3rd Class Medical

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Flymo

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Flymo
I've been flying the last few years using my PP as a sport pilot. I want to get a 3rd class medical, but I have a couple of issues I want to make sure I am correct about. I'm a type II, and only take Metformin, so I don't think that will be an issue. I also have Sleep Apnea, and I am compliant with a CPAP. Everything I've seen has indicated I can get a Special Issuance, but I want to make sure before I go as obviously I don't want to be denied. Am I correct?

Thanks!
 
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From what little I think I know, you should be able to get an SI.

From what I actually do know, I strongly suggest that you contact Dr. Bruce Chien before you fill out a single form or visit an AME. http://www.aeromedicaldoc.com/

You want to have all your ducks quacking neatly in a row before you apply.

Rich
 
Fourth or Fifth, whichever it is now...you want to talk with someone. Working through an SI is not a matter of BEING correct, it's a matter of SHOWING that you're correct. There is a difference.
 
I am a DM Type II and also diagnosed OSA.

If your A1C can be documented at 6.5 or below AND KEPT THERE, there is an office issuance provision under "Conditions an AME Can Issue" or CACI

http://www.faa.gov/about/office_org...es/aam/ame/guide/media/c-cacipre-diabetes.pdf

If it is greater than 6.5, but less than 8.5, you can get an SI. Main parts are stable on your meds (such as metformin) for at least 60 days with no adverse side effects and no hypoglycemic events, no renal issues, no opthal issues (eyes), and no neuro issues especially peripheral nerves. If your primary doc is willing to write all of that up in simple simple language, and supply the blood lab paperwork to back it up, a top dawg senior AME (like Dr. Bruce Chien) and arrange to issue that in office (versus a deferral and long delay)

If it is 8.6 to 9.0, you are in the extreme yellow arc. You can still be issued, but you will get a stern lecture to bring it down immediately. 9.0 and above is edging on denial territory and is a major danger zone for general health anyway, fuggitabut flying.


With OSA, it is a special issuance. Main parts are a recent (less than 90 days) sleep study, documentations saying you have been compliant with CPAP therapy for a minimum hours each night and a minimum # of nights within a recent period), no tendency to be sleepy during the day beyond the norm, and no right heart failure on exam.

Again, if you can get all of this prepared in advance and done the way the FAA wants/expects it, an AME of the level of Dr. Bruce can issue in office.
 
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My A1C is well below the 6.5 for several years, so that shouldn't be an issue. I've only done my original sleep study which was done years ago. I have been compliant with CPAP since then (about 10 years).
Thanks!
 
Flymo said:
My A1C is well below the 6.5 for several years, so that shouldn't be an issue.
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Then talk with the AME to find out what items you need to bring for the CACI issuance.

I've only done my original sleep study which was done years ago. I have been compliant with CPAP since then (about 10 years).
Thanks!
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Unfortunately, "years ago" doesn't fit the FAA Criteria. They will need something submitted that's less than 90 days old. So repeating the sleep study might be required. I am uncertain if a home study is acceptable or you need to head for a accredited sleep lab.

The new OSA requirements went live March 2. So you will need to consult with a good AME who can provide proper guidance on what you need to do to get everything done for an easy SI submission.


One of the big keys to making the Medical Certification system run smoothly for you is supplying all of the correct, not too little and not too much, information in plain language with minimal use of the medical thesaurus. Goal is for the packet to be understandable and approvable by the lower level minions who can compare the submission against the standard and quickly say "yes" to it.

When you submit too little, too much and open pandora's worm can, or write it in a confusing way, it has to leave the lower minion level and head for one of the overloaded MD's to read and review. Their multiple inboxes are rammed full of submissions and it will take a long time before yours makes it to the top.

Top AME's like Bruce Chien will aid you in making it punch list and checkbox simple. This is what you want.
 
AggieMike88 said:
Unfortunately, "years ago" doesn't fit the FAA Criteria. They will need something submitted that's less than 90 days old. So repeating the sleep study might be required. I am uncertain if a home study is acceptable or you need to head for a accredited sleep lab.
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Since you've been through this, quick question.

After the SI is issued for OSA, I understand that you need to submit CPAP/Therapy compliance every year, but do you actually need a new study as well every other year, or is that just needed for the original issuance?

I ask, because I just got my SI for OSA for the first time in September.
 
No new study is required unless your primary doc feels there has been a major change and new data is needed.

So far, all I need to bring to the AME is a status letter from my primary doc saying he reviewed my CPAP machine report, epworth score, conducted an exam for right heart failure (and found none), and I am alert, well rested, and do not get sleepy or fatigued beyond the normal.

So far that has proven acceptable to AME and FAA for SI compliance.

And according to Dr. Bruce over on the Red Board, should suffice for existing OSA SI's even under the new guidance/rules.
 
Thanks, I can get my primary care dr to supply that.
 
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Flymo said:
Thanks, I can get my primary care dr to supply that.
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What I supplied was for the renewal. If you are applying for the first time, then a recent study may be required. Double check with the AME to be certain.
 
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