OPINION By RICHARD SCOTT SAVELL
I’m a U.S. Air Force veteran, private pilot, husband, and father. I also serve as chief academic officer for a nationally accredited school that trains chaplains in clinical pastoral education. I manage a full schedule, mentor future spiritual care providers, and still find time to take out the trash.
But according to the FAA, I’m apparently on the fast track to memory care.
Since 2018, I’ve been trying to get back in the air under BasicMed — the very program Congress created to help pilots like me who are medically stable but tired of navigating the FAA’s bureaucratic obstacle course. Unfortunately, what Congress gave, the FAA has decided to bury in red tape.
My original special issuance application was filed in 2019. Since then, I’ve received two denials, each granting me the right to appeal directly to the Federal Air Surgeon — who, if I had to guess, hasn’t read a word of those appeals.
They disappear into the FAA’s opaque and unaccountable review process where logic goes to die.
And then it got weird.
One denial cited untreated PTSD as the reason for grounding me.
Problem: I’ve never been diagnosed with PTSD. I’ve never been treated for it. I’ve never even claimed to have it.
Another letter claimed severe cognitive decline. Again completely fabricated. I’ve never been diagnosed with any such condition and every medical professional I’ve consulted has affirmed my full cognitive functioning.
I’ve undergone thorough neurological and psychological evaluations. I even met with an FAA Human Intervention Motivation Study (HIMS)-designated psychiatrist — at the agency’s request — who concluded I was mentally sound and had no disqualifying conditions.
The FAA’s own internal neurology panel also reviewed my case in depth and issued a formal conclusion: “No further workup in neuro needed.”
But apparently, those internal clearances carry no real weight. Whoever serves as the final arbiter is free to ignore the FAA’s own expert panels and issue a denial anyway — which is exactly what happened in my case.
On top of that, I’ve had every kind of cardiology workup imaginable, all leading to the same conclusion: Stable with very low likelihood of incapacitation. I’m now nine years post-heart surgery, and every test shows I’m in good shape to fly.
Yet the FAA still cites “cardiology” as a basis for denial — ignoring expert consensus and leaning instead on vague hand-waving and fear-based justifications.
Here’s the kicker: They tell you a one-time special issuance is required to qualify for BasicMed, but what they don’t tell you is this: You’ll never get it. The FAA has no intention of approving you. It’s a bureaucratic shell game designed to appear compliant with Congressional intent while doing the exact opposite.
And just when you think you’ve cleared one hurdle, they stall. The FAA often takes a year or more to respond to submissions. By the time they do, they claim your labs, tests, or letters are “too old,” forcing you to repeat the process all over again.
Sometimes they suggest that if you just get one more test and it comes back favorable, you’ll be cleared — only to dredge up something else, often a condition already addressed or even previously cleared internally, like the neurology issue.
It’s not a process — it’s a trap.
I’ve spent thousands of dollars out of pocket. I’ve met every demand the FAA has made and still they keep moving the goalposts. At this point, it feels less like a medical process and more like a war of attrition. The FAA, it seems, is simply hoping I’ll give up.
But I’m not going anywhere. All I’ve got is time.
I share this not just for myself, but for every pilot who’s been buried under this bloated and arbitrary system. BasicMed was supposed to offer relief. Instead, the FAA has turned it into a mirage — visible, promising, but always just out of reach.
I’m not asking for a free pass. I’m asking for due process, transparency, and for the FAA to follow the law that Congress enacted. If it can’t — or won’t — do that, we’ve got a bigger problem than outdated paperwork. We’ve got an agency that believes it’s above the very statutes that govern it.
Until then, I remain grounded — not because I’m unfit to fly, but because the FAA keeps inventing reasons to keep me from doing what I’ve already proven I’m capable of.
In recent months, I’ve also reached out to every elected official who represents me. Senator Mitch McConnell’s office submitted an official inquiry to the FAA on my behalf, although I haven’t seen the contents of that inquiry, so I can’t say whether it will carry much weight.
Separately, I’ve contacted the FAA administrator, the Secretary of Transportation, the Department of Transportation’s Office of Inspector General, and even the FAA’s own Medical Ombudsman.
At this point, I’m hoping someone — anyone — with the authority to act will take this seriously and intervene. The system isn’t just broken — it seems willfully indifferent.
My FAA Medical Timeline
Pre-2016
I held a valid medical certificate with no history of denials or disqualifying conditions. I was actively flying with no medical restrictions prior to my heart surgery.
2016
I underwent successful heart surgery. Since then, I’ve remained stable, with excellent follow-up cardiology and a low risk of incapacitation confirmed in multiple evaluations.
2018
I began the process of returning to flight under BasicMed. My health was strong, and I believed I met the intent and requirements of the program Congress had created for pilots like me.
2019
I submitted my first special issuance application. The FAA requested additional testing, which I completed and submitted. At the time, I mistakenly believed that if the results came back favorable — which they did — I would be granted the special issuance. COVID-19 soon disrupted FAA processing times, causing additional delays.
2020
I underwent full neuropsychological testing as part of the FAA’s requirements. The results confirmed my mental fitness to fly and revealed no disqualifying conditions.
2021
I received my first denial from the FAA. The letter cited “untreated PTSD” — a condition I’ve never been diagnosed with, never treated for, and never even claimed to have. I was permitted to appeal to the Federal Air Surgeon, which I did, though I have no indication that the appeal was ever reviewed.
2021–2024
During this time, I completed a wide range of FAA-requested evaluations. I met with an FAA HIMS-designated psychiatrist, who concluded that I had no disqualifying mental health conditions. The FAA’s own internal neurology panel reviewed my case in depth and issued a formal finding: “No further workup in neuro needed.”
Despite this, in 2024 I was again required to undergo neuropsychological testing. The results once again confirmed my cognitive and psychological fitness. Still, the FAA continued to cite shifting concerns, often revisiting previously resolved issues.
2025
I received a second denial. This time, they claimed I was experiencing “severe cognitive decline,” again without any supporting diagnosis or clinical basis. I appealed to the Federal Air Surgeon once more, but to date have heard nothing in response.
Ongoing
The FAA often takes a year or more to respond to my submissions. When they finally do, they claim that my test results or specialist letters are “too old,” forcing me to repeat everything.
They frequently suggest that if I just complete one more test, everything will be resolved — only to raise a new concern, even one already addressed or cleared.
When it comes to the so called one-time special issuance for cardiology and neurology, they don’t stop there. They dig down as deep as they can to paper wall the process.
Recent Actions
I’ve reached out to every elected official who represents me. Senator Mitch McConnell’s office submitted a formal inquiry to the FAA. I’ve also contacted the FAA administrator, the U.S. Secretary of Transportation, the Department of Transportation Inspector General, and the FAA Medical Ombudsman.
Additionally, I reached out to the Aircraft Owners and Pilots Association (AOPA). Although I am not currently a member, they responded and noted that while they hear stories like mine often, mine may be the longest-running unresolved BasicMed case they’ve encountered.
Scott,
I’m sorry to hear this. I too went through this very close scenario with my medical. I had mitral valve repair 8 years ago. Although, my 3rd class lapsed and I was granted basic med through the online course and a doctor’s evaluation.
The tricky part came when I applied for my 2nd class medical. That’s where the can of worms opened with the back and forth tests, paperwork, and FAA requests. I ended up over 5k out of pocket and almost 2 years later. I did receive my paperwork and excited, I read on to learn it expired in 2 weeks. Back to the beginning of tests and appointments it was.
So frustrating and costly because we are denied for hemorrhoids caused by the process itself.
We are all in your corner and keep at it. I hope you’re able to fly with a safety pilot or CFI just to stay in the seat.
Hearing stories like this is frustrating. Having spoken to our Federal Air Surgeon, Dr. Susan Northrup, directly, I know she’s keenly aware of the unacceptable backlog and opaqueness of the medical process and is making tangible improvements (a recent special issuance request was resolved in 48 hours). However, I know she, and we at AOPA, would acknowledge there’s still a long way to go. AOPA’s Medical Services team helps members every day with navigating the intricacies of the Aero Medical process, and we’re very often successful in getting good outcomes largely by knowing in advance exactly what the FAA needs to see to make an informed and timely decision. I feel for Mr. Savell and will make sure to echo this audience’s continued frustrations when we speak with the FAA at Oshkosh in 10 days time. Much like we did with Basic Med, we’ll continue to fight for improvements that help keep more of us flying safely and to push for processes and tools that provide greater transparency to the airman and speed in getting issues resolved fairly.
I, too, have had problems with FAA medical management. As an air traffic controller I had a condition that I provided the FAA with all documentation from flight surgeons. The FAA initially agreed with the conclusion that I was safe to control traffic. About 2 years later, while working a busy traffic rush, my manager called up to say stop working! The FAA says you’re medically grounded! Someone decided that my condition was grounding. I had to provide further medical evidence from a flight surgeon that my condition was benign. A few days later I was reinstated and continued to work traffic until retirement–14 years later!
I’m also an instrument rated private pilot and got biennial Class II physicals from a flight surgeon. After retiring as an air traffic controller, I got biennial Class III physicals from flight surgeons, but the cost of which kept rising. Finally Basic Med was approved. It was instigated by Senator James Inhofe (R-OK). (Who, incidentally, was a pilot who landed on a closed runway in Texas! He overflew the big flashing X, landed, made a U-turn and took off over the same flashing X. Luckily all construction workers saw the oncoming airplane and took evasive action. They also got the N-number!)
Anyway, it might be best to get a Class III medical than mess with Basic Med.
The FAA caused my friend to have a nervous breakdown and a premature death, this is more than an inconvenience for some.
It might be time to hammer on AOPA and EAA about a petition drive in each state to get the elected congress people to lay down the law with the FAA.
I have my own story to tell. But I don’t want to be a me to, I want to find a way to fix this. After seeing what has been said here, I can see that there is much more to this than I had realized.
Yes! We need to find a way to fix this for others who are, or will, experience the same horrendous treatment by the impersonal bureaucracy that is the FAA medical division.
Yes indeed. I understand very well now why so many people fly their machines without medical certificates of any kind.
I am 76 and in perfect health (my last FAA Med Xam was last December), my insurance was even reduced but I didn’t have to deal with this guy situation YET, but as I age, I ALSO KNOW THAT FAA WILL NOT BE HAPPY UNTIL I AM NOT HAPPY OR QUIT….but quitting for me will only be decided by ME.
Good luck to this gentleman.
A similar experience, what a mess. My conclusion as someone who just wants to bore holes in the sky is to just go do it. Give the FAA the finger . . .as they have done much worse to us. ABOLISH THE FAA from the top down, make it a PRIVATE concern!
My experience with the FAA 3rd Class Medical was similar to Mr Savell’s, although it took me “only” three years and tens of thousands of dollars out of pocket to get a special issuance and then go on Basic Med. The big problems I had with the FAA medical team were:
1. Zero transparency – The FAA is the most opaque government agency I’ve ever dealt with. They may provide a general reason for the denial but with no backup or specific reasons for their conclusion. They know that if they explain how they came to their conclusion then arguments could be made that they based the conclusion on bad data or the logic could be challenged. By not explaining in any way how they reached their conclusion, they insulate themselves from having to justify the reason.
2. Lack of communication – You cannot talk to someone to plead your case. Everything must be done via snail mail. They selectively answer questions in your communication, if at all.
3. No Appeals, no Oversight – While the NTSB is ostensibly a body to which a pilot can appeal, in practice the NTSB defers to the FAA in almost all medical denials. Writing to your congressional representative will not help. While your representative can jog the FAA to respond with your case status, our representatives will (like the NTSB) defer to the FAA for medical judgements. Any organization without oversight will inevitably abuse their powers and countless examples of pilots treated unfairly by the FAA abound. As Lord Acton said, “power corrupts and absolute power corrupts absolutely”.
4. Ambiguous Instructions – In my denials the FAA said that if I passed certain tests and met certain requirements they would “consider” a special issuance. Note they NEVER EVER say if you pass certain tests you WILL be granted your medical. They always hold the cards close to their vest. The problem with their list of requirements was that the requirements were ambiguous with no definition of what would constitute acceptability to the FAA. After a year of letters the FAA finally provide some additional detail that allowed me understand what they wanted and to move forward, except….
5. Raising the bar – after I successfully passed all the tests and met all written requirements, the FAA raised the bar with an entirely new list of 8 additional steps or requirements, NONE of which were based on the results of my previous tests, which were all 100% in my favor. Since every report or test I sent to the FAA was in my favor, then the only conclusion can be that they knew full well they were going to pile on more requirements after I met all the previous ones.
6. Ignoring their own experts. The FAA “experts” in Oklahoma City routinely ignore the positive reports from their own Aviation Medical Examiners. I know this because that is what my AMEs have told me. When my AME complained on my behalf to Oklahoma City, they gave justifications that my AME agreed did not make any sense. The only value I can see that AMEs provide to the FAA medical division is if they give a ‘negative’ report then the FAA will definitely deny you. If they give a positive report then the FAA will ignore the AME and decide on their own.
7. No in-person exams or interviews – The FAA keeps the pilot at arms length, communicating only through paper mail which takes months between correspondences. In this way they have a much less informed view of the pilot than the AMEs ‘on the ground’.
8. Threatening Language – In every single one of the many denial letters I got from the FAA, they threatened criminal action if I didn’t follow all their steps or provide all the documentation they demanded.
Conclusion:
In my opinion, as well as some other medical professionals knowledgable about the FAA 3rd class medical, the draconian process does not actually do what it was intended to do, increase aviation safety. This can be demonstrated by the success of Basic Med:
1. The FAA itself has studied the accident rate of Basic Med pilots and finds no difference with pilots carrying a 3rd Class Medical.
2. The argument that Basic Med is successful because the pilot previously had to pass an FAA medical is not credible. A pilot can get Basic Med with an FAA medical that is up to 19 years old. Every medical impairment that the FAA is concerned with can occur to an individual over a 19 year period, making the previous medical certificate irrelevant to the pilot’s current health.
A solution to this problem is easy and would greatly reduce the FAA workload without impairing safety. Simply allow anyone to apply for Basic Med, independent of whether they have had a previous FAA medical or not.
I, too have been dealing with the faa on my special issuance for cardiac stents. I also had a special issuance for lymphoma in 2012. Now they want evaluations from the cancer doc stating I’m in remission. For 12 yrs on basic med it only needed a no change in diagnosis to renew my basic med. l have spent over 14,000 dollars on testing and all test are positive for reissue of my med. my AME says I’m fit to fly, faa does not listen to my doc who knows me personally. Why have an AME exam if it doesn’t count anyway? I think it is time for congress to step in and stop this crap. It’s like they do this to justify the position they hold. Next is a sleep study for sleep apnea that I have never been diagnosed with and I’ve never had anyone question my sleep habits before. Even my cardiologist just shakes his head in disbelief at the run around that exists at the ACMD.
I have been flying under BasicMed for over 6 years. However, when I reached age 80, I could not get insurance on my Lake Amphibian (which I have been flying for 20 years) unless I got a Class III FAA medical every year. I have no trouble getting the Class III, I just prefer to avoid any unnecessary contact with FAA for reasons exemplified in Richard’s article: it’s a trap. It’s not just the FAA that thinks BasicMed is “cheating,” it’s insurance underwriters. I truly feel my primary care doc has a better idea of my fitness to fly than a doc who doesn’t know me. I sent a letter to the Editor of AOPA Magazine, which they chose not to publish, perhaps because it was critical of their affiliate Assured Partners Aerospace: they would only cover the plane if I at all times had a type-qualified pilot or CFI flying with me (same as a non-licensed aircraft owner). I was able to get insurance through the Bullock Agency with the Class III requirement.
You have been Hoovered.
So I got a medical but never explained why they had to send the forms to the FAA. So I had some outside tests accompany my medical results. However to get qualified medical I had to send the in when they already had them. So I just determined it was a bureaucratic nightmare and dropped the seeking a qualified medical.
Scott,
Like you and previous commenters, I’ve had problems with special issuance delays and age. I finally found out what to do by accident. Depending on your family and professional situation, you may wish to consider moving….seriously!
Years ago, I got an email from my US Congressman, Cory Mills (FL -7). He’s a highly organized former combat veteran serving Volusia County FL. His email stated “if you’re having problems with a federal government agency, comtact my office…’ so I did.
Cory has a whole team of people to resolve problems, and has publicly stated he has helped in nearly 30,000 situations to get quick resolution with a wide variety of agencies. They know who to contact. In my case they broke a 8-month old log-jam I faced such as you describe in two weeks!
Now, I send his office a note before the 60 day deadline to issue and I’ve gotten my medical certificate back within one week after the deadline…no stonewalling, silence or bullshit from the Aeromedical Branch.
This is not a political comment, but your current elected representatives might or might not be able to cut thru the Gordian knot in very short order, IF they know what to do. Mills is one of the most effective Congressional Representatives I’ve ever voted for. Check out his website.
Glenn Kautt ATP, CFI
former US Navy
Is it any wonder there are so many pirates that ignore the physicals and fly anyway? I know so many physically fit people that are mired down in the FAA’s never ending Aeromedical red tape to be allowed to fly.
I read Richard’s story and flash back to my 18 month ordeal with the FAA medical certification group. Unbelievable delays, repeated demands for information already provided, sometimes multiple times. No accountability, never able to talk to someone who ever cares to help, ignoring the opinions of multiple true medical professionals who actually, gasp, examined me. Denials asking for more and new information . After spending a great deal of money on a consultant, a whole group of true medical professionals and an attorney i finally received my 3rd class medical with only a few months remaining and demands for follow up data sets that were both unreasonable and frankly outrageous in the volume.
I am now on BasicMed and thank AOPA for that forward thinking program.
Reading this story, I feel sympathetic to Richard’s plight at the hands of the nameless faceless bureaucracy where somehow we are more victims than clients, well I would gladly join any reasonable process to get these types of stories out there to force the FAA into an accountability.
I am sure there are good and reasonable people in the FAA medical certificate group, I just never had the chance to deal with them.
I had the same experience. Several years of delays, extra expenses with all medical professional approving me very safe flying.
It got so bad you could not even leave a text to them. Professional doctors were frustrated that they did not understand answers to their request. The last time I sent all required data to them January one, got cleared mid July, activated my basic med and hope I never talk to them again.
I squeaked through the process. I have a type of reactive arthritis. It’s called Ankylosing Spondylitis and have had the condition since 1992. I have always disclosed my condition to the FAA, and have been fortunate that I respond well to a sulfa drug that isn’t problematic for flying. So, all was well until 2016 when somebody in the FAA’s Oklahoma offices decided I was unfit to fly without a special insurance. My AME had cleared me for my 3rd Class Medical after evaluating my flexibility in addition to all the other standard factors reviewed during an aviation medical. It required a year of expensive visits to specialists to obtain my special insurance, but I finally got it. I immediately switched to basic med and haven’t looked back. Now, I complete my individual online review every 2 years and see my GP for the Basic Med review every 4 years. Basic Med is much cheaper and results in decisions about my fitness to fly being made by physicians that have actually seen me rather than by a desk jockey in a distant city that has never interacted directly with me. This is the way it should operate! I miss being able to fly to Canada, but at least I’m still flying!
Years ago, when I was going through the air facility certification process, I had to work closely with the FAA, those men (and they were all men who I dealt with) were consummate professionals, many of whom had thousands of flight hours in high performance aircraft. Acting Administrator, Chris Rocheleau, his Deputy Liam McKenna and Chief of Staff Pete Hearding are all first rate. A formal letter (on printed paper and sent by Registered Mail) to any of them or to Chris with the Deputy and COS cc’d will get the matter resolved. Those fellows will surely give you a fair hearing, but there is no guarantee that the FAA will rule in your favor.
Once you get a response to your snail mail letter to the Administrator, if they rule in your favor, that would be great for you. However, if they say no and you still think that the FAA is wrong, then hiring a good lawyer who has won cases against the FAA would be a logical next step.
While I implicitly trust the current leadership of our FAA, that doesn’t mean that bureaucracies are infallible. Sometimes the only way to get the proper level of attention on an issue is via the Courts.
Best of luck to you.
Did you write a (paper) letter to President Trump?
Just electronic.
Please keep posting updates. Your story is important.
Been there. Based on my experience, as well hush-toned comments from staff at my regional Regional Flight Surgeon’s office, it often comes down to which FAA staff member was assigned to your case and their past experiences getting burned on cases similar to yours. Luck of the draw.
I am having a similar problem. Medical professionals, like my cardiologist, and others say I have minimum chance for a stroke due to LAA intervention and other tests, Yet they ignore them. Did 10 different test to prove my health was good, passed all with no issues, they never made any comment about that just complained because of some medications i was taking. I stopped all meds they did not like with no problems and they still denied because of a CHAD score of 6. That was in error as I am not a diabetic, A1c’s in mid 5’s and taking no meds for diabetes They say am not eligible for special Issuance because and only recourse is to appeal to the NTSB which I have done. Waiting, waiting, waiting months for replies. Out of hand system.
They only have the power we give them. Sadly, we give them the power.
It’s not WE who give them their power. Not pilots. It’s THEY that give them the power (bureaucrats and politicians). The voters? They don’t even know this situation exists.
I had a similar situation although it took “only” 20-months to get my Special Issuance (SI) which in-turn led me to simply stick with the BasicMed. The root cause of this ongoing issue at the FAA (specifically the Aerospace Medical Certification Division) is:
1. They never fully embraced BasicMed. By fully I mean not everyone at ACMD. Sure, when comes to BasicMed ACMD talks the talk but stumbles when they walk the walk.
2. ACMD has (like every federal organization) deadwood. Problem is at ACMD there is deadwood in key positions which influence and controls the SI process (BTW the SI board only meets 3-times a year!). FAA leadership has failed to clean out the deadwood.
3. Most important – Trust. ACMD simply will not trust and provide sufficient authority to the local AME to determine medical fitness for flight. This lack of trust is frankly rooted in control. I get the control aspect of it…but when you fail basic efficient administrative tasks dealing with the SI process then it’s time to clean house. I too can give several examples during my 20-month wait to get the FAA Class Medical…nothing short of a fiasco…all self inflicted by ACMD.