by Dr. John W. Beasley, MD
Airmen Medical Examiner, Professor Emeritus and Clinical Professor, Department of Family Medicine – University of Wisconsin – Madison
Of course, we’re talking about “pilot duties” here – as a passenger you could be dead and the FAA doesn’t care. But that’s not what we’re talking about. We are talking about resuming pilot-in-command (PIC) duties after some injury, illness or surgery.
First of all, you have an obligation to not act as PIC if you have a significant (although temporary) problem that would disqualify you. This means that if you know that you are not up to standards (maybe you have the flu or broke your arm and required surgery), then until you are better, you have the responsibility to not be a required crewmember or PIC. The FAA gives you credit for good judgment and expects you to use it.
Here are the technicalities:
Title 14 CFR § 61.53, Prohibition on Operations During Medical Deficiency
“…a person who holds a current medical certificate… shall not 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.
That’s about it for pilot qualifications where you make the decision. You are over the flu or your arm is out of the cast and you are good to go, assuming, of course, no residual problem. Maybe your broken arm still interferes with your violin playing, but if you can use it well enough to flair during landing, you are okay. The FAA wants to be sure (you don’t have to come to your AME for this) that you have normal function (motion and reasonable strength). And you need to be aware that “…the airman cannot be taking any analgesics on a regular basis.”
By the way, note item 2, above. You have allergies and took benedryl (diphenhydramine). No aviating for you until it’s completely out of your system. Watch out for those medications and visit the AOPA website for a list of approved and unapproved ones.
How about other surgery? Well, same thing. If you are healed and if there is no residual problem from the surgery, and the problem was taken care of completely, then you should be good to go. The exception would be, for example if the surgery were for something like cancer, where the FAA may want to be sure that the problem is not likely to come back. If chemotherapy is required after cancer surgery (or for any other reason), then you will not be eligible until you have completed therapy and have no evidence of recurrence.
Considering refractive surgery? Take a look at the FAA brochure on this issue: http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/LaserEye_II.pdf. Basically, once things have stabilized and if there are no complications and any residual refractive error is corrected by glasses, then you are good to go. However, if you were having this surgery to avoid bifocals and create “monovision” with one eye for near and one for far, then if you want to fly without wearing glasses, you will have to have a 6-month period of adjustment and then get a Statement of Demonstrated Ability (SODA) before you can fly without glasses. As I’ve noted in other articles, while refractive surgery is very safe, nothing is 100% and if you can see well enough with glasses to meet standards, I don’t recommend refractive surgery. As many as 1 to 3% of patients will have a loss of best visual acuity (FAA opinion). Heck, you’ll need at least sunglasses on a nice day anyway.
For cataract surgery, as soon as your vision is stable and meets standards, you are okay to go and you just need to report it at your next examination. However, multi-focal intra-ocular lenses are not approved.
How about heart problems? Here things get more complicated. Whether you had surgery or a stent placed or just a heart attack without any intervention, there is a 6-month waiting period and required testing (just what depends on the class of medical you are applying for) before you can be pilot-in-command again.
So, mostly it’s common sense. In general, the FAA wants to know that you are fit to fly – and mostly relies on your judgment in this regard. Some issues (those such as heart disease or known cancer) that require a “Special Issuance” must be resolved in collaboration with your airman medical examiner. For the most part, the FAA is pretty reasonable about things.
Happy flying, stay fit, and don’t break anything!
