The "Fit-to-Fly" document

Have you fallen ill or been involved in an accident whilst on holiday? Do you need to return to Belgium by plane but your state of health raises concerns? In this case, the airline may ask you for a document called a ‘Fit to Fly’ certificate.

Well known to medical assistance teams and airlines, this certificate can sometimes make the difference between a smooth boarding process and being refused boarding at the airport.

Here’s everything you need to know.

What is a Fit to Fly (FTF) certificate?

A Fit to Fly (FTF) certificate is a medical certificate confirming that a person is fit enough to travel by air without the flight posing a significant risk to his/her health or that of other passengers.

The document is usually issued by a doctor following an assessment of the patient’s state of health. It certifies that the patient is fit to fly under specified conditions and may also detail any specific assistance requirements.

Why do airlines require a Fit to Fly certificate?

The environment on a plane is not comparable to that on the ground. At high altitude, even though the cabin is pressurized, atmospheric pressure is lower and the available oxygen level is slightly reduced. These conditions can have an impact on certain medical conditions or recent injuries.

Nor must the passenger pose a risk to other passengers, particularly if they have a contagious condition.

The general state of health must also be good enough to cope with the stress and uncertainties of a flight, which, in some cases, can be quite long.

For this reason, airlines wish to ensure that a sick or injured passenger can travel without significant risk. They also want to prevent a medical emergency from occurring during the flight.

In what circumstances might a Fit to Fly certificate be required?

Not all medical conditions require a certificate. A simple cold or a minor injury generally poses no problem.

However, a ‘Fit to Fly’ certificate may be required in the following situations:

After surgery

Certain surgical procedures require a waiting period before travelling by air. The doctor must then assess the risks associated with flying, particularly due to changes in air pressure.

After a hospital stay

Airlines may request confirmation that no complications are likely to arise during the journey.

In the event of a fracture or plaster cast

A limb that has recently been put in a plaster cast may swell during the flight. Some airlines have specific rules regarding recently applied plaster casts.

During late pregnancy

Beyond a certain stage of pregnancy, some airlines require a medical certificate to confirm that the journey does not pose any particular risk.

Beyond a certain stage of pregnancy, air travel is strongly discouraged.

In the event of a heart or respiratory condition

Passengers with a heart or lung condition, or who require oxygen, may need to provide additional medical documentation.

In the case of a contagious illness

An airline may refuse to allow a passenger to board if they have a condition that could be transmitted to other passengers.

Who issues the Fit to Fly certificate?

The certificate is usually drawn up and issued by the patient’s GP or by the doctor treating the patient abroad.

There is no universally recognised template worldwide. Some airlines use their own medical forms, whilst assistance companies such as Redion also have standardised documents to simplify the process.

What does a Fit to Fly certificate contain?

• the diagnosis or nature of the injury;
• the date of the medical incident;
• the date from which travel is permitted;
• any restrictions or precautions;
• whether or not a carer is required;
• whether or not wheelchair assistance is required;
• whether or not nursing or medical support is required.

What should you do if you need to travel by plane?

Have you booked a flight but fallen ill or had an accident just before your departure? In this case, in most instances, you will have to cancel your trip and book a new flight or postpone your departure.

If your medical condition requires special care but you feel fit to travel by plane, discuss this with your GP. They will be able to carry out the necessary checks to issue you with an FTF certificate.

Be aware, however, that your assistance provider may refuse to provide cover if a medical condition known prior to departure is currently being treated and poses a real risk of rapid deterioration, or if it has not been stable for at least two months prior to the start date of your assistance cover. Relapses or worsening of an illness or medical condition known before your trip may also exclude you from assistance cover.

Procedure to follow:

• check with your airline;
• consult your GP;
• check the medical conditions applicable to your flight;
• check your assistance cover and any exclusions;
• keep all your medical documents;
• contact your travel assistance provider immediately if a problem arises when you are abroad.

Good preparation often helps to avoid last-minute complications at the airport.

What should you do if you are travelling abroad?

If you are abroad and have experienced a medical issue requiring special care, contact your assistance centre immediately. When Redion organises and covers the cost of medical repatriation by air, the necessary arrangements are made to ensure the airline can obtain the FTF.

The assistance provider’s doctors can liaise with local doctors, assess your medical condition and, if necessary, organise repatriation under the best possible conditions. They can also help you obtain the medical documents required by the airline.

Can you be denied boarding?

Yes.

Even with a valid ticket, an airline may refuse boarding if it considers that a passenger’s state of health poses a risk to themselves or to other passengers. In some cases, failure to provide a ‘Fit to Fly’ certificate requested by the airline may also result in being denied boarding.

FAQ: Everything you need to know about the Fit to Fly certificate