FAA Medical Deferral: What Happens and How Long It Takes

A deferral means your Aviation Medical Examiner (AME) cannot issue your certificate at the exam. Your file goes to the FAA for a decision instead. This post explains what that means, how long it usually takes, and what you can do to move things along.

What a Deferral Actually Means

Only an FAA-designated AME can issue an FAA medical certificate. Sometimes the AME is not allowed to issue at the exam. When that happens, the AME denies or defers your application. A deferral is not a denial. It means the FAA will review your file and make the call.

The AME may defer for a few common reasons:

Your condition is not on a list the AME can issue for on the spot.
The AME needs more records or testing before deciding.
The FAA Guide for Aviation Medical Examiners or an authorization letter tells the AME to defer.
Something in your history needs a closer look, such as a cardiac event, a mental health history, or a sleep apnea diagnosis.

A denial is different. A denial is a final decision by the AME at the exam. A deferral sends the question to the FAA. Many deferrals end with a certificate, sometimes with conditions.

Where Your File Goes

Most deferrals go to the FAA Aerospace Medical Certification Division in Oklahoma City. Some go to a Regional Flight Surgeon. The FAA reviews your application, your exam report, and any records you send. Then a Medical Officer makes a decision.

You may get a letter asking for more information. Pilots often call this a 60-day letter because it gives you a window to respond. Read it carefully. It lists exactly what the FAA wants. Missing that window can slow your case or lead to a denial.

How Long It Takes

There is no fixed timeline. The FAA does not promise a set number of days. Reviews can take weeks or months. Some cases move faster. Complex cases with several conditions, or cases that need outside testing, often take longer.

A few things affect the timeline:

How complete your file is when it arrives.
Whether the FAA asks for more records.
How long your doctors take to send records.
How many conditions are under review.
The FAA's current workload.

You can check the status of your case by contacting the FAA. Ask your AME's office which office has your file. Then call that office and ask for a status update. Be polite and patient. The staff handle many files.

How to Speed It Up

You cannot control the FAA's review speed. You can control how fast your side moves. Here is what helps most.

Send a complete file the first time

Before your exam, gather records for any condition that might come up. Bring doctor notes, test results, and treatment history. If your AME has what they need, the file may need less back and forth.

Answer every request fast

When the FAA sends a letter, respond within the window it gives you. Send exactly what it asks for. Do not send extra paperwork that was not requested. Extra pages can slow review.

Keep copies of everything

Keep a copy of every record you send and every letter you get. If something gets lost, you can resend it quickly. Note the date you sent each item.

Follow up on the phone

Call the FAA office handling your file and ask for a status. Ask if anything is missing. If a doctor has not sent records, call that doctor's office yourself.

Ask about faster paths

Some conditions qualify for Special Issuance under 14 CFR 67.401. Some qualify for AME Assisted Special Issuance, where an AME can reissue under set rules. Some conditions are on the Conditions AMEs Can Issue list, which lets an AME issue on the spot. Ask your AME if your case fits any of these. If it does, you may avoid a long deferral. Our Special Issuance guide explains how these paths work.

What Can Happen After Review

The FAA can issue a certificate, issue one with conditions, ask for more information, or deny. If you get a Special Issuance, you may need to send follow-up reports on a schedule. Mark those dates. Missing them can put your certificate at risk.

If the FAA denies, you have options. You can ask for reconsideration or appeal. Talk to an aviation attorney or a pilot advocacy group before you act. Deadlines apply.

Common Conditions That Lead to Deferrals

Many deferrals involve the same handful of issues. These include:

Heart conditions, including some cardiac events and arrhythmias.
Mental health history, including use of some antidepressants. The FAA allows some antidepressants with a Special Issuance after a stable period, including fluoxetine, sertraline, citalopram, and escitalopram.
ADHD history or ADHD medicine. These often need extra review, sometimes with neuropsychological testing. Stimulant medicines are not allowed while flying.
Obstructive sleep apnea. It can be certified when treated, for example with CPAP and compliance reports.
Vision or hearing that does not meet the standard without a waiver.

If you have one of these, plan ahead. Talk to your AME before you fill out FAA Form 8500-8 in MedXPress. Ask what records to bring. A little prep can turn a long deferral into a same-day issue.

Start With the Right AME

Some AMEs handle deferral cases often. Others do not. If you have a known condition, look for an AME with experience in that area. You can find an AME near you and read how we rank AMEs. If you are in a large state, you can also browse Aviation Medical Examiners in California, Aviation Medical Examiners in Texas, or Aviation Medical Examiners in Florida.

Before your exam, fill out FAA Form 8500-8 in MedXPress and bring the confirmation number. The MedXPress application stays valid for 60 days. Answer every question truthfully. Answering falsely is a federal offense.

If you are unsure whether your case needs a deferral, ask your AME. Rules and worksheets change. Check the current FAA Guide for Aviation Medical Examiners or call your AME's office. Our post on what to expect at your exam can help you prepare.

Key takeaways

A deferral means your AME cannot issue at the exam, so the FAA reviews your file. It is not the same as a denial.
There is no fixed timeline. Reviews can take weeks or months, and complex cases take longer.
Send a complete file the first time, respond to FAA letters within the window, and keep copies of everything.
Ask your AME if your condition fits a faster path, such as a Conditions AMEs Can Issue worksheet or AME Assisted Special Issuance.
If you have a known condition, pick an AME with experience in it and confirm the current rules with the FAA Guide for Aviation Medical Examiners or your AME.

Common questions

What happens if my FAA medical certificate is deferred?

The AME does not issue your certificate that day. Instead, the AME sends your file to the FAA Aerospace Medical Certification Division in Oklahoma City or to a Regional Flight Surgeon. The FAA reviews your records and then mails you a decision. That decision can be an approval, a request for more information, or a denial.

How long does it take the FAA to review a deferred medical?

There is no set time. The FAA says reviews can take weeks or months. How long yours takes depends on your condition, how complete your records are, and how busy the FAA is. Sending complete records up front can help avoid extra back and forth. Ask your AME what to expect in your case.

What happens if the FAA denies your medical?

A denial means the FAA decided you do not meet the medical standard for the class you applied for. You can request reconsideration or appeal, and you may ask about Special Issuance under 14 CFR 67.401. Some pilots later qualify through a Special Issuance with conditions. Talk to your AME or an aviation attorney about your options and deadlines.

What medical conditions disqualify you from flying?

The FAA looks at each case, so there is no simple list. Conditions that often need extra review include heart disease, uncontrolled blood pressure, sleep apnea, ADHD, and some mental health conditions. Many of these can still be certified with treatment or a Special Issuance. Ask your AME before you apply so you know what records to bring.

This guide is general information, not medical or legal advice. FAA rules change. Check the FAA Guide for Aviation Medical Examiners or ask your AME about your own case. Read our editorial policy.