Denied a Fit to Fly Certificate? What You Can Do Next
There is no formal appeal against a decision that you are not fit to fly. A doctor who declines to issue a fit-to-fly certificate is recording a clinical judgement about the risk of flying with your condition, and no complaints process, airline or regulator can require that doctor to reach a different conclusion. What you can do is find out the exact reason, deal with the underlying problem, ask for a fresh assessment once something has genuinely changed, or use the refusal as medical evidence for a travel insurance claim.
That distinction matters. A refusal is not an administrative obstacle to be worked around. Cabin pressure at altitude reduces the oxygen available to you and expands trapped gas in the body, which is why the UK Civil Aviation Authority publishes minimum waiting periods after certain events and treats some conditions as outright contraindications to flight. Looking for a doctor who will certify you when nothing about your condition has changed is not an appeal, and it puts you at risk in an environment where advanced medical care is hours away.
What this page is, and is not
It is not a route to overturning a clinical decision, and nothing here suggests that a second review is likely to produce a different answer. A second doctor working from the same facts will often reach the same conclusion, and that is the system working as intended.
It is a guide to the four things that genuinely help: getting the reason in writing, correcting incomplete information, treating or waiting out the underlying issue, and documenting a refusal properly so your insurer can act on it.
Common Reasons a Fit-to-Fly Certificate Is Refused
| Reason for Refusal | What This Means | What You Can Do |
|---|---|---|
| Insufficient waiting time since surgery or procedure | A recognised minimum interval has not yet passed. CAA guidance lists an uncomplicated heart attack within 7 days and a complicated one within 4 to 6 weeks as contraindications to flight, and says patients may travel 7 to 10 days after a recent myocardial infarction if there are no complications. It treats the presence of a pneumothorax as an absolute contraindication, and says it should generally be safe to travel about 2 weeks after successful drainage with full expansion of the lung. It also advises avoiding air travel for 10 days after abdominal surgery and about 7 days after neurosurgery. Source: UK Civil Aviation Authority, Cardiovascular disease, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/cardiovascular-disease/. Source: UK Civil Aviation Authority, Respiratory disease, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/respiratory-disease/. Source: UK Civil Aviation Authority, Surgical conditions, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/surgical-conditions/. | Wait out the interval, then ask for a fresh assessment. Waiting periods are the one category where time alone changes the answer |
| Active infection or contagious illness | An active or contagious infection. CAA guidance says patients with active or contagious infection are unsuitable for travel until there is documented control of the infection and they are no longer infectious, and that airline staff may refuse to let you travel if they think you may still be contagious | Delay travel until the infection has resolved, then ask for a fresh assessment. Source: UK Civil Aviation Authority, Respiratory disease, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/respiratory-disease/. |
| Uncontrolled medical condition | A condition that is not adequately managed. CAA guidance lists uncontrolled hypertension, decompensated congestive heart failure, unstable angina and uncontrolled cardiac arrhythmia among cardiovascular contraindications to commercial flight, and notes that treated hypertension under satisfactory control is not a contraindication | Work with your GP or specialist to get the condition under control, then return for reassessment. Source: UK Civil Aviation Authority, Cardiovascular disease, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/cardiovascular-disease/. |
| Pregnancy complication | A complication such as placenta praevia or pre-eclampsia, or a stage of pregnancy past the airline’s own cut-off. Gestational limits are set by each carrier, not by the doctor and not by the CAA, so they differ between airlines | Seek specialist obstetric review, and check the cut-off published by the airline you are actually booked with before rebooking |
| Incomplete medical history provided | Doctor could not make a full assessment without complete information | Obtain relevant medical records and attend a more comprehensive consultation |
| Condition genuinely preventing safe travel | The clinical risk of flying is real and the refusal is correct. This is the most common outcome, not the rare one | Do not fly. Ask for written confirmation that you are not fit to fly and use it as evidence for a travel insurance cancellation claim |
Steps to Take After a Refusal
Work through these in order. Steps 1 to 5 are about changing the clinical picture or correcting the record. Step 6 is what to do when the refusal is right, which is the most likely case.
- Ask for the specific reason, you are entitled to know why the certificate was refused. Ask the doctor to document the clinical reason clearly. This helps you identify whether the refusal is based on a temporary factor (waiting period, current infection) or a more fundamental concern.
- Obtain your relevant medical records, if the refusal was due to incomplete information, request your GP records and any specialist correspondence, then attend a new consultation with the full picture.
- Ask for a reassessment only if something has changed, whether that is new evidence, a resolved infection, an elapsed waiting period or better control of your condition. You are entitled to consult a different doctor, and a second GMC-registered doctor can assess you independently, but tell them about the previous refusal and the reason for it. Withholding that means the second doctor is working from an incomplete picture, and a certificate obtained that way is not a clearance, it is a gap in the record. A second review may well reach the same conclusion, and no outcome can be promised.
- Address the underlying issue, if the refusal was because your blood pressure is uncontrolled or your condition is unstable, the correct response is to optimise treatment and seek reassessment, not to keep asking until someone overlooks the same issue. Shopping for a certificate does not make the flight safer, it only removes the warning.
- Consult a specialist if appropriate, for cardiac or respiratory refusals, a specialist consultation with a cardiologist or respiratory physician may resolve the uncertainty and provide clearance that a GP alone cannot give.
- Claim on your travel insurance, if flying is genuinely not safe, written documentation from your doctor confirming you are not fit to fly is the medical evidence an insurer will normally want for a cancellation claim. Whether the claim is paid depends on your policy wording, so contact your insurer before you cancel anything.
Need a Fit-to-Fly Certificate or Not-Fit-to-Fly Documentation?
Our GMC-registered doctors carry out flying fitness assessments and issue either a fit-to-fly certificate or a not-fit-to-fly letter, whichever the assessment supports, online and same day. If the doctor cannot issue documentation after clinical review, you are refunded in full automatically.
Who Actually Decides: the Airline, the Doctor and the CAA
A common misunderstanding is that a doctor grants permission to fly. Two separate decisions are involved, and only one of them belongs to a doctor.
| Who | What they decide | What they cannot do |
|---|---|---|
| Your doctor | Whether, on clinical grounds, they can state that you are fit to fly | Guarantee that an airline will carry you |
| The airline | Whether to carry you. CAA guidance is explicit that the final decision whether or not to carry a passenger is that of the airline | Require a doctor to certify someone the doctor believes is not fit to fly |
| The UK Civil Aviation Authority | Publishes health guidance for passengers and for health professionals, and runs an Aviation Health Unit that clinicians can contact for advice at ahu@caa.co.uk | Issue, refuse or overturn an individual passenger’s fit-to-fly certificate |
Medical clearance and the MEDIF form
Where an airline has concerns about a condition, it runs its own medical clearance process rather than relying on a certificate alone. CAA guidance describes it this way: most airlines have medical advisers who provide advice and clear passengers as fit to fly, the information they need is the nature and severity or stability of the condition, the medication being taken and any relevant information about mobility, and clearance can be done by telephone or through the MEDIF form, which structures that information in a way most airlines can process. The CAA also notes that the more information is provided in advance, the more likely a reasonable, evidence-based decision can be made. Source: UK Civil Aviation Authority, Assessing fitness to fly, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/assessing-fitness-to-fly/.
Clearance procedures, the forms used and any gestational or condition-specific cut-offs are set by each carrier. Check the medical clearance or special assistance pages published by the airline you are booked with, because they differ, and no third party can tell you in advance what a given airline will decide.
Using a Refusal for a Travel Insurance Claim
Written confirmation that you are not fit to fly is the medical evidence most insurers ask for when you cancel a trip on health grounds. What that evidence buys you depends entirely on your policy: cancellation cover, what it excludes and what documentation it requires are set by the individual policy wording, not by any general rule, so read the wording and speak to your insurer before you cancel a booking.
Two things to be aware of. GOV.UK advises declaring existing conditions and any pending treatment or tests when you buy cover, and warns that failing to declare something may invalidate your travel insurance. And flying when a doctor has told you that you are not fit to fly means travelling against medical advice, which you would need to disclose to your insurer and which your policy may treat differently from an ordinary claim. If in doubt, ask your insurer in writing before you travel. Source: GOV.UK, Foreign travel insurance, gov.uk/guidance/foreign-travel-insurance.
What to Request from Your Doctor
Ask your doctor for a letter on headed paper, or on an official digital letterhead, confirming: (1) your name and date of birth, (2) the medical reason they were unable to certify you as fit to fly, (3) the dates of your planned travel, and (4) that you were unfit to travel on those dates. This is not a fit-to-fly certificate, it is a not-fit-to-fly letter, and it is the document insurers most commonly ask for on a cancellation claim. Check what your own insurer requires before you request it, as some ask for their own form to be completed.
Frequently Asked Questions
Can I appeal directly to the airline if a doctor refuses a certificate?
No. There is no appeal, because an airline cannot require a doctor to certify someone the doctor believes is not fit to fly. It also works the other way: a certificate is not a boarding pass. CAA guidance states that the final decision whether or not to carry a passenger is that of the airline, so a carrier can still decline to fly you even with a certificate in hand. If your issue is administrative rather than clinical, for example the format of a document the airline would not accept, take that up with the airline’s medical clearance or special assistance team, who can tell you what they need. Source: UK Civil Aviation Authority, Assessing fitness to fly, caa.co.uk/air-passengers/about-your-trip/health-and-medical/guidance-for-health-professionals/assessing-fitness-to-fly/.
What if I think the doctor made a mistake?
You are entitled to a second opinion. If you believe the first doctor was working with incomplete information, or made a clinical error, ask a different registered practitioner to assess you and give them the most complete medical history you can, including the earlier refusal and the reason given for it. Be realistic about the outcome: on the same clinical facts a second doctor will frequently reach the same conclusion, and a different answer is not something anyone can promise. If you believe the first doctor acted negligently or unprofessionally, you can raise a complaint with the GMC, though that will not change your travel plans in the short term.
Will a refusal affect my future ability to get a fit-to-fly certificate?
No, a refusal at one point in time does not create a permanent record that prevents future certificates. If your condition improves, the underlying issue is resolved, or sufficient time passes (e.g. after a waiting period post-surgery), a doctor can certify you fit to fly at that later point. Certificates are assessments of your fitness at a specific time, not lifetime determinations.
Can I fly anyway if a doctor refuses to certify me?
No, you should not, and this page will not help you do it. A refusal means a doctor has judged that flying carries a real risk to you. That risk does not go away because nobody at the gate asks to see a certificate. In the air you are hours from a hospital, the cabin holds less oxygen than sea level and trapped gas in the body expands, which is exactly why the CAA treats some conditions, such as the presence of a pneumothorax, as absolute contraindications to flight and publishes minimum intervals after events like a heart attack or abdominal surgery.
There are practical consequences too. Travelling against medical advice is something you would have to disclose to your travel insurer, and GOV.UK warns that failing to declare relevant health information may invalidate your travel insurance. If your condition is contagious, CAA guidance says airline staff may refuse to let you travel and that you should delay until you are no longer infectious. If you are unsure how serious the risk is, ask the doctor who refused to explain it, or ask your GP or specialist, rather than looking for a different answer. Source: GOV.UK, Foreign travel insurance, gov.uk/guidance/foreign-travel-insurance.
Do I get my money back if the doctor declines to issue a certificate?
Yes. If the reviewing doctor determines that documentation cannot be issued following clinical review, MedicalCert provides a full refund automatically, and no action is required from you. That covers cases where there is insufficient clinical basis to issue a certificate or medical letter, where you are assessed as not clinically eligible for the documentation requested, and where the doctor declines the request on professional grounds. You are not charged for a decision you did not want. See our refund policy for the full terms.
How long after a refusal can I reapply for a certificate?
It depends entirely on the reason. If the refusal was due to a minimum interval, such as the 7 to 10 days CAA guidance describes after an uncomplicated heart attack, you can ask for a new assessment once that interval has passed. If it was an active infection, once you have recovered. If it was an uncontrolled condition, once you have evidence of adequate control. There is no fixed waiting period for asking again, and there is no point in asking again while nothing has changed: the relevant question is whether the clinical concern behind the refusal has actually been resolved.
Fit-to-Fly or Not-Fit-to-Fly Certificate: Same Day
Our GMC-registered doctors carry out flying fitness assessments and issue whichever document the assessment supports, whether that is confirmation you are fit to fly or the not-fit-to-fly letter an insurer needs. The outcome follows the assessment, and a full refund is automatic if no documentation can be issued.
