Basic Med and Sleep Apnea

Discussion in 'Medical Topics' started by Basic Med and Sleep Apnea, Dec 14, 2020.

    • Pilot has 3rd class medical issued 2016
    • Medical Expires
    • Pilot gets sleep test, has Apnea, gets CPAP, analysis of CPAP data reveal Apnea no longer occurring while using CPAP
    • Pilot's personal Dr knows of this, considers Pilot to be capable of flying, Apnea/CPAP usage not an issue, Signs Basic Med
    • Is this the proper use of Basic Med?
     
  1. bflynn

    bflynn Final Approach

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  2. Thank you for the answer.
    What "crosses the line"?
    Are there any FAA prescribed conditions that prevent the personal doctor from signing Basic Med?
     
  3. jbarrass

    jbarrass Line Up and Wait PoA Supporter

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  4. GeorgeC

    GeorgeC Administrator Management Council Member PoA Supporter

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  5. WannFly

    WannFly Final Approach

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

    Medical Conditions Requiring One Special Issuance Before Operating under BasicMed
    • A mental health disorder, limited to an established medical history or clinical diagnosis of—
      • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
      • A psychosis, defined as a case in which an individual —
        • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
        • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
      • A bipolar disorder; or
      • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
    • A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
      • Epilepsy;
      • Disturbance of consciousness without satisfactory medical explanation of the cause; or
      • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
    • A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
      • Myocardial infarction;
      • Coronary heart disease that has required treatment;
      • Cardiac valve replacement; or
      • Heart replacement.
     
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  6. So since my 3rd class expired, I could have

    -had sleep Apnea and how use a CPAP
    -had kidney stones treated
    -been put on anti depressants
    -gotten a hearing aid

    And if the personal doctor reviews and sees that all is under control, sign Basic Med?
     
  7. WannFly

    WannFly Final Approach

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    thats on FAA No-No list of medications
     
  8. bflynn

    bflynn Final Approach

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    If he's comfortable with you flying an airplane, yes.

    "Crossing the line" is limited to the 3 conditions listed above - cardiac, neurological and mental health.
     
  9. So a Pilot can have a deficit such as sleep apnea, but can be prescribed a device (CPAP) to address that condition, and can fly on basic med. CPAP is not on the "banned" list.

    A Pilot can have a deficit such as depression (which is not on the Basic Med list of conditions, unlike Bi Polar), and can fly on basic med if not treated if the doctor thinks the pilot can fly as is. But such person cannot take a prescription for depression on basic med, because the prescription is on the banned list. In other words, Basic Med does not override the list of banned prescriptions.
     
  10. Brad Z

    Brad Z Final Approach PoA Supporter

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    Because your medical condition is not one of the identified conditions requiring a one-time medical certificate with a special issuance for BasicMed, you are required to disclose the medical condition to the physician completing the comprehensive medical examination by documenting it, along with all other pertinent medical history in section 2 of FAA form 8700-2. Any documentation you need to show evidence of treatment will be at the discretion of the physician conducting the examination.
     
  11. Can a student pilot go straight to basic med without ever holding a 3rd class?
     
  12. GeorgeC

    GeorgeC Administrator Management Council Member PoA Supporter

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    No.
     
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  13. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    Is the banned list regulatory?
     
  14. Matthew

    Matthew Touchdown! Greaser!

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    Here's a scenario:

    Class III - 2 yr renewal
    OSA SI on an annual renewal.

    Say even numbered years are when the Class III renews.

    If pilot gets Basic Med on an odd year, then doesn't renew the SI for that year, which means the Class III isn't valid anymore either: Is that a simple expiration of both the Class III and the SI? That isn't going to result in any kind of "deferral" or "denial for lack of information" that would cause some problems with the Basic Med?
     
  15. Kenny Phillips

    Kenny Phillips En-Route

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    Nope.
     
  16. bflynn

    bflynn Final Approach

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    Unclear.

    I believe the 3rd class remains in effect and any requirements to maintain that 3rd class must be maintained. There is no mechanism to surrender 3rd class and move straight to Basicmed that I'm aware of if. If you surrender it, it's treated as withdrawn and you'll lose Basicmed.

    But I also cannot think of a situation where this would be needed. Why would you give up a medical while it was still valid?
     
  17. Matthew

    Matthew Touchdown! Greaser!

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    I guess I was confusing things. I'm not talking about surrendering or giving up the medical. I was trying to ask about letting it expire without renewing it. But if the medical requires and SI to stay active, would NOT renewing the SI and letting the SI expire be the same as letting the Class III expire?

    It's a timing issue:

    Suppose Class III is a 2 year that renews (physical required) on even years:

    2020, 2022, 2024, ...

    OSA SI is an annual renewal (on even years the SI and the physical are both required):
    2020, 2021, 2022, 2023, 2024, ...

    Note that the Medical paperwork will always say "Not valid for any class after xxx/202x" where 202x is the SI renewal date, annually, even though the physical is only required on a normal 2 yr schedule.

    If you want to go Basic Med in 2021, the Class III is still good (no physical required) as long as you get the SI renewed.

    So - get Basic Med in 2021 before the SI expires and skip all the paperwork and expense of the SI renewal in 2021. Now what? The Class III requires the SI be renewed, but you skipped it. Will the Class III expire a year early? I get that you can have both a Basic Med and a Class III while you wait for the Class III to expire, but what happens if you need an annual SI but skip it while the Class III is still in effect? I know it isn't valid, but it also isn't really expired, so will that cause an issue that would invalidate the Basic Med like a denial would?

    Or do you have to wait for the even numbered year where both the SI and the physical are both due and then let everything expire at the same time?
     
  18. WannFly

    WannFly Final Approach

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    You have 3rd class medical with a SI
    You go to basicmed
    Unless you develop any of those issues mentioned in the article above, you fly with basicmed
    No SI renewal is necessary
     
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  19. bflynn

    bflynn Final Approach

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    What he said.

    Before your medical expires, you get BasicMed. You can do this after your medical expires, but in the gap you have no medical and can only fly sport.
    There are no SIs under BasicMed, just the three conditions and whatever you discuss with your doctor. If you're happy and he's happy, you're flying.
    You let the medical expire.
    The Medical and the SI go dead, but you don't care because you have BasicMed.

    Yes, it kinda feels like cheating because it doesn't follow the old rules. The first time I flew, I felt like I was breaking a rule and actually went back and re-read the Basicmed rule the night before.

    And then you start to realize what a pain the FAA medical system is.
     
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  20. Brad Z

    Brad Z Final Approach PoA Supporter

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    letting a SI letter lapse is not an issue...

    https://www.faa.gov/about/office_or...ngo-AFX-1-2 - (2018) Legal Interpretation.pdf
     
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  21. Matthew

    Matthew Touchdown! Greaser!

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    Thanks. It makes sense but it really seems like it shouldn’t. I have another 11 months before I need to worry about it.
     
  22. Brad Z

    Brad Z Final Approach PoA Supporter

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    Once the medical certificate has expired the FAA cannot take action on it.
     
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  23. bbchien

    bbchien Touchdown! Greaser!

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    Correct. But in 2018 we had to educate “some components” at CAMI as to that...

    just make sure no doc office send them a thing. I one recently interpret the receipt of am office visit record direct from an office, as reapplication. At tat point he got a demand letter for everything else, “or we will deny.....”. I had to add that interpretation to his file to “kill it”.

    no matter what organization, Somebody doesn’t get the memo.....
     
  24. I cannot find a list of medications that are banned besides the OTC list.

    Where can I find a list of banned prescription medicines?
     
  25. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    That's because the FAA doesn't officially publish one. This is the closest you'll come to it:
    https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/
    https://www.aopa.org/go-fly/medical-resources/medications-database (if you're an AOPA member)
    https://www.aviationmedicine.com/medication-database/ (if you're not a sucker)
     
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  26. WannFly

    WannFly Final Approach

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    i use the AOPA medication database: https://www.aopa.org/go-fly/medical-resources/medications-database

    a note from that page:

    Medication usage under BasicMed
    If you are taking a medication that is currently on the disallowed list, it doesn't automatically mean it is disallowed under BasicMed. When you visit your physician for the BasicMed examination, the checklist that you and your physician complete will list any prescription or non-prescription medication that you currently use, as well as information such as the medication name and dosage. Your physician will then address, as medically appropriate, any medications the individual is taking and discuss the medication’s potential to interfere with the safe operation of an aircraft or motor vehicle. Certain medications are not safe to be used at all while flying and others require a reasonable waiting period after use. Pilots, in discussion with their physician, should consult available aeromedical resources to understand potential flight hazards associated with any medications being taken, such as whether the underlying condition the medication is being taken for makes flight unsafe, or to understand side-effects that may be unnoticeable before flight but could impair the ability of a pilot to make sound decisions. In addition to the BasicMed rules, pilots taking medication must also comply with existing Federal Aviation Regulations, such as the self-grounding requirements of FAR 61.53 and FAR 91.17’s prohibition on operations while using any drug that has effects contrary to safety. AOPA’s online medical education course will include medication considerations when evaluating your fitness to fly. AOPA is also continuing to work with the FAA concerning the use of certain medications under BasicMed rules.
     
  27. bflynn

    bflynn Final Approach

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  28. I sounds like it's up to the family doctor signing the basic med to make the final determination on what prescription is acceptable.
     
  29. bflynn

    bflynn Final Approach

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    Yes, with the caveat that you still have to consider the effects and reason for the medicine. If I'm taking a pill so I can function, I probably shouldn't be flying, just in case I forget to take that pill.