Antidepressants

K

K.T.

Guest
My husband was a flight instructor for many years, but quit flying about 10 years ago when it just didn’t pay the bills anymore. He’s struggling with depression and anxiety and the doctor has prescribed him cymbalta, the expectation is that he’ll stay on it for about a year. If he were to decide to fly again - let’s say two - three years from now (for enjoyment, not for work) would having previously been on this medication prevent him from doing so? In other words - would former use of medication- assuming several years have passed and he has a clean bill of physical and mental health - prevent him from being cleared to fly medically??
 
Sounds like he may be a good candidate for BasicMed--it's an alternative to getting a medical certificate. He can even reinstate his instructor certificate and instruct under BasicMed if he chooses to do so.

BasicMed simply requires the airman to not have any medical conditions that would prevent him from safely flying. FAA medial certification standards do not apply. One simply needs to do a comprehensive medical exam from any state licensed physician...doesn't have to be an FAA approved doc.

For medical certification, Antidepressants require a special issuance, and that's only if it is one of the approved medications and certain requirements are met.

A medical certificate application that is denied takes away the option of BasicMed, so he will want to do his research before even considering to apply for a
Medical certificate.
 
Yes, even though your husband is probably fit to fly and would not have any trouble being pilot in command the faa would instantly deny the medical application. Best to go basic med even though I think that would also require one special issuance due to the admission of taking medication. The process takes 1-2 years and will cost 5-10 thousand dollars and there is no guarantee the faa will issue you a certificate.
 
jstone said:
Yes, even though your husband is probably fit to fly and would not have any trouble being pilot in command the faa would instantly deny the medical application. Best to go basic med even though I think that would also require one special issuance due to the admission of taking medication. The process takes 1-2 years and will cost 5-10 thousand dollars and there is no guarantee the faa will issue you a certificate.
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A one time special issuance is only required for the specific medical conditions listed in 14 CFR 68.9. Neither Depression or Anxiety are listed.

That said, if I were her husband I'd want to consult with a medical professional who was familiar with my issues to ensure they had no concern with me operating an aircraft.
 
Brad Z said:
Sounds like he may be a good candidate for BasicMed--it's an alternative to getting a medical certificate. He can even reinstate his instructor certificate and instruct under BasicMed if he chooses to do so.

BasicMed simply requires the airman to not have any medical conditions that would prevent him from safely flying. FAA medial certification standards do not apply. One simply needs to do a comprehensive medical exam from any state licensed physician...doesn't have to be an FAA approved doc.

For medical certification, Antidepressants require a special issuance, and that's only if it is one of the approved medications and certain requirements are met.

A medical certificate application that is denied takes away the option of BasicMed, so he will want to do his research before even considering to apply for a
Medical certificate.
Click to expand...

thanks so much for your response, is the special issuance needed even long after he stops taking the medication? I’ll talk to him about the BasicMed idea - thank you!
 
K.T. said:
thanks so much for your response, is the special issuance needed even long after he stops taking the medication? I’ll talk to him about the BasicMed idea - thank you!
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The question is "have you ever..."
 
see below. Nothing about depression or anxiety. I was under the impression that an Si would be required.

Mental Health
  • Personality disorder severe enough to have repeatedly manifested
    itself by overt acts,
  • Psychosis,
  • Bipolar disorder, or
  • Substance dependence within the previous two years.
 
jstone said:
see below. Nothing about depression or anxiety. I was under the impression that an Si would be required.

Mental Health
  • Personality disorder severe enough to have repeatedly manifested
    itself by overt acts,
  • Psychosis,
  • Bipolar disorder, or
  • Substance dependence within the previous two years.
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For better or worse, depression or anxiety we're not called out as medical conditions requiring a special issuance, regardless of what Dr. Chien believes.

Nevertheless, the airman needs to clear the condition with his treating physician. As a mental health condition, 68.9(c) applies, which states:

(c) Special rule for mental health conditions.
(1) In the case of an individual with a clinically diagnosed mental health condition, the ability to operate an aircraft under §61.113(i) of this chapter shall not apply if—

(i) In the judgment of the individual's State-licensed medical specialist, the condition—

(A) Renders the individual unable to safely perform the duties or exercise the airman privileges required to operate an aircraft under §61.113(i) of this chapter; or

(B) May reasonably be expected to make the individual unable to perform the duties or exercise the privileges required to operate an aircraft under §61.113(i) of this chapter; or

(ii) The individual's driver's license is revoked by the issuing agency as a result of a clinically diagnosed mental health condition.
 
Kenny Phillips said:
Hmmm ... if Dr. Bruce says it, I'm just gonna take his word for it. He, um, wrote the book on it. Literally.
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I wasn’t aware that Dr. Bruce was involved in the rule-making for BasicMed, or wrote a book on it, especially considering BasicMed is not a medical certification program.
 
Dr. Bruce is a flight instructor as well as an AME, and is pretty much considered THE national expert in such things.
 
I didn't know Basic med was a way to not disclose mental issues, doesn't sound correct to me.
 
PaulS said:
I didn't know Basic med was a way to not disclose mental issues, doesn't sound correct to me.
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Too many people believe the BasicMed can sweep health issues under the table. It does nothing of the sort.
 
PaulS said:
I didn't know Basic med was a way to not disclose mental issues, doesn't sound correct to me.
Click to expand...

Kenny Phillips said:
Too many people believe the BasicMed can sweep health issues under the table. It does nothing of the sort.
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There seems to be some serious misunderstandings here. An airman operating under BasicMed is ABSOLUTELY required to disclose their mental health issues to the state-licensed physician who is conducting the comprehensive medical examination. The airman is not, however, required to go back apply to the FAA for a medical certificate with a special issuance for the mental health condition. Whether or not that makes sense rolls back to Congress; they specified in Section 2407 of FESSA exactly which medical conditions required a special issuance and the FAA implemented the rule accordingly.

As I mentioned previously, 68.9(c) does not allow you to operate under BasicMed if in the judgement of a state-licensed specialist, your mental health condition prevents you from being able to safely operate the aircraft. That does not mean you have to get an SI for the condition.

I put lots of faith in Dr. Bruce's advice regarding medical certification issues. However, BasicMed is not a medical certification issue. The FAA office of aerospace medicine does not drive the policy for BasicMed. Policy guidance is driven by Flight Standards General Aviation and Commercial Division.

I don't know where Dr. Bruce got information indicating that medical conditions not listed on 68.9 need a one-time medical. I wish he would share it (a PM would be sufficient) so I could trace it's origins and help clarify any misunderstandings that are being propagated by the agency.
 
this is from the faa's website and mentions nothing about depression or anxiety requiring a one time special issuance. it lists a few mental health conditions that do indeed require a one time special issuance but non of those are depression or anxiety.

https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/

FAA Home ▸ Licenses & Certificates ▸ Airmen Certification
BasicMed



The BasicMed rule is now effective! Print off a BasicMed Comprehensive Medical Examination Checklist (CMEC) (PDF) and get your physical exam with a state-licensed physician. Then complete a BasicMed online medical course Then go fly!

Please check back on this page for more BasicMed updates.

On July 15, 2016, Congress passed legislation to extend the FAA's funding. This legislation, FAA Extension, Safety, Security Act of 2016 (FESSA) includes relief from holding an FAA medical certificate for certain pilots. This relief is called BasicMed.

When can I fly under BasicMed?
If you meet the BasicMed requirements, you can operate under BasicMed (without an FAA medical certificate) right now!

What do I need to do to fly under BasicMed?

  1. Comply with the general BasicMed requirements (possess a U.S. driver's license, have held a medical after July 14, 2006).
  2. Get a physical exam with a state-licensed physician, using the Comprehensive Medical Examination Checklist
  3. Complete a BasicMed medical education course;
  4. Go fly!

(1) A mental health disorder, limited to an established medical history or clinical diagnosis of—

  1. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
  2. A psychosis, defined as a case in which an individual—
    1. Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
    2. May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
  3. A bipolar disorder; or
  4. A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
 
The question for the husband however is when his last medical was valid. "Ten years ago" is a bit nebulous and on the fringe of basic med eligibility (since you don't need a medical to instruct anyway, he may have still been an active instructor without one as long as he didn't need to be PIC).
 
Brad, the standard for aviation health is published in the Pilot's Bill of Rights in 2009. It has and has remained, "normal natural health or its equivalent as determined by the federal air surgeon on best external medical advice".

I can think of at least 100 different SIs, and there are really only a dozen and a half, in 68.9. In fact 68.9 doesn't say anyplace that that's the entire list. Those are the current version of the mandatory published grounding conditions. What you did was parse it to mean what you wanted it to mean.

68.9 simply means that airmen are on notice that at LEAST for that list, they're grounding and require an SI. (And there is no SI for bipolar disorder).

You have misconstrued FAR 68.9

B.
 
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Are there any letters of interpretation or adjudicated cases regarding this yet? (I know Basic Med is rather new, but it seems like Congress was quite explicit about the mental health conditions requiring an SI in 68.9).

68.1 says Ҥ 68.1 Applicability.
This part prescribes the medical education and examination requirements for operating an aircraft under § 61.113(i) of this chapter without holding a medical certificate issued under part 67 of this chapter.”

That would seem to imply that 68.9 is what is required, and that the normal requirements of part 67 do not apply.

If the PBOR was written in 2009, well before BasicMed, it strikes me that a colorable argument can be made that any such determinations from that time do not apply to BasicMed, since they pre-dated Congress’ specific language.

I would not be surprised to see this boil down to a fight between medical certification and the standards office within the FAA which @Brad Z mentions.
 
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I might be wrong, but I think folks may be talking past each other here.

What Bruce says is true for the first-time 3rd class prior to going Basic.

I think, though, for someone who held a 3rd class on or after July 2006, a new SI would only be needed for the conditions of 68.9.

We are assuming the OP held a medical on or after July 2006, but Bruce might not be making that assumption.
 
bbchien said:
Brad, the standard for aviation health is published in the Pilot's Bill of Rights in 2009. It has and has remained, "normal natural health or its equivalent as determined by the federal air surgeon on best external medical advice".

I can think of at least 100 different SIs, and there are really only a dozen and a half, in 68.9. In fact 68.9 doesn't say anyplace that that's the entire list. Those are the current version of the mandatory published grounding conditions. What you did was parse it to mean what you wanted it to mean.

68.9 simply means that airmen are on notice that at LEAST for that list, they're grounding and require an SI. (And there is no SI for bipolar disorder).

You have misconstrued FAR 68.9

B.
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What does the 2009 PBOR have to do with the 2016 Section 2307 of FESSA? Congress drafted prescriptive language in FESSA that was implemented EXACTLY as written. Please direct me to where in AC 68-1a supports your assertion that medical conditions beyond those listed in 68.9 require a medical certificate with a SI.
 
Brad Z said:
There seems to be some serious misunderstandings here. An airman operating under BasicMed is ABSOLUTELY required to disclose their mental health issues to the state-licensed physician who is conducting the comprehensive medical examination. The airman is not, however, required to go back apply to the FAA for a medical certificate with a special issuance for the mental health condition. Whether or not that makes sense rolls back to Congress; they specified in Section 2407 of FESSA exactly which medical conditions required a special issuance and the FAA implemented the rule accordingly.

As I mentioned previously, 68.9(c) does not allow you to operate under BasicMed if in the judgement of a state-licensed specialist, your mental health condition prevents you from being able to safely operate the aircraft. That does not mean you have to get an SI for the condition.

I put lots of faith in Dr. Bruce's advice regarding medical certification issues. However, BasicMed is not a medical certification issue. The FAA office of aerospace medicine does not drive the policy for BasicMed. Policy guidance is driven by Flight Standards General Aviation and Commercial Division.

I don't know where Dr. Bruce got information indicating that medical conditions not listed on 68.9 need a one-time medical. I wish he would share it (a PM would be sufficient) so I could trace it's origins and help clarify any misunderstandings that are being propagated by the agency.
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I see this a lot in my industry. Those who have no real knowledge of state code simply read the words in the code and think they know what it means.

I've spent a lot of time over the years trying to explain to those not in the field, that you just can't simply read the words in the code and think you know the intent and the practical or historical interpretations.

Unless you work in the industry, unless you've dealt with the authorities over the issue, unless you understand the historical background, you can't really understand the law.

People who think they can just read a code or law and think they can interpret it correctly are most of the time wrong. But it's hard to convince them if this....

You can quote all the words and phrases and try to take them literally. But arguing medical interpretations by the FAA with Dr. Bruce is just wasting your breath. You will convince no one of your layman's interpretations.
 
Brad Z said:
What does the 2009 PBOR have to do with the 2016 Section 2307 of FESSA? Congress drafted prescriptive language in FESSA that was implemented EXACTLY as written. Please direct me to where in AC 68-1a supports your assertion that medical conditions beyond those listed in 68.9 require a medical certificate with a SI.
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2009 was where Sen Imhofe codified the standard into law: “normal natural health or its equivalent as determined by the federal air surgeon on best available medical advice”.

Adam you have failed to integrate the bits into the whole. Are you saying that the SI for
Anemia’s
Atrial Fib
Kidney stones
Non insulin Diabetes
Epilepsy
AVM in the brain
Stimulant use
...are all illegal because they aren’t listed?

I frequently have to remind attorneys that their parsing of any certain sections, taken OUT of the whole, is specious. They (paying me the deposition rate). spend hours & hours without understanding the rest of the refs.

What you cite in section 68.9 are the “published grounding conditions” and nothing more. They are published so that airmen cannot escape responsibility to know for those 15 conditions, that they have to have an SI (basic med onetime, or not). Operating with any of those without an authorization is ground for PILOT cert. action, e.g a pilot violation of the regs.

And none of this has anything to do with BASIC, other than to put the onus on the PILOT, who has cause to know, and not the family doc (who should know but frequently ignores “instructions to the State licensed doctor”). For these 15, if you happen to get a basic med, FAA can action your pilot certificate.

Get real. I don’t have the 7 pages from the federal register on this iPAD, but I do have them. And for this set of conditions, depression mild/mod/severe....severe (“he is struggling”) implies interference with outside world functioning.....reality (as opposed to “being treated for”) and that was meant by the congress (I was there for the early rounds) to require an SI first, B4 basic. 68.9 puts the airman on notice that he cannot simply say “I’m fine” get his blithe doc to sign, and go merrily along. This particular condition is explicitly addressed on pg 6 of 2307, does require an SI first, and the two yearly renewal (not 4), and requires supervision by a “state licensed specialist” e.g Psychiatrist. It’s all in there, go read it. Coronary disease, stroke/Epilepsy (disturbance of neurological function) are two others specifically addressed as requiring SI prior to Basic.

lndWarrior has it right.

So, Read 2307 all the way through and in detail. And also 68.9 is not what you think it is. It is “airman on notice”.

Believe what you will. I guess all those SIs are illegal because 68.9 doesn’t say so..... What a load of hockey.....even third class airmen have been flying on these SIs for the 23 years I have been an AME. But according to you, these are unnecessary SIs.

The cite is federal register HR 636 sec 2307 July 16, 2016 (from memory). The conditions that have to be cleared are listed there and have NOTHING to do with the published prohibited conditions that apply to all pilots, even flying on basic med.

.....and FYI we can get a waiver for any of them except bipolar.

Brad, late attach, see arrow in red.....the "cite" is the Congress of the United States, signed into law July 16, 2016 per the federal register of the same date.
 

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flyingron said:
The question for the husband however is when his last medical was valid. "Ten years ago" is a bit nebulous and on the fringe of basic med eligibility (since you don't need a medical to instruct anyway, he may have still been an active instructor without one as long as he didn't need to be PIC).
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His last medical was in fall of 2010 I believe.
 
bbchien said:
2009 was where Sen Imhofe codified the standard into law: “normal natural health or its equivalent as determined by the federal air surgeon on best available medical advice”.

Adam you have failed to integrate the bits into the whole. Are you saying that the SI for
Anemia’s
Atrial Fib
Kidney stones
Non insulin Diabetes
Epilepsy
AVM in the brain
Stimulant use
...are all illegal because they aren’t listed?

I frequently have to remind attorneys that their parsing of any certain sections, taken OUT of the whole, is specious. They (paying me the deposition rate). spend hours & hours without understanding the rest of the refs.

What you cite in section 68.9 are the “published grounding conditions” and nothing more. They are published so that airmen cannot escape responsibility to know for those 15 conditions, that they have to have an SI (basic med onetime, or not). Operating with any of those without an authorization is ground for PILOT cert. action, e.g a pilot violation of the regs.

And none of this has anything to do with BASIC, other than to put the onus on the PILOT, who has cause to know, and not the family doc (who should know but frequently ignores “instructions to the State licensed doctor”). For these 15, if you happen to get a basic med, FAA can action your pilot certificate.

Get real. I don’t have the 7 pages from the federal register on this iPAD, but I do have them. And for this set of conditions, depression mild/mod/severe....severe (“he is struggling”) implies interference with outside world functioning.....reality (as opposed to “being treated for”) and that was meant by the congress (I was there for the early rounds) to require an SI first, B4 basic. 68.9 puts the airman on notice that he cannot simply say “I’m fine” get his blithe doc to sign, and go merrily along. This particular condition is explicitly addressed on pg 6 of 2307, does require an SI first, and the two yearly renewal (not 4), and requires supervision by a “state licensed specialist” e.g Psychiatrist. It’s all in there, go read it. Coronary disease, stroke/Epilepsy (disturbance of neurological function) are two others specifically addressed as requiring SI prior to Basic.

lndWarrior has it right.

So, Read 2307 all the way through and in detail. And also 68.9 is not what you think it is. It is “airman on notice”.

Believe what you will. I guess all those SIs are illegal because 68.9 doesn’t say so..... What a load of hockey.....even third class airmen have been flying on these SIs for the 23 years I have been an AME. But according to you, these are unnecessary SIs.

The cite is federal register HR 636 sec 2307 July 16, 2016 (from memory). The conditions that have to be cleared are listed there and have NOTHING to do with the published prohibited conditions that apply to all pilots, even flying on basic med.

.....and FYI we can get a waiver for any of them except bipolar.

Brad, late attach, see arrow in red.....the "cite" is the Congress of the United States, signed into law July 16, 2016 per the federal register of the same date.
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Section 4 of the actual PBOR law that passed in 2012 addresses medical certification, but makes no reference to the phrase you cited above. Nevertheless, BasicMed is not a medical certification program, it is an alternative means of establishing medical eligibilty to act as PIC.

You are correct, the onus absolutely is on the airman to ensure their medical condition is not a condition that requires a one-time SI. The OP said her husband was being treated for anxiety and depression. If his medical condition rises to the point of meeting the FAA's definition of psychosis, then absolutely the airman must apply for a medical and be issued an SI before considering BasicMed. That said, it's a bit of a stretch to suggest that all cases of anxiety or depression are associated with psychosis and require a one-time SI. If there's ever a question, an airman may contact a regional flight surgeon and ask for assistance and determining if their diagnosis of the airman's actual medical condition meets the 68.9 definition of requiring a one-time special issuance. While BasicMed is not a Aeromedical program, regional flight surgeons are routinely called upon on a consultative basis to address medical issues of eligibility since aviation safety inspectors are not medical professionals.

FWIW, the portion of H.R. 636 you attached was codified in section 2307 of P.L. 114-190 ("FAA Extension, Safety, and Security Act of 2016" or FESSA) and enacted in 14 CFR 68.9(a)(1)(ii) verbatim. So what you attached is what is in the regs.

I'm not sure what you're referring to regarding illegal SIs. There are plenty of medical conditions that require a SI in order to be issued a medical certificate, but have no special requirements under BasicMed. Obstructive sleep apnea and diabetes mellitus are two common ones. Considering who lobbied for the provisions in section 2307, I suspect that wasn't by accident. Whether it's a good idea for aviation safety remains to be seen.

Lastly, I applaud those of you suggesting not to blindly believe what you read from SGOTI posting advice. When I read something on POA, I view it as I do Wikipedia: what they say doesn't hold much weight, but look at their sources and seek experts to confirm. Don't be afraid to contact the FAA with questions. If you call the FAA about BasicMed, you'll probably get sent to the guy who wrote this article in this edition of FAA Safety Briefing.
 
K.T. said:
His last medical was in fall of 2010 I believe.
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That would be recent enough. An airman has to have held a medical certificate that was valid at some point after July 14, 2006, and the last medical certificate issued may not have been revoked, suspended or SI withdrawn, and last application was not completed and denied.
 
Brad Z said:
Section 4 of the actual PBOR law that passed in 2012 addresses medical certification, but makes no reference to the phrase you cited above. Nevertheless, BasicMed is not a medical certification program, it is an alternative means of establishing medical eligibilty to act as PIC.

You are correct, the onus absolutely is on the airman to ensure their medical condition is not a condition that requires a one-time SI. The OP said her husband was being treated for anxiety and depression. If his medical condition rises to the point of meeting the FAA's definition of psychosis, then absolutely the airman must apply for a medical and be issued an SI before considering BasicMed. That said, it's a bit of a stretch to suggest that all cases of anxiety or depression are associated with psychosis and require a one-time SI. If there's ever a question, an airman may contact a regional flight surgeon and ask for assistance and determining if their diagnosis of the airman's actual medical condition meets the 68.9 definition of requiring a one-time special issuance. While BasicMed is not a Aeromedical program, regional flight surgeons are routinely called upon on a consultative basis to address medical issues of eligibility since aviation safety inspectors are not medical professionals.

FWIW, the portion of H.R. 636 you attached was codified in section 2307 of P.L. 114-190 ("FAA Extension, Safety, and Security Act of 2016" or FESSA) and enacted in 14 CFR 68.9(a)(1)(ii) verbatim. So what you attached is what is in the regs.

I'm not sure what you're referring to regarding illegal SIs. There are plenty of medical conditions that require a SI in order to be issued a medical certificate, but have no special requirements under BasicMed. Obstructive sleep apnea and diabetes mellitus are two common ones. Considering who lobbied for the provisions in section 2307, I suspect that wasn't by accident. Whether it's a good idea for aviation safety remains to be seen.

Lastly, I applaud those of you suggesting not to blindly believe what you read from SGOTI posting advice. When I read something on POA, I view it as I do Wikipedia: what they say doesn't hold much weight, but look at their sources and seek experts to confirm. Don't be afraid to contact the FAA with questions. If you call the FAA about BasicMed, you'll probably get sent to the guy who wrote this article in this edition of FAA Safety Briefing.
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You think you are just arguing with some internet dude??? You might want to do just a little bit of research before your ignorance on this subject, and person, make you look worse than you already do.
 
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Lndwarrior said:
You think you are just arguing with some internet dude??? You might want to do just a little bit of research before your ignorance on this subject, and person, make you look worse than you already do.
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Well, HE doesn't think so. so I say, beware of what you read that makes it onto this site. And, Like I said, the definition is in the 2009 law (not 2012). He did ask.
Bradz said:
For better or worse, depression or anxiety we're not called out as medical conditions requiring a special issuance, regardless of what Dr. Chien believes.
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Did you bother to look at the red English annotations to the law which I attached? It's not only about diagnoses, its' about symptoms. I suppose now I should look for your medical licensure, wanna tell me where to find that?

Nevertheless, the airman needs to clear the condition with his treating physician. As a mental health condition, 68.9(c) applies, which states:


And I am done with this "conversation", in which every one is an "expert". This is a case in which the beholder wants it to say what he wants it to say, not about what it sez....and this attach is what you get when you play loose with "what it actually sez".
 

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Sounds like no letters of interpretation or adjudicated administrative law cases on this then yet?

And doesn’t @Brad Z work for the FAA in the standards section?
 
PeterNSteinmetz said:
Sounds like no letters of interpretation or adjudicated administrative law cases on this then yet?

And doesn’t @Brad Z work for the FAA in the standards section?
Click to expand...

I don't speak for my employer here on POA, but the second to last page of the FAA Safety Briefing I linked to in my last message may shed some insight to my credentials to speak on the topic of BasicMed.
 
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Brad Z said:
I don't speak for my employer here on POA, but the second to last page of the FAA Safety Briefing I linked to in my last message may shed some insight to my credentials to speak on the topic of BasicMed.
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So did you READ the red in the page I posted?The crucial item is the "or" which was added when I was still at BAMA....and that is the LAW of the land.

Brad, a bit of what I do is to prepare pilots who have received that letter to get their SI......and FYI, the basic med program was moved back to the medical branch in 2018....if you can show that an accident analyst has a report to AAM 100, then show me in internal interpretation that what I have posted isn't so. I mean I have maybe a dozen pilots who have received that letter, and they have chosen to win their one time SI
 
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In terms of the OPs question, it did not sound like the husband had received a denial letter from the FAA.

In terms of whether having a condition that would normally require an SI if one makes a medical application requires that one not use BasicMed when one has valid prior medical and has not received a denial letter and has a doctor that will approve the application, it sounds to me like this will not finally be decided until the FAA decides to violate someone who has gone the BasicMed route under those conditions and it has been adjudicated. By which I mean worked its way up through the administrative law court to the appellate court. I say that because it seems like an issue where the aeromedical division will have one interpretation and Congress and the courts may have another.

But for the OP, I suppose best to consult an aviation attorney before making a decision about it.
 
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Ugh. So I've been thinking about this. What we got was some really bad legislation.
The architects of the legislation (and Brad, being a nonmedical accident analyst) would not know these:

There are two large categories of depressive/anxiety disorders. One, (referred to as 'Former') is called dysthymia. It recurs and never really goes away; the airmen are not cognitively normal even when in between episodes. Recurrent disease (even if it hasn't recurred yet) unmonitored and untreated, should not fly. I agree with that.

Then there is the "Latter", chronic simple depression, which recurs but with a very long time to recurrence ("Tau" = ~18 years) and in between, the pilots are totally normal.

The legislation lets through the door, by the use of the word "or", a whole list of symptoms that do occur in a psychosis but also occur when there is No psychosis. This is where "disorganized behavior" comes from.

And this attachment, from form 8900-2, points to the entire AME guide, to guide the family doc. YGBSM! Why did you guys open that door! The do not issue do not fly list is bad enough....that was created really for 1st 2nd-3rd and by citing it they have crossed it into Basic Med. I have one of those on my hands currently.

Having seen the detailed medical records of some of the airmen who got kicked out and got the Warning letter, which basically warns the basic med holder that if he operates, the agency warns, can act against the only cert left- the PILOT certificate, and serves a certified warning of same....The agency review is always that if they have the former situation, but have not won an SI, that they need an SI because even though they are not psychotic, Cognition sure isn't normal. IOW they are "not clearly qualified" to operate under basic med. The LATTER should and needs and is, allowed to fly (even First class, and I have a couple of those, too). In fact there are 650 pilots flying on "prophylactic against recurrence" use of SSRI for just the LATTER situation. So if they make the medical certification stds, these 650 CLEARLY meet the Basic med std (whatever hazy that is....).

So on the one hand we have what the framers tried to create- "not clearly disqualified" vs what happens in a review- "not clearly qualified". I think this is why airman branch didn't want the Basic med review function and neither did medical branch. And guess who lost. Had control of basic med remained in the airman branch's hands, Brad's commentary would be a breath of fresh air and this poorly specified part would in fact be quite simple.

As the original petitioner for the SSRI program (yes, me) the evaluative authority is NOT shared with the outside- it resides at AAM 300. But with Basic, the family docs (whose exam and training is not controlled by the agency) makes a decision ("not clearly disqualified from flying on a basic med"), and god forbid, agency's review when it comes before the agency always is a matter of ("not clearly qualified to exercise a basic med"). And the result has not been pretty.

So there is some painful grappling with this going on, and all because, (1) community psychiatry expertise is not at an all time high, and (2) what we got out of the grinder wasn't "good" legislation. It was.....well it was what we got. Which has to do with why I bailed.

But it is the very portion of the legislation which I marked in red which is not consonant with current psychiatry....and that creates lots of worms and heartaches.
So, It is NOT as simple as you say.
 

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Lndwarrior said:
You think you are just arguing with some internet dude??? You might want to do just a little bit of research before your ignorance on this subject, and person, make you look worse than you already do.
Click to expand...
You might take your own advice.
 
Strikes me as an excellent analysis of where the guidance which includes reference for the physician to the AME guide creates a conundrum. I was just looking through Public Law 114, section 2307, part c, which specifies what the physician must do for Basic Med.

From what I read there this troublesome language was not part of the legislation. I assume it was inserted by someone at the FAA as wrote this set of instructions.
 
bbchien said:
Ugh. So I've been thinking about this. What we got was some really bad legislation.
The architects of the legislation (and Brad, being a nonmedical accident analyst) would not know these:

There are two large categories of depressive/anxiety disorders. One, (referred to as 'Former') is called dysthymia. It recurs and never really goes away; the airmen are not cognitively normal even when in between episodes. Recurrent disease (even if it hasn't recurred yet) unmonitored and untreated, should not fly. I agree with that.

Then there is the "Latter", chronic simple depression, which recurs but with a very long time to recurrence ("Tau" = ~18 years) and in between, the pilots are totally normal.

The legislation lets through the door, by the use of the word "or", a whole list of symptoms that do occur in a psychosis but also occur when there is No psychosis. This is where "disorganized behavior" comes from.

And this attachment, from form 8900-2, points to the entire AME guide, to guide the family doc. YGBSM! Why did you guys open that door! The do not issue do not fly list is bad enough....that was created really for 1st 2nd-3rd and by citing it they have crossed it into Basic Med. I have one of those on my hands currently.

Having seen the detailed medical records of some of the airmen who got kicked out and got the Warning letter, which basically warns the basic med holder that if he operates, the agency warns, can act against the only cert left- the PILOT certificate, and serves a certified warning of same....The agency review is always that if they have the former situation, but have not won an SI, that they need an SI because even though they are not psychotic, Cognition sure isn't normal. IOW they are "not clearly qualified" to operate under basic med. The LATTER should and needs and is, allowed to fly (even First class, and I have a couple of those, too). In fact there are 650 pilots flying on "prophylactic against recurrence" use of SSRI for just the LATTER situation. So if they make the medical certification stds, these 650 CLEARLY meet the Basic med std (whatever hazy that is....).

So on the one hand we have what the framers tried to create- "not clearly disqualified" vs what happens in a review- "not clearly qualified". I think this is why airman branch didn't want the Basic med review function and neither did medical branch. And guess who lost. Had control of basic med remained in the airman branch's hands, Brad's commentary would be a breath of fresh air and this poorly specified part would in fact be quite simple.

As the original petitioner for the SSRI program (yes, me) the evaluative authority is NOT shared with the outside- it resides at AAM 300. But with Basic, the family docs (whose exam and training is not controlled by the agency) makes a decision ("not clearly disqualified from flying on a basic med"), and god forbid, agency's review when it comes before the agency always is a matter of ("not clearly qualified to exercise a basic med"). And the result has not been pretty.

So there is some painful grappling with this going on, and all because, (1) community psychiatry expertise is not at an all time high, and (2) what we got out of the grinder wasn't "good" legislation. It was.....well it was what we got. Which has to do with why I bailed.

But it is the very portion of the legislation which I marked in red which is not consonant with current psychiatry....and that creates lots of worms and heartaches.
So, It is NOT as simple as you say.
Click to expand...

I'm going to avoid weighing in on any debate regarding whether Congress erred in their choice of language in identifying conditions requiring a one-time special issuance. I will however caution folks to avoid falling into the trap of treating BasicMed as a 4th class medical certificate and attempting to apply part 67 standards. Generally when there's a question of eligibility, the bigger issue is whether the airman appropriately disclosed the condition to the doctor signing off on the 8700-2. Again, I don't speak for my employer here, and I don't speak for enforcement, but I would have a hard time imagining a borderline eligibility case would result in any certificate action when the airman properly disclosed the condition and was signed off by the state licensed physician. After all, the signing physician is not reviewing the 8700-2 for compliance with 68.9...that's the airman's responsibility. That said, if the airman doesn't know whether his or her condition is considered a disqualifying condition for BasicMed without an SI, the airman would benefit from seeking guidance from a medical professional who is familiar with those nuances. If the question was posed to me, I would refer it to one of my aeromedical colleagues.

Regarding the link to the AME guide on the 8700-2; you've brought that up before in past POA threads on BasicMed. The resources listed are not required, thus the use of the word "should" rather than "must" or "shall". The documents are included on the form to provide signing physicians on opportunity to consider the guidance provided to AMEs for medical certification. They are under no obligation to read them or to apply the standards established in part 67. They can use them. They can use higher standards if they wish. By virtue of including the guidance does not make part 67 standards applicable to BasicMed. Interestingly, in the nearly three years that BasicMed has been live no one else has mentioned the AME guide.

In previous conversations regarding this topic you've brought up the legal liability that a doctor assumes signing the 8700-2 for a condition that would be disqualifying under part 67. I don't disagree; liability is a valid concern for a doctor. But ultimately this is up to the doctor, not the airman. Many physicians have chosen not to offer BasicMed exams for many reasons, with liability and malpractice insurance coverage being a common one. I think you've mentioned that you do not conduct BasicMed examinations for that very reason. Whether adhering to part 67 standards when evaluating an airman for BasicMed affects liability will ultimately be up to civil litigation and the courts to decide.
 
Brad Z said:
... thus the use of the word "should" rather than "must" or "shall". ...
Click to expand...
But when push comes to shove, "should" has this definition: Should: verb used to indicate obligation, duty, or correctness, typically when criticizing someone's actions.
If an action isn't required, it must not be mentioned. If it's mentioned, it must be required, unless it's labeled optional. That's how I see things working, but only from my observations dealing with gov't agencies. YMMV, but there's a reason we don't allow such "weasel words" in our FAA documentation.
The bottom line is that some see BasicMed as a way around things, and the rules are fuzzy enough to entrap some. Best to fix the health issues, or take up fishing.
 
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