Are physical requirements between 3rd Class and Basic Med the same?

[DMD3.]

Is passing a physical for Basic Med any less stringent than a physical for a 3rd class medical? For example, 20/40 vision with/without corrective lenses is required for both, and a BP of no more than 155/95 is required for both. So there’s no difference regarding those. Does Basic Med have any higher tolerances over a 3rd class? I’m aware of 3rd class needing to be done every 2 years by an AME versus Basic Med being done only every 4 years and by any state licensed physician for pilots over 40.

 

[jbarrass]

There are no specific limits for BasicMed. It's up to the sate licensed physician to determine, using his professional judgement, if he'll sign you off to fly.

The examples you mentioned make sense, but are not established by any regulation.

 

[Mark K]

Well, as a recently retired physician, if your visual acuity was less that 20/40, your bp was 155/95 and you didn't want to deal with it, well, then I wouldn't sign off on your form...

But yes, to answer your question specifically, assuming you've held a class three in the proper time frame, the Basic Med rules are notably less stringent... But you do need a DL. And don't you have to have 20/40 Va to have DL in most every state? IIRC there are a couple of states that may be 20/50-20/60, but I'm not 100% sure about that.

 

[Noah Lorang]

It's perhaps best to think of the difference between sport pilot self-certification, Basic Med, and an AME-issued medical certificate to be less about your medical qualifications, but the level of certainty that the FAA wants to have that you're safe to fly.

The FAA doesn't want anyone flying anything in any operation if they're unsafe to fly. Even a sport pilot has to self-certify on every flight that they do "Not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner." (FAR 61.23 c 2 iv).

That's the basic standard for any operation - don't be unsafe. What varies is what the FAA wants to go through to be sure you're not going to be unsafe:

• For exercising sport pilot privileges, they take your word for it as long as the state DMV hasn't revoked your license for some medical reason.
• For exercising privileges under Basic Med, they take your state licensed physician's word for it, combined with educating you on how to identify if you're a risk on a regular basis, but don't exercise any direct oversight over the examination your doctor provides.
• For non-commercial privileges as a private pilot, they require you to see a physician they've specially trained occasionally, and might want to personally review your medical records.
• To exercise commercial privileges, they want you to see the AME more frequently.
• To exercise the privileges of an ATP, they want you to see the AME even more frequently, and they want an EKG.

Once you've seen one of their specially trained doctors and that doctor (with their oversight) has been unable to determine you are safe to fly, the FAA won't let you self-certify or state-physician certify that you are until they've made sure of it themselves. It's a trust issue.

If you're actually safe to fly with whatever condition you have, in theory you can always get a medical -- almost anything is capable of getting a special issuance, but the cost and effort can be prohibitive. Conversely, if you're truly not safe to fly, you aren't really legal to do it under Basic Med or sport pilot either.

In practice, can you get a doctor to sign you off for Basic Med w/ conditions that would cause them to defer you for a medical? Almost certainly. Is this all a good system? No. Does it incentivize hiding medical conditions or avoiding treatment? Absolutely.

 

[jbarrass]

In practice, can you get a doctor to sign you off for Basic Med w/ conditions that would cause them to defer you for a medical? Almost certainly. Is this all a good system? No. Does it incentivize hiding medical conditions or avoiding treatment? Absolutely.

I was deferred for prostate cancer that had been treated and cured, even my BasicMed doc thought the FAA position was comical and seemed almost embarrassed he had to defer. The actual "doctor (?)" that made the decision wouldn't know my prostate from yours. How is that a better path?

I think it's much, much, better to put the decision in the hands of a licensed physician that actually examines you.

 

[sarangan]

Probably a big difference is that you can't fail a basicmed. You can come back and redo, or go to a different physician. It's like the flight review - there is no pass/fail that stays in your record.

 

[Kenny Phillips]

I was deferred for prostate cancer that had been treated and cured, even my BasicMed doc thought the FAA position was comical and seemed almost embarrassed he had to defer. The actual "doctor (?)" that made the decision wouldn't know my prostate from yours. How is that a better path?

I think it's much, much, better to put the decision in the hands of a licensed physician that actually examines you.

How much time does the FAA want after treatment for prostate cancer?
(I had RALRP 5.5 months ago, will be going for a six-month exam shortly, both PSAs undetectable so far.)

 

[midlifeflyer]

In practice, can you get a doctor to sign you off for Basic Med w/ conditions that would cause them to defer you for a medical? Almost certainly. Is this all a good system? No. Does it incentivize hiding medical conditions or avoiding treatment? Absolutely.

I'm not sure what you meant by this. Tw questions to clarify.

How does your personal physician being able to sign you off for something that would be deferred by the FAA incentivize hiding medical conditions or avoiding treatment? Seems to me the exact opposite is true.

How is a personal physician being able to sign you off for something based on your medical history while the FAA would defer until you got several thousands of dollars in unnecessary tests a bad system?

 

[Noah Lorang]

I'm not sure what you meant by this. Tw questions to clarify.

How does your personal physician being able to sign you off for something that would be deferred by the FAA incentivize hiding medical conditions or avoiding treatment? Seems to me the exact opposite is true.

How is a personal physician being able to sign you off for something based on your medical history while the FAA would defer until you got several thousands of dollars in unnecessary tests a bad system?

Sorry for the confusion, I was referring to the 1st/2nd/3rd class medical certification system (including the inability to get Basic Med or fly as a sport pilot following a deferred medical) which absolutely incentivizes hiding medical conditions and is not a good system. Basic Med and sport pilot privileges are, in my opinion, a huge benefit to pilots and reduces the incentives to hide or avoid treatment. I would edit my post to make that clearer, but the edit window has passed.

 

[midlifeflyer]

Sorry for the confusion, I was referring to the 1st/2nd/3rd class medical certification system (including the inability to get Basic Med or fly as a sport pilot following a deferred medical) which absolutely incentivizes hiding medical conditions and is not a good system. Basic Med and sport pilot privileges are, in my opinion, a huge benefit to pilots and reduces the incentives to hide or avoid treatment. I would edit my post to make that clearer, but the edit window has passed.

Thanks for the clarification. But I'm not sure about the accuracy of the bolded statement. At least to me, "deferred" refers to the decision being delayed pending the receipt of additional information; until it is either denied or approved, the application is still in progress.

 

[jbarrass]

How much time does the FAA want after treatment for prostate cancer?
(I had RALRP 5.5 months ago, will be going for a six-month exam shortly, both PSAs undetectable so far.)

No idea what the FAA wants these days. 17 years ago it was a post op PSA of zero. I applied 3 weeks post op and had my SI 3 weeks after that. But that was then.