Now What? (very long, sorry)

I

In Cog Nito

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Okay! I posted before under "Deferred to faa" here: https://www.pilotsofamerica.com/community/threads/deferred-to-faa.119897/
And I don't like to start another thread but now the real difficult part begins and I have questions.

I received a letter from Office of Aerospace Medicine with requests for more information based on my MedXPress application taken to my AME. ( got this response sooner than I thought I would!)

The FAA is requesting the following (the problems are listed after each in bold).

1. Due to your Obstructive Sleep Apnea (OSA) treated with Continuous Positive Airway Pressure (CPAP), submit all the information as outlined on the enclosed Obstructive Sleep Apnea Specification Sheet.

No Problem here, I can get the original report sent to my regular "treating physician" as the sleep study was done within the last several years. And no problem getting the items requested under the OSA spec sheet.

2. Due to your Motor Vehicle Accident; submit all these specific hospital records as outlined: history and physical, admission summary, discharge summary, operative/procedure report (s), pathology report(s), and the interpretive report (s) of all diagnostic imaging (CT Scan, MRI, x-ray, etc...) performed.

This motorcycle accident occurred in 1986, I was laid up recovering for 2 years (10 surgeries) to 1988 +- 6months (I re-fractured (stress fracture) and had some difficulties with the brace that caused a bursa to inflame). I was able to return to my same job, in a factory, doing exactly what I had done before. The records are no longer available as the statute for the state that this occurred in is 7 years for clinic and 10 years for hospital. I have NO metal in my leg, no prosthetic and walk with a limp as the leg is about 2 inches shorter than the other, and I don't wear a lift. But have been doing just fine for what 34 years? AND, I HAD a 3rd class WITH THE SAME CONDITION>

3. A detailed current orthopedic evaluation from your treating physician regarding your Leg and Shoulder conditions. The report must address history, symptoms, diagnosis, treatment plan, current medications (name, dosage and frequency of use), and prognosis. Specific mention must be made regarding your range of motion, mobility, strength, and any functional limitations that would preclude you from safely operating an aircraft.

I had rotator cuff surgeries on both shoulders due to work injuries, the last of which was in 2006, (Back in my home state, so no records available due to statute) there's some residual soreness on rare occasion, ROM is very good, strength is pretty normal for a 64 year old. Treating Physician should be able to determine this, and provide necessary eval.

4. Due to your Asthma and use of medication, submit a current status report from your treating physician regarding your history of asthma that addresses history, dates of treatment (including exacerbations leading to hospitalization) over the past 12 months, treatment plan, current medications (dosage, frequency of use, and side effects), and prognosis.

Mild Asthma per pulmonologist in this state, use an emergency inhaler on rare occasion. no other inhalers.

5. A current pulmonary function test (PFT).

What is "current"? I've been here for nearly 5 years, had the PFT at request of my "Treating Physician" maybe 3 years ago, no change in prognosis or symptomology.

Again, I apologize for the length. I wanted to be thorough. Since the accident (leg)I have built my own home, and even after the rotator cuff surgeries, I continued my normal job at the plant before I retired. I will fly again...

One additional factoid: I had all the records and would still, except for one thing... My house was lost in a fire (total loss) in 1998.
 
To answer your initial question. "Now what?" Knowing the FAA, prepare to spend a bunch of money proving you are healthy.
 
To answer your initial question. "Now what?" Knowing the FAA, prepare to spend a bunch of money proving you are healthy.

Yeah, well... I thought I'd wait longer than I did for the letter... And I think all of this is "doable" without spending lots of money... But wondering about the records that no longer exist. And what to do about them... Probably just tell the FAA that they are no longer available and provide everything else from my "Treating Physician."

Not everything in flying requires mega AMUs. And, it shouldn't.
 
So, I've gotten the CPAP records sent from the sleep doc to my "treating physician" I'll wait a week, schedule with treating physician and they can do a PFT at that office.

I guess I'll just include a letter regarding the unavailability of records from original accident with the Ortho assessment from the treating physician.

Does anyone think there's anything else I can do?
 
No interest in light sport, hang gliders, or gyrocopters... Else I wouldn't have bothered with AME, 3rd class.

I like flying friends and family. More than 2up.

I love flying. I've had 2 lapses in currency. This being my second.

I will fly again. As PIC in a 4 seat aircraft.

Thanks for all the responses... Together, we'll figure it out and get to the goal.
 
It's good to have goals... There are a couple of AMEs on here that might step in to help... They specialize in troublesome medicals... Look them up or... Maybe they'll chime in
 
Best thing I can suggest is contact one of the senior AMEs for a consult on how to deal with the unavailability of old records. Obviously they're going to want something, probably a current evaluation of the condition.
 
Best thing I can suggest is contact one of the senior AMEs for a consult on how to deal with the unavailability of old records. Obviously they're going to want something, probably a current evaluation of the condition.

That was asked for in #3 from the FAA...
"3. A detailed current orthopedic evaluation from your treating physician regarding your Leg and Shoulder conditions. The report must address history, symptoms, diagnosis, treatment plan, current medications (name, dosage and frequency of use), and prognosis. Specific mention must be made regarding your range of motion, mobility, strength, and any functional limitations that would preclude you from safely operating an aircraft."

I can do that if treating physician is my current MD.

And, as stated quote that the statute in my previous state is expired...​
 
That was asked for in #3 from the FAA...
"3. A detailed current orthopedic evaluation from your treating physician regarding your Leg and Shoulder conditions. The report must address history, symptoms, diagnosis, treatment plan, current medications (name, dosage and frequency of use), and prognosis. Specific mention must be made regarding your range of motion, mobility, strength, and any functional limitations that would preclude you from safely operating an aircraft."

I can do that if treating physician is my current MD.

And, as stated quote that the statute in my previous state is expired...​
What the FAA asked for pretty much spells out what they want in a status letter from the doctor who is treating you. If that is your current primary care physician, then have him perform the examination and write the letter.

In addition to working with a Senior AME who is well versed and experienced with challenging cases, be sure to take the letter written by the "treating physician" and show it to him/her for review. The questions are,
  • Does what was written satisfy what the FAA asked for?
  • Was there anything left out?
  • Was anything unneeded added in that will cause new different alarm bells to go off?
  • Is the wording straight forward and "low level reviewer minion" simple or did someone swallow a medical thesaurus?

If the Senior AME says there are some issues with the letter, then the consultation gives you the chance to go back to the doctor and fix it... without the nutty long wait period if you had blindly sent it to OKC.

If the Senior AME says the letter is good, then make sure to put a sticker in the upper right hand corner of each page with your birthdate, and all numbers that identify you to the FAA Medical Division (see the letter you got from them for that). Photocopy it. Then send it to OKC via Certified Mail, Return Receipt Requested (the green postcard). This provides tracking that they got it as well as when they got it.
 
Best thing I can suggest is contact one of the senior AMEs for a consult on how to deal with the unavailability of old records. Obviously they're going to want something, probably a current evaluation of the condition.
Agree in essence - my only comment is that as I understand it, a Senior AME only means that the AME is authorized to issue a 1st class med cert. Plenty of senior AMEs are not good choices for an airman with a difficult medical. My first AME was a senior AME, and he was also a Dr. Dee-Furr-All who deferred me for something the FAA never commented on (though they wanted a mountain of documentation for a different issue he didn't even mention). The OP wants a Difficult Case AME - who is likely a Senior AME as well, but the Senior part is not what you are looking for, you want someone who has experience with problem medicals and is willing to go the extra mile (which might be for an extra fee, but it is well worth it).
 
Wish me luck, say a prayer, whatever. I go to my "treating physician" today. To have her prepare all the necessaries for Uncle Sam.

Then, I'll send it all off.
 
Wish me luck, say a prayer, whatever. I go to my "treating physician" today. To have her prepare all the necessaries for Uncle Sam.

Then, I'll send it all off.

If you are not running this through a senior AME who specializes in difficult cases, and trying to answer the FAA queries yourself by going to the treating physician, I suspect this could cause more iterations with the FAA and delay.

The advantage of such an AME is that they know what is needed for each query and will work to make sure it is all correct the first time.
 
If you are not running this through a senior AME who specializes in difficult cases, and trying to answer the FAA queries yourself by going to the treating physician, I suspect this could cause more iterations with the FAA and delay.

The advantage of such an AME is that they know what is needed for each query and will work to make sure it is all correct the first time.


All true, but I'll elaborate just a bit. There is often very specific language and wording that the FAA is looking for. When I was doing my class 3 last year, Dr. Bruce provided template letters for some of my physicians to ensure that their letters said exactly what the FAA wanted.

As Peter suggests, it would be a good idea to have an AME at least review the responses before submittal. A misstatement might cause delays, and at worst it might even result in an unnecessary denial.
 
I GOT IT!

Checked the airman's database every day now for a month... Today, it changed!

Now, under medical info, 3rd class is listed with the exception of needing glasses for distance, and reading...

Proof, that not-too-complex medicals can be obtained by the average Joe, doing what FAA requests to best of ability, without Mega $AMU outlays.

That said, if you're medical is expired, and you're too far out to do Basic Med: Do a consultation with a GOOD AME before doing the online submission.
 
Under MY name, after the fact that I opted out of disclosing my address....

Medical Class: Third Medical Date: 7/2019
NOT VALID FOR ANY CLASS AFTER 07/31/2020.
MUST WEAR CORRECTIVE LENSES FOR DISTANT VISION AND HAVE GLASSES FOR NEAR VISION.
BasicMed Course Date: None BasicMed CMEC Date: None


I am SO HAPPY,
 
Congrats!
Thanks! I was getting nervous... I was afraid they'd ask for more info, or just sent it...

But Uncle Sam came through... And, in less time than I thought it would take... Now, to get the real deal in the mail... And the saga will be over... With the good parts to come!
 
Congrats. It sounded like you were in for a battle but truth be told these were really minor issues and old issues.
Can show they can really nitpick though!
 
Congrats! Now, quickly, before the ink dries, go get Basic Med!

As Dr. Bruce pointed out to me, the easiest time for a physician to sign the Basic Med form is immediately after the FAA has legally declared you fit to fly. Lock it down now and you'll never have to jump through the FAA hoops again.
 
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