PBOR Senate bill text

[bflynn]

For everyone's reference and to make it easy to view - the text from the Senate bill.

Subtitle F--Third Class Medical Reform and General Aviation Pilot
Protections

SEC. 2601. SHORT TITLE.

This subtitle may be cited as the ``Pilot's Bill of Rights 2''.

SEC. 2602. MEDICAL CERTIFICATION OF CERTAIN SMALL AIRCRAFT PILOTS.

(a) In General.--Not later than 180 days after the date of
enactment of this Act, the Administrator of the Federal Aviation
Administration shall issue or revise regulations to ensure that an
individual may operate as pilot in command of a covered aircraft if--
(1) the individual possesses a valid driver's license
issued by a State, territory, or possession of the United
States and complies with all medical requirements or
restrictions associated with that license;
(2) the individual holds a medical certificate issued by
the Federal Aviation Administration on the date of enactment of
this Act, held such a certificate at any point during the 10-
year period preceding such date of enactment, or obtains such a
certificate after such date of enactment;
(3) the most recent medical certificate issued by the
Federal Aviation Administration to the individual--
(A) indicates whether the certificate is first,
second, or third class;
(B) may include authorization for special issuance;
(C) may be expired;
(D) cannot have been revoked or suspended; and
(E) cannot have been withdrawn;
(4) the most recent application for airman medical
certification submitted to the Federal Aviation Administration
by the individual cannot have been completed and denied;
(5) the individual has completed a medical education course
described in subsection (c) during the 24 calendar months
before acting as pilot in command of a covered aircraft and
demonstrates proof of completion of the course;
(6) the individual, when serving as a pilot in command, is
under the care and treatment of a physician if the individual
has been diagnosed with any medical condition that may impact
the ability of the individual to fly;
(7) the individual has received a comprehensive medical
examination from a State-licensed physician during the previous
48 months and--
(A) prior to the examination, the individual--
(i) completed the individual's section of
the checklist described in subsection (b); and
(ii) provided the completed checklist to
the physician performing the examination; and
(B) the physician conducted the comprehensive
medical examination in accordance with the checklist
described in subsection (b), checking each item
specified during the examination and addressing, as
medically appropriate, every medical condition listed,
and any medications the individual is taking; and
(8) the individual is operating in accordance with the
following conditions:
(A) The covered aircraft is carrying not more than
5 passengers.
(B) The individual is operating the covered
aircraft under visual flight rules or instrument flight
rules.
(C) The flight, including each portion of that
flight, is not carried out--
(i) for compensation or hire, including
that no passenger or property on the flight is
being carried for compensation or hire;
(ii) at an altitude that is more than
18,000 feet above mean sea level;
(iii) outside the United States, unless
authorized by the country in which the flight
is conducted; or
(iv) at an indicated air speed exceeding
250 knots.

 

[bflynn]

(b) Comprehensive Medical Examination.--
(1) In general.--Not later than 180 days after the date of
enactment of this Act, the Administrator shall develop a
checklist for an individual to complete and provide to the
physician performing the comprehensive medical examination
required in subsection (a)(7).
(2) Requirements.--The checklist shall contain--
(A) a section, for the individual to complete that
contains--
(i) boxes 3 through 13 and boxes 16 through
19 of the Federal Aviation Administration Form
8500-8 (3-99);
(ii) a signature line for the individual to
affirm that--
(I) the answers provided by the
individual on that checklist, including
the individual's answers regarding
medical history, are true and complete;
(II) the individual understands
that he or she is prohibited under
Federal Aviation Administration
regulations from acting as pilot in
command, or any other capacity as a
required flight crew member, if he or
she knows or has reason to know of any
medical deficiency or medically
disqualifying condition that would make
the individual unable to operate the
aircraft in a safe manner; and
(III) the individual is aware of
the regulations pertaining to the
prohibition on operations during
medical deficiency and has no medically
disqualifying conditions in accordance
with applicable law;
(B) a section with instructions for the individual
to provide the completed checklist to the physician
performing the comprehensive medical examination
required in subsection (a)(7); and
(C) a section, for the physician to complete, that
instructs the physician--
(i) to perform a clinical examination of--
(I) head, face, neck, and scalp;
(II) nose, sinuses, mouth, and
throat;
(III) ears, general (internal and
external canals), and eardrums
(perforation);
(IV) eyes (general),
ophthalmoscopic, pupils (equality and
reaction), and ocular motility
(associated parallel movement,
nystagmus);
(V) lungs and chest (not including
breast examination);
(VI) heart (precordial activity,
rhythm, sounds, and murmurs);
(VII) vascular system (pulse,
amplitude, and character, and arms,
legs, and others);
(VIII) abdomen and viscera
(including hernia);
(IX) anus (not including digital
examination);
(X) skin;
(XI) G-U system (not including
pelvic examination);
(XII) upper and lower extremities
(strength and range of motion);
(XIII) spine and other
musculoskeletal;
(XIV) identifying body marks,
scars, and tattoos (size and location);
(XV) lymphatics;
(XVI) neurologic (tendon reflexes,
equilibrium, senses, cranial nerves,
and coordination, etc.);
(XVII) psychiatric (appearance,
behavior, mood, communication, and
memory);
(XVIII) general systemic;
(XIX) hearing;
(XX) vision (distant, near, and
intermediate vision, field of vision,
color vision, and ocular alignment);
(XXI) blood pressure and pulse; and
(XXII) anything else the physician,
in his or her medical judgment,
considers necessary;
(ii) to exercise medical discretion to
address, as medically appropriate, any medical
conditions identified, and to exercise medical
discretion in determining whether any medical
tests are warranted as part of the
comprehensive medical examination;
(iii) to discuss all drugs the individual
reports taking (prescription and
nonprescription) and their potential to
interfere with the safe operation of an
aircraft or motor vehicle;
(iv) to sign the checklist, stating: ``I
certify that I discussed all items on this
checklist with the individual during my
examination, discussed any medications the
individual is taking that could interfere with
their ability to safely operate an aircraft or
motor vehicle, and performed an examination
that included all of the items on this
checklist. I certify that I am not aware of any
medical condition that, as presently treated,
could interfere with the individual's ability
to safely operate an aircraft.''; and
(v) to provide the date the comprehensive
medical examination was completed, and the
physician's full name, address, telephone
number, and State medical license number.
(3) Logbook.--The completed checklist shall be retained in
the individual's logbook and made available on request.

 

[bflynn]

(c) Medical Education Course Requirements.--The medical education
course described in this subsection shall--
(1) be available on the Internet free of charge;
(2) be developed and periodically updated in coordination
with representatives of relevant nonprofit and not-for-profit
general aviation stakeholder groups;
(3) educate pilots on conducting medical self-assessments;
(4) advise pilots on identifying warning signs of potential
serious medical conditions;
(5) identify risk mitigation strategies for medical
conditions;
(6) increase awareness of the impacts of potentially
impairing over-the-counter and prescription drug medications;
(7) encourage regular medical examinations and
consultations with primary care physicians;
(8) inform pilots of the regulations pertaining to the
prohibition on operations during medical deficiency and
medically disqualifying conditions;
(9) provide the checklist developed by the Federal Aviation
Administration in accordance with subsection (b); and
(10) upon successful completion of the course,
electronically provide to the individual and transmit to the
Federal Aviation Administration--
(A) a certification of completion of the medical
education course, which shall be printed and retained
in the individual's logbook and made available upon
request, and shall contain the individual's name,
address, and airman certificate number;
(B) subject to subsection (d), a release
authorizing the National Driver Register through a
designated State Department of Motor Vehicles to
furnish to the Federal Aviation Administration
information pertaining to the individual's driving
record;
(C) a certification by the individual that the
individual is under the care and treatment of a
physician if the individual has been diagnosed with any
medical condition that may impact the ability of the
individual to fly, as required under (a)(6);
(D) a form that includes--
(i) the name, address, telephone number,
and airman certificate number of the
individual;
(ii) the name, address, telephone number,
and State medical license number of the
physician performing the comprehensive medical
examination required in subsection (a)(7);
(iii) the date of the comprehensive medical
examination required in subsection (a)(7); and
(iv) a certification by the individual that
the checklist described in subsection (b) was
followed and signed by the physician in the
comprehensive medical examination required in
subsection (a)(7); and
(E) a statement, which shall be printed, and signed
by the individual certifying that the individual
understands the existing prohibition on operations
during medical deficiency by stating: ``I understand
that I cannot act as pilot in command, or any other
capacity as a required flight crew member, if I know or
have reason to know of any medical condition that would
make me unable to operate the aircraft in a safe
manner.''.
(d) National Driver Register.--The authorization under subsection
(c)(10)(B) shall be an authorization for a single access to the
information contained in the National Driver Register.

 

[bflynn]

(e) Special Issuance Process.--
(1) In general.--An individual who has qualified for the
third-class medical certificate exemption under subsection (a)
and is seeking to serve as a pilot in command of a covered
aircraft shall be required to have completed the process for
obtaining an Authorization for Special Issuance of a Medical
Certificate for each of the following:
(A) A mental health disorder, limited to an
established medical history or clinical diagnosis of--
(i) personality disorder that is severe
enough to have repeatedly manifested itself by
overt acts;
(ii) psychosis, defined as a case in which
an individual--
(I) has manifested delusions,
hallucinations, grossly bizarre or
disorganized behavior, or other
commonly accepted symptoms of
psychosis; or
(II) may reasonably be expected to
manifest delusions, hallucinations,
grossly bizarre or disorganized
behavior, or other commonly accepted
symptoms of psychosis;
(iii) bipolar disorder; or
(iv) substance dependence within the
previous 2 years, as defined in section
67.307(a)(4) of title 14, Code of Federal
Regulations.
(B) A neurological disorder, limited to an
established medical history or clinical diagnosis of
any of the following:
(i) Epilepsy.
(ii) Disturbance of consciousness without
satisfactory medical explanation of the cause.
(iii) A transient loss of control of
nervous system functions without satisfactory
medical explanation of the cause.
(C) A cardiovascular condition, limited to a one-
time special issuance for each diagnosis of the
following:
(i) Myocardial infraction.
(ii) Coronary heart disease that has
required treatment.
(iii) Cardiac valve replacement.
(iv) Heart replacement.
(2) Special rule for cardiovascular conditions.--In the
case of an individual with a cardiovascular condition, the
process for obtaining an Authorization for Special Issuance of
a Medical Certificate shall be satisfied with the successful
completion of an appropriate clinical evaluation without a
mandatory wait period.
(3) Special rule for mental health conditions.--
(A) In the case of an individual with a clinically
diagnosed mental health condition, the third-class
medical certificate exemption under subsection (a)
shall not apply if--
(i) in the judgment of the individual's
State-licensed medical specialist, the
condition--
(I) renders the individual unable
to safely perform the duties or
exercise the airman privileges
described in subsection (a)(8); or
(II) may reasonably be expected to
make the individual unable to perform
the duties or exercise the privileges
described in subsection (a)(8); or
(ii) the individual's driver's license is
revoked by the issuing agency as a result of a
clinically diagnosed mental health condition.
(B) Subject to subparagraph (A), an individual
clinically diagnosed with a mental health condition
shall certify every 2 years, in conjunction with the
certification under subsection (c)(10)(C), that the
individual is under the care of a State-licensed
medical specialist for that mental health condition.
(4) Special rule for neurological conditions.--
(A) In the case of an individual with a clinically
diagnosed neurological condition, the third-class
medical certificate exemption under subsection (a)
shall not apply if--
(i) in the judgment of the individual's
State-licensed medical specialist, the
condition--
(I) renders the individual unable
to safely perform the duties or
exercise the airman privileges
described in subsection (a)(8); or
(II) may reasonably be expected to
make the individual unable to perform
the duties or exercise the privileges
described in subsection (a)(8); or
(ii) the individual's driver's license is
revoked by the issuing agency as a result of a
clinically diagnosed neurological condition.
(B) Subject to subparagraph (A), an individual
clinically diagnosed with a neurological condition
shall certify every 2 years, in conjunction with the
certification under subsection (c)(10)(C), that the
individual is under the care of a State-licensed
medical specialist for that neurological condition.
(f) Identification of Additional Medical Conditions for the Caci
Program.--
(1) In general.--Not later than 180 days after the date of
enactment of this Act, the Administrator shall review and
identify additional medical conditions that could be added to
the program known as the Conditions AMEs Can Issue (CACI)
program.
(2) Consultations.--In carrying out paragraph (1), the
Administrator shall consult with aviation, medical, and union
stakeholders.
(3) Report required.--Not later than 180 days after the
date of enactment of this Act, the Administrator shall submit
to the Committee on Commerce, Science, and Transportation of
the Senate and the Committee on Transportation and
Infrastructure of the House of Representatives a report listing
the medical conditions that have been added to the CACI program
under paragraph (1).

 

[bflynn]

(g) Expedited Authorization for Special Issuance of a Medical
Certificate.--
(1) In general.--The Administrator shall implement
procedures to expedite the process for obtaining an
Authorization for Special Issuance of a Medical Certificate
under section 67.401 of title 14, Code of Federal Regulations.
(2) Consultations.--In carrying out paragraph (1), the
Administrator shall consult with aviation, medical, and union
stakeholders.
(3) Report required.--Not later than 1 year after the date
of enactment of this Act, the Administrator shall submit to the
Committee on Commerce, Science, and Transportation of the
Senate and the Committee on Transportation and Infrastructure
of the House of Representatives a report describing how the
procedures implemented under paragraph (1) will streamline the
process for obtaining an Authorization for Special Issuance of
a Medical Certificate and reduce the amount of time needed to
review and decide special issuance cases.
(h) Report Required.--Not later than 5 years after the date of
enactment of this Act, the Administrator, in coordination with the
National Transportation Safety Board, shall submit to the Committee on
Commerce, Science, and Transportation of the Senate and the Committee
on Transportation and Infrastructure of the House of Representatives a
report that describes the effect of the regulations issued or revised
under subsection (a) and includes statistics with respect to changes in
small aircraft activity and safety incidents.
(i) Prohibition on Enforcement Actions.--Beginning on the date that
is 1 year after the date of enactment of this Act, the Administrator
may not take an enforcement action for not holding a valid third-class
medical certificate against a pilot of a covered aircraft for a flight,
through a good faith effort, if the pilot and the flight meet the
applicable requirements under subsection (a), except paragraph (5) of
that subsection, unless the Administrator has published final
regulations in the Federal Register under that subsection.
(j) Covered Aircraft Defined.--In this section, the term ``covered
aircraft'' means an aircraft that--
(1) is authorized under Federal law to carry not more than
6 occupants; and
(2) has a maximum certificated takeoff weight of not more
than 6,000 pounds.
(k) Operations Covered.--The provisions and requirements covered in
this section do not apply to pilots who elect to operate under the
medical requirements under subsection (b) or subsection (c) of section
61.23 of title 14, Code of Federal Regulations.
(l) Authority To Require Additional Information.--
(1) In general.--If the Administrator receives credible or
urgent information, including from the National Driver Register
or the Administrator's Safety Hotline, that reflects on an
individual's ability to safely operate a covered aircraft under
the third-class medical certificate exemption in subsection
(a), the Administrator may require the individual to provide
additional information or history so that the Administrator may
determine whether the individual is safe to continue operating
a covered aircraft.
(2) Use of information.--The Administrator may use credible
or urgent information received under paragraph (1) to request
an individual to provide additional information or to take
actions under section 44709(b) of title 49, United States Code.

 

[Mason]

Wow. Just wow.

 

[mscard88]

A link would have.....

 

[RJM62]

No private physician in his right mind would sign the required statement as worded.

Rich

 

[bbchien]

Especially one who knows what the comparison (read, "court") standards are going to be.....

 

[denverpilot]

Does it even matter what's in the bill? FAA has ignored Congressional mandates before and not seen any real consequences for it. (As have other Federal agencies, FWIW...)

All any bureaucracy has to say is the magic word, "safety", and nothing Congress sends them as directives, need be obeyed.

 

[RJM62]

Does it even matter what's in the bill? FAA has ignored Congressional mandates before and not seen any real consequences for it. (As have other Federal agencies, FWIW...)

All any bureaucracy has to say is the magic word, "safety", and nothing Congress sends them as directives, need be obeyed.

I dunno about that. The SP rule -- which was an FAA creation, not a Congressional one -- is far more lenient than the proposed PBOR bill. I mean, seriously, possession of a DL only proves that the individual wasn't too blind or too senile to find his or her way to the DMV the last time they renewed. Even the verbiage in the SP Rule about SPs discussing health issues with their personal physicians is weak because it's merely a suggestion. There is no requirement that an SP ever actually see a doctor.

Nonetheless, the Rule seems to work. I haven't noticed a deluge of SPs dropping from the sky.

What Congress has done in this case is what one would expect of Congress: They've taken a simple concept and complicated it, while simultaneously including verbiage that would scare away any physician who actually reads paperwork before he or she signs it. The bill would require physicians to expose themselves to bufu liability by subjectively certifying to something that they are not qualified by training or experience to determine.

In fact, this bill places more of a burden on PCPs than the FAA places on AMEs. AMEs are not required to certify to an airman's fitness. They merely certify that an airman "has met the medical standards prescribed in Part 67," yada yada yada. The fitness determination is incorporated into the regulations and consists of a very specific list of requirements. The AME is certifying only that the airman meets those requirements, not making any subjective judgments about an airman's fitness. There's a huge liability difference between the two.

Another thing that puzzles me about the bill is why they want a physical examination only every four years (which I think is much too long for someone who presumably is in less-than-wonderful health if they're seeking to fly under this loophole), but an online Medical Education Course every two years. Wouldn't the airman be better off getting another physical than sitting through a boring online course (or more likely, paying their kids or grandkids to sit through it)?

My suggestion has long been that the medical standards for non-commercial operation of small aircraft in day VFR should be:

(1) possession of a driver's license; and

(2) proof that the airman has undergone a medical exam within the past 12 months.

The exam wouldn't need to be reported to the FAA, and the doctor wouldn't have to certify to anything. The airman would merely need proof of having been examined, such as a receipt, not any sort of determination. For night or IFR ops, an additional statement from an eye care professional that the airman doesn't suffer from color blindness or night blindness would also be required.

The reason why I suggest a physical exam in addition to the DL is to enable informed self-certification, as well as the opportunity to identify and treat any conditions that are found. The reason I suggest that the exam be performed once a year is the assumption that most people seeking an alternate medical option are in less-than-stellar health. The reason why I suggest that the exam be non-reportable is to encourage pilots to be honest with their doctors and actually treat any conditions that are found, rather than hiding them.

I think my way would work at least as well as what this bill sets forth; would be easier to administer; would place less of a burden on pilots (because most pilots taking advantage of it probably see their doctors at least once a year, anyway, for treatment of whatever condition is preventing them from being certified); would place less of a liability burden on pilots' personal physicians (because they wouldn't be certifying to anything); and would actually encourage pilots to seek treatment for any ailments that are uncovered, rather than hiding them.

Unfortunately, no one in Congress asked for my opinion.

Rich

 

[Hank S]

Rich--

You seem hung up on pilots "taking advantage" of the new regulations because they have "less than stellar health," when in fact the PBOR is laying out the rules for ALL PILOTS to follow regardless of health. It may leave the Sport Pilot stuff intact, I'm not sure, I haven't reread it recently. But it's for ALL OF US. So it's written generically.

Is it perfect? No, and neither is your proposal. I've. Ever had a doctor give me a receipt or any written "proof" of an exam, unless it was an FAA Medical Exam, in which case I've left with the required little slip of paper.

 

[oldShar]

This is a totally worthless bill --- far more onerous than what presently exists in 14CFR67, Subpart D

 

[RJM62]

Rich--

You seem hung up on pilots "taking advantage" of the new regulations because they have "less than stellar health," when in fact the PBOR is laying out the rules for ALL PILOTS to follow regardless of health. It may leave the Sport Pilot stuff intact, I'm not sure, I haven't reread it recently. But it's for ALL OF US. So it's written generically.

If you really strip it down to its bare essentials, the bill allows you to substitute an examination by your own doctor for one by an AME if you previously held a medical that simply expired, if your last trip to see an AME didn't result in a denial, and if you agree to take an online course. That's assuming that you can find a doctor who's willing to sign off on it, which is unlikely for liability reasons -- especially if you're honest about completing the "checklist," which consists of all the medical history, arrest, etc. questions from the 8500-8.

So you still have to have to answer all the questions, the DQing conditions are still DQing unless you got an SI at some point, you still have to get a physical (assuming you can find a doctor crazy enough to sign off you), and you have to take the medical education course. Wouldn't it be just as easy to just see an AME and get a medical?

Unless, of course, you're likely to fail an "official" flight physical, which is the only reason I can think of to use the exemption, which in turn is why I believe that people using the exemption will tend to be in less-than-stellar health.

Is it perfect? No, and neither is your proposal.

Perfection is an illusion; and because I'm a pragmatist, I'm not looking for perfection. But this bill does nothing for us. At best, it allows you to search for a pencil-whipping doc-in-a-box, who knows nothing about aerospace medicine, but is willing to put his license on the line by certifying that a pilot who, for whatever reason, doesn't want to see a doctor who actually does know something about aerospace medicine, is fit to fly.

Lotsa' luck with that.

I've. Ever had a doctor give me a receipt or any written "proof" of an exam, unless it was an FAA Medical Exam, in which case I've left with the required little slip of paper.

Ask and it shall be given. If you ask for a receipt, you'll get one.

Rich

 

[azure]

So you still have to have to answer all the questions, the DQing conditions are still DQing unless you got an SI at some point, you still have to get a physical (assuming you can find a doctor crazy enough to sign off you), and you have to take the medical education course. Wouldn't it be just as easy to just see an AME and get a medical?

The problem is that many of those SIs need to be renewed year after year with a requirement for expensive tests that are just not necessary from a medical standpoint. Case in point: this year I need to get a full set of Humphreys visual fields to the tune of $400, even though I do not have any condition that would justify it. The reason is that I had a PVD with vitreous hemorrhage a little over a year ago. My Humphreys fields last year were completely normal, but the FAA wants another set this year too. I've also had to do a number of FAA-mandated echocardiograms because of a decades-old, probably bogus diagnosis of mitral valve prolapse, though after last year the FAA relented for some reason and is not requiring the test this time around. But an echocardiogram costs over $2000 and my current insurance does NOT cover it when there is no medical justification.

Neither of those conditions is listed as requiring an SI under PBOR2. Even if they are deemed as possibly relevant to aviation safety, the most I would need is to attest that I am under treatment for them - and since I've been discharged for both, I doubt even that would be needed. I would MUCH rather be able to limit medical testing to what is actually medically necessary, and that seems to be possible in most cases under PBOR2. In addition, I won't miss the long waiting periods on the ground for OKC to approve the SI. I can live with the need for an SI for a limited number of conditions, as all of the ones listed in the bill appear to have a serious impact on one's ability to safely operate an aircraft. Currently, the FAA requires an SI for many conditions that would only impact aviation safety in the most severe cases.

 

[luvflyin]

does anyone have a link where this formatted as
(a)
...(7)
......(A)
.........(i)
EDIT: just found that it probably was. This site ignored the spaces and I had to add the ....'s to get the indents to show

instead of
(a)
(7)
(A)
(i)

What I am getting is (special issuances aside) is that the routine process hasn't changed much. You still fill out a form and answer all the "have you ever" questions. You still go see a doctor and he/she (or any combination thereof) examines you according to guidelines set forth by the FAA. The doctor then issues you approval to fly. What changes is the documentation of the exam is handed back to you to attach to your log book instead of being forwarded to the FAA for further scrutiny and final approval or denial.

I figure I'll just keep going to the same guy I've been going to and hope it pretty much goes as it has in the past. I'm not holding my breath though. His envelope of "responsibity" is now very big. No more "the FAA's medical branch issued the final approval your Honor."

I fear that this is going to be classic example of "be careful what you wish for, you just might get it." I hope I am wrong.

 

[jbarrass]

It's simpler than that. It's now a medical program, between you and your doctor, not a bureaucracy program, no FAA involvement.

For example, in my case, no doctor in real life thought prostate cancer, treated and cured, represented any risk at all of sudden incapacitation. But the bureaucrats in OKC apparently do and I had to have an SI for 2 years. Even my AME who knew it was no risk had to comply with rules that made no sense.

It can't get worse, the 3d class medical still exists and if you don't like the new rules you can keep doing it the old way. But I think this is progress, but still hope maybe PBOR-3 will get rid of the Feinstein amendment in the next round.

 

[Mike Smith]

With all due respect, I am willing to bet that many, if not most doctors will sign the form if they do the exam and what they attest to is the truth. I haven't called my doctor yet as I am waiting for the final bill(law). I am certain my doc will sign the form. I could be wrong, but so could the naysayers.

 

[Palmpilot]

I haven't seen this mentioned yet, but I think the Feinstein amendment may create an incentive for some pilots to continue getting third class medicals and just avoid going to doctors.

 

[denverpilot]

I dunno about that. The SP rule -- which was an FAA creation, not a Congressional one -- is far more lenient than the proposed PBOR bill.

While I appreciate the SP discussion and disagree that "it works" (there's little evidence in public that larger aircraft piloted by even seriously ill idiots who self-certify, pose any significantly greater real public risk public at large, only political risk), you do realize I was speaking to numerous Congressional mandates of the past, still in force, as law, that FAA ignores as a matter of routine, right?

I was saying that it's possible FAA could willfully ignore whatever this Congress passes, right or wrong. Eros plenty of precedent for that. They've done it in the past. All the folks excited about this "new law" shouldn't get too excited, knowing that fact.

 

[luvflyin]

SP rule??? Feinstein amendment??? All I get when I search that is you can't publish bomb making instructions.

 

[RJM62]

SP rule??? Feinstein amendment??? All I get when I search that is you can't publish bomb making instructions.

SP Rule: http://www.ecfr.gov/cgi-bin/retriev...72d48&mc=true&n=sp14.2.61.j&r=SUBPART&ty=HTML

Feinstein Amendment to PBOR2: https://www.congress.gov/amendment/114th-congress/senate-amendment/2928/text

Rich

 

[luvflyin]

SP Rule: http://www.ecfr.gov/cgi-bin/retriev...72d48&mc=true&n=sp14.2.61.j&r=SUBPART&ty=HTML

Feinstein Amendment to PBOR2: https://www.congress.gov/amendment/114th-congress/senate-amendment/2928/text

Rich

Thanks

 

[luvflyin]

SP is Sport Pilot. Got that. The Feinstein amendment is basically just the whole Medical thing amended to the PBOR? Do I have that right?

 

[RJM62]

With all due respect, I am willing to bet that many, if not most doctors will sign the form if they do the exam and what they attest to is the truth. I haven't called my doctor yet as I am waiting for the final bill(law). I am certain my doc will sign the form. I could be wrong, but so could the naysayers.

Unless your doctor has some specific training in aerospace medicine, he or she would be taking a big chance signing the certification. It seems innocuous enough:

"I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft."

The problem is that the first time a pilot certified by a non-AME has an in-flight medical problem that results in actionable damages, the plaintiffs' attorneys will ruthlessly attack the doctor's qualifications to have made that determination. Unless the doctor is an AME or was formerly a military flight surgeon, he or she is open to attacks against his or her qualifications to make aviation-related fitness determinations, and those attacks will likely be successful.

The fact that the doctor possessed a state medical license would be no defense. Medical licenses do not strictly define which types of medicine physicians are allowed to practice nor which types of procedures they are allowed to perform. They are expected to restrict their practices to those areas of medicine in which they are trained and qualified.

I'm not saying that your run-of-the mill internist or family practitioner isn't qualified by common sense to make a pretty good evaluation of whether an airman's medical conditions will affect his or her ability to fly a light aircraft. The problem is a legal issue, not a practical one. I doubt that very many non-AMEs who think this through will be willing to take the risk. If I'm wrong, great! But I don't think I am. The risk is too large.

As an aside, when I was diagnosed with gallstones, my personal doctor (who knew that I flew under the SP rule) grounded me until after the gall bladder was removed and the surgeon cleared me. The problem was that the surgeon (who was a friend of mine, by the way) wasn't willing to sign off on anything having to do with flying. Instead, he gave me a note restricting me from flying for 14 days after the surgery, which created an implicit reinstatement at the end of that period, but without his actually stating that I was fit to fly.

Rich

 

[RJM62]

SP is Sport Pilot. Got that. The Feinstein amendment is basically just the whole Medical thing amended to the PBOR? Do I have that right?

Pretty much, but most specifically the language of the certification is what's problematic. That one line creates a legal precipice for non-AME doctors.

Rich

 

[luvflyin]

Pretty much, but most specifically the language of the certification is what's problematic. That one line creates a legal precipice for non-AME doctors.

Rich

I'd think it would be the same for AME's, maybe even more so. The argument could be made that with their experience, they should have known better. AME or not, if it's not sent to the FAA for final scrutiny and approval, theirs is the last signature in the process.
'

 

[Kiddo's Driver]

Wouldn't the airman be better off getting another physical than sitting through a boring online course (or more likely, paying their kids or grandkids to sit through it)?

I am one of the people who would benefit from the PBOR, IF it ends up being workable with a primary care provider. I am perfectly comfortable taking an online course or a webex. It is not just old school pilots who could use a little relief. I don't need to pay my kids to do the class and I don't have grand kids.

 

[RJM62]

I'd think it would be the same for AME's, maybe even more so. The argument could be made that with their experience, they should have known better. AME or not, if it's not sent to the FAA for final scrutiny and approval, theirs is the last signature in the process.
'

AMEs don't certify to anything other than that the airman "has met the medical standards prescribed in Part 67," et seq. Take a look at your medical if you have one. The AME never certified to your fitness to fly. He or she merely certified to your meeting the requirements defined by the regulations. Legally speaking, that's a very big difference.

Rich

 

[RJM62]

I am one of the people who would benefit from the PBOR, IF it ends up being workable with a primary care provider. I am perfectly comfortable taking an online course or a webex. It is not just old school pilots who could use a little relief. I don't need to pay my kids to do the class and I don't have grand kids.

Hey, if it works for you, that's great. I suppose any improvement is better than none at all. But on a whole, I don't think this bill is that big a deal.

Had Feinstein's amendment as touching upon the certification language been worded along the lines of the individual not suffering from any condition that would prevent them from safely operating a motor vehicle, I think it would have been workable. Family doctors make those assessments all the time for state DMVs, and many of them are also certified to do DOT medicals. That would remove the liability for the physician based on his or her alleged ignorance of aerospace medicine. It also would have been more in line with the thoughts behind the DL medical for SP, from which this proposed extension to slightly larger aircraft originated.

Rich

 

[azure]

The problem is that the first time a pilot certified by a non-AME has an in-flight medical problem that results in actionable damages, the plaintiffs' attorneys will ruthlessly attack the doctor's qualifications to have made that determination. Unless the doctor is an AME or was formerly a military flight surgeon, he or she is open to attacks against his or her qualifications to make aviation-related fitness determinations, and those attacks will likely be successful.

Rich, are you an attorney? I'm not, and although I'm concerned by the wording of the statement, I'd like to hear from an attorney practicing in tort law or medical malpractice on this. While I wouldn't be at all surprised if most doctors would decline to sign off without consulting an attorney, I'm not at all sure how the courts would rule on this. For one thing, the context of the statement is in a paragraph describing the checklist the doctor is expected to use in conducting the physical exam. It seems plausible to me that unless the pilot uses this doctor as their regular GP physician, the statement could be read in the context of the exam and the standards applied by the courts might be no more rigorous than those applied to a doctor conducting, say, a physical on a teenager to clear him for participation in team sports. In other words, unless the condition is one that a competent physician would be expected to uncover in the course of the required exam, the doctor might not face any liability for signing his name to the form.

I don't know whether this will be a dealbreaker issue for most pilots; you and Dr. Bruce might be right, but then again maybe not. It seems to me this will have to be addressed by attorneys versed in the relevant law (and ultimately by the courts), rather than ordinary pilots on a pilot forum or even an AME of Bruce's caliber. My apologies if you are, in fact, an attorney with relevant experience.

 

[mulligan]

I'm not of the opinion this will pass soon but if it did, there are plenty of doctors who will sign anything. Is it ethical? No. But are there doctors in every city who would fill any script you asked for for a small fee. I'm guessing by the amount of addicts the answer is yes. I'm also guessing that there will be less then ethical doctors who would be willing to sign a piece of paper for said fee. They will just let their insurance handle to fallout. Again, not saying it's right. Just saying that those doctors exist.


Sent from my iPhone using Tapatalk

 

[RJM62]

Rich, are you an attorney? I'm not, and although I'm concerned by the wording of the statement, I'd like to hear from an attorney practicing in tort law or medical malpractice on this. While I wouldn't be at all surprised if most doctors would decline to sign off without consulting an attorney, I'm not at all sure how the courts would rule on this. For one thing, the context of the statement is in a paragraph describing the checklist the doctor is expected to use in conducting the physical exam. It seems plausible to me that unless the pilot uses this doctor as their regular GP physician, the statement could be read in the context of the exam and the standards applied by the courts might be no more rigorous than those applied to a doctor conducting, say, a physical on a teenager to clear him for participation in team sports. In other words, unless the condition is one that a competent physician would be expected to uncover in the course of the required exam, the doctor might not face any liability for signing his name to the form.

I don't know whether this will be a dealbreaker issue for most pilots; you and Dr. Bruce might be right, but then again maybe not. It seems to me this will have to be addressed by attorneys versed in the relevant law (and ultimately by the courts), rather than ordinary pilots on a pilot forum or even an AME of Bruce's caliber. My apologies if you are, in fact, an attorney with relevant experience.

I'm not an attorney. I just had to sit through a whole ****load of liability seminars back when I was a paramedic. Most of them were aimed at health care providers in general, including doctors, so I sat through the same seminars that they did.

I doubt that any of the doctors who managed to stay awake though even a single one of the seminars would sign off on someone being fit to fly. Hell, the lawyers giving the seminars didn't even want family doctors signing little kids off to play Pop Warner football, much less pilots to fly airplanes.

I'm not of the opinion this will pass soon but if it did, there are plenty of doctors who will sign anything. Is it ethical? No. But are there doctors in every city who would fill any script you asked for for a small fee. I'm guessing by the amount of addicts the answer is yes. I'm also guessing that there will be less then ethical doctors who would be willing to sign a piece of paper for said fee. They will just let their insurance handle to fallout. Again, not saying it's right. Just saying that those doctors exist.

Yep, which is why I said in an earlier post that you can always search for a pencil-whipper. I'll even tell you how: Just stop at any busy truck stop and look for the bulletin board. It's usually back by the showers. There will be at least half a dozen business cards pinned to the board by doctors who promise "quick," "easy," or "convenient" DOT physicals. Those are all code for "Unless you're totally blind, you pass."

Rich

 

[1RTK1]

I don't see how any general practitioner could give a less thorough evaluation of my health than any AME I have ever seen.
I see my GP every couple of years for a complete physical and blood work. This is a much more complete work up than any AME has performed, I also see my eye doctor every couple of years and he completes many more test than look at this and see if you can read it.

 

[azure]

I doubt that any of the doctors who managed to stay awake though even one the seminars would sign off on someone being fit to fly. Hell, the lawyers giving the seminars didn't even want family doctors signing little kids off to play Pop Warner football, much less pilots to fly airplanes.

Agreed, but the real question is whether the courts will interpret that sentence as signing off someone as being "fit to fly". That most conscientious doctors will read it that way before it's been tested in court, of that I have little doubt; but there will always be exceptions (and I don't necessarily mean pencil-whippers).

And let's not forget that the bill is not the regulation, and the FAA will still have to come up with their own wording, no doubt with an NPRM/comment period, so there will be plenty of opportunity for changes and clarifications.

 

[luvflyin]

AMEs don't certify to anything other than that the airman "has met the medical standards prescribed in Part 67," et seq. Take a look at your medical if you have one. The AME never certified to your fitness to fly. He or she merely certified to your meeting the requirements defined by the regulations. Legally speaking, that's a very big difference.

Rich

That's my point. That's what they do now. Then the FAA reviews it (supposedly) and the final approval is theirs. Under the new system he's just another doctor who does the process and hands you the paper. He's the last step. My thinking was that IF something bad happens, some F. Lee Bailey wanna be is going to hook his thumbs under his suspenders and play the "you, an AME, of all doctors should have known better" card

 

[RJM62]

That's my point. That's what they do now. Then the FAA reviews it (supposedly) and the final approval is theirs. Under the new system he's just another doctor who does the process and hands you the paper. He's the last step. My thinking was that IF something bad happens, some F. Lee Bailey wanna be is going to hook his thumbs under his suspenders and play the "you, an AME, of all doctors should have known better" card

Ah, I see what you mean. You're talking about a case in which a doctor who also happened to be an AME certified the airman, but under the alternate system, using Diane's certification language rather than the usual language on a medical.

Frankly, I doubt that too many AMEs would do that. But I'm not an AME, so I really don't know. Maybe Drs. Bruce and Lou will share their opinions.

I suppose if an SI had previously been issued, and the airman's condition hadn't deteriorated, that might be a case where an AME might be willing to go out on that limb. By definition, SI's are issued to airmen who don't meet the requirements, but who have been determined by the FAS to be able to safely fly if certain requirements, limitations, and so forth are observed, and if their conditions don't worsen. So perhaps an AME might be willing to basically affirm the prior decision of the FAS if there has been no worsening of the airman's condition since the SI was issued.

But if that's the case, then I think the AME would also have to cover himself or herself by ordering whatever tests the FAA would have required in order to renew the SI, had the airman chosen that option, before making that determination, which means that the cost would be essentially the same. The waiting time would be reduced or eliminated, however, so at least that would be an improvement.

Rich

 

[JohnWF]

He has not suggested this to me, but a pilot/md retired friend of mine was waiting to see what PBR2 would do for him as his 3rd class med is about to expire.

I wondered to myself: could he legally sign himself off under the proposed legislation?

 

[bnt83]

Ah, I see what you mean. You're talking about a case in which a doctor who also happened to be an AME certified the airman, but under the alternate system, using Diane's certification language rather than the usual language on a medical.

Frankly, I doubt that too many AMEs would do that. But I'm not an AME, so I really don't know. Maybe Drs. Bruce and Lou will share their opinions.

I suppose if an SI had previously been issued, and the airman's condition hadn't deteriorated, that might be a case where an AME might be willing to go out on that limb. By definition, SI's are issued to airmen who don't meet the requirements, but who have been determined by the FAS to be able to safely fly if certain requirements, limitations, and so forth are observed, and if their conditions don't worsen. So perhaps an AME might be willing to basically affirm the prior decision of the FAS if there has been no worsening of the airman's condition since the SI was issued.

But if that's the case, then I think the AME would also have to cover himself or herself by ordering whatever tests the FAA would have required in order to renew the SI, had the airman chosen that option, before making that determination, which means that the cost would be essentially the same. The waiting time would be reduced or eliminated, however, so at least that would be an improvement.

Rich

I have spontaneously recovered from ITP over 7 years ago, a bleeding disorder that they have no clue what or why sufferers get it or how they spontaneously recover from it. I have not had symptoms or treatment for over 7 years, yet I don't meet the regulations due to (verbatim from my SI) "history of ITP". That's not even recent history yet they still want me to go through the SI process? Its ridiculous...

I've had mine revoked and reinstated in less than 12 months in the same year (around 2002) and I was still fighting ITP then every two weeks, yet with a clean 7 years I'm still on an SI. The symptoms of this disease are very easy to recognize. I didn't need a blood count and a doctor to tell me that my platelet count was low, the bruises on my arms and legs were all I needed to see.


Another example of overreaction by the process IMHO.

http://journalstar.com/news/state-a...cle_a8e34693-82c8-54e1-b59f-969e5aa8ae21.html

 

[luvflyin]

He has not suggested this to me, but a pilot/md retired friend of mine was waiting to see what PBR2 would do for him as his 3rd class med is about to expire.

I wondered to myself: could he legally sign himself off under the proposed legislation?

Damn. Knew I should have studied harder in PreMed