Update on Medicals (special issuance)

[Rick Junkin]

5 minutes ago, RoundTwo said:

I’m talking about the inefficiency of a government agency that takes 9 1/2 months to approve a medical for a guy with sleep apnea.

I have an SI authorization for sleep apnea that is good for five years, requiring an annual Class 2 physical and submitting all of the required data/reports to my AME. But it’s a CACI (Condition AMEs Can Issue) authorization and my AME gives me a renewed medical certificate on the spot. We mail the data package to Oklahoma City and I’m good to go for another year. I got a letter asking for more data once, but that letter said I could continue flying on my issued certificate while they reviewed the data. My five year authorization letter has been renewed twice with no issues.

Not all SIs are the same, but if yours is truly just for sleep apnea I’d ask your AME about requesting an extended CACI authorization.

Cheers,
Rick

[rbp]

Just now, Rick Junkin said:

Not all SIs are the same

100% true, and moreover, not every medical situation is the same and not ever AME knows all the rules/processes

[Steve0715]

12 minutes ago, rbp said:

so you get more efficient service from your state DMV?

Lol…ah hell no.  But I’ll have to say it’s location dependent.  I now go to a small town dmv that I can walk into with no lines.  And no, I’m not tell where it is..

[rbp]

46 minutes ago, Steve0715 said:

Lol…ah hell no.  But I’ll have to say it’s location dependent.  I now go to a small town dmv that I can walk into with no lines.  And no, I’m not tell where it is..

so are you proposing local control of medical certification for the national airspace?

[Marauder]

What I find interesting is the DOT physical requirements for truck drivers. You can have a whole laundry list of health issues and drive on public roads with a 70,000 pound truck.

I’ve always believed flying has been treated as a privilege and driving a right. I get the need to have some higher level medical assurances for those flying people around for hire. But for us pond scum, flying our lawn mower types, I really don’t get the additional medical scrutiny.

Basic Med has been a great step forward but who poses a greater risk? Two guys with the same health condition, one driving a 70,000 pound rig or the guy flying his lawn mower?


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[Steve0715]

23 minutes ago, rbp said:

so are you proposing local control of medical certification for the national airspace?

Hmm, it’s a thought.  But no, that’s not at all what I meant.  Just stating that imo, it’s a petty, inefficient bureaucracy.  

 

1 hour ago, rbp said:

100% true, and moreover, not every medical situation is the same and not ever AME knows all the rules/processes

I would 100% agree with this.  
 

Take my case for example.  I have coronary heart disease.  I’ve been under the care of a cardiologist for 12 years.  We tried a couple of stents but 3 years ago I had bypass surgery.  I see my cardiologist twice a year.  After deciding to get my 3rd class medical again (30 years for the previous), I discussed this with said cardiologist.  She approves and told me she has other Pilot patients older and less fit that me.  So I plan for the FAA requirements, including the always fun Bruce protocol stress test,  pull hospital records on my procedures, and lastly get my cardiologist to write up a good narrative into my records.  The I take and pass the AME exam.  Everything goes into the FAA with the knowledge that both the AME and my cardiologist tell me my case is an easy pass.

Given that all this is true, FAA medical should have a process where this is approved quickly.  In days, not months.

Instead you have a bureaucracy that plods along with a process that turns it into a stressful mess.  

[Steve0715]

24 minutes ago, Marauder said:

What I find interesting is the DOT physical requirements for truck drivers. You can have a whole laundry list of health issues and drive on public roads with a 70,000 pound truck.

I’ve always believed flying has been treated as a privilege and driving a right. I get the need to have some higher level medical assurances for those flying people around for hire. But for us pond scum, flying our lawn mower types, I really don’t get the additional medical scrutiny.

Basic Med has been a great step forward but who poses a greater risk? Two guys with the same health condition, one driving a 70,000 pound rig or the guy flying his lawn mower?


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Well said.  

[RoundTwo]

2 hours ago, Rick Junkin said:

I have an SI authorization for sleep apnea that is good for five years, requiring an annual Class 2 physical and submitting all of the required data/reports to my AME. But it’s a CACI (Condition AMEs Can Issue) authorization and my AME gives me a renewed medical certificate on the spot. We mail the data package to Oklahoma City and I’m good to go for another year. I got a letter asking for more data once, but that letter said I could continue flying on my issued certificate while they reviewed the data. My five year authorization letter has been renewed twice with no issues.

Not all SIs are the same, but if yours is truly just for sleep apnea I’d ask your AME about requesting an extended CACI authorization.

Cheers,
Rick

You are correct. Renewals are at discretion of AME but need to be done on an annual basis. It was the initial approval that took 9.5 months that had me miffed. Now, it’s clear sailing as long as my sleep doc fills out the treatment status form and my AME stamps me good for another year.

[Hank]

1 hour ago, RoundTwo said:

You are correct. Renewals are at discretion of AME but need to be done on an annual basis. It was the initial approval that took 9.5 months that had me miffed. Now, it’s clear sailing as long as my sleep doc fills out the treatment status form and my AME stamps me good for another year.

Go Basic Med and the sailing is clear. No wait, no need to ever renew that pesky SI, it's not one of the three exclusions. 

[jaylw314]

58 minutes ago, Hank said:

Go Basic Med and the sailing is clear. No wait, no need to ever renew that pesky SI, it's not one of the three exclusions. 

It does kind of crack me up that you could be a quadraplegic with emphysema sporting a colostomy and a urostomy bag, and you wouldn't have one of the exclusions.  I mean, wasn't Admiral Bull Halsey sidelined by a case of eczema in WWII?

[Fly Boomer]

4 hours ago, Marauder said:

But for us pond scum, flying our lawn mower types, I really don’t get the additional medical scrutiny.

I've never looked into it but one difference is that we carry passengers, truckers usually don't.

[Marauder]

I've never looked into it but one difference is that we carry passengers, truckers usually don't.

My brother is a trucker and there are many long haul truckers who live with their spouse in their rigs.

If it is a matter of safety, who is more likely to be a public risk? A 400 pound trucker with high blood pressure and a few undisclosed ailments like sleep apnea driving behind a school bus of kids on a field trip or a similarly BMI challenged pilot with unreported sleep apnea flying over a city?

I think there is a lot of medical requirements placed on pilots that the driving public doesn’t have (anyone else remember the conversation about being the time to hand over the car keys?)

Considering the small Pilot population, it is a lot less likelihood they would be involved in creating an issue, let alone running into that school bus.

It is an example of an over regulated activity. Basic Med helps a lot but until we get to a point that it is a right versus a privilege, you are only one medical ailment away from losing that privilege.


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[GaryP1007]

Spoke to AOPA yesterday. Even though my medical expired I can still apply for Basic Med as it was never denied or rescinded. As my process is already underway for Class 2 I must comply with any requests the FAA makes to complete the process. If Class 2 reapproved then I let it expire next year and the Basic Med takes over. If for some reason it’s denied then my Basic Med is not good and I must do what I need to do to get a class 2 or 3 again and then reapply for Basic Med.

AOPA was quite helpful.


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[rbp]

1 hour ago, GaryP1007 said:

Spoke to AOPA yesterday. Even though my medical expired I can still apply for Basic Med as it was never denied or rescinded. As my process is already underway for Class 2 I must comply with any requests the FAA makes to complete the process. If Class 2 reapproved then I let it expire next year and the Basic Med takes over. If for some reason it’s denied then my Basic Med is not good and I must do what I need to do to get a class 2 or 3 again and then reapply for Basic Med.

AOPA was quite helpful.


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Yes. Same for me. 
 

there is no way to withdraw a medical application. It’s either granted (SI or regular), or denied. 

[Steve0715]

For anyone interested, there is a thread in BeechTalk concerning Special Issuance and denied medicals.  I spent 4 hours reading through this and it’s rather depressing.  Stay healthy my friends and don’t get old..

https://www.beechtalk.com/forums/viewtopic.php?f=7&t=214371

[GaryP1007]

Got my Basic Med yesterday as I wait for the Class 2 to be processed. Thanks to all on here who helped me understand that option.


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[midlifeflyer]

On 12/11/2022 at 12:20 PM, rbp said:

so, the reason BasicMed came about is because Congress was not able to reform the FAA medical process in Part 67 based on lobbying from EAA and AOPA because of counter-lobbying from ALPA and NBAA, which didn't support reducing any medical requirements. So Congress just made an entirely new set of regs Part 68 (Basic Med), and took it out of the FAA medical division's hands.

Some of that history is accurate but the "civics" is a bit off.

Congress doesn't write regulations. It enacts laws. In the absence of FAA regulatory action on the subject, Congress wrote provisions into the FAA Extension, Safety, Security Act of 2016 telling the FAA to "issue or revise regulations" within 180 days to allow "an individual may operate as pilot in command of" certain aircraft. if they meet certain minimum requirements.  The FAA did so, incorporating the medical requirements into the FAA's new Part 68 and both adding new and modifying  regulations in other parts of the FAR to account for it. The incorporation was almost verbatim. 

And it's not completely out of the medical division's hands. The FAA still has the ability to request medical history and other information to determine whether the pilot is qualified to operate under BasicMed. A few pilots have received one of these:

[rbp]

On 12/19/2022 at 10:49 AM, Steve0715 said:

For anyone interested, there is a thread in BeechTalk concerning Special Issuance and denied medicals.  I spent 4 hours reading through this and it’s rather depressing.  Stay healthy my friends and don’t get old..

https://www.beechtalk.com/forums/viewtopic.php?f=7&t=214371

o get on basic med before this happens