by Dr. Bill Blank, M.D.
I want to talk about four subjects, which I think will be of interest to airmen: CACI, stents, over-the-counter medication side effects, and MedXPress.
CACI or Conditions AMEs Can initially Issue. These conditions previously required a Special Issuance (SI). The SI process was conceived to safely certify airmen who might have previously been permanently disqualified. The initial SI had to be issued by the FAA. A few years ago the process was changed to allow AMEs to issue subsequent SIs provided that the applicant had met the requirements in the SI authorization letter. The AME forwarded the medical records to Oklahoma City for review, but was permitted to issue as long as he felt that the requirements had been met. This is called an AASI (AME Assisted Special Issuance).
In order to further improve the process, the FAA has reduced the number of conditions requiring SIs. The goal is to reduce delays in certification for airmen and decrease the FAA’s workload without compromising safety. This will free up time for the FAA to evaluate complicated cases more quickly.
Worksheets have been developed for these conditions. They can be found and printed out from the AME Guide, which is available online. The conditions, which have already been released include: arthritis, asthma, hepatitis C, hypertension, hypothyroidism, pre-diabetes, migraine and chronic headaches, renal cancer, testicular cancer, and prostate cancer. Another group of worksheets will be issued later this year. The conditions included will be: kidney stones, carotid artery stenosis, colitis and irritable bowel syndrome, bladder cancer, leukemia, and Hodgkin’s disease and lymphoma.
If you have one of the conditions covered by the already issued worksheets, take the worksheet to the physician treating that condition within 90 days of your flight physical. Ask him/her to complete the worksheet, sign it, and date it. Bring it to your AME for your flight physical. If you meet the requirements spelled out in the worksheet, your AME will issue your certificate. All he needs to do is write in the comment section (box 60) of the 8500-8 Form: “Airman meets certification requirements for (name of the disease).” If you previously had an SI, he should write: “Airman had previous SI for this condition and now meets the regular issuance criteria for (name of disease).” Your AME is not required to submit the worksheet to the FAA or keep it unless he wants to do so. If you do not meet the requirements, he will defer your exam and forward your records to the FAA for consideration for special issuance.
Stents – For most airmen who have had stents implanted, the waiting period prior to certification has been decreased from 6 months to 3 months. This is for all classes.
Over The Counter (OTC) Medications Side Effects – The GA Joint Steering Committee has recently sent a letter to all pilots warning them about the sedative effects of some OTC medications. Benadryl, for example, can cause significant drowsiness. The National Transportation Safety Board (NTSB) has investigated several accidents, which seem to be related to the use of OTCs. If you are taking one of these medications, you are advised not to fly until five (5) times the dosing interval has passed.
MedXPress – Some pilots are still not aware that as of October 1, 2012, the 8500-8 form must be filled out online prior to seeing your AME. You are no longer permitted to fill it out by hand at the office. It is valid for 60 days. If you do not see the AME during that period, you will need to recomplete the form. When you complete the form, you will be given a confirmation number, which you must bring to the exam. I strongly recommend that you print two (2) copies after you click on submit. Keep one copy for your records and take the other one to your AME. If you make an error, the AME can correct it.
EDITOR’S NOTE: William A. Blank is a physician in La Crosse, Wisconsin, and has been an Aviation Medical Examiner (AME) since 1978, and a Senior AME since 1985. Blank is a retired Ophthalmologist, but still gives some of the ophthalmology lectures at AME renewal seminars. Flying-wise, Blank holds an Airline Transport Pilot Certificate and has 5300 hours. He is a Certified Instrument Flight Instructor (CFII), and has given over 1200 hours of aerobatic instruction. In addition, Blank is an active airshow performer and has held a Statement of Aerobatic Competency (SAC) since 1987, and for Level 1 Surface since 1989. He has completed 200 performances throughout his career.