Basic Med - vision issue

The pro, and con, of Basic Med is that signoff is at the discretion and judgment of the state-licensed physician that you choose. Some may have unreasonably high (or low) standards. If the state-licensed physician that you choose has standards you disagree with, it doesn't make him wrong, it just makes him the wrong choice for you. The other great thing about Basic Med, is that, like a flight review, you can't fail. So find another doc.
 
bonefishpete said:
I can't find any mention of vision requirements. Search keeps coming back to 1,2,3 class medical requirements.
Click to expand...
I found it in some AOPA documentation. But I can't find anything either on anything from the FAA. I would think there has to be a minimum standard.

Looking at multiple states minimum vision requirements for a Drivers License, they were all 20/40. So I'll assume they went with that standard for the Basic, but it would be nice to be able to find it documented someplace.
 
M20K said:
I found it in some AOPA documentation. But I can't find anything either on anything from the FAA. I would think there has to be a minimum standard….
Click to expand...
See 14 CFR 68.7
…
b) A section with instructions for the individual to provide the completed checklist to the State-licensed physician performing the comprehensive medical examination required under § 68.5; and
(c) A section, for the physician to complete, that instructs the physician—

(1) To perform a clinical examination of—

(i) Head, face, neck, and scalp;

(ii) Nose, sinuses, mouth, and throat;

(iii) Ears, general (internal and external canals), and eardrums (perforation);

(iv) Eyes (general), ophthalmoscopic, pupils (equality and reaction), and ocular motility (associated parallel movement, nystagmus);

(v) Lungs and chest (not including breast examination);

(vi) Heart (precordial activity, rhythm, sounds, and murmurs);

(vii) Vascular system (pulse, amplitude, and character, and arms, legs, and others);

(viii) Abdomen and viscera (including hernia);

(ix) Anus (not including digital examination);

(x) Skin;

(xi) G-U system (not including pelvic examination);

(xii) Upper and lower extremities (strength and range of motion);

(xiii) Spine and other musculoskeletal;

(xiv) Identifying body marks, scars, and tattoos (size and location);

(xv) Lymphatics;

(xvi) Neurologic (tendon reflexes, equilibrium, senses, cranial nerves, and coordination, etc.);

(xvii) Psychiatric (appearance, behavior, mood, communication, and memory);

(xviii) General systemic;

(xix) Hearing;

(xx) Vision (distant, near, and intermediate vision, field of vision, color vision, and ocular alignment);

(xxi) Blood pressure and pulse; and

(xxii) Anything else the physician, in his or her medical judgment, considers necessary;
….
M20K said:
….Looking at multiple states minimum vision requirements for a Drivers License, they were all 20/40. So I'll assume they went with that standard for the Basic, but it would be nice to be able to find it documented someplace.
Click to expand...
Don’t assume anything not written in 14 CFR 68.
 
You won't find it because it doesn't exist. There are no Government standards for BasicMed. It's based on the clinical Judgment of the state licensed physician that examines you.

You do have to have a drivers license though and you do have to comply with any restrictions on it, so in most states 20/40 becomes an indirect boundary.

But it's not an FAA medical at all so looking at Class 1/2/3 requirements is a rabbit hole.
 
M20K said:
I found it in some AOPA documentation. But I can't find anything either on anything from the FAA. I would think there has to be a minimum standard.

Looking at multiple states minimum vision requirements for a Drivers License, they were all 20/40. So I'll assume they went with that standard for the Basic, but it would be nice to be able to find it documented someplace.
Click to expand...

A current DL is required for Basic so you get the state's vision requirements by default.
 
Net net - you need at least 20/40

Not a bad thing
 
TCABM said:
See 14 CFR 68.7
Click to expand...
Totally agree about not assuming or interpreting the Regs. :D But not my point, sorry if you missed that. I'm "assuming" the Docs are going with the driving standard, and I'd still like to see something from the FAA.
 
M20K said:
Totally agree about not assuming or interpreting the Regs. :D But not my point, sorry if you missed that. I'm "assuming" the Docs are going with the driving standard, and I'd still like to see something from the FAA.
Click to expand...

Why make the assumption on what the docs using to conduct the clinical evaluation?

I can tell you my BasicMed doc asked me if I was under the care of an optometrist and whether or not I was following the optometrist’s recommendation. That was the totality of the clinical evaluation for vision.

As a side note, I haven’t seen a PCM in a decade that had even as much as a vision chart in their office/clinic.
 
Yeah - my PCP doesn’t have a vision chart. Hence I used a local clinic that does DOT exams.

As far as what gets us to at least 20/40, this sums it up/gets the job done:
Half Fast said:
A current DL is required for Basic so you get the state's vision requirements by default.
Click to expand...
 
TCABM said:
I can tell you my BasicMed doc asked me if I was under the care of an optometrist and whether or not I was following the optometrist’s recommendation. That was the totality of the clinical evaluation for vision.
Click to expand...
That wouldn't cut it to get a drivers license. But you think it's okay to fly a plane?

ADDED: Forget my comment. @Half Fast pointed out you must have a DL to get a Basic Med. So that covers the vision test. (Duh!)
 
Last edited:
M20K said:
That wouldn't cut it to get a drivers license. But you think it's okay to fly a plane?
Click to expand...
I think it is sufficient for Basic Med if the state-licensed physician thinks it is.

My old PCP wouldn't do Basic Med for me specifically because he had no means to trest my eyesight. My current PCP did it, but then called me back because he forgot to test my eyesight. He had me read some arbitrary line from an arbitrary distance on an eye chart that he just happened to have hanging behind a door in his office. But it checked a box. (I have 20/15 vision BTW.)
 
Last edited:
M20K said:
That wouldn't cut it to get a drivers license. But you think it's okay to fly a plane?…
Click to expand...
Doesn’t matter what I think; Congress passed and law and a President signed it that directed the FAA to enact rules for BasicMed. if you really want to go there, I had a flying .mil career and have no bones stating the vast majority of FAA AMEs, Senior AMEs, HIMS AMEs, and DMEs have zero functional expertise in aerospace medicine.

It’s appears to me you either have a bias against BasicMed or don’t understand Part 68 is a direct result of legislation.

If I recall correctly, @Brad Z has some in depth, inside knowledge of the FAA’s position on BasicMed. Maybe he can help you better understand why the FAA pretends Part 68 does not exist.
 
TCABM said:
Doesn’t matter what I think; Congress passed and law and a President signed it that directed the FAA to enact rules for BasicMed. if you really want to go there, I had a flying .mil career and have no bones stating the vast majority of FAA AMEs, Senior AMEs, HIMS AMEs, and DMEs have zero functional expertise in aerospace medicine.

It’s appears to me you either have a bias against BasicMed or don’t understand Part 68 is a direct result of legislation.

If I recall correctly, @Brad Z has some in depth, inside knowledge of the FAA’s position on BasicMed. Maybe he can help you better understand why the FAA pretends Part 68 does not exist.
Click to expand...
Wait…the FAA pretends Part 68 doesn’t exist?
 
Half Fast: that is not reasonable. My last DMV visual acuity enounter was 5 years ago. A lot changes in 5 years esp. in our age group. So the Basic Med doc has to attempt to "be reasonable with that". Now if you're in a state that calls you in every 24 months- that's a horse of a different color.
 
Last edited:
All's well that ends well. I sent my vision results to the doc and he sent me back the signed form.

My bad #1: If you wear multiple glasses, bring them all to the examination. I was incorrectly expecting the doctor to note a Corrective Lens Restiriction or something versus validating my prescription.
My bad #2: Even though it's basic med, I had unrealistic expectations on consistency. This exam was very different from my 1st BM exam.
My bad #3: The doctor's assistant gave the exam. When the doctor entered the room, the first words out of his mouth were, as if I were hiding something, "why are you basic med"? The next words were something about my reading vision was too poor for him to sign off. I think his tone sent me into defensive mode. The level of service with just about everything has dropped off a cliff since covid and I guess I'm expecting/anticipating frustration so I played right along.
My bad #4: I went to this guy blind (haha) so as to avoid 3+ hours in the car. It would have helped to find a doc based on a recommendation and briefing on what to expect.
 
Last edited:
giphy.gif
 
If I can generalize a little bit, as a physician myself.

As a general rule docs hate forms. It's one of the least enjoyable parts of medicine. We get it, somewhat necessary. Having said that, if you want things to go smoothly, here are my tips for making the provider happy. (Because if the provider is happy, everyone leaves happy...)

1-Please complete all sections that say, "Patient to complete." You instantly get 10 demerits when you hand me a blank form where you didn't bother to print your name, address, drivers license info, personal medical history information and anything else that the form asks you to complete. Telling me you'll fill it out "afterwards" isn't really acceptable to me. Usually, the form asks me to certify I've reviewed all this information. Well, I can't really certify it since you were too lazy to fill it out...

2-If you wear glasses or hearing aids, and the form asks for some type of review of said vision and hearing, please bring them. Really, it's a bit sad to have to explicitly state this. How can I certify you can see or hear, when, in my office, well, today, at the time of exam, you can't. Right... I mean yeah, maybe it's because you forgot your glasses. But how do I know...???

3-Don't ask the doc to lie. Again, I can't believe I have to say this. Not even a little lie. For example, for FMLA paperwork, we have to certify your illness. There is also a box (at least on the CA forms) that says, "patient states they were sick, but were not seen by the doc." This is for the folks who had, say, a sinus infection two weeks ago, got better, never came to see me, and HR tells them they need some sort of note because they took two weeks off for their sinus infection. The problem is, the patient says, "please don't check the box that says patient states, please just certify my illness." Sigh, I can't really certify that you were sick since I never saw you!" The sad reality is that your illness may not qualify for FMLA, but asking the doc to lie about it is not the right way to go.

4-If you are on meds, please don't "forget them" the day of the exam. Yes, really, happens more often than you would think. "So, Mr. Jones, your bp is a bit high today, 185/102." "Oh, I haven't taken my morning BP meds" "But, it's 11:45 in the morning?" "Oh, it's ok, it comes right down when I take it." So now I can't certify that you have a reasonable BP, but I can certify that you have poor medical judgement in forgetting your meds. Sigh...

5-Accept that different docs have different rules for forms, in this case, BasicMed. Because it's so heavily weighted along "physician judgement," you can have one exam where the doc might do a cursory eye exam, and a valid DL, and say that's good enough and the other might test your near, far, and color vision very explicitly. And, well, Both technically meet the rule. And, you'll have to go with it. Telling the doc you have a valid DL doesn't get you out of an eye exam if the provider asks you to do one. And, if you can't, for what ever reason, well, what did you expect? Bring your glasses next time...
 
I think what confuses many primary care doctors is the lack of standards, yet the suggested requirements of near and intermediate vision, visual field testing, color vision, ocular motility testing, or lack of stereoscopic vision. My internist barely knows what end of the ophthalmoscope to use. He refuses to perform the exam therefore. I went to a clinic that does DOT physicals only, but they refused due to lack of standards and was outside their routine(drug tests,etc) where they make their living(20-50y/o on no meds) Finally found FP doc who had never seen me before, that just signed the form afteronly using a stethoscope checking my heart/ lungs, after I took him a recent exam from my Ophthalmologist. Give me the physician that hesitates signing such an open ended basic med form, over a “doc” that will sign whatever is put before him.
 
Eldorado said:
I think what confuses many primary care doctors is the lack of standards,
Click to expand...
Best bet is to find a Doc that is also a Pilot. Doesn't matter if they're an AME or not (probably better if they're not). This way they have a clue of what it's like to fly and what you need to see and do. So I would think... hope... it would then be a pretty straight forward and relatively quick exam.
 
frfly172 said:
Such a simple fix,I would go to an eye doctor for a sign off. Never know what the doctor could find,may need an adjustment to your glasses.
Click to expand...
Nice thought, but in some areas it may take a month or more to get an appointment with an eye doctor.
 
Not too many eye docs maintain or want to admit their expertise in rectal or prostate exams.
 
Back
Top