[House Hearing, 110 Congress]
[From the U.S. Government Publishing Office]
THE FEDERAL AVIATION ADMINISTRATION'S OVERSIGHT OF FALSIFIED AIRMAN
MEDICAL CERTIFICATE APPLICATIONS
=======================================================================
(110-60)
HEARING
BEFORE THE
SUBCOMMITTEE ON
AVIATION
OF THE
COMMITTEE ON
TRANSPORTATION AND INFRASTRUCTURE
HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
FIRST SESSION
__________
JULY 17, 2007
__________
Printed for the use of the
Committee on Transportation and Infrastructure
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COMMITTEE ON TRANSPORTATION AND INFRASTRUCTURE
JAMES L. OBERSTAR, Minnesota, Chairman
NICK J. RAHALL, II, West Virginia JOHN L. MICA, Florida
PETER A. DeFAZIO, Oregon DON YOUNG, Alaska
JERRY F. COSTELLO, Illinois THOMAS E. PETRI, Wisconsin
ELEANOR HOLMES NORTON, District of HOWARD COBLE, North Carolina
Columbia JOHN J. DUNCAN, Jr., Tennessee
JERROLD NADLER, New York WAYNE T. GILCHREST, Maryland
CORRINE BROWN, Florida VERNON J. EHLERS, Michigan
BOB FILNER, California STEVEN C. LaTOURETTE, Ohio
EDDIE BERNICE JOHNSON, Texas RICHARD H. BAKER, Louisiana
GENE TAYLOR, Mississippi FRANK A. LoBIONDO, New Jersey
ELIJAH E. CUMMINGS, Maryland JERRY MORAN, Kansas
ELLEN O. TAUSCHER, California GARY G. MILLER, California
LEONARD L. BOSWELL, Iowa ROBIN HAYES, North Carolina
TIM HOLDEN, Pennsylvania HENRY E. BROWN, Jr., South
BRIAN BAIRD, Washington Carolina
RICK LARSEN, Washington TIMOTHY V. JOHNSON, Illinois
MICHAEL E. CAPUANO, Massachusetts TODD RUSSELL PLATTS, Pennsylvania
JULIA CARSON, Indiana SAM GRAVES, Missouri
TIMOTHY H. BISHOP, New York BILL SHUSTER, Pennsylvania
MICHAEL H. MICHAUD, Maine JOHN BOOZMAN, Arkansas
BRIAN HIGGINS, New York SHELLEY MOORE CAPITO, West
RUSS CARNAHAN, Missouri Virginia
JOHN T. SALAZAR, Colorado JIM GERLACH, Pennsylvania
GRACE F. NAPOLITANO, California MARIO DIAZ-BALART, Florida
DANIEL LIPINSKI, Illinois CHARLES W. DENT, Pennsylvania
DORIS O. MATSUI, California TED POE, Texas
NICK LAMPSON, Texas DAVID G. REICHERT, Washington
ZACHARY T. SPACE, Ohio CONNIE MACK, Florida
MAZIE K. HIRONO, Hawaii JOHN R. `RANDY' KUHL, Jr., New
BRUCE L. BRALEY, Iowa York
JASON ALTMIRE, Pennsylvania LYNN A WESTMORELAND, Georgia
TIMOTHY J. WALZ, Minnesota CHARLES W. BOUSTANY, Jr.,
HEATH SHULER, North Carolina Louisiana
MICHAEL A. ACURI, New York JEAN SCHMIDT, Ohio
HARRY E. MITCHELL, Arizona CANDICE S. MILLER, Michigan
CHRISTOPHER P. CARNEY, Pennsylvania THELMA D. DRAKE, Virginia
JOHN J. HALL, New York MARY FALLIN, Oklahoma
STEVE KAGEN, Wisconsin VERN BUCHANAN, Florida
STEVE COHEN, Tennessee
JERRY McNERNEY, California
VACANCY
(ii)
Subcommittee on Aviation
JERRY F. COSTELLO, Illinois, Chairman
BOB FILNER, California THOMAS E. PETRI, Wisconsin
LEONARD L. BOSWELL, Iowa HOWARD COBLE, North Carolina
RICK LARSEN, Washington JOHN J. DUNCAN, Jr., Tennessee
RUSS CARNAHAN, Missouri VERNON J. EHLERS, Michigan
JOHN T. SALAZAR, Colorado STEVEN C. LaTOURETTE, Ohio
DANIEL LIPINSKI, Illinois FRANK A. LoBIONDO, New Jersey
NICK LAMPSON, Texas JERRY MORAN, Kansas
ZACHARY T. SPACE, Ohio ROBIN HAYES, North Carolina
BRUCE L. BRALEY, Iowa SAM GRAVES, Missouri
HARRY E. MITCHELL, Arizona JOHN BOOZMAN, Arkansas
JOHN J. HALL, New York SHELLEY MOORE CAPITO, West
STEVE KAGEN, Wisconsin Virginia
STEVE COHEN, Tennessee JIM GERLACH, Pennsylvania
NICK J. RAHALL, II, West Virginia MARIO DIAZ-BALART, Florida
PETER A. DeFAZIO, Oregon CHARLES W. DENT, Pennsylvania
ELEANOR HOLMES NORTON, District of TED POE, Texas
Columbia DAVID G. REICHERT, Washington
CORRINE BROWN, Florida CONNIE MACK, Florida
EDDIE BERNICE JOHNSON, Texas JOHN R. `RANDY' KUHL, Jr., New
ELLEN O. TAUSCHER, California York
TIM HOLDEN, Pennsylvania LYNN A WESTMORELAND, Georgia
MICHAEL E. CAPUANO, Massachusetts MARY FALLIN, Oklahoma
DORIS O. MATSUI, California VERN BUCHANAN, Florida
MAZIE K. HIRONO, Hawaii JOHN L. MICA, Florida
VACANCY (Ex Officio)
JAMES L. OBERSTAR, Minnesota
(Ex Officio)
(iii)
CONTENTS
Page
Summary of Subject Matter........................................ vi
Committee Report on Falsification of Airman Medical Certificate
Applications................................................... x
TESTIMONY
Boyer, Phil, President, Aircraft Owners and Pilots Association,
Frederick, MD.................................................. 23
Garber, Mitchell A., M.D., M.P.H., M.S.M.E., Medical Officer,
National Transportation Safety Board........................... 3
Sabatini, Hon. Nicholas A., Associate Administrator for Aviation
Safety, Federal Aviation Administration, accompanied by
Frederick E. Tilton, M.D., M.P.H., Federal Air Surgeon,
Director, Office of Aerospace Medicine, Federal Aviation
Administration................................................. 3
Scovel, III, Hon. Calvin L., Inspector General, U.S. Department
of Transportation.............................................. 3
PREPARED STATEMENTS SUBMITTED BY MEMBERS OF CONGRESS
Costello, Hon. Jerry F., of Illinois............................. 27
Matsui, Hon. Doris O., of California............................. 30
Mitchell, Hon. Harry E., of Arizona.............................. 33
Oberstar, Hon. James L., of Minnesota............................ 36
PREPARED STATEMENTS SUBMITTED BY WITNESSES
Boyer, Phil...................................................... 40
Garber, Mitchell A............................................... 61
Sabatini, Nicholas A............................................. 107
Scovel III, Calvin L............................................. 119
SUBMISSIONS FOR THE RECORD
Boyer, Phil, President, Aircraft Owners and Pilots Association,
Frederick, MD, responses to questions from the Subcommittee.... 55
Garber, Mitchell A., M.D., M.P.H., M.S.M.E., Medical Officer,
National Transportation Safety Board, responses to questions
from the Subcommittee.......................................... 66
Sabatini, Hon. Nicholas A., Associate Administrator for Aviation
Safety, Federal Aviation Administration, accompanied by
Frederick E. Tilton, M.D., M.P.H., Federal Air Surgeon,
Director, Office of Aerospace Medicine, Federal Aviation
Administration, reponses to questions from the Subcommittee.... 112
Scovel III, Hon. Calvin L., Inspector General, U.S. Department of
Transportation, responses to questions from the Subcommittee... 131
ADDITIONS TO THE RECORD
Federal Aviation Administration's 2006 Survey of Satisfaction
with the Aviation Medical Examination Process.................. 138
Federal Register, Department of Transportation, Federal Aviation
Administration, 14 CFR Parts 61 and 67......................... 140
James R. Vanderpool, ANM-700, Northwest Mountain Division Manager
(Retired), written statement................................... 150
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HEARING ON FAA'S OVERSIGHT OF FALSIFIED AIRMAN MEDICAL CERTIFICATE
APPLICATIONS
----------
Tuesday, July 17, 2007
House of Representatives
Committee on Transportation and Infrastructure,
Subcommittee on Aviation,
Washington, DC.
The Subcommittee met, pursuant to call, at 10:00 a.m., in
Room 2253, Rayburn House Office Building, the Honorable Jerry
F. Costello [Chairman of the Subcommittee] presiding.
Mr. Costello. The Subcommittee will come to order. The
Chair will ask all Members, staff, and everyone to turn their
electronic devices off or on vibrate.
The Subcommittee is meeting today to hear testimony on the
FAA's oversight of falsified Airman Medical Certificate
applications.
The Chair will give a brief statement, recognize Mr. Petri,
the Ranking Member, and any other Member that wants to make a
statement, and then we will introduce our witnesses today.
I welcome everyone here today to this hearing on the FAA's
oversight of falsified Airman Medical Certificate applications.
In July 2005, the Department of Transportation's Inspector
General found egregious cases of pilots failing to disclose
debilitating medical conditions on their applications for
Airman Medical Certificates. The U.S. Attorney's Office
prosecuted more than 40 cases, but hundreds more could have
been pursued if adequate resources had been available. The
Department of Transportation Inspector General made three
recommendations in that report, and the FAA is actively
pursuing those recommendations.
In April 2007, the FAA began working to implement a
strategy and system to coordinate with the Social Security
Administration to verify information on Airman Medical
Certificate applications. Further, the FAA is revising its
application form to explicitly ask the applicant if they are
receiving medical disability benefits. Both are important
changes, and I am interested in hearing more from Mr. Sabatini
and Mr. Scovel on this development.
The FAA has some of the strictest medical requirements in
the world. By taking the necessary steps to improve the
process, by establishing a way to verify medical information
reported to the FAA, we can continue to ensure the safety of
the pilot and the flying public.
I am also pleased that Mr. Boyer, Phil Boyer, is here today
to testify from AOPA. AOPA is the largest civil aviation
organization in the world, and they have developed a four-point
plan of action to educate pilots to address this problem. I am
interested in hearing more about the plan from Mr. Boyer when
he testifies.
I have repeatedly said that, while the United States has
the safest air transportation system in the world, we cannot
rely on or be satisfied with our past success. We must work
together to ensure the highest level of safety for the
traveling public.
Before I recognize Mr. Petri for his comments or opening
statement, I ask unanimous consent to allow two weeks for all
Members to revise and extend their remarks, and to permit the
submission of additional statements and materials by Members
and witnesses. Without objection, so ordered.
At this time, the Chair recognizes the Ranking Member, Mr.
Petri.
Mr. Petri. Thank you very much, Mr. Chairman. I would like
to join you in welcoming the witnesses this morning and saying
that I look forward to learning more about the Department of
Transportation's Office of the Inspector General investigation
into falsified FAA Airman Medical Certificate applications. I
guess they are called Operation Safe Pilot.
The vast majority of pilots are law-abiding citizens.
However, the Inspector General's investigation indicates that,
whether knowingly or not, some pilots have made false
statements on their Airman Medical Certificate applications.
These applications are used to evaluate a pilot's physical and
mental fitness to fly.
Of the 40,000 pilot samples considered in Operation Safe
Pilot, the Inspector General prosecuted 45 of the most
egregious cases, ultimately resulting in criminal penalties and
the revocation of pilots' licenses. Forty-five pilots whose
cases were brought to prosecution were receiving Social
Security Administration medical disability benefits for
disqualifying conditions without reporting those medical
conditions on the application for a medical certificate.
There may have been more criminal cases, but resource
limitations prevented the U.S. Attorney's Office and the
Inspector General from expanding the investigation.
It is important to note that the true nature of the problem
is still not clear. Regardless, I look forward to hearing from
our panelists on how we can address these issues in a manner
that is appropriate to the level of risk these types of
omissions pose to the safety of the system and to the public on
the ground.
It is my understanding that the FAA is considering a
revision to the application for the Airman Medical Certificate.
Changes to the application will make questions clearer so that
a pilot could not justify an omission based on the wording of a
question. I am interested to hear the progress on this effort,
as well as an estimate of the cost of reviewing and evaluating
medical conditions.
About 20 years ago, the FAA offered a brief amnesty period
to allow both commercial and recreational fliers the
opportunity to come forward and report ailments without being
subjected to criminal penalties for the omission. I am
interested in hearing from our panel as to whether allowing
another brief amnesty period would make sense.
Amnesty only works when there is some threat of enforcement
after the amnesty period closes. Given the resources available
in the budget, would it be possible for the FAA to audit all of
the 600,000 commercial and recreational pilot applications, or
would such action divert resources away from higher risk safety
initiatives? Perhaps the FAA could audit a percentage of the
applications each year. That way there is always the risk that,
if you falsify, you could get caught. It works for the IRS. Why
not FAA?
In any event, I would like to thank our witnesses for
participating in today's hearing, both our government witnesses
and one of the user groups, the Aircraft Owners and Pilots
Association. AOPA is one of our great partners in the effort to
keep the skies safe, and I appreciate their participation in
today's hearing.
With that, I yield back the balance of my time.
Mr. Costello. The Chair thanks the Ranking Member and, at
this time, would first welcome our witnesses and thank you all
for being here today. Let me introduce our first panel.
First, the Honorable Calvin Scovel III, who is the
Inspector General for the U.S. Department of Transportation,
who has testified before this Subcommittee many times and who
shared tenure as the IG; Dr. Mitchell Garber, who is the
Medical Officer for the National Transportation Safety Board;
the Honorable Nicholas Sabatini, who is the Associate
Administrator for Aviation Safety with the FAA, and Mr.
Sabatini has testified many times before the Subcommittee; and
Dr. Frederick Tilton, who is the Federal Air Surgeon for the
Director of the Office of Aerospace Medicine with the FAA, who
is accompanying Mr. Sabatini here this morning.
The Chair, at this time, would recognize Mr. Scovel for
your testimony.
TESTIMONY OF THE HONORABLE CALVIN L. SCOVEL III, INSPECTOR
GENERAL, U.S. DEPARTMENT OF TRANSPORTATION; MITCHELL A. GARBER,
M.D., M.P.H., M.S.M.E., MEDICAL OFFICER, NATIONAL
TRANSPORTATION SAFETY BOARD; THE HONORABLE NICHOLAS A.
SABATINI, ASSOCIATE ADMINISTRATOR FOR AVIATION SAFETY, FEDERAL
AVIATION ADMINISTRATION, ACCOMPANIED BY FREDERICK E. TILTON,
M.D., M.P.H., FEDERAL AIR SURGEON, DIRECTOR, OFFICE OF
AEROSPACE MEDICINE, FEDERAL AVIATION ADMINISTRATION
Mr. Scovel. Mr. Chairman, Ranking Member Petri, Members of
the Subcommittee, we appreciate the opportunity to testify
today regarding falsification of the FAA's application for
Airman Medical Certificate. Our testimony today is primarily
based on an investigation called Operation Safe Pilot, which we
conducted with the Social Security Administration's Office of
Inspector General and U.S. Attorney Offices in California. The
investigation focused on pilots who represented to FAA that
they were medically fit to fly, while at the same time claiming
medical disability benefits.
Today, Mr. Chairman, I would like to discuss three key
points, as we see them, for mitigating the safety risks posed
by airmen who falsify their Airman Medical Certificate
applications.
First, it is important to recognize that the Airman Medical
Certification Program is an essential safeguard to ensure that
pilots are medically fit to fly. FAA requires that each pilot
have a valid medical certificate before being allowed to
operate an aircraft. To receive a medical certificate, pilots
must complete an Airman Medical Certificate application and be
examined by an FAA-designated Aviation Medical Examiner. Those
who meet the appropriate medical standards based on an in-
person medical examination and an evaluation of medical history
are issued a medical certificate. As of June 2007, FAA's
database showed there were over 625,000 pilots with current
Airman Medical Certificates.
The Federal Air Surgeon has identified certain medical
conditions that specifically disqualify an individual from
receiving a medical certificate because those conditions could
compromise a pilot's ability to safely operate an aircraft.
These conditions include neurological and psychiatric
disorders.
Second, our investigation, Operation Safe Pilot, disclosed
a potential systemic problem regarding falsification of medical
certificates that requires greater attention and oversight by
FAA. In 2003, our office initiated Operation Safe Pilot to
determine whether a scheme uncovered in 2002 reflected a
systemic problem. In the 2002 case, we determined that a pilot
in California had defrauded both FAA and Social Security by
making false statements to doctors for the purpose of
maintaining his FAA private pilot certificate while obtaining
Social Security benefits. For approximately 14 years, this
pilot had used two different doctors, one to conclude that he
was in good physical health in order to maintain his Airman
Medical Certificate, and one to diagnose him with a disabling
disease in order to fraudulently receive Social Security
benefits. He was ultimately convicted of fraud and sentenced to
serve a 21 month prison term and pay nearly $200,000 in
restitution.
Operation Safe Pilot began with a universe of about 40,000
pilots residing in Northern California. We focused our
investigative efforts on a smaller group of 48 pilots who were
receiving Social Security disability benefits. At our request,
the FAA Regional Flight Surgeon reviewed case files for those
pilots and determined they would not have passed the airman
medical examination had the examining physicians known about
the pilots' disqualifying medical conditions.
The U.S. Attorney's Office initiated criminal prosecutions
against all 48 pilots, 45 of whom were convicted of making
false statements to FAA. In all 48 cases the pilots failed to
notify FAA about their well documented, severe, pre-existing
medical conditions. Many of those pilots had multiple
disqualifying conditions, with the most common condition being
some type of mental disorder such as schizophrenia.
In addition to Operation Safe Pilot, both the NTSB and FAA
have published reports showing that pilots often did not
disclose serious medical conditions which sometimes resulted in
accidents and fatalities. For example, a May 2006 FAA research
report of post-mortem toxicology for 4,143 pilots who died in
aviation accidents between 1993 and 2003 found that nearly 10
percent were taking some type of psychotropic, cardiovascular,
or neurological medication not reported on their Airman Medical
Certificate applications. The report's authors essentially
concluded that pilots who took certain types of medications and
were involved in fatal accidents rarely reported those
medications and their underlying medical conditions to FAA.
Third, FAA can take several actions to ensure that disabled
pilots do not circumvent the medical certification process. In
July 2005, we sent a memorandum to the DOT Secretary and FAA
Administrator highlighting the results of Operation Safe Pilot.
We pointed out that FAA did not have a mechanism for
identifying certificated pilots who were receiving medical
disability benefits. We recommended that FAA work with the
Social Security Administration and other Federal disability
providers to, one, develop and implement appropriate checks and
take enforcement actions; and, two, consider revising its
application for Airman Medical Certificates to require
applicants to explicitly identify whether they are receiving
medical disability benefits.
In April 2007, FAA initiated discussions with Social
Security to match the FAA database of pilots against relevant
Social Security databases. Both agencies have been discussing
how such a process could be structured under the Privacy Act to
ensure compliance with law. FAA has also expressed its
intention to revise the application for Airman Medical
Certificate to explicitly ask about the receipt of medical
disability benefits.
These are appropriate first steps. In our opinion, FAA
should also consider two additional measures: one, conduct an
education and outreach effort to ensure pilots are fully aware
of their responsibilities for accurately disclosing their
medical histories on the Airman Medical Certificate
application; and, two, offering a grace period to pilots who
self-identify previously undisclosed medical conditions. FAA,
however, would need to make it absolutely clear that all
medical conditions disclosed would be evaluated and, unless
pilots were found at that time to be medically fit to fly,
their Airman Medical Certificates would be subject to
revocation.
That concludes my statement, Mr. Chairman. I would be
pleased to address any questions you or other Members of the
Subcommittee may have.
Mr. Costello. The Chair thanks you and recognizes Dr.
Garber for his testimony.
Dr. Garber. Good morning, Chairman Costello, Chairman
Oberstar, Ranking Member Petri, and Members of the
Subcommittee. Thank you for allowing me the opportunity to
present testimony on behalf of the National Transportation
Safety Board regarding Federal Aviation Administration's
oversight of falsified Airman Medical Certificate applications.
It is a privilege to represent an agency that is dedicated to
the safety of the traveling public.
On June 17th, 2002, an aircraft operated by a commercial-
rated pilot performing wolf survey flights under contract to
the Michigan Department of Natural Resources descended at high
speed into terrain. The pilot and his personal physician, who
later became his aviation medical examiner for many years, had
concealed from the FAA information regarding the pilot's
multiple, serious medical conditions on seven applications for
Airman Medical Certificates. The pilot's physician had denied
knowing the pilot when the FAA was investigating a report that
the physician was treating him for these conditions.
At the time of the accident, the pilot's physician had been
decertified as an aviation medical examiner for failure to
complete required training, and the pilot did not have a
current medical certificate, having been deferred for
certification by a new aviation medical examiner who noted some
abnormal heart rhythms on examination. The Safety Board
concluded that the accident was caused by the incapacitation of
the pilot and that a contributing factor was the pilot and his
physician providing false information on the pilot's medical
applications.
A recent staff review of over 20,000 aviation accidents
investigated since 1995 found 327 in which impairment,
incapacitation, or a medical condition were identified as
causes or factors. Medications and substances of abuse were
each found in over 100 of these cases. In 26 of these cases, it
was determined that a pilot with a current medical certificate
and a known medical condition had information regarding that
condition that was not revealed to the FAA at the time of the
most recent application for medical certificate.
It is important to note that these numbers are certainly an
underestimate of the extent to which this issue is involved in
accidents. In many cases, there is insufficient evidence
available to completely evaluate the possibility of impairment
or incapacitation.
The Safety Board is fortunate to benefit from the resources
of the FAA Toxicology Laboratory at the Civil Airspace Medical
Institute, likely the finest toxicology laboratory in the world
for analysis of specimens for accident investigations. We are,
therefore, often able to determine that a pilot used a specific
substance in the hours or days preceding the accident, most
frequently a substance that was not reported to the FAA.
The Safety Board has been concerned for many years
regarding the inappropriate use of certain medications by
pilots and other vehicle operators and, in 2000, issued
comprehensive recommendations on this topic to the Department
of Transportation, the Food and Drug Administration, and modal
agencies to improve information provided to such operators
regarding the use of appropriate medications while engaged in
vehicle operations. Although some modal agencies have taken
responsive actions, the overall response to date from the DOT
and the FAA has been limited, and the majority of the
recommendations on this topic have not been implemented.
The Safety Board has also noted that, with many accidents
due to a pilot's intoxication by alcohol, illicit substances,
or large amounts of potentially addictive medications, the FAA
was or should have been aware of information that would have
led them to conclude that the pilot was substance dependent and
would have restricted issuance of a medical certificate. In
particular, the Board has noted a number of instances in which
the FAA did not request details of an identified DUI conviction
in order to determine the circumstance of that violation.
Additionally, the Board has found that the information
available to the FAA on potentially substance-dependent pilots
was often not provided to individuals evaluating the pilots for
possible substance dependence. Furthermore, the Board is
concerned that, unlike other chronic conditions, the FAA does
not now routinely require that pilots with substance dependence
be followed for the condition for the period that they hold
their medical certificate. The Board has recently issued
several recommendations to address these deficiencies.
Finally, the Safety Board notes that, unlike many other
countries, and inconsistent with the International Civil
Aviation Organization recommendations, there is no requirement
for the reporting of medical conditions in between periodic
examinations. This significantly increases the complexity of
establishing that a condition was concealed from the FAA, since
it may not have become apparent until after the most recent
medical examination. The FAA has recently proposed increasing
the interval between medical examinations for certain pilots
and the Safety Board has noted in its comments to that NPRM
that a reporting requirement in between examinations would be
desirable.
This concludes my prepared statement, and I would be happy
to answer any questions.
Mr. Costello. Thank you, Dr. Garber.
The Chair recognizes Mr. Sabatini.
Mr. Sabatini. Good morning, Chairman Costello, Chairman
Oberstar, Congressman Petri, and Members of the Subcommittee. I
am pleased to appear before you today to discuss the Federal
Aviation Administration's oversight of the Airman Medical
Certification application process.
Let me assure you that the FAA takes this matter seriously,
and we are very concerned about any falsification of
information on Airman Medical applications. Let me also say
that the vast majority of our nation's pilots are honest,
dedicated, and have contributed significantly to our current
unprecedented safety record.
FAA agrees with the recommendations of the Inspector
General on falsified Airman Medical applications, and we are
taking steps to implement those recommendations, as I will
discuss. We are also taking other proactive steps regarding
this issue, which I will also discuss.
As you are aware, the Department of Transportation
Inspector General issued a report in 2005 describing the
results of an investigation known as Operation Safe Pilot. I
will not spend time discussing the details of the IG's
findings; they are already well known to you. However, I will
discuss the IG's recommendations and the FAA's response to
those recommendations.
The Inspector General recommended that FAA work with the
Social Security Administration and other disability benefits
providers to develop and implement a strategy to conduct checks
of applicants for Airman Medical Certificates with the
databases of those disability benefits providers and take
appropriate enforcement actions where falsifications are found.
The IG also recommended that FAA consider revising our
application for Airman Medical Certificate to require
applicants to explicitly identify whether they are receiving
medical disability benefits from any provider.
I am pleased to inform you that the FAA is moving forward
to implement both of the IG's recommendations. FAA is working
to develop a program in cooperation with the Office of the
Inspector General for the Social Security Administration to
cross-check randomly selected applicants for FAA Airman Medical
Certificates with the Social Security disability database to
determine if any applicants are receiving disability from the
Social Security Administration.
I must emphasize that we are still working with the Social
Security Administration's IG's Office and the Social Security
Administration itself to determine what information they are
willing to grant us access to and then develop a framework for
how such checks will be conducted. We hope to start by cross-
checking applicants to the Social Security Administration
databases because, to receive Social Security disability
benefits, an individual must be totally disabled. Thus,
virtually any applicant who is receiving Social Security
Administration disability benefits will necessarily have a
condition that would disqualify the applicant from holding an
Airman Medical Certificate from the FAA.
While it is premature to discuss any future expansion of
the cross-checking of applicants to disability databases other
than the Social Security Administration, we would have to
carefully consider the potential resources required to conduct
investigations and make medical determinations regarding an
applicant's disability and whether that condition disqualifies
the applicant from holding an Airman Medical Certificate before
taking such a step.
In order to proceed with cross-checking applicants for
Airman Medical Certificates against the Social Security
Administration disability database or any other database, FAA
must first make a change in the policy allowing routine use of
private information. This will require publishing a notice of
the proposed change in the Federal Register and a comment
period before the change can be implemented and FAA could begin
any cross-checking. This process might take six to twelve
months to complete.
However, we will immediately begin efforts to implement the
IG's second recommendation, the addition of a question to the
Airman Medical Certificate application regarding disability
benefits. The FAA will propose to OMB the change to the
application form to include the question. Upon approval from
OMB, the new application form can be printed and distributed to
Airman Medical Examiners nationwide.
We are proposing to change the Airman Medical Certificate
application to add a question specifically asking if the
applicant is receiving any disability benefits. While this
additional question appears straightforward, the investigative
work will begin after a positive response to the question. Once
an applicant indicates he or she is receiving disability
benefits, FAA would then have to investigate to determine the
disability benefits provider, the condition for which the
applicant is receiving disability benefits, and the extent of
the applicant's disability.
FAA is also being proactive in other areas regarding
falsification of data on Airman Medical Certificate
applications. The FAA Civil Aerospace Medical Institute has now
developed an integrated scientific information system that will
provide a continuous monitoring of all Airman Medical
Certification records compared to aviation accidents or
incidents and post-mortem toxicology reports.
The FAA will, therefore, have the capability of
continuously monitoring any aircraft accidents and accessing
any discrepancy between the information on the certificate and
any post-mortem findings. This includes prescription and non-
prescription medications and medical abnormalities that could
affect the ability to safely perform duties permitted by the
Airman Certificate and which are related to the National
Transportation Safety Board causal accident factors.
In 2006, the FAA's Office of Aerospace Medicine initiated a
routine process analysis study to evaluate and improve the
efficiency of airman medical certification within the FAA. The
Airman Medical Examiner Airman Certification Quality Assurance
Study evaluates the accuracy of AMEs in determining the
suitability of Airman Medical certification. It is another tool
that will assist the FAA in monitoring this issue. We are
committed to expanding our efforts to review medical
certificates and pursue appropriate enforcement actions when
falsifications are discovered.
Let me conclude, Mr. Chairman, by stating that the FAA's
first priority always has been and always will be safety.
Safety is our agency's mission, and we have dedicated our
careers to promoting safety. It is a responsibility we do not
take lightly.
This concludes my statement, and I would be happy to answer
any questions the Committee may have.
Mr. Costello. The Chair thanks you, Mr. Sabatini.
At this time, the Chair recognizes the distinguished
Chairman of the Full Committee, Chairman Oberstar.
Mr. Oberstar. Thank you, Mr. Chairman, for holding the
hearing; and, Mr. Petri, for your participation, your support
of this initiative; and our staff for their extraordinarily
rigorous inquiry undertaken, beginning early this year, into
this issue of falsified medical certificates.
I read over, last night and early this morning, the
testimony of all the witnesses, and I am very encouraged by
what I see. The response of FAA to the issue is a positive one
and encouraging.
We do have the safest aviation system in the world. We do
have the most complex aviation system in the world. But the
fact that a number of certificated pilots have lied about grave
medical conditions in order to retain their pilot's license is
troublesome, worrisome, and in some cases, perhaps frightening.
Surely, we can appreciate and be grateful for the statistics
that the number of fatal accidents caused by medical
incapacitation are low. But we shouldn't have to rely on the
grace of God to get there.
A single impaired, intoxicated pilot could cause extensive
and widespread damage to the public through loss of life or
property damage. That is what the FAA wrote in an earlier
rulemaking. FAA does require pilots to undertake periodic
medical exams for fitness, but they are limited; they rely
heavily on self reporting, and not all medical conditions are
going to be obvious to a doctor who is seeing a patient for the
first time, especially in the case of mental illness. And not
all of these AMEs are as thorough as they should be.
The 2006 FAA survey, the Medical Service Airman Customer
Satisfaction Survey--they have got these wonderful long words
and usually they come down to an acronym--found that 15 percent
of airmen reported their medical history had not been reviewed
by their medical examiner. Seventy-nine percent had no medical
history review done at all of that small 15 percent sample. But
if you extrapolate that survey result to the entire pilot
population, it could be in 1986 that 89,000 pilots did not have
an AME review their medical histories, and nearly 24,000 pilots
did not have a physical exam done by an AME.
Now, the reason we have this AME process is so you have
persons who are designated by the FAA who know what they are
looking for, know what questions to ask, know what kind of exam
to give, and they should not be subverted or averted.
Inspector General Scovel, in 2005, your office found
egregious cases of airmen lying to the FAA about medical
conditions in order to pass their medical exams. In the 40,000
pilot sample, the IG's Office found 3,200 airmen with current
medical certificates simultaneously receiving Social Security
disability pay. Forty of those cases ultimately were
prosecuted, but hundreds more could have been prosecuted if
they had had enough personnel in the U.S. Attorney's Office to
do it.
Over a 10 year period, FAA's own researchers found 400
fatal accidents where pilots had potentially disqualifying
medical conditions. I note with interest in Mr. Sabatini's
testimony, his more detailed testimony, that FAA has gone
through these and reduced it down to a very small number, small
fraction; that if those exams had been done and if corrective
actions had taken, and if a number of other things had
happened, you would have had a fraction of a percent of
irregular medical conditions. But that is not good enough and I
think, Mr. Sabatini, you recognize that, and you have agreed to
coordinate with the Social Security Administration.
In Social Security determination, if you are disabled, you
are 100 percent disabled. Not so with the VA, which has
gradations of disability. Some VA disability conditions may
permit a person to continue to fly, but that is going to take
very careful review. It is going to take very careful
consideration of all those varying medical conditions.
I appreciate the seriousness with which Mr. Sabatini, Mr.
Chairman, undertakes his responsibilities. He is a premier
safety professional. But bringing together the National Driver
Register, notifying airmen that they are subject to review
through the National Driver Register I think is an important
point. I am the author of the National Driver Register, over 26
years ago. Well, not quite the author; it was John Rhodes who
preceded me by six years. But I did upgrade the National Driver
Register and brought it to what it is today, and I think it is
an exceptionally valuable tool in getting the full picture of
airmen's conditions.
So I think, while this process has been uncomfortable,
maybe even painful for the FAA, thanks to the Inspector
General's Office, thanks to the NTSB, thanks to our
investigative staff, the issues have been raised, they have
surfaced, they have been examined, they have been evaluated,
and FAA is on track to taking some vigorous steps toward
resolution of the problem and creating an even safer airspace.
I will have some questions later. Thank you, Mr. Chairman.
Mr. Costello. Thank you.
The Chair now recognizes the Ranking Member, Mr. Petri.
Mr. Petri. Thank you very much. Thank you all for your
testimony. This is an important subject, as the Chairman of the
Full Committee has pointed out, and it is good that we have
oversight on it.
I wonder, maybe Mr. Sabatini might be the right one, if you
could just sort of walk us through how the procedure works now
and whether this episode or whatever has pointed out some ways
of improving the procedure because of computerization and
opportunities for cooperation between agencies and the like.
Mr. Sabatini. The current system today requires that in
order to exercise the privileges of an Airman Certificate, one
must have an appropriate medical certificate to accompany those
privileges. Depending on the class of medical certificate,
nonetheless, one must complete an application which has a host
of questions, one of which specifically requires that you
answer whether or not you have been convicted of a DUI, or
driving while under the influence, and, in that instance, 100
percent of medical applications are matched or cross-checked
with the National Driver Registry. If there is a positive hit,
then there is a follow-up investigation that is conducted to
assess that situation.
The system is dependent on pilots being honest, and if
someone is intent on defrauding the system, as the Inspector
General has discovered, then certainly that is possible. So the
current system could stand to_as we have agreed_to have some
improvements included, one of which is going to be adding a
question to the questionnaire that specifically requires an
answer to whether or not you are receiving disability benefits
from any disability provider. And we will then, on a sampling
basis, compare that with, starting with the Social Security
Administration, a records match; and, of course, then follow-up
investigation in that regard.
We are also proposing to not only do the cross-checking,
but also to add the question, and we are strong advocates of
educating the community in the many different ways that we can
do that. So we can advise the community that this is now going
to be on the medical certificate and make them aware that there
is the potential for serious follow-up in terms of enforcement,
whether it is from the criminal side or whether it is ours,
from an administrative procedures side. We will vigorously
follow up any indication that there is misrepresentation of
one's medical condition.
Mr. Petri. There have been stories in the press from time
to time--I suppose they are accurate, though may be
exaggerated--indicating that when people retire from the
military or even from various civilian jobs, like being a bus
driver or so on, they often discover they have some disability
and that increases their retirement under some of the programs.
I don't know how widespread that is in the Air Force or among
pilots, but is that checked?
Mr. Sabatini. We do not now, today, have a method in place
to check exactly what it is that you have suggested. But I
would also tell you that is--and I don't have factual
information, but I can tell you anecdotally that we know that
there are military retirees who have a percentage of disability
that, in and of itself, would not necessarily mean being
disqualified, or having a condition that would prohibit the
issuance of an FAA medical certificate. So we don't have any
numbers on that, Mr. Petri, and that is the current state, but
we hope to change that.
Mr. Petri. One question. This works both ways, with Social
Security, at least, and some of these other programs; people
may be perfectly good pilots, but they may not actually have
the disability that they are getting paid for. Was fraud
discovered that way as this match was done, or was it only a
check on the qualification of people to actually fly airplanes?
Mr. Sabatini. The investigation_and I might defer to the
Inspector General who conducted the investigation_was primarily
to assess people who were claiming disability and who also had
a pilot medical certificate. And Social Security Administration
disability is 100 percent disability, and once you have that,
you would not qualify for an FAA medical certificate, so that
would be a concern to us and we would want to ferret that
information out.
Mr. Petri. Maybe I should ask Mr. Scovel.
Mr. Scovel. Thank you, Mr. Petri. I do have some
information that may help you understand the extent of that
problem. We touched base last week with the Social Security
Administration Office of Inspector General and we were informed
that, to date, six cases of disability fraud from Operation
Safe Pilot had been identified for their purposes. They report
total monetary achievements--and that is their term--of
$499,706 achieved from Operation Safe Pilot. The breakdown
includes $425,160 in savings due to canceled benefits
extrapolated over a period of five years; $66,513 in fraud
identified; and $8,033 recovered by way of restitution.
It is clear that, while Social Security has identified six
cases to date, they have informed us that they continue to work
other cases, so a limited number of subsequent court cases may
well come to our attention. Comparing that against the number
of cases which we identified and which the U.S. attorney chose
to prosecute, it is clear that the intent on the part of most
of the pilots that we identified as investigative targets was
to deceive the FAA, as opposed to the Social Security
Administration.
Mr. Petri. Thank you.
Mr. Costello. The Chair recognizes the gentleman from New
York, Mr. Hall.
Mr. Hall. Thank you, Mr. Chairman, Mr. Ranking Member, and
our esteemed witnesses.
Inspector General, what do you estimate that it costs per
prosecution to carry out Operation Safe Pilot, and would the
FAA likely incur similar costs if they were to pursue
administrative sanctions? If not, what would account for the
difference?
Mr. Scovel. Thank you, Mr. Hall. We had an opportunity to
evaluate the cost to my office of pursuing Operation Safe
Pilot. They amounted to a total of $401,192. The majority of
that had to be charged to the direct labor hours of the
investigation, but we also incurred administrative overhead
costs, some travel costs, and other direct costs. That cost
figure did not include FAA or U.S. Attorney Office costs, I
should note.
The cost per case prosecuted--and I will note that there
were 45 cases prosecuted--was $8,915 per case. My testimony
mentioned the figure of 48 cases. Those were the number of
individuals that we referred to the U.S. attorney for
consideration for prosecution. Three of those cases could not
be pursued, as I mentioned in my testimony, two because the
individuals died before the U.S. attorney could bring charges
and one because the individual was deemed to lack sufficient
capacity to participate in his defense at trial.
Mr. Hall. Thank you. On another topic, during Operation
Safe Pilot, did you find that the falsifications were more
prevalent in the general aviation community or were cases where
cargo or air transportation pilots were not being truthful? And
do these categories pose a higher safety risk than GA pilots?
Mr. Scovel. Thanks. I will note that among the cases that
we identified and referred to the U.S. attorney, there were 4
airline transport-rated pilots, 6 commercial pilots, 28 private
pilots, and 7 student pilots. The figure of 28 private pilots,
presumably all GA pilots, amounted to 62 percent of the number
of cases we referred to the U.S. attorney. I don't think, and I
won't say today on the record, that that indicates that general
aviation pilots pose a greater threat. The reason, as I see it,
that, in fact, 62 percent of our investigative targets happen
to be private and presumably GA pilots was simply because of
the investigative parameters that we and the U.S. Attorney's
Office set. In other words, we were looking at the type of
disability claimed, the nature and duration of the
falsification that had been submitted to FAA as part of the
medical certificate application, and also the U.S. attorney's
prosecutive requirements; they basically were looking for open
and shut cases. Applying all of those factors to the number of
cases that we had under consideration, more private pilots--in
fact, 62 percent--rose to the surface, and air transport pilots
and commercial pilots represented smaller numbers.
Mr. Hall. Thank you, sir.
This one is both to Dr. Garber and to Mr. Sabatini. The
Inspector General's testimony notes that the FAA and SSA are
trying to work in compliance under the Privacy Act to create a
list to cross-check applicants who may not have disclosed this
potentially disqualifying type of condition. In your
estimation, can the system be set up within the current
structure of the Privacy Act or, at some point, does Congress
need to consider amending the statute to allow the process to
move forward?
Dr. Garber. I think that that question probably would be
better handled by Mr. Sabatini, as it goes to the sharing of
information between those two agencies, so I will defer to him
on that question.
Mr. Sabatini. What we are proposing is a notice in the
Federal Register to inform the public about routine use of
information that would be available through the Social Security
Administration database and our database. As to the Privacy
Act, I would have to defer to our attorneys to answer that
question, since that is more of a legal issue, but certainly we
would respect whatever the requirements are of the Privacy Act.
Mr. Hall. Are there technological or proprietary barriers
to moving forward in terms of this coordination with SSA and
FAA?
Mr. Sabatini. We are in discussions with the Social
Security Administration, the Social Security Administration
Office of the Inspector General, and, of course, our people,
working out a memorandum of understanding on how best to
implement this.
Mr. Hall. Thank you very much.
Thank you, Mr. Chairman. I yield back.
Mr. Costello. The Chair thanks the gentleman and now
recognizes the gentleman from New York, Mr. Kuhl. You pass?
Very good.
The Chair now recognizes the gentleman from North Carolina,
Mr. Hayes.
Mr. Hayes. Thank you, Mr. Chairman, and thank you very much
for having a very worthwhile and thoughtful hearing on an
important safety issue. I thank Mr. Oberstar, as well, for his
interest and concern in this vital matter.
Thank you all for very extensive and informative testimony.
As a pilot--I was just looking--the form that we fill out is
quite comprehensive in nature and it can lead in a number of
different directions. Safety is the issue which everyone in
this room holds above_by considerable margins_anything else we
are talking about.
So, with that as a backdrop, would you all care to
speculate out loud about the dangers we face? We have talked
about medical issues, we have talked about falsification, all
of which are very serious. We have talked about jointly looking
at double-dipping. All these are crucial. Having said that,
again, do you have any concern that we might get beyond where
we need to go and make this complicated form even more
complicated, which, at the end of the day, puts a damper on the
vital commerce provided by commercial_and that is an issue,
because some of the things we do here concern commercial
pilots_that the process may be slowed down for them. By the
same token, general aviation and that group of pilots is
important to business and commerce as well.
Could you just speculate for me about some of the
precautionary measures that we, on both sides of the bench,
should be aware of as we move forward in this very important
process? Dr. Tilton, we have left you alone. May I start with
you?
Dr. Tilton. Thank you, sir, for the question. I am
certainly, obviously, very concerned. As you said, safety is
paramount. I work for Mr. Sabatini in the Office of the
Associate Administrator for Aviation Safety, so whenever I give
a talk, the first thing I say is the safety of the airspace is
number one; and then number two is to make sure, once we make
that as the ground assumption, that every airman that we can
possibly get back in the air, we do so. And we have a good
record. Obviously, we are very concerned about the small
minority of people who might take advantage of the system and
give us incorrect information.
And I am concerned somewhat about making the process more
complicated, but I think what we proposed are the correct level
of response to the IG's investigation. I don't think that we
are asking for any more ominous requirements on the part of the
airman; we are just making the questions a little more explicit
so there is absolutely no question in his or her mind that,
when they answer the question, they are doing it correctly. And
it give us one more opportunity to make sure the airspace is
safe.
Certainly, I am not interested in making the system more
egregious and difficult to participate in, but I think safety,
again, is paramount in this situation.
Mr. Hayes. Thank you very much. At the risk of sounding
like doing a promotion for AOPA, which is not my intention, I
held up the AOPA turbo medical, which is an online service that
pilots who are for the first time or going to renew their
certificate, can go online and look at some of the very
complicated but relevant chemical and other issues there are. I
am working with constituents right now. If you check off a
block that says ``have you ever been unconscious,'' then a
whole host of things happens to you. In this particular case,
there was an automobile accident and the law enforcement
officer said the person was unconscious and he says he never
was. Well, if he was never unconscious, his life is much
easier. Again, neurological issues are important. I simply make
the point, going forward, that I would encourage the
continuation of this process, but filtering in as heavy a dose
of common and practical sense as we can moving forward.
Again, this is kind of off the wall, it is not in the
official questions, but is there an appropriate place to
consider even a fourth class medical? It is kind of like
somebody learning to drive. If you are out in the pasture and
there is not a tree within 300 yards, and you are driving and
learning, that is one thing. There is a lot of aviation that
relates to that, as opposed to using sophisticated aircraft in
congested area space. Good reason for first, second, and third
class. Is there any fault, again, as a part of this effort, to
improve safety and focus on the right areas that maybe even an
additional to correspond with sport class license might be
appropriate.
Mr. Sabatini or Dr. Tilton? Anyone. My time has expired.
Mr. Sabatini. Thank you, Mr. Hayes. We do not now have any
thoughts about a fourth class medical certificate, but we do
have different grades, the first, second, and third; and we
also have, for light support aviators, other conditions under
which they cannot safely operate. That was done through a very
rigorous process of an NPRM and comments from the general
public, and we are convinced that is a safe approach. So, in
essence, there almost is something like a fourth class medical
certificate.
Mr. Hayes. Thank you, Mr. Chairman. I have taken it over my
time, but I appreciate your thoughtful responses as we work
toward better aviation safety and a practical response. Thank
you very much.
Mr. Costello. The Chair thanks the gentleman and now
recognizes the distinguished Chairman of the Full Committee,
Chairman Oberstar.
Mr. Oberstar. Thank you, Mr. Chairman.
Dr. Garber, in your statement you allude to the number of
aviation accidents where medical conditions contributed to, or
were a factor, and say that that number is underestimated. What
was your basis for that?
Dr. Garber. Well, we don't have the resources, sir, the
NTSB does not have the resources to do a complete aeromedical
investigation of every single accident. We focus on those
accidents where there is evidence, either from autopsy
information, toxicology information, or the circumstances of
the accident itself, suggesting in fact that there may be
medical or medication issues in regard to the accident itself.
So those are the ones that we look at.
Given that, there are probably some of those that we are
not able to make a determination; there is simply insufficient
information available, even with a comprehensive investigation,
to come to a conclusion as to whether or not the medical
condition or the medication played a role in the accident. For
that reason I say that the circumstances are certainly
underestimated. To that extent, it is difficult to say, but I
would say that we do a thorough job investigating those where
we have significant information suggesting that the individual
may have been impaired.
Mr. Oberstar. You had a staff review of 20,000 aviation
accidents, which you reviewed, since 1995 and found 327 in
which a medical condition, impairment or incapacitation,
including over-the-counter medications, antihistamines and
commonly known name of Benadryl. So it raises the question what
makes a condition a disqualifying condition. Some of these are
cardiac valve replacements; diabetes requires insulin;
epilepsy. What other conditions are disqualifying? And what
medications taken randomly, even over-the-counter medications,
can cause incapacitation?
Dr. Garber. Sir, I will speak a little bit to the
medication issue in that the NTSB has recommended more
comprehensive information be provided to pilots and other
transportation operators with regard to the medication issue.
There is no real comprehensive list of medications that are
either disqualifying or permitted within the transportation
industry or oversight regulatory area, so it is very difficult
to determine which medications, from an operator perspective,
would be allowed or would be disallowed if one was to indicate
that they were using those; and we believe that that should be
corrected. The NTSB has made recommendations in regard to that.
With regard to the question about the medical conditions
which are disqualifying and why, I think I will defer that
question to the FAA. They can give you more background as to
why they have chosen the particular conditions that they have
as being disqualifying in that regard.
Mr. Oberstar. I will pursue that in a moment. Recently, the
Board made a recommendation that FAA should require airmen
reporting conditions involving driving while impaired by
alcohol or drugs to provide a complete copy of the relevant
arrest report, including, maybe, court records. Why do you
believe that is necessary?
Dr. Garber. In the same way that the FAA requires records
to be submitted on any disqualifying condition. If you were to
mention to the FAA, as an example, that you had been in an
emergency room for chest pain, they would request information
as to the outcome of that evaluation and the specific
information that was developed during that evaluation. In the
same way, we think it is very important for circumstances like
a DUI, which are significant indicators of a potential problem
with substance abuse or dependence, should be evaluated more
completely. An individual who may have had one or two drinks
may not have an issue with abuse of the substance or
dependence, but an individual who is driving on a very high
level of alcohol may certainly be exhibiting evidence of
tolerance, which, by the FAA's own definition, is an indication
of substance dependence.
Mr. Oberstar. Well, I think it is an important
recommendation and an important action to take because that
arrest report gives a complete picture, not just a little
slice, not just a little subtitle or headline; but it gives the
medical examiner an opportunity for a complete review of the
circumstances. As Mr. Hayes referenced a moment ago, the
question of ``were you ever unconscious.'' Well, under what
circumstances? The arrest report would provide that kind of
information.
In the course of NTSB review of all--you looked at 20,000
records, you at NTSB and your staff followed these issues very
thoroughly, very carefully. Are you persuaded that the airman
medical evaluation is rigorous enough? Should the whole process
be reconsidered, re-evaluated?
I want to get Mr. Scovel's reaction to that as well.
Dr. Garber. The NTSB has made specific recommendations in a
variety of areas; for instance, medications and substance
dependence, as we have discussed here. Also, we have commented
that we believe that there should be a reporting requirement to
the system itself. The system itself, however, is fairly
robust, like many other areas of aviation, and provides a
significant review of those conditions under fairly strict
guidelines, and in that regard probably is something of a model
for other agencies, other organizations that share the same
sort of regulatory oversight. There are areas for improvement,
and the NTSB has certainly specified the areas where we believe
improvement is both possible and should be made in the interest
of safety. At the same time, we do recognize that this is a
significant oversight function which is generally performed in
a fairly substantial manner by the FAA.
Mr. Oberstar. Mr. Scovel, have you evaluated the airman
medical review and do you think it is adequate as it stands, or
should it be overhauled?
Mr. Scovel. Good morning, Mr. Chairman. I would begin by
noting that my testimony this morning, of course, is based on
Operation Safe Pilot, which was a criminal investigation
project undertaken in one corner of the Country, really. We
have not audited a full-blown audit of the Airman Medical
Certification Program, so I am not able to say with authority
that the program itself is systemically deficient.
I think we can say, however, based on both the results of
Operation Safe Pilot and on the results of an FAA survey from
2006, which was referred to by the Committee earlier, that
improvement in oversight certainly is to be desired. Operation
Safe Pilot identified some limited systemic problems and we
have suggested improvements to FAA and to the Committee to
remedy those. The 2006 survey, which, to its credit, FAA itself
undertook--it was not an IG project--identified problems,
however, with the airman medical examination itself. Some of
those examinations, as reported by airmen, had been conducted
not by physicians, but by non-physicians. In a significant
number of instances there was no detailed inquiry during the
examination of the airman's reported medical history. That too
is required by FAA regulations. We would encourage the
Committee and, of course, FAA to tighten up its oversight and
the procedures involved in the actual examination that airmen
undergo by Airman Medical Examiners, too.
Mr. Oberstar. Thank you, Mr. Scovel.
Dr. Tilton, are you satisfied that FAA's AME is as good as
it should be, needs to be?
Dr. Tilton. Sir, I am satisfied that the process----
Mr. Oberstar. And enough oversight of the process and
enforcement?
Dr. Tilton. I am certainly satisfied that the standards we
have and the process we have set up is correct. I am obviously
not satisfied by results of the survey that the IG just told
you about and that you have referred to because we always have
concerns any time we find out someone is not complying or
following the correct process. So, in the case of this
particular survey, it was an anonymous survey, so how do we
then proceed upon reviewing the results and making a
determination? What we do is, we talk to our AMEs. And the
purpose of the bulletin, where you noted that particular
survey, is education to the AMEs on how they should be
educating their airmen. The other thing that we do is, we go to
air shows. For instance, in a week or so I will be at Oshkosh;
we go to Sun 'n Fun and we talk to airmen directly. In every
seminar we have with airmen, we talk to them about the
importance of the system, and we also tell them if they find an
AME like the ones that are reported in this anonymous survey,
they should let us know. And when we know that information, we
take positive action against that AME to make sure that he or
she is appropriately disciplined, including de-designation.
So although I think we need to do more, we always can do
more, I think we have a good system. We need to keep looking at
it and making sure that every time we find information like
this, we take positive action to correct it.
Mr. Oberstar. Well, taking the positive action is
critically important, and strong enforcement action.
Mr. Sabatini, an FAA researcher last winter found, during a
10 year period, 10 percent of pilots involved in fatal
accidents tested positive for medications used to treat
potentially disqualifying medical conditions, but only 20
percent of them reported their medical condition on their
airman application. Is that acceptable?
Mr. Sabatini. Absolutely not, sir. As I said in my opening
comments and my closing comment, safety is paramount for us,
and every system can stand improvement, and I can assure you,
Mr. Chairman, that we will vigorously pursue anyone who
falsifies information provided as required to be provided.
I would also like to point out that while this report, this
survey that is being discussed here was exactly that, it was
anonymous to solicit information, again, it is an indication of
how the FAA is being vigilant to assess what is going on in a
system that is highly dependent on voluntary compliance.
I would also add that the recommendation that was made by
the NTSB has been taken very seriously by us, and, in
discussions as recent as this past week, I can assure you that
we will be taking the kind of action that is going to require
an airman to provide us with the full record of that person's
arrest or conviction, or whatever the case may be, as well as
exploring whether we can, in fact, get that record from the law
enforcement organization. So it is a new area for us, but we
take very seriously what has been recommended. It makes good
sense. There is a possibility of tolerance. That is
unacceptable in our community, and we are working vigorously to
address these areas of, as has been said, in the area of
oversight.
I would also tell you, as Dr. Tilton has said, the
standards that we have are global standards. We are sought
after and asked to share with the global community how we go
about the business of certifying from, a medical perspective,
our airmen. So I believe the standard is more than adequate and
I would tell you that the FAA is vigilant and will continue to
be vigorous in its pursuit of anyone who misrepresents
information.
Mr. Oberstar. We are counting on you to be vigilant. We are
counting on FAA to be the gold standard for the whole world in
all of aviation safety, and that means pursuing these matters
vigorously. In that analysis of the research, 40 percent of
those pilots were rated for air transport or cargo operations.
It didn't say whether they actually were operating as Part 121
pilots, but it is troubling that apparently these more
stringent medical exams were not applied in those cases. You
are going to correct that?
Mr. Sabatini. Oh, absolutely, sir. Yes, sir.
Mr. Oberstar. All right, thank you.
Thank you, Mr. Chairman.
Mr. Costello. Thank you.
The Chair now recognizes Mr. Reichert.
Mr. Reichert. Thank you, Mr. Chairman. I would like to
follow up on a couple of comments and a couple of lines of
questioning by Mr. Oberstar and Mr. Petri that has to do with
process.
I am not a pilot, but I fly a lot as a passenger, and have
over the last number of years. But what I have done in my past
career is investigate; 33 years with the sheriff's office in
Seattle. My last eight years was as the sheriff. We have an air
support unit there, so I have been responsible for, of course,
making sure that our pilots are trained well and meet the
medical requirements. And as you know, safety, of course, is
our number one priority in the sheriff's office, too. And here,
today, we are talking about safety and keeping our airlines
safe and the pilots safe and the passengers safe.
Again, the process is_it seems like there are a lot of
moving pieces here, for me. The medical evaluation and the
medical application is completed; there is an employment
application. Does that marry up? Do those two documents marry
up when the pilots apply--in the case of a commercial pilot--to
the airlines for a job? How does that work? Or do they have
their own separate medical document that they need to complete?
Mr. Sabatini. First of all, let me say that we have a lot
in common. I am a retired New York City police officer, spent
20 years in the NYPD, 11 of those years flying in the air unit.
So I am very familiar with that kind of support.
Mr. Reichert. Thank you for your service.
Mr. Sabatini. I would say that the medical certificate is
required to be provided as evidence to a potential employer as
to the qualifications that are required for that particular
position. You will then be subjected to, say, an air carrier's
own medical examination as well. So, in that sense they come
together. Whether the air carrier in fact researches the
medical certificate, I can't answer that with certainty at this
point in time.
Mr. Reichert. You know, in the NYPD and in the King County
Sheriff's Office, as you go through this process of hiring
someone, a medical application is completed, there is a release
that is signed for medical records. Does that occur in the
pilot field?
Mr. Sabatini. Before someone can be hired in the air
carrier world, I know the acronym, I can't think of the actual
description, but it's the pilot record, PRIA, that has to be
complied with in terms of_the air carrier has access to the
previous history of the pilot, and I believe that will include
the medical certificate as well.
Mr. Reichert. So as these applications are completed, is
there--we have background investigators that go out to the
sites and visit with neighbors and friends of people applying
for a job. Is there a polygraph given to prospective employees
of airline companies?
Mr. Sabatini. I don't know of any air carrier, so I can't
speak with authority on it, but I doubt that there would be a
polygraph. There are many examinations that are required,
written exams or questions that need to be answered. But I will
tell you this, that the system is a robust system. Before
someone actually ends up at the controls of an aircraft--and
let's use the air carrier world as an example--one must go
through required training, basic indoctrination to that air
carrier's system. And that is not an option, it is required by
Federal regulation. Once the training is complete, then that
person must demonstrate through a flight check with their own
instructors that the person is competent and proficient in that
particular pilot station that person may be sitting in; then
followed by an FAA proficiency check to ensure that that person
can in fact execute the responsibilities of that position.
Mr. Reichert. Thank you. My time is really going by here
fast. In the law enforcement world, you fill out this
application, you know, ``have you used drugs in the past;''
and, of course, there are time limits on some of the more major
drugs. Marijuana is also listed on there; how long ago did you
use it, those sorts of things. And when those questions are
asked on the medical application, the polygraph test is given
and they say on the application ``we have never taken this
drug, we have never taken this drug,'' and it has been 10 years
since but it has been 5 years in reality. A polygraph test
catches that sort of thing.
The other thing is, we have a fit-for-duty, as you know, in
law enforcement. When you recognize something with a pilot, is
there a fit-for-duty examination?
And the last comment I want to make here, before you
respond, is the connection between SSA and the FAA and medical
records--and you say if they are on Social Security, there is
100 percent disability. There is no need, then, to really know
what the personal medical history is if the Social Security
system has already reviewed that, given the 100 percent
disability. All you need to know is if he or she is on Social
Security, and they are gone.
I am over time, but could they answer, Mr. Chair? Thank
you.
Mr. Sabatini. That is true. We would, at that point in
time, if it was an SSA disability, that person would
automatically be disqualified. But there is a due process that
we must follow and revoke that medical certificate.
Mr. Costello. The Chair thanks the gentleman.
Mr. Sabatini and Dr. Tilton, you have heard from the
Chairman of the Full Committee, Chairman Oberstar, and I think
other Members of this Subcommittee were pleased that the FAA is
moving in the right direction to correct some of these
problems, one, by looking at the database and working with the
Social Security Administration; two, by revising the form to
specifically ask the question if the applicant is receiving any
disability. So we are pleased that you are moving in that
direction.
You heard Mr. Scovel testify that there are improvements
that need to come about in oversight. Also, the fact that there
were some examinations apparently given by non-medical doctors.
I want to give both of you the opportunity to comment on both
of those issues, on improving oversight and the fact that
apparently some examinations have been given by non-medical
doctors. I wish you would comment on both, please.
Mr. Sabatini. Sir, let me give you my first response in
terms of non-medical. Again, it is the FAA aggressively
pursuing information that can help us be good at the work that
we are responsible for, and that is the oversight of the
system. I would suspect that--first, let me say that no one has
ever been issued a medical certificate that was not signed off
by a doctor. So perhaps in the office--and this is speculation
on my part, and that is the issue that we have in terms of
surveys that are anonymous_we can't pursue that person and find
out exactly what they are referring to. But it is possible that
there are physician assistants who performs a preliminary
medical examination and then present the information to the
doctor in the office, and that doctor is then required to, of
course, be the person who signs off on the medical
authorization and the issuance of the certificate.
But I will turn to Dr. Tilton and ask him to expand on
that.
Dr. Tilton. I agree with what Mr. Sabatini said. It
certainly is possible that occurred. It is not in line with our
process. We do use ancillary personnel to do things such as
EKGs or draw blood or check the blood pressure, but the AME, he
or she, is duly responsible to do that examination; they are
required to lay hands on the patient, to do the various tests
that the physician should be doing to ensure to him or herself
that that is done correctly.
Whenever we find out that there is a case where that hasn't
been done, we take aggressive action against that AME. It is
difficult sometimes to get that information, and we have heard
anecdotes about some people traveling a long way to get their
physical because they know if they pay such an amount of money,
they will get it without a whole lot of difficulty involving
the AME himself. When we find out about that case, we take
action against those; and we rarely find those. In fact, we
have a process now that we look at all our AMEs; we look at how
many examinations they do, we look at where they are located,
we look at how far people travel to get to that AME to compare
distances. For instance, if someone has traveled 3,000 miles to
get their physical_why? We have a good example of that in
Prescott, Arizona. Although Prescott, Arizona has the school
Embry-Riddle, so there is good reason why people coming from
some other State might have their physicals there. We haven't
found any meat in that data, although we have reviewed it very
carefully.
I am very concerned about this information where we hear
that an AME has not done the physical correctly or they haven't
seen the doctor, and when we find that out, we will take
aggressive action to make sure that doesn't happen again.
Mr. Costello. Dr. Garber mentions in his statement the fact
that he talks about anonymous reporting, and I am just curious
how many anonymous reports on a pilot's medical condition does
the FAA receive? Is it a large number or is it rare that
someone anonymously reports a medical condition to the FAA of a
pilot?
Dr. Tilton. Sir, I wouldn't say it is--it is not every day,
but it is not rare, either. We get several anonymous reports
yearly, and what we do with those reports is we immediately go
out to that airman and we acknowledge that we have information
that may affect that airman's privileges, and we ask them for
more information. Of course, with an anonymous report,
sometimes we find out it was somebody who had some kind of
reason, an ex-wife or something, and that does occur
occasionally. But we do take action; we ask for more
information. Sometimes we get family members saying, you know,
my husband is 86 years old and I am really concerned and I
don't want to do anything about it myself, but I would really
like you to do something. We will pursue that; we will ask for
more medical information to see if there is substance. If there
is substance, we take action.
Mr. Costello. Last question. I think we all recognize that
some pilots have intentionally failed to disclose information
on their applications and others inadvertently leave off, omit,
or fail to report either medication or other debilitating
illnesses. Both the IG and AOPA have suggested that there
should be an amnesty period before we begin to do the match-up,
the matching program, and I just want your comments, Mr.
Sabatini and Dr. Tilton. Do you believe that we, in fact,
should proceed with an amnesty program? Please.
Mr. Sabatini. I believe a grace period would be an
appropriate action to take, but I would caution so that we all
understand. In those circumstances where someone were to reveal
a medical condition that would be disqualifying, we would still
take the appropriate revocation action of that medical
certificate, even though they came forward voluntarily and
revealed that condition. In other circumstances we would not
pursue any punitive action.
Mr. Costello. The Chair thanks you, Mr. Sabatini, Dr.
Tilton, Dr. Garber, and Mr. Scovel, for your testimony today,
and we look forward to following up on this important issue
with the FAA as they move forward to implement this program. We
thank you, and the first panel is dismissed.
We would ask the second panel, consisting of one witness,
to come forward, please.
Let me recognize and introduce our sole witness on the
second panel and let Members know, and the first panel know, of
course, as always, that there are questions that we will submit
both for the first panel and Mr. Boyer, as well, in writing for
the record. So we want both Members and witnesses to know that.
We recognize now Mr. Phil Boyer, the President of the
Aircraft Owners and Pilots Association, for his testimony. And
let me say, before you present your testimony, Mr. Boyer, we
greatly appreciate both you and your organization taking this
issue very seriously and coming up with a four-point plan to
address the issue, and we look forward to hearing your
testimony and hearing you explain what that plan is about.
TESTIMONY OF PHIL BOYER, PRESIDENT, AIRCRAFT OWNERS AND PILOTS
ASSOCIATION, FREDERICK, MD
Mr. Boyer. Well, thank you, Mr. Chairman. Just before
starting, not exactly the appropriate place, but I would like
to thank you, your leadership, the Committee, Ranking Member
Petri for a really sane approach to financing the entire FAA,
not just the section we are talking about here. You have our
undivided support of all of our membership for H.R. 2881.
You know about us, 412,000 members. That is two-thirds of
all of those certificates that were reported earlier. And, in
the main, many of these are the private pilots that we were
talking about. The organization has always taken medical
services very, very seriously. As a matter of fact, there are
about 30,000 member contacts a year, 13,000 of those by phone
that we answer. So it is a good example of industry and the
industry self-policing itself. We even cover non-members. We
talk about medical action in magazines and in our electronic
publications, including the website.
Let me tell you--and pardon me, Mr. Graves, for talking
about something you know about--a medical certificate is a
pilot's most prized possession. It is sacred. I mean, getting a
license is one thing, but let's not forget, you must be
medically certified to be in one of these categories that we
are talking about. Therefore, when ramp checked or anything
else, a pilot has to have not only the original license of
issue, but also that medical certificate, and since 9/11,
through the actions of our group, a photo ID.
Once again, pardon me, Sam, but just to clarify, there are
three levels of medical certification. The third class, that is
somebody who flies not for hire, generally taking a family, a
business associate, somebody who knows them up; not, as was
mentioned, somebody who is flying or taking up in law
enforcement. That is good for three years except, for most of
us over 40, for two years we go to the doctor. And, actually,
there is a proposal and a ruling right now on the docket that
would--a notice of proposed rulemaking that would extend that
period to five years. It is an example of our talking about an
issue that is constantly changing. The technology, the
medicines really do need to be looked at, and not stay with
rules from 1940 or earlier, when we are looking at what we
certify and what we don't certify; and, as we all know, that
brings us a lot of longevity.
The second class medical, which is the first place in which
you would fly for hire or carry passengers, is used for the
commercial pilot certificate. It is good for one year. And then
the airline pilots that we were talking about have to go for a
medical--and the corporate aircraft--every six months. And this
rulemaking I talked about is being proposed to extend that to
one year.
One thing that wasn't brought up that I think is very, very
interesting and should be considered as we talk about that is
the FARs continue to emphasize that the pilot must determine
that he or she is healthy to fly before every flight. And it is
a violation of the rules--whether you are taking an
antihistamine, a prescription drug, or whatever--if you are not
self-certifying before flights. And those of us who have flown
many times know bad cold, maybe an injury to the foot or
something that might affect a rudder pedal is a reason we might
have another pilot onboard flying our plane.
Just to look at the misconception out there is_you heard a
lot of statistics. In the end, we are dealing with reasonable
people who don't want to go out and kill themselves and their
family; a very conservative group of people who will ground
themselves before flights when they are taking a medication or
have some other kind of medical situation; and medical
incapacitation is rare. One-quarter of one percent of all
accidents are due to medical incapacitation.
Now, you heard larger numbers than that, but that would be
like me looking at somebody who had 50 stab wounds, was
obviously killed, and then we examined that individual and
found that they may have had a plaque buildup in their
arteries. The real reason were those 50 stab wounds. The plane
ran out of fuel or this or that. But, once again, you heard
that word ``possibly.'' The actual data shows one-quarter of
one percent. And if we look at medical fraud, five-one
hundredths of one percent. Now, once again, we don't condone
any kind of falsification of fraudulent records.
And I will tell you, in preparing for this, in talking to
the Committee, and in really seeing the IG's report, as a 40-
year pilot, I was never aware that this complicated form that
Congressman Hayes referred to_that there were these kinds of
penalties if we didn't get something right; and I will tell
you, it is not difficult to forget that doctor's exam that you
went to. I just was thinking about, now, where would that apply
to me when I go in next April. And, you know, I went to the
doctor about four months ago for a sore in my heel. Turned out
to be a burr caused by a shoe. I might forget that when I am
going to an AME. It had nothing to do with my flying. And that
would be counted as a falsification of the record. So we have
got to understand that there are inadvertent errors.
There is a question 17 on here: Do you take any non-
prescription medicines? Somebody starts filling it in and it
causes you to be kicked back if you, once in a while, take a
Tylenol. Believe me, in this job, and I am sure in your jobs,
you have to take one of those every once in a while.
One of the things I think we want to protect is, that the
FAA budget, the Civil Aviation Medical Institute is not well
funded; it is a flat budget. The people that you are looking
for_Sabatini and Tilton_to do all this fact checking are not
given a great budget, and right now many of your members
probably write you and say, ``could you help me get my medical;
I've put in all the paperwork and it doesn't come through.''
That is because this area of FAA has never been given the
proper money. So if we are going to do other things, let's make
sure the FAA has the budget to do them.
And I think the four-point plan that we have outlined--and
I am not going to take a lot of time on it because, actually,
you are aware of it in my testimony and it has been spoken to
already, but we ought to have a warning on the form, a public
disclosure that the data will be shared with public agencies.
Let's face it now, security agencies are looking at this, not
just the driver record. So let's add to that all agencies. And,
you know what? In September of 2005, when the IG report first
came out, we wrote a letter to the FAA saying let's do this;
not waiting for this Committee to have a hearing or anything
like that.
Proactively, let's look at identifying falsifications. So
let's say I had filled out that application last April and I
hadn't talked about this little burr on the heel of my foot
when I visited a doctor. Once again, not disqualifying, but I
didn't put that I had that physician visit. Let's give this
amnesty period we talked about for people to clear up things
like that; not that I had heart bypass surgery and I didn't put
it in. I mean, they will have to go through the rigors of
getting back in.
And then I think one of the most important things is a data
sharing program. Let's not put the onus on the FAA. They don't
have the budget to do this, and it is going to slow down, it is
going to increase your e-mail and letter flow, and mine, to
help pilots as our constituents.
But the most important thing is we will help. With the size
of our publications, the size of our organization, the many
ways to reach pilots, we will get back in and talk about the
changes that will occur to the medical form. For more than four
years we have had, like Turbo Tax, a medical form online. It
was referred to here by Congressman Hayes. It allows you to go
through, and if you make a mistake or fill in a box wrong--this
is before you go to the doctor--it kicks it back and says that
medication is not valid under FAA rules, you may want to try
this kind of beta blocker or something else.
For four years we tried to get the FAA to accept this form.
They spent a lot of money and now have just recently come out
with their own electronic form, so now they are saying, okay,
we will accept yours. We had already spent the money and could
have done it for the FAA, but it is out there and we will
promote that.
The penalties_things I didn't know about_we would love to
let members know that, careful now, this is an important form,
and if you make a mistake on it, you could be subject to these
onerous penalties that are out there.
And the amnesty period. Anything that has to do this.
Pilots are very law-abiding people and, believe me, they don't
want to defraud the Government. They don't want to fly
unsafely.
And I thank you very much for allowing me this time to
explain what I think would be a great program for the FAA and
for AOPA to undertake.
Mr. Costello. The Chair thanks you, Mr. Boyer, and
recognizes the Ranking Member, Mr. Petri.
Mr. Petri. Thank you. Thank you for your testimony.
Obviously, much thought and work was put into it; it was a very
professional job. I think it does remind us all that we are, in
our Country, self-governing, and that is how the system really
works and works best, and if it is driven by the people who are
involved in these systems, they have the best sense of what is
working and what is not working, and also incentive to make it
as effective, but also as simple and user-friendly as possible.
I hope you may be in Oshkosh. I don't know if you are going to
be there next week or not. Not this year?
Mr. Boyer. Oh, I am there for two different sessions.
Mr. Petri. Oh, you are.
Mr. Boyer. Four days total.
Mr. Petri. Then you know the manifestation of pride in
aviation, and in our Country, really, that is there, and it is
a unique kind of a thing in all kinds of subtle ways. So
anything we can do to help you and your association as you
promote safety and, at the same time, attempt to make this an
open and accessible process for Americans so that they have the
freedom to engage in this aspect of science and of life, we are
eager to work with you on that. Thank you very much for your
testimony.
Mr. Costello. Thank you, Mr. Petri.
Mr. Boyer, I had just a few questions, and you answered
them in your presentation, so I have no other questions. As you
indicated, we had a prior discussion several weeks ago, and you
put together what I think is an action plan that is workable
and makes sense and is very reasonable. We look forward to
working with the FAA and other agencies that will be involved
in the process to follow up as the process goes forward.
I do believe there should be a grace period. There are many
pilots out there that, as I mentioned earlier, some may have
intentionally failed to disclose, but many, many others it is
just an omission on their part that they forget to put on the
form. So I believe there should be a grace period, and I think
a one-year grace period, as AOPA is proposing, is reasonable.
So we thank you for your testimony. We thank you for your
always being proactive, and that concludes this hearing.
[Whereupon, at 11:35 a.m., the Subcommittee was adjourned.]
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