Fighting Denied Medical

[Unregistered]

Good day, all,

My S.I. class 3 medical was recently denied due to chronic lower back pain and accompanying numbness in thighs (neither are cause for S.I.). The numbness was due to L1/S5 bulge. After trying numerous options; chiropractor, D.O. and massage therapists, it was decided to visit a back surgeon on the recommendation of the D.O.

The back surgeon ordered an MRI which showed the disc issue but it was described as normal for someone in their 40's. All of this was reported on my February renewal. As a side note, I also self grounded due to extreme pain and the use of Rx pain meds to alleviate some of the pain. It was at this time the DME submitted paper work to OKC.

About 30 days post renewal OKC requested additional documentation from my back surgeon. The surgeon letter indicated history of severe lower back pain as well as leg numbness (there's a term used that I can't recall). Around the time the letter was written I was on my 2nd of 3 injections into the epidural. All requested paper work was submitted to OKC for consideration within the 30 day window.

Another 30 days lapses and I have completed the 3rd injection into the epidural and significant pain relief is obtained and the numbness has been eliminated. Around this time I receive notice from OKC they are declining my medical due to the back issue. I contact OKC for clarification it was the back issue that caused the denial and that was confirmed.

The denial letter states I have 60 days from the dated of letter (Feb 25) to request a hearing to dispute the denial. The letter also states to submit any additional information to OKC to support my request for reversal.

Here's the catch; the first appointment with the back surgeon is for next Tuesday 5/31. The letter will take another week to receive and submit to OKC. That puts us somewhere around 6/7 or 18 days from the expiration of my right to request hearing.

Here's the question; should I submit the 5 copies of the denial letter (as stated) and the latest doctor letter to NTSB, OKC or both? My concern is that if I don't request a NTSB hearing now, the 60 days will lapse and there will be no recourse.

Thank you for your guidance.

 

[Henning]

Good day, all,

My S.I. class 3 medical was recently denied due to chronic lower back pain and accompanying numbness in thighs (neither are cause for S.I.). The numbness was due to L1/S5 bulge. After trying numerous options; chiropractor, D.O. and massage therapists, it was decided to visit a back surgeon on the recommendation of the D.O.

The back surgeon ordered an MRI which showed the disc issue but it was described as normal for someone in their 40's. All of this was reported on my February renewal. As a side note, I also self grounded due to extreme pain and the use of Rx pain meds to alleviate some of the pain. It was at this time the DME submitted paper work to OKC.

About 30 days post renewal OKC requested additional documentation from my back surgeon. The surgeon letter indicated history of severe lower back pain as well as leg numbness (there's a term used that I can't recall). Around the time the letter was written I was on my 2nd of 3 injections into the epidural. All requested paper work was submitted to OKC for consideration within the 30 day window.

Another 30 days lapses and I have completed the 3rd injection into the epidural and significant pain relief is obtained and the numbness has been eliminated. Around this time I receive notice from OKC they are declining my medical due to the back issue. I contact OKC for clarification it was the back issue that caused the denial and that was confirmed.

The denial letter states I have 60 days from the dated of letter (Feb 25) to request a hearing to dispute the denial. The letter also states to submit any additional information to OKC to support my request for reversal.

Here's the catch; the first appointment with the back surgeon is for next Tuesday 5/31. The letter will take another week to receive and submit to OKC. That puts us somewhere around 6/7 or 18 days from the expiration of my right to request hearing.

Here's the question; should I submit the 5 copies of the denial letter (as stated) and the latest doctor letter to NTSB, OKC or both? My concern is that if I don't request a NTSB hearing now, the 60 days will lapse and there will be no recourse.

Thank you for your guidance.

That would be L5-S1 IIRC (I had surgery on the same disc, C4-C5 as well) and I never had an issue with getting a medical over it.

 

[Unregistered]

That would be L5-S1 IIRC (I had surgery on the same disc, C4-C5 as well) and I never had an issue with getting a medical over it.

You are correct, L5/S1. OKC's concern is with the thighs going numb (similar to when a foot "falls asleep"). That was resolved with the series of shots in the epidural.

While on corrections, I meant AME not DME in the original post. Sorry for any confusion these two errors may have caused.

 

[Henning]

You are correct, L5/S1. OKC's concern is with the thighs going numb (similar to when a foot "falls asleep"). That was resolved with the series of shots in the epidural.

While on corrections, I meant AME not DME in the original post. Sorry for any confusion these two errors may have caused.

Surgical solutions aren't necessarily bad, but you do need to find a good surgeon, preferably a neuro surgeon.

 

[shenanigans]

The denial letter states I have 60 days from the dated of letter (Feb 25) to request a hearing to dispute the denial. The letter also states to submit any additional information to OKC to support my request for reversal.

Here's the catch; the first appointment with the back surgeon is for next Tuesday 5/31. The letter will take another week to receive and submit to OKC. That puts us somewhere around 6/7 or 18 days from the expiration of my right to request hearing.

I'm confused by your dates. If the letter was dated Feb 25th, 60 days was in April. And if 6/7 is 18 days late, then the deadline was last week. Either way, the 60 days are up. Are you sure about the dates in your timeline?

I'm sure someone will along to give advice, but I'd guess it would help them to know whether the 60 days have expired or not.

 

[Unregistered]

I'm confused by your dates. If the letter was dated Feb 25th, 60 days was in April. And if 6/7 is 18 days late, then the deadline was last week. Either way, the 60 days are up. Are you sure about the dates in your timeline?

I'm sure someone will along to give advice, but I'd guess it would help them to know whether the 60 days have expired or not.

Dang, I should sleep prior to asking for help.
The request for info from the surgeon was dated February. The denial letter was dated April.
Thanks for allowing me to clarify.

 

[bbchien]

The denial doesn't matter one whit. Resolve your issues and reapply. You can reapply fifty times, but the time that counts is when you have new information to bring to the party.

I would also see if you have someone competent in your community who can do competent sensory discography. The MRI cannot tell you much about pain generated INSIDE a failing disc....which will simply look dark and less tall than a normal.

I would never have done this the way you did. Never submit a thing until you have got a winner. Sigh... But now you're in for a penny and in for a pound.

 

[Unregistered]

The denial doesn't matter one whit. Resolve your issues and reapply. You can reapply fifty times, but the time that counts is when you have new information to bring to the party.

I would also see if you have someone competent in your community who can do competent sensory discography. The MRI cannot tell you much about pain generated INSIDE a failing disc....which will simply look dark and less tall than a normal.

I would never have done this the way you did. Never submit a thing until you have got a winner. Sigh... But now you're in for a penny and in for a pound.

Thank you, doctor.
The back problem is resolved.

 

[bbchien]

Re-apply. But bring documentation.

 

[somorris]

Don't know where you are, but if you can you should get Dr. Bruce involved. He has helped a lot of aviators stay in the air.

 

[steingar]

The fact that we need uber-intelligent guys like Bruce to help get pilots medically certified when they drive cars that are heavier and probably faster than their aircraft is one of crowning idiocies of the FAA and the way they do things.

Bet of luck to the OP. I hope it all works out.

 

[Henning]

The fact that we need uber-intelligent guys like Bruce to help get pilots medically certified when they drive cars that are heavier and probably faster than their aircraft is one of crowning idiocies of the FAA and the way they do things.

Of course the natural counter to that is "Dude, look at the people driving cars, do you want them in the air as well?!?" I know a lot more people driving who shouldn't be than people flying who shouldn't be. A good bit of that process is the medical system.

 

[CJones]

The fact that we need uber-intelligent guys like Bruce to help get pilots medically certified when they drive cars that are heavier and probably faster than their aircraft is one of crowning idiocies of the FAA and the way they do things.

You should know that the trucker that is hauling the flammable petroleum products at 80mph in the direct opposite direction from you < 6' off of head-on has gone through a medical certification process as well....

(If you've ever had a DOT physical, you will understand the DEEP sarcasm in this post.)

 

[steingar]

Of course the natural counter to that is "Dude, look at the people driving cars, do you want them in the air as well?!?" I know a lot more people driving who shouldn't be than people flying who shouldn't be. A good bit of that process is the medical system.

You've been to sea too long. What keeps people out of the cockpit is mostly money. Mostly money is what it takes to overcome these idiotic medical certification problems.

More importantly, those folks medically unfit to fly a 1301-pound aircraft can now fly one 0.45 kilograms lighter sans medical. It will be somewhat lighter, and almost as fast as loads of certificated airplanes. No doubt the world will implode upon itself with such danger abroad.

Again, good luck to the OP.

 

[Henning]

You've been to sea too long. What keeps people out of the cockpit is mostly money. Mostly money is what it takes to overcome these idiotic medical certification problems.

If you don't have the money to overcome the medical process, you don't really have the money to fly. Flying's freakin expensive. I could build a transglobal jet and fly it around the world without a medical...Legally even. You just claim (and achieve) "motor launch glider" status. You do need to be appropriately rated, but the appropriate rating doesn't require a medical. You don't need such an extravagant craft either. You can build much more "down to earth" priced motor gliders. Gliders and motor gliders are available to everyone regardless of medical condition.

I kinda agree that you could do away with third class, I just don't see it happening, I could get surprised.... Commercial operations though, yeah, if you're hauling pax, they have the right to certain expectations about the health of who is flying.

 

[steingar]

I kinda agree that you could do away with third class, I just don't see it happening, I could get surprised.... Commercial operations though, yeah, if you're hauling pax, they have the right to certain expectations about the health of who is flying.

It makes sense to have a medical for a professional who might have hundreds of lives at stake. But for one little dude (or dudette) flying along in a little 172, not so much.

It makes sense to have strict certification standards for multi-ton jets than can carry hundreds and destroy whole buildings if they crash. For little spam cans, not so much. The record for experimental is not that much worse than for certificated.

But we seem to be stuck with the FAA and their little policies. And the only thing you get when you have rules is more of them. They will be the death of GA. And I doubt anyone will notice it missing.

 

[Henning]

But we seem to be stuck with the FAA and their little policies. And the only thing you get when you have rules is more of them. They will be the death of GA. And I doubt anyone will notice it missing.

Actually, they will notice. China even noticed the lack after that earthquake so now they are building a GA system and have bought Cirrus and Teledyne Continental (at least the diesel program) to stock it with aircraft.

 

[somorris]

It makes sense to have a medical for a professional who might have hundreds of lives at stake. But for one little dude (or dudette) flying along in a little 172, not so much.

I read something somewhere about the FAA actually looking at the third class medical with respect to the cost of maintaining the bureaucracy to administer it and whether or not they could eliminate it for some types of flying other than the Sport Pilot license. Maybe some day that will happen, but I will probably be dead and gone by then .

 

[Mtns2Skies]

The fact that we need uber-intelligent guys like Bruce to help get pilots medically certified when they drive cars that are heavier and probably faster than their aircraft is one of crowning idiocies of the FAA and the way they do things.

Bet of luck to the OP. I hope it all works out.

Uhh if a pilot has a heart attack in the air with pax on board... they will not know what to do and likely cause fatalities. If a driver has a heart attack the car will likely come to a stop, if not the passenger will likely have an idea of what to do. The aircraft weight has nothing to do with it, its the competency required to operate an aircraft that matters. So I for one support the "crowning idiocies of the FAA"

 

[Henning]

Uhh if a pilot has a heart attack in the air with pax on board... they will not know what to do and likely cause fatalities. If a driver has a heart attack the car will likely come to a stop, if not the passenger will likely have an idea of what to do. The aircraft weight has nothing to do with it, its the competency required to operate an aircraft that matters. So I for one support the "crowning idiocies of the FAA"

Not nothing, heavier planes kill more people per accident.

 

[Gary F]

Uhh if a pilot has a heart attack in the air with pax on board... they will not know what to do and likely cause fatalities. If a driver has a heart attack the car will likely come to a stop, if not the passenger will likely have an idea of what to do. The aircraft weight has nothing to do with it, its the competency required to operate an aircraft that matters. So I for one support the "crowning idiocies of the FAA"

The FAA medical process only attempts to predict the risk of incapacitation in pilots with a known history of medical problems. There are plenty of people walking around with coronary artery disease who do not know that they have it. Although rare, even those with 1st class medicals have died in-flight.
http://www.foxnews.com/story/0,2933,527076,00.html
http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a6cV8EpM5WDw

 

[Mtns2Skies]

The FAA medical process only attempts to predict the risk of incapacitation in pilots with a known history of medical problems. There are plenty of people walking around with coronary artery disease who do not know that they have it. Although rare, even those with 1st class medicals have died in-flight.
pid=newsarchive&sid=a6cV8EpM5WDw[/URL]

But do we know how many incidents have been prevented? Probably not but I'd be willing to bet more than a few. There will always be anomalies no matter how vigorous the screening process.

 

[Unregistered]

O.P. here.

Had a follow up with the back doctor yesterday and he gave an all clear. We reviewed the MRI and even to a layman like me it was obvious the disc bulge was hitting the nerve causing the numbness. Since the shots in the epidural have resolved the issue he agreed to pen a letter to that effect. I'll submit that to OKC and see what happens. Thanks to all who provided information.

 

[Gary F]

But do we know how many incidents have been prevented? Probably not but I'd be willing to bet more than a few. There will always be anomalies no matter how vigorous the screening process.

This has not been the case with glider or balloon pilots who do not need a medical or with Sport Pilots so far. I favor relaxing the 3rd class medical process to DOT CDL standards and giving AMEs more flexibility.

 

[steingar]

O.P. here.

Had a follow up with the back doctor yesterday and he gave an all clear. We reviewed the MRI and even to a layman like me it was obvious the disc bulge was hitting the nerve causing the numbness. Since the shots in the epidural have resolved the issue he agreed to pen a letter to that effect. I'll submit that to OKC and see what happens. Thanks to all who provided information.

Good luck. I hope it works out.

 

[steingar]

Uhh if a pilot has a heart attack in the air with pax on board... they will not know what to do and likely cause fatalities. If a driver has a heart attack the car will likely come to a stop, if not the passenger will likely have an idea of what to do. The aircraft weight has nothing to do with it, its the competency required to operate an aircraft that matters. So I for one support the "crowning idiocies of the FAA"

Yeah, so the TSA is an uber-important part of the government, since there haven't been any terrorist takeover of an aircraft since they've been on the scene. You bet.

 

[rotorhead1026]

O.P. here.. Since the shots in the epidural have resolved the issue he agreed to pen a letter to that effect.

Have they? Are you sure? I'd run it by an AME experienced in FAA's ways before I lick the stamp (or let one of the docs here opine). I say this because the underlying condition still exists and the pain could recur. Suddenly. Overwhelmingly. Trust me . Anyway, FAA may take that position and still deny. Doctors?

 

[Gary F]

Uhh if a pilot has a heart attack in the air with pax on board... they will not know what to do and likely cause fatalities. If a driver has a heart attack the car will likely come to a stop, if not the passenger will likely have an idea of what to do. The aircraft weight has nothing to do with it, its the competency required to operate an aircraft that matters. So I for one support the "crowning idiocies of the FAA"

What about a heavily loaded tractor trailer or other large truck with which we share the roads?

 

[Henning]

This has not been the case with glider or balloon pilots who do not need a medical or with Sport Pilots so far. I favor relaxing the 3rd class medical process to DOT CDL standards and giving AMEs more flexibility.

Yep, I suggested just using a standard DOT physical for a third class before. Thing that gets me is that a Third Class (or Second or First for that matter) Airmans certificate (issued through DOT) cannot be substituted for any other DOT physical. Please guys, one security card, one physical...

 

[Henning]

What about a heavily loaded tractor trailer or other large truck with which we share the roads?

2-5 people will die, rarely a great loss.

 

[Gary F]

2-5 people will die, rarely a great loss.

Probably the same or less risk than someone flying a typical GA aircraft.

 

[Unregistered]

Good luck. I hope it works out.

Thank you.

 

[Unregistered]

Have they? Are you sure? I'd run it by an AME experienced in FAA's ways before I lick the stamp (or let one of the docs here opine). I say this because the underlying condition still exists and the pain could recur. Suddenly. Overwhelmingly. Trust me . Anyway, FAA may take that position and still deny. Doctors?

Once I receive the letter I will post it here.

 

[Mtns2Skies]

Yeah, so the TSA is an uber-important part of the government, since there haven't been any terrorist takeover of an aircraft since they've been on the scene. You bet.

Hey Possibly... but they've gone too far. I dont think the FAA has.

What about a heavily loaded tractor trailer or other large truck with which we share the roads?

Dont they need a DOT medical?



Why is everyone so up-in-arms over the fact that I think medicals are useful? I certainly don't want someone that weighs 350lbs with a major heart condition in the cockpit...

 

[bbchien]

I read something somewhere about the FAA actually looking at the third class medical with respect to the cost of maintaining the bureaucracy to administer it and whether or not they could eliminate it for some types of flying other than the Sport Pilot license. Maybe some day that will happen, but I will probably be dead and gone by then .

That's just David Wartofsky trying tocall attention to himself. there is NOBODY, repeat nobody, on the congressional staff or at FAA, taking him the least bit seriously.

 

[Gary F]

Dont they need a DOT medical?

Yes they do but getting a DOT CDL physical is much less onerous than a 3rd class. I think the 3rd class standards should be similar to the DOT physical and give AMEs a little more latitude in issuing them.

 

[CJones]

Yes they do but getting a DOT CDL physical is much less onerous than a 3rd class.

I think my fastest turn-around on a DOT physical was 15mins from the time they called me back until I was back out to the lobby - and 5 mins of that was waiting for the Dr. to show up after the nurses did their bit.

 

[Mtns2Skies]

I think my fastest turn-around on a DOT physical was 15mins from the time they called me back until I was back out to the lobby - and 5 mins of that was waiting for the Dr. to show up after the nurses did their bit.

that sounds about like what my 3rd class was like.

 

[Gary F]

that sounds about like what my 3rd class was like.

Lucky that you don't have any significant medical issues, if you ever do be prepared to wait for months while things get sorted out. I think that more stuff should be handled by the local AME using FAA standards without having to submit everything to Oklahoma City.

 

[jbarrass]

That's just David Wartofsky trying tocall attention to himself. there is NOBODY, repeat nobody, on the congressional staff or at FAA, taking him the least bit seriously.

I know my representative has it on his radar. He could care less about us, but the potential budget savings got it on his list. Things have changed, regulation reduction and budget are now trumping "business as usual". I'm sure the FAA is not pushing this but there are a lot of cuts coming. It would be nice if they cut something useless rather than someting we could use.