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Cardiovascular

Miscellaneous

(Includes Endocrinopathies, fi :

etc.)

Neuropsychiatric

Eye

Abdominal

Ear, Nose, Throat

Bones & Joints

Respiratory

Muscles

FIGURE 6. CAUSE

7 33.1

28.3

Jo.3

Annual Rates per 10,000 Applicants

FOR APPLICANT DENIAL

BY MAJOR BODY SYSTEM, 1975-1!976.

20


CHARACTERISTICS OF MEDICALLY DISQUALIFIED
AIRMAN APPLICANTS IN
CALENDAR YEARS 1975 AND 1976

Introduction.

The Federal Aviation Administration (FAA) and its
predecessor, the Civil Aeronautics Administration, have been
charged with the responsibility for medical certification of
all United States and some international civil airmen since
1927. Except for certain categories of airmen such as
glider and balloon pilots, each airman must hold a current,
corresponding class of medical certificate for performing
the duties of any pilot certificate he may possess. Federal
Aviation Regulations stipulate that a first-class physical
examination must be performed at 6-month intervals for
duties requiring an air transport pilot certificate; a
second-class physical examination must be performed
annually for duties requiring commercial pilot certificates,
an air traffic control tower operator certificate, etc; and,
a third-class physical examination must be performed at
2-year intervals for duties requiring a private pilot
certificate. Different medical standards apply to the
different categories of medical certification.

Medical certification criteria will continue to change
as a result of the evolution of aviation medicine and
increased efforts in the area of aeromedical research.

Previous studies (1,2,3) that provided descriptive
data concerning airmen who were denied medical certifica-
tion have proved to be of great value. Numerous questions
have been answered for the FAA and the aviation community
concerning these airmen. Comprehensive data reflecting
pertinent denial rates with respect to the medical and
general attributes of those airmen denied medical certifica-
tion are needed for program monitoring with respect to
workload information, aeromedical standards, appeal system
appraisal, research direction, and risk determinations by
the aviation community. Of course, the primary purpose
of these efforts continues to be the promotion and
enhancement of aviation safety through medical program data
analysis. .

This study provides comprehensive data reflecting
pertinent denial rates with respect to the medical and
general attributes of those airmen denied medical certifica-
tion in calendar years 1975 and 1976. Comparisons to 1973-
1974 findings are also made. Also provided are such
descriptive epidemiologic data as age, sex, occupation, class



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Iv.

This group is essentially purged of any disease prevalence that
contributes to higher rates for other groups. Also, due to
occupational reasons, these individuals are less likely to
voluntarily remove themselves from follow-up observation for
known medical conditions which would preclude FAA medical
certification.

Conversely, voluntary attrition is a frequent occurrence
among non-occupationally connected airmen who recognize that
they are not medically qualified and, therefore, are never
heard from again by the FAA.

Annual age-specific denial rates increase to the highest
rate of 242.2 per 10,000 applicants at the age interval
55-59 (see Table 8). See Figure 8 for the age distribution
and average age of denied airline pilots.

The most significant causes for denial are cardiovascular,
the miscellaneous category, and neuropsychiatric, with denial
rates per 10,000 airmen of 23.3, 14.9, and 10.1 respectively
(see Table 8 and Figure 7). The importance of these categories,
particularly over age 45, is again recognized.

Summary.

This study of CY 1975 and 1976 applicants has provided
comprehensive data reflecting pertinent denial rates with
respect to the medical and general attributes of those airmen
denied FAA medical certification. A similar study is planned
every 2 years to monitor any changes in the epidemiologic
findings concerning denied airman applicants.

As of December 31, 1975 (the midpoint for the denied
applicant group), there were 763,793 active certified airmen.
In CY 1975 and 1976, 12,112 airman applicants were denied
medical certification, resulting in an overall denial rate
of 7.9 per 1,000 applicants. By class of certificate applied
for, the denial rate was 4.5, 6.0, and 10.2 per 1,000
applicants for first-, second-, and third-class respectively.

As expected, the mean age of the denied airmen group
was higher (by 6 years) than the mean age of the active airman
population group but was consistent with previous findings.
Age-specific denial rates for the younger age intervals
were higher than for the 30-34 and 35-39 age intervals. This
can be attributed to new applicants not having been previously
screened by the FAA. At the 40-44 age interval the denial
rates start upward, with the highest overall rate at the
70-and-older interval.

23



F. Medical Characteristics of Denied Airmen

Tables 6 and 7 and Figure 6 provide annual cause-specific
denial data, per 10,000 applicants, by class of medical
certificate applied for and sex. In Table 6, one can
observe an increasing denial rate for third-class over
second-class and for second-class over first-class. This
is also true for the cause-specific rates except in the ear,
nose, throat, and mouth, and neuropsychiatric categories where
the second-class rates are larger than the first- and third-
class rates; and, first-class rates are larger than the second-
and third-class rates in the bones and joints category. The
most significant causes for denial (regardless of class
applied for) are cardiovascular (with an annual denial rate
of 33.1 per 10,000 applicants); the miscellaneous category,
which includes endocrinopathies, general systemic conditions,
use of disqualifying medications, and administrative denials
for failure to provide additional medical information (with
an annual denial rate of 28.3 per 10,000 applicants); and
neuropsychiatric (with an annual denial rate of 19.4 per
10,000 applicants). Eye pathology is next in importance at
a substantially lower rate. These findings are essentially
the same as the findings of the study of 1973/1974
applicants (3).

Administrative denials for failure to provide additional
medical information represent a large portion of the denials
in the miscellaneous pathology category. Of the 4,318
denials in this category, 1,496 or 34.6 percent were for
failure to provide additional medical information.

As shown in Table 7, cause for denial by sex indicates
that males were most frequently denied for cardiovascular
reasons, second for miscellaneous causes, and third for
neuropsychiatric reasons. Females, however, were most
often denied (40 percent) for miscellaneous causes (the
majority of denials in this category were for failure to
provide additional information), followed by neuropsychiatric
reasons, then cardiovascular reasons. These findings are
the same as in the previous study of 1973/1974 applicants (3).
However, for all denied applicants, four pathology categories
(cardiovascular, miscellaneous, neuropsychiatric, eye)
account for more than 90 percent of all denials.

The female population also experienced a higher overall
denial rate (99.8 per 10,000 applicants) than did the male
population (93.4 per 10,000 applicants).

G. Airline Pilot Data

Observations of the airline pilot group probably come
the closest to a true reflection of incidence of disqualify-
ing disease as is possible to observe from the data available.
19



appraised by the FAA, whereas new pilots are more likely to
make application for third-class medical certification.

This relationship is further substantiated, as previously
discussed, in that 34 percent of all third-class, 7 percent of
all second-class, and 1 1/2 percent of all first-class
examinations performed in 1975 and 1976 were "new applications."

D. Occupations of Denied Airmen

The majority of denied airmen are not occupationally
connected with aviation (see Table 4). Eighty-two percent
of all denied airman applicants indicated nonaeronautical
occupations on their application. These applicants yield an
annual denial rate of 7.8 per 1,000 applicants. The largest
denial percentages of applicants occupationally connected to
aviation was the 11 percent among air traffic controllers (ATCs).
The ATC category also experienced the second highest overall
annual denial rate (18.1 per 1,000 applicants). The flight
service station specialists (FSS) category experienced the
highest denial rate (18.6 per 1,000 applicants). Of these
occupationally connected airmen, flight engineers, self-
employed commercial pilots, and aircraft mechanics had the
next highest rates (5.1, 5.0, 5.0 respectively). Airline
pilots had the sixth highest rate of 4.8 per 1,000 applicants
(see Table 4 and Figure 4). Only 2.7 percent of the total
denials were in the airline pilot occupation category. All of
the other occupation categories combined represented less
than 5 percent of total denials.

These findings are consistent with previous experience as
to denial data by occupation (3).

E. Total Flying Time of Denied Airmen

Flying time data further emphasize the contribution of
new applicants to total denials. Table 5 and Figure 5 show
total civilian flying time as recorded by the applicant on his
denied application for medical certification. Fifty-one
percent of the denied airmen indicated less than 40 hours total
flying time (the number of hours required for a private pilot's
license). Thirty-two percent of these airmen indicated no
flying time. Of course, some of these airmen indicating no
hours flown, as many as 1,041, are strictly air traffic con-
trollers (see Table 3). However, if the 1,041 controller
denials are subtracted, the remainder still indicates that new
pilot applicants are the major contributor to total denials.
The "less than 40 hours flying time" category still equals
42.3 percent when the "air traffic controller only" figure
is subtracted,

The next largest percentage of denials occurs at the
“more than 1,000 hours" interval (16.7 percent) followed by
the "100-299 hours" interval (12.5 percent).

14


IIt,

same control data information (last name, first initial, date
of birth, and SSN). This action helps to assure accuracy of
the control data by providing manual review of the medical
record.

Occupation is coded from information furnished by the
applicant in block 10 of the application form. Only
aeronautical occupations are coded for input to the automated
System. If the item is left blank by the applicant and cannot
be determined from other information provided on the examina-
tion, the occupation is entered as "nonaeronautical."

The cause for denial was determined by the presence of an
alpha prefix to a specific pathology code. The prefix and
code are assigned by medical review clerks in the Aeromedical
Certification Branch. Internal computer edits assure logical
assignment of such prefixes and pathology codes. These edits
are applied when initial file maintenance to an airman's
record is made and again at the end of each quarter to
eliminate discrepancies in pathology and denial data on the
active master file. Data presented regarding pathology rep-
resent conditions cited as cause for denial, not applicants.
Some airmen denied medical certification for legal or
administrative reasons or for failure to provide additional
medical information would not necessarily have a pathology
code assigned. There are also airmen who are denied for
more than one cause.

Findings and Discussion.

A. General Comments

As of December 31, 1975, there were 763,793 active airmen
in our automated system; 77,466 held first-class medical
certificates, 307,528 held second-class certificates, and
378,799 held third-class certificates. In CY 1975 and 1976,
12,112 airmen were denied medical certification. The annual
denial rate based on airman applicants is, therefore, 7.9
per 1,000 airmen. During the same 2-year period, 1,052,476
FAA physical examinations were performed giving a denial rate
per 1,000 applications of 11.5.

The annual denial rate per 1,000 applicants is 4.5 for
first-class, 6.0 for second-class, and 10.2 for third-class
certification.

In the previous study of CY 1973-1974 applicants (3), the
denial rate per 1,000 applicants was 8.9 and the rate per
1,000 applications was 13.1. It would appear that the
per-applicant denial rate is declining. However, this
could -be attributed to a change in processing "pending"
applications on which no additional information is received.

6


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26


Annual rates were computed to provide data more useful
for answering the many questions received concerning airmen
denied medical certification. In CY 1975 and 1976, 12,112
airmen were denied medical certification for various medical
and/or administrative reasons; e.g., failure to provide
additional medical information. The frequency tables that
follow were compiled based on data extracted from these
airmen's medical records and comparable data extracted from
the active airman population as of December 31, 1975. The
active population at that time totaled 763,793 airmen.

A copy of the application for medical certification is
provided for reference to block numbers cited in the following
discussion.

Age of denied airmen was computed to last birthday as of
the date of the physical examination. Age of the active
population airmen was computed to last birthday as of
December 31, 1975. Date of birth is provided by the airman
in block 3 of the medical application form, and computer edits
assure a reasonable month, day, and year.

Class of certificate applied for is determined from
information supplied by the applicant in blocks 9A and 9B
(Class of Medical Certificate Applied For and Type of
Airman Certificate(s) Held) of the application.

In many areas, accuracy of data is contingent upon the
completeness and accuracy of information supplied by the
airman applicant. Other data are coded by Aeromedical
Certification Branch personnel. Some human error is
recognized but is not considered significant enough to
seriously bias the data provided in this study.

Some airmen who hold first-class certificates will have
applied for medical certification four times during the 2-
year period, some airmen who hold second-class certificates
will have applied twice, and airmen with third-class
certificates will have applied once. However, rate data
are provided for the number of applicants versus the number
of applications, except for a portion of Table 1. The active
master file provides applicant data because it contains only
the most recent examination of an airman. Both the denial
data and the population data are maintained on the active
master file.

Previous examination data were determined by whether
the applicant entered a date in block 20 of the application
form and a "match" was made to a previous examination on the
active master file. If the applicant indicates a previous FAA
examination has been performed, a notification will be
received by medical review personnel if the previous examina-
tion cannot be located on the active master file with the

3



It.

of medical certificate applied for, total flying time, and
cause~specific annual denial rates for medically disqualified
applicants. Data on airline pilot denials are also included.

Methods and Source.

The Aeromedical Certification Branch of the Civil
Aeromedical Institute is the central screening facility and
repository within the FAA for the collection, processing,
adjudication, investigation, and analyses of medical data
generated by the aeromedical certification and related
regulatory programs.

The Aeromedical Certification Branch's computerized
medical records provide historical data both for daily
screening of document input and for statistical/research
purposes. The "active master file" contains the most recent
record within the past 3 years of an airman's medical applica-~
tion for certification. This file includes applications
issued, pending, or denied and abbreviated records of
significant pathology cases retained indefinitely for further
medical reference in the event an inactive airman decides to
again exercise his flying privilege.

The denial data were obtained from computer files as of
July 1, 1976, for calendar year (CY) 1975 applicants and
July 1, 1977, for CY 1976 applicants. The 6-month time lapse
was allowed to assure that final certification action had
been taken in the majority of cases. The data were summed
for the 2 calendar years to provide a larger group for
comparison with the active airman population.

A medically certified airman is considered "active" for
a maximum of 24 calendar months following the most recent FAA
medical examination; i.e., regardless of the class of medical
certificate issued, it is valid for third-class purposes for
24 calendar months unless otherwise limited or recalled by
the FAA.

The active airman population as of December 31, 1975,
was.used as the population base for rate computation. This
population was used since it is the midpoint for the denied
applicant group.

Data from the most recent medical record were selected and
extracted from the active master file for construction of the
various frequency tables presented in this study.

Data presented are descriptive in nature, and appropriate
population comparisons are made via conventional statistical
methodology where compatible data exists and statistical
treatment would be meaningful.

2


Flight Service Station

Specialist 18.6

Air Traffic Controller 18.1

Non - Aeronautical

Flight Engineer

Commercial Pilot,
Self-Employed

Aircraft Mechanic
Airline Pilot

Flight Navigator

Business /Executive
Pilot

Commercial Pilot,
Not Self-Employed

Aerial Application Pilot

Flight Instructor 2.3

Annual Rates per 1,000 Applicants

FIGURE 4. ANNUAL DENIAL RATES BY
OCCUPATION, 1975-I976.
15



REPORT OF MEDICAL EXAMINATION

CHECK EACH ITEM IN APPROPRIATE

NOR.
COLUMN (Enter NE if not evaluated)

‘MAL

NOTES: Describe every abnormality in detoll,
betore

AB.
NOR.
Maat

ich comment, Use additional sheets if necessary

jaler applicable item number

‘ond ottach to this form.

35, Head, foce, neck ond scalp

76. Nove

27, Sinvvee

28, Movih and throat

ker, generel SE Ey

30, Drums (Pvforaton)

31. Eyes, general (Visual ecuy under isms 50 & 81)

32, Ophtholmoscople

‘39, Pupils iquatty end reaction)

Fa. Ocolor monlity Cac para Raven

‘5. Longe and chest _(Znching besa)

‘36, Heart cranes sie, rAyihm, sound)

37, Vascular system

‘36, Abdomen ond viscera (inciting hernia)

39, Anus and rectum (Hemorrhoids, fata, prowas)

40, Endocrine eyslem

AV, G—U system

[2 Upper ond lower exivemilien Granta

3. Spine, other musculoskeletal

44, Identifying body marks, scars, tattoos

45, Skin and lymphatics

46, Nevrologhe  Goniie sey

48. Gen

systemic

FOR FAA USE~ PATHOLOGY CODE NOS.

49. HEARING RIGHT EAR’

EAR 50, DISTANT VISION (Standard test types only)

ST, NEAR VISION (Use linear values)

nSPERED VOICE

wriset
(star SIDEWAYS FI.

RIGHT EVE | 20/ CORRECTED 10 20/ 207

Ga

CORRECTED 10 20/

NOING 5h
DISTANT EAR CLOSED) [360 [7500]7000]7000.

panoya000 | err eve | 20/7 “CORRECTED 10 207 207

‘CORRECTED 10 20/

‘AUDIOMETER
(Decibel Loss)

orm eves | 207 CORRECTED TO 20/ 20/

‘CORRECTED 10 20/

52. INTRAOCULAR TENSION (Tonometry required
for Air Traffic Control Specialist)

33. COLOR VISION (Test used. number of plates missed)

TIGHT EVE TFT EVE

TACTILE

TONOMETRIC

‘54, FIELD OF VISION

55. HETEROPHORIA

DIOPTERS (Not required for Class Three)

BIGHT EVE ert eve DISTANCE

‘ESOPHORIA ‘EROPHORA RIGHT

‘56. BLOOD PRESSURE

‘37, PULSE (Wri)

‘S¥sTOUC DIASTOLIC

RECUMBENT.
Moa MERCURY

RESTING AFTER EXERCISE

TAINUTES AFTER EXERCISE

“38, URINALYSIS 39, ECG (Date)

BOM SUGAR

40, OTHER TESTS

Gr, COMMENTS ON HISTORY AND FINDINGS, RECOMMENDATIONS (Adjach all consultation report, BCGe, X-rays, ee. to

this report before

FOR FAA USE

coped

PUNCHED

VERIFIED

62, APPLICANT'S NAME

G3. DISQUALIFYING DEFECTS (List by iam no.)

wasseen issuco ((] meo. cennr PIL} CERIIF

NO CERIIF. ISSUED - FURTHER EVALUATION REQUIRED

HED. AND STUDENT

HAS BEEN DENIED - LEMER OF DENIAL ISSUED (anashed)

‘EXAMINER CODES

CLERICAL REJECT

Ga, MEDICAL EXAMINER'S DECLARATION
medical examination report, and that this

Thereby certify that

1 personally ‘examined the
report with any attachment em

odies my findings comp!

icant named on this
and correctly.

DATE OF EXAMINATION
(Type or print)

‘AVIATION MEDICAL EXAMINER'S NAME AND ADDRESS

AVIATION MEDICAL EXAMINER'S SIGNATURE

Figure 1b. FAA Form 8500-8 (back) - Report of Medical Examination.



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21



Technical Report Documentation Page

T. Report No. 2, Government Accession No. 3. Recipient's Catalog No.

FAA-AM-78-25
4. Title and Subtitle 5. Report Date
Characteristics of Medically Disqualified
Airman Applicants In Calendar Years 1975 6. Performing Orgonization Code
And 1976

[@. Performing Organization Report No.

7. Author's)
Shirley J. Dark, Audie W. Davis, M.D.
9. Performing Organization Name and Address 10. Work Unit No. (TRAIS)
FAA Civil Aeromedical Institute
P.O. Box 25082 TT. Contract or Grant No.

Oklahoma City, Oklahoma 73125

13. Type of Report and Period Covered

12. Sponsoring Agency Nome ond Address
Office of Aviation Medicine

Federal Aviation Administration
800 Independence Avenue, S.W. T4. Sponsoring Agency Code
Washington, D.C. 20591

15. Supplementary Notes

16. Abstract

This study provides comprehensive data reflecting pertinent denial
rates with respect to the medical and general attributes of those
airmen denied medical certification in calendar years 1975 and 1976.
Also provided are such descriptive epidemiologic data as age, sex,
occupation, class of medical certificate applied for, total flying time
and cause-specific annual denial rates for medically disqualified
applicants. Data on airline pilot denials are also included. The
annual denial rate based on airman applicants is 7.9 per 1,000 airmen.
By class of certificate applied for, the annual denial rate per 1,000
applicants is 4.5 for first class, 6.0 for second class, gnd 10.2 for
third class. As anticipated, general aviation and new applicants
contributed greatly to total denials, reflecting that the latter are
being screened for the first time. The most significant causes for
denial (regardless of class applied for) are cardiovascular, the
miscellaneous pathology category (endocrinopathies, disqualifying
medications, and administrative denials), neuropsychiatric, and at

a substantially lower level, eye pathology. Age-cause-specific
findings for airline pilots follow epidemiologic expectations, with
age being a significant variable associated with increased rates.

17. Key Words 18, Distribution Statement ,

Airman Certification (Medical) Document is available to the public

Pilots, Denied through the National Information

Statistical Analysis Service, Springfield, Virginia
22151

19. Security Clossif. (of this report) 20, Security Classif. (of this page) WV No, of Pages | 22. Price

Unclassified Unclassified 28

Form DOT F 1700.7 (8-72) Reproduction of completed page authorized



In November 1975, an automated procedure was implemented
which assigns a denial class code to these "pending" records
later than the previous manual system.

B. Age Distribution of Denied Airmen

Tables 1 and 2 reflect the age distribution and age-specific
denial rates by class-applied-for. Table 1 shows that airmen
applying for third-class certificates account for 64 percent of
all denials, with second-class accounting for 30 percent and
first-class applicants only 6 percent.

Denial rates by class-applied-for also indicate that the
highest crude rates for denials are applicants for third-class
medical certification (general aviation/private or student
airmen) with an annual denial rate of 10.2 per 1,000 applicants.
Occupationally connected airmen require first- or second-class
medical certificates, and denial rates for these categories
(4.5 and 6.0 per 1,000 applicants respectively) are sub-
stantially lower than the general aviation (third-class)
category or the total population denial rate (7.9 per 1,000
applicants). In the previous study, denial rates by class
applied for were 11.2 for third-class, 7.1 for second-class,
4.5 for first class, and 8.9 for the total denial population.

Airmen may apply for and obtain any class of medical
certificate for which they qualify; however, most new
applicants apply for third-class medical certification,
consistent with their intended use of the certificate. First-
and second-class medically certified airmen are more likely
to be occupationally connected airmen, either on a fullygtime
or part-time basis. As such, these airmen are, to some extent,
medically purged and denial rates for these two classes are
more likely to reflect incidence rather than prevalence of
disqualifying pathology among a more stable numerical
group. Applicants for third-class medical certificates are
comprised of many new applicants whose medical statuses have
not been previously appraised by the FAA (as many as 145,000
for CY 1975 and 1976, or 34 percent of all third-class
examinations performed during those years). Only 1 1/2
percent of all first-class examinations and 7 percent of all
second-class examinations performed are for new applicants (6).
Therefore, the substantially higher denial rate for the
third-class group more likely results from a combination of
prevalence and incidence of disqualifying pathology than from
any recognizable epidemiologic factor. New applicants
account for approximately 15 percent of the total applicants
for medical certification.

Also shown in Table 1 and Figure 3 are the mean ages for
the three class-applied-for-denial groups and the three class-
issued-population groups. First-class airmen were oldest
(denied airmen--47.2, active airmen--38.1); third-class

8


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REFERENCES

Siegel, P. V., and Booze, C. F.: A Retrospective Analysis
of Aeromedical Certification Denial Actions, January 1961-
December 1967. FAA Office of Aviation Medicine Report

No. AM-68-9, 1968.

Booze, C. F.: Characteristics of Medically Disqualified
Airman Applicants During Calendar Year 1971, FAA Office of
Aviation Medicine Report No. AM-74-5, 1974.

Dark, S. J.: Characteristics of Medically Disqualified Airman
Applicants in Calendar Years 1973 and 1974. FAA Office of
Aviation Medicine Report No. FAA-AM-76-10, 1976.

Aeromedical Certification Branch: 1975 Statistical Handbook
Computer Run (Internal Workload Report), RIS: AC 8500-1,
December 31, 1975.

Aeromedical Certification Branch: Denied Airmen Summary
Report (Internal Workload Report), RIS: AC 8065-8 through -13,
1975 and 1976.

Aeromedical Certification Branch: Examination Computer Submission

Report (Internal Workload Report), RIS: AC 8500-3, 1975 and
1976.

28


As anticipated, general aviation (third-class) applicants
and new applicants contributed greatly to total denials,
reflecting again that new applicants are being screened for
the first time. Almost half (45 percent) of all denied
applicants indicated no previous FAA medical application had
been made. Eighty-two percent of all denied applicants
indicated nonaeronautical occupations on their application.
Of the professional categories, the flight service station
specialist and air traffic controller groups had the highest
denial rates, with 18.6 and 18.1 per 1,000 applicants.
Airline pilots were sixth highest of the occupationally
connected airmen with a rate of 4.8 per 1,000 applicants.

Total flying time data also substantiated the contribution
of new applicants to total denials with 51 percent of the
denied applicants indicating less than 40 hours total
flying time and 32 percent indicating no flying time.

For denials by pathology, an increasing overall denial
rate for third class over second class and for second class
over first class was observed. The most significant causes
for denial (regardless of class applied for) were
cardiovascular, miscellaneous pathology, neuropsychiatric,
and, at a substantially lower level, eye pathology. These
four categories are involved in 92 percent of all denials.

Cardiovascular causes resulted in the highest denial rate
for males, while the miscellaneous pathology category
provided the highest denial rate for females.

Epidemiologic findings are consistent with expectations
and previous findings on denied airmen.

For airline pilots, annual age-specific denial rates
increase to the highest rate at the age interval 55-59.
The most significant causes for denial are cardiovascular,
the miscellaneous category, and neuropsychiatric
respectively. The importance of these categories,
particularly over age 45, is again recognized.

27



‘COPY OF FAA FORM t800-9 (MEDICAL CERTIF.

saroisremmentowa""" AAT 496.467 [arucrron ror] Mamta — C] wuQPAMPethetn
MEDICAL CERTIFICATE____GLASS FOU NAME Cheat fins mie) PAM CONTROL :
AND STUDENT PILOT CERTIFICATE

ZA. ADDRESS (No. Street, Olly, Slate, 21P No.) SOCIAL SECURITY Nal

LI

THIS CERTIFIES THAT (Full name and address)

'2C. PLACE OF BIRTH (Student plot applicants only)

7 ease print tase toms

la RECHT— TLOONOF TER
(hl, dy. yar) nn) pea ry eves:
[SATE OF Binm [HEIGHT] weiGnT [Raik [EYES [sex
WA. CLASS OF __[98, TYPE OF AIRMAN CERTIFICATE(S) HELD.
medical stondarde prescribed in Part 67, Federal Chesicate AIRUNE TRANSPORT FLIGHT INSTRUCTOR
Aviation Regulottons for the class of Medicel Cerificate, SPPLIED FOR COMMERCIAL PRIVATE
FIRST ‘ATC SPECIALIST STUDENT
° SECOND FLIGHT ENGINEER NONE
FA THIRD FLIGHT NAVIGATOR ‘OTHER
= TO. OCCUPATION (If ATC Specialist, specify position and y)
_ 1). EXTENDED ACTIVE DUTY MEMBER OF ‘12. EMPLOYER
[DATE OF Bean TAL, [e. AIRFORCE fs. COAST GUARD
a TS-TENGTH OF TIME
ARM ATL GUARD TENG OF
B]SIONATURE fe NAVY / MARINES 1 NONE OCCUPATION
MILITARY SERVICE NO 14, PRIMARY TYPE OF FLYING
[RrEo NAME [eusivess |_| pleasure
FAIRMAN'S SIGNATURE. 15. CURRENTLY USE ANY MEDICATION (Including eye drops)
ves | TPE AND PURPOSE
WHEN [SUED ASA MEDICAL-STUDENT PILOT CERTIFICATE,
the holder has met ed in Fart 61, FAR for such | Tho
certificate, and is prohibited from carrying passeny
TOTAL PLOT TIME TTE- RAS ART FAK AMANT MEDIEAT SHAVE YOU, ASH PUOT- HAO AN] 30-OATE GFURST FAT
CERTIFICATE EVERBEEN DENIED,| AIRCRAFT ACCIDENT WITHIN THE PHYSICAL EXAM
|’ TODATE _{17. LAST6 MOS] __ SUSPENDED, OR REVOKED PAST 2 YEARS (Af none, state 20)
cn ves JOATE Jes [oaTe
MILITARY INO [No
21. MEDICAL HISTORY — HAVE YOU EVER HAD OR HAVE YOU NOW ANY OF THE FOLLOWING! (For each “yes” checked, describe condition in REMARKS)
tes}No} Condition foe] No) Condition [Yer Nof Condition [res No} Condition
a: Frequent or severe headechen fa: Hear wouble im: Nervous rouble of ony won foo -shaedabal
b. Distiness or fang spell h. High or low blood pressure ns Any drog or aorcale habit 1 Rejection for He iavronce
© Unconadlovenens for ony rearon 1. Stomach Wouble fe. Bxcennve drinking hobit o- Adminaton te howptal
[a Eye rouble except glamor I: Ridoey Hone or blood tn wring fp. Anerpted woiade Record of te convicions
fe Hey fever i Sugar or albumin i wring Motion snot requiring vat Record ofathoreanvichons
1 Aste 1 Eoitepny or fa Miltary medial ducherge Other inane

REMARKS (If no changes since last report, 60 etale) FOR FAA U:
REVIEW ACTION CODES

22. HAVE YOU EVER BEEN INO ee er eCTS hiviwaven ‘OF WAIVER SERIAL NO.
GF Demonenateo| — [YES ips aioe and
ABILITY (WAIVER)
ae, 1 ee LICANTS DECLARATION ty me ba tie
mer = ANS SANTOR
Sei Sek oer toast ra done ral ya
‘a. material foes, or who make or and 1 agree that Usey are to be considered part of te basis for issuance
See: aoe
‘ein ,07, Speument pnouing De same to, corssln ony, SIGNATURE OF APPLICANT (Tn ink) Date
ae a eect!
Bone o ears,

Fan FORM 65008 (1-671
BLERON TO SF be AND SF-49, APPROVED BY BUREAU OF IME BLOGET, DEC, 1960 SUPERSEDES FAA FORM 1004,

Figure la. FAA Form 8500-8 (front) - Application for Medical Certification
4


Table 5. CY 1975 and 1976 Denied Applicants by Total

Recorded Flying Time

Total Flying Time* Percent
(Hours) Number Denied Of Total
0 3,847 31.8
1-10 1,367 11.3
11 - 20 536 4.4
21 - 40 419 3.4
Subtotal 6,169 50.9
41 - 99 742 6.1
100 - 299 1,516 12.5
300 - 499 711 5.9
500 - 1,000 949 7.9
More than 1,000 2,025 16.7
Subtotal 5,943 49.1
TOTAL 12,112 100.0

*The total civilian flying time recorded in Block 16, FAA

Form 8500-8, determines total flying ti

18

me.


Miscellaneous

(Includes Endocrinopathies,
etc.)

Neuropsychiatric | 10.1
Bones & Joints |

Ear, Nose, Throat | 2.2

Eye Bis
Abdominal Ee

Muscles ffo.s

Respiratory fos

Annual Rates per 10,000 Applicants

FIGURE 7. CAUSE FOR DENIAL OF AIRLINE PILOTS
BY MAJOR BODY SYSTEM, 1975-1976.

24




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ACKNOWLEDGEMENT

Appreciation is extended to Dr. Charles F. Booze, Jr.,
Chief, Medical Statistical Section, Aeromedical Certification
Branch, for his valuable guidance, comments, and suggestions
during the preparation of this study. The authors also
express appreciation to Mrs. Mary Randall for her
assistance in the review and preparation of this study.



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Table 1. CY 1975 and 1976 Denied Applicants by Age and Class
of Medical Certificate Applied For

First Second Third
Age* Class Class Class Total
Less than 20 12 37 267 316
20-24 25 304 699 1,028
25-29 34 530 816 1,380
30-34 47 387 638 1,072
35-39 52 397 610 1,059
40-44 64 476 767 1,307
45-49 72 414 1,047 1,533
50-54 162 560 1,157 1,879
55-59 188 395 856 1,439
60-64 37 138 491 666
65-69 5 44 222 271
70 and over 1 24 137 162
Total Denied 699 3,706 7,707 12,112
Percent of Total Denials 5.8 30.6 63.6 100.0
Total Issued-
1975 & 1976* 183,649 440,660 416,055 1,040,364
Percent of Total
Applications Issued 17.6 42.4 40.0 100.0
Total Applications
1975 & 1976* 184,348 444,366 423,762 1,052,476
Denial Rate per
1,000 Applications 3.8 8.3 18.2 11.5
Total Applicants** 77,466 307,528 378,799 763,793
Annual Denial Rate per
1,000 Applicants 4.5 6.0 10.2 7.9
Mean Age of
Denied Airmen*** 47,2 41.3 42.9 42.7
Mean Age of Active
Population Airmen**** 38.1 36.6 36.4 36.7

*Examination Computer Submission Summary Reports, RIS: AC 8500-3,
Calendar Years 1975 and 1976.

**Examination Time Period Summary, RIS: AC8065~-4, December 31, 1975.
*kkAge as of the date of examination to last birthday.

xkkRAge at last birthday as of December 31, 1975.
9



airmen were the next oldest (denied airmen--42.9, active
airmen--36.4); and second-class airmen were the youngest
(denied airmen--41.3, active airmen--36.6). The mean age
for all denied applicants was 42.7, compared to a mean age
of 36.7 for the active airman population. Denied airmen's
average age was 6 years older than the active population
airmen's average age. The mean age of denied airmen has
increased about 2 years for all classes since the 1973-1974
study (3).

Table 2 reflects similar age trends by class of medical
certificate; however, age-specific rates were higher for
second-class over first-class and third-class over both first-
and second-classes. Overall, the age-specific denial rates
for the younger age intervals were higher than the 30-34 and
35-39 age intervals. Again, this is attributed to new
applicants not having been previously screened by the FAA.

At the 40-44 age interval the denial rates again start upward.
Second-class, third-class, and total denied airmen rates
continue upward from that point reaching the highest age-
specific denial rate at the 70-and-older age interval.
Whereas, first-class rates go upward from the 45-49 age
interval reaching the highest age-specific denial rate at

the 55-59 age interval.

C. Previous Application Status of Denied Airmen

Data contained in Table 3 provide a more detailed break-
down of denied airmen by age, class of medical certificate
applied for, and whether a previous FAA medical examination
was recorded for the individual. This breakdown allows for
appraisal of denied airmen by "new applicant" versus
"previously certified" status. Comparable data from the
active population were not available and denial rates could
not be computed. However, trends from the proportional
comparisons can be observed and certain assumptions made on
the basis of relative contribution to overall denials from the
data provided.

For total denied applicants, the ratio of new applicants
to previously certified applicants is approximately 1 to 1
(new applicants--45 percent; previously certified applicants--
55 percent). However, within the three classes of medical
certification, a different picture emerges. Approximately
86 percent of the first-class denials and 74 percent of the
second~class denials were previously certified airmen. In
sharp contrast to the relationship existing in the first-
and second-class categories, more than half (56.7 percent)
of the third-class denials were new applicants, with 47.9
percent of these appearing in the "student pilot" category.

Again, this relationship was expected because the first-
and second-class categories are normally associated with
professional pilots who have been previously medically

12