On April 1, 2024, the ARC published a Recommendation Report, which contained 24 specific recommendations intended to reduce the barriers that hinder both disclosure and treatment of mental health conditions. The recommendations aim to enhance safety in the National Airspace System (NAS) through improved mental health among pilots and ATCs as well as more accurate reporting to aid the FAA in assessing latent risk. This article highlights some policy changes implemented by the FAA to address the barriers identified by the ARC and reduce the wait time many pilots and ATCs currently face as their applications await review.
Much remains to be done in reducing the stigma surrounding mental healthcare in aviation. But the FAA seemed to respond to several of the ARC recommendations through recent updates to the Guide for Aviation Medical Examiners (AME Guide). Of particular significance is a change to guidance regarding airmen applying for any class of medical certificate with a history or diagnosis of certain anxiety, depression, and related conditions, which allows immediate issuance of an unrestricted airman medical certificate to pilots and aspiring pilots after an exam with their AME.
The new guidance allows issuance to airmen with an “established medical history or clinical diagnosis” of up to two of eleven specified “uncomplicated” anxiety, depression, or related conditions. The guidance is limited, though, as other factors such as additional mental health diagnoses or hospitalizations, suicidal ideation, suicide attempts, self-harm, or recurrence of symptoms over time may require further review, which can take months or even years.
Once the AME determines that an airman’s medical history contains two or fewer of those listed conditions, they must look to the treatment. The new guidance allows immediate issuance to airmen being treated with psychotherapy (counseling or talk therapy), but not current or recent medication use. AMEs may issue to airmen who last used mental health medication two or more years ago but must defer the airman for further review if they used medication within two years of the exam. In addition to the two-year time restriction on medication use, the airman cannot have a history of using multiple mental health medications simultaneously at any time in their life.
So, barring any additional concerns from their AME, airmen with a history of one or two uncomplicated mental health conditions treated with psychotherapy and/or historical medication use more than two years ago may now be issued their medical certificate in the office of their AME immediately after their physical exam.
The recent updates to the AME Guide should not be read as an invitation from the FAA for airmen to report all previous mental health diagnoses, therapy sessions, or prior medication use that was not disclosed on previous applications. Failure to answer every question on Form 8500-8 or MedXPress completely and honestly is a violation of the FARs, as is conducting operations while an airman is aware of a condition that may prevent them from acting as PIC. Reconciliation of inaccurate applications for airman medical certification is a complex process not addressed in the ARC’s Recommendation Report. If you are in the position of reporting a previously undisclosed issue, you should seek competent legal advice immediately.
Matt Bulow is an aviation attorney with Ramos Law – Aviation in Broomfield, Colorado. Ramos Law was founded by Dr. Joseph Ramos, MD, JD, who, in addition to being a medical doctor and attorney, is an active pilot. The Aviation Division of Ramos Law is directed by Joseph LoRusso, JD, an ATP-rated professional pilot who opened his own law firm after realizing the need for advocacy on behalf of pilots, which eventually led him to join forces with Dr. Ramos at Ramos Law. Zeke Denison, JD, is the Medical Certificate Defense Lead at Ramos Law – Aviation, focusing exclusively on the often-complex medical certification process that most pilots must navigate regularly. In addition to medical certificate defense, Ramos Law – Aviation provides legal services to victims of aviation crashes. Ramos Law – Aviation is passionate about providing the best possible representation to pilots and keeping safe pilots in the air.
