Issues with the online medical application

gismo

gismo

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This was posted on another forum:

Anyone out there that has taken your flight med exam in last few weeks? Took mine today.. I use an eye drop 2 times daily for macular degeneration. When I logged on and filled out the form 8500-8 MedXPress form I answered it truthfully as you should and I entered on the medication question that i use a .25 Timilol eye drop. This seemed to throw a complete monkey wrench into everything. Now I have to schedule a eye exam and get a form I have never heard of filled out from my Optmologist and get it back to the examiner in 13 days or my exam will be deferred to FAA doctor and can take up to 4 months to get my medical card. Now this won't hurt me because I fly for pleasure and not for a living.. You guys that fly for a living and take any type medication you may be faced with huge delays and expense to get your medical. I hold a class 3 no telling what you class 1 guys will be faced with. Just heads up. Don't wait too late to get it started
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I'm wondering if anyone else is having similar problems and/or if this kind of thing is "normal". I was under the impression that using the online application was just a move to reduce paperwork but it sounds like there's more to it than that.
 
I don't see anything new here. He was on a medication that is associated with glaucoma. He would undoubtedly need that exam whether he had filed electronically or via paper. If he had an expert AME like Dr. Bruce, they would have discussed everything before the AME took possession of the electronic file or the airman laid a hand on the paper 8500-8, and he would have had more time.
In its ophthalmic form (brand names Timoptol in Italy; Timoptic), it is used to treat open-angle and occasionally secondary glaucoma by reducing aqueous humour production through blockage of the beta receptors on the ciliary epithelium. The pharmacological mechanism by which it actually does this is still unknown. First beta-blocker approved for topical use in treatment of glaucoma in the USA (1978). With monotherapy, depresses IOP 18-34% below baseline within first few treatments. However, there are short-term escape and long-term drift effects in some patients. That is, tolerance develops. May reduce extent of diurnal IOP curve up to 50%. IOP higher during sleep. 5-10x more potent beta-blocker than propranolol. Light sensitive; preserved with 0.01% benzalkonium Cl (and also comes BAC free). Can also be used in adjunctive therapy with pilocarpine or CAIs.
Side effects

The most serious possible side effects include cardiac arrhythmias and severe bronchospasms. Timolol can also lead to fainting, congestive heart failure, depression, confusion, worsening of Raynaud's syndrome and impotence.
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gprellwitz said:
I don't see anything new here. He was on a medication that is associated with glaucoma. He would undoubtedly need that exam whether he had filed electronically or via paper. If he had an expert AME like Dr. Bruce, they would have discussed everything before the AME took possession of the electronic file or the airman laid a hand on the paper 8500-8, and he would have had more time.
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I'm not questioning the need for an eye exam etc. but I was surprised that the need for this gets triggered by filling out the form (vs visiting an AME). I don't know any more details but it's possible that the condition (macular degeneration) was "previously reported" and unchanged since the last medical.
 
It sounds to me like this story is somewhat compacted and leaves out several steps in the process which must have occurred in addition to what the poster said. What I'm seeing is that the poster is talking about his medical having been deferred for more information because of a medication he said he was using, and that has nothing to do with the MedXpress on-line application process. The real lesson learned is to do your homework and make sure that if you have any sort of condition or are taking any sort of medication which may result in deferral, you show up for the exam with the necessary paperwork already done to hand to the AME so your medical is approved, not deferred.
 
As Ron said, I think that the airman went to the AME and the AME took control of the file. That's the same as the airman putting pen to the form. It must either ultimately be approved or denied. The deferral was done by the AME and gives the airman time (though maybe not adequate time) to get the requisite paperwork and tests together.
 
Lance go back on that forum and tell them, that although the FAA considers that when a AME downloads the MedXpress into his FAA inbox, the FAA considers the form "signed", the AME still has discretion to delete it.

I am instructing all my airmen to "save work as "PDF" on the page after SUBMIT, adn then Email the pdf to me. I never download the file until I have reviewed all the "whereas's and but fors", and have all the documentation. Then I download it and we're live.

Any AME should be smart enough to do it in a non-jeopardy producing way. You just need some smarts.

Thus I conclude: the guy with the glaucoma meds-->has the wrong AME. You have to have a relationship over time with your AME so you can call him when you.....are offered drops, for example. And he'll give you the skinny:

8500-7, Humphrey Visual fields, statement of stability.....
 
bbchien said:
Lance go back on that forum and tell them, that although the FAA considers that when a AME downloads the MedXpress into his FAA inbox, the FAA considers the form "signed", the AME still has discretion to delete it.

I am instructing all my airmen to "save work as "PDF" on the page after SUBMIT, adn then Email the pdf to me. I never download the file until I have reviewed all the "whereas's and but fors", and have all the documentation. Then I download it and we're live.

Any AME should be smart enough to do it in a non-jeopardy producing way. You just need some smarts.

Thus I conclude: the guy with the glaucoma meds-->has the wrong AME. You have to have a relationship over time with your AME so you can call him when you.....are offered drops, for example. And he'll give you the skinny:

8500-7, Humphrey Visual fields, statement of stability.....
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Thanks Bruce, that's what I was looking for (how to work with the form on my next medical).
 
Bruce, what is the advantage to using Med Express? It only takes a few minutes to fill out the paper one in the office...
 
Henning said:
Bruce, what is the advantage to using Med Express? It only takes a few minutes to fill out the paper one in the office...
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Paper forms are going away and MedXpress will be the only way to go.

Pilot participation in MedXPress is currently voluntary; however, as was recently announced by the Federal Air Surgeon (PDF), the use of MedXPress is mandatory beginning October 1, 2012.
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http://www.faa.gov/other_visit/avia...elegations/designee_types/ame/amcs/medxpress/

I didn't have any problems with it.
 
  • Henning said:
    Bruce, what is the advantage to using Med Express? It only takes a few minutes to fill out the paper one in the office...
    Click to expand...
The advantage to the AGENCY: more elements of the history are availalbe to the AME, meaning we get held to more data. For example, an A/M I issued today, had fogotten about his past Prozac use. He HAS to check 18M yes (as he had once before), or the issuance falls out. But I could see that even though he forgot. Yesterday I was able to get his "letter of eligibility" for that condition.

The advantage to the AME, if we can teach airmen to send the onetime pdf file OUTSIDE the AME download system, is we can see the application ahead of time and from a distance, and put out problems prior to the day-of. The trick is saving the pdf just after the "submit" screen, it's one time only. If the AME chooses not to download the official file, it turns to dust in 60 days.

The advantage to the AIRMAN: he can sit with his humana screen on one monitor, medXpress on the other and fill that long history in.

But the real advantage is that the agency can get rid of the last FTEs devoted to digitization of AME work.
 
So for guys like me I'm better off walking in and filling out the form. Typical, when I did my MES ride it had to be done on an 8710 instead of IACRA.
 
My AME wanted me to switch a year or so ago. Saves him the trouble of re-entering the information in the system. I was using AOPA's Turbo Medical prior to that.
 
A few moments ago MedXpress saved a charter captain from a deferral.....he'll send the pathology from his squamous cell carcinoma (said to have clear margins) on Tues for Wednesday issuance. I still haven't officially downloaded his pdf though I am looking at it.
 
bbchien said:
A few moments ago MedXpress saved a charter captain from a deferral.....he'll send the pathology from his squamous cell carcinoma (said to have clear margins) on Tues for Wednesday issuance. I still haven't officially downloaded his pdf though I am looking at it.
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So with the right AME it's actually got some benefit to pilots, eh?
 
gismo said:
So with the right AME it's actually got some benefit to pilots, eh?
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Following the thread, that's what I'm thinking. With the emphasis on "the right AME".

Bruce, For you to download, we still need to provide you with a particular code number to find it in the system, correct? You're not able to find/download just by name?

What I'm aiming at is, the saavy airmen learning about the PDF's might have some insulation by being able to fax or email over the PDF for consultation without the AME causing a problem by downloading ahead of time (and thus starting a problem chain).
 
AggieMike88 said:
Following the thread, that's what I'm thinking. With the emphasis on "the right AME".

Bruce, For you to download, we still need to provide you with a particular code number to find it in the system, correct? You're not able to find/download just by name?
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That is correct. However, if you really wanted to push it, the AGENCY upon request can do that...but they don't.
What I'm aiming at is, the saavy airmen learning about the PDF's might have some insulation by being able to fax or email over the PDF for consultation without the AME causing a problem by downloading ahead of time (and thus starting a problem chain).
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Well, even if it gets downloaded by the AME ahead of time, he can still destroy it. We won that option some time ago.

However, it really boils down to the saavy of the AME. Non-downlaoded MEdXpresses turn to dust in 60 days.
 
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