THE FAA’S UNTOLD MEDICAL SCANDAL: HOW FEDERAL BUREAUCRATS SEIZED POWER OVER PILOTS’ PRIVATE HEALTH RECORDS

THE FAA’S UNTOLD MEDICAL SCANDAL:

HOW FEDERAL BUREAUCRATS SEIZED CONTROL OF PILOTS’ HEALTH, PRIVACY, AND LIVELIHOODS — WITHOUT CLEAR LEGAL AUTHORITY

For decades, the FAA’s Aeromedical Certification Division in Oklahoma City has operated with virtually unchecked power. Its physicians — many of whom never meet or examine the airmen they judge — make decisions that determine whether pilots can fly, earn a living, or support their families.

But beneath the surface lies a deeper, more explosive issue that aviation attorneys and constitutional scholars are only now beginning to confront:

The FAA may have no lawful authority to collect, store, or review pilots’ private medical records, and the agency’s entire medical process may be violating state medical laws across all 50 states.

This is not hyperbole.

This is not theoretical.

This is the unavoidable conclusion when you apply the law — federal and state — to the FAA’s current system.

And with Chevron deference dead, the FAA’s long-standing legal shield has evaporated.

THE FEDERAL GRAB OF PRIVATE MEDICAL RECORDS — WITHOUT CLEAR STATUTORY BASIS

When a pilot applies for a medical certificate, they are effectively required to surrender:

• Full medical history
• Hospital records
• Psychiatric notes
• Sleep studies
• Diagnostic tests
• Prescription history
• Counseling records
• Cardiovascular files
• Surgical reports
• Childhood medical information

If a pilot refuses this intrusion?

The FAA grounds them.

No other profession in America — not police, firefighters, truck drivers, nuclear operators, or federal agents — must surrender their most sensitive private medical data to a Washington bureaucracy simply to work.

This raises a foundational question:

Where in Title 49 did Congress authorize the FAA to seize a citizen’s private medical records?

The answer: nowhere.

Congress empowered the FAA to issue airman certificates, not to build a national medical-surveillance apparatus. The agency simply created this expectation through regulation and then treated it as inherent authority.

But authority over private medical records is not implied — it must be explicit.

And the FAA does not have it.

WHY THE FAA SHOULD NOT HAVE ANY ACCESS TO PILOTS’ MEDICAL FILES

If aviation safety requires medical assurance, the solution is simple:

A pilot’s licensed, treating physician should determine that pilot’s fitness to fly —

not a federal bureaucrat reviewing medical records in another state.

This is how it works in nearly every other regulated profession:

• Commercial drivers require a DOT medical exam — by a licensed examiner.
• Railroad engineers undergo medical clearance — by their own licensed clinicians.
• Police and fire personnel receive fitness evaluations — by local medical professionals.

None of these occupations require an individual to surrender their entire medical history to a federal agency.

Only pilots are subjected to that level of intrusion.

The FAA has wedged itself into the private medical relationship between pilots and physicians — a place the federal government was never meant to be.

THE FAA’S PROCESS IS INDISTINGUISHABLE FROM THE PRACTICE OF MEDICINE

The FAA frequently argues:

“We are not practicing medicine — we are conducting administrative evaluations.”

But facts matter.

FAA medical officers routinely:

• Diagnose conditions from charts
• Interpret ECGs, imaging, and lab results
• Assess psychological and cognitive status
• Evaluate cardiac and neurological risk
• Override licensed physicians who actually examined the patient
• Issue binding medical judgments affecting employment and certificate privileges

This is not “paperwork review.”

This is the practice of medicine, exactly as defined by state law in all 50 states.

And here is the legal bombshell:

State law defines the practice of medicine as occurring where the patient is located — not where the doctor sits.

So when the FAA renders a medical decision about a pilot in:

• Michigan
• Florida
• Texas
• California

…the FAA physician is, by law, practicing medicine in those states.

Are FAA physicians licensed in those states?

Almost never.

If a private doctor did this, they would be prosecuted.

The FAA simply calls it “regulation” and moves on.

But in a post-Chevron world, a court may not look the other way.

THE FAA’S LACK OF EXAMINATIONS EXPOSES EVEN MORE LEGAL RISK

State medical practice acts require:

• Physician-patient relationship
• Examination
• Direct evaluation before diagnosis

Yet FAA doctors:

• Never examine the pilot
• Never speak to the pilot
• Never build a physician-patient relationship

They diagnose from afar, without licensure in the pilot’s state, without examination, and without any of the safeguards required of actual clinical practice.

It is the most unregulated practice of medicine in America — carried out by the very people who insist they are not practicing medicine at all.

THE POST-CHEVRON LANDSCAPE: THE FAA’S LEGAL SHIELD HAS DISAPPEARED

For 40 years, Chevron deference insulated federal agencies from judicial scrutiny. Courts were required to defer to an agency’s interpretation of vague statutory language.

That era is over.

Now judges must ask:

1. Where did Congress authorize the FAA to access civilian medical records?
2. Where did Congress authorize FAA physicians to render medical judgments nationwide?
3. Where did Congress authorize the FAA to override state medical licensing laws?
4. Where did Congress authorize the FAA to impose medical surveillance on one class of private citizens?

The FAA cannot answer any of these questions.

Because the authority does not exist.

DUE PROCESS FAILURES ARE BAKED INTO THE SYSTEM

Pilots routinely experience:

• No right to question the FAA physician
• No hearing before denial
• No requirement for the FAA to provide evidence
• No timeline for processing
• Months or years of delays
• No ability to challenge factual or medical errors
• No recourse for misuse of medical records

This is not safety.

This is bureaucracy weaponized against the very people who keep American aviation running.

AMERICA FIRST: PUT PILOTS ABOVE BUREAUCRACY

America relies on its pilots — not its bureaucrats — to maintain the world’s safest aviation system.

Yet the FAA continues to treat pilots as liabilities, not professionals:

• Stripping medical privacy
• Overriding physicians
• Making diagnoses without licensure
• Delaying livelihoods
• Acting outside congressional authority

This is not government oversight.

This is federal overreach masquerading as safety.

And it must be confronted.

THE QUESTION THAT CAN NO LONGER BE AVOIDED

If the FAA has no statutory authority to seize private medical records…

If FAA physicians are practicing medicine without state licensure…

If due process is routinely denied…

If pilots are forced to give up their medical privacy under threat of losing their career…

Then the entire FAA medical certification framework is not just broken —

It may be fundamentally unlawful.

And once this question reaches the courts, the FAA may finally be forced to answer for a system that has operated for decades without proper legal foundation.

Appendix: Legal Definitions & Statutory Authority Relevant to FAA Medical Review

I. Representative State Statutes Defining the Practice of Medicine

Below are 10 state statutes showing how consistently — and broadly — states define “practice of medicine,” including diagnosis, evaluation, interpretation of tests, and determination of physical or mental fitness.

All of these activities are routinely performed by FAA physicians.

1. Florida — Fla. Stat. § 458.305

“Practice of medicine means the diagnosis, treatment, operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition.”

2. Texas — Tex. Occ. Code § 151.002(13)

“The practice of medicine includes diagnosing, treating, or offering to treat a mental or physical disease or disorder, or assessing a physical or mental condition of a person.”

3. California — Cal. Bus. & Prof. Code § 2052

“Any person who practices, attempts to practice, or advertises or holds himself or herself out as practicing any system or mode of treating the sick or afflicted… diagnosing, treating, operating, or prescribing for any ailment… is practicing medicine.”

4. New York — N.Y. Education Law § 6521

“The practice of medicine is diagnosing, treating, operating or prescribing for any human disease, pain, injury, deformity or physical condition.”

5. Washington — RCW 18.71.011

“To practice medicine” means to diagnose, cure, advise, or prescribe for any human disease, injury, or mental or physical condition.”

6. Tennessee — Tenn. Code Ann. § 63-6-204

A person practices medicine who “diagnoses, treats, operates on, or prescribes for any physical ailment, injury, or deformity of another.”

7. Ohio — Ohio Rev. Code § 4731.34

The practice of medicine includes “the diagnosis, treatment, correction, or prevention of disease, ailment, defect, or injury of a human being.”

8. Michigan — Mich. Comp. Laws § 333.17001

Medicine includes “diagnosing, treating, preventing, curing, or relieving human disease, ailment, defect, complaint, or other physical or mental condition.”

9. Arizona — Ariz. Rev. Stat. § 32-1401(21)

“‘Practice of medicine’ means to diagnose, treat, correct, advise, or prescribe for any human disease, injury, ailment, infirmity, deformity, pain or other condition.”

10. Oregon — ORS 677.085

A person is practicing medicine if they “offer or undertake to diagnose, cure or treat… any disease, illness, deformity, injury or any abnormal physical or mental condition of any person.”

II. Key Legal Principle (Multistate Standard)

Interstate Medical Licensure Compact (IMLC) Core Rule

“The practice of medicine occurs where the patient is located at the time of the physician-patient encounter.”

This principle is recognized in over 35 states, and is fatal to the FAA’s current model:

• FAA doctors in Oklahoma are making medical determinations about pilots in every other state.
• Under the Compact and state statutes, these acts are legally occurring in the pilot’s home state.
• FAA physicians are not licensed in those states.
• Thus, FAA doctors are arguably practicing unlicensed medicine across the entire United States.

III. Creditable (Real-World) Situations Showing This Would Be Illegal Outside the FAA

Use this list to demonstrate the absurdity and legal inconsistency of allowing the FAA to do what no private doctor or employer could ever do.

1. Telemedicine Without a State License Is Illegal

If a physician in Oklahoma diagnoses a patient in Michigan by reviewing charts or records without a Michigan license, it is the unlicensed practice of medicine.

FAA physicians do this daily.

2. Employers Cannot Demand Full Medical Records

Even the Pentagon, police departments, and nuclear facilities cannot force employees to surrender full medical files. Only job-related evaluations by qualified examiners are permitted.

The FAA demands far more from civilian pilots.

3. Disability Insurers Cannot Override Treating Physicians Without Examining a Patient

Insurance companies get sued — and lose — when they deny claims based solely on record review without exam or licensure in the claimant’s state.

FAA physicians override treating doctors constantly.

4. A Physician Cannot Determine Fitness-for-Duty for Out-of-State Workers Without Licensure

Fitness-for-duty exams (FFDs) are regulated medical acts. A doctor must be licensed where the employee works.

FAA medical officers render nationwide FFD decisions without holding any state license outside Oklahoma.

5. HIPAA Requires Voluntary Consent — FAA “Consent” Is Coerced

Medical privacy law prohibits forced disclosure of full medical history as a condition of employment or licensure.

FAA medical “consent” is not voluntary — it’s demanded under threat of grounding.

IV. Summary of Legal Exposure

Based on the statutes above, FAA physicians routinely engage in activities that state law defines as:

• Diagnosis
• Evaluation of physical/mental fitness
• Interpretation of medical tests
• Medical decision-making

Because these acts are legally occurring in the pilot’s home state — where FAA doctors are not licensed — the FAA’s system exposes itself to:

• Claims of unlicensed practice of medicine
• Claims of ultra vires agency action (acting beyond congressional authority)
• Due process violations
• HIPAA and medical privacy challenges
• Constitutional challenges under federalism principles