FAA Medical Outcomes
First, the expected outcome for a physical examination is that the medical certificate will be ISSUED. In this circumstance, the pilot completes the FAA Form 8500-8, Application For Medical Certification, at the time of the physical examination and assuming he or she meets all of the standards, walks out of the AME's office with a new medical certificate in hand. The overwhelming majority of physical exams have this result.
A second result is a DENIAL of the medical certificate. If pilot's clearly do not meet FAA medical standards, particularly if they have conditions that are specifically grounding in Part 67 of the FARs or the Guide to Aviation Medical Examiners, the aviation medical examiner may issue a denial letter to the pilot revoking the pilot's current medical privileges. That information is forwarded to the FAA Aeromedical Certification Division which will then issue a formal denial letter and request return of the current Airman's Medical Certificate. Denials are not necessarily permanent. If the pilot can present information that the disqualifying medical condition has resolved or is being treated in an aeromedically safe manner, the FAA may reinstate the airman's medical certificate.
The third possible outcome is an intermediate decision termed a DEFERRAL. In this situation, the AME notes a medical condition that is questionable with regards to eligibility for medical certification. The pilot takes the physical examination, but rather than issue the medical certificate or give the pilot a denial letter, the AME defers the application and medical certificate to the Regional Flight Surgeon or the Aeromedical Certification Division in Oklahoma City. With the AME's permission, the pilot may continue to fly on their current medical certificate until it lapses.
Unfortunately, deferrals often take 2 or more months to obtain a response from the FAA. The FAA response letters frequently request the pilot provide additional medical information to support the application. A 30 day suspense from the date of the FAA letter on this reporting requirement is common. If no information is received at the end of the period, the FAA may deny the airman's medical certificate. Assuming there is not a grounding condition, the pilot is not eligible to use the older medical certificate after it expires. Instead, the pilot must await the arrival of the previously deferred certificate to be returned from the FAA office to which the AME forwarded it. If additional information is required by the FAA, this process may take several months. Submission of complete information to the FAA is CRITICAL to timely certification decisions.