Air Travel
Regulations and Codes
Carriers may not refuse transportation on the basis of disability. By law, U.S. air carriers must comply with highly detailed regulations that affect people with disabilities. These do not cover foreign carriers serving the United States.
- All U.S. and non-U.S. carriers are required to file annual reports of disability-related complaints with the U.S. Department of Transportation (DOT). The DOT maintains a toll-free hotline (800-778-4838, available 7 am to 11 pm Eastern Standard Time) to provide real-time assistance in facilitating compliance with DOT rules and to suggest customer-service solutions to the airlines.
- The Transportation Security Administration (TSA) has established a program for screening of travelers with disabilities and their equipment, mobility aids, and devices. TSA permits prescriptions, liquid medications, and other liquids needed by persons with disabilities and medical conditions.
- International Air Transport Association (IATA) member airlines voluntarily adhere to codes of practice that are very similar to U.S. legislation based on guidance from the International Civil Aviation Organization. However, smaller airlines overseas may not be IATA members.
Airlines are obliged to accept a declaration by a passenger that he or she is self-reliant. Medical certificates can be required only in specific situations (for example, if a person intends to travel with a possible communicable disease or will require a stretcher or oxygen, or if unusual behavior is anticipated that may affect the operation of the flight).
Assistance and Accommodations
When a disabled person requests assistance, the airline is obliged to provide access to the aircraft door (preferably by a level entry bridge), an aisle wheelchair, and a seat with removable armrests. Aircraft with <30 seats are generally exempt. Airline personnel are not required to transfer passengers from wheelchair to wheelchair, wheelchair to aircraft seat, or wheelchair to lavatory seat. Disabled passengers who cannot transfer themselves should travel with a companion or attendant, but carriers may not without reason require a person with a disability to travel with an attendant.
Only wide-body aircraft with two aisles are required to have fully accessible lavatories, although any aircraft with >60 seats must have an on-board wheelchair and personnel must assist with movement of the wheelchair from the seat to the area outside the lavatory. Wet-acid batteries in electric wheelchairs may require special, separate stowage. Airline personnel are not obliged to assist with feeding, visiting the lavatory, or dispensing medication to travelers.
Airlines may not require advance notice that a person with a disability is traveling; however, they may require up to 48 hours’ advance notice and 1-hour advance check-in for certain accommodations that require preparation time, such as the following:
- Medical oxygen for use on board the aircraft, if the service is available on the flight
- Carriage of an incubator, if the service is available on the flight
- Hook-up for a respirator to the aircraft electrical power supply, if the service is available on the flight
- Accommodation for a passenger who must travel in a stretcher, if the service is available on the flight
- Transportation for an electric wheelchair on a flight scheduled to be made with an aircraft with <60 seats
- Provision by the carrier of hazardous material packaging for a battery used in a wheelchair or other assistive devices
- Accommodation for a group of ten or more qualified individuals with disabilities who make reservation and travel as a group
- Provision of an on-board wheelchair on an aircraft that does not have an accessible lavatory
Assessment and Preparation
With high incidence of cardiopulmonary disease and millions of people traveling by air, many people are at risk for significant hypoxia and respiratory symptoms while flying. Generally patients with an oxygen saturation by pulse oximetry above 95% do not require supplemental oxygen and those with a saturation below 92% will require it during air travel. The hypoxia altitude simulation test (HAST) can identify those patients (with an oxygen saturation by pulse oximetry between 92% and 95%) who may benefit from oxygen supplementation during air travel, decreasing their risk for significant cardiopulmonary effects of induced hypoxia at higher altitude.
Internationally standardized codes for classifying disabled passengers and their needs are available in all computerized reservations systems. Disabled passengers should use travel agents experienced in the use of the disability coding; it is critical that appropriate codes and inter-airline messages are sequentially entered for all flights. The delivering carrier is always responsible for a disabled passenger until a subsequent carrier physically accepts responsibility for that passenger.
