Issue Spotlight
DUI… DON’T… but if you DO… Here’s What You Need to Know (Part 2)
If you haven’t already, please refer to our last issue for Part 1 of this series discussing reporting obligations for DUI. In this issue, we discuss what happens if your certificate is deferred to Oklahoma City. That answer can be far ranging and surely varies by each case. I will attempt to outline the most probable scenarios based on our experience.
If the certificate was deferred because the required documents outlined above were not available, then the situation can usually be resolved by providing those documents to Oklahoma City. Once all documentation is provided and if the results show all outcomes to fall within the clear column, the certificate will likely be issued. This process of deferral, followed by providing documents to the FAA, can take weeks if not months.
If the certificate is deferred because there was a BAC reading of 0.15 mg/dl or greater, this was a second offense, or there was a refusal to provide blood/breath test at the time of the arrest, the FAA will most likely require additional information to include a substance abuse evaluation.
So what information are they likely to request? In our years of experience, we have found that, along with the supporting court, police and DMV documents, the FAA will request an evaluation by a Substance Abuse Professional (SAP). SAPs can vary in their ability to provide the FAA the type of evaluation they require. The outline of that evaluation can also be found on the “FAA Certification Aid” In this case, I refer you to Page 3 of the aid, “Report from Substance Abuse Evaluation (SAE).” The issue that we have found over the years is that most SAPs are not familiar with the differences between a medical diagnosis of substance abuse or dependence and the FAA’s regulatory definition. Those differences are explained briefly in the FAA’s Substance abuse FAQs, which is found at this link. The primary difference is that an airman only needs to meet one of the criteria as outlined in the regulation. This differs from the clinical diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Should a substance abuse evaluation be required, we normally recommend the pilot seek an evaluation by one of the HIMS trained psychiatrists. The FAA does not publish its list of HIMS trained psychiatrists to the general public. The best way to locate a qualified HIMS psychiatrist is by contacting our office, your FAA Regional Flight Surgeon (numbers found here) or a HIMS trained AME ( AMEs found here). Once that evaluation is completed it will need to be provided to the FAA along with other required documents if not previously done so.
What occurs once the FAA reviews the evaluation and makes a determination? If one does not meet the FAA criteria of substance abuse or dependency, the airman is usually granted his/her medical certificate but warned not to have another alcohol or drug-related event.
Should the FAA determine the airman meets the criteria of substance abuse, on occasion, they will grant certification under Special Issuance with monitored abstinence. This requires total abstinence for a period of two to three years, with random periodic drug/alcohol testing and monitoring by a HIMS AME. In this case, the FAA requires several months of testing/monitoring before willing to clear with Special Issuance.
A determination that one meets their definition of substance dependence will normally require participation in a HIMS or HIMS-like program. Participation requires remaining abstinent for your career, in-patient or possibly intensive out-patient treatment, random periodic drug/alcohol testing, participation in group aftercare and monitoring by a HIMS AME, peer and company monitoring. The monitoring requirement is typically 3 to 5 years but can be longer.
Should an SAE be required, the FAA will then typically take weeks or more often months to make a determination. Should treatment and HIMS participation then be required, an additional 8 to 12 months or more will be required before one is likely to have an FAA determination.
As you can see, the process following a DUI (once the FAA becomes aware) can take months or well over a year at times. The more one understands this process and the sooner one starts providing the required information for a determination the better.
Under current FAA policy, I will summarize the outcomes as follows:
- Single, first time DUI with a BAC of less than 0.15 mg/dl and all documents provided to the AME/FAA usually results in certification.
- Single, first time DUI with a refusal to roadside test will require an SAE. The outcome will depend on the SAE evaluation. This may result in certification. However, more often than not, will require 2 to 3 years of monitored abstinence. The key is getting a proper SAE with a HIMS trained psychiatrist as soon as possible.
- Single DUI with a BAC of 0.15 mg/dl to 0.2 mg/dl, or a second event with the first event being greater than 5 years prior will require an SAE. There is the possibility of monitored abstinence, however we are seeing more situations where full HIMS participation is required.
- 3 DUIs at any time, 2 DUIs within 5 years or a first time BAC of greater than 0.2 mg/dl will require treatment and full HIMS participation. This will more than likely be required for consideration of Special Issuance regardless of what the SAE shows.
For all of the above situations, we recommend remaining abstinent from alcohol use until a determination on certification is made. In the above outcomes numbered 2, 3 and 4, we recommend in addition to remaining abstinent that the airman start a program of random alcohol testing in order to document this fact since the FAA requires several months of testing/monitoring data before willing to clear.
Often the debate comes from the evaluation and the definition of the disqualification under the regulation. Under the system of FAA Medical Certification, the determinations are made by the Office of the Federal Air Surgeon. For the most part, their determinations are consistent and generally follow the outcomes noted above. The primary complaint by most is the time required for the office to make such determinations. The best way to avoid such delays is by providing complete and accurate information the first time through. Even so, if your local AME is not able to resolve and make a determination at the time of your medical application, you can expect months or longer for that determination to be made at a higher FAA level. Should you have an arrest for DUI, we recommend starting that process immediately. One should NOT wait until the time of the next FAA medical application.
For more information or assistance with reporting DUI arrests or convictions, contact an AMAS staff physician to discuss your concerns confidentially.
Stay Safe, Drink Responsibly, and use rideshare services as needed.
Keith
W. Keith Martin, MD, MPH, Chairman