The Six Year Authorization

Probably the one thing that pilots fret more about than anything else is seeing their aviation medical examiner to renew a medical certificate.  We’re an aging population with an increasing amount of pathology, and having a medical deferred by the medical examiner for anything is the last thing we want to have happen.  The medical certification process can get really messy in a hurry if a medical application or the physical exam reveals anything that requires additional information for the FAA’s review.  If there isn’t any supporting documentation for the aviation medical examiner to review, a deferral is probably in your future, and that could mean being without a medical for weeks if not months.

Fast forward a bit, past all the frustration of getting information to the FAA, waiting for a decision, and finally getting the medical certificate in hand.  Depending upon the condition, the medical could be tied to a special issuance authorization that limits the duration of the medical and that requires annual or more frequent follow-up testing for continued certification. 

Years ago, AOPA worked with the FAA on an initiative to improve the efficiency of the review and certificate issuance process.  The result of that effort is the Six Year Authorization that allows medical examiners to reissue certificates for about 40 different medical conditions, after the FAA has cleared the case initially. This is a major improvement in the way the FAA does certification because it “decentralizes” to some extent the medical oversight process, and puts more decision-making authority in the hands of the AME.  The pilot, of course, still has to undergo the required testing or obtain the needed reports from the treating doctor annually, but the process bypasses the lengthy wait while the FAA staff wades through the queue of pending cases.

The FAA is still swamped, and as of this post, remains under a mandatory partial shutdown because of the failure of congress to pass funding legislation in light of the pending debt limit crisis.  The writing on the wall suggests that government funding shortfalls will be the rule and not the exception going forward, so FAA medical certification programs will continue to be resource-strapped.

Recently, we’ve seen a spike in the number of members who have one of these Six Year Authorizations (and you’ll know it’s a six year auth because it says that at the beginning of the letter that comes with the medical certificate) but for some reason have chosen to send their records to the FAA instead of taking them to the AME for reissuance.  I’m not sure what’s going on here, but it could be that pilots either aren’t carefully reading those six year letters and don’t know that their AMEs can reissue, even in the off-year when they are not due for an FAA physical exam, or they think that since in the past the FAA reissued their certificates  reasonably quickly, they don’t need to take advantage of the AME-issuance option. Granted, these six year letters are a little complicated to read and understand, and there is language in the letter that states that if the airman doesn’t want to take the records to the AME for an office issuance, they can send the records to the FAA for approval. We strongly suggest that you don’t do that unless you’re not in any big hurry to fly.

If you have a the luxury of a six year authorization, use it, even if you have to pay the AME a few bucks for his/her time to process the records.  For most pilots, the cost is well worth it to be able to walk out the door with a new medical certificate in hand with no lapse in flying privileges. 

Here’s a tip:  If you will be reporting anything new on your next medical application, be it a medical condition, a visit to health professionals, or a new medication, do your pre-medical briefing and know what records you will need for the AME.  If it is something fairly straightforward, like a new prescription for blood pressure medication or a back surgery for a disc removal without complications, the AME may be able to issue your medical in the office if you have the basic evaluation for the condition.  Even if the condition requires a deferral, having good supporting documentation when you see the AME will save you a lot of time and will get you certified faster.  AOPA Online is an excellent resource for medical certification information, and you can give us a call at 800 872 2672 and speak with our medical certification specialists for even more detailed information about your particular situation.

Fly Safe, and fly often!

Gary Crump
Director, Medical Certification Services

AOPA Pilot Information Center  |  AOPA Medical Services Program

26 Responses to “The Six Year Authorization”

  1. John says:


    I am concerned about the creeping hyper-vigilance of the FAA over medical issues with private pilots. The FAA has a mania for pursuing to the nth degree the medical condition of a private pilot. We must list every prescription or over the counter drug, every medical condition we have ever had, however irrelevant or long ago, detailed docotr reports and hospital records, arrests, traffic records, and more, on the application form. Simply listing any of these things (under draconian penalties if not) creates doubt, which then has to be pursued. Then, depending on the whim of the examiner, the application can be denied, or delayed while a lengthy consideration takes place at a higher FAA level. It’s bureaucracy at its worst, where the private pilot is completely at the mercy and good graces of an all powerful bureaucracy.

    Yet, the same person (the pilot) can drive a car or truck anywhere with no such monitoring at all. A sudden incapacity could cause a fatality there too, so why the disproportionate and ridiculously stringent pursuit of medical issues with a private pilot? Are they trying to achieve a risk free world? Can’t the examiner judge whether the person is sound enough to fly? IMO this has accreted over time, as federal bureaucrats need to justify their existence. (the added requirement of a bi -annual flight review is another example, after many years of not requiring it, the bureaucracy needs to do something to justify it’s existence.) It is important to note that the number of fatalities due to pilot incapacity is negligible, a fraction of a percent. This fact alone should trump a lot of the FAA over- zealous action with medical certification. There are essentially infinitely many ways a pilot could injure himself. Any pilot could go to a bar and get drunk before flying for example. Or he might sniff glue. It would be an extremely irresponsible thing to do. But the point is, at bottom, some assumption of good judgment has to be made, that the pilot is not an idiot or suicidal, and will self ground himself when not healthy enough to fly.

    This medical certification issue is a big problem when one contemplates the purchase of a $100,000 airplane. What happens if his medical certificate application fails ? Well, he then owns a useless $100,000 piece of hardware. And under the present FAA medical/legal regime, he has little recourse except to hope the bureaucracy (while taking it’s sweet time) will reverse itself.

    Is there any hope of mitigating this incredibly intrusive aspect of private flying? The LSA category was a step in the right direction, but I would like to see private pilot privileges to have the same medical requirements as that. Understand I am talking about private pilots, who fly for recreational purposes, not commercial for hire or large aircraft commercial pilots. The LSA restrictions are really arbitrary and needlessly limiting in most cases. The class should include most light single engine aircraft. For example, there is nothing more risky about flying a Cessna 172 than any current LSA.

    I would be interested in any thoughts (or actions) the AOPA has on this.


  2. David Hickman says:

    Well said!

  3. James Holland says:

    This is the view of every private pilot I know who has to deal with the FAA class 3 medical requirements. There are no alternatives to the totally irrational, ineffective and absurdly useless rituals we undergo. Medical practices, technologies, treatments and pilot demographics have combined to render the FAA’s approach not only unnecessary but anachronistic.

    Now that LSA has been in existance long enough to generate accident stats, lets ask the FAA to put or shut up on this issue. The one thing that would have the greatest impact on preserving our unique privilage to fly in this county is elemination of the class 3 medical.


  4. Frank Novak says:

    There has long been discussion on the irrational nature of the 3rd class medical given that pilots essentially are required to self-certify every time they step into the cockpit. Further, the record of light sport pilots clearly indicate that operating a light aircraft without beneift of a medical certificate has not resulted in an increase of aircraft accidents caused from medical incapacitation. With all this in mind, perhaps, given the current FAA budgetary situation, this would be an excellent time for AOPA to press the FAA to eliminate the requirement for a 3rd class medical at least for pilots operating under part 91 and perhaps for aircraft weighing less than 6,000 pounds. Saving public funds and exercising common sense. Seems like a practical solution does it not?

  5. Don Arnold says:

    If Light Sport is indeed collecting a higher percentage of the pilots with medical anomalies and if the resulting frequency of accidents are not significantly higher than Private, then I’m on board. At the very least, common things like Prostate should be left out. I’m flying along and, aarrgh, honey, you’re gonna hafta land it, my prostate, arrgghh!

  6. Herbert L Davis, Jr., LCDR USNR-ret says:

    The above responses are right on target so there is no need for me to add my 2 cents. I started flying a Cub on floats in 1936, went on to flying fighters in WW 2 and ASW thereafter, recalled for a year during Cuban missle flying S2F until my retirement in 1971. I have a commercial with single and multi eng land and sea, instructor and instrument, and can’t use it because of a beaurocratic jackass In FAA misinterprated my stress test. I would love to be able to fly my own Ercoupe under LSA but I refuse to go thru a medical every year because of the catch 22. My question is this, has anyone sued FAA to eliminate that catch 22 of using a valid driver license to fly LSA UNLESS one has failed most recent medical. Its high time somthing was done to deregulate one of the most overregulated agencys in government

  7. Dan Barrans says:

    What’s needed to get a six year authorization? Is this something that has to be requested by the airman, or does the FAA decide on their own to do it based on evaluation of the airman’s medical application and supporting medical records?

    • Anonymous says:

      Same question here

      • Anonymous says:

        An airman does not need to request for a six year authorization. The FAA will decide if your medical condition qualifies (the article above mentions approx. 40 conditions). I personally received a six year authorization after reporting treatment for Sleep Apnea. The Medical is renewable by my AME each year but I have to have an annual checkup for the Sleep Apnea prior to applying for my renewal.

  8. Donald Hobel says:

    I just went thru the turmoil of having a medical delayed by an AME that I had never seen previously.
    I had never had an AME make an issue of hearing ability. In this case I was subject to the most difficult of the choices of
    67.305 the tone audiometric test. The AME determined a problem and simply walked away saying I’ll see if I can get a waiver.
    Why is that test even there for 3rd class?
    I never had a chance to discuss. I do not go anywhere radio contact is required. An independent hearing test was requested.
    Positive numbers came back, but the AME insisted all had to go to the FAA.
    I was able to get past Oklahoma City when I became aware of the Eastern Region Medical Office.
    There I was actually able to talk to an analyst. I faxed the hearing report and had my certification by Email next day.
    There needs to be publicity that Regional Medical Offices exist.
    I have submitted complaint of this AME to local and state medical offices

  9. Jack A. says:

    This is just the kind of whining I hear when I go visit my 80 year old mother at the home. You nanny’s need to man up. Sue the FAA? What kind of moron are you? The laws are there for a reason, to keep the skies safe from old deaf, dumb and blind farts like you. just because you’re getting old and can’t see, hear or pee the way you used to is just a fact of life. My suggestion is just shutnup and fly. Why bother with a license or a current medical. I’ve been flying for years and have never been checked. Just keep your mouth shut and don’t tell all you buddies at the Legion hall what you’re doing ;)

    • John M. says:

      You have a problem & BAD attitude! Flying Now without a medical is a perfect example of someone breaking the law.

      This is about experienced legal pilots being able to fly under certain limitations, without being subject to an
      extensive Physical exam.

      We are NOT old deaf, dumb and blind farts like you. I’m 66!

  10. Eugene Paul Letter says:

    With Bladder cancer and high BP contained the six year FAA issuance has been very easy as long as you have documentation and verification from your doctors , Just renewed this July and able to keep myself , family , freinds, and a PA 28 140 flying. Great
    program if you follow the rules

  11. Robert Pizzola says:

    I’ve got a beaut for your consideration. At a recent Class III exam, I got a case of the stupids and told the truth; that being, almost two years prior to the exam, I had been hospitalized for severe bronchitis. The treatment employed steroids and I discovered that I had “steroid induced Type II diabetes”. This means that when I take steroids, I have diabetes, but only when I am taking doctor-prescribed steroids. I put this on my form. Much later, I was told my medical had been revoked for failure to respond to the FAA letter asking for more information. Much later, after trying to explain that I had done no such thing as ignore an FAA letter, I found out they had mailed my letter to an out-of-date address for my Air Force son, who shares my last name only. They then demanded an A1C test (which gives a history going back a maximum of a few months and insisted on this even though I said the incident was, by this time, well over two years old; rendering this test totally pointless. The doctor who resolutely refused to listen to reason was, in my opinion, attempting to punish me for my tenerity in “ignoring” their original request for more data. To him, the returned mail for inability to deliver had no significance. The same for the first one or two follow-on letters returned: unable to deliver. So, basically, I lost a year of flight privilege because the FAA can’t send mail to the correct address of record and a FAA doctor chose to be incredibly obtuse and inflexible. How was this ultimately resolved?… almost physically accosting the top medical official who came to 2009 Airventure as part of an FAA meet and greet opportunity. In relative terms to the screwing I got, the later apology from the Chief Medical Examiner, a doctor who wasn’t personally involved, wasn’t worth a bucket of warm spit. My attempt at an earlier time to get this issue bumped up to him personally was ignored and the inflexible jerk who was responsible for the entire problem was the respondent to my letter requesting he be removed from my case. Let’s hope we can get rid of the Class III medical and remove such people from Class III decision making. Perhaps they’ll be more reasonable on the more stringent medical clearances. Furthermore, FAA medical examiners ought not be permitted anonymity, as all correspondence is attributed to the Chief Medical Examiner who may have no direct knowledge of the specific case. Also, requests for review should be handled by a different examiner or, better still, a panel of examiners.

  12. Harvard Holmes says:

    I agree with most about the lack of necessity of the third class medical.

    To directly address Gary Crump’s observation, I have a six year authorization and sent the paperwork for my interim medical to the FAA simply to save money. As the FAA points out, your AME will likely charge you to process the paperwork, and so he does! $130 or so. The old 6 year authorization allowed data up to 90 days in advance – so I could give them 9 to 10 weeks to process it. The new authorization changed that to 60 days so I have to hustle to allow them 6 weeks to process it. If 4 weeks pass without any hope from the FAA, then I guess I’ll ask my AME if he can fit me in and spend the $130. I had not figured on the FAA budget crisis though. I guess Gary has a point!

  13. I agree with the posts…..seems like a trend with the blog. Overzealous AMEs are also part of the mix. I dread medical approvals. I own my own plane, and that idea of having a very expensive travel device I could not use would be a huge hit.

  14. Vaughn Price says:

    I’m 80 years old, 14000 hrs. Flown 128 different models, owned 2 Part 141 Schools. Quit it all 35 years ago. Took a third class medical july 2010 passed. Drove to Fairbanks. stopped in Seattle coming south, and took an hour in a 7-AC Champ, 2 Hours in a 172 I still knew how to fly. I picked up my mail in so cal and had a Notice from OKC med that They were canceling my Medical because of a slight irregularity in my heart beat. I had My HMO Doctor Write them explaining that as he read part 91 I was eligible for class 3. They wrote back denying that they had revoked my medical But requested a Battery of Heart tests Including Nuclear scans, all very expensive. I passed all. Paid for By HMO. This Process Used Up seven months of my remaining time on this Planet. I received the six year Authorization. Compared To The old CAA The FAA has become a group of Control
    Freaks More interested in International Norms than Helping Americans Fly

  15. Robert J. Carter says:

    Don’t be fooled fellows, the FAA didn’t do senior pilots any favors by establishing the LSA. What they did do was say it’s OK for you old guiys to fly substandard aircraft, “experimental aircraft” that haven’t been through the normal catagory certification process. And therefore can’t be as safe as the C-172 you were flying. And as if that isn’t bad enough they benied all those pilots without medical certificates access to the IFR system. Being forced to fly substandard aircraft with out access to the IFR system is a serious compromise of avaition safety. Is the FAA really interested in safety, this writer doesn’t think so.

    The FAA is trying to manage every pilots health maintenance program from washington. They cann’t do it. They don’t have the mandate, the funding or the staffing to even begin. All they are managing to do is herase whats left of general aviation community. The FAA is like the rest of our goverment BROKEN!

    The FAA sould keep in mind that if they succed in grounding all the pilots, they thenselves will disappear.

    • John M. says:

      You make some good points. Not all of them however. This is about Experienced Pilots being able to
      continue flying for pleassure, the Airplanes they are already qualified in.

      I’ve never had the opportunity to fly an “experimental aircraft”, but they look promising.
      New Certified Aircraft are priced out of the range of middle class people being able to afford or even rent.
      A new 172 cost $200or 300K! a 182 Half a Mill! Even a skycatcher is $110,000+!!!

      Many aircraft that qualify for LSA are quite old. J-3s & DC-3s would probably not meet current certification
      standards. Yet they are 2 of the GREATEST airplanes EVER built!!

      You also need to learn how to spell!

  16. Herb Delker says:

    After 36,000 hhs of flying I know when I am able to fly. I don’t fly when I don’t feel good. I only fly when I feel like I am able to bring the aircraft back to the ground safely. I have flown B747s. Why should I need a Class III medical to fly a 172

  17. Roger Bocox says:

    I have been fighting the EAA Medical staff in OK City for about 8 years now. First they thought I had a fungus, but I was, eventually diagnosed with psoriatic arthritis. My only symptoms ever experienced were ugly finger and toe nails and fingertips being a little larger than normal. My MD put me on Methotrexate in about 1995 and it was reported each 2 years on my new medical report. In about 2004, I was not feeling well. I go to my GP and he said I needed a stress test. Being about 52 at the time, I thought it would be good to get my old ticker checked out. They did the stress test with sonogram, and the results were inconclusive. He rattled off a bank of other tests, and being somewhat frugal (cheap), I did not want to go through a battery of tests to just have them want another test. I asked my GP if there was a gold standard for heart issues and he said that an angiogram was the best you could do to find out the condition of my heart. I reported this test at my next AME exam. Stupid me. The results of the angiogram were that I had a really small blockage that was nothing to worry about about 5% or less in one artery. The heart guy said I was normal and in great shape for a guy my age. My heart was fine. This showed up as a big red flag with OK City. I lost my medical for about 6 months as we went back and forth with more tests, reports, etc. etc. etc. Basically, I think OK City thought a bank of heart surgeons were either lying to them or just incompetent and that OK City knew more than they did. This issue finally went away, the surgeons finally convinced OK City that my heart was OK.and guess what? I was issued a conditional medical for 6 years. What for? My heart? Heck no. It was because I was taking methotrexate, which was previously reported for many years, and isn’t even on their list of prohibited medications.

    Now the plot thickens. I finally got my medical from the FAA in OC City, but it was for the same time as my old medical certificate. It expired in 10 days. Fighting the FAA is not easy. I contacted my local Congressman, Leonard Boswell who was on Aviation subcommittee and he was a big help dealing with the FAA. Thanks Leonard. I emailed him my a picture of the new certificate and the old one, and they were identical. He made a phone call to the FAA, and immediately, I got a new medical certificate in the mail. I got a big SORRY from the FAA saying they screwed up. I was issued the 6 year conditional, and they cited the reason was because I was taking methotrexate. I haven’t taken that medication in over 2 years. I just received a letter today in the mail from the FAA stating that my 6 years is about up and they want to keep me in the system for another 6 years, with no justification, except citing some FAR that don’t even apply. I am tired with putting up with the garbage coming out of the FAA medical department. I am going to get my congressman, and senator involved, write letters, and even document this in magazine articles if I can get someone to publish the story. I am tired of dealing with overbearing beaurocrats that appear to work on the philosophy that once they get into their system, there is about no way they will ever let you out. I plan on being a big thorn in their side until this is resolved to my satisfaction. Satisfaction to me is to get back on a regular 2 year class 2 schedule. They have no justification for doing this to me. And the really wonder why people lie on their medical applications! Amazing!


    • John says:

      The 3rd class medical can be shown to be a absurdly disproportionate risk mitigation, in terms of cost/benefit ratio . Consider this: It is estimated that outright pilot physical incapacity is responsible for about 1% of general aviation deaths. But, let’s be pessimistic, and say 5% of GA deaths are from pilot physical incapacity. Since there are only about 600 total deaths in all of GA per year, that works out to 30 deaths a year due to pilot physical incapacity. To put that in perspective to other risks, consider that about 50 deaths a year are due to lightning, 400 per year from falling out of bed! (should we have federal bed inspectors?), 740 from bicycle accidents (do we need federal regulation of bicycles ?), 565 from falls on level ground or floors (federal walking instruction anyone?), etc. etc. And of course there are 40,000+ per year deaths in automobile accidents. But if we stick to the 1% figure for GA deaths, then there are 6 deaths a year due to pilot physical incapacity! Does either figure warrant a federal bureaucracy administering the 3rd class medical ? There are innumerable other causes of death with far greater fatality numbers than due to GA pilot incapacity. The number of fatalities due to pilot incapacitation are truly infinitesimal when compared to other causes of death. When these relative statistics are seen in perspective, the obvious absurdity of the hyper-zealous medical 3rd class exam can be seen. Having an entire federal bureaucracy to harass private pilots with the 3rd class physical is a huge mis-allocation of time and tax-payer money as well as an infringement on our freedoms.

  18. Dennis says:

    i don’t understand why the proposal by the aopa only lets one passenger in day vfr. Most recreational flying is done day vfr, and by allowing one passenger you are already accepting the risk (if there even is one) of potentally harming a non pilot. What makes a difference if one or two more are willing to accept that risk? Most single prop planes are three seaters due to weight anyway. I think the aopa stopped just short of a great proposal.

  19. Edward says:

    I just recently got my six year and even call aeromedical to do a status check. They were real helpful and courteous. Don’t be afraid to call them. Anyway I got it and my third class plan to upgrade to a second in the near future so I can train for my commercial certificate. I must say my faith has been restored because it took me 10 years to run into the information and use it to get back in the air. Boy what a view!!!

  20. Alice says:

    I totally agree with getting rid of the 3rd class medical. I drive commercially and have never failed a physical which I must take every 2 years as well. If I can drive a tractor trailer or charter bus safely, I think I can fly a cessna 172. If I drop dead in a loaded charter bus, I have up to 56 passengers plus whoever I hit. I think the FAA would be happy to have me fly as even if I die in the plane at most a handful of people are at risk. I have personally had the experience of dealing with OKC as at one time I had sleep apnea. I was treated surgically and am fine. I have the sleep study to prove it, but it still took months to get retired medical records and submit them. Same problem with cataract surgery. I see fine but cannot focus up close also a problem with older people. I use cheater glasses and no problem. Needed records for that too. Whats next full body cavity search? Time to stop fretting about a non existent problem and concentrate FAA resources on those that fly for a living. I could pass and get an ATP cert if I wanted one, but I don’t so why should I have to kiss up just to fly light planes?

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