Your FAA Medical Was Deferred. What Happens Next?

Hearing that your FAA medical application has been deferred can be alarming. But a deferral is not the same thing as a denial.

A deferral simply means that your Aviation Medical Examiner (AME) cannot issue your medical certificate at the time of the examination and must send the application to the FAA for further review.

Why Do FAA Medical Applications Get Deferred?

There are many reasons. Some applicants don't meet one of the basic medical examination standards, such as blood pressure, visual acuity, or color vision. Others have a medical history that requires additional FAA review.

Examples can include diabetes, certain heart conditions, recurrent kidney stones, psychiatric conditions such as active ADHD, depression, anxiety, or OCD, and histories involving drug use or drug-related convictions.

This is far from an exhaustive list. In fact, it would be nearly impossible to list every reason an FAA medical might be deferred. Essentially, whenever an applicant has a medical finding or history that the AME cannot clear under the FAA's applicable issuance criteria, deferral may be necessary.

What Happens After a Deferral?

The AME submits the medical application and available supporting information to the FAA. The FAA then reviews the case.

There are several possible outcomes. Sometimes the FAA has enough information from the initial submission to make a final decision and grant the medical certificate. Other times, the FAA will send the applicant a letter requesting additional information.

This is why good communication between the pilot and the AME is important. If you know that your medical history may result in a deferral, it is helpful to discuss the issue with your AME and gather the relevant records before the examination (or as soon as possible after the examination) whenever possible. The AME can then submit those records along with the deferred application.

A complete initial submission does not guarantee certification, but it gives the FAA more information to work with from the beginning. That may allow the FAA to reach a certification decision without first sending the pilot a letter asking for records that could have been submitted with the original application.

Sometimes You Can Anticipate What the FAA Will Ask For

Experience can also help an AME anticipate some of the FAA's requests.

For example, after certain drug-related incidents—such as a recent positive workplace drug test or a history involving a drug-trafficking charge—the FAA sends a letter requiring the applicant to complete drug testing within 48 hours of receiving the letter.

That creates an unnecessary scramble for everyone involved. The pilot has to find an appropriate testing facility almost immediately, and the AME may need to help coordinate everything under a very short deadline.

Because I have encountered this before, when appropriate I will ask an applicant with this type of history to complete drug testing before I submit the deferred medical application to the FAA. That way, the FAA receives the drug-testing information as part of the initial submission rather than having to request it afterward.

This does not guarantee that the FAA won't request additional testing or documentation. But anticipating likely FAA requests can make the process considerably smoother.

This is one reason having an experienced AME can be particularly useful for an applicant with a complex medical history.

What Else Might the FAA Request?

When additional information is needed, the FAA may request medical records, a current evaluation from a treating physician or specialist, laboratory testing, imaging, psychological or neuropsychological evaluation, or other documentation.

Sometimes the FAA wants to see that a condition has been appropriately treated and stable for a certain period of time. In those situations, the applicant may be asked to undergo treatment, wait until a specified time interval has passed, obtain a new evaluation, and then provide updated information to the FAA.

If the FAA spells out exactly what you need to do before it will reconsider you for medical certification, consider that good news. It means there is still a potential pathway to getting medically certified.

How Can I Get Help with the Next Steps?

If your medical application has been deferred and you are unsure what to do next, start by asking your AME for help. Your AME may be able to explain what the FAA is requesting and help you determine what records, evaluations, or testing you need.

If you would like additional help navigating a deferred FAA medical application, you may also make an appointment with me to review your case and discuss the next steps.

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