Medical Standards and Certification

Forms and Documents

Document Name	Status
Form 8500-14 Ophthalmological Evaluation for Glaucoma Form	Unchanged
Form 8500-8 Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate Form and Instruction	Modified
Form 8500-7 Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma Form	Unchanged
2120-0034 2016a.doc Supporting Statement A	2016-01-29

IC Document Collections

IC ID	Document Title	Status
211732	Ophthalmological Evaluation for Glaucoma Form	Unchanged
196926	Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate Form and Instruction	Modified
196924	Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma Form	Unchanged

ICR Details

OMB Control No: 2120-0034	ICR Reference No: 201601-2120-004
Status: Historical Active	Previous ICR Reference No: 201405-2120-003
Agency/Subagency: DOT/FAA	Agency Tracking No:
Title: Medical Standards and Certification
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/14/2016
	Date Received in OIRA: 01/29/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved	05/31/2018
Responses	396,782	0	414,300
Time Burden (Hours)	572,673	0	598,950
Cost Burden (Dollars)	13,469,488	0	46,367,100

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Abstract: The DOT/FAA certification program is implemented by Title 14 CFR parts 61 and 67. The Parts prescribes minimum airman medical standards, and duration of a medical certificate. Information collected substantiates the applicant's eligibility. This is being revised in response to GAO recommendations.

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Authorizing Statute(s): US Code: 49 USC 44702 Name of Law: Issuance of certificates
   US Code: 49 USC 44703 Name of Law: Airman certificates
   US Code: 49 USC 44709 Name of Law: Amendments, modifications, suspensions, and revocations of certificates
   US Code: 49 USC 40113 Name of Law: Administrative
   US Code: 49 USC 44701 Name of Law: General requirements
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 35695	06/22/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 55711	09/16/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma	8500-7	Report of Eye Evaluation
Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate	8500-8	Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate
Ophthalmological Evaluation for Glaucoma	8500-14	Ophthalmological Evaluation for Glaucoma

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	396,782	414,300	0	0	-17,518	0
Annual Time Burden (Hours)	572,673	598,950	0	0	-26,277	0
Annual Cost Burden (Dollars)	13,469,488	46,367,100	0	0	-32,897,612	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The number of applicants submitting FAA Form 8500-8 has decreased since the last submission in 2014. FAA is revising the information it is collecting on FAA Form 8500-8. These revisions are needed primarily to respond to recommendations made in an April 2014 Government Accountability Office report entitled “FAA Should Improve Usability of its Online Application System and Clarity of the Pilot’s Medical Form.

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Annual Cost to Federal Government: $2,675,113

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/29/2016

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