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-   -   Deferred medical (https://www.airlinepilotforums.com/pilot-health/16487-deferred-medical.html)

fatmike69 09-02-2007 11:26 AM

Deferred medical
 
Let's say one applies for a medical at say, the beginning of the month, and also currently holds a valid medical. The AME then for some reason decides to defer the medical decision to the FAA (a deferral, not a denial). Is the medical currently held still valid until the end of the month, or does the deferral also automatically invalidate the currently held medical as well? I was thinking about this because if the current medical would still be valid, then it would be advantageous to get your medicals at the beginning of the month because if something came up, it would buy more time before you had to stop flying.....

rickair7777 09-02-2007 03:21 PM


Originally Posted by fatmike69 (Post 224790)
Let's say one applies for a medical at say, the beginning of the month, and also currently holds a valid medical. The AME then for some reason decides to defer the medical decision to the FAA (a deferral, not a denial). Is the medical currently held still valid until the end of the month, or does the deferral also automatically invalidate the currently held medical as well? I was thinking about this because if the current medical would still be valid, then it would be advantageous to get your medicals at the beginning of the month because if something came up, it would buy more time before you had to stop flying.....


That's a good question. I also suspect that a deferral would not invalidate your existing medical...if the AME felt confident that you should not fly, he would deny the medical.

If you're ever in this situation, just ask the AME.

Bug Smasher 09-03-2007 05:07 AM

I read an account of someone going through a similar situation years ago. The final word from the feds is, basically, once you start filling out the application for the new medical, the old one is null. :rolleyes: even though the old one is good till the end of the month.

Ask your AME to be sure that nothing changed...

Bumper 05-21-2023 05:51 AM

FAA order om deferred medical
 
1 Attachment(s)

Originally Posted by fatmike69 (Post 224790)
Let's say one applies for a medical at say, the beginning of the month, and also currently holds a valid medical. The AME then for some reason decides to defer the medical decision to the FAA (a deferral, not a denial). Is the medical currently held still valid until the end of the month, or does the deferral also automatically invalidate the currently held medical as well? I was thinking about this because if the current medical would still be valid, then it would be advantageous to get your medicals at the beginning of the month because if something came up, it would buy more time before you had to stop flying.....


Good question, I am going through same thing. I just got a second class in Jan which is all that my current jobs wants.I decided to get a first class last month. Medical was fine till the end and AME could not process the first class due to it being within 90 days of the last medical. AME said FAA would issue the medical in two weeks since there was nothing medically disqualifying. Well about a week later got a letter from FAA saying they want current report of eye evaluation and VA disability letters. I had current eye report at the medical and have previously disclosed my VA ratings. Technically you would think my second is still valid since my first was not denied. After many phone calls I reviewed the FAA order and it states "Operating with a known disqualifying medical condition or when application for medical certificate is deferred or denied/" I spoke with an aviation attorney and his advice was do not fly. I'm grounded from my current job. I am not risking it as the FAA could view it as any medical deferral. I researched FAA legal opinions as well and found nothing about the subject, if anyone has any info to share that would be great. Attached is two pages from the order.

Excargodog 05-21-2023 08:43 AM

While any AME can defer any physical they have questions about to the FAA physical standards people, they USUALLY defer them because they have detected a finding that REQUIRES deferral. In those cases the person indeed DOES NOT meet the requirements for a physical UNTIL it has been approved by the FAA.
If anyone is considering continuing to fly on an old physical it is prudent that they document their AMEs agreement that it is legal to do so.

JohnBurke 05-21-2023 09:48 AM


Originally Posted by fatmike69 (Post 224790)
Let's say one applies for a medical at say, the beginning of the month, and also currently holds a valid medical. The AME then for some reason decides to defer the medical decision to the FAA (a deferral, not a denial). Is the medical currently held still valid until the end of the month, or does the deferral also automatically invalidate the currently held medical as well? I was thinking about this because if the current medical would still be valid, then it would be advantageous to get your medicals at the beginning of the month because if something came up, it would buy more time before you had to stop flying.....

If you have any condition, at any time, that makes you medically unable to meet the standards, then your medical isn't valid. If you got a medical certificate issued to you yesterday, following a visit with your AME, and today you have a sinus infection, your medical is invalid, and not legally acceptable for flight, regardless of the expiration date.

If you hold a current medical certificate and while that medical certificate is current and valid, apply for a new medical certificate, your current medical certificate is valid until its expiration (as applicable to your case, age, etc. In other words, the mere application for a new certificate doesn't end the old one. However, if you have a condition for which a new medical certificate cannot be immediately issued, and you know of this condition which throws into question your ability to hold a certificate, then your medical status is not valid under your current certificate. This is purely circumstantial, meaning you're going to have to be a lot more specific about the circumstances; how this affects you does not affect someone else, unless they have the same identical circumstances. When we talk about your case, we're talking about your case and not someone else's case.

Take the obvious case of an airman who holds first class privileges, with a certificate issued two months ago. The airman experiences a cardiac arrest. Clearly he cannot continue on your medical certificate, despite it not expiring for first class privileges for several more months. A heart attack is going to require substantial examination and testing. But what about something not so obvious?

I was upgrading in the 747, and was due to take a commercial flight in the morning, to begin day one of OE. The night prior, however, I went to the hospital with what turned out to be a kidney stone, in the worst pain I'd ever felt. Surgery was in order. I made a call to the Chief Pilot to advise him I wouldn't make the trip, and told him what was going on. His reply, which startled me at the time, was simply, "call me when you get your medical back." It's just a kidney stone, right? Pass the stone or get it removed, life goes on, right? Report it at the next medical, right (everyone does)? Wrong.

The FAA has strict guidelines about kidney stones, precisely because they can be 100% debilitating. I can't imagine having the same experience a day later, during a flight. I couldn't answer simple questions, like "what's your name?" I couldn't have flown, and if I'd been incapacitated in flight, other than the obvious safety problems (big ones), it would have greatly complicated my medical application later. The FAA doesn't intend to wait and see. Although many pilots have this condition and pass their stone and move on, some concealing it, some reporting it at their next physical, it's a dangerous condition and it does require medical evaluation. In my case, working through my own AME and through a union physician, it took three months of testing and x-rays and other documentation before the FAA formally approved me to continue. I still held a valid first class medical on paper, but so long as I held that condition, my medical was NOT valid, regardless of what I held on paper. Further, as long as the FAA was considering my case, I was not medically fit to fly. I spent those three months under some very tough physical conditions, turning wrenches on C-130's to stay busy: I was in good shape, and kept working, but I wasn't medically fit to fly because despite having a paper FAA 1st class medical certificate, I had a condition which required FAA evaluation. It wasn't a deferred application, but a case of having a medical condition that meant that I didn't meet the requirements of a FAA medical, until further testing and evaluation was done. Among that is evidence that there are no more kidney stones, and they are not expected to recur, stipulated by one or more physicians, and based on x-ray and other evidence.

If you have a condition which requires deferral, that you hold a paper medical certificate means nothing. It's simply a certificate that says you met the standard on the day you applied, and that you were certified to be reasonably expected to be able to continue to hold it until expiration of the privilege period of that certificate. Anything which changes your condition, from a head cold to a heart attack, means that your medical certification is NOT VALID for the duration of that condition. Holding the paper in hand or wallet doesn't change that. If you have a condition that requires deferral (because medical certification cannot be issued or granted at that time), then you're not medically valid for flight and holding the paper certificate doesn't change that. It's not like you can get a medical exam and certificate that says you're medically airworthy, experience a condition that would require a deferral (or denial), and keep flying until your next medical application. Your medical status is in question every moment and every day, even if your exam was yesterday. If your condition ever changes from what it was on the day your took your medical certificate, then your medical status and privilege changes accordingly. That paper in your pocket is not carte blanche authority to operate until your next medical is in hand. Not at all.

I just recently had surgery. I contacted the Chief Pilot a month prior, with the particulars. I contacted my AME. I verified that my surgery, my recovery, etc, would not prevent me from exercising the privileges of my medical certificate. I had a post-surgery recovery period, when I could not exercise those privileges, but after that time, I could. Further I verified what documentation I'd need to bring to my next medical application to cover the event, and how to report it. Transparency. No secrets. A month after my surgery, I made my next medical application and showed up with surgery records, doctor reports, and other documentation in hand, which I gave to the AME, and he subsequently forwarded to the FAA. No deferral was required, and I made sure of that well in advance. Had it been required, however, and had my condition been such that my medical airworthiness was in question and needed further evaluation, I'd have been grounded medically, until that decision was formalized.

JohnBurke 05-21-2023 11:49 AM

A review of your medical certificate, on the back of the certificate, will note the conditions of issue, which include to "comply with the standards relating to prohibitions on operation during medical deficiency (14 CFR 61.53, 63.19, and 65.49).

14 CFR 61.53 states (emphasis is mine):

https://www.ecfr.gov/current/title-1.../section-61.53


§ 61.53 Prohibition on operations during medical deficiency.

(a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:

(1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or

(2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

(b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

(c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in § 61.23(c), a person must meet the provisions of—

(1) Paragraph (a) of this section if that person holds a medical certificate issued under part 67 of this chapter and does not hold a U.S. driver's license.

(2) Paragraph (b) of this section if that person holds a U.S. driver's license.
The back of the medical certificate, Form 8500-9, also states that a condition of issue is that one will "comply with validity standards specified for first, second, and third class medical certificates (14 CFR 61.23).

14 CFR 61.23 sets the requirement to hold a medical certificate, and which level of medical certification privilege is required (eg, 1st, 2nd, or 3rd class, as well as basic med and use of a driver license in lieu of a medical certificate for certain operations).

The latter, use of a driver license in lieu of a medical certificate, is of interest, in part because it requires that one has demonstrated the ability to get a FAA medical certificate, and also because one cannot have any condition that would prevent issuance, and one's most recent application has not been denied or would not have prevented one from obtaining a FAA medical certificate. This is of interest here because these same standards apply to holding your first class medical, including the question at hand in this thread, regarding holding a medical, but an issue with the most recent application.

As previously noted, if you have any condition that would prevent issuance (including delaying or deferring it), regardless of whether you are initiating a new application, then you're not medically fit to hold the certificate and cannot exercise the privilege of the certificate for the duration of the period that you have that condition, or until that condition is resolved. If you take a medication that impairs you in any way, for example, while that medication has effect, you are not medically qualified to exercise the privileges of your medical certificate (and by default, your pilot certificate, so long as it requires you to hold medical certification). This is the case with all FAA certification; even the airworthiness certificate for an aircraft states on the back of the certificate the conditions for which it is issued, and includes a clear statement that the aircraft is not airworthy, so long as it does not meet its certification standard (type certificate data sheet, for example, and any amendments thereto). Just as an airplane isn't airworthy if it doesn't meet its certification standard, you're not airworthy if you don't meet your pilot or medical certification standard, even if only temporarily, and even if you still hold a paper certificate that says you're qualified. The paper qualification is invalidated until you fully meet the standard once again. You can have alcohol, but until it's passed from your system, you are not medically fit to fly and your paper medical certificate does not make you fit.

Looking at the basic med and use of a driver license in lieu of a medical certificate, we can see a statement that bears a closer look: the applicant must have been found eligible to hold at least a third class medical certificate at the time of his or her most recent application. This could have been ten years ago, this most recent application, but the intent is clear: the applicant must have previously held a medical and it can't have been denied. This thread isn't asking about basic med or the use of a driver license or a third class medical, so how does this possibly apply? The standard is the same: you can't operate if you've been denied a medical, or if you have a condition that would prevent you from holding one.

This brings us to bear on the pivotal question of the thread: what if it's a condition that's been deferred; sent for further consideration (but hasn't been denied)? A FAA Chief Legal Counsel letter of interpretation can be read to gain some insight into that. The letter is written to cover a question about basic med and the driver license, but addresses the most recent medical application, and it is that portion of the interpretation that is significant here. Let's look at it:

In March 28, 2007 Chief Counsel letter of interpretation from Rebecca MacPherson to Frederick Tilton (Federal Air Surgeon), the issue was addressed of an airman who wanted to use his driver license in lieu of a medical certificate, but had previously been denied a medical application. The applicants argument was novel: under the regulation, failure to contest a denial after 30 days is considered a withdrawal of the application. The applicant chose not to contest the denial, and after thirty days, his application was thus considered withdrawn. His argument, then, was that he couldn't be disallowed from using his driver license as a medical, if his previous medical application had been withdrawn. The chief legal counsel saw it differently (and consequently, so must we, as this represents the position of the FAA Administrator here). Quoted in part:

https://www.faa.gov/sites/faa.gov/fi...rpretation.pdf


​​​​​​​The FAA recognized that a person may recognized apply for an airman medical certificate and, for a number ofofreasons,reasons, a final agency action may not be immediatelyimmediately forthcoming. In addition to the case where a person's application for a person's application medical certificate is considered withdrawn, a final agency action may not be immediately immediately forthcoming in cases such as those where an applicant may possess a medical condition that requires the submissionsubmission of additional information or further medical evaluation. Under such evaluation. situations, the agency considers it inappropriate for an individual to exercise the privileges of the of certificates specified in § 61.23( cc)(1))(1) until a determinationdetermination of that person's eligibility for the person's issuance of a medical certificate has been made.

ugleeual 05-21-2023 12:39 PM

Old one is no longer valid.

JohnBurke 05-21-2023 12:41 PM


Originally Posted by ugleeual (Post 3639722)
Old one is no longer valid.

On what basis?

ugleeual 05-21-2023 02:01 PM


Originally Posted by JohnBurke (Post 3639723)
On what basis?

This is simple; if the AME doesn’t issue a new medical at the time of evaluation the old medical, regardless of expiration date, is no longer valid. Call your AME


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