APPLICATION REVIEW

Items 59-64 of FAA Form 8500-8

ITEMS 59-64 of FAA Form 8500-8

This section provides guidance for the completion of Items 59-64 of the FAA Form 8500-8. The AME is responsible for conducting the examination. However, he or she may delegate to a qualified physician's assistant, nurse, aide, or laboratory assistant the testing required for Items 49-58. Regardless of who performs the tests, the AME is responsible for the accuracy of the findings, and this responsibility may not be delegated.

The medical history page of FAA Form 8500-8 must be completed and certified by the applicant or it will not appear in AMCS. After all routine evaluations and tests are completed, the AME should review FAA Form 8500-8. If the form is complete and accurate, the AME should add final comments, make qualification decision statements, and certify the examination.

ITEM 59. Other Tests Given

I. Code of Federal Regulations

All Classes: 14 CFR 67.413(a)(b)

II. Examination Techniques

Additional medical information may be furnished through additional history taking, further clinical examination procedures, and supplemental laboratory procedures.

On rare occasions, even surgical procedures such as biopsies may be indicated. As a designee of the FAA Administrator, the AME has limited authority to apply 14 CFR 67.413 in processing applications for medical certification. When an AME determines that there is a need for additional medical information, based upon history and findings, the AME is authorized to request prior hospital and outpatient records and to request supplementary examinations including laboratory testing and examinations by appropriate medical specialists. The AME should discuss the need with the applicant. The applicant should be advised of the types of additional examinations required and the type of medical specialist to be consulted. Responsibility for ensuring that these examinations are forwarded and that any charges or fees are paid will rest with the applicant. All reports should be forwarded to the AMCD, unless otherwise directed (such as by a RFS).

Whenever, in the AME's opinion, medical records are necessary to evaluate an applicant's medical fitness, the AME should request that the applicant sign an authorization for the Release of Medical Information. The AME should forward this authorization to the custodian of the applicant's records so that the information contained in the record may be obtained for attachment to the report of medical examination.

ITEM 60. Comments on History and Findings

Comments on all positive history or medical examination findings must be reported by Item Number. Item 60 provides the AME an opportunity to report observations and/or findings that are not asked for on the application form. Concern about the applicant's behavior, abnormal situations arising during the examination, unusual findings, unreported history, and other information thought germane to aviation safety should be reported in Item 60. The AME should record name, dosage, frequency, and purpose for all currently used medications.

If possible, all ancillary reports such as consultations, ECGs, x-ray release forms, and hospital or other treatment records should be attached. If the delay for those items would exceed 14 days, the AME should forward all available data to the AMCD, with a note specifying what additional information is being prepared for submission at a later date.

If there are no significant medical history items or abnormal physical findings, the AME should indicate this by checking the appropriate block.

ITEM 61. Applicant's Name

Item 61. Applicant’s Name

The legal name applicant's name should be entered.

ITEM 62. Has Been Issued

(Updated 04/27/2022)

The AME must check the proper box to indicate the status of the application for Medical Certificate. Note: The “x” will appear until the AME selects an option:

o Medical Certificate o Medical and Student Pilot Certificate o No Certificate Issued – Deferred for Further

Evaluation o Has Been Denied – Letter of Denial Issued (copy attached) A. Applicant's Refusal or Exam Not Complete: If applicant leaves before the exam is completed or elects not to continue if more information or evaluation is required: Note in Block 60, do not issue any certificate, and contact AMCS Support for instructions.

B. AME Issuance: When the AME receives all required information AND the applicant meets all FAA medical standards for the class sought, the AME may issue a medical certificate. If the applicant has an Authorization for Special Issuance, refer to the Authorization Letter to determine if you must also add a time limitation. If the AME or the applicant will send in supporting records or reports WITHIN 14 DAYS, note what items are coming in Block 60.

C. AME Deferral: AME should defer if:

Do not delay transmitting an exam (beyond 14 days) while waiting for the applicant to provide requested records or reports.

Note in Block 60 any concerns, findings, or if more information was requested; do not issue any certificate, and transmit as deferred.

D. AME Denial: If the AME determines the applicant is clearly ineligible for certification (see Medical Certificate Decision Making), give the applicant a signed and dated AME Letter of Denial. The letter provides the applicant with reasons for the denial and how to request reconsideration. The AME must send a copy of the AME Letter of Denial to the FAA.

ITEM 63. Disqualifying Defects

The AME must check the “Disq” box on the Comments Page beside any disqualifying defect. Comments or discussion of specific observations or findings may be reported in Item 60. If all comments cannot fit in Item 60, the AME may submit additional information on a plain sheet of paper and include the applicant’s full name, date of birth, signature, any appropriate identifying numbers (PI, MID or SSN), and the date of the exam.

If the AME denies the applicant, the AME must issue a Letter of Denial, to the applicant, and report the issuance of the denial in Item 60.

ITEM 64. Medical Examiner's Declaration