Medical Certification Issues

[Doc]

Hello: I have been very impressed with the professionalism, helpfulness and friendliness of this group. Thanks. I am a Senior Aviation Medical Examioner in the SAT (Fort Worth District) area and would welcome any questions (through private messages) regarding medical certification issues that any of the members might have. All responses would be treated as confidential and would remain private - the FAA does not receive any information until you sign a Form 8500-8 (Medical Examination) at your AME's location. Over 15% of the airmen I follow have some sort of medical issue that requires "Special Issuance" and I have been very successful working with airmen who have been motivated to keep their certificates current. My opinion as an AME to any of your questions would be just that - an opinion that leaves you free to do with as you wish. Doc

[Jim Herpst]

Re: Medical Certification Issues

As the first I suppose to read this on this fine sunday morning, thanks Doc

[flylo]

Re: Medical Certification Issues

Thanks Doc! I'm sure this will be a great help to many.

[paulp]

Re: Medical Certification Issues

Howdy Doc,

That is a very fine thing. Thank you. I know it will help a bunch of folks.

[94973]

Re: Medical Certification Issues

Howdy, doc. What's the FAA saying about taking metformin? You know us tcraft types, never would we fly without a medical or with the airplane over gross. By the book, we are.

[VictorBravo]

Re: Medical Certification Issues

Thanks, Doc! The one thing I would think this group would benefit from is knowing what to do and what not to do when it comes time for a medical. Without putting yourself in any kind of a compromised position, could you reveal what are the "red flags" on a medical application, or what types of things that pilots might want to be a little less talkative about? I am absolutely certain that this might be very interesting reading for some folks here on this group. For entertainment purposes, of course.

However much you would care to discuss on or off this forum will be appreciated by many. Maybe by me personally sooner than I'd care to have it

Bill

[Doc]

Re: Medical Certification Issues

Hello: Here are some big red flags....1. Any history of heart disease, angina, angioplasty, stents, bypass surgery; 2. Diabetes requiring medication; 3. New diagnosis/treatment for hypertension; Severe lung disease (usually needs oxygen); Unexplained unconsciousness for any reason; 4. Use of the new antidepressant (SSRI) agents!!!!!; 5. Alcohol or drug use / arrests; 6. Any change of medication by your doctor for a stable condition warrants a "time-out" period from flying, usually 30 days. 7. Pacemaker insertion; 8: Automatic defibrillator insertion is an absolute, permanent "No FLY" condition. Actually, there are 15 stated conditions that are disqualifying and require that the FAA in Oklahoma City make a determination for eligibility for a "Special Issuance". Please note that FAR 61.53 states that if you have a known medical condition that is disqualifying, your medical is invalid - please be careful. Also, FAR 61.53 and the new FAR for Sport Pilot will address this issue again. Most sport pilots do not understand that they may not self certify under a driver's license if they have one of those 15 conditions. MOST AMEs are sympathetic, especially the pilot AME's. Have a frank discussion with your personal AME - the info should not go to the FAA until you sign the Fom 8500-8, Report of Medical Examination. I will answer any personal questions through private messages on this forum to protect your privacy, or you can request my e-mail address for the same. The website www.cami.jccbi.gov has some bullet points on medical issues that may be helpful before you talk with your AME. On the good side, the FAA has a low permanent refusal rate, usually due to the airman not completing the paperwork - but this may be related to the cost of recurrent medical examinations required by some Special Issuances. I personally like my pilots to call me with their questions BEFORE we get to the office exam so that we can get some information to expedite the paperwok when we are ready to go forward! Thanks for your question. Doc

[paulp]

Re: Medical Certification Issues

Howdy Doc,

I really appreciate the last post. Good info. It's certainly a comfort knowing that there is someone to whom a med ? can be directed and not have to worry about having strings attached. Many thanks.

Doc, you have to be a Taylorcraft owner. If not, you have to have one. They are old, drafty, slow, noisy, sometimes a pain in the a#@ and the greatest airplane ever built.

[Doc]

Re: Medical Certification Issues

Hello: N43306 is a '46 BC12-D undergoing complete restoration to include the A-65. I enjoyed the time I had in her before exposing all of her warts to the hangar walls. She and a '39 Aeronca LA65 will be recovered together. They share space with an RV-8 project and a C210E that I began restoration on 10 years ago (finished 5 years ago) and now functions as my air-truck. These projects beat ranching in South Texas as the best way to get rid of any money lying around . Doc

[selje]

Re: Medical Certification Issues

Hello: Here are some big red flags....1. Any history of heart disease, angina, angioplasty, stents, bypass surgery; 2. Diabetes requiring medication; 3. New diagnosis/treatment for hypertension; Severe lung disease (usually needs oxygen); Unexplained unconsciousness for any reason; 4. Use of the new antidepressant (SSRI) agents!!!!!; 5. Alcohol or drug use / arrests; 6. Any change of medication by your doctor for a stable condition warrants a "time-out" period from flying, usually 30 days. 7. Pacemaker insertion; 8: Automatic defibrillator insertion is an absolute, permanent "No FLY" condition. Actually, there are 15 stated conditions that are disqualifying and require that the FAA in Oklahoma City make a determination for eligibility for a "Special Issuance". Please note that FAR 61.53 states that if you have a known medical condition that is disqualifying, your medical is invalid - please be careful. Also, FAR 61.53 and the new FAR for Sport Pilot will address this issue again. Most sport pilots do not understand that they may not self certify under a driver's license if they have one of those 15 conditions. MOST AMEs are sympathetic, especially the pilot AME's. Have a frank discussion with your personal AME - the info should not go to the FAA until you sign the Fom 8500-8, Report of Medical Examination. I will answer any personal questions through private messages on this forum to protect your privacy, or you can request my e-mail address for the same. The website www.cami.jccbi.gov has some bullet points on medical issues that may be helpful before you talk with your AME. On the good side, the FAA has a low permanent refusal rate, usually due to the airman not completing the paperwork - but this may be related to the cost of recurrent medical examinations required by some Special Issuances. I personally like my pilots to call me with their questions BEFORE we get to the office exam so that we can get some information to expedite the paperwok when we are ready to go forward! Thanks for your question. Doc

Doc, in the above you state, "Most sport pilots do not understand that they may not self certify under a driver's license if they have one of those 15 conditions." I have studied the sport pilot rules and see no support for that statement. If true, then a sport pilot with for example stable type 2 diabetes on long term metformin would require an special issuance to fly as a sport pilot. I do not believe that is true. What is the written support for this statement?

[94973]

Re: Medical Certification Issues

Doc: It's great having you around, and I appriciate your advice. When I checked with AOPA and with my CFI, they both said that as long as a pilot has never been turned down for a medical, they could self certify with a drivers license. Has the FAA changed the rule, or do AMEs get guidlines CFIs don't?

[selje]

Re: Medical Certification Issues

The link below is to a FAA web site on sport pilot medical questions and speaks to the above question.

http://www.faa.gov/licenses_certificates/medical_certification/sportpilots/response5/index.cfm

This answer is consistent with a careful reading of FAR 61.53(c) and FAR 61.23(b).

[Doc]

Re: Medical Certification Issues

Hello: Both FAR 61.53 and FAR 61.23 address these issues. Although it appears at first reading that a sport pilot may consult a private physician to determine whether or not he/she has a medical deficiency that would interfere with piloting duties, FAR 61.53 prohibits all pilots -- those who are required to hold airman medical certificates and those who are not -- from exercising privileges during periods of medical deficiency. I, as an AME, cannot issue a medical certificate for certain medical conditions -- one of which is diabetes requiring medication. However, an AME can help an airman qualify for a 3d class (or higher) medical certificate. Under FAR 61.5, the FAA firmly plants responsibility ONTO THE PILOT to determine whether or not the airman is qualified medically to fly. This is a hot political issue which the aviation lawyers will have to sort out as the FAA will point to FAR 61.53 when there is an incident that may be attributed to a medical condition. You can imagine what your insurance carrier will do in this circumstance. My REAL advice is to work with your AME to obtain a "Special Issuance" of your 3rd Class Medical Certificate. "The Federal Air Surgeon's Medical Bulletin", Vol 42, No. 3 (2004) discusses these issues, and may be "googled". There will NOT be a 4th Class Medical Certificate for Sport Pilot, as the FAA will adhere to medical standards under current FAR's -- and FAR 61.53 is not well understood by most pilots, flight instructors, others, etc. -- and takes the aeromedical people of the FAA "off of the hook" when there is a medically related incident. Best wishes. Doc

[selje]

Re: Medical Certification Issues

Doc,

The following is a quote from the FAA medical website with link in my above post,

"Sport Pilot Medical Certification-Frequently Asked Questions

Provided I otherwise qualify and have never sought FAA medical certification, am I authorized to exercise sport pilot privileges on the basis of a current and valid driver’s license if I have a chronic medical condition such as diabetes?

Response by the Federal Air Surgeon

You should consult your private physician to determine whether you have a medical deficiency that would interfere with the safe performance of sport piloting duties. You may exercise sport pilot privileges provided you are in good health, your medical condition is under control, you adhere to your physician’s recommended treatment, and you feel satisfied that you are able to conduct safe flight operations."

FAR 61.53 has three parts with part (c) applying to "Operations requiring a medical certificate or a U.S. driver's license."

Is it your opinion that liability issues will trump the FAR's and Federal Air Surgeon's view?

[Doc]

Re: Medical Certification Issues

Hello: The publication is very ambiguous and not definitive For example, the statement..."provided that you are in good health" is the type of statement that places responsibility on the pilot. I will tell you what is told us (AME's) - the same medical standards apply to all pilots (again, FAR 61.53)...a pilot with medication controlled diabetes (or other problems) has a chronic condition - whether or not you can state you are in "good health" is very subjective. Let's put this aside for a while and I will personally contact the Federal Air Surgeon in Washington, DC (Dr. Jordan) and his #1 representative in OKC (Dr. Silberman) to get a written opinion on whether a sport pilot with one of the 15 disqualifying medical conditions can get his personal physician to allow him to fly with a drivers license...this letter will state the assumption that the FAA NEVER was informed (via a FAA medical exam) that the pilot had one of these conditions. I know that this is a difficult area for us, but as a Senior AME, I can only give you information based upon our understanding of the FAR's, and verbal instructions given to us in recurrent seminars by the Civil Aeromedical Institute of the FAA. Although AME's are not suposed to be involved in Sport Pilot Driver License certifications, we have been told that FAR 61.53 is operative in all cases of aircraft operation.......Sorry. Doc