Medical news

[N201MKTurbo]

https://www.msn.com/en-us/health/other/5000-pilots-suspected-of-hiding-major-health-issues-most-are-still-flying/ar-AA1fPJX8

[Echo]

Wow, Ripping off taxpayers.  What a shock. Having your cake and eating it too. Could of milked a line of duty eye injury. Didn’t.  Shame. SHAME.  SHAME!

[A64Pilot]

I don’t see how it’s ripping off the taxpayer, 20 years after military Retirement I finally started VA disability claims. None of which would keep me from flying. I should have 20 years ago but I was too busy building a business and second career, there are a LOT of appts you have to make for the VA, too many to be building a second career.

The issue isn’t that 2500 pilots 600 of which are Airline pilots have disqualifying medical issues, the issue is they didn’t self report.

But how do you know what your supposed to report? There is or was anyway a laundry list of questions of do you or have you ever had the following you had to answer. I thought the list covered what the FAA considered important, or why is there a list?

One day years ago I was getting my 2nd class medical, the examiner tells me due to my neck size and weight that he was going to have me have a sleep study, it was a new DOT requirement.

I tell him I’ve been using a CPAP for years, he gets upset and says you should have told me that, I ask why, he says you need a special issuance, I ask how was I supposed to know, there is a laundry list of issues, if the FAA wanted to know if you were using a CPAP, why isn’t it on the list? 

An issue as I see it is we aren’t medical professionals how do we know what he or she needs to know?  I get up to pee several times a night now, should I tell him that? What about my heel spurs / flat feet, degenerative joint disease, arthritis? If it was that important why don’t they go through my medical records, those are Government property it seems, I had to fill out a freedom of information request to get them, and of course it took six months for me to get my records, as they go back 40 years there was a whole lot I had forgotten to be truthful.

This is someone who is making a name for themselves, advancing through the system and it made the news.

If there had been any kind of increase in medical problems causing issues in pilots that would be one thing, but this isn’t that.

You can have disabilities that don’t disqualify you from flying, like heel spurs, Plantar Fasciitis/ flat feet for example, it’s real, easily diagnosed and common for people who carried heavy loads in boots or ran a lot, especially over years of doing so.

 

Even military retirement isn’t at all what it used to be. When I joined I was promised if I kept my nose clean and completed 20 years that I would retire on 50% pay and have free medical, dental and vision for life, this was to compensate me for likely getting killed, maimed etc and 20 years of moving any time I was told and living at times in conditions that Criminals can’t be kept in, and pay well less than my Civilian cohorts.

So I did my 20, find out that the 50% retirement is really 25% because it’s only base pay, that the Dental and Vision are gone, 0% for those and my “free” medical, I pay 20% until I’ve paid out $4,000 out of pocket, then when you reach 65 you MUST purchase medicare part B at a cost of $175 or so a month or you have NO insurance, and that Retirement medical you stayed 20 years for? It’s just a Medicare supplement now.

Oh and your Retirement pay is taxable income when it wasn’t supposed to be, you pay taxes on it, but it’s not included as income to determine your Social Security benefits. Does that sound right? Does anyone else pay taxes on an income that doesn’t count towards income for computing SS benefits?

No, I’m sorry but Vets especially Retirees aren’t ripping off the government, it’s not a hard argument to make that they are being ripped off by the Government.

You want to see who is ripping off the Government? Go to your local Social Security office, I did to sign up for part B because they had screwed that up and as of Dec this year I would have No medical insurance, but anyway I and one other were the only Retirement aged people in line, none in line were in a wheelchair or had a cane, crutches etc. Average age I’d guess was in the 30’s.

Listening to them talk to each other apparently they were frequent visitors, talking about what day and time was least busy etc.

That’s who’s ripping off the government.

I’m not bitter, a little disappointed to be honest, but I sort of knew better to be truthful. The acronyms SNAFU, and BOHICA have existed at least since WWII and exist for a reason.

I’ll adapt, improvise and overcome, because that was my training

Mock up of Fat Man at the Airforce Museum

”Joint Army, Navy, Civilian F Up” There was no Air Force then.

 

[Pinecone]

Read the article.

These are people with things that are disqualifying conditions for an FAA Medical, but are collecting VA disability money for that.

NOT flat feet.

[A64Pilot]

I did read the article, it’s been going on for years. the investigation that is, many Airline pilots in the neighborhood, this came up a few years ago.

The article is clearly hitting Vets, because they are easy I guess. You see unlike everyone else the Government has a copy of ALL my medical records, even those from Civilian Dr’s, that makes us easy targets. But Vets are a small portion of the “problem” This from the article, what happened in just a portion of California apparently dwarfs the Vets of the entire Untied States, so what is the purpose of this article I ask you?

About 3,200 pilots in Northern California were collecting Social Security disability benefits, claiming they were too sick to work, but reporting to the FAA that they were medically fit to fly. Many worked as commercial pilots even though, under the law, those receiving disability compensation from Social Security can only work limited hours.

[C.J.]

4 hours ago, A64Pilot said:

But how do you know what your supposed to report? There is or was anyway a laundry list of questions of do you or have you ever had the following you had to answer. I thought the list covered what the FAA considered important, or why is there a list?

One day years ago I was getting my 2nd class medical, the examiner tells me due to my neck size and weight that he was going to have me have a sleep study, it was a new DOT requirement.

I tell him I’ve been using a CPAP for years, he gets upset and says you should have told me that, I ask why, he says you need a special issuance, I ask how was I supposed to know, there is a laundry list of issues, if the FAA wanted to know if you were using a CPAP, why isn’t it on the list? 

An issue as I see it is we aren’t medical professionals how do we know what he or she needs to know?  I get up to pee several times a night now, should I tell him that? What about my heel spurs / flat feet, degenerative joint disease, arthritis?

What you self-report is up to you, but FAA Form 8500-8's question #19 is the catch-all beyond the specific medical conditions "laundry listed" in question #18.

 

[A64Pilot]

 

I’m not arguing and in my instance my previous AME must have known about the CPAP because I would have filled out the form, either it didn’t become a special issue until later which I suspect or he missed it. I’ve been using a CPAP pretty much since retirement and I retired in 03. I think it didn’t become a special issuance until later, but that’s my guess.

Seems 2015, which would be about the time my new AME wanted me to have a sleep study.

https://www.faa.gov/newsroom/sleep-apnea-aviation

 

So in my case for example it seems CPAP wasn’t an issue for the FAA until years after I had been using one.

So there are holes if you will in the three year question

[DCarlton]

Interesting.  I had breakfast with a gent in his mid '80s a few weeks ago that was a former pilot.  He eventually lost his physical due to reporting CPAP use.  

[A64Pilot]

2 hours ago, bluehighwayflyer said:

I know a former Army rotor wing pilot.  Half way into his career he was diagnosed with a non service-related or life threatening disease for which the Army grounded him.  He served the remainder of his career in various non-flying jobs.  When he got his 20 years he got a 100% non-taxable CW3 medical disability retirement and then took a civilian job doing air ambulance work.  I never understood how the Army grounded him but the FAA didn’t.  Maybe he was one of these guys.  IDK.  I always chalked it up to different standards and maybe it was.  I agree completely about the pervasiveness of SS Disability abuse, FWIW. 

Reason is and of course some will argue but the Military’s standards are much higher than the FAA’s. There are no special issuances in the Military.

I also had a friend, a Blackhawk driver who had an unexplained loss of consciousness, that was later diagnosed and explained, but that one time was enough to get him permanently grounded. His issue as silly as this sounds but he got up to pee in the middle of the night and passed out when he did. Seems if your blood pressure is really low like it is if your really healthy and sleeping that voiding your bladder can make it drop low enough for a momentary blackout. It’s exactly like standing up too quick and getting lightheaded, just the decrease size of the bladder drops blood pressure too. I don’t pretend to be a Doc, this is just what I was told.

His mistake? He told the Doc about it. Some against regulations will pay a Civilian Doc out of their pocket to get a diagnosis to find out what’s going on, I know some that went to Chiropractors for their back, which wasn’t allowed. I was literally allowed to take one dose of aspirin, nothing else and even then I had to go to the flight Doc for an upslip. But honestly it was so easy usually to get to the Doc and of course you didn’t pay so we did.

Your friend was lucky, mine didn’t make it to 20 and Retire, most don’t. Reason is he was a Blackhawk driver and his promotion boards were against other Blackhawk pilots, a grounded pilot isn’t worth much so they don’t do extremely well on yearly evals so they get passed over for promotion, second passover and your out. A CW3 gets his or her second look for 4 prior to making 20. So normally you have to make 4 to be eligible for Retirement.

I don’t think he got any disability either, because passing out once while sitting on the John isn’t a disability. Last I saw of him he was a Contractor working at the NTC

I Retired as a CW-3 only because I had 5 years prior enlisted time, so I had 20 years in prior to my second passover. My only way out was to be passed over as a Longbow MTP / MTFE they wouldn’t accept a request for Retirement. It’s a game, request Retirement and you will come down on PCS orders, want to take the family? Then that’s three years, go unaccompanied and it’s two. You can’t Retire from an overseas assignment, and even then it’s a REQUEST for retirement. Only sure way out is to get passed over, then they have to let you out, although they offered me three more years, which I didn’t take of course

To get Military disability your medical condition doesn’t have to be a direct cause of service, the burden of proof is that your service was as likely as not to worsen it.

For instance heel spurs / flat feet. It’s unlikely for military service to be the cause of it, or every single infantryman over x number of years would get it and many don’t. But it’s likely that being an infantryman would exacerbate the condition, enough so that same guy living an ordinary life would never develop heel spurs or if they did they wouldn’t worsen to Plantar Fasciitis, without the marching in boots. So you get some disability, but probably 10%

Thats a whopping $165 a month

https://www.va.gov/disability/compensation-rates/veteran-rates/

When I Retired I didn’t bother with putting in for disability because at time if you got disability they reduced your Retired pay by the amount of the disability, so the money you got didn’t change, only difference was disability isn’t taxed but Retirement is.

That has apparently changed and now under certain circumstances you can receive both disability and Retirement pay, but I don’t know when it changed

https://www.military.com/benefits/military-pay/concurrent-retirement-and-disability-pay-crdp-overview.html

[A64Pilot]

21 minutes ago, DCarlton said:

Interesting.  I had breakfast with a gent in his mid '80s a few weeks ago that was a former pilot.  He eventually lost his physical due to reporting CPAP use.  

I had to get a special issuance, it’s a PIA as I’m sure all are, but you have to get a print out from the machine that proves it’s both working and your using it, give that to the AME, he I guess writes a statement and sends it to the FAA. I don’t know why anyone wouldn’t use one but seems some won’t wear it, before I got on the CPAP I was drinking enormous amounts of Caffeine and would nod off if I sat down for long, I thought it was just fatigue as my normal work days were over 14 hours.

My guess is at his age that was the excuse to deny his Medical.

Once I started using the CPAP I started dreaming again, sounds silly but apparently without it I never got into the dreaming phase of sleep and hadn’t had a dream for I think years.

I used Sleepyhead software which is an astonishingly powerful software and the machines record a huge amount of data. It was freeware and was so good that many tried to make money off of it and the developer just quit, but you can still download it if you know anyone who has a CPAP, if you want to REALLY know if your CPAP is effective I highly recommend downloading it. Your not supposed to but of course you can adjust the machine yourself, once you learn what your doing with the help of the software you can tune your machine and get your Apnea down really low and sleep like a kid again.

Until you have to get up to pee of course, it doesn’t stop that  

https://sleepyhead.jedimark.net

[C.J.]

5 hours ago, A64Pilot said:

 

I’m not arguing and in my instance my previous AME must have known about the CPAP because I would have filled out the form, either it didn’t become a special issue until later which I suspect or he missed it. I’ve been using a CPAP pretty much since retirement and I retired in 03. I think it didn’t become a special issuance until later, but that’s my guess.

Seems 2015, which would be about the time my new AME wanted me to have a sleep study.

https://www.faa.gov/newsroom/sleep-apnea-aviation

 

So in my case for example it seems CPAP wasn’t an issue for the FAA until years after I had been using one.

So there are holes if you will in the three year question

excerpt from link you provided;

What is the background on the FAA’s actions on OSA?
The FAA has always used the special issuance medical certification process to certificate pilots with OSA. In November 2013, the FAA proposed guidance that would have required treatment for pilots with a body mass index (BMI) of 40 or more. 

Clearly sleep apnea & use of CPAP wasn't an issue for the FAA until 10 years after your retirement. Sorry I mis-interpreted your post.

Several pilots at my airline that had been using CPAP for years told me they never self-reported their treatment on question #19 three year medical history or question #18(X) "EVER IN YOUR LIFE" "illness" medical history, which is the other catch-all on Form 8500-8. None of these guys would've been caught in the BMI 40+ or neck circumference dragnet. All of them had acted responsibly in addressing their medical issues but out of grave concern of losing their income wisely chose to keep FAA Aero-Medical Dept from turning it into a major Charlie Foxtrot.

 

[Schllc]

I think the operative word here is "could" preclude them from flying.  

I am ex military, and a few of the guys I served with have disability pay, but none of their disabilities would affect ability to get a ppl.  I would be a fraction of those 5,000 have conditions that conflict with FAA guidelines.  While I agree any is too many, I suspect this will come down to less than 10% of the cases reported.  

Disability simply means less function that prior to the condition, and is very subjective based on the doctor and the case.  I can tell you it isn't the racket that the post office has going where over 30% of their employees retire with some form of disability!

[A64Pilot]

For any that are curious after being retired for 20 years I’m finally seeking disability but only after having my knees replaced and the second one getting a Staph infection, which means if I’m lucky I only have to have it replaced twice more for a total of three knees on that leg which means that beyond the years of pain and recovery means knee #3 isn’t nearly as good as knee #1 would have been due to the scarring and bone loss and the fact it’s a cemented joint etc. Moderately lucky I lose the leg above the knee, really unlucky and I don’t survive it. The knees based on my military medical records are definitely service related, first scope right after retirement showed severe degeneration and the Board Certified Surgeon who replaced them wrote a letter that in his opinion Military service is why they wore out. Called a Nexxus Ltr.

By VA regulations it’s a slam dunk way more proof than required as any one of the three is enough.

So of course the VA has denied the knees since I have so much proof  I’m requesting a higher level review. I can’t sue the Government being Military I don’t have that right, I’m restricted to asking and saying pretty please.

But they granted me disability for the CPAP which I have no proof for? There is NO logic that I can ascertain, but I think the CPAP decision is Political.

I was on a CPAP long before getting fat, I think the knees are largely why I’m fat because my activity level is much lower now, of course I should eat less with lower activity.

I’m not trying to screw the Gubermint but I know for sure my knees were from running in the Army, I was an exceptional runner. Army likes good runners and when you’re Enlisted trying for flight school maxing your PT test and being the fastest runner in the unit helps. I could run two miles in 12:30, but after a hard run I had serious pain under my knee caps and my calves, figured it was just weakness leaving the body  I knew I had “bad” knees but didn’t know what I was in store for, but knew if I complained much that would get me discharged with a 10% disability or so and My goal was 20 and Retire. So I didn’t complain much

Anyway when I get disability for the knees which is assured (I hope logic will finally prevail) when they finally own up to it, that comes with survivors benefits for the Wife should I die from a complication from the disability as it was service related. That’s why I’m doing this, yes I have life insurance for the first time in my life too.

I’m sure she would have to fight for that and to be honest I don’t even know what those benefits are, but now that I write this down and think about it, those benefits may be why I’m being denied the knees?

Oh, and none of my disabilities would keep me from flying unless of course I lose the leg.

Of course I had PTSD, if I didn’t I wouldn’t have been normal, but most people get over that with time just like most do for any other catastrophic event like losing a child or spouse etc. Even then I knew better than to say I had any mental health issues. Not trying to downplay it just I think it’s existed as long as there has been war and owning up to it can seriously degrade your chances for a career after the military.

[A64Pilot]

On 9/5/2023 at 1:57 PM, C.J. said:

excerpt from link you provided;

What is the background on the FAA’s actions on OSA?
The FAA has always used the special issuance medical certification process to certificate pilots with OSA. In November 2013, the FAA proposed guidance that would have required treatment for pilots with a body mass index (BMI) of 40 or more. 

Clearly sleep apnea & use of CPAP wasn't an issue for the FAA until 10 years after your retirement. Sorry I mis-interpreted your post.

Several pilots at my airline that had been using CPAP for years told me they never self-reported their treatment on question #19 three year medical history or question #18(X) "EVER IN YOUR LIFE" "illness" medical history, which is the other catch-all on Form 8500-8. None of these guys would've been caught in the BMI 40+ or neck circumference dragnet. All of them had acted responsibly in addressing their medical issues but out of grave concern of losing their income wisely chose to keep FAA Aero-Medical Dept from turning it into a major Charlie Foxtrot.

 

Having gone down the special issuance route for CPAP I think you need to get them to own up to it, because all that’s required is for them to prove that your using the machine and that treatment is effective, both of which the machine shows by downloading the data. Having an issue your hiding can cause real problems and this one is so easy to get approval for. As I said I used Sleepyhead software for the printout, at least have them do the download, ensure it gives the data they need so they know they will be successful, then talk to the Flight Doc.

I think if I were them I’d go to a new Dr and get a new prescription and maybe not own up to being on a CPAP for years.

Without the machine I wake up with a headache, feel exhausted because I had little sleep, feel like I have a hang over, it increases risk for heart disease, high blood pressure, strokes and other things. Before using the CPAP I would honestly nod off when flying at cruise with the Autopilot on. I had friend who nodded of spraying and put a brand new Thrush G-10 in a cotton field, this was before CPAP though

If I wear the mask I have none of that, sure it’s a pain you get used to it though, but I can’t figure out why anyone wouldn’t wear the thing, but it seems many won’t.

[A64Pilot]

Sorry to keep beating the Sleep Apnea drum, but if you suspect an issue or just want to know it’s very easy, all you need is a recording pulse oximeter, you probably wanted one for flying anyway and they are cheap.

Put the pulse Ox on your finger, put a sock over your hand to keep from knocking it off in your sleep and sleep, next day download it and if your O2 saturation level crashes several times during the night you have an issue, probably OSA but maybe not so you need to see the Doc and find out, you’ll need a sleep study for the prescription to buy a CPAP anyway. Not all apnea is obstructive some can be from the central nervous system, but I don’t know anything about that other than it exists

Of course if your O2 saturation isn’t crashing then maybe your just overworked or have a different issue.

My Wife argued she didn’t have an issue but I could hear the way she breathed when she slept, I did the pulse Ox thing and that convinced her to do a sleep study.

We both have mild apnea.

 

[Fly Boomer]

On 9/7/2023 at 9:00 AM, A64Pilot said:

Sorry to keep beating the Sleep Apnea drum, but if you suspect an issue or just want to know it’s very easy, all you need is a recording pulse oximeter, you probably wanted one for flying anyway and they are cheap.

Put the pulse Ox on your finger, put a sock over your hand to keep from knocking it off in your sleep and sleep, next day download it and if your O2 saturation level crashes several times during the night you have an issue, probably OSA but maybe not so you need to see the Doc and find out, you’ll need a sleep study for the prescription to buy a CPAP anyway. Not all apnea is obstructive some can be from the central nervous system, but I don’t know anything about that other than it exists

Of course if your O2 saturation isn’t crashing then maybe your just overworked or have a different issue.

My Wife argued she didn’t have an issue but I could hear the way she breathed when she slept, I did the pulse Ox thing and that convinced her to do a sleep study.

We both have mild apnea.

 

Reduced O2 saturation is not good, but worse is that repeated dips in saturation resets your CO2 "sensor" which causes you to take your next breath.  When that setting gets too far out of spec, you just fail to take that next breath.  Game over.

[Smiles201]

Not to cast aspersions on military service or downplay any of the overwhelmingly legitimate suffering that persons are sometimes left with from service to our country, but I am the guy who evaluates people for ssi disability and find that a small proportion of people claiming PTSD from their military time do not actually have symptoms of PTSD, and that the VA sometimes advises individuals to stop working to justify the diagnosis and their receipt of benefits from the VA.  

[A64Pilot]

On 9/9/2023 at 9:52 PM, Smiles201 said:

Not to cast aspersions on military service or downplay any of the overwhelmingly legitimate suffering that persons are sometimes left with from service to our country, but I am the guy who evaluates people for ssi disability and find that a small proportion of people claiming PTSD from their military time do not actually have symptoms of PTSD, and that the VA sometimes advises individuals to stop working to justify the diagnosis and their receipt of benefits from the VA.  

There is no telling, first what is PTSD anyway? My guess is anyone who loses a Wife or child etc suffers from it, yet they have to continue to work. Of course some “fall apart” and some even pass away themselves pretty soon, but they are a fraction of the norm, some suicide.

I suspect Military members fall into the same pattern, that is it damn sure wasn’t enjoyable, you dream about it for some time etc., even waking up in a panic, feel depressed and guilty, I think guilt is the biggest reason some suicide, but over time you get over it, sure it’s always there, you wouldn’t wish it on your worst enemy etc. but you cope, you don’t have much choice, you have to raise your kids etc. A few don’t or can’t and a not insignificant number of those that can’t suicide, which from societies view solves the problem, cruel observation but it is what sometimes happens.

Is guilt PTSD? At least some combat activities are or could I guess be thought of as murder. It was one thing to be an infantryman in Vietnam etc facing an enemy charge, that was kill or be killed, self defense. But if your sitting in airconditioned comfort a long ways away, but you have a gyro stabilized 126 power magnification sight and can pretty much see faces of people that don’t even know you exist and your told to “take them out” with a 30mm Cannon, you get to watch them get torn apart, because a 30mm Cannon designed to destroy light armored vehicle does tear a human apart. That’s tough to get over, you get to wondering that surely there was a different way to handle that.

But in truth many of these people are so dedicated that they will literally blow themselves up in the hope to kill a few of you, that’s also a real tough thing to imagine, because I do not have that kind of dedication. If you let yourself think about this too much it will get to you. Nothing in any kind of “normal civilized” life can prepare you for the brutal truth of how savage people can be and how savage you have to be to combat it, you sort of have to become the thing your trying to eradicate, and that eats on anyone with empathy. Some seem to not have any empathy, I saw that in business, some have no ethics, when pushed they look at you like your stupid and tell you “it’s just business” 

 

I doubt the “VA” is telling them to not work, but as with everything else that has money in it, the law offices of Dewey, Cheatem and Howe are involved, for a cut of the benefits for as long as the recipient is alive anyway and that can add up over time to a large sum, especially if your getting 40% of hundreds of peoples disability

Additionally the VA has “certified” individuals to assist in disability applications, how do they get paid you ask? They get a cut of your disability, the VA set that system up, they created it.

But there are some agencies that will help for free, but to be honest you sometimes get what you pay for, on paper the American Legion is helping me, but in reality I found an older Marine Corp Nurse recommended by a friend that’s helping me, and yes I pay her, but not by a cut of my disability. You think taxes are complicated? They are simple compared to VA forms and paperwork, many that contradict each other of course, I’m certain the complexity is intentional.

Do you think these people who are after a cut of your disability just might advise you on how to “game” the system, tell you to get the max benefits you have to quit work and school you on what to say etc. remember they get a percentage and they aren’t perjuring themselves, you are.

How often do you see people with the cripple tags or license plates park in the disabled spots get out and walk or even run into a store when it’s raining? More often than not from my observation, people are crooks plain and simple, and most of them feel entitled to be so.