Pilot Protection Services June Medical Mailbag

QUESTION: I have Parkinsons Disease, well controlled on Levodopa. Does this require special issuance under the current regulations?

ANSWER: Parkinson’s Disease is a chronic condition characterized by both muscular rigidity limiting mobility, and tremor that can greatly impact quality of life. Sometimes, repetitive trauma can lead to a syndrome that mimics Parkinsons, and, of course, The Greatest, Muhamad Ali suffered from this. A shuffling gait, classic tremor that looks like one is rolling a pill between finger and thumb, a mask-like face and affected mood complete the picture. However, medication such as Levodopa, a synthetic version of dopamine that the brain is missing, can often control symptoms for many years. When patients become resistant to drugs, placing an electrical stimulator in the brain can dramatically control the effects of the disease as in this video:

The FAA can allow a special issuance if symptoms are well controlled on allowed medications.  Currently, the only medications allowed by the FAA are those with the active ingredients carbidopa/levodopa.  You would be certificated annually and asked to provide a status report from your treating physician each year for continued certification.


QUESTION: My special issue medical has expired; can I fly as a sport pilot until I get it renewed?

ANSWER: As long as your special issuance expired, and was not withdrawn, terminated, or suspended/revoked, and your most recent application for another medical (if any) was not denied, you would be eligible to self-certify under FAR 61.53 and fly under the Sport Pilot rules.


QUESTION: I currently hold a restricted 2nd class medical due to having 2 stents inserted back to back in the right coronary artery – I did not have a heart attack, just some blockage. I own an aerial advertising company and flying is an integral part of that business, however it does not involve carrying passengers or cargo. Would my flying for the company require me to go through all the tests required to renew limited 2nd class which expires in a couple of months, or would my circumstances allow me to operate on a 3rd class medical and would I be eligible for it now with the new regulations?

ANSWER: Disease of the blood vessels supplying the heart with oxygen and nutrition kills more people in the United States than in any other. It is also the most common medical topic AOPA is asked about.  If left untreated, narrowing of the arteries supplying blood to the heart, leads to angina pectoris (chest pain), myocardial infarction (heart attack) or death – which requires no definition methinks!

Very often treated by coronary artery bypass, which is the cardiac surgeons’ version of building a bypass around a town, the minimally invasive route is now very common. Via a catheter placed into an artery in the groin or elsewhere, the narrowed area is identified, stretched with a balloon and then held open with a cardiac stent, a metal tubular cage, sometimes coated with drugs to limit further narrowing. Sometimes the doctor doing this procedure, an interventional cardiologist, may expand and stent more than one artery.

Unfortunately, your proposed flight operation would not qualify for BasicMed as the rules do not allow flying for compensation or hire, except for limited circumstances such as flight instruction or as permitted by FAR 61.113, such as flights only incidental to employment, pro rata cost sharing, charitable flights, etc.  These restrictions still apply if you are receiving compensation but not carrying persons or property.  And it sounds like your operations for the advertising company are part of your job, rather than only incidental to your employment.  So, you would not be eligible for BasicMed and would need to maintain the limited second class medical. But at least your disease has been detected and treated and you can still fly!


QUESTION: I am a 65 year old ATP rated pilot in multi-engine land/sea airplanes and rotorcraft/helicopters; also CFII airplane and rotorcraft.

 I have hypertrophic cardio-myopathy and had two bouts of Atrial fibrillation. The first one reverted on its own, the second required treatment with electric shock and I am now also taking various drugs including metoprolol and aspirin.

I am physically fit and do a work out regime every day and also monitor and record my heart rate and blood pressure. My heart rate and blood pressure are both good. I have also had a hip replacement.

I currently hold a special second class medical that must be renewed yearly. Even though I’m in about as good a shape as anyone can be with my heart conditions there is always the chance that the FAA will find something they don’t like and cancel my medical; my flying days could be over or at least curtailed until I tried fighting their decision. I would like to keep my second class medical, but not at the risk of losing my ability to fly.

My medical expires April 30, 2017 – perfect timing since BasicMed starts the next day. As long as I get the requirements out of the way by then I can do most of the flying I Iike, but can’t get compensated for performing at air shows, etc.

So – how do we work with the FAA to encourage folks like me to stay engaged with the current special medical program without jeopardizing my flight status? Since I am in the driver’s seat and can choose to never visit an AME again it would seem to behoove the FAA to work with me and others like me. Can AOPA help work out a program where we can send in all the medical data I normally would on IACRA, but initially just to have them look it over and see if they would GUARANTEE that IF I submitted it I would receive another one year class two medical. I would also need to be assured that during the year if they wanted to revoke my medical I would have the chance instead to sign up for BasicMed. If I qualified for BasicMed I would be allowed to fly under that with its restrictions and NOT have my medical revoked.

I know that the FAA is not always known for helping, but since this might give them at least some control they might go for it or some version of it. As a single pilot, I don’t have much hope they would ever pay any attention to such a proposal; but if it were to come from AOPA…. well, maybe a different story. Think you folks could help?

ANSWER: We have left the majority of your question intact so that other readers can see the complex and valid issues raised by our members! The appropriate way to do what you are asking for is to send your records to AOPA.  As a Pilot Protection Services Plus member, we can review your records and help you determine if your medical would be reissued under special issuance. That would be far preferable to sending records to the FAA and asking for an opinion as to “if” they would be able to reissue you based on the information you provide. We would not recommend that!

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.

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