Deferred: Is this the End?!

When you show up for a flight physical three things can happen: you get your medical certificate (most often); you are issued a medical certificate under a CACI (about 5 to 10% of the time in my practice); you don’t get your certificate and are deferred to the FAA’s medical division for further evaluation (about 5% of the time). Obviously, you would like to get your medical on the spot, one way or the other. If you are deferred, it means a wait, maybe a long wait. So, what can you do to reduce the chance of your being deferred?

First of all, stay healthy! Your getting deferred will occur if you have a medical condition which is not well-controlled, which might cause sudden or insidious incapacitation in the cockpit. Following a moderate diet, getting regular exercise, staying away from smoking or illicit drugs are all common-sense ways to reduce the odds of your getting anything that might impair your qualifications. Sometimes though, even doing all these virtuous things isn’t enough and you do develop health issues. What next? First of all, ground yourself until you know what’s going on. See your primary health care provider to obtain an accurate diagnosis and appropriate treatment. Once she/he thinks things are under good control, it’s time to see your AME for a flight physical. Before the exam you will have to fill out an FAA Form 8500-8 on MedXpress. This is a simple health questionnaire but you must fill it out completely. Failing to disclose a medical condition can have serious consequences for your aviation career, like fines and prison time! That is an extreme, but at least count on having your license suspended or revoked. Also, your insurance company won’t be too happy about things when they find out. So, let’s say you are acting like the Eagle Scout you once were and are truthful. The first thing you need to know is if your medical condition is covered by a CACI (Condition and AME Can Issue). The CACI Program was set up by the FAA in 2013 to give AMEs more latitude in decision making. The CACI Program allows them to issue medical certificates to airmen having a defined number of conditions that are well-controlled and not likely to affect aviation safety. Each condition has a check-list of criteria. If all of these are med, you can receive your medical certificate on the spot. There are a few catches. Some CACIs are time limited. Most require some documentation from your provider and/or lab work. Check to see if there is a CACI for your medical issue. Here’s the current list: https://www.faa.gov/ame_guide/certification_ws. The count is at 36 although new conditions are added frequently. If you do find your condition has a CACI, download and print it. Carefully check what statements and documentations are required. Go to your doc, if needed and get what the CACI requires. Bring all of it to your AME along with your CACI Worksheet, if it looks like you qualify.

Let’s say your medical problem doesn’t have a CACI or if it does, you do not meet the criteria. This means you will have to be deferred. Don’t be discouraged. It will take time, but if you stick with it the odds are in favor of you getting your medical. First of all, there will be a wait. It typically takes 2 to 8 weeks for the FAA’s medical division (CAMI of the Civil Aerospace Medical Institute) to respond with a letter describing what studies and/or documentation they need to decide on your eligibility. Get it together. Send it in and wait. How long. In the old days, 2 to 8 weeks. Now that the federal government is being “revised” that’s anyone’s guess. You can check on your status, however, by logging into MedXpress. They have a Dashboard which notes the status of your deferral. Unless you have a procedural question, I don’t recommend calling CAMI. They’ll only tell you what you could have found out on MedXpress. Be patient in the knowledge that unless you are on a respirator or hooked up to an IV, with time and patience you probably will get your medical certificate.

Fly wisely. See you next month.

As always, comments, questions and suggestions are welcome: jdlakinmd@gmail.com.

Also, we’ve moved our office to Airlake Airport’s FBO (KLVN). Call 952-469-4414 or

info@aloft-aviation.com for a flight physical appointment.