Overcoming FAA Nonsense ~ Denied

Discussion in 'Medical Topics' started by ScottAir1, Apr 16, 2023.

  1. ScottAir1

    ScottAir1 Filing Flight Plan

    Apr 16, 2023

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    I have been pursuing a special issuance since 2019. I have been flying since high school and licensed since 2004. In 2016, I underwent open heart surgery. On the advice of a CFI, I let my medical expire. Later, when I decided to pursue Basic Med I was told the way to Basic Med for me was via a 3rd Class Medical or SI. I visited an AME in 2019 and submitted all my heart records, and military medical records (100% DAV) which included a visit to the head doctor. I might also add I am diagnosed with Type 2 Diabetes (T2D). As expected, the AME deferred to the FAA. Several months later I received the expected news that the FAA had not been able to establish eligibility to hold an airman medical certification. It included instructions for obtaining additional medical testing for reconsideration: (1) A current psychiatric evaluation, (2) update on OSA, (3) a current neurological exam, (4) a current neuropsychological evaluation, and (3) a current stress test and cardiology evaluation.

    I complied with all the above. I even forked out $2000 to be seen by an FAA HIMS psychiatrist for the psychiatric evaluation. I was able to see a VA psychologist for the neuropsychological evaluation (which saved me a few bucks). I provided two letters from my primary doctor attesting to the fact my diabetes is well controlled without the use of medication and is considered in remission due to the fact my A1C is 5.2 and my fasting blood sugar is below 100. All testing was normal. My OSA is well controlled via use of CPAP. The FAA HIMS psychiatrist noted, "He did not at any point meet the criteria for a primary anxiety or depressive disorder and the identified symptoms of anxiety or depressive disorder and the identified symptoms of anxiety and depressed mood occurred in reaction to identified life stressors now resolved... He has no disqualifying psychiatric conditions." The VA psychologist noted all testing was normal and, "the veteran does not meet DSM-V diagnostic criteria for any neurocognitive disorder." A later entry in my FAA medical record noted, "Multiple neurologic symptoms. Case discussed at AMCD neuro conference and internal panel. No neurologic issue. Symptoms most consistent with prior psychologic history. No further workup needed in neuro."

    COVID came on the scene and slowed the process down but I was able to complete the neurological and cardiology testing (all normal) and submit to the FAA. In 2022, the FAA sent me a letter directing me to get an updated medical exam from an AME, which I did in June of 2022. The FAA responded with a request for an updated stress test, cardiology workup, and OSA compliance letter. I submitted all the testing within 60 days. Stress test was normal and the cardiology workup was normal, as well, noting good progress and prognosis. OSA report noted compliance and good daily use of CPAP. Both the AME and myself felt I was on the road to, at the very minimum, a SI which would enable me to go the Basic Med route.

    In March 2023, I received a denial letter from the FAA. The letter noted the neurological issues and history of untreated PTSD. It also noted cardiac history that has required treatment and diabetes mellitus that requires any hypoglycemic drug for control, and adjustment disorder with mixed anxiety and depressed mood.

    I was flabbergasted given the fact the FAA medical folks had previously cleared me on the neurological/psychological issues. I was further irritated they were claiming I take medications for diabetes which I do not and I have noted this for them through multiple letters from my doctor. I was surprised to learn I apparently have a history of PTSD since I have never, to my knowledge, been diagnosed with PTSD or otherwise treated for PTSD. I don't know what to think about their response to the cardiac issues since I have submitted numerous stress test, nuclear stress tests, and cardiology workups all noting normal and good prognosis. I really don't know what they hell they want but I do know several pilots with cardiac issues who are flying on SI. So I know it's not out of the question.

    The letter gave me the option of accepting the denial which would not preclude me from applying again in the future, or appealing to the Federal Air Surgeon. I chose to appeal to the Federal Air Surgeon and fired off a multi-page memo going line by line in the denial letter and including copies of the pertinent FAA medical record and testing submitted. I emphasized the FAA's own previous clearance for the neurological/psychological concerns and wondered why it was being dredged back up at this point. I also wondered, in the letter, if the person reviewing my record had actually reviewed my record and the tests/reports submitted since the denial letter indicated this was unlikely otherwise they would have seen the previous clearance for the neuro/psych non issues, and the fact I do not take medication for T2D, which is well controlled.

    Anyway, I guess my question is this--is there any point in pursuing this further, especially since testing and workups that clearly indicate good results and prognosis apparently mean nothing to the FAA? I doubt I would appeal to the NTSB as that would get costly but I might be willing, if the Federal Air Surgeon upholds the denial, to immediately see the AME again and start the process over, mostly out of spite but also with the slim hope that maybe a SI will come as a result.
  2. Pinecone

    Pinecone Pattern Altitude

    May 24, 2022

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    It almost sounds like they sent you the wrong letter or the person was looking at the wrong records.

    I wish you the best of luck.
  3. Tools

    Tools Cleared for Takeoff

    Aug 6, 2020

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    I’ve seen this a bunch. It’s (unfortunately) fairly normal.

    Different application at a different time might well yield different results. The old adage same thing expecting different results doesn’t really apply here… ironic.

    From what I’ve seen, an appeal to the NTSB sounds like a better odds proposition. Sounds like you’ve already done all the costly stuff, might well be able to present yourself. I know a (albeit well versed) truck driver who did it himself with good results.
  4. TCABM

    TCABM En-Route

    Apr 23, 2013

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    That was likely bad advice that should have been verified then. But, water under the bridge.

    You likely have an award letter from the VA that says PTSD on it. That’s the diagnosis. If you haven’t received care for that diagnosis, then the FAA considers it untreated. Doesn’t matter what the VA shrink says, if you were diagnosed with PTSD in a C&P exam, and it’s documented in your VA award letter as approved, then the FAA won’t question that diagnosis.

    You may not agree with the FAAs policy, but it is what it is. There was a contingent of airline pilots receiving VA benefits for PTSD and not disclosing it on their medicals recently. The FAA did not take that lightly. Here’s just one who’s been made an example of.

    As for trying to resolve this, I suggest you request a blue ribbon copy of your FAA record. Once you get that, you will have all the FAAs internal documentation and deliberation on your case. Take that along with you VA award letter(s) that has the list of conditions on it, and your military medical records then find a doc like Bruce Chien who will consult with you on the path forward, if there is one. If Bruce can’t take your case, ask him who he would advise you work with.

    I had pediatric open heart surgery in the early 1980s and as recently as 2019 renewed an FAA Class III with the current cardiology report, a Bruce stress test following FAA protocol w/echo, and a bubble echo.

    OSA is a nothingburger with documented compliance.
  5. Randomskylane

    Randomskylane Pre-takeoff checklist

    Jun 2, 2021

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  6. WingmanMed

    WingmanMed Pre-Flight

    Jan 25, 2023

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    Many times when we see cases like this there is a discrepancy between what the pilot and their doctors think they are sending in and what the FAA asked for. Either information is missing or additional information, previously unknown to the FAA, was provided. A lot of times these are simple documentation errors about medications and past diagnoses being listed as still active. Similarly the FAA really started looking at VA disability last year and if there is a discrepancy between what they see with the VA and what was told to them, they are disinclined to issue a certificate.

    This would require a thorough review of everything you have sent to the FAA and everything they have sent to you. Like TACBM said, getting a full copy of your file to someone very familiar with the system may help. Then again, that review may show that you still have work to do.

    Keep in mind that the FAA only looks at you on paper. If the paper looks bad, confusing, contradictory, etc. then they aren't going to issue a medical certificate.
  7. Robert Young

    Robert Young Filing Flight Plan

    Nov 11, 2018

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    Just Bob
    I feel your frustration. I am 2 years 8 months trying for SI. Finally after 1 year 8 months FAA responded with reference to elicit drugs and enemia. Never done drugs or diagnosed with anemia. Have no idea where this stuff is coming from. It’s impossible to talk to anyone at the FAA or to get a timely response.