In addition to the AME examination, FAA has a  computer system that initially processes all the applications and prioritizes  some for review, such as those where the AMEs deferred the decision or  denied the certificate. The computer system also identifies for further  review applications where the AME has issued the medical certificate and  the application indicates potentially disqualifying medical conditions. Finally, FAA checks the National Driver Register to help ensure pilots  meet standards by checking for indications of substance abuse. AMEs Determine Whether Pilots Meet Medical Standards Based on Pilots’ Applications and Physical Examinations

AMEs determine whether a pilot meets FAA medical standards based on  their review of the pilot’s medical certification application and the results  of their physical examination. In 2007, FAA application examiners  evaluated all 34,590 priority applications (see fig. FAA Checks for Drug- and Alcohol-Related Motor Vehicle Actions Using National Database

FAA checks the National Driver Register each time a pilot applies for  medical certification to look for indications of substance dependence. Specifically, FAA has  established two quality assurance review programs in which FAA has  identified instances in which AMEs issued medical certificates to pilots  that have disqualifying medical conditions and in which FAA application  examiners overlooked relevant medical documents and made clerical  errors. According to FAA officials, they plan to continue reviewing AME- issued certificates and collecting data from the reviews. Also, as  previously mentioned, FAA checks the National Driver Register for  indications of substance abuse to help ensure pilots who are issued  medical certificates meet medical standards. FAA currently does not  check federal disability benefits for indications of disqualifying medical  conditions. Our comparison found that federal disability benefits  databases can provide useful information on pilots’ medical conditions. According to FAA  officials, the impetus for this quality assurance program was that FAA  recognized it needed to see if AMEs issued medical certificates  appropriately because the majority of these determinations are closed  without FAA review, thus making the AME decision final. These additional data from subsequent years could  help identify increases or decreases in incomplete or inappropriately  issued certificates and demonstrate how well its certification procedures  are ensuring that medical certificates are being properly issued. In its 2007 reviews, FAA did not find any medical  certificates that application examiners had inappropriately issued. GAO’s Database Match Results Indicate Disability Databases Have Information on Potentially Disqualifying Medical Conditions

We found that for February 2008, less than 1 percent (1,246 of 394,985  pilots) of U.S. pilots with a current medical certificate were receiving  Social Security disability benefits. FAA has also developed programs to determine if medical  certificates have been properly issued. The Department of  Transportation indicated that it generally agreed with our findings. Appendix I: Objectives, Scope, and Methodology

In order to assess the Federal Aviation Administration’s (FAA) efforts to  screen medical certification applicants and identify medically unqualified  pilots, we answer the following questions (1) what procedures does FAA  use to certify that pilot applicants meet medical standards and (2) how  does FAA determine that medical certificates have been properly issued? To identify FAA’s procedures for certifying that pilots meet medical  standards, we reviewed agency guidance and federal regulations. We matched FAA pilot  medical certification records with two Social Security disability databases  to determine (1) the number of pilots with current medical certificates  who were receiving disability benefits; (2) from the group of pilots  receiving disability benefits, how many had supplied their Social Security  number to FAA and how many did not provide their Social Security  number; and (3) what the most common disabling medical conditions  were for pilots receiving disability benefits.
Why GAO Did This Study

The Federal Aviation Administration (FAA) seeks to make the U.S. aviation system one of the safest in the world. However, a 2005 Department of Transportation Inspector General investigation found that FAA had issued medical certificates to a small percentage of pilots with disqualifying medical conditions, such as heart conditions, schizophrenia, and drug or alcohol addiction. In response to your request, our report addresses the following questions: (1) what procedures does FAA use to certify that pilot applicants meet medical standards and (2) how does FAA determine that medical certificates have been properly issued? In addressing these objectives, GAO researched FAA guidance and federal regulations; interviewed federal officials; analyzed FAA's application review procedures, quality assurance program, and its use of the National Driver Register; and conducted a data match between FAA's pilot registry and Social Security Administration's disability programs. The data match does not determine if pilots receiving disability benefits have medical conditions that would disqualify them from holding an FAA medical certificate. GAO is not making recommendations in this report. The Department of Transportation generally agreed with our findings. FAA and the Social Security Administration provided technical clarifications, which we incorporated as appropriate.

What GAO Found

FAA's pilot medical certification procedures consist of a multi-step process intended to determine whether pilots meet medical standards. As part of its certification procedures, aviation medical examiners (AME) review information provided by pilot applicants and the results of their physical examination before issuing medical certificates. In the majority of cases (about88 percent in 2007), applicants meet medical standards and AMEs issue certificates. FAA uses a computer system to process all the applications. It designates some applications for additional review by FAA application examiners, such as when AMEs do not issue the medical certificate or defer the decision. The computer system also identifies for FAA review the applications in which AMEs issued the medical certificate and the application indicates potentially disqualifying medical conditions. Finally, FAA checks each pilot applicant against the National Driver Register to look for drug- and alcohol-related motor vehicle actions and indications of substance abuse. FAA has developed programs to help it determine whether it has properly issued medical certificates. Specifically, FAA has established two quality assurance review programs--one evaluating certificates that the AMEs issued and the other evaluating certificate decisions made by FAA application examiners. In its 2007 reviews, FAA identified 19 instances in which AMEs issued certificates to pilots who have disqualifying medical conditions as well as 16 cases in which FAA application examiners overlooked relevant medical documents and 44 with clerical errors. According to FAA officials, they plan to continue reviewing AME-issued certificates and collecting the results. These additional data from subsequent years could help FAA identify how well its procedures are ensuring that medical certificates are being properly issued. In addition, FAA relies on the National Driver Register check to help ensure pilots meet medical standards. Finally, due to recently resolved litigation, FAA currently does not check federal disability benefits databases for indications that pilots may have disqualifying medical conditions. Although our analysis of the Social Security Administration's disability databases found that 1,246 of 394,985 medically certified pilots were receiving disability benefits, this does not necessarily mean these pilots do not meet FAA medical standards. It may, however, indicate that federal disability databases can provide useful information on potentially disqualifying medical conditions.