WHAT IS A “SPECIAL ISSUANCE”?
ONCE ISSUED, HOW TO KEEP IT …
The FAA will grant medical certification for a number of conditions which, after considering the medical information, are determined not to pose a threat to flight safety. Such issues can include treatment for high blood pressure, kidney stone, controlled diabetes, and many others.
A special issuance is granted for certain length of
time which can be from 6 months to several years, but most commonly for 12 month
intervals. When granted, the airman is sent a letter from the FAA outlining the
conditions of the ‘grant’ and a set of instructions on what to do to
re-qualify at the next interval. This instruction sheet is called a
specifications sheet and is included with your FAA grant letter. Keep
a copy of this specification sheet with your medical folder. Refer to it
early before your next evaluation.
PLEASE NOTE: Due to changes in how
international agencies interpret ICAO and JAA regulations, the FAA will ask you
to carry a copy of your special issuance letter with your medical certificate or
at least have it readily available with you at all times when you are flying,
especially internationally.
The specification sheet will outline exactly what is needed (usually it is a report from your doc or some lab work, or both) and how often. If you have this required information in hand when you go to your AME, the AME can usually issue you your medical certificate right on the spot. This avoids the delay of having to wait while the FAA in OKC considers the required data.
Now here is the rub: The airman is responsible for arranging and having this required information done in a timely manner and in the format the FAA letter specifies. The AME does not usually get involved in obtaining this unless it is to ‘grease the skids a little’ with another doc’s office. With some advanced planning on your part, it is usually possible to have this 'report' or 'consultation letter' in your hands 30 days or so prior to end of the specified interval, which is ideal. Frankly, most physician offices now days are run by corporations that do not do anything "extra", so allow plenty of time, bring the office help a box of candy, etc......
Remember:
1. We AME's have no choice but MUST submit your current exam information to the FAA within 14 calendar days of your FAA exam whether we have the special issuance report or not. If submitted without it, the exam is automatically “deferred” to the FAA until the information is received and then the FAA issues your certificate.
2. The airman, not the AME, is responsible for getting the “specification sheet” instructions fulfilled in a timely manner. I suggest you communicate early with your doctor’s office to schedule enough time ahead to arrange for testing, a consultation visit, and sufficient transcription time.
3. The FAA’s letter will usually ask for a report dated within 30 to 90 days prior to the end of the interval specified. Remember, this is required on what ever interval the FAA letter states, whether your FAA exam is due or not. If you are not due an exam, you can bring your required consultation to the office for review, and if OK, you can then be issued a fresh medical certificate on the spot. The option is to mail the consultation report to the FAA at OKC yourself and wait for their consideration.
HERE IS AN ARTICLE FROM DR. WARREN SILBERMAN regarding submission of tests. It was taken directly from the Federal Air Surgeon's Bulletin, Vol. 47, No. 3, received at our office August 2009:
Dr. Silberman is directing his comments to us AME's but you may peek over my shoulder to get an idea of the problems the FAA and I run into almost weekly working with a pilot's special issuance request. The article is quoted in part:
"...Do It Our Way
Another frequent problem is noncompliance with our request for a specific test or a particular way for a test to be performed. When we request a specific test, we want it done for good reasons!
A perfect example is when we request a maximal nuclear stress test. Our consultants prefer this type of test because the inter-hospital variability is predictable, and it is the more sensitive test for ischemia. Instead, when we request this test, we sometimes receive a pharmacologic nuclear stress or a stress echocardiogram.
During the pharmacologic nuclear stress test, the airman rarely reaches maximal exercise, and it is not as sensitive for demonstrating ischemia as the exercise test. Also, we rarely get an explanation as to why, when we asked for a maximal nuclear stress test, we are provided an alternate. Physicians, nurses, and ancillary help are trained and familiar with the usual nuclear stress test.
Pharmacologic stress protocols are less familiar and more complex. The drug dose is calculated based on weight and must be placed into a pump device, which requires programming, and the procedure is more complicated. More importantly to your airmen, though, is that it is more expensive! If your applicant has some sort of musculoskeletal problem, we may accept this test, but someone needs to inform us of this in writing.
To the FAA, a stress echogram must be performed a particular way when we request one. There is more inter-center variability in the performance of the actual test. Should a private pilot (third class) have a stress echocardiogram, we will generally accept the results. However, it is our policy that we do not accept this test for first- or second class airmen, unless our consultants request one.
Neuropsychological Tests
Neuropsychological testing has strict requirements. To make a certification decision, we rely upon specific tests that our consultants have recommended. If these procedures are not followed, the airman will be denied (under Chapter 14 Code of Federal Regulations part 67.113) for failure to provide the FAA the information that was requested.
Bottom Line
When further testing is required for certification, please explain to your airmen that there is a rationale for everything we request. Sending us old testing results, handwritten physician reports, incorrect tests, or even not providing a test because their treating physician did not feel it was necessary, will usually lead to a denial—and long delays for the airman while we correspond back and forth to obtain the correct documentation...."