history of 1 seizure 20 some years ago holding up 3rd class med...

B

Beech33W

Guest
I am looking for help / guidance in appealing and getting my wife Barb’s 3rd class medical approved. According to Barb’s parents (now deceased), when Barb was 17 (she is now 42) she had a "seizure" while helping with the canning in the kitchen during the summer. They took her to the family doctor who indicated she overheated and passed out. There are no records of this event, and the clinic the family used for their routine medical needs has long since closed and we live in another state.

Because of our desire to be completely honest, Barb disclosed the event on her application for her 3rd class medical on 04/22/2008.

When she got in the exam room with the AME, he indicated that she should have left the application item regarding seizures blank and talked to him about it and he could have “worded” it differently so that it would not delay her application. I would have thought if that were an option, then just void the application and do another one treating the first one as a mistake.

The AME indicated he could not approve the 3rd class application, and recommended we select the Neurologist of our choice to perform an independent exam and provide a report that indicates Barb presents no risk of a seizure. The AME further indicated that we needed the results from the Neurologist in the AME’s hands within two weeks so he could submit the application because anything more than that would raise a red flag in the eyes of the FAA Doctors that would be reviewing it.

Remarkably, we were able to schedule a consult with a local Neurologist, scheduled the EEG and MRI he requested, and the final consult to review his findings within the two weeks prescribed by the AME. The Neurologist indicated it was not medically possible to certify that any patient was “at no risk of seizure.” The Neurologist did indicate that it was his professional opinion that the event we called a “seizure” was in fact not a seizure at all, but a syncopatic episode.

Based on some small pinhead sized spots (4 of them) found in the MRI, the Neurologist requested a followup exam in 6 months to 1 year to make sure they are of no medical significance. At this time the Neurologist finds that Barb is normal and presents no symptoms to indicate that she is abnormally susceptible or prone to have a seizure.

The MRI was over read (unofficially but an official overread would be no problem if that would help) by a local Radiologist who indicated that the spots on the MRI are of no medical significance.

We just received a letter from the FAA indicating that Barb’s 3rd class medical was denied and she has 30 days to appeal.

Do you have any recommendations or suggestions on how to get her legal to continue with her lessons? She was about to solo when she went for the exam so you can see how this has seriously impacted her excitement about flying…
 
I'm sorry your wife is having this happen. You should have been referred to a senior AME for only a consult to determine what best path to take on such issues.

Doc Bruce will have the best advice for you. I just hope there's a solution somewhere in all of this without it being a financial burden on top of what you spend to train for a certificate.

While CFIs may think it's none of their business, they could provide a great help to students in such cases. I've begun to ask EVERY student I get (who does not already have a current medical) about past medical issues as well as drug and alcohol use or related judicial matters as a result of drug or alcohol use.

Is it personal? You betcha. But, you can save that student a LOT of heartache by inquiring then having them seek a consult with the doctor PRIOR to completing the Form 8500 for a medical certificate.

I have a student starting this next week with an issue that will have to be dealt with before reaching the AME. Thanks to Doc Bruce, I have some added insight on how to assist this student and cut down on the hassle and heartache not to mention the time that could delay a solo flight.

I have another student who went through his medical application pretty quick by having the appropriate supporting documents from his primary physician.

I have yet another student I took over a couple months ago. He had been waiting for a medical certificate since January. It arrived just last week and he'll finally get to solo next week after returning from his vacation. This should not have been the case.

CFIs can really provide a great service by apologetically delving into the lives of their new students and insuring there won't be a hurdles to that student's progress.
 
This is a classic case of the negative consequences of a lay(wo)man using the wrong word on a medical form. It is indeed regrettable that your wife did not have better advice on this matter before filling out and signing that application -- had she put this down as an explainable fainting episode, there would have been no issue to resolve, and absent an official diagnosis as a "seizure," there would have been no evidence to the contrary. However, the fact is that once you sign it and submit it to the AME, you cannot retract or withdraw it, and an AME who allows you to do so risks loss of his/her AME designation, and anything you said on it becomes part of the record. I strongly suggest doing nothing further until Bruce Chien chips in with his expert advice, but I think a better course of action than trying to prove she isn't epileptic would be to legally modify the original application to reflect a mistake by the applicant rather than an actual medical condition. Whether that's possible at this point is something Dr. Bruce will have to address.
 
Ron Levy said:
had she put this down as an explainable fainting episode, there would have been no issue to resolve,
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Amen to this... I had a syncope in high school, reported same on my first and all subsequent medicals, and there has been no issue.

-Skip
 
This is the classic "fit, or faint" problem. Beech 33W you need to email me from this board, for I have a fix for you......

After you are certified, I will ask you ONE quiz question, and you will get it correct. I'll bet the others here know the answer....it starts off with, "when you have a complex medical which do you do:
(1) Bomb on into the AME office...
(2) Get good advice on how to report what, before you even touch an 8500-8.
(3) Get an EEG (this is a don't be doing this!)
(4) get angry.

Sigh.
 
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bbchien said:
This is the classic "fit, or faint" problem. Beech 33W you need to email me from this board, for I have a fix for you......

After you are certified, I will ask you ONE quiz question, and you will get it correct. I'll bet the others here know the answer....it starts off with, "when you have a complex medical which do you do:
(1) Bomb on into the AME office...
(2) Get good advice on how to report what, before you even touch an 8500-8.
(3) Get an EEG (this is a don't be doing this!)
(4) get angry.

Sigh.
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We need to have CFI's discussing this with Students pre medical.:yes:
 
RE: Emailing Dr. Bruce...

I can't seem to figure out how to either post while signed on, or to e-mail to a user from this forum... I have submitted an e-mail to the webdesigner asking for help in locating the appropriate FAQ which appears to be the tree that I can not see due to the forest blocking my view.

Dr. Bruce, in the mean time - feel free to e-mail me at bob.larimer (at) gmail.com if that will help.

My wife has finally (reluctantly) embraced the idea of appealing the denial and as such she has scheduled a 2nd EEG for next week and an over read of the MRI. The Neurologist indicated that EEGs are progressively more accurate with each one performed. I was unclear on your post but I think you were hinting that we do not need to a (second) EEG. We are prepared to cancel our appointment for next week if needed and follow Dr. Bruce's suggestion to the letter.
 
Beech33W said:
RE: Emailing Dr. Bruce...

I can't seem to figure out how to either post while signed on, or to e-mail to a user from this forum... I have submitted an e-mail to the webdesigner asking for help in locating the appropriate FAQ which appears to be the tree that I can not see due to the forest blocking my view.

Dr. Bruce, in the mean time - feel free to e-mail me at bob.larimer (at) gmail.com if that will help.

My wife has finally (reluctantly) embraced the idea of appealing the denial and as such she has scheduled a 2nd EEG for next week and an over read of the MRI. The Neurologist indicated that EEGs are progressively more accurate with each one performed. I was unclear on your post but I think you were hinting that we do not need to a (second) EEG. We are prepared to cancel our appointment for next week if needed and follow Dr. Bruce's suggestion to the letter.
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To e-mail a member, just left-click on their name next to their post (e.g. "Bruce C") and you should see a menu appear. One of the options is to email the member. Select that and a form will appear in which you can type your e-mail.

Edit: I don't know if this works if you haven't registered an account. If that turns out to be a problem, just register another account and use it only for creating this email, if you're worried about anonymity.

And Dr. Bruce was indicating that you shouldn't have ANY more tests done until you talk with an AME who's familiar and comfortable with something more than rubber-stamp medicals. Find out from that doctor precisely what will be required to go back to the FAA and get them to reconsider their decision, then get that AND ONLY THAT done. Do NOT get any extra tests that the non-AME may suggest, albeit with the best of intentions.

He may also point out that this would have been a whole heck of a lot easier had you done this BEFORE filling in the 8500, but I suspect you've figured that out by now!:yes: Unfortunately, as has been mentioned, this is not something that's taught by the average CFI, though it probably should be. One learns it from the school of hard knocks!
 
Ok, I have created a new account and am able to post from this account. I have sent Dr. Bruce a Private message because I still can't seem to get the "Send email to bbchein" option to work.
 
Just to give you an update:

Dr. Bruce has referred us to a Neurologist that is 'approved' by the FAA and Dr. Bruce indicates that the FAA will generally accept the recommendations of this Neurologist. We have spoken with this Neurologist and have an appointment with him in late July and he has given us hope that this may be a resolvable issue. We are not counting on that yet, but we are somewhat encouraged.

I will keep you (and Dr. Bruce) posted.

Thanks!
 
If anyone can get you through this mess it's Dr. Bruce. Listen and follow his advice to the letter and she will be flying soon.
 
Well, I have potential good news. Barb saw Dr. Hastings (at Dr. Chein's suggestion). Dr. Hastings was quite pleasant and was a breath of fresh air after our previous experience with our first AME and the FAA office in OKC. Dr. Hastings indicated that his assesment of Barb's "Fit or Flight" was that she was fit to fly and he is sending a letter to the FAA recommending they reverse the denial of her medical.

Of course, we still have to wait to hear from the FAA but it sounds promising at this point. We are hopeful his recommendation will convince the powers that be to make the change.

Will keep you posted.
 
Beech33W said:
Well, I have potential good news. Barb saw Dr. Hastings (at Dr. Chein's suggestion). Dr. Hastings was quite pleasant and was a breath of fresh air after our previous experience with our first AME and the FAA office in OKC. Dr. Hastings indicated that his assesment of Barb's "Fit or Flight" was that she was fit to fly and he is sending a letter to the FAA recommending they reverse the denial of her medical.

Of course, we still have to wait to hear from the FAA but it sounds promising at this point. We are hopeful his recommendation will convince the powers that be to make the change.

Will keep you posted.
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Good on you guys. And guess what? They will do what Dr. Hastings recommends. Because, when they send it out for review they will send it out to.....guess who?

"Oh, we see it's from Dr. Hastings........."
Good you make the trip. Sometime the shortest path is not the shortest, the least expensive is not the best value. Gad I wish you had consulted before you applied, but this too will pass :). And SOON.
 
We have news :yes:.

I took my wife to see Dr. Hastings. The Dr. indicated she'd had a faint and not a fit (seizure). He wrote a letter to the FAA and about a week later Barb received her 3rd class medical in the mail without any further ado. There was a lot of happy dancing going on. She is on cloud 9.


Things we have learned in this process:
  • Find an AME that is highly recommended and not just "one I have used once and he was OK.
  • "If you have ANY medical issues you suspect will / may cause you problems, ask the examiner before you fill out your paperwork.
  • If you do not pass your exam DO NOT do anything until you find out for certain if that action will be acceptable / useful in your process.
  • I expect the FAA may have a list of acceptable doctors who they have credentials on file for and accept that they are trained to an acceptable standard. If you submit something from some other doctor they can (will) not take the time to verify said Dr. is an expert so that was done in vain...
  • This forum and the good Dr. Bruce Chein are a great resource!
On another note: I passed my checkride as a private pilot on 8/13/08 - which was also our 20th wedding anniversary. So if there was any doubt as to the saintlyness of the lady I married - she spent the day waiting on me to get done with my oral and checkride and then only got to go for a small scenic flight because we were expecting wx to move in that evening...

Thanks for everything!

Tailwinds to all,

Beech33W
 
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Beech33W said:
We have news.I took my wife to see Dr. Hastings. The Dr. indicated she'd had a faint and not a fit (seizure). He wrote a letter to the FAA and about a week later Barb received her 3rd class medical in the mail without any further ado. There was a lot of happy dancing going on. She is on cloud 9.Things we have learned in this process:Find an AME that is highly recommended and not just "one I have used once and he was OK."If you have ANY medical issues you suspect will / may cause you problems, ask the examiner before you fill out your paperwork.If you do not pass your exam DO NOT do anything until you find out for certain if that action will be acceptable / useful in your process. I expect the FAA may have a list of acceptable doctors who they have credentials on file for and accept that they are trained to an acceptable standard. If you submit something from some other doctor they can (will) not take the time to verify said Dr. is an expert so that was done in vain...This forum and the good Dr. Bruce Chein are a great resource!On another note: I passed my checkride as a private pilot on 8/13/08 - which was also our 20th wedding anniversary. So if there was any doubt as to the saintlyness of the lady I married - she spent the day waiting on me to get done with my oral and checkride and then only got to go for a small scenic flight because we were expecting wx to move in that evening...Thanks for everything!Tailwinds to all,Beech33W
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Sounds like you also passed your Advanced Medical Certification Process Awareness test. Good on you and your wife!!! Enjoy.

-Skip
 
great news!
Congrats to your wife and to you too!
Another mystery of the medical mayhem maze solved with the help of the good. Just don't faint in a fit of joy.
Dr. Watson.... err...Dr. Bruce!
Bravo Zulu Doc!
 
Beech33W said:
We have news.I took my wife to see Dr. Hastings. The Dr. indicated she'd had a faint and not a fit (seizure). He wrote a letter to the FAA and about a week later Barb received her 3rd class medical in the mail without any further ado. There was a lot of happy dancing going on. She is on cloud 9.
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As it should be.... :D
 
Congratulations to you and your wife collectively (for the PPL, the medical, and the anniversary), and a big BZ to Dr. Bruce! Bruce, I hope you realize just how much of an impact you have on peoples' lives here, and how much you and your efforts are appreciated!
 
I see... the fix is in! Doc Bruce is a great fixer-upper for difficult situations.

I'm glad it worked out and she can now get that magic green card! :)
 
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