Many of us throughout the year encounter a variety of illnesses that require a visit to Urgent Care, the Emergency Department, or other health care provider. What should you report to the FAA on your medical application and what documentation does the FAA need from you? In an article we published some time ago, we discussed Item 19 of the MedXpress application form, which asks about visits to health professionals in the last three years. Technically, the FAA expects us to interpret that request fairly literally; however, there is some leeway. For example, we are not required to report routine visits to dentists and eye care specialists, and the visits to our AME for periodic FAA flight physicals. Now, that makes it a little easier, right?
Another frequent question we are asked is, “Do we have to report every single visit to the same doctor?” The answer is no. We can aggregate, or combine multiple visits to the same doctor for the same condition, such as followup visits for back pain or pneumonia, or regular periodic wellness visits. Just enter the date of the most recent visit, and in the explanation, just indicate “multiple routine office visits” or something similar.
If the physician is your primary care doctor, the FAA will be happy to see that you are getting regular wellness check-ups. Obviously, though, if those multiple visits are to a cardiologist or other specialist and this is the first time you are reporting the visits, you will be doing some explaining to the FAA in the form of test results and reports from that doctor explaining why he or she has been seeing you.
So, what are some conditions that you should report?
Appendectomy: What if you were admitted to the hospital for a “hot appendix” and ended up having the appendix removed? This is a condition that requires no interim reporting to the FAA; you will just note it on your next regular FAA physical examination. If it’s a recent surgery, since your last FAA physical exam, you will need either the hospital admission/discharge summaries and operative report, or you can just obtain a letter or office note from the surgeon that notes the date you were admitted to the hospital for surgery, that there were no complications or any if there were, and what date you were discharged. The note also should indicate the date you were cleared to return to work.
Treatment for genital herpes: This is a sexually transmitted condition. It is caused by the same virus that causes cold sores. There is a common oral anti-viral medication that can be used to abort the condition when there is a flare-up and to prevent the sores from occurring once the disease is diagnosed. The virus in this condition resides in the nerve cells and under certain conditions can contribute to the development of the sores. The medications used to treat the condition are acceptable for use while flying, but the FAA does want to know why the medication is being used. (We’ll talk about reporting of medications another time!) A short note from your treating physician is usually all you need to provide at the time of your next FAA exam.
Routine colonoscopy: If you have read any of our wellness consultant Jonathan Sackier’s articles, you are well versed on this screening procedure. You also are well “versed” as this drug, along with “Fentanyl” is the sedating cocktail that makes having a colonoscopy so much fun. This is a procedure generally performed by a gastroenterologist in which a flexible fiberoptic scope is introduced into the colon that allows the doctor to examine the bowel, take biopsies for questionable pathology, and even treat some forms of inflammatory bowel conditions. I have all of my pilots who have this procedure obtain the operative report and provide it when they come in for their physical. In the majority of cases, depending upon what—if any—pathology is found, I can issue a medical to the airman at the time of the exam.
Visits for counseling: This one can be a bit dicey, but the FAA instructions for Item 19 state that visits for counseling are reportable “only if related to a personal substance abuse or psychiatric condition.” If you and your spouse are visiting with a counselor to solve some marital difficulties, and there are no psychiatric or psychological issues that escalate the counseling to other treatment, there is no requirement to report those sessions.
One final, important note: If your health care provider tries to give you a handwritten note explaining a visit or visits, or, worse, tries to write something up on a prescription pad, save the doctor and yourself some time. The last thing the FAA doctors want to see is some indecipherable scribble (You know what doctors’ handwriting looks like!) that doesn’t provide adequate information to explain the details of the office encounter. Tell them it needs to be a formal, typed “consultation note” addressed to “To Whom It May Concern.” That one tip alone may save you weeks of waiting if your application is deferred to the FAA for review.