And the wait goes on...

I think I can recall from my growing-up years the elders in the room often saying, “The road to hell was paved with good intentions.” I also recall that statement was probably directed at me when I provided some lame excuse for not cleaning my room or taking out the trash.

I’ve associated the quote with some of the things coming out of government lately. In the FAA world we work with, Aerospace Medicine, we have over the years developed a good relationship with all the folks who do pilot medical certification in Oklahoma City, Okla.; Washington, D.C.; and the nine regional medical offices around the country. The last twelve months were pretty brutal with respect to the bugaboo that has haunted the FAA since the beginning of time—timely processing of medical certificate applications and delivery of special issuance authorizations. 

Over the years, we have seen small bits of incremental improvement in certification policy and practices, and those changes have been welcome by all. A couple of years ago, the FAA instituted a new program called CACI (Conditions AMEs Can Issue) under then Federal Air Surgeon Fred Tilton. This program changed the requirements for 10 medical conditions that had required special issuance authorizations, comprising arthritis, asthma, hepatitis C, hypertension, hypothyroidism, pre-diabetes, migraine and chronic headaches, renal (kidney) cancer, testicular cancer, and prostate cancer. Under the new program, with a simple check-off box worksheet for each condition, your aviation medical examiner can now issue a medical certificate at the time of your FAA physical examination. This program is very successful and has eased the processing burden of the FAA, and the frustration of pilots with these conditions.

The logical step, then, would be to take a successful program and keep making it better. The FAA did just that, and moved on to CACI 2.0 early last year when Tilton announced that the next group of CACIs would be “posted soon.”  Those conditions include kidney stones, carotid artery stenosis, colitis and irritable bowel syndrome, colon cancer, bladder cancer, leukemia, and Hodgkin’s disease and lymphoma. Great plan. Great intentions. The problem is, the program hasn’t been implemented yet one year after the pronouncement of “coming soon.” 

During the last year, the FAA’s medical support system, called Document Imaging Workflow System (DIWS), that I have spoken of before, crashed, more than once, and brought processing of medical review to a standstill; the government sequestration requirement kicked in with mandatory furloughs for federal employees; and, oh yeah, the so-called government shutdown last fall lasted three weeks. Throw into the mix a really nasty winter with storms that closed the FAA Aerospace Medical Certification Division in Oklahoma City and Washington, and the failure to implement a new program that would shunt thousands of cases through the backdoor at FAA, and we ended the year, and started 2014, with a backlog that still is causing delays of 90 to 120 days, particularly with special issuance renewals.

As we enter the busy spring and summer flying season, we are now ever more hopeful that some sanity will infiltrate the FAA and that we can expect some response to our now two-year old medical exemption petition that would provide significant relief for many pilots who fly recreationally. In the meantime, we shall continue to press the FAA to implement CACI 2.0, and even begin developing version 2.0.1. Stay tuned!

Portrait of Gary Crump, AOPA's director of medical certification with a Cessna 182 Skylane at the National Aviation Community Center.
Frederick, MD USA
Gary Crump
Gary is the Director of AOPA’s Pilot Information Center Medical Certification Section and has spent the last 32 years assisting AOPA members. He is also a former Operating Room Technician, Professional Firefighter/Emergency Medical Technician, and has been a pilot since 1973.
Topics: Emergency, Training and Safety

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