SI Issuance

[dbahn]

OK, got it. Thanks for the clarifications.

 

[StraightnLevel]

Malignant melanoma - in addition to all of the doctor's notes, the initial requirement is for a PET scan of the head and neck as well as an MRI, both looking for the unlikely appearance of metastases with NO CLINICAL EVIDENCE of their presence. The MRI needs to be repeated every year for the next four years after the Special Issuance. The problem is that there is no medical evidence that the screening MRI is useful, so insurance doesn't pay for it and the airman is paying $5k a year out of pocket for four years. That's why I bailed out and went to Basic Med.

So, if you go to basic med, then get a melanoma diagnosis, can you go back to a std med cert after 5 years, or would the melanoma history trigger SI, which then lives for 5 years regardless of the original diagnosis date?

 

[TCABM]

So, if you go to basic med, then get a melanoma diagnosis, can you go back to a std med cert after 5 years, or would the melanoma history trigger SI, which then lives for 5 years regardless of the original diagnosis date?

Had melanoma in 2009. You’ll need to know depth, have path records, and FBSE histories. I flew on a DoD physical until 2016, then did an FAA class 3 with nothing but the records and was issued in office. I’m on BasicMed now, but the FAA never asked me to get a PET/MRI or other imaging.

Here’s the decision criteria.

https://www.faa.gov/ame_guide/app_process/exam_tech/item40/amd/malignantmelanoma

 

[dbahn]

So, if you go to basic med, then get a melanoma diagnosis, can you go back to a std med cert after 5 years, or would the melanoma history trigger SI, which then lives for 5 years regardless of the original diagnosis date?

You start fresh with an AME and get the FAA required testing, which for me included a head and neck MRI, a PET scan, notes from a dermatologist and an oncologist, then wait for the SI to be issued.

After I had a radical excision of the melonoma and proof of no lymph node involvement, the doctor's notes and the MRI (not the PET scan) needed to be repeated for continuation of the SI, so I went on to Basic Med. But here's a related catch. Since I let the SI lapse while on Basic Med, my AME (and a personal friend) advised me that the FAA no longer accepts thr original work-up and would require a new full work-up, including another PET scan and other te$t$.

 

[dbahn]

Had melanoma in 2009. You’ll need to know depth, have path records, and FBSE histories. I flew on a DoD physical until 2016, then did an FAA class 3 with nothing but the records and was issued in office. I’m on BasicMed now, but the FAA never asked me to get a PET/MRI or other imaging.

Here’s the decision criteria.

https://www.faa.gov/ame_guide/app_process/exam_tech/item40/amd/malignantmelanoma

Well, that's a step in the right direction if the stage of melanoma was the same for both of us. I'm hopeful that's because CAMI was ultimately convinced that people were getting a useless and expensive test according to the oncologists, with the airman often having to pay out of pocket for it. But when I had the surgery that wasn't the case. (I've since had two more melanomas removed, and neither required an MRI but both were also less invasive.

Mine also might have just exceeded the acceptable depth of the lesion.

 

[jbarrass]

When I got my SI for cancer (prostate) a long time ago I was told they would want a scan. When I went to my real doctor for my status letter and told him, he was very upset and wouldn't prescribe it. His opinion was the last thing a cancer patient needed was unnecessary radiation. I submitted my packet and got issued without. That was a long time ago and I'm not sure what the bureaucrats would do in 2024.

The FAA won't order the scans, so you'll have to convince a real doctor to order a medically unnecessary test and fight with the insurance company to get paid.

Yeah basicmed!