New Guidance Eases Burden Of ADHD-Related Aeromedical Qualifications


The Aircraft Owners and Pilots Association (AOPA) reported last week that the FAA has made it less onerous for pilots with past histories of attention-deficit/hyperactivity disorder (ADHD) to qualify for medical certification. The director of AOPA’s pilot information center for medical certification, Gary Crump, wrote that, previously, applicants for medical certificates who had any previous diagnoses of ADHD “required an extensive, expensive, and time-consuming review process typically handled by FAA staff in Washington, D.C.”

But new FAA guidance directed at aviation medical examiners (AMEs) cites specific ADHD diagnoses and/or medications that, should they apply to an applicant, would enable AMEs to issue medical certificates without the lengthy, expensive review process.

According to Crump, “The new FAA guidance to AMEs recognizes that not all applicants who report a history of ADHD diagnosis or treatment with medications necessarily require the extensive evaluation that previously applied to anyone reporting that history on the medical certificate application. This is the result of a comprehensive review of literature by the FAA as well as case history experience from the large number of applications submitted to the FAA over the past few years.”

Criteria for waiving the review process include documentation of “no treatment or use of ADHD meds for any reason in the past four years; no symptoms in the past four years; detailed records showing no instability in academic, occupational, or social functioning within the past four years; and no other psychiatric conditions or diagnosis.”

While applicants who do not meet all the qualifications for acceptance under the new guidance can still go through the existing process of evaluation for medical exemption, Crump points out that many pilots will be able to avoid a regime that would likely take several months and significant expense. Crump wrote, “This change represents the FAA’s ongoing commitment to finding the proper balance between aviation safety and providing as many people as possible the opportunity to fly.”

Mark Phelps
Mark Phelps is a senior editor at AVweb. He is an instrument rated private pilot and former owner of a Grumman American AA1B and a V-tail Bonanza.

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  1. Now can they start getting reasonable on other things? The new guidance for blood pressure medications (which they implemented without warning) is expensive and time consuming. It also put me out of work for a few weeks while I tried to get an appointment with my primary care physician. Was that really necessary?

    I think most of us are happy to work with the FAA. But they need to stop acting like an abusive parent. The ADHD thing is a good start, but they must do much better.

  2. I remember my ordeal / debacle regarding my issue with the FAA over a false positive color blind diagnosis. It took me quite some time and numerous doctor and eye specialists to strengthen it out. I thought it was harder to keep up my medical than getting my ticket….

  3. A perspective from someone diagnosed with ADHD. This is far from reasonable. We know these rules were written in blood but as with a lot of this stuff a subset of people are having most of the crashes. They’re a one-size-fits-all solution that is straight out unfair to a lot of people.

    I was diagnosed with ADHD in my 40s after a friend saw great benefit and it got me thinking. The acts of driving, flying, riding, sailing etc were never an issue previously. Now though my general ability to knuckle down on tasks is greatly improved. Those pills are akin to corrective lens. The majority of pilots wear glasses for all or part of the time as we age. There is no sense in treating the corrective measures for a hidden disability differently to the corrective measures for more visible ones. No pun intended.

    Plenty of us can demonstrate our specific and long run competence of flying while taking medication. That would be a reasonable thing to spend on money on.

  4. I applied for a 3rd class medical about 3 years ago. Acting against the recommendations of several pilot friends, I decided to be honest on my medical application. At the time, I hadn’t been on medication for ADHD for more than 15 years. I was originally diagnosed over 20 years prior. I had held a stable job with no issues for many years as an aircraft mechanic. I just wanted to follow the system and trusted it would work for me. It took over a year of back and forth communication with the FAA. I waited 3 months for each response. Each time, I had to see yet another doctor to get yet another test. By the way, this is all prior to them making any determination for a special issuance. The final test was a 7 hour long day of intense mental exercises performed by a HIMS Neuropsychologist for $2,500. The conclusion at the end of a very long-winded report was that I “likely had an attention disorder.” At the end, the FAA denied my medical. I wanted to appeal, but I no longer had any money left to do so. If I had spent any more money on the medical, I definitely wouldn’t have been able to afford flight training.

    I have been at the controls of an aircraft with a flight instructor on several occasions. I am 100% confident that I could safely fly a Cessna 172 around local airports. I just wanted to be a recreational pilot. I wasn’t asking to fly a 737 into O’Hare. My dream of becoming a pilot died that day.

    If I started pilot training with a flight instructor that had an ounce of integrity, that flight instructor should be able to easily recognize whether I have the requisite attention span to safely fly a slow, single-engine aircraft. To me it is all very simple. Put the student in the air with a CFI and see how well they do. If they prove to be capable, approve the medical. If not, don’t give them any more lessons. ADHD doesn’t come with a risk of seizures or heart failure. At most, some medications have a slight risk of causing high blood pressure. This condition can easily be monitored and kept in check. I can’t believe that I was naive enough to trust that the system would actually work. It’s quite sad.

    This article points to a tiny step in the right direction. However, they have an entire mountain range to climb before any meaningful change is made to the FAA’s ignorant treatment of mental health disorders.