Basic Med....but wait, there’s more

Discussion in 'Medical Topics' started by wrbix, Feb 22, 2020.

  1. wrbix

    wrbix Pattern Altitude

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    I’ve held Third Class until went Basic Med in 4/2018.....all well and good until today I received a letter from the FAA OC Med branch requesting information on previous diagnoses which have been quiescent and not affecting piloting ability:
    - “SVT” - actually a workup a number of years ago for palpitations that included TMET and Holter without significant findings,
    - Cluster Headaches - another diagnosis thoroughly worked up and vetted through the FAA a number of years ago, and likewise quiescent,
    - Hypogonadism - managed by my Primary Internist with topical supplements, and quiescent, asymptomatic, and closely regulated.
    None of the above required a Special Issuance.

    So I question what prompted this inquiry from the FAA, and what’s the use of Basic Med if certification by myself and my primary care physician as to lack of impact on flying has been made?
    I can get documentation of quiescence of latter two diagnoses from my Internist but they’re also requesting another 24 hour Holter monitor. Any idea what got me on the FAA’s radar? Anyone else have similar experience?
     
    Last edited: Feb 22, 2020
  2. p1l0t

    p1l0t Line Up and Wait

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    What happens if you just ignore the letter? I mean you never were denied and already have the basic med.

    Sent from my SM-G975U using Tapatalk
     
  3. Stewartb

    Stewartb Final Approach

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    Interesting situation. I wonder if a letter to the FAA stating you no longer use or need your medical cert is a good idea?
     
  4. jallen0

    jallen0 Pre-takeoff checklist

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    I wonder if they deny the third class then everything derived from it is also denied. If so then the BasicMed is forfeited.
     
  5. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser!

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    My money is on someone's job depending on finding things that can be investigated, so he/she went looking. As more people go basic med, said individuals will be forced to dig into old applications to keep their investigations per month statistic up.
     
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  6. hindsight2020

    hindsight2020 En-Route

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    This will be an interesting case study. Maybe AOPA and BasicMed users did a premature victory lap, if these retroactive witchhunts yield post facto medical revocations, which by statute also sweep basicmed from under these people's feet.
     
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  7. Luigi

    Luigi Pre-takeoff checklist

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    I wonder if the FAA is reviewing your LAST third class medical application and feel that they should have further considered before issuing?
    I have heard of pilots being asked for more information well after a medical has been issued.

    I sure hope this works out for you!
     
  8. wrbix

    wrbix Pattern Altitude

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    Appreciate y’all’s input and support....something is definitely amiss here:
    The letter refers to an “electronically transmitted application...from your AME”, whom I’ve not seen since 2016 and a copy of the letter was cc’d to him.
    My first contact on Monday will be AOPA Pilot Protection, and I’ll thereafter get an appointment to see this AME (DEFINITIVELY without an associated exam or medical interview).
    Ignoring the FAA contact seems ill advised, based on their bolded AND underlined verbiage: “if no reply is received within 60 days from the date of this letter, we will either refer your case for legal enforcement action or deny your application”. What application?

    One kicker here...a number of months ago after noting my vision becoming better without corrective lenses than with, I had my Ophthalmologist fill out the FAA eye exam documentation form defining this and requested removal of “must wear corrective lenses” from my Certificate, but the AME had no part in this. Wonder if this got me inappropriately on the FAA’s radar for other issues.
    I see a fuster cluck brewing here.
     
    Last edited: Feb 22, 2020
  9. p1l0t

    p1l0t Line Up and Wait

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    What application is a very good question.

    Sent from my SM-G975U using Tapatalk
     
  10. bbchien

    bbchien Touchdown! Greaser!

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    YES!
    This the scenario in which the doc office sent something directly to the FAA. The timespan is EXACTLY correct for that. That is always interpreted as reapplication, provided that any tail of eligible time remains on your last certificate.

    ...that is why I’ve always HARPED in the necessity for my airmen to makes sure that the only address the office has for FAA....well, is MINE! There is always a helpful Hannah in the back, I’m afraid.

    or...the letter starts “the FAA QA branch has reviewed your file and can’t determine if you certification was appropriate. Please within 60 days.....” ....and then the teeth.you have no choice but to comply and win this round :(. This can be years later.

    If I were doing this I’d be wanting to see you earlier “eligibility” letters. If you never got one, these diagnoses were never vetted. Failing that someone in my shoes would be “stat” reading you Blue Ribbon medical record....and I’d get and wear that holter.

    And I would switch ophthalmology practices.
     
    Last edited: Feb 23, 2020
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  11. belbert

    belbert Pre-Flight

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    I'm curious how the FAA became aware of these conditions. Did they pull your med records or perhaps you disclose them during your last 3 class?
     
  12. dbahn

    dbahn Pre-takeoff checklist

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    Bruce, is this the ophthalmologist's fault? The OP wanted to have the glasses restriction removed from his Medical Certificate, even though he was operating under Basic Med, and he asked the ophthalmologist to send the exam to the FAA. How else could the restriction be removed? It seems to me that the mistake made here was electing to change an FAA certificate that he wasn't even using, particularly for something as relatively insignificant as a requirement to wear glasses, which most of us that need them do anyway.

    My sympathies to the OP, but it is a good lesson for all.
     
  13. wrbix

    wrbix Pattern Altitude

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    All of these three diagnoses were disclosed and fully worked up and vetted by the FAA in my previous Third Classes. No SIs.
    Cannot fault the Ophth - all he did is fill out the form as I requested.
    How my previous AME got involved, if he indeed did, is a mystery to me.
    I will comply with their requests.....but the next issue I suspect may arise is if they expect me to proceed through the rest of the Third Class exam/eval. I would, of course, prefer to stay under Basic Med. Dr C, any thoughts on that?
     
    Last edited: Feb 23, 2020
  14. bflynn

    bflynn Final Approach

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    You had the ophthalmologist send a form to the FAA. That was probably the event triggering a general medical review.

    I don’t suppose, PRNC is gonna work here. I would start with a reminder that you do not hold a medical certificate with a request as to what they are investigating. They can not deny or withdraw a dead medical, can they?
     
  15. Larry Vrooman

    Larry Vrooman Pre-takeoff checklist

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    My understanding is that the FAA Med branch has 60 days following your application or issuance by an AME to review the issuance of a medical certificate. If it does not occur within 60 days (and no new med issues develop), you're good to go.

    However, as noted above, requesting the vision restriction be removed from the prior certificate would be viewed as a new application.

    You should not have provided them with that opening.
     
  16. dbahn

    dbahn Pre-takeoff checklist

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    Over the years I've had four or five similar letters asking for documentation "or else". In each case I dutifully provided the documentation (by certified mail) and never heard another word from CAMI and never had any interruption of my privileges.

    But I don't think any of them suggested legal enforcement would be considered. That's a little scarier, and I would definitely defer to Bruce or another knowledgeable AME for advice on this one. (Maybe it's just new wordsmithing at CAMI. I don't know.)

     
  17. PiperW

    PiperW Pre-takeoff checklist

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    Your former AME is probably as confused on this as you are.

    also, a little common sense goes a long way. You obviously went thru the rigid process of getting issued and yet calmly tell the Ophth to forward your exam paperwork to the FAA....addressed to who inside the FAA...general mail?

    Good luck, I hope it works out for you quickly and painlessly.
     
  18. Brad Z

    Brad Z Final Approach

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    The AMCD staffer processing inbound paperwork may try to treat it as a new application, but it's not. I'd recommend contacting your regional flight surgeon to straighten it out. If your last medical has expired, they can't do anything further, unless they have reason to believe there was falsification, which certainly doesn't seem to be the case here. It's too late for them to revoke, and they can't deny an application that you have not submitted.
     
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  19. Half Fast

    Half Fast Final Approach

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    True, but....

    At his direction, his ophthalmologist requested removal of a vision restriction. The FAA can’t amend an expired certificate any more than they can revoke one, so it’s logical for them to treat his request as an application for a new medical.

    I’m confused as to why he made the request if he intended to stay with Basic Med. The restriction on his former class 3 has no bearing whatsoever on Basic Med. Now he’s faced with trying to unring a bell.
     
  20. wrbix

    wrbix Pattern Altitude

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    So, you’re saying if a Pilot is severely myopic, requiring corrective lenses, once he or she goes to Basic Med then glasses are no longer required while flying?
    Bet the insurance company would have a hay day with that in the event of, say, a mid-air.
     
  21. wrbix

    wrbix Pattern Altitude

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    .......and likewise, by the same logic, if a Pilot has seizures long term controlled with medication, once he or she goes to Basic Med then no one but he or she should care if these meds are stopped?
     
  22. wrbix

    wrbix Pattern Altitude

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    There’s a good suggestion.....I found the regional flight surgeon (Atlanta) quite approachable and reasonable when vetting the cluster headaches.
     
  23. Dana

    Dana Cleared for Takeoff

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    Doesn't basicmed require you to have a drivers license? If so then you need any corrective lenses specified on the drivers license.
     
  24. Half Fast

    Half Fast Final Approach

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    I'm saying that it's no longer up to the FAA. If he no longer needs corrective lenses ("...after noting my vision becoming better without corrective lenses than with..."), he does not need to deal with the FAA to fly without glasses. Except for a few special issuance criteria, a pilot on Basic Med need not get the FAA's permission to fly; it's between the pilot and his physician.
     
    Last edited: Feb 23, 2020
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  25. Half Fast

    Half Fast Final Approach

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    You're required to have a DL to use Basic Med so I assume you're required to abide by any restrictions on it, but I'm not sure and can't look it up right now.
     
  26. Half Fast

    Half Fast Final Approach

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    Are you suggesting that the FAA be queried? If the pilot's doc signs the Basic Med form, the pilot is legal to fly. No disclosure or "mother-may-I" to the FAA is required.

    Do you not understand how Basic Med works?
     
  27. wrbix

    wrbix Pattern Altitude

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    Thought I did, and just tried to apply some logic to it. So much for that I guess.
     
  28. Half Fast

    Half Fast Final Approach

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    Under Basic Med, the pilot is responsible for assessing his own fitness to fly. Every two years he must take a class and pass a test, and every four years he must have an exam from a physician. These are to provide him with the information he needs to make an informed decision about his fitness. The physician signs a form attesting to his fitness to fly, but it does NOT go to the FAA. Instead, the pilot keeps the form in his logbook. The FAA does not get any medical info and it's not up the FAA to determine fitness.

    So, the OP could have simply flown without corrective lenses if he and his doc determined he no longer needs them, without getting the FAA involved at all.
     
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  29. Brad Z

    Brad Z Final Approach

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    I agree, the situation is confusing. Nevertheless, the RFSs will be able to help the OP sort things out.
     
  30. bflynn

    bflynn Final Approach

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    So...who is the AME? He didn't pay an AME for an exam, there's nobody who owns this and no exam was done. Can you just make a application like this and get a new medical issued without going through an AME?
     
  31. Half Fast

    Half Fast Final Approach

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    Presumably, once begun like this the FAA would require you to go through an AME to complete the process.
     
  32. bbchien

    bbchien Touchdown! Greaser!

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    I’d have to see the verbiage in the letter...but this has happened to other airmen in which the seemingly benign act of sending anything in the interim to FAA triggers the inspection.

    ...or is a QA program review letter.
     
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  33. Palmpilot

    Palmpilot Touchdown! Greaser!

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    Was your last medical certificate still valid when you requested this?
     
  34. wrbix

    wrbix Pattern Altitude

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    Third Class had timed out, Basic Med in effect.
     
  35. Brad Z

    Brad Z Final Approach

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    It has. I worked a situation with an airman who was a long-time SI holder who switched to BasicMed and got the same letter when his cardiologist sent in his annual status report for the airman (as he had always done for several years prior, and apparently wasn't told by airmen to stop sending) and triggered the same process at AMCD.
     
  36. Larry Vrooman

    Larry Vrooman Pre-takeoff checklist

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    Obviously you can't just apply for a new medical without an AME being involved, but it's more complicated than that.

    I spent 12 years as a fed inside the beltway. It was not the FAA (so don't panic), but 5 years of that involved liaison work with other departments and I found a few things to be endemic in federal agencies. There are some exceptions, but most field offices are staffed with people with at least some, and sometimes substantial, specific program knowledge and subject matter expertise. However, in the central offices, and in administrative positions in central offices you start seeing an increasing percentage of staff with little or no program background or subject matter expertise. In fact, you start seeing an increasing percentage of people who have a law degree, but never practiced law, and may have never sat for or passed a bar exam. Universities churn out way more law school graduates than we need, and a large percentage of the surplus go into government thinking they are well suited to writing, implementing and enforcing regulations. They are not. In the absence of program knowledge and practical experience doing whatever that program/agency oversees, that legal trained person defaults to a narrow read of the law and that always ends badly from a practical, program focused perspective.

    To you or I, if a opthamologist submitted a request to remove a restriction on a pilot's expired medical certificate, the logical response would be to contact the airman in question and advise them that the current medical is expired and that any request to remove a restriction would need to be done as part of an application for a new medical, then refer you to an AME to start the required application process. However, that's problematic for a couple reasons - there most likely isn't a category for such requests that is not connected to either a request for a new medical certificate or review of a current medical certificate. That's because the people who wrote the regs and sub regulatory guidance failed to either envision or account for this kind of request. Logically, an agency should be able to manage all sorts of very low probability/low frequency events like this one. As a practical matter however, they don't due to concerns about regulatory burden and the time and expense required to develop additional processes that are ultimately almost never used.

    Given that background, a career bureaucrat with only a legal background will default to the legal requirements and a very narrow read of the law. In this case, that means it's an "application" to be approved or denied within a 60 day timeline. To that person, this request gets treated as an application because there is no other category to fit it into, or worse because it has already been put in the in-basket to process as an application by whoever opened it and stamped it in, with the result that it's already part of the performance monitoring process and the 60 day clock is already ticking. From that perspective, contacting the airman in question is all risk and downside with no upside. It takes time to contact the airman, and then the airman may take not take timely action or may take no action at all to continue the application process. If that action occurs slowly, or never occurs at all, the request (which is being treated as an application) will go over the allotted 60 day time limit and then be treated as a negative in both individual and agency performance metrics, as it was never approved or denied. The only control the staff processing it has is to treat it as an application and then deny it if no further information is received within the allotted time period.

    Would that denial of a request on an expired medical mean anything to the airman? If would if it is counted and recorded as a denied application for a third class medical. If not, then it's not significant. The OP will need to consult with the FAA and with an aviation attorney to get an answer on that. Even then the answer from the FAA may still be "maybe" if they don't have some prior precedent and case law to work from. Feds cast in the legally trained the bureaucratic mold are generally speaking risk averse and their default response switch is safety wired in the least risk possible position.

    That kind of mess gets created because the people who wrote the law, the regs and the sub regulatory guidance may not have been aware of or did not consider that this kind of thing could happen. Until the regs are re-written or sub regulatory guidance is written that creates a way to process this kind of misinformed request, it'll get treated as a new application, so it can be denied in a timely manner if no further action is taken. That inability to just ignore or return to sender an ill considered/misguided/inappropriate request is a negative and unintended outcome of laws requiring government accountability, internal controls, and performance requirements.

    Unfortunately, not many federal employees are going to take the time or the risk to bump a request like this upstairs and make the argument that it is outside the scope of the law and should be treated as an exception. Trust me, advocating for that kind of realistic interpretation of law, reg, and guidance is not career enhancing, especially when the people up the chain of command are attorneys who know very little about the actual program and are much more concerned with performance measures based on timely adherence to process.

    Then there is also the element of potential bureaucratic inertia. I don't know how the medical branch views Basic Med. They could see it as a big positive and a way to reduce workload, they could disagree with the whole idea see it as a threat to air safety or, particularly the folks higher up in the branch, they could see it as a threat to their kingdom by reducing the size, scope and authority of the branch. in either of the latter two cases, this request could be seen as an opportunity to dig into an airman's basic med cert and demonstrate that the process failed and that the airman operating under Basic Med, should not be flying.

    In short, it's either being treated as an application in order to just deny the request (on what is an already expired certificate) get in the outbox within 60 days. Or alternatively, they are using it as a means to assess the quality of, or even disprove that Basic Med, as a concept, is working.
     
  37. midlifeflyer

    midlifeflyer Touchdown! Greaser!

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    This. This is the reality.

    You can't give even a tentative answer without knowing what the question is. "I'd have to see the verbiage in the letter" is a basic (but not the only) difference between a professional and SGOTI.
     
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  38. Palmpilot

    Palmpilot Touchdown! Greaser!

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    Am I correct in thinking that you were under the impression that the limitation on your former medical certificate was somehow binding on your BasicMed privileges?
     
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  39. wrbix

    wrbix Pattern Altitude

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    Yes, indeed....that is why I initiated all this with a Form 8500-7 to the FAA.
     
  40. Half Fast

    Half Fast Final Approach

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    Ooops. That limitation on an expired medical has no effect at all on Basic Med.