VA Disability – Part 2

Welcome back to Part 2 of our series about VA Disability benefits. If you haven’t seen it already, go back and read Part 1 for important context before you dig in here!

In Part 1, we looked at why each and every pilot in the military is expendable. The government acknowledges this and planned to pay you disability benefits long before you’d even agreed to serve. Taking these benefits does not mean you’re mooching off the system. It means that you’re doing the most American thing possible – abiding by the terms of a voluntary contract you signed with the government when you entered military service.

My conclusion from Part 1 is: there is no moral reason why you shouldn’t apply for VA Disability benefits.

As clearly as I believe I made that point, many pilots still worry that taking these benefits could affect their flying careers after the military. In one obvious and recent example, The Department of Justice levied federal charges against four major airline pilots for failing to properly disclose information about their VA Disability benefits on applications for FAA medical certificates. As you might expect, these charges cost the pilots their jobs (at least temporarily) and their ability to fly at all in the United States.

Today we’re going to look at why those pilots got into trouble. Then we’re going to take a look at the actual requirements for holding an FAA medical certificate. You’ll see that the requirements are generally pretty broad, leaving a lot of room for VA Disability diagnoses without having to sweat anything at all. For context, we’ll also look at the FAA’s perspective on medical clearance for some other types of flying. When we put all this together, I hope you’ll see that there are very few VA Disability conditions likely to jeopardize a military pilot’s FAA medical certificate.

I confirmed any big-picture statements here with my Aviation Medical Examiner (AME) before writing this article. I’m leaving him anonymous for this post, but I will recommend another fantastic AME I know whom you can use to ask questions.

Table of Contents

  1. How to Guarantee Trouble
  2. FAA Medical Requirements
  3. Disqualifying Conditions
  4. A Waiver For Everything?
  5. Recreational Medical Requirements – For Context
  6. VA Disability vs FAA Requirements
  7. Real-World Tactics
  8. Conclusion

How to Guarantee Trouble

First off, let’s look at the poor airline pilots who got into a world of hurt over their VA Disability claims.

If you read the actual charges on the DOJ announcement, you’ll see that none of these individuals got in trouble for flying with a specific medical condition. All of the charges in this case related to making a false official statement on a government form, and/or trying to hide information.

Don’t you wonder why the DOJ decided to dig deep enough into pilot medical records to levy charges against four pilots?

I picture a couple of flunkies who work at some Attorney General’s office on a business trip. Over a beer at the airport bar one comments to the other, “Did you see the pilot on our last flight? That dude was so fat I sincerely doubt he’s capable of pulling the yoke to the aft stop.”

Lawyers with time on their hands. One of the reasons you need to be upfront about your medical history on FAA forms.

“No kidding. That guy is a heart attack waiting to happen. Isn’t the FAA supposed to set standards for cardiovascular fitness?”

“That’s a good question. We should dig into this a bit when we get back to the office. Maybe we could win some brownie points with the boss by providing her grounds to start a high-visibility witch hunt!”

In the ensuing investigation, our intrepid flunkies realize that many military pilots receive VA Disability benefits before moving on to the airlines.

“Hey man, what do you think are the odds that at least one pilot failed to fully read the instructions on this FAA Form 8500-8 and didn’t properly report everything for which he’s getting VA Disability payments? We have access to all of that data. I bet you $20 we can find at least one.”

“F— that. I bet you $100 we can find at least four.”

The sad truth is that if these pilots had accurately reported the conditions for which they were receiving VA Disability benefits on their FAA Form 8500-8, they’d probably have kept their jobs and prevented hundreds of thousands of dollars in lost income and legal fees.

The moral of this story is Read the [Fine] Instructions when filling out a form, and then follow those instructions. In the case of the FAA Form 8500-8, those instructions comprise a 36-page long PDF. If you’re like me, reading the instructions is the last thing you’re thinking about the morning of your medical exam when you wake up and realize that you procrastinated filling out the form until it was almost too late. However, if you have anything in your medical history that could cause a future issue, you absolutely need to put sufficient attention into this form every time you fill it out.

Let’s take a look at a part of that form:

Notice the all-capital letters for: “HAVE YOU EVER IN YOUR LIFE BEEN DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE ANY OF THE FOLLOWING?”

That’s pretty cut and dried for me. A VA Disability rating for a given condition counts as a “DIAGNOSIS” and should be reported on this form. As we’ll see shortly, answering “yes” to an item here is not the end of the world in most situations. Even if it is an issue, there are ways around things.

The pilots in our recent example didn’t lose their jobs for reporting a medical issue, they got in trouble for checking “no” here when they shouldn’t have. Your first step to preserving your long-term career is to answer this form truthfully.

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FAA Medical Requirements

If you’re concerned about a VA Disability diagnosis affecting your civilian flying career, your first step should be to read the Federal Aviation Regulation on the subject, 14 CFR Part 67. Although this regulation seems daunting to read, it’s actually not that bad. If you’d like to skim the highlights, the FAA has a 1-page PDF guide (cheatsheet) intended for Aviation Medical Examiners summarizing the requirements from Part 67. Here’s a screenshot from part of that guide:

Although this regulation is filled with a lot of medical jargon that I’m not smart enough to understand, the basics are very straightforward. At the most basic level, the FAA’s standard for determining whether a condition diagnosed as part of the VA Disability process affects your FAA medical certificate is to ask whether that condition prevents you from meeting these standards. If the answer is “no” then they have no reason to deny you a medical certificate.

We’re going to cover some caveats before discussing applications of this principle. However, I feel like an example is useful at this point. I have a 10% VA Disability rating for Gastroesophageal Reflux Disease, or GERD, because the VA determined that my propensity to get heartburn is “service-related.” I reported this to the FAA on my Form 8500-8 when I applied for a Class 1 medical while applying for airline jobs.

At the time, I took some medication for the condition. On my application, I noted that the condition was controlled through medication and diet. I’ve since stopped taking the prescription medication and found that I can control the condition with diet and the occasional OTC antacid. I’ve reported that change to the FAA, but ever since my explanation for checking the “yes” box on this condition has been the FAA-prescribed: “PREVIOUSLY REPORTED, NO CHANGE.”

If you look up at the “ENT” section of the FAA’s standards, you’ll understand why the FAA has never called me for more information. My condition is not “manifested by, or…reasonably be expected to be maintained by, vertigo or a disturbance of speech or equilibrium.”

Done.

Easy, right?

Yes, but there’s certainly more to it. Let’s look at the very bottom of the FAA’s standards and consider the list of no-go items.

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Disqualifying Conditions

Although you can have a lot of conditions without getting anywhere near the limits of the FAA’s standards, there are a few items that just aren’t allowed:

I hope you don’t suffer from any of these, but can we understand why most of these are too much to ask…at least when it comes to carrying passengers for hire? Diabetes and major cardiovascular issues have a tendency of going from “just fine” to “100% incapacitated” in a very short about of time. The infamous crash of Germanwings 9525 explains pretty well why the FAA won’t clear pilots with certain mental conditions.

One of the sad things about several of these conditions is they’re mostly preventable. Although there are certainly genetic and environmental factors to consider, things like artery damage, heart attacks, and other forms of heart disease don’t happen overnight. They develop slowly, over a long time and are heavily influenced by our diets and exercise…or lack thereof.

If you don’t want one of these issues to threaten your family’s livelihood a few decades from now, your best bet is to eat right and exercise now. If you think you’re at risk for heart disease later in life, make sure you start getting treated by your military doctors now. There are plenty of very diagnosable steps along the road to heart disease that can be documented and treated long before your issues become “clinically significant” enough to cost you your medical certificate. This point has some important implications we’ll get to later.

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A Waiver for Everything?

In military aviation, we like to say that “there’s a waiver for everything.” In many cases, it takes a lot of stars on your shoulder and/or a tremendous amount of pull with someone important to get a waiver. However, I’m saying there’s a chance.

Although I like to joke that “FAA” stands for Federales Against Aviation, I find that their overall philosophy is they want to find ways to keep pilots flying. If you have a condition that might otherwise disqualify you from obtaining a medical certificate, it’s possible to petition the FAA for a “special issuance” – the civilian equivalent of a waiver.

The special issuance process can be lengthy and obnoxious, but it’s not at all uncommon. There are even flight docs who specialize in consulting for pilots who need a special issuance. (I’ll explain shortly why I think the Aviation Medicine Advisory Service (AMAS) is a great resource for a pilot in a tough situation.)

One of the most important things about any waiver process is that it’s a data-gathering tool. The FAA watches advances in medical science and the results that come from special issuances they’ve given in the past. They recently announced a protocol that can allow pilots with diabetes to obtain a Class 1 medical certificate and work as airline pilots. (Yes, this condition is #1 on the list of “Disqualifying Conditions” I posted. That list was last revised in 2006.) This new protocol was based largely on the FAA deciding to let private pilots obtain Class 3 medicals for the last couple of decades, and seeing positive results.

If you have a condition that you think might be an issue, the best thing you can do is talk to a civilian flight doc who specializes in helping people in similar situations. We’ll get into the tactics of that shortly. For now, let’s look a little closer at the idea that the FAA wants to keep you flying.

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Recreational Medical Requirements – For Context

The FAA’s standards for Class 1, 2, and 3 medical certificates are fairly specific and stringent. They make sense given the liability concerns of carrying passengers or cargo for hire. However, even the FAA is willing to admit that it’s possible to safely fly an aircraft under far less stringent standards. Let’s look briefly at three other levels of FAA medical flying approval:

Glider Pilots

Flying a glider never requires any type of medical certificate. Here’s the statement from the FAA’s own website:

“To be issued Glider or Free Balloon Airman Certificates, applicants must certify that they do not know, or have reason to know, of any medical condition that would make them unable to operate a glider or free balloon in a safe manner. This certification is made at the local FAA FSDO.”

Aren’t those standards what Part 67 is really trying to get at? The FAA is just trying to make sure pilots don’t have any “medical condition that would make them unable to [fly]…in a safe manner.” They publish the guidance in that part to quantify some standards, but they also grant special issuances when they believe a pilot can meet this standard.

You may be tempted to think of glider flying in terms of simple, cheap aircraft. However, the top end of the soaring community involves aircraft in the $150,000 – $200,000 range. These aircraft routinely fly hundreds of miles in a day, and there’s a thriving worldwide glider racing circuit. Many gliders have motors and can cruise just like any other airplane. Aircraft like the S10 and S12 series from Stemme AG are arguably more capable and more challenging to fly than even the fanciest entry-level Cessna. (It has a 75’ wingspan, a 50:1 glide ratio, retractable gear, electric flaps, spoilers, a folding propeller and movable nosecone, and it’s a taildragger.)

The Stemme S10 is a serious and capable airplane…and no medical is required to fly it.

The fact that the FAA is happy to let pilots fly such complex aircraft with no medical certificate whatsoever tells me that they are at least realistic in their ultimate understanding of what types of conditions are safe to fly with.

(I’ll take a second here to note that if you were to find yourself the victim of one of the disqualifying conditions listed above, glider flying may still be an option for you both personally and professionally. As long as you and your regular doctor agree that you’re safe to do it, you can fly gliders for fun, you can race them, you can do competition aerobatics, you can give rides, and you may even feel comfortable teaching. No, it’s not airline flying. You’ll make less money, but to be honest, it’s a lot more fun than airline flying in almost every way.)

Sport Pilots

One level up from gliders is the FAA’s Sport Pilot Rating. Though Sport Pilots are restricted to non-commercial flying in relatively simple 2-place aircraft, the FAA only requires 20 flight hours to earn this rating. For this rating, a valid US driver’s license takes the place of a medical certificate. As long as you have one, you can fly…though you must adhere to any restrictions on your license while flying as well. (I’ve only ever heard of “must wear glasses” or “no driving at night,” though I’m sure there are others.)

The most impressive example I’ve seen of taking the FAA at its word here is a pilot named Jessica Cox. Despite being born without arms, Jessica exercises her privileges as a Sport Pilot to fly as Pilot in Command of her own, unmodified Ercoupe (including solo flying.)

Jessica Cox sitting on her Ercoupe. She’s a fantastic example of overcoming difficulty to live a great life. She’s also evidence that the FAA is willing to work with pilots who can demonstrate an ability to fly safely.

This is an impressive and inspiring story in and of itself. It also does a great job of showing that the FAA is willing to let pilots fly as long as they’re capable of safely operating their aircraft.

Basic Med

Thanks to the success of the Glider and Sport Pilot medical programs, the FAA came up with a new rule in 2016 called BasicMed. Sport Pilots are limited to day, VFR flying in small single-engine aircraft. BasicMed allows a pilot to fly aircraft up to 6,000 pounds and 6 seats in VFR and IFR conditions, up to 18,000’ and 250 KIAS. (Like Sport Pilots, flying under BasicMed is limited to non-commercial operations.)

The requirements for BasicMed are a little more involved. You have to do regular online training and get periodic exams with your doctor, though that doc doesn’t have to be an AME.

I’m a tad disappointed that the BasicMed requirements are a bit convoluted and onerous. However, I think this setup helps make the point that the FAA is increasingly interested in letting pilots fly as long as they can demonstrate the ability to do so safely.

Now that we have this context, let’s talk about balancing VA Disability against getting an FAA medical certificate.

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VA Disability vs FAA Requirements

Up to this point we’ve shown that the FAA’s Class 1 and 2 medical requirements are relatively broad…in a good way. There are a few issues that could cause pilots trouble, but most of them are preventable. If it’s too late for that, the FAA still considers special issuance for those pilots who can document an ability to operate safely with their condition. We’ve also shown that the FAA seems to be predisposed to letting pilots fly.

My AME noted that special issuance of a medical certificate can include conditions that are treated by the ongoing use of medication, in some instances. This may require switching to a medication that the FAA is more comfortable with, but that’s still a potential win for a pilot like you and me.

So, first and foremost, I assert that most conditions that qualify for some level of VA Disability won’t cause you any issues with the FAA at all. I would feel confident about pursuing a Disability claim for these conditions.

Do you have knee issues from all the running you do for the USAF’s embarrassingly silly PT test? Do you have a bad back from flying in terrible ejection seats and/or pulling lots of Gs? (When I was in the 34th Bomb Squadron, a few of my WSO buddies had to get back surgery immediately after their first deployment due to the B-1’s terrible ergonomics.) I don’t see any reason that these conditions would impact your ability to get an FAA medical certificate.

Seats like this are carefully designed to do many things. Preserving your long-term back and joint health is not one of them. I almost can’t imagine a pilot logging 1000+ hours in seats like this and not having back problems.

Has exposure to loud engines, firearms, artillery, and other equipment for extended periods of time impacted your hearing? As long as you can pass the FAA’s hearing test, there’s no reason why claiming some hearing loss with the VA should preclude you from having an FAA medical certificate.

Have you spent months of your life deployed next to burn pits where the US government incinerated garbage and human excrement because it was cheaper and more convenient than building a landfill or sewage treatment plant? Have you noticed respiratory issues since that time?

I believe that each and every one of us should make sure to document these types of conditions and apply for our related VA Disability benefits. This is a very easy answer in my mind.

Remember from Part 1, VA Disability is awarded based on any evidence of a service-related impact. It’s a cold, mathematical calculation of your lifetime healthcare costs, with the expectation that the impacts on your health will probably increase over time. If your symptoms ever get bad enough to preclude your ability to safely fly an aircraft this could impact your FAA medical certificate. In the meantime, as long as you meet the standards you’ll be good to go. The FAA isn’t going to take away your medical certificate, or your birthday, as long as you don’t lie to them about what your VA Disability rating is for.

We can also get to some tougher situations. Did the high-pressure environment and constant grind of military aviation leave you with some anxiety or depression? It’s possible that these could count as a “personality disorder that is severe enough to have repeatedly manifested itself by overt acts.” However, when I see phrases in here like “severe,” “repeatedly,” and “overt acts” I feel like there is a lot of room to treat these conditions in a way that doesn’t go anywhere near the FAA’s standard for “Disqualifying Conditions.”

Now, there’s certainly some gamesmanship to approaching conditions like this. Let’s have that discussion.

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Real-World Tactics

First and foremost, we at BogiDope recommend that you report all physical and mental health concerns to your physician and get proper treatment! Don’t go untreated to avoid documentation so that you can get an FAA medical certificate down the line. Your long-term quality of life will suffer more from leaving a bad condition untreated than it will from any presumed (though perhaps unrealistic) expectation of impact on your flying career.

That said, it’s definitely worth thinking about how and when you get things documented.

As I mentioned, there are a lot of issues that start off small and only get big if we let them. You’re far better off going to your military flight doc for treatment of conditions early-on.

If, at any point, you’re in doubt about whether documenting a condition will cause you problems later, then ask someone! The airline application process is very frustrating, in part, because there’s a distinct lack of reliable information. The FAA Medical process is not like that. There are AMEs and companies who specialize in consulting or advising on aeromedical issues. Many of them will charge you some money for their time, but I promise that it’s money well spent!

If I needed to consult one of these services, one of my first stops would be Aviation Medicine Advisory Service, or AMAS. My recommendation is based on my personal interactions with Dr. Quay Snynder, the company’s president. As a USAF O-6, Doc Snyder was one of the only flight docs to be Combat Mission Ready in the F-16C. He’s also a CFI and Designated Pilot Examiner for Gliders. Doc Snyder was a reservist while I was a cadet glider IP at the USAF Academy. He frequently flew with us and had permission from the FAA and USAFA to give us free FAA checkrides. I earned my Glider Private, Commercial, and Flight Instructor ratings with him.

Doc Snyder lecturing about pilot safety issues at the Air Line Pilots Association (ALPA) Leadership Conference in 2012, as shown on C-SPAN.

Doc Snyder is a wonderful person to fly with. He is a pilot advocate who enthusiastically spreads his love for aviation and works tirelessly to help others share that enjoyment. If you’ve spent any time lately on the Black Forest Soaring Society’s Facebook page, you’ve seen that he’s still giving checkrides on a regular basis.

I can’t speak for his methods now, but the oral exam portion of his checkrides used to consist of him buying dinner for the examinee, and quizzing aviation knowledge over excellent Chinese food.

Doc Snyder’s company, AMAS exists for pilots like you and me to ask our questions about potential medical issues before having to report them to the FAA or even document them in our military medical records. They’ll help you figure out the best ways to get the treatment you need while protecting your flying career.

Further down the line, they also specialize as an interface with the FAA for pilots who need a special issuance medical certificate. They’re well-known by the FAA’s medical department in Oklahoma City. AMAS can help you determine what testing or documentation you need to justify a special issuance, and then help you gather and submit all the paperwork.

Based on my personal knowledge of Doc Snyder, I wouldn’t hesitate to call AMAS for help on either side of that equation.

Another part of balancing VA Disability with FAA medical is to be conscious about the VA Disability benefits you apply for.

When you prepare to leave full-time military service you’ll attend a Congressionally-mandated class called the Transition Assistance Program, or TAP. Unfortunately, it’s an embarrassingly silly waste of time for most pilots who plan to continue working as pilots. However, one of the useful briefings will include a rep from the veteran’s support organization who helps you fill-out and submit your VA Disability application.

These people are frequently volunteers, and their hearts are absolutely in the right place. They want your family to receive all the benefits guaranteed by your military service contract. They’ll tell you to claim absolutely every possible disability-qualifying condition you can think of. It’s important to realize that these people are not pilots and that they have almost no understanding of our career field. Beware of these helpers’ enthusiasm. Don’t let them talk you into claiming a condition that you may be able to justify, even though it may only be peripherally related to your military service or future needs.

As an example, the rep at my TAP class had the entire group convinced that they needed to claim VA Disability for PTSD. Although PTSD is a serious issue that needs to be treated, I suspect it’s relatively uncommon for many pilots like us. Although it’s possible to obtain an FAA medical certificate with PTSD, there is a process involved. It’s not worth going through that process if you have an honest expectation that PTSD won’t significantly impact you in the future.

Having a VA Disability rating comes with many benefits, not the least of which is a monthly check. However, neither that check, nor the other benefits are so impressive that they’re worth giving up an airline career for. If you’re debating whether it’s worth claiming VA Disability for a given condition, it may be worth leaving off your claim. In my experience, most of us get enough wear and tear over the years to justify a decent rating, even if we leave some things out.

If I were going through TAP again, I’d take the time to consult an AME or a company like AMAS before submitting my VA Disability application. They could definitely help run this cost/benefit analysis.

Note that choosing to not claim a condition on VA Disability doesn’t mean that you can’t be treated for it. It also doesn’t absolve you from reporting it to the FAA if you’ve been diagnosed with it in the past.

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Conclusion

There’s a lot of leeway for obtaining an FAA medical exam despite having pre-existing medical conditions. Many of the items that could be claimed with the VA should have no impact whatsoever on the ability to obtain an FAA medical. Despite horror stories you may have heard, the FAA really is interested in keeping pilots flying.

As long as you’re mindful about the conditions you claim and the way you do so, there’s a good chance you’ll be able to obtain an FAA medical certificate with most disability conditions. If you’re in doubt about the impact of addressing a particular medical issue under any circumstances, with your military flight doc, a civilian doc, or the VA Disability system, you should not hesitate to consult with an AME or a company that specializes in helping pilots like us.

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< Part 1 | Part 2 | Part 3 | Part 4 >

 

Image Credits:

This post’s feature image eye exam is from: https://www.dvidshub.net/image/3676106/20-20-readiness.

The shot of DOJ lawyers causing trouble for pilots is from Showtime’s excellent program “Billions.” I found the pic in this article on thrillist. If you’re looking for something interesting to watch while you’re on a COVID-19 layover, you could do a lot worse than Billions.

The Stemme S10 picture is from here: https://commons.wikimedia.org/wiki/File:Stemme_S10_(8736172304).jpg. The Stemme AG website has some even better pictures. I have a request in with them and this picture may change. Check back!

The photo of Jessica Cox in her Ercoupe is from her website: https://www.jessicacox.com/gallery/#gallery-1.

The ejection seat installation is from: https://www.dvidshub.net/image/3458044/egress-last-chance-life.

Doc Snyder’s C-SPAN appearance is from C-SPAN2: https://www.c-span.org/video/?307494-4/air-line-pilots-top-safety-issues&event=307494&playEvent. You can watch his actual lecture on that website.

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