step into or onto any piece of equipment, have a complete battery of tests run every 6 months, and would simply not attempt to fly an airplane without 20/20+ corrected vision. I agree with the conclusion that the Medical Certification Administrators in OKC have absolutely no respect for the applicant. In fact I go a step further to state that their actions clearly indicate that they regard Pilots as fools on a fool’s errand.

    Again, thank you for all that you and Martha do for the community.

    Reply
  9. Dave Widby

    John:
    Congratulations on the medical, now back to what we all enjoy, FLYING.
    I am in that circle now getting a basic med instead of regular 2nd class, but first I have to get a SI medical to tell them about bypass surgery I had and its doing fine, gathering all the paper work seems the biggest hurdle so far, as soon as I get the SI 3rd class I will turn right around and get the basic med which lets me determine if I am up to flying with minimal doctor visits. Seems like things are getting better for older pilots.

    Reply
  10. JIm Cistone

    I am in a similar “airplane”, with my medical certification under review for a series of issues including sleep apnea, a melanoma, and a distal pancreatectomy. My view of the FAA, especially when it comes to new territory, is that the easiest and safest answer for them to give is “NO”. If they say “YES”, they they are accountable and if some day something should happen on a flight that might be related to a pilot’s condition, then the “YES” answer comes under intense scrutiny and the “YES” person is often thrown under the bus. So, “YES” can be career limiting, but “NO” is safe.

    Reply
  11. Dan Gross

    These ridiculous decisions by the FAA are the reason many pilots do not report things that should be reported.

    Reply
  12. Clive Waters

    Well done John.

    You have been an inspiration to me and thousands of other pilots over the years.

    As you say in the States, way to go.

    From a grateful Brit who did all my ground school 25 years ago with King School books.

    Clive

    Reply
  13. daniel f savage

    Congratulations John. You and Martha are my teachers as I have spent many hours learning by watching your numerous videos. May we both enjoy stable good health for years to come. Dan Savage
    CFII

    Reply
  14. James Bloomberg

    Great News John King! The Medical Branch of the FAA has always been behind the times. I am glad to hear that you prevailed and it made the process better for folks behind you.

    Reply
  15. BOB.C

    YOU SHOULD FILE A CLASS ACTION LAWSUIT AS ALMOST EVERY PILOT AGREES THE FAA IS A OUT OF CONTROL FEDERAL AGENCY THAT IS ANTI- GENERAL AVIATION AND THE MEDICAL PROCESS IS JUST ONE WAY THEY GROUND GOOD PILOTS. WITH THE CRY OF THE DIMINISHING PILOT POPULATION AND FEW NEW STUDENTS MOST OF THE AIRLINES WILL BE USING NON -AMERICAN PILOTS BECAUSE THE FAA IS DISTROYING GENERAL AVIATION. FILE A LAWSUIT PLEASE FOR ALL OF US.

    Reply
  16. Hal Abrams

    This is a good story. I’m delighted that you came out on top. Many pilots don’t. I was denied because I take an antidepressant medication. 1 in 6 Americans takes antidepressants. Many fly, but just don’t admit to taking the medication at their exam. I was truthful and open about this fairly benign medication. That was a strike against me. Unfortunately I don’t have the funds to hire an attorney and legal battle that may ensue.

    Reply
  17. Mike Hunter

    Mr King,

    You finish you article with “I am happy to be one of their success stories.” I say, you are lucky enough to be able to throw enough money at the problem to make them pay attention. The FAA Aeromedical division has people jump through hoops and seem, pending a successful outcome of those, you’ll get your medical back. But, you didn’t. You had good tests, good consultations, and still had to go even farther.

    There needs to be a certain amount of difficulty in getting a medical back. But, when you do everything that they ask of you, and all the tests come back good, that should be it. That wasn’t the case here. If I were to lose my medical, I’d be done. I don’t have the money to get it back, which means I’d be out of work.

    Reply
  18. Ray Belmonte

    My nightmare with Oklahoma City ended yesterday. The AME couldn’t issue the certificate (class III for private pilot) because I have mono vision, meaning I see near with one eye and far with the eye. With both eyes open, my vision is 20/20, but this doesn’t meet FAA guidelines. So I needed to get a different prescription for eyeglasses. Other than my vision, I am 100% healthy with absolutely no medical conditions. I got the new glasses, submitted the unending documentation to OK, and waited for 9 months. It wasn’t until these past 3 weeks with my insistent phone calls, did I ever get a resolution. I have been waiting to start my flight training, have already passed the written exam, which expires after 2 years. Already I’ve wasted 9 months. What a hassle.

    Reply
  19. Ray Belmonte

    need to edit my post: “…meaning I see near with one eye and far with the OTHER*** eye”

    Reply
  20. Richard Weil

    Glad it worked out, but what a hassle. It’s like the decades-long battle to change the airline pilot retirement age from 60 to 65 (still too low in my opinion). Or the long nonsense that Bob Hoover had to go through to regain his medical. Arbitrary and stubborn decisions, becoming deeper entrenched the more people objected. It’s too bad because the FAA people can be really helpful and positive out in the field, but there is a disconnect above the “8th floor” headquarters in OK. Perhaps they will do a little better as Basic Med becomes more common, or at least have less to monkey with.

    Reply
  21. William Lehr

    Thanks for sharing your experience. About 8 years ago I had detached retinas in both eyes (not simultaneously, thankfully), then vitrectomies, then cataract surgery. I remember having to explain the regulations to the FAA physician in Atlanta to get a special issuance. After a few years I was able to get a normally issued medical. Then last month I passed my commercial checkride, thanks in part to the King Commercial Checkride course.

    Reply
  22. Jim Shamp

    As a retired FAA Senior Flight Safety Officer for Flight Standards, I have seen many of these cases. I don’t anticipate seeing any improvement until the FAA relinquishes more decision making authority to the AMEs. I had a lengthy conversation with the Western Pacific Aeromedical Branch last February. In that conversation I learned that those FAA is having difficulty hiring doctors and are having to farm out medical evaluation to doctors who are busy with their practices and who know nothin about the Airman and their situation other than what is in a report, including history and the patients personal well being. As a result of the shortage of doctors with aviation knowledge and the inability of the FAA to fully understand the need to delegate more, the inability of Airman to resolve many medical issues to a satisfactory conclusion, will continue and will more than likely get worse. The BsicMed program should be a real eye opener to the FAA as to their failure to address the needs of the Airman. I believe that as a result of the FAAs failure to adequately address this issue, the BasicMed program will grow and will expand the latitude of approval beyond the current program. If the FAA can make a decision, and we all know how difficult it was for them for the BasicMed program.

    Reply
  23. Joe Barretto

    Glad to see you are still in the air John, I admire the two of you , I have learned so much from both you and Martha, Keep up the good work, Joe Barretto Mass,

    Reply
  24. Bill McCord

    John, thanks very much for sharing this story. My experience with the Aviation Medical Branch has been similar. As a late-in-life student pilot, I went through a tortured effort to get a special issuance third class certificate. The initial basis for denial was that I have a cardiac pacemaker. After 2 years of cycling through additional tests, reports, demands for more information, and re-submittals, I was able to get a certificate that had a one-year expiration. It was conditional on semi-annual cardiology reviews. But, when I made the submissions, they would seize on some other issue and start another line of inquiry that simply extended the cycle infinitely. There was not the slightest hint of an interest in getting to Yes. Hopefully, the new rules will make it more accessible to others.

    Reply
  25. Tommy Gaebel

    John,
    Thank you for the hopeful success story- and for going through that gauntlet for us!
    I now know what to expect in the event I have a similar issue, as well as a viable path to follow to maintain my PPL, and continue my love affair with flying. You are, as always, an inspiration.

    Reply

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