What exactly is a special issuance?

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comanche

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Comanche
I have sleep apnea and for the last 6 months have completed (I hope) all of the stated requirements the FAA has determined necessary to once again have the medical authorization to fly. The documentation has been received by the FAA and now I am in a holding pattern while my situation is evaluated.

I looked on the AOPA site and under Sleep Apnea and their blurb indicated that if the patients condition improves (mine has) and no longer requires certain medications that a special issuance can be given.

What is a special issuance? Does this come with tighter restrictions than a clean medical? Who is eligible to issue one? As I am older than 40 I realize a 3d class is good only for two years. Does the Special issuance reduce that time frams even more? I have had the privilege to discuss my situation with Doctor Bruce, but at the time we communicated, I was not aware of a special issuance.
 
An SI is essentially the FAA making an exception - a pilot has a disqualifying condition, but the FAA allows the pilot to get a medical anyway as long as the pilot follows specific procedures. Many SIs need to be renewed annually to keep the medical current, but the medical itself stays on its normal schedule. Some SIs can be issued in-office, others can be issued with a phone call, still others must go through FAA.
 
Matt, Thank you. If the FAA considers my situation acceptable to allow me to fly with OSA, does that automatically mean all pilots diagnosed with OSA and have documentated improvement get a Special Issuance or do they ever grant those with OSA a clean medical?

This is all new to me.
 
If you are completely healthy the authority to issue you a medical cert. comes from one reg, but a special issuance comes from another reg, that of the authority of the federal air surgeon to determine that despite your condition, you can document equivalent safety. That means both now and to the end of your "medical certification".

For Sleep Apnea, you have to demonstrate at the beginning, and annually prior to renewal, that your CPAP is working and that you use it.

(1) Airman appears well rested: subjective.
(2) No excess tendancy to fall asleep (epworth evaluation)
(3) Are compliant with therapy: Printout from the CPAP machine.
(4) No evidence of right heart failure (a late complication of untreated sleep apnea), on physical exam if the doc is willing to state, or some docs require a cardiac Echo to say that.

They require the split sleep study record, or if it wasn't done in a "half to diagnose, half to setup treatment" manner, a Mandatory watchfullness test; the compliance (use) record, and the doc's statement for the rest. Non sleep (pulmonary or neurol) MDs have a terrible record of not being able to "write the talk" and those letters get generally spekaing, rejected.

Annually you need to submit the doc's letter and the compliance printout. they want 75% of nights, 6 hours of usage or more, though thy will accept 4...but not 3.9, seriously.

The medical exam is done 2-yearly for third class, but the certificate only lasts a year to enforce your sending in the reports.

You only are allowed off the SI if after three year off of CPAP your letter is still good, and you've lost the weight and kept it off. If you do, you can go back to the two year cycle on a "Letter of eligibility" for normal third class certification.
 
It's where you're too screwed up to hold a medical without supervision greater than the normal spec calls for but not so screwed up that you need to be denied a medical altogether.
 
Wow!

Thank all especially Dr. Bruce for that detailed explanation. I am so happy that our government goes such great lengths to protect its citizens I think.

On a more positive note, I am lucky to have such a fine physician in Dr. James Curlee owner of the Gerogetown, TX Sleep Center. He is tops both for my health and for
understanding the "correct verbiage" required by the government for this procedure.

I should get my answer in a couple weeks hopefully.
 
There's a few of us on the board with an SI for OSA. I've had one for ... hmmm, 14 years now? give or take a few...
 
gkainz said:
There's a few of us on the board with an SI for OSA. I've had one for ... hmmm, 14 years now? give or take a few...
Click to expand...

I'm also part of the nose hose Squadron
 
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