Friedman v. Federal Aviation Administration

841 F.3d 537, 2016 U.S. App. LEXIS 20459, 2016 WL 6694954
Court of Appeals for the D.C. Circuit·Decided November 15, 2016·No. 16-1007·Published·Cited by 25 cases

Opinion

BROWN, Circuit Judge:

“I’ve never known an industry that can get into people’s blood the way aviation does.”

—Robert Six, founder of Continental Airlines

Petitioner Eric Friedman (“Friedman”), a commercial airline pilot, claims Respondent Federal Aviation Administration (“the FAA” or “the Agency”) has behaved in an arbitrary and capricious manner in assessing his request for a commercial airline pilot’s license. Friedman has been diagnosed with Insulin Treated Diabetes Melli-tus (“ITDM”), and although he holds a third class medical certificate authorizing him to pilot non-commercial flights in the United States, he seeks the first class certificate necessary to serve as a commercial airline pilot. He argues the FAA has im-permissibly conditioned issuance of a first class license on ninety days of continuous blood glucose monitoring, a costly and invasive procedure not medically necessary for his care. Since we believe the Agency’s unwavering position constitutes final action, we remand to the FAA to provide reasons for its denial.

I.

Congress has granted the FAA broad authority to regulate those “practices, methods, and proeedure[s] the Administrator finds necessary for safety in air commerce and national security.” 49 U.S.C. § 44701(a)(5). Accordingly, the FAA issues airman certificates to pilots who are “qualified for, and physically able to perform the duties related to, the position.” Id, § 44703(a). The Agency has also, established rules requiring pilots to hold both a medical certificate and a pilot certificate. See, e.g., 14 C.F.R. § 61.3(a) & (c). The FAA lists a number of conditions generally disqualifying for any class of medical certification, among them a “medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control,” otherwise known as ITDM. 14 C.F.R. §§ 67.113(a), 67.213(a), 67.313(a). While a diagnosis of ITDM generally excludes a pilot from any medical certificate issued by the FAA pursuant to 49 U.S.C. § 44703(a), the FAA has .the discretionary authority to grant exceptions to the medical regulations contained in 14 C.F.R. § 67. See 49. U.S.C. § 44701(f), An Authorization for Special Issuance of a Medical Certificate may be provided to an applicant with á disqualifying condition “if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force.” 14 C.F.R. § 67.401(a).

Regulations require the Federal Air Surgeon (“FAS”) to make his determination using standards published for each condition as set forth in the FAA’s Guide to Aviation Medical Examiners (“AME Guide”). See id, § 67.407(a). The process includes a medical examination performed by a member of the community of Aviation Medical Examiners . (“AME”s), see. id. § 67.401(a), and it may require pilots to provide additional medical information to the FAA where necessary, see id. *540 § 67.413(a). Specifically, the FAS must “consider[ ] the need to protect the safety of persons and property in other aircraft and on the ground.” Id. § 67.401(e).

For much of its history the FAA enforced a blanket ban on the issuance of medical certificates to individuals with ITDM, but in 1996 it reversed course and established criteria for pilots with ITDM to receive a third class medical certificate (but not a first class certificate). Since the policy change was adopted, there has been no medically related accident, incident, or inflight incapacitation, from any cause, of any such insulin treated special issuance pilot. In light of the strong record of third class pilots with ITDM, and in reliance on the expert analysis provided by an Expert Panel on Pilots with Insulin Treated Diabetes (“Expert Panel”)—convened by the American Diabetes Association (“ADA”) at the FAA’s request—the FAA amended its AME Guide to broaden the third class ITDM protocol to all classes of medical certificates on April 21,2015.

On April 27, 2015, Friedman submitted a completed application for a first class license to the FAA. A few days later, on April 30, 2015, the FAA requested supplemental information, including “any and all information that you may have that is relevant to your condition, which may include ... (if applicable) continuous glucose monitor readings.” JA 73. The next month, Friedman inquired as to the FAA’s method for evaluating glucose testing results and stated “I do not use a continuous glucose monitor.” JA 31-32. Continuous Glucose Monitoring (“CGM”), according to the ADA, is an invasive procedure that “uses a sensor inserted under the skin to check glucose levels in tissue fluid. A transmitter sends information about glucose levels via radio waves from the sensor to a wireless monitor.” ADA Amicus Br. 14. This technique provides a “historical record of glucose levels over time” and can “provid[e] helpful information about historic trends in one’s blood sugar levels and how those levels have been affected by diet and exercise.” Id. However, CGM data is not as accurate as other blood glucose measures like fingersticks. Id. 15-16. Moreover, CGM is costly and is not covered by insurance unless medically necessary.

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Friedman v. Federal Aviation Administration, 841 F.3d 537, 2016 U.S. App. LEXIS 20459, 2016 WL 6694954 (D.C. Cir. 2016).

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