Medical Special Issuance Policy Changes??

[MikeOH]

I just received my annual SI letter(special issuance) from OKC and boy have the requirements for my condition changed!

This has been a stable condition for OVER 20 YEARS!  Historically, I've only had to submit an informal status letter from my 'treating physician', sometimes, but not always, with a set of current labs (which have always been perfect, BTW).  On my 'off years' I submit the info directly to OKC and they send me a new medical and status letter, when I see my AME every other year he is allowed to issue my medical based on my submission of the letter and labs (if required).

NO LONGER!  OKC now wants a VERY long and detailed list of items specifically addressed by my 'treating physician' formally recorded in HIS official "clinical notes".  I now MUST submit a copy of those clinical notes.  Further, the SI letter now specifically states my AME is NOT allowed to issue during my biennial exams; he, too, must submit all this to OKC for them to issue!

Has there been some 'crackdown' policy change at the OKC Aeromedical division that would explain this draconian change?

I've maintained my 3rd Class up until now with some effort over the SI, but now I think I'm done!  I had a physical with my GP on Friday and she is signing off on my Basic Med paperwork.  Maybe that's what OKC is trying to do? "Encourage" 3rd Class SI holders to just go Basic Med?

I'm a bit bummed as I recently retired and was thinking my wife and I might fly to Canada/Mexico at some point...oh, well.

Just curious if any other SI holders out there have seen similar changes.

[Fly Boomer]

1 minute ago, MikeOH said:

I just received my annual SI letter(special issuance) from OKC and boy have the requirements for my condition changed!

This has been a stable condition for OVER 20 YEARS!  Historically, I've only had to submit an informal status letter from my 'treating physician', sometimes, but not always, with a set of current labs (which have always been perfect, BTW).  On my 'off years' I submit the info directly to OKC and they send me a new medical and status letter, when I see my AME every other year he is allowed to issue my medical based on my submission of the letter and labs (if required).

NO LONGER!  OKC now wants a VERY long and detailed list of items specifically addressed by my 'treating physician' formally recorded in HIS official "clinical notes".  I now MUST submit a copy of those clinical notes.  Further, the SI letter now specifically states my AME is NOT allowed to issue during my biennial exams; he, too, must submit all this to OKC for them to issue!

Has there been some 'crackdown' policy change at the OKC Aeromedical division that would explain this draconian change?

I've maintained my 3rd Class up until now with some effort over the SI, but now I think I'm done!  I had a physical with my GP on Friday and she is signing off on my Basic Med paperwork.  Maybe that's what OKC is trying to do? "Encourage" 3rd Class SI holders to just go Basic Med?

I'm a bit bummed as I recently retired and was thinking my wife and I might fly to Canada/Mexico at some point...oh, well.

Just curious if any other SI holders out there have seen similar changes.

If you have a current valid medical and SI, get out now.  Without a good medical and attendant Special Issuances, Basic Med is not happening.

[Hank]

Must.be new bureaucrats a couple levels up, flexing their administrative muscles and thumping their pasty, hairless chests . . . .

[MikeOH]

Just now, Hank said:

Must.be new bureaucrats a couple levels up, flexing their administrative muscles and thumping their pasty, hairless chests . . . .

Good as explanation as anything; the letter was signed by a different guy (actually signed by an underling of the different guy)

[MikeOH]

3 minutes ago, Fly Boomer said:

If you have a current valid medical and SI, get out now.  Without a good medical and attendant Special Issuances, Basic Med is not happening.

Exactly!  I've become pretty accustomed to the SI routine over the last 20 years and haven't had much trepidation since it has gone smoothly.  This change really sounds like I'm being "set up" for a denial.  Not to mention in today's clinical environment with insurance controlling everything medical, I have only about 10 minutes each year with my specialist "treating doctor"; somehow I need to convince him to specifically address every single one of OKC's items completely and with a suitable response AND make sure he records them in his clinical notes.  In other words, I have to tell him how to do his job...oddly enough many physicians really don't appreciate patients trying to do that!

[EricJ]

I think Mexico and the Bahamas now allow BasicMed, so it's only Canada that is a limitation.   Some of the other BasicMed limits get increased on the next rule cycle, so that's nice, too (e.g., max GW goes up to 12500 lbs).    Still can't go into Class A airspace, but that's not a huge thing for Mooney operators, especially NA airplanes.

 

[MikeOH]

Thanks.  I knew about the Bahamas (but, didn't they recently raise some kind of fees?) but not Mexico.  Yeah, my F is NA so over 18K isn't really an issue (and my dream of trading up to a turbo has been quashed by my wife's desire for a sailing yacht). I have always wanted to make a trip to Alaska so the Canada no Basic Med is unfortunate.

[Fly Boomer]

7 minutes ago, MikeOH said:

I have always wanted to make a trip to Alaska so the Canada no Basic Med is unfortunate.

I have not planned a trip like that, but I have read that overflight is not prohibited.

[MikeOH]

Just now, Fly Boomer said:

I have not planned a trip like that, but I have read that overflight is not prohibited.

Neither have I planned it out.  But I always thought making it non-stop was a bit of a stretch.

[Hank]

25 minutes ago, MikeOH said:

Neither have I planned it out.  But I always thought making it non-stop was a bit of a stretch.

Check the coastal route, it's shorter.

[MikeOH]

14 minutes ago, Hank said:

Check the coastal route, it's shorter.

Yes, looks like around 4:30 from Port Angeles to Ketchikan

[MooneyMitch]

2 hours ago, MikeOH said:

Yes, looks like around 4:30 from Port Angeles to Ketchikan

That’s doable in your F (no strong headwinds).   

[GeeBee]

It seems strange they would be maker it harder. Dr. Northrup has always been a "KISS principle" kind of doctor before she was at the FAA and even while with the FAA in the Southeast region.

 

[MikeOH]

42 minutes ago, GeeBee said:

It seems strange they would be maker it harder. Dr. Northrup has always been a "KISS principle" kind of doctor before she was at the FAA and even while with the FAA in the Southeast region.

 

I agree, I even looked to see if she was still in charge; she is.

I really can't fathom why OKC wants to make it harder.  Hence my curiosity if others have seen increased requirements for their SI.  Systemic change, or just 'picking on me'

[M20F]

On 8/18/2024 at 6:09 PM, Fly Boomer said:

I have not planned a trip like that, but I have read that overflight is not prohibited.

BasicMed – Flying in Canadian Airspace
Due to the non ICAO-compliant nature of the BasicMed regime, Transport Canada does not currently allow aircraft to be operated in Canadian airspace by U.S. pilots flying under BasicMed. This includes transiting without landing (i.e. to/from Alaska). COPA is currently collaborating with AOPA and Transport Canada on a way forward which would allow certain BasicMed operations that comply with the restrictions imposed on Canadian Recreational Pilot Permit Holders.
 

[Fly Boomer]

1 minute ago, M20F said:

BasicMed – Flying in Canadian Airspace
Due to the non ICAO-compliant nature of the BasicMed regime, Transport Canada does not currently allow aircraft to be operated in Canadian airspace by U.S. pilots flying under BasicMed. This includes transiting without landing (i.e. to/from Alaska). COPA is currently collaborating with AOPA and Transport Canada on a way forward which would allow certain BasicMed operations that comply with the restrictions imposed on Canadian Recreational Pilot Permit Holders.
 

Well, so much for my reading.  Thanks for the clarification.

[MikeOH]

4 hours ago, M20F said:

BasicMed – Flying in Canadian Airspace
Due to the non ICAO-compliant nature of the BasicMed regime, Transport Canada does not currently allow aircraft to be operated in Canadian airspace by U.S. pilots flying under BasicMed. This includes transiting without landing (i.e. to/from Alaska). COPA is currently collaborating with AOPA and Transport Canada on a way forward which would allow certain BasicMed operations that comply with the restrictions imposed on Canadian Recreational Pilot Permit Holders.
 

Thanks, I found that, too.  Further, the last sentence has some relevance to the problem, I think.  There is some indication that the problem is that the US won't recognize Canadian Recreation Pilots...so, in a reverse quid pro quo, Canada isn't going to recognize Basic Med!  Peeing contest, it would seem

[Pinecone]

Social Flight has Phil Boyer on a while back,  He said that the issue is Basic Med is not ICAO recognized.  And it would be a lot of work to get Canada to recognize it now.  But once ICAO recognizes it, it will be simple for Canada to do so,  So they are waiting.

[DXB]

On 8/18/2024 at 5:28 PM, MikeOH said:

I just received my annual SI letter(special issuance) from OKC and boy have the requirements for my condition changed!

This has been a stable condition for OVER 20 YEARS!  Historically, I've only had to submit an informal status letter from my 'treating physician', sometimes, but not always, with a set of current labs (which have always been perfect, BTW).  On my 'off years' I submit the info directly to OKC and they send me a new medical and status letter, when I see my AME every other year he is allowed to issue my medical based on my submission of the letter and labs (if required).

NO LONGER!  OKC now wants a VERY long and detailed list of items specifically addressed by my 'treating physician' formally recorded in HIS official "clinical notes".  I now MUST submit a copy of those clinical notes.  Further, the SI letter now specifically states my AME is NOT allowed to issue during my biennial exams; he, too, must submit all this to OKC for them to issue!

Has there been some 'crackdown' policy change at the OKC Aeromedical division that would explain this draconian change?

I've maintained my 3rd Class up until now with some effort over the SI, but now I think I'm done!  I had a physical with my GP on Friday and she is signing off on my Basic Med paperwork.  Maybe that's what OKC is trying to do? "Encourage" 3rd Class SI holders to just go Basic Med?

I'm a bit bummed as I recently retired and was thinking my wife and I might fly to Canada/Mexico at some point...oh, well.

Just curious if any other SI holders out there have seen similar changes.

This is exactly the f*cking idiocy I keep ranting about with the FAA medical branch.  I've personally helped create and compile accurate, ironclad-appearing documentation from the medical record as a favor a couple of patients who are also pilot friends. I've written well organized notes summarizing all relevant background radiology, pathology, evaluations of other specialists, and also provided copies of those documents.  I explicitly created a summary on the record why their condition added no risk to their operation of an aircraft and likely never would, writing at a level that any MD should instantly grasp and leaving my direct cell phone contact for questions.   It's ridiculous that people need a "special issuance" for so much of this stuff, and a casual glance at many of the situations by someone with moderate expertise should lead to immediate approval.   Instead, both instances I describe led to 6+ month delays, and in one case a request for more documentation (!).   I'm not sure I really helped either of them.

I think what they need is an up front expediter for the large fraction of trivial stuff, allowing for thoughtful and timely focus on the subset meriting more careful consideration.  Even for those cases, the goal needs to be to HELP the pilot find a reasonable and timely path to a medical certificate if at all possible. Instead, everyone is getting put through the same glacially slow bureaucratic meat grinder.    

[jetdriven]

One thing to consider is who the AME is. If you use a Senior AME with HIMS, they have a lot more sway with OKC. In my case, a phone call got me recertified under a CACI worksheet.

[MikeOH]

23 minutes ago, jetdriven said:

One thing to consider is who the AME is. If you use a Senior AME with HIMS, they have a lot more sway with OKC. In my case, a phone call got me recertified under a CACI worksheet.

I have used the same Senior HIMS AME (my condition is NOT HIMS released, however) for all 20 years.  I plan to discuss this with him, but I doubt he can get OKC to rescind and rewrite my 'new' SI letter.  Absent that happening I just don't see the risk worth it vs.  just going Basic Med.

I am curious how long I can 'sit on' my Basic Med Exam before submitting it, as my 3rd Class doesn't expire until next March.  In theory I could go to my specialist in December, have him write his notes, run them by my AME and submit to OKC if he believes them to be ok.  Seems a bit of a hassle for not a lot of gain (Canada travel).

[midlifeflyer]

On 8/18/2024 at 6:09 PM, Fly Boomer said:

I have not planned a trip like that, but I have read that overflight is not prohibited.

I'm curious where you read that.

Are you sure it wasn't "you'll probably get away with an overflight because they have no reason to check your medical"?

[Fly Boomer]

No, my admittedly glitchy memory is that the advice was very specific to overflight vs landing.  The idea was that, if you had to land, you needed a medical, but if you just cut across a corner somewhere, you didn't.  Clearly that memory is faulty.

[MikeOH]

6 hours ago, Pinecone said:

Social Flight has Phil Boyer on a while back,  He said that the issue is Basic Med is not ICAO recognized.  And it would be a lot of work to get Canada to recognize it now.  But once ICAO recognizes it, it will be simple for Canada to do so,  So they are waiting.

Maybe.  But it seems Bahamas and Mexico have no issue accepting Basic Med despite it not being ICAO compliant.  What's the big deal for Canada?