There are many medical conditions for which the FAA expects the airman to provide some documentation at the time of the physical exam, but which will not lead to a special issuance. If you do not provide the aviation medical examiner with the proper documentation and the AME issues you a medical certificate anyway, the FAA may request some documentation and this will cause you unnecessary aggravation.
A good rule of thumb is if you see a health professional or undergo some medical testing that hasn’t been reported to the FAA previously, you should include the records of that encounter at the time of your examination. So, here are some common medical conditions and what the FAA would want to see for them.
If you have a skin lesion or tumor removed, you need to be specific about what it was that was removed. Get the pathology report and a statement from the treating dermatologist as to any further treatment plans. The FAA does not know if you had a benign skin mole removed or a melanoma, which can be a serious cancer. The skin cancers that will likely require a special issuance are squamous cell and malignant melanoma. Most other dermatologic conditions will probably be office issuances.
A hernia occurs when a portion of the intestines pokes through a weakening in the tissue that covers the abdomen. If your treating physician is going to just observe the hernia, but doesn’t recommend surgical correction, you will need a typed statement from the doctor explaining the location of the hernia and that there is not a likelihood of “strangulation.” A strangulated hernia happens when the bowel becomes lodged in the defect and the blood supply is compromised, potentially killing the affected bowel. This is a serious emergency that requires surgery. If, however, the hernia was surgically corrected, then bring in the operative report and a letter from the treating surgeon that comments on how you have done.
What about problems with a spinal disc? If you have ever had the kind of pain that occurs when a spinal disc “collapses,” you’ll know that it is grounding condition, and you certainly would not be able to fly. The FAA will want to see a good explanation that notes how the disc problem arose and what location in the spine is the involved disc. You should also provide the results of a CT or MRI scan. Most importantly, you will need to show what type of treatment you underwent. If you had surgery, provide the operative report and a current status report on how you have done since the surgery. The report should note any limitations in your range of motion. Unless you are having chronic pain, weakness of the nerve at that level, or are requiring narcotic analgesics, your AME should be able to issue you without the requirement for a special issuance.
What about joint replacement surgery? Since one is generally admitted to the hospital for this, you should provide the admission and discharge summary notes, the operative report, and once the surgeon has felt you have reached maximal physical therapy benefit, a typed letter stating your functional capabilities. If you could also get the surgeon to include a statement in the status report that you are able to manipulate the rudder pedals and are not having significant pain, that would be very beneficial.
So, for any condition like this, gather up the documentation when the condition occurs and have it with you when you see the AME for your next FAA flight physical. I will share my recommendations for many other of these types of conditions next week in part two of this discussion.