Autism Spectrum Disorder, class 1

[AviationDad2]

Lindberg- he's been off all meds for about 18months. This was the recommendation of Pilot Medical Solutions and an AME in North Caroline

 

[Anthem]

sounds like they want to remove any drug possibilities that the FAA will have issues with. Now the important thing is whether a) he can function in life without them - which is the most important thing (more than flying certainly). And then b) what its going to take to get some sort of approval of an SI.

From what it sounds - the odds are pretty bleak as you have read. The successes are few and far between. Not even going to guess what its going to take, but I wish you best of luck. And while I know everyone always says keep pushing, and push through - Im much more of a pragmatist. Its your call, your money, but at the same time, your kids direction. Its a tough situation to be in for sure.

 

[Lindberg]

Lindberg- he's been off all meds for about 18months. This was the recommendation of Pilot Medical Solutions and an AME in North Caroline

The chronology is not clear to me, but it seems that your son's next step should be to consult with a senior "hard case" AME and then reapply for a medical certificate once that AME is confident your son has done everything he can do to make the best case to the FAA. Unfortunately, that may involve time spent waiting.

 

[guest user]

A couple of thoughts, based upon what has been presented here (none of which are ground breaking):

1) The FAA is not known for being on the cutting edge of anything. Take a look at some of the other threads about something as simple as anxiety or depression. So, it is not really surprising they are taking as hard a stance on this situation where you have bipolar and autism* together.

2) While the FAA is known for wanting a certain amount of time off medications, plus exams to prove no ill effect, I think it would be a good thing, as suggested above, for you son to move on into another line of work besides just holding out with an "airline pilot or nothing" attitude. This will benefit his attempt to be airline pilot as it will show that despite his diagnosis, he can indeed work well in leadership positions with no problems. Also, it will allow him to get experience in other areas of the work force. Whether that be as an accountant, firefighter, sales, etc. Breadth of experience is rarely a bad thing. Finally, if all does fail (as it has for many people before you and your son showed up, and will for many after), he will be further along in an alternate career than if he had waited until the final verdict from the FAA came down before embarking on said career.

From a personal point of view, I can understand the "We're going to fight and come out victorious over the FAA!" mentality. But even if you had jumped on Dr. Chien's advice and were the miracle patient who fought against both bipolar and autism*, you'd still only be about 1/2 of the way there now. Considering you haven't even started, you're at least 4yrs out, probably more.

For the record, I truly wish you and your son the best of luck with this endeavor. Please keep this thread updated as you go along. Would be great to later hear you guys were successful and he is now an ATP.

* Note that I repeated bipolar and autism because despite the fact that you know it is only autism, the FAA has it in their records that it is both. So you really are having to fight both. You have to prove 1) he does not have bipolar, never did have bipolar, is not affected by bipolar, should never have been on his record and 2) his autism is not an impediment to his being a pilot.

 

[Guest]

Skimmed this: Autism with a medical is definitely a thing.

You can count a third person here, and mine doesn’t require any annual evaluations (I am not on an SI). I’m extremely high functioning though and have no mental health medication history. I am also not a career pilot but a private pilot working in another industry. Only applied for a second class when I applied as well.

https://www.pilotsofamerica.com/com...edical-wait-times-and-contact-numbers.121061/

I would actually, however, think that the medication history you mentioned + the bipolar diagnosis (even if it is a false diagnosis) would be a huge concern here, especially since bipolar is explicitly called out in the CFR. You need to prove beyond all reasonable doubt that the bipolar was never the case. The FAA, from my experience, is also really really uptight about meds taken for psychotropic reasons. From speaking to others, from their experiences, that’s the portion that might require a continuous SI.

https://www.ecfr.gov/current/title-14/chapter-I/subchapter-D/part-67

67.107(a)(3)

 

[desertrat]

Exactly. In fact this all is beginning to appear to be discrimination. I have read other pilot forms with plenty of pilots that are "on the spectrum". Other than quirks like lining up pencils in a neat row there is little to differentiate and most people do not even know that a person might be on the autism spectrum

I was diagnosed recently at 64 with what used to be called Asperger's. I really hate that it was dumped into something they call a "spectrum" that gives people the impression that people on the high end of the spectrum aren't much different than those at the low end. It's far from a flat spectrum; it's more like a dumbell with two big peaks on either side that represent the average IQs of subjects on this "spectrum"

When was your son diagnosed? If it was before 2013, it was probably Asperger's, and later changed to "autism" (or ASD). I think this sucks, mainly because his IQ tests probably were really high. He's likely going to fall into any kind of "GIFTED" category you'll find at most educational institutions. While I admire your support for him, I'd suggest trying to get him to refocus on identifying and leveraging his GIFTS ... do something else while the FAA is catching up.

Aspies are very well suited for a lot of unexpected roles: corporate law, maybe aviation law; aeronautical engineering (among others); programming; computer tech; so-called 'ethical hacking'; accounting, and particularly forensic accounting, etc. I think the character of Gil Grissom on CSI was modeled after someone with Asperger's. There are so many fields that his gifts are a perfect fit for ... don't waste them waiting for an extremely conservative, risk-averse government agency to become "enlightened".

I recently saw an article about a woman who graduated from college with a fairly generic degree (English Lit or something like that) because she was diagnosed with ASD and everybody at her school figured, what's the point, she's autistic and she'll never get much of job. The job recruiters at school kept pushing her towards menial, low-skilled jobs that kids with autism are typically herded into, but her mom kept urging her to find something better. Somehow she got an interview with someone from the CIA. She was called back and invited to interview further. They ended up hiring her ... she looks at satellite images taking days and weeks apart and can find changes in them that indicate things of interest to spy folks that takes her MINUTES while their best computers take DAYS, and she's far better at identifying likely targets than the software. The manager who hired her was so impressed that the CIA has started an HR initiative to specifically identify jobs that are good fits for Aspies, and then recruiting those people directly! This girl said she LOVES the job and never dreamed she'd be able to get such a high-paying job doing "real work" that was meaningful and fun. Most people would be bored to death, but this is how the Aspie brain works.

Here's something else to consider: back when I was in school (the 60's), they didn't really know what's what when it came to learning differences. I was bored out of my mind, and teachers didn't like it. I was not motivated by grades, I just wanted to learn. in 6th and 7th grades, I'd ask questions, and inevitably be told something like, "That involves math that you won't get to until you're a Junior or Sr. in High school" and was given the brush-off. I ignored them and figured things out anyway. I got my Novice ham license at 13 and passed the General exam a year later, but failed the Morse Code test. A year later I nearly aced the General test and missed the Advanced test by just a couple of questions. I accomplished this all on my own, just reading a couple of books. Yet teachers wrote things on my report cards like, "lazy", "not self-motivated", "does not apply himself", "refuses to do his homework", ... stuff like that. This is from people who told me I couldn't figure stuff out when I actually did -- I just didn't tell them because I thought they wouldn't believe me. In fact, I could figure things out and master games so quickly that people were constantly accusing me of cheating, while my report card repeatedly said, "does not live up to his potential". I got so tired of being called a cheater that I just stopped playing games with kids from school -- and people ask why I'm so anti-social. If they only knew!

Back then, I was bullied a lot, made the butt of lots of practical jokes, and people called me "retarded". That was the popular term back then.

I'm a baby boomer. And this was "our reality" back then. The sad truth is statistics suggest that about 0.5% of the population has Aspergers, only hardly anybody over the age of 30 has been diagnosed. I KNOW I've worked with LOTS of Aspies in the computing world over my career, only none of us knew!

I think the best reason to get diagnosed is to find out for sure what the foundations of your GIFTS are, which is simply a side-effect of the battery of IQ tests they give. But for most adults, and especially baby boomers, their question is a little more blunt: "Why would I want to get diagnosed and find out I really AM a 'retard'?" So most remain undiagnosed and invisible. And there's some truth to that, because the diagnosis today is for a "mental disorder". Aspies have GIFTS, but GIFTS aren't part of DSM-IV or -V diagnostic result.

People look at us and say, "wow, you don't LOOK autistic; you don't SOUND autistic; in fact, you seem VERY NORMAL!" I hear that a lot. They NEVER ask, "So what are YOUR unique gifts?"

Spend more time talking with your son to uncover his GIFTS. I can get his passion around flying, but I'm sure there are other things he'd find just as fun and exciting. Maybe corporate law focusing on ADA discrimination, and then go after the FAA! I mean, I'm constantly reading things and hearing interviews with people who state that the statistics around FAA medical criteria show virtually no correlation between the fears of what they're afraid of happening, and actual occurrences.

As an aside, I can't get any cardiologists to do an angiogram or even a CT angiogram on me; they don't want to deal with the insurance companies, and they generally see angiograms as "high risk" (something like a 1-2% mortality rate). Yet the FAA requires them ANNUALLY to keep up a Class-1 Medical certificate! A CT angiogram is just as good for their needs, and the mortality risks are only a fraction of a full angiogram that uses a catheter inserted close to the heart. Surely there are statistics that show a certain death rate among pilots getting these procedures annually that relates directly to the number of pilots who have random heart attacks that these tests are not catching. I'm like a lot of others who think that while the regs may be driven based on fear, they should be justified by statistical relevance, and those that are not statistically relevant should be dropped. I think this is the REAL fight your son should be taking on! Heck, he could get into researching neurological disorders like autism and maybe get some research grants from the DOD or DARPA to help characterize the best uses of people with Asperger's. The question is, are they being optimally deployed within the military and the Government oveall?

 

[Mason]

Where can we find documentation that an annual angiogram is a requirement?

 

[Racerx]

As an aside, I can't get any cardiologists to do an angiogram or even a CT angiogram on me; they don't want to deal with the insurance companies, and they generally see angiograms as "high risk" (something like a 1-2% mortality rate).

The total complication rate was 1.33%. The procedure-related mortality rates were 0.02%.

Insurance companies ruin so many things.

 

[desertrat]

Where can we find documentation that an annual angiogram is a requirement?

I'm pretty certain I saw it somewhere, but now I can't find it. I had a cardiac infarction due to excessive stenosis in my LAD artery and they put a stent in. That was 2011, and I've been fine since. However, that procedure puts me in a "disqualified until/unless AME says otherwise" category, and also mandates other things, even though 12 years without even a single episode of angina has passed. Maybe only an EKG is required otherwise.

 

[Mason]

I have difficulty believing any cardiologist would perform an angiogram unless it was absolutely medically necessary, and certainly not to simply satisfy the FAA. Nor would any insurance pay for it.

 

[desertrat]

I have difficulty believing any cardiologist would perform an angiogram unless it was absolutely medically necessary, and certainly not to simply satisfy the FAA. Nor would any insurance pay for it.

I've read that no insurance will cover the AME exams at all, regardless. Is that true? (Several sites I've seen say they won't even bill insurance for AME exams.)


As an aside, most men are required to have regular prostate exams when we pass 50. We're also supposed to get colonoscopies every 5 years or so. They're both invasive procedures, and insurance covers them both, because they're considered "preventive".

I honestly don't know why they care about these two issues specifically because clogged arteries account for 55% of deaths, and these two are just a small fraction in comparison. Yet no insurance company will pay for PREVENTIVE angiograms, or even the far less risky CT angiograms. Nor will the medical community even consider Cardiac Calcium CT Scans that highlight calcified plaque buildup in your arteries. Even after you've had a heart attack, they REFUSE to do ANOTHER angiogram! They just don't want to know if your arteries are clogged, I guess. The only thing I've been offered was a typical echo-stress test, which is something that if your arteries are sufficiently clogged even though your blood lipids are fine, it can send you into cardiac arrest.

I had a heart attack in 2011. I had a stent put in. I have been pestering my docs for a decade for another look INSIDE MY ARTERIES to see WHAT'S REALLY GOING ON -- the same way they insist that I get a colonoscopy and regular prostate screenings. They adamantly REFUSE! They simply want to refer to my total blood lipids, keep insisting I take statins (which I refuse to do) and tell me that if I don't, then I can expect another heart attack any day (for a decade now) ... but they really have no idea. And they don't seem to want to know. As the docs who put my stent in kept saying, "You're a really lucky guy!" Ok, there we have it -- the answer to Life, the Universe, and Everything. Or, 42 by last count.

I'm past retirement age, and am only looking to fly for fun. I may be best off getting a license that keeps me off the FAA's radar entirely, because nobody seems to seriously care about my cardiovascular health, but only indirect measurements that amount to flying blind with totally inoperable instruments. The FAA doesn't advocate that, but they accept such results from the medical community just because that's what is considered "acceptable". (The value of said data regarding pilot safety is apparently a point of contention within the industry.)

The truth is, I care a hell of a lot more about my own cardiac health than either my docs or the FAA do. But my interests don't seem to matter to these folks. I cannot get the care I believe is warranted, and am told instead that I have to accept a Standard Of Care that is based entirely on statistical profiling and political skulduggery: docs won't do it and insurance won't cover it. I don't know why the FAA even cares.

 

[TCABM]

I've read that no insurance will cover the AME exams at all, regardless. Is that true? (Several sites I've seen say they won't even bill insurance for AME exams.)…

Can’t speak to AME exams and ALL insurers, but I’ve never had one pay for the exam however, I did have two cardiac exams(hx of open heart surgery for ASD repair) required by the FAA in their follow up letter covered 100% by my insurer. I was issued the medical in office and this was a follow up request that resulted in NO SI required.

My PCM completes a BasicMed CMEC annually as part of my annual wellness exam; due to my history, he prefers to have a cardiac workup every five years but that’s not a requirement for BM.

You mentioned colonoscopies required at 50 and every 5 years after for most men. I mus be an edge case; my PCM recommended one at 50, but my decision to make, so I did one. The GI doc said based on my results not to come back for ten years, which aligns with ACS and USPSTF and other agencies recommendations.

Recommendations do not equal requirements, though.

 

[Angren918]

@ Aviation Dad 2,
I just joined this thread. My son is 14 and also has an ASD/ ADHD diagnosis. He has wanted to be a pilot his entire life too and is very knowledgeable and passionate about all things aviation. He's been in the Civil Air Patrol for almost two years now and has been thriving. This thread has been so disheartening to read, especially as we start planning for his future career path. Please keep me posted about how things pans out for your kiddo. I wish him the absolute best of luck.

I know how you feel. I applaud your fight. Big hugs. If I could figure out how to message you privately to exchange emails, I would.

 

[Palmpilot]

@ Aviation Dad 2,
I just joined this thread. My son is 14 and also has an ASD/ ADHD diagnosis. He has wanted to be a pilot his entire life too and is very knowledgeable and passionate about all things aviation. He's been in the Civil Air Patrol for almost two years now and has been thriving. This thread has been so disheartening to read, especially as we start planning for his future career path. Please keep me posted about how things pans out for your kiddo. I wish him the absolute best of luck.

I know how you feel. I applaud your fight. Big hugs. If I could figure out how to message you privately to exchange emails, I would.

It looks like AviationDad2 hasn't logged into the forum in just over a year.