FAA want's more info regarding my ankylosing spondylitis

A

AS patient

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I applied for a class 3 medical and it was deferred to due to my ankylosing spondylitis, the AME informed me I would need to get a letter from my rheumatologist stating my medication and range of motion which I did and their office faxed it to FAA. After about 3 months I got a letter requesting more information, it reads as follows.

Due to your history with ankylosing spondylitis treated with the medication Remicade, you must provide the following information for the Aerospace Medical Certification Division's review.

A current history and clinical examination from your treating rheumatologist regarding your history with ankylosing spondylitis treated with the medication Remicade. The report should address any history of past complications and symptoms, diagnosis, current treatment plan, all current medications, relevant laboratory testing , future treatment plan and prognosis and the results of any current testing deemed appropriate.

Include a statement regarding your motor strength, cervical range of motion, and any resulting functional limitations.

When my rheumatologist wrote me the first letter it was pretty brief and she told me she had never written a letter for the FAA before (also never had an AS patient so ambitious as to want to learn to fly). My question is what exactly do they need from her? When they refer to "relevant laboratory testing" how far back into my history should I submit lab results? I have been with the same rheumatologist since 2006 and stable with my current medication for almost a decade. The only other medication I take is for blood pressure which I reported and doesn't appear to be an issue. I am just concerned about my Dr not getting the letter right and having to wait another 3 months only to get another letter from FAA wanting additional information.
 
AS patient said:
FAA letter reads as follows.

Due to your history with ankylosing spondylitis treated with the medication Remicade, you must provide the following information for the Aerospace Medical Certification Division's review.

A current history and clinical examination from your treating rheumatologist regarding your history with ankylosing spondylitis treated with the medication Remicade. The report should address any history of past complications and symptoms, diagnosis, current treatment plan, all current medications, relevant laboratory testing , future treatment plan and prognosis and the results of any current testing deemed appropriate. Include a statement regarding your motor strength, cervical range of motion, and any resulting functional limitations.

When my rheumatologist wrote me the first letter it was pretty brief and she told me she had never written a letter for the FAA before (also never had an AS patient so ambitious as to want to learn to fly).
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your doctor just needs guidance ... just take the above to her. Most doctors appreciate the guidance.
 
With the biologics it is vitally important for the rhumatologist to say, "no side effects or complications of remicade reported. Make sure she describes your LACK of limitations to climbing sitting, getting out of a chair and your longitudinal stability over time (state period). Basically FAA want to know that you can preflight, ingress, egress and push rudder pedals which in the doc's view is:

Climbs stairs
descends stairs
Can get in and out of a small vehicle
Good leg strength
Normal gait

Bruce :)
 
Thanks so much, I will relay this info when I see her next week. In regards to lab tests, how far back do I need to submit? Most recent blood tests or more?
 
AS patient said:
I applied for a class 3 medical and it was deferred to due to my ankylosing spondylitis, the AME informed me I would need to get a letter from my rheumatologist stating my medication and range of motion which I did and their office faxed it to FAA. After about 3 months I got a letter requesting more information, it reads as follows.

Due to your history with ankylosing spondylitis treated with the medication Remicade, you must provide the following information for the Aerospace Medical Certification Division's review.

A current history and clinical examination from your treating rheumatologist regarding your history with ankylosing spondylitis treated with the medication Remicade. The report should address any history of past complications and symptoms, diagnosis, current treatment plan, all current medications, relevant laboratory testing , future treatment plan and prognosis and the results of any current testing deemed appropriate.

Include a statement regarding your motor strength, cervical range of motion, and any resulting functional limitations.

When my rheumatologist wrote me the first letter it was pretty brief and she told me she had never written a letter for the FAA before (also never had an AS patient so ambitious as to want to learn to fly). My question is what exactly do they need from her? When they refer to "relevant laboratory testing" how far back into my history should I submit lab results? I have been with the same rheumatologist since 2006 and stable with my current medication for almost a decade. The only other medication I take is for blood pressure which I reported and doesn't appear to be an issue. I am just concerned about my Dr not getting the letter right and having to wait another 3 months only to get another letter from FAA wanting additional information.
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Ya gotta treat it like a written test in essay question format. And, use lots of appropriate jargon.

I took my Orthopedic Surgeon's chart notes and wrote the letter for him, supplying a detailed answer to each item of additional info requested in the FAA's letter. It worked like a charm.
 
AS patient said:
Thanks so much, I will relay this info when I see her next week. In regards to lab tests, how far back do I need to submit? Most recent blood tests or more?
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not unless FAA asks. unlikely.
 
wilkersk said:
Ya gotta treat it like a written test in essay question format. And, use lots of appropriate jargon.

I took my Orthopedic Surgeon's chart notes and wrote the letter for him, supplying a detailed answer to each item of additional info requested in the FAA's letter. It worked like a charm.
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lol ... that works too!
 
wilkersk said:
Ya gotta treat it like a written test in essay question format. And, use lots of appropriate jargon.

I took my Orthopedic Surgeon's chart notes and wrote the letter for him, supplying a detailed answer to each item of additional info requested in the FAA's letter. It worked like a charm.
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You wrote your own letter? Did you discuss it with your Dr and have him sign it? Doesn't really seem like a legit thing to do unless maybe I could write a draft and have the Dr retype and sign.
 
AS patient said:
You wrote your own letter? Did you discuss it with your Dr and have him sign it? Doesn't really seem like a legit thing to do unless maybe I could write a draft and have the Dr retype and sign.
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My orthopedic surgeon works his butt off and doesn't have time to write letters. He is either in surgery, or seeing patients in clinic. And, usually ends up trying to eat something while dictating and writing orders. I wouldn't want his job.

I wrote the letter, printed it out complete with address headers and took it to him. I showed him how my letter followed the same order as the FAA's request for further info. And, how it just simply restated what he had dictated to his chart notes. He signed it, then used his rubber stamp and gave me one of his office's business envelopes to mail it back in.

Word of caution: I've worked in the medical field for the last 14 years. And before that, I was career military with lots of report writing experience. If your writing skills aren't there, you might try asking someone who's are.
 
wilkersk said:
My orthopedic surgeon works his butt off and doesn't have time to write letters. He is either in surgery, or seeing patients in clinic. And, usually ends up trying to eat something while dictating and writing orders. I wouldn't want his job.

I wrote the letter, printed it out complete with address headers and took it to him. I showed him how my letter followed the same order as the FAA's request for further info. And, how it just simply restated what he had dictated to his chart notes. He signed it, then used his rubber stamp and gave me one of his office's business envelopes to mail it back in.

Word of caution: I've worked in the medical field for the last 14 years. And before that, I was career military with lots of report writing experience. If your writing skills aren't there, you might try asking someone who's are.
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I write ‘em all the time, tell a/m to take to receptionist, place face down on copier with practices’ letterhead in the feed bin. Press “copy”. Present to doc. Everyones’ happy.
 
bbchien said:
I write ‘em all the time, tell a/m to take to receptionist, place face down on copier with practices’ letterhead in the feed bin. Press “copy”. Present to doc. Everyones’ happy.
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There you go OP, the man himself has offered to help. I'd take him up on it!
 
Thanks for all the replies, much useful info to share with my doc on Friday. I was just reviewing the original letter she wrote for me and it states "he has limited range of motion of his neck without any pain". I'm sure this is something FAA want's some elaboration on, the only thing I see in my records is an occiput to wall measurement which seems pretty consistent over the years at about 15cm. Would this be disqualifying or are there any other neck tests be appropriate to mention when I see her?
 
Finally got the second letter from my Dr. and it does not appear to answer what FAA is asking, getting close to the deadline to have this submitted. Do I submit it and wait for another letter from FAA requesting more info? What happens if I go past the deadline, will they just deny? Can I reapply once I have the requested documentation? I should add here that it is one of the nurse practitioners at my rheumatologist's office that has written the previous two letters, wasn't able to get in with my actual rheumatologist before the deadline.
 
write them and ask for an extension. they will give you another 60 days. Do not miss deadlines.
 
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AS Patient said:
Finally got the second letter from my Dr. and it does not appear to answer what FAA is asking, getting close to the deadline to have this submitted. Do I submit it and wait for another letter from FAA requesting more info? What happens if I go past the deadline, will they just deny? Can I reapply once I have the requested documentation? I should add here that it is one of the nurse practitioners at my rheumatologist's office that has written the previous two letters, wasn't able to get in with my actual rheumatologist before the deadline.
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Special cases like this are when retaining the services of someone like lbfjrmd or Dr Bruce makes sense. They know the system, know what the FAA wants to hear, and can either coach you or directly coach the doctor in what is needed.
 
Well I haven't got anything in the mail yet but I just checked the airman registry and my medical status has been updated,
Medical Class: Third Medical Date: 10/2017
NOT VALID FOR ANY CLASS AFTER. (CONTACT AAM-300 405-954-4821 FOR DATE)
MUST WEAR CORRECTIVE LENSES.
I presume this means I should be getting good news in the mail soon?
 
Call 405-954-4821 in the AM and have them fax the authorization and the certificate to you, and then go fly :)
 
Finally called FAA to see if they would fax it over, I was told they are still working on it and I should hear something soon. Why would it show up on the registry if it's still in process?
 
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