Abdomen & Viscera : What to Expect at the Flight Physical
Item 38: FAA Policies on the Airman Medical Exam
Apr 2014
Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 88-92, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).
I. Code of Federal Regulations
Legal References: 14 CFR 67.113(b)(c), 67.213(b)(c), 67.313(b)(c),
Legal Extract (Applies to All Classes):
-
(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
- (c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
II. Examination Techniques
- Observation: The Examiner should note any unusual shape or contour, skin color, moisture, temperature, and presence of scars. Hernias, hemorrhoids, and fissure should be noted and recorded. A history of acute gastrointestinal disorders is usually not disqualifying once recovery is achieved, e.g., acute appendicitis. Many chronic gastrointestinal diseases may preclude issuance of a medical certificate (e.g., cirrhosis, chronic hepatitis, malignancy, ulcerative colitis). Colostomy following surgery for cancer may be allowed by the FAA with special followup reports.
- The Examiner should not issue a medical certificate if the applicant has a recent history of bleeding ulcers or hemorrhagic colitis. Otherwise, ulcers must not have been active within the past 3 months. In the case of a history of bowel obstruction, a report on the cause and present status of the condition must be obtained from the treating physician.
- Palpation: The Examiner should check for and note enlargement of organs, unexplained masses, tenderness, guarding, and rigidity.
III. Aerospace Medical Disposition
FAA Note: See Item 48. (General Systemic) or details concerning diabetes and Item 57 (Urine Test) for other information related to the examination of urine).
The following table lists the most common genitourinary conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with abdominal medical conditions that require deferral, or for any condition not listed in the table that may result in sudden or subtle incapacitation without consulting the AMCD or the Regional Flight Surgeon. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.
|
Abdominal Disorders | |||
|---|---|---|---|
|
ABDOMINAL DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|
Hepatitis |
All |
Submit all pertinent medical records, current status report to include any other testing deemed necessary |
If disease is resolved without sequela - Issue Otherwise - Requires FAA Decision |
|
Hepatitis C |
All |
Review all pertinent medical information and current status report, include duration of symptoms, name and dosage of drugs and side effects |
If disease is resolved without sequela and need for medications- Issue - AME Authorized to Issue the Certificate If applicant has chronic Hepatitis C, see
Hepatitis C - Chronic Worksheet
|
|
Inguinal, Ventral or Hiatal Hernia |
All |
Document history and findings |
If symptomatic; likely to cause any degree of obstruction - Requires FAA Decision Otherwise - AME is authorized to Issue Certificate |
|
Liver Transplant |
All |
Submit all pertinent medical information and current status report, include duration of symptoms, name and dosage of drugs and side effects |
Requires FAA Decision |
|
Peptic Ulcer |
All |
Requires FAA Decision | |
|
Splenomegaly |
All |
Submit all pertinent medical information and current status report, include duration of symptoms, name and dosage of drugs and side effects |
Provide hematologic workup |
|
(Cancers Affecting Your Abdominal Organs) | |||
|
DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|
Colon/Rectal Cancer |
All |
Submit all pertinent medical records, operative/ pathology reports, current oncological status report; and current CEA and CBC |
Initial Special Issuance |
|
Other Malignancies |
All |
Submit all pertinent medical records, operative/ pathology reports, current oncological status report, including tumor markers, and any other testing deemed necessary |
Requires FAA Decision |
FAA Notes: An applicant with an ileostomy or colostomy may also receive FAA consideration. A report is necessary to confirm that the applicant has fully recovered from the surgery and is completely asymptomatic.
In the case of a history of bowel obstruction, a report on the cause and present status of the condition must be obtained from the treating physician.
This page discussed the Abdomen & Viscera section of the Fight Physical Examination required of pilots.
Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now