For pilots, few things are more challenging than being grounded due to a serious injury. Whether the result of an accident, surgery, or a medical condition, returning to the skies after such an event requires careful preparation—especially when it comes to reobtaining or maintaining an FAA medical certificate. Fortunately, with the right documentation and guidance, in most cases you will be able to get back in the cockpit.
The FAA’s Office of Aerospace Medicine is charged with ensuring that all pilots meet the medical standards necessary for safe flight. After a significant injury, the FAA must determine that a pilot is both medically and functionally fit to resume flying duties. This determination hinges on comprehensive documentation.
What Constitutes a “Significant Injury”?
A “significant injury” typically refers to any condition that could impair cognitive, physical, or psychological functioning. Common examples include:
- Major orthopedic injuries (e.g., fractures requiring surgery)
- Neurological events (e.g., stroke, traumatic brain injury)
- Cardiac events (e.g., heart attack, coronary artery disease with intervention)
- Major surgeries
- Conditions requiring prolonged hospitalization or rehabilitation
Don’t be Surprised by a “Deferral”
- Even if you feel fully recovered and symptom-free, don’t be surprised if your Aviation Medical Examiner (AME) needs to defer your application to the FAA for review. This is not a denial, but rather a standard part of the process when a condition or recovery falls outside the scope of what an AME can approve directly.
- Many significant injuries—especially those involving hospitalization, surgery, or neurological issues—automatically require FAA review, regardless of current health status. The key is that if your recovery is complete and well-documented, most pilots are ultimately successful in obtaining their medical certificate.
- Patience, persistence, and good documentation are essential. Trust the process and work closely with your AME to ensure the FAA has everything they need to make a favorable decision.
The Documentation You’ll Need
Before an Aviation Medical Examiner (AME) can issue or defer a medical certificate, the FAA expects complete and well-organized medical documentation. Key records generally include:
- Hospital and Surgical Records
- Admission history and physical
- Operative reports
- Discharge summaries
- Admission and progress notes
- Physician Narrative Summaries
- A current status report from the treating specialist(s), detailing:
- The nature of the injury
- Treatment and recovery progress
- Prognosis and functional limitations (if any)
- Medications and side effects
- Clearance to resume flight duties (if applicable)
- See the link below for the FAA’s definition of a current detailed progress note. “John is OK to fly” does not cut it with the FAA. Work with your doctor to make sure they write a good note that supports your application
- https://www.faa.gov/ame_guide/media/PilotInformation_DetailedClinicalProgressNote.pdf
- A current status report from the treating specialist(s), detailing:
- Diagnostic Studies and Imaging Reports
- MRI, CT scans. In many cases the FAA wants not only the reports, but the actual scans. Your AME can guide you.
- Lab results if relevant to the condition
- Functional Recovery Evidence
- Physical therapy progress notes
- Neurocognitive testing (if the injury involved the brain)
- Stress testing or exercise tolerance testing (for cardiovascular conditions)
- Any FAA-Specific Testing or Evaluations Requested
- Neuropsychological testing (if required)
- FAA Form 8500-7 (Eye Evaluation) or 8500-14 (Neurologic) if applicable
Working with Your AME
Early communication with your AME is critical. They can guide you on what specific records the FAA will need based on your condition and help determine whether your case can be cleared in the office or must be deferred to the FAA for review.
Submission Tips
- Organize documentation chronologically and clearly label each report.
- Avoid submitting duplicate records.
- Provide only the required information-nothing more.
- Include only finalized medical reports—not preliminary or unverified notes. “After visit summaries” are not acceptable.
- If possible, have the documents uploaded to your FAA file by your AME. This speeds up the process significantly. Unfortunately, there are limitations on the file size, and actual scans cannot be uploaded.
Recovery Must Be Physical and Psychological
While physical healing is often the most visible part of recovery, don’t overlook the importance of psychological readiness. A significant injury, especially one related to an accident or serious illness, can have lasting emotional or mental effects—ranging from anxiety to subtle cognitive changes. It can shake your confidence. The FAA considers both physical and psychological fitness when determining medical eligibility.
Even if you feel “back to normal,” it’s wise to self-assess honestly—or better yet, talk with a trusted aviation medical professional—before scheduling your FAA exam. Pilots are known for being resilient, but resilience doesn’t mean ignoring stress or trauma.
Consider Warm Up Flights Before Your Medical Exam
Before stepping into the AME’s office, consider spending a few hours flying with a flight instructor, especially if it has been a while since your last flight. This isn’t just about refreshing your stick-and-rudder skills—it’s a chance to:
- Evaluate your comfort level in the cockpit
- See how your body and mind respond to the flight environment
- Rebuild confidence and situational awareness
If you’re sharp and relaxed in the air, that can be a reassuring sign—for both you and your examiner—that you’re truly ready to return to flight.
Patience and Persistence
Depending on the complexity of your case, the FAA review may take several weeks or months. While this can be frustrating, thorough documentation at the outset significantly reduces delays.
Conclusion
Returning to flying after a significant injury is a journey that requires planning, patience, and a proactive approach to medical certification. By assembling complete, concise, and relevant medical documentation, and working closely with an experienced AME, pilots can clear the FAA’s medical hurdles and get back to what they love most — flying.
Fly smart. Fly honest. Fly safe.
