If you are denied a medical, are you denied forever?

[Unregistered]

Hi Guys,

Late 20s wannabe pilot here (since I was very young). Finally have the financial means to do so the way I would want to do it.

Unfortunately, my kidneys have given up the ghost and I'm on Dialysis.

I understand it's technically possible to get a 3rd class while on dialysis, and if I thought I had a good chance of this I would go for it.

While I understand the reasons behind the medical and totally understand that for some dialysis patients, flying would NOT be a good idea, it's frustrating at the same time as I'm individually confident fit as a fiddle to fly.

My question boils down to this: if my chemistries are all under what the FAA may issue for dialysis patients, should I TRY to get a 3rd class, even though I may be denied for some reason? At some point I may get a kidney transplant and be "healthy" again. If I were denied, am I able to re-apply when my situation changes? Would the earlier denial hurt my chances of issuance post-transplant?

Some people may say, "Just go SP!". Unfortunately there are not a lot of good SP rental options in my area (MN).

Thanks for all your help

 

[Brad Z]

Hi Guys,

Late 20s wannabe pilot here (since I was very young). Finally have the financial means to do so the way I would want to do it.

Unfortunately, my kidneys have given up the ghost and I'm on Dialysis.

I understand it's technically possible to get a 3rd class while on dialysis, and if I thought I had a good chance of this I would go for it.

While I understand the reasons behind the medical and totally understand that for some dialysis patients, flying would NOT be a good idea, it's frustrating at the same time as I'm individually confident fit as a fiddle to fly.

My question boils down to this: if my chemistries are all under what the FAA may issue for dialysis patients, should I TRY to get a 3rd class, even though I may be denied for some reason? At some point I may get a kidney transplant and be "healthy" again. If I were denied, am I able to re-apply when my situation changes? Would the earlier denial hurt my chances of issuance post-transplant?

Some people may say, "Just go SP!". Unfortunately there are not a lot of good SP rental options in my area (MN).

Thanks for all your help

You have a very specialized situation and you need to talk to a FAA Medical Certification Expert before sitting for an FAA medical exam. You may wish to initiate conversations with Dr. Bruce Chien, who frequents the boards.

Once you're denied, you're denied LSAs forever, or at least until you are able to provide the necessary documentation to pass at least a third class medical.

 

[jnmeade]

Once you're denied, you're denied LSAs forever, or at least until you are able to provide the necessary documentation to pass at least a third class medical.

Some would contend you can fly gliders, and some gliders look an awful lot like an LSA - maybe even better - but they would be on the bigger money end of aircraft for some.
You might consider buy a Champ or similar cheap and learning to fly and then flying that as LSA - $25K might get one. Use a Subchapter H CFI if you want to apply the hours to a later certificate upgrade.

 

[poadeleted20]

You might consider buy a Champ or similar cheap and learning to fly and then flying that as LSA - $25K might get one. Use a Subchapter H CFI if you want to apply the hours to a later certificate upgrade.

Keep in mind that just because you have a driver's license, you can't necessarily fly as a Sport Pilot even if you've never been deferred/denied for an FAA Medical Certificate. If you have a condition which would disqualify you for that FAA medical, you must be able to obtain agreement with your personal physician that you can safely fly as a Sport Pilot. I'm not sure a physician would buy that for someone on dialysis but you'll have to discuss that with your physician.

That said, many, many pilots who were denied or had medicals revoked later resolved their medical problems and obtained either Special Issuance or even standard FAA medicals. So, denied once is not necessarily denied forever -- it really can be done.

 

[Palmpilot]

...If you have a condition which would disqualify you for that FAA medical, you must be able to obtain agreement with your personal physician that you can safely fly as a Sport Pilot. I'm not sure a physician would buy that for someone on dialysis but you'll have to discuss that with your physician...

Do you have a reference for that? I'm not disputing what you're saying, but I'd like to know where that requirement is, so that I can both read it and cite it if the subject comes up in the future.

 

[bbchien]

Richard, the medical standard for LSA is the community physician's opinion, + the DL, provided the last interaction with FAA wasn't denial, or deferral w/o issunace.. You can write Fred Tilton and ask him. But he is no longer allowed to "publish" it.

To unreg, the FAA will not certify you on dialysis. That will be a denial. There are quite a few after transplant that have medical certificates, however

 

[Capt. Geoffrey Thorpe]

Do you have a reference for that? I'm not disputing what you're saying, but I'd like to know where that requirement is, so that I can both read it and cite it if the subject comes up in the future.

61.303
(b) A person using a U.S. driver's license to meet the requirements of this paragraph must—
(1) Comply with each restriction and limitation imposed by that person's U.S. driver's license and any judicial or administrative order applying to the operation of a motor vehicle;
(2) Have been found eligible for the issuance of at least a third-class airman medical certificate at the time of his or her most recent application (if the person has applied for a medical certificate);
(3) Not have had his or her most recently issued medical certificate (if the person has held a medical certificate) suspended or revoked or most recent Authorization for a Special Issuance of a Medical Certificate withdrawn; and
(4) Not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner.

Also, 61.53

See also http://www.faa.gov/licenses_certificates/medical_certification/sportpilots/

 

[Palmpilot]

Thanks for the info and references!

 

[jasonlee]

I believe, Brad is right, you can only be eligible for flying if fit medically. Other than that you can enjoy paragliding etc.

 

[davyvfr]

Hi Guys,

Late 20s wannabe pilot here (since I was very young). Finally have the financial means to do so the way I would want to do it.

Unfortunately, my kidneys have given up the ghost and I'm on Dialysis.

I understand it's technically possible to get a 3rd class while on dialysis, and if I thought I had a good chance of this I would go for it.

While I understand the reasons behind the medical and totally understand that for some dialysis patients, flying would NOT be a good idea, it's frustrating at the same time as I'm individually confident fit as a fiddle to fly.

My question boils down to this: if my chemistries are all under what the FAA may issue for dialysis patients, should I TRY to get a 3rd class, even though I may be denied for some reason? At some point I may get a kidney transplant and be "healthy" again. If I were denied, am I able to re-apply when my situation changes? Would the earlier denial hurt my chances of issuance post-transplant?

Some people may say, "Just go SP!". Unfortunately there are not a lot of good SP rental options in my area (MN).

Thanks for all your help

Ok, I recommend calling up the FAA in Oklahoma, here is their number: 405-954-4821. They have flight surgeons on hand, and they won't charge you to get advice. Press 2 (I believe, for special issuance since your case will possibly result in this).

Calling up an AME will result in varied answers, but if you do, I recommend bringing as much documentation as possible. Get an official doctors note from your physician detailing the diagnoses, treatment plan, and symptoms. If denied, have your AME write a letter to the FAA. Just don't use people like Pilot Medical Solutions.

Remember though, once you go to get your medical, your AME only has 14 days before he must submit the information to the FAA, even if your test documents are not in your favor. So, it's best to be fully prepared the first time. Also, it's best to get the kidney transplant, and wait until you recover.

This is what the FAA says without transplant:

If the remaining kidney function and anatomy is normal, without other systemic disease, hypertension, uremia, infection of the remaining kidney - Issue a certificate

If you do get a transplant:

Required medical documentation:

1) Hospital admission, operative report and discharge summary
2) Current status report including:
-The etiology of the primary renal disease
-History of hypertension or cardiac dysfunction
-Sequela prior to transplant
-A comment regarding rejection or graft versus host disease (GVHD)
-Immunosuppressive therapy and side effects, if any
-The results of the following laboratory results: CBC, BUN, creatinine, and electrolytes

You may not need a Special Issuance.

 

[NorCalSim]

welp, that pretty much leaves me out. Diabetic with kidney transplant.

 

[davyvfr]

welp, that pretty much leaves me out. Diabetic with kidney transplant.

I would still call FAA in Oklahoma. Also, email 25 or so AME's detailing your condition and ask if your condition is disqualifying, or special issuance. Go to the one that sounds most likely to issue a medical. Keep the same wording on all emails sent to each AME. It's not difficult getting a medical, I know people way off worse than you. So far, 33 people have been issued a medical with a kidney transplant and diabetic. You must have your diabetes under control with medication or insulin.

Get an official note from your doctor, and make sure it's worded how you want. Wording is the BIG thing here, and can make the difference of you getting a medical or not

Also, are you type one or type 2?

 

[poadeleted20]

I would still call FAA in Oklahoma. Also, email 25 or so AME's detailing your condition and ask if your condition is disqualifying, or special issuance. Go to the one that sounds most likely to issue a medical.

Venue shopping isn't a viable tactic. If you don't meet the standards for issuance with a condition like this, finding one AME who doesn't know the rules well enough to deny you on the spot isn't going to help. When the package hits Oklahoma City, it will be rejected there.

 

[Kelvin]

To the OP. You can take this advice if you choose (and ther are good points in this advice) or you can take the advice you will get here, on the AOPA forums and the purpleboard...and that is to talk to Dr. Chien.

From personal experience, I can tell you that if it can be issued, Dr. Chien wll direct you in the path that will lead to success.

Good luck and hope to hear from you in the future holding a PPC!

I would still call FAA in Oklahoma. Also, email 25 or so AME's detailing your condition and ask if your condition is disqualifying, or special issuance. Go to the one that sounds most likely to issue a medical. Keep the same wording on all emails sent to each AME. It's not difficult getting a medical, I know people way off worse than you. So far, 33 people have been issued a medical with a kidney transplant and diabetic. You must have your diabetes under control with medication or insulin.

Get an official note from your doctor, and make sure it's worded how you want. Wording is the BIG thing here, and can make the difference of you getting a medical or not

Also, are you type one or type 2?

 

[bbchien]

Ok, I recommend calling up the FAA in Oklahoma, here is their number: 405-954-4821. They have flight surgeons on hand, and they won't charge you to get advice. Press 2 (I believe, for special issuance since your case will possibly result in this).

Calling up an AME will result in varied answers, but if you do, I recommend bringing as much documentation as possible. Get an official doctors note from your physician detailing the diagnoses, treatment plan, and symptoms. If denied, have your AME write a letter to the FAA. Just don't use people like Pilot Medical Solutions.

Remember though, once you go to get your medical, your AME only has 14 days before he must submit the information to the FAA, even if your test documents are not in your favor. So, it's best to be fully prepared the first time. Also, it's best to get the kidney transplant, and wait until you recover.

This is what the FAA says without transplant:

If the remaining kidney function and anatomy is normal, without other systemic disease, hypertension, uremia, infection of the remaining kidney - Issue a certificate

If you do get a transplant:

Required medical documentation:

1) Hospital admission, operative report and discharge summary
2) Current status report including:
-The etiology of the primary renal disease
-History of hypertension or cardiac dysfunction
-Sequela prior to transplant
-A comment regarding rejection or graft versus host disease (GVHD)
-Immunosuppressive therapy and side effects, if any
-The results of the following laboratory results: CBC, BUN, creatinine, and electrolytes

You may not need a Special Issuance.

I don't know where to begin with you, DavyVFR.

First, if you call FAA you will get a analyst. You will not get to talk to a flight surgeon.

No way can you get a medical certificate, post transplant without a Special Issuance.

The list of requirements is incomplete. Add a current set off liver functions, absence of protein in the urine, you missed a few things that you got off the PMS website, I'd guess.

Persons with Kidney transplants and diabetes CAN be special issued, the list of requirements is quite long but is do-able by an organized conscientious person who is already under both good diabetic and rejection control.

I can tell who is emailing 25 AMEs and I don't mess with them.

 

[cg2112]

(4) Not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner.

Just a quick point - having a condition that would result in denial of medical certification is not the same thing as having a condition that would make a person unable to fly in a safe manner.

 

[F01LA]

Just a quick point - having a condition that would result in denial of medical certification is not the same thing as having a condition that would make a person unable to fly in a safe manner.

Just to have some fun with the LSA paradox... :wink2:

Is it somehow easier to operate an LSA in a safe manner than it is to operate a regular aircraft in a safe manner?

Or is "able to operate an aircraft in a safe manner" not really the standard for a medical certificate?

 

[Capt. Geoffrey Thorpe]

Just to have some fun with the LSA paradox... :wink2:

Is it somehow easier to operate an LSA in a safe manner than it is to operate a regular aircraft in a safe manner?

Or is "able to operate an aircraft in a safe manner" not really the standard for a medical certificate?

What is the standard for a medical certificate? With or without S.I.? With or without a big pile of documentation to prove to the FAA what your family doctor already knows?

Which class of medical? Is it somehow easier to operate an aircraft in a safe manner when you are not getting paid vs. when you are?

Does getting a third class medical mean that you are "able to operate an aircraft in a safe manner"? If not, what is the standard?

 

[poadeleted20]

Just a quick point - having a condition that would result in denial of medical certification is not the same thing as having a condition that would make a person unable to fly in a safe manner.

The Federal Air Surgeon's comment on that point suggests that if you know that you do not qualify for an FAA medical, you are presumed not to be safe to fly as a Sport Pilot unless/until you obtain confirmation to the contrary from your personal physician. Simply saying you think you are safe to fly with, say, epilepsy or a serious cardiac condition without further medical consultation to support your belief is disingenuous, and will not be accepted by the FAA.

Bruce Chien can tell you more about what's going on behind the scenes in the FAA about pilots who let their medicals lapse because they know they'll fail the next one, keep flying as a Sport Pilot despite that condition, and then have a medically-related accident. And yes, those events are happening and being studied, and will be the FAA's primary piece of evidence if the AOPA and EAA keep pushing for approval of pilots to exercise PP privileges with only a DL instead of a Third Class.

 

[poadeleted20]

Is it somehow easier to operate an LSA in a safe manner than it is to operate a regular aircraft in a safe manner?

The difference is that by their limited mass and velocity, LSA's will do less damage to persons and property on the surface if they crash. That's why the FAA set those mass/velocity standards as they are after a great deal of engineering analysis, and why they are willing to accept greater risk with them. However, they are not willing to accept an even greater level of risk by allowing pilots who have good reason to know they cannot from a medical standpoint fly even an LSA safely to exercise Sport Pilot privileges.

Or is "able to operate an aircraft in a safe manner" not really the standard for a medical certificate?

If you read the regulation again, you'll see it says "the aircraft," not "an aircraft." They are speaking about the particular aircraft you will be flying, not any aircraft out there. Given the difference in demands on the pilot and the potential hazards on the ground, you'd be hard pressed to say that there is no difference in the level of fitness necessary to fly LSA's safely versus larger, heavier, faster aircraft. Thus, there is no "paradox" here at all.

 

[Palmpilot]

Or is "able to operate an aircraft in a safe manner" not really the standard for a medical certificate?

I guess that depends on whether you think the FAA is infallible.

Even non-medical people like me recognize that there are conditions that make one unsafe to fly LSA. There are other conditions where it is not so clear cut. For example, for non-commercial flying in relatively slow aircraft, I have a hard time seeing a safety rationale that would require a pilot to have at least 20-40 vision in each eye separately. It seems kind of excessive to me.

 

[poadeleted20]

For example, for non-commercial flying in relatively slow aircraft, I have a hard time seeing a safety rationale that would require a pilot to have at least 20-40 vision in each eye separately.

Maybe you should have your vision checked.

 

[Palmpilot]

Very funny!

 

[ChrisK]

I guess that depends on whether you think the FAA is infallible.

Even non-medical people like me recognize that there are conditions that make one unsafe to fly LSA. There are other conditions where it is not so clear cut. For example, for non-commercial flying in relatively slow aircraft, I have a hard time seeing a safety rationale that would require a pilot to have at least 20-40 vision in each eye separately. It seems kind of excessive to me.

As someone who barely makes 20/40 in his left eye, let me tell you it hurts the flare...

 

[Palmpilot]

As someone who barely makes 20/40 in his left eye, let me tell you it hurts the flare...

For me, it's the right eye, but I haven't had any trouble with the flare.

 

[ChrisK]

For me, it's the right eye, but I haven't had any trouble with the flare.

It is for a stupid reason. With the front of the aircraft in front of me I was freaking out transitioning to using primarily my left eye to track the runway (cessna 152, 37' wide runway). Eventually I figured out it doesn't matter much.