Guest Blog: FAA Quietly Adds Special Issuance Medical Expiry Dates

News Discussion
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The FAA is charged by Congress with issuing certificates to qualified persons. These certificates are federal licenses. One such license is the medical certificate, issued by the FAA's Office of Aerospace Medicine ("AAM") under 14 CFR part 67, Medical Standards and Certification. In accordance with section 67.3, a person who meets the medical standards in part 67 is entitled to the applied-for medical certificate. Part 67 does not provide for an expiration dates on medical certificates; instead, medical certificate validity periods are listed in part 61, section 61.23(d) specifically.

This is a companion discussion topic for the original entry at https://www.avweb.com/insider/guest-blog-faa-quietly-adds-special-issuance-medical-expiry-dates
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This is why I feel I made a wise choice in switching to BasicMed, even though I could otherwise pass an FAA medical. For as much as they claim to be making it easier for pilots to pass a medical, and the supposed “90% of pilots walk out of the exam with a medical”, they sure seem to be working hard to make it a painful process (especially over the last several months).

As far as I’m aware, very rarely does the FAA recind a newly-issued rating issued by a DPE, but it’s not so rare for them to rescind or modify or suspend a medical issued by an AME (who actually saw the pilot in question). As far as I’m concerned, the AAM should only become involved if the AME is unable to issue the medical, or if there was a serious oversight by the AME (in which case, their certification as an AME should be in question).

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I’m not sure what “last few years” means, the FAA has been adding this language for at least three decades. It’s nothing new.

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The use of that language seems to be increasing, though. There was a time not too long ago that one could get a special issuance but still be subject to the normal validity period. Now, every special issuance has that language. And though I don’t have any direct evidence for this, I suspect based on circumstantial evidence that any time the AAM gets involved, the medical comes back with “not valid for any class after XXX”, with the time period being 1 year from the date of issuance.

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It most definitely has not been 30 years. AAM only began adding the drop-dead date limitations to some medical certificates since the era of all-electronic applications. It’s hard to pinpoint exactly because they never documented the practice. This has also led to disparate treatment of similarly situated certificate holders.
What we know for sure is that the practice directly interferes with the regulatory validity periods prescribed at section 61.23(d), as well as the language on the face of every medical certificate that demands its holder comply with those validity periods.

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If the practice were documented anywhere, we would know more about it. However, AAM just began doing it without public notice, most likely as a workaround for shortcomings in their data system (AMCS). It’s not even described in AAM’s unofficial, informal policy document directed at their designees (the Guide for Aviation Medical Examiners, or GAME). Additional point: AAM’s use of the GAME appears to be contrary to a law called the Administrative Procedure Act. In the Flight Standards Service, my training was that, if you wished to regulate the public, you must create a rule. AAM has been bypassing the rulemaking process by acting as though the GAME were regulatory. It isn’t.

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OK 28 years then. I know from personal experience. If i can dig up the medical i’d show you. Also, there is clear guidance in the regulations. 14 CFR 67.401 states how a waiver (whcih is what a special issuance medical is) is granted and that the FAA may limit its duration. FAA is basically saying “this condition is disqualfying but we can provide an alternate means of compliance” It’s vailid to argue many of these conditions shouldn’t be disqualfyinng, that the FAA takes too long, and that it often requires out dated tests. No argument on those points.

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Hi Andrew, it hasn’t been 28 years either. But the essential point is that the practice is both undocumented and without any regulatory basis.
Importantly, section 67.401 does not provide a basis to impose a drop-dead date as a limitation on a medical certificate. Section 67.401(d) provides that the FAS can “Limit the duration of an Authorization.” It does not provide any authority to date-limit a medical certificate itself. Moreover, the preambles to the current section 67.401 refer repeatedly to the section 61.23(d) validity periods.
The reality is that AAM just started imposing these date limitations in the fairly recent past, solely, as far as I can tell, as a workaround for shortcomings in their own data systems. These drop-dead date limitations actively interfere with the regulatory validity periods at 61.23(d) (which are referenced on the face of every medical certificate).

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An essential point to me is that when an article says “quietly adds,” I’m expecting it to be about something new. When you say that about something that has been around for decades, it kind makes the rest of the analysis suspect.

I agree with Andrew. I had a special issuance third class medical for about 5 years, beginning in 1997. There’s your 28 years. And yes, each certificate bore the logo, “Not valid for any class after [Date].” The date was 1 year later.

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The headline is from the editor, not me, but I think the word “quietly” is intended to express that AAM started doing something without having a regulatory basis and without notice to the impacted public.

The essential point is not when exactly AAM began imposing drop-dead limitations on some (not all) “special issuance” medical certificates. The essential point is that the practice is undocumented, has no regulatory basis, and imposes a burden on the public in exchange for no safety benefit. In addition, and perhaps worst of all, the practice indisputably interferes with the regulatory validity periods at 61.23(d), which (by rule) are applicable to all medical certificates.

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Yes it has been 30 years. I have had the “Not Valid For Any Class” limitation since 1994. However, the oldest copy of my medical I can find is from 1996.

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Might I add that anytime terms like “drop dead” dates are used in connection with medical certificates, it’s a bad choice of words.

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I got my special issuance in September of 2002. The 3rd class medical had that language (not valid for any class) and every medical since that time has had it too.

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Eric, I agree with you. I just re-read the entirety of Part 67 and the standards the AMCD must follow. They do use the AME Guide as direction for their designees and they do have the authority under §67.315 and the parallel sections for Class 1&2. Once an airman cannot meet all of the requirements of Part 67 Subparts B, C, or D, they fall under SubPart E. The fact that they use the AME Guide to interpret the FARS, in my mind is problematic, but the regulations grant them that authority.

§67.401 At the discretion of the Federal Air Surgeon, an Authorization for Special Issuance of a Medical Certificate (Authorization), valid for a specified period, may be granted to a person who does not meet the provisions of subparts [B], [C], or [D] if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force. . . . A medical certificate of the appropriate class may be issued to a person who does not meet the provisions of subparts B, C, or D of this part if that person possesses a valid Authorization and is otherwise eligible. An airman medical certificate issued in accordance with this section shall expire no later than the end of the validity period or upon the withdrawal of the Authorization upon which it is based. [emphasis mine]

The regulations, as written give the FAS and AMCD all the wiggle room they need if, an airman cannot meet the basis for regular issuance, for better or worse.

Perhaps it may be time to revisit Part 67 for possible revisions. I have no strong opinion on this as the outcome could be worse than we have now.

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Unfortunately, the FAA has adopted the onerous policy approach’s similar to the ways the ATF folks made up their policy changes behind closed doors before they appeared in the public register. Most always they were a detriment to the “public” they were supposed to be serving?

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You really, really should fact check posts like this before putting them out there to get people all worked up. Expiration dates on Special Issuance medical certificates have been there for decades, and nothing – nothing – has changed recently.

A Special Issuance means the individual has a condition that would make him ineligible for certification, but has provided evidence that it is well enough controlled that FAA grants him a certificate, with specific instructions for what kind of follow-up they need to see to continue to certify him. For most conditions, they require a yearly update. For certain conditions like drug or alcohol abuse/dependence or antidepressant medication use it’s every six months. For a few conditions, like certain aggressive forms of cancer, it might even be every three months. The individual doesn’t need a whole new FAA application and exam at those intervals. The next MedXPress application and exam are due on the standard schedule for that class of certificate and pilot age. He only has to provide documentation of whatever specific information - testing, treatment, reports from treating physicians - is required to satisfy the terms of the authorization letter. Again, depending on the condition, the authorization may specify that the individual only needs to bring the documentation to his AME, and the AME can issue a new certificate with a new expiration date. For other conditions the information needs to be sent to FAA well before the expiration date, and FAA will issue the new certificate.

The Special Issuance medical certificate will have the limitation “Not valid for any class after [for example] March 31, 2026.” That means if he is 35 with a First Class certificate, it will not downgrade to a Third at the end of one year. With a one-year “not valid after” date, if he is over 40, his First Class will be valid as a Second after six months, but not downgrade to a Third.

I’ve been an AME for 42 years, and this has been the case as long as I can remember.

Wherever Eric Friedman got his information, he is flat wrong. You shouldn’t have published this erroneous article.

Stephen D Leonard, MD, FACS
Senior AME/HIMS

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You are correct, Art. It’s worth noting that the Special Issuance process was instituted by AMCD as a way to allow them to certify pilots who would otherwise simply be disqualified. They are continually working on identifying new conditions that they can include in this process.

It used to be a diagnosis of coronary artery disease, or cancer, or depression, or a DUI, simply meant the pilot was done - grounded for life. Now, thanks to this process, if he provides evidence that the condition is adequately treated, he can return to flying, and can continue flying so long as his condition remains under control - often for the rest of his career.

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This is the wording of a Special Issuance Authorization letter, this one to a pilot with treated sleep apnea. The language is essentially the same for other conditions:

—————

We are please to inform you that after a review of your application … you have been granted an Authorization for Special Issuance of the enclosed third-class Airman Medical Certificate pursuant to 14 CFR §67.401.

The enclosed CERTIFICATE
Is valid until August 31, 2025
Requires your signature
Supersedes any previously issued certificates.

This AUTHORIZATION:
Shall be effective until it expires on August 31, 2030 or withdrawn
by the agency;
Supersedes any previously issued Authorization
Must be presented to your AME at the time you undergo an airman
medical examination.

You have been granted this Authorization for Special Issuance following the FAA’s determination that you do not meet the medical standards prescribed in 14 CFR Part 67 under Section(s) 67.113(b)(c), 67.213 (b)(c) and 67.313 (b)(c) for an unrestricted airman medical certification due to yuour established medical history or clinical diagnosis of ……

You must follow the Airman/AME Instructions set forth in this authorization for continued certification under this authorization.

—————

This makes it crystal clear what they are doing and what their authority is for doing it. It also makes it clear that this is a gift. “You are not qualified for medical certification, but instead of just telling you you are grounded, so go away, we have found a safe way for you to keep flying, provided you keep us up to date on your condition.” This is not any kind of unreasonable or oppressive intrusion on our rights. 50 years ago, most people with these Special Issuances would simply have been grounded forever.
The wording from an actual Special Issuance Authorization is above, but the point is that for the small percentage (maybe 5%) of applications for pilots who have some condition that might disqualify them, the specifics are reviewed on a case-by-case basis. Some are simply approved, with a caution to report deterioration in the condition. Some are given one of these SI authorizations. A very small fraction - consistently about 0.1% - are denied.

A few years ago several of us suggested to then-Federal Air Surgeon Dr Fred Tilton, that they give AMEs guidance for some conditions that would allow us simply to issue certificates for some conditions after verifying that all necessary data had been supplied and was within parameters. That led to the “CACI” (Conditions AMEs Can Issue) program. Those pilot don’t need a Special Issuance, don’t get a limitation on their medical certificate, and the AME is charged with documenting on the exam, “CACI qualified for [for example] hypothyroidism.”

For many others, even that isn’t necessary, but the burden is on the AME to be sure that whatever the condition is, it is adequately controlled, and simply annotate that when we submit the 8500-8 to FAA.

The standards for all of these are very clearly spelled out in the Guide for Aviation Medical Examiners, which is freely available on FAA’s website. Google it.

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