Does the signoff BASIC-MED physician have the authority to determine what medications are LEGAL to fly under?

timotb said:
This is a Basic-med legal question. Looking for case precedent. Does the basic-med signoff physician have the authority to determine what medications are LEGAL to fly under?
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Clarification:
Take the example of the mostly benign medications, Prozac, an SSRI or an SNRI like Cymbalta. Can a physician issue a Basic-Med sign-off assuming the doctor believes these medications are safe to fly on? Both the pilot and the sign-off physician believe he is fit to fly.

Just looking for opinion.
 
All of the above points to the problem with bureaucrats; they cannot write a clear directive.
 
timotb said:
Clarification:
Take the example of the mostly benign medications, Prozac, an SSRI or an SNRI like Cymbalta. Can a physician issue a Basic-Med sign-off assuming the doctor believes these medications are safe to fly on? Both the pilot and the sign-off physician believe he is fit to fly.

Just looking for opinion.
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When we get into these types of medications we are typically getting into mental health areas excluded from BasicMed until the pilot gets a Special Issuance.

But yes, in theory, a BasicMed physician can issue a sign off when the pilot who has already had and SI uses them. But that doesn’t mean the pilot is legal to fly on any particular day.
 
midlifeflyer said:
When we get into these types of medications we are typically getting into mental health areas excluded from BasicMed until the pilot gets a Special Issuance.

But yes, in theory, a BasicMed physician can issue a sign off when the pilot who has already had and SI uses them. But that doesn’t mean the pilot is legal to fly on any particular day.
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Not necessary. The SI requirements for mental health conditions in 68.9(a)(1) are pretty specific and do not cover all circumstances in which one may be prescribed SSRIs.
 
timotb said:
Clarification:
Take the example of the mostly benign medications, Prozac, an SSRI or an SNRI like Cymbalta. Can a physician issue a Basic-Med sign-off assuming the doctor believes these medications are safe to fly on? Both the pilot and the sign-off physician believe he is fit to fly.

Just looking for opinion.
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Yes.
 
Half Fast said:
Yes.
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Sounds like some people may be trying to justify their taking of "questionable" drugs while flying.
If involved in an accident, I would think one's blood test should come back completely clean of any impairing drugs even though "my doctor that signed off on my MedExpress said it was ok".
The victim's attorneys will love that statement.
 
How many people who post here are from the FAA, AMCD, or are just Feds in some way?
 
N_A_M_E_24 said:
How many people who post here are from the FAA, AMCD, or are just Feds in some way?
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You'd be surprised. Most aren't open about it (BradZ being an exception) and conceal their identity with screen names. For example, Lindberg is really Mike Whitaker IRL. But don't spread it around.
 
N_A_M_E_24 said:
How many people who post here are from the FAA, AMCD, or are just Feds in some way?
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The number, from "some" to "many" doesn't matter. If you have something to say that you don't want the FAA to hear, don't say it here.

Or anywhere else on social media, for that matter.
 
Baked Potato said:
So will the insurance adjuster.
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...and then the doc, is asked, on the stand, "what are your aviation credentials?".
"...and Are you a board certified psychiatrist""

Since the ABFP statement doens't have the word aviation in it anywhere, the guy loses his "expert status" before the court and becomes a simple defendant.
 
Kenny Phillips said:
All of the above points to the problem with bureaucrats; they cannot write a clear directive.
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dbahn said:
Some of 61.53 doesn't apply to Basic Med, notably (a), which applies only to operations that require a medical certificate. Below that (b) applies to Basic Med, since operations require a driver's license. But the standards are different, i.e. one applies to "meeting the requirements of the medical certificate" and the other applies to being able to "operate the aircraft in a safe manner".

There's a big difference between certification and operation, with Part 61 covering certifications and Part 91 covering operations.

§ 61.53 Prohibition on operations during medical deficiency.​


(a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:
(1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or
(2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

(b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

(c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in § 61.23(c), a person must meet the provisions of—
(1) Paragraph (a) of this section if that person holds a medical certificate issued under part 67 of this chapter and does not hold a U.S. driver's license.
(2) Paragraph (b) of this section if that person holds a U.S. driver's license.

On the other hand, 91.17 (c) prohibits operating while using any drug contrary to safety, which includes Benadryl and other over-the-counter drugs as well as opiods, hallucinogenics, and other obvious candidates for that restriction.

§ 91.17 Alcohol or drugs.​


(a) No person may act or attempt to act as a crewmember of a civil aircraft—
(1) Within 8 hours after the consumption of any alcoholic beverage;
(2) While under the influence of alcohol;
(3) While using any drug that affects the person's faculties in any way contrary to safety; or
(4) While having an alcohol concentration of 0.04 or greater in a blood or breath specimen. Alcohol concentration means grams of alcohol per deciliter of blood or grams of alcohol per 210 liters of breath.
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Anyone know if basic med is issued under part 67? This question is more difficult than expected.
 
midlifeflyer said:
We have had out share. DPEs, ASIs, controllers, AMEs. They are all
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Clip4 said:
Finally someone got around to 91.17. I suppose there are some who will argue meds on the prohibited list don’t affect the pilots faculties in any way contrary to safety.
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What if the meds in question are not on the prohibited list?
 
Maybe someone should ask this question to the AOPA medical/legal division.
 
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timotb said:
What if the meds in question are not on the prohibited list?
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What "prohibited list" are you referring to? The FAA publishes a list of "do not issue" drugs for certification purposes, and they test for specific drugs on DOT random testing for specific drugs. But from a certification standpoint, it's case by case.

For operations requiring only a driver's license the determinant is 91.17 (a)3 "While using any drug that affects the person's faculties in any way contrary to safety", and that's followed by:

(d) "Whenever the Administrator has a reasonable basis to believe that a person may have violated paragraph (a)(3) of this section, that person shall, upon request by the Administrator, furnish the Administrator, or authorize any clinic, hospital, doctor, or other person to release to the Administrator, the results of each test taken within 4 hours after acting or attempting to act as a crewmember that indicates the presence of any drugs in the body."
 
timotb said:
Anyone know if basic med is issued under part 67? This question is more difficult than expected.
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Basic Med is implemented by Part 68.

Part 67 is for medical certificates. Part 68 is for operation of certain aircraft without a medical certificate. Basic Med is not a medical certificate; it's an alternative to having one.
 
dbahn said:
What "prohibited list" are you referring to? The FAA publishes a list of "do not issue" drugs for certification purposes, and they test for specific drugs on DOT random testing for specific drugs. But from a certification standpoint, it's case by case.

For operations requiring only a driver's license the determinant is 91.17 (a)3 "While using any drug that affects the person's faculties in any way contrary to safety", and that's followed by:

(d) "Whenever the Administrator has a reasonable basis to believe that a person may have violated paragraph (a)(3) of this section, that person shall, upon request by the Administrator, furnish the Administrator, or authorize any clinic, hospital, doctor, or other person to release to the Administrator, the results of each test taken within 4 hours after acting or attempting to act as a crewmember that indicates the presence of any drugs in the body."
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The FAA also publishes a "do not fly" list
 
61.53(b) requires those of us without an FAA medical certificate to not fly when there is a medical condition that interferes with our ability to fly safely.
61.53(a) only requires that those of you with a certificate be able to meet the requirements for that certificate and do not require you to be able to fly safely.
 
Capt. Geoffrey Thorpe said:
61.53(b) requires those of us without an FAA medical certificate to not fly when there is a medical condition that interferes with our ability to fly safely.
61.53(a) only requires that those of you with a certificate be able to meet the requirements for that certificate and do not require you to be able to fly safely.
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Not exactly. Having a medical certificate does not require you to operate with it. You can hold a medical certificate and still operate under Basic Med. It's an important distinction and a good reason for many pilots to have both.

For example, you are newly diagnosed with cancer, kidney disease, sleep apnea, or many other medical conditions. Without certain documentation you can not meet the requirements for a medical certificate. If you also have Basic Med you may be able to operate under Basic Med after you leave the doctor's office without any further action until your next medical (if you choose to continue that route).
 
dbahn said:
For example, you are newly diagnosed with cancer, kidney disease, sleep apnea, or many other conditions. Without certain documentation you can not meet the requirements for a medical certificate. If you also have Basic Med you can operate under Basic Med after you leave the doctor's office without any further action until your next medical (if you choose to continue that route).
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:yeahthat:

When I got my SI Class 3, Bruce advised me to get Basic immediately, which I did. The easiest time for a physician to approve you for Basic Med is while the FAA ink is still wet on an FAA document giving you medical approval to fly.

And it's a good thing I did that, because a couple of months later I was diagnosed with a kidney stone while I was training to upgrade my Sport ticket to Private. No problem, I only flew with my instructor until the stones were handled and I had recovered. Once the doc gave me the all clear, I resumed flying under Basic Med and never had to deal with OKC about the matter at all.
 
Half Fast said:
:yeahthat:

When I got my SI Class 3, Bruce advised me to get Basic immediately, which I did. The easiest time for a physician to approve you for Basic Med is while the FAA ink is still wet on an FAA document giving you medical approval to fly.

And it's a good thing I did that, because a couple of months later I was diagnosed with a kidney stone while I was training to upgrade my Sport ticket to Private. No problem, I only flew with my instructor until the stones were handled and I had recovered. Once the doc gave me the all clear, I resumed flying under Basic Med and never had to deal with OKC about the matter at all.
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What happens under BasicMed if someone develops another stone?
 
Skyrys62 said:
What happens under BasicMed if someone develops another stone?
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It's not one of the Big Three issues that require an airman on Basic Med to get an SI. Whether the pilot is safe to fly, and what treatment would be necessary to make him so, is between the physician and the pilot. No OKC involvement.
 
Half Fast said:
It's not one of the Big Three issues that require an airman on Basic Med to get an SI. Whether the pilot is safe to fly, and what treatment would be necessary to make him so, is between the physician and the pilot. No OKC involvement.
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Thanks..
My friend will be happy to hear that.
 
Skyrys62 said:
What happens under BasicMed if someone develops another stone?
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The PIC determines for every flight if he can operate safely. That includes a risk assessment of (1) the likelihood of another event and (2) an assesment of that pilot's ability to safely operate should that event occur.

Note that there are lots of pilots currently flying with a medical certificate issued after a history of kidney stones. The determination of safety has been made by the FAA based on certification standards. Under Basic Med that determination is made by the pilot. In the event of an adverse occurence, compliance with 16.53 would likely be determined on a case-by-case basis by a judge and depend on the specific conditions, including the fact that a physician attested to the degree of safety.
 
dbahn said:
Under Basic Med that determination is made by the pilot. In the event of an adverse occurence, compliance with 16.53 would likely be determined on a case-by-case basis by a judge and would depend on the specific conditions.
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Quite true. AFAIK, there's no case history yet. If the pilot had documented approval from his physician and was in compliance with Basic Med, though, I think it would go a long way to bolstering his case that to the best of his knowledge he was safe to fly.
 
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