If you insist on having an airman medical certificate becaue you're already a rated pilot and need it to make money, then special issuance makes sense.

But if you're not a paid pilot, you're better off not going down that route, since once you're on record as having a deficiency, that's a permanent concern to the FAA. And if they decline the special issuance, you're also not eligible for the drivers license medical.

I would advise nobody with issues who wants to fly for hobby reasons to go down the PPL route since you can get banned for failng a medical. There's almost no upside and huge downside to risking that.

Definitely agree. In my case it was use of antidepressants. I thought the whole country is basically doing them so surely that’s not a problem when I went to an FAA AME for the PPL 3rd class medical. Well now I’m fucked for life apparently. There only 3 antidepressants they accept for a special issuance with costly on-going tests each year. Even if I’m off them entirely it’s still a problem.

I did witness an AME re-approve a commercial guy with a DUI though while in the waiting room. Good on you, FAA.

Well, the Hummel is an all-metal ultralight that looks like a real airplane, so try that route.

Thanks for the DUI anecdote. Great that he got re-approved, but that can be retracted anytime.

Just to recap - the FAA assumes if you get an airman medical, you might try to carry passengers, so their medical rules are maximally strict.