Not on the FAA Medical Form

[Unregistered]

My wife says that I need to see a neurologist and chiropractor for an issue I have with lower back pain. Maybe once a year, the pain is severe enough that I need prescription painkiller. We moved recently, so I don't have a regular MD at the moment and thankfully I haven't had an episode. The last episode sent me to the ER and I was prescribed there.

I injured by an automobile a few years ago but because of my ego I just live with it. I have previously refused because of concern about my medical certificate.

I want to come clean.

 

[Jaybird180]

I'm not an AME and don't even play one on TV but since it's not on the Form and - you did tell the truth, they just didn't ask it shouldn't be an issue, right?

I suppose as long as you don't fly when you're on pain meds.

But you can wait until the experts (like Dr Bruce) comes along with an official answer.

 

[Jaybird180]

....2nd thought, does the FAA medical have a "catch all clause" similar to the function of self-grounding where the FAA makes the decision for you?

 

[gprellwitz]

Yes, there's a catch-all. I think it's '18x'. But take care of your medical issues!

 

[poadeleted20]

My wife says that I need to see a neurologist and chiropractor for an issue I have with lower back pain. Maybe once a year, the pain is severe enough that I need prescription painkiller. We moved recently, so I don't have a regular MD at the moment and thankfully I haven't had an episode. The last episode sent me to the ER and I was prescribed there.

I injured by an automobile a few years ago but because of my ego I just live with it. I have previously refused because of concern about my medical certificate.

I want to come clean.

I'm not sure what the question is here.

Did you fail to report the ER visit and the medication on a medical application since that event? If so, you need legal, not medical advice. You should contact an aviation attorney to represent you with the FAA and negotiate a deal to "come clean" and tell them now what you didn't tell them then in return for an agreement not to exact the usual penalty for falsification (revocation of all FAA certificates).

Or are you asking whether you should do what your wife says and obtain further medical evaluation and, if necessary/appropriate, treatment? If so, then I'd say (in my non-medical professional opinion) if it hurts enough that you need prescription pain meds, you should find out what's wrong and get it fixed. Find an appropriate medical practitioner who can deal with the problem, and once you know all the medical facts, consult an aviation medical examiner for advice on whether you need to ground yourself during treatment. And report all of those visits and any medication you take as a result on your next FAA medical application.

 

[gismo]

Or are you asking whether you should do what your wife says and obtain further medical evaluation and, if necessary/appropriate, treatment? If so, then I'd say (in my non-medical professional opinion) if it hurts enough that you need prescription pain meds, you should find out what's wrong and get it fixed. Find an appropriate medical practitioner who can deal with the problem, and once you know all the medical facts, consult an aviation medical examiner for advice on whether you need to ground yourself during treatment. And report all of those visits and any medication you take as a result on your next FAA medical application.

Definitely worth trying to find out the pain's root cause but IME there are lots of back pain issues that modern medicine can't "fix".

 

[rotorhead1026]

Definitely worth trying to find out the pain's root cause but IME there are lots of back pain issues that modern medicine can't "fix".

Agreed, but mine was fixed very well. Take care of yourself first, then worry about your medical. I recommend seeing no less than a neurosurgeon for an issue like this. No, I'm not a doc, but I've had a spinal fusion with a great result.

One course of action FAA-wise is to leave well enough alone. I'm not a lawyer either, though, and the advice to seek legal counsel is sound. However, a report "out of the blue" that you went and saw a doctor for lower back pain this month would not normally be queried for previous issues. Back pain pops up on its own for many of us, auto accident or no. I personally recommend coming clean, as you say, but this may not be worth stirring up a hornets' nest. See what an attorney thinks. If the scrips were opiates, though, it's all the more serious.

If you had an accident tomorrow and the visit / prescriptions showed up in the course of an investigation, it could be trouble. If you have one five years from now after successful surgery / rehab (all duly reported), this might not be so serious.

It's best to tell the truth the first time, huh?

 

[Jaybird180]

I'm not sure what the question is here.

Did you fail to report the ER visit and the medication on a medical application since that event? If so, you need legal, not medical advice. You should contact an aviation attorney to represent you with the FAA and negotiate a deal to "come clean" and tell them now what you didn't tell them then in return for an agreement not to exact the usual penalty for falsification (revocation of all FAA certificates).

I looked at a medical form and didn't see a box for back issues. How would he have reported?

 

[poadeleted20]

I looked at a medical form and didn't see a box for back issues. How would he have reported?

Box 18x -- "Other illness, disability, or surgery." Also, the ER visit would have to be reported in block 19, and the pain meds in block 17. If the OP failed to report any of that on a previous medical application after the car accident, then if the FAA found out, they would likely deem that application falsified/fraudulent and invoke 61.59.

 

[bbchien]

Actually, that's not how it's been working recently, Ron. The agency is short of even lawyer power as well as doc time.

Nobody wants to make a referral to enforcement, though if it's bad enough they still will. They'd rather clear the case if the guy is certifiable and issue a registered warning.

The unreg. CAN go through an attorney, of course it will be answered by the Transp. IG and maximal threat of revocation of pilot certificates will be laid out.

Or, he can obtain a letter from the guy who write the rxs detailing the amount and period of time over whcih the Rx has been issued. It can say, "patient reported to me that he does not fly during periods of use". And that will be that.

This needs come from the guy's old MD. If he can't get that documentation, then he has no choice but to get the attorney. $2,000 to retain him.....and he's going to have to get that testimony anyway.

Now one more thing that I hope the OP (anon) has enough ego to withstand. You're a dumb_ss. Lying to the federal government is a losing proposition. I have very little sympathy for liars, even though I have been known to help even them. But first you have to convice me that what you're telling me is the whole truth. That means I see the TOTAL medical record and read the whole thing.

He needs to NEVER bend metal or get called by the Tower. That is the point when they pull diagnosis codes and then the pilot certificate is TOAST as well.

Most AMEs are this way as well as their butts are ON THE LINE.

 

[Unregistered]

I am the original poster. I just reviewed my medical application. Here is the full story:

When the original incident occurred I was a non-flyer. I did not get a medical (student pilot) until 1yr and 4 months after. I may be guilty of an inconsistency for checking "no" in block 18x but I listed the Doctor that I saw,the date and that it was for an accident in Block 19. The ER visit was 7 months after I got my medical. I wasn't actively flying at the time of the ER visit and hadn't flown 4 months prior. I was prescribed 10Mg Flexeril and took 29/30 and Percocet and took 7/15. I haven't been to ER since that day. My medical expires 5 years from issue. I thought I did not have to report anything until my next medical. I did not fly again until 7 months after the ER visit and I deemed myself fit to fly.

Living with it means that it does not impede upon my everyday life but I do not lift any heavy objects nor do any horse-play that would cause strain. I don't do many of the things that most men do at my age because I don't want to mess up my back any further.

Occasionally, I get out of bed a little stiff, but it usually is fine about mid-morning. Sometimes, normal man-chores around the house will cause a minor 3-4 day flare up but that is about all. I may take an Advil at night, but nothing more. If I drank alcohol that may help, but I do not drink nor smoke.

 

[poadeleted20]

It's like listening to Paul Harvey -- "And now...


...the rest of the story..."

When the original incident occurred I was a non-flyer. I did not get a medical (student pilot) until 1yr and 4 months after. I may be guilty of an inconsistency for checking "no" in block 18x but I listed the Doctor that I saw,the date and that it was for an accident in Block 19.

So far, so good -- no problems at all.

The ER visit was 7 months after I got my medical. I wasn't actively flying at the time of the ER visit and hadn't flown 4 months prior. I was prescribed 10Mg Flexeril and took 29/30 and Percocet and took 7/15. I haven't been to ER since that day. My medical expires 5 years from issue. I thought I did not have to report anything until my next medical.

You are correct -- no need to report until then.

I did not fly again until 7 months after the ER visit and I deemed myself fit to fly.

Again, doing the right thing.

So far, you've done nothing wrong in the FAA's book. If you keep grounding yourself whenever you take those meds, you are fulfilling your responsibility. In addition, if you go to the neurologist or chiropracter for treatment, and even get meds prescribed, you are still fine without any immediate report of that as long as you ground yourself when needed.

Of course, whenver you go for your next medical and fill out a new application, you'll have to report all those visits and any meds you are taking at the time. But with this additional information, you're right on the straight and narrow with everything you've done until now.

 

[gprellwitz]

Box 18x -- "Other illness, disability, or surgery." Also, the ER visit would have to be reported in block 19, and the pain meds in block 17. If the OP failed to report any of that on a previous medical application after the car accident, then if the FAA found out, they would likely deem that application falsified/fraudulent and invoke 61.59.

It doesn't sound to me as if the meds would be reportable in 17, because (s)he wasn't taking the meds at the time of the application.

And just to confirm with you and Dr. Bruce, (s)he wouldn't need to report the ER visit under 18(u) "Admission to hospital" because an ER visit is not an admission, correct?

 

[Jaybird180]

In medicine, admission is considered overnight.
(a medical professional told me so)

 

[bbchien]

It doesn't sound to me as if the meds would be reportable in 17, because (s)he wasn't taking the meds at the time of the application.

And just to confirm with you and Dr. Bruce, (s)he wouldn't need to report the ER visit under 18(u) "Admission to hospital" because an ER visit is not an admission, correct?

Correct, but it would be reported in that case as a doctor visit and subject to quizzing.

The OP just needs to write the old doc and get the letter. He'll be just fine. No attorney needed if he gets it.

 

[poadeleted20]

One last thing based on two weeks less than 33 years of marriage -- if your wife wants you to visit a neurologist or chiropracter, vist a neurologist or chiropracter. Your back will be in much less pain without your wife's weight on it.

 

[pilot_dude]

Definitely worth trying to find out the pain's root cause but IME there are lots of back pain issues that modern medicine can't "fix".

 

[Jaybird180]

I have a couple questions about this. Firstly, let me apologize to Dr Bruce for volunteering him. I should not have done that and I apologize to you.

Secondly, my question is (taking an opposite view) why does this matter? My DPE explained to me the concept of material omission, and I think that even IF he didn't enter the doctor in Block 19 that it would not be material.

My understanding is that a car accident would not be material enough to disqualify a person from being a (private) pilot, so if he listed it or not it should not matter. It would only matter if someone investigated, but after lawyering up I believe that it would only prove a waste of gov't time and money trying hammer this guy.

And why should he get the letter? The scripts were after he got the medical. The form asks for last 3 years of medical treatment and he's on the 5 year plan.

What I am not getting?

 

[poadeleted20]

Secondly, my question is (taking an opposite view) why does this matter? My DPE explained to me the concept of material omission, and I think that even IF he didn't enter the doctor in Block 19 that it would not be material.

If you read the case law on omissions on medical applications, you'll find that there's no such thing as an omission being immaterial when it comes to Block 19 on medical applications -- either it meets the criteria in the instructions or it doesn't, and if it does, you cannot claim that it wasn't material. Thus, if you went to an ER and were seen by anyone past the admissions clerk, it must be reported for the next three years. Also when the FAA catches one, and the applicant claims the AME said it was OK to leave it out, the AME's testimony is always, "He never told me about it, and I never told him that."

My understanding is that a car accident would not be material enough to disqualify a person from being a (private) pilot, so if he listed it or not it should not matter.

It's not the car accident that's at issue -- it's the ER visit and the injury which led to the visit which must be reported. While the ER visit would not have to be reported more than three years after the visit, the injury is permanently reportable via 18x. In addition, if he's still taking prescription meds periodically, he must have been visiting a health care practitioner more recently to get that scrip renewed, and those visits also must be reported for three years after the visit.

 

[Jaybird180]

If you read the case law on omissions on medical applications, you'll find that there's no such thing as an omission being immaterial when it comes to Block 19 on medical applications -- either it meets the criteria in the instructions or it doesn't, and if it does, you cannot claim that it wasn't material. Thus, if you went to an ER and were seen by anyone past the admissions clerk, it must be reported for the next three years. Also when the FAA catches one, and the applicant claims the AME said it was OK to leave it out, the AME's testimony is always, "He never told me about it, and I never told him that."

It's not the car accident that's at issue -- it's the ER visit and the injury which led to the visit which must be reported. While the ER visit would not have to be reported more than three years after the visit, the injury is permanently reportable via 18x. In addition, if he's still taking prescription meds periodically, he must have been visiting a health care practitioner more recently to get that scrip renewed, and those visits also must be reported for three years after the visit.

I didn't get that from my reading of the post, unless you consider the Advil and his original post saying once a year, but it looks like he intended to make a correction with the timeline.

Why is this overly complicated I've had my own share of woes dealing with Aeromedical, but I digress.

I have previously trifled when reading the stories of those with medical certification issues. This makes me want to gather my medical history and organize it all in one place (like I'd been promising to do - one day).

Off Topic: Does the medical process address Dental issues? Why or why not? Nobody ever talks about that but dental can be just as serious.

 

[poadeleted20]

Off Topic: Does the medical process address Dental issues? Why or why not? Nobody ever talks about that but dental can be just as serious.

Visits to the dentist are not on the FAA's list of reportable visits. Maybe Bruce knows why, but I don't.

 

[bbchien]

It's what's on the MRI at the ER visit that's the Issue (or the CT); or whether the injuries were minor enough not to warrant (in a doctor's judgement, in this case the ER guy).

FAA decides, not the applicant.

As for dental, there are no aeromedical implications unless you have an abscess. In that case, believe me, it'll show up on the medications list.

 

[denverpilot]

I had a dental issue that ended up on my form, indirectly, many years ago...

When the antibiotics they give ya for yanking wisdom teeth kill everything useful off in your intestines and you end up with an ER visit and weeks of Flagyl (sp?) and uhh... Other awful things that go along with infections in intestines...

Yeah, that's gonna end up on a medical form somewhere!

It's not my recommended way to lose 20 lbs either, but you do.

I will very happily never wish to do THAT ever again!

 

[Unregistered]

I did not have an MRI or CT during the ER visit, only prescribed meds. When I spoke with the practicioner who prescribed, he said that in all his experience dealing with pilots, this is the first of such requests that he's had and that the discharge summary usually serves the function of any statement that he would make that the patient was instructed 'not to operate heavy machinery while' taking the medication. Furthermore, the medication is since expired and if I do not upgrade my medical, would be outside the 3 year reporting period anyhow.

I think I was worried for nothing, but at least I feel better about the situation now. If there is something I need to do to cover my 6, please advise.