SI Issuance

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Anthem said:
You can’t. Some special issuances have progressive things jb their requiring compliance throughout the SI. And without compliance they withdraw the SI and you are then denied. So no - you can’t go right when you get it for some, you have to comply with the SI and let it expire.
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I'm not familiar with the progressive things. I've had two SIs and both just required renewal at a specified time, but neither prevented me from operating on Basic Med while the existing SI was still in effect. I suppose the FAA could consider that you operated only on your class 2 medical as long as it was in effect, even though you had completed the Basic Med requirements, but I don't know if that's been a practical issue for anyone.

But you bring up a good point. Are you obligated to continue to "meet the requirements of the medical certificate" while it's valid or do you simply comply with the "operate the aircraft in a safe manner" clause. They are very different, and Basic Med only requires the second of those. My reading of 61.53 is that as you must continue to meet the requirements of the medical certificate only if you do NOT hold a U.S. driver's license.
 
Anthem said:
yes there are several that require continued compliance to continue to hold the si during its validity. But you also bring up a certain clause - that you can also get basic med right after. And operate on basic med. HOWEVER the si can be cancelled with failed compliance during its validity and then the basic med immediately also becomes invalid
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Read the Domingo letter straight from the FAA legal team. It specifically states that the airman is only obligated to comply with the special issuance while they hold a valid special issuance medical certificate. If their most recent medical certificate is expired, their most recent MedXpress application no longer has standing, and there is no pending MedXpress application for a new medical certificate, the airman is no longer on the hook to comply with the special issuance terms and the special issuance cannot be withdrawn for noncompliance while the airmen no longer holds a valid medical certificate.

https://www.faa.gov/about/office_or...Domingo-AFX-1-2_2018_Legal_Interpretation.pdf

Also...

https://www.faa.gov/licenses_certificates/airmen_certification/basic_med
 
As I understand, you can apply for and obtain your Basic Med while still under a SI, but, you must fulfill the requirements of the current SI until it expires. At that point you continue flying under BM. In other words, you do not have to wait until the SI expires to obtain BM, but you are still flying under the SI until all obligations met and it expires.
 
are you saying there are SI’s where some type of compliance is required before the NVA date on the certificate? I’ve never seen that, I can’t imagine AMCD having a pilot on the honor system for providing a report. I’m thinking of the expiration of the actual certificate, not the expiration on the SI (which could be 2-3-4 years down the road). If you’re on SI / AASI and just let your certificate expire, I don’t think you’ll get a denial for not keeping with the requirements of the SI letter. That seems like it would defeat the purpose of BM for most pilots who are on it?
 
craig d said:
are you saying there are SI’s where some type of compliance is required before the NVA date on the certificate? I’ve never seen that, I can’t imagine AMCD having a pilot on the honor system for providing a report. I’m thinking of the expiration of the actual certificate, not the expiration on the SI (which could be 2-3-4 years down the road). If you’re on SI / AASI and just let your certificate expire, I don’t think you’ll get a denial for not keeping with the requirements of the SI letter. That seems like it would defeat the purpose of BM for most pilots who are on it?
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Yes, there are SIs with stipulations regarding treatment in between the 6 month intervals that must be complied with. See this reddit thread where an airman with a history Autism and epilepsy needs to have biweekly visits with a therapist in between 6 month renewals: https://www.reddit.com/r/flying/comments/11vyqs2/got_my_special_issuance_with_a_history_of/

Regarding the implications for going basic med in this scenario, I am not entirely certain of. @bbchien @lbfjrmd @WingmanMed any thoughts on if someone with additional periodic requirements in their SI letter can immediately go basicmed?
 
craig d said:
are you saying there are SI’s where some type of compliance is required before the NVA date on the certificate? I’ve never seen that, I can’t imagine AMCD having a pilot on the honor system for providing a report. I’m thinking of the expiration of the actual certificate, not the expiration on the SI (which could be 2-3-4 years down the road). If you’re on SI / AASI and just let your certificate expire, I don’t think you’ll get a denial for not keeping with the requirements of the SI letter. That seems like it would defeat the purpose of BM for most pilots who are on it?
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Some SIs require compliance actions during their periods of validity. Random drug testing, for example. If you fail to comply the FAA will revoke your medical and you become ineligible for BM. You have to maintain compliance until the NVA date.
 
robin ardoin said:
As I understand, you can apply for and obtain your Basic Med while still under a SI, but, you must fulfill the requirements of the current SI until it expires. At that point you continue flying under BM. In other words, you do not have to wait until the SI expires to obtain BM, but you are still flying under the SI until all obligations met and it expires.
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I think that's the correct interpretation.

There are lots of varieties of SI authorizations, most include an obligation to report any change in the condition for which the SI was issued. Absent that, the SI has a valid time frame, after which it expires, at which point Basic Med is valid and the airman is not longer obligated to report anything to the FAA related to the SI. So, for instance if an SI is issued for malignant melanoma it will have a "not valid after" date and a requirement to report a change, so if another lesion is identified during that time it must be reported to the FAA, in which case they may or may not modify the terms of the current SI. In that same situation if the airman incurs, say, a condition like diabetes that would make him "unable to meet the requirements" of the medical certificate at that time he would not need to self-ground as he could legally operate under Basic Med since the SI is unaffected and he has reason to know that he can operate safely even in the presence of diabetes under good control.

My understanding is that three years ago the FAA issued a "HIMS step-down program" which in some cases results in lifetime requirements to maintain the SI. I only learned about this as I was just now researching this topic, and wondered how much authority they have to apply this to other conditions. (I'm happy to not have any HIMS issues.)
 
In an ideal world those with substance issues would not fly, rather they would be honest, clean themselves up, present themselves and answer everything truthfully about their issues, be issued quickly and fly from then on without any recurrence. Unfortunately that is not what happens. There is a long history of pilots given second, third or whatever chances, then falling off the wagon and continuing to fly, sometimes to disastrous ends taking innocents with them. I believe, even in the past year or so, there have been cases of pro pilots showing up to fly passengers while under the influence and luckily getting caught. Inertia in the system to approve pilots who have had these issues does not seem like a bad idea to me. Sorry to anyone who has to go through this, but actions have consequences. Patience is important in piloting.
 
I tried to quote you but site wouldn’t allow since I’m new

I watched that Reddit thread when it popped up, just looked at it again. Re the epilepsy, last seizure was 17 yrs previous and he had been off meds since 2012. OP said the autism was NBD. Did his Class 3 Jan 22, got his SI / C3 Mar 23 with NVA Jan 24. OP said to reup his Class 3 in January for another 12 months all he needs is the report from neuro, nothing regarding the ASD. His next Class 3 is due Jan 2027 but he will do BM if the SI becomes too costly or time consuming. I didn’t see the therapist requirement, but I didn’t read his personal blog either.
 
Red Baron is correct....of course you don't have to comply and then you get downed.....I still have a few guys who still throw away the letter and then contact me 14 days prior to expiration. Go figure.
 
craig d said:
I tried to quote you but site wouldn’t allow since I’m new

I watched that Reddit thread when it popped up, just looked at it again. Re the epilepsy, last seizure was 17 yrs previous and he had been off meds since 2012. OP said the autism was NBD. Did his Class 3 Jan 22, got his SI / C3 Mar 23 with NVA Jan 24. OP said to reup his Class 3 in January for another 12 months all he needs is the report from neuro, nothing regarding the ASD. His next Class 3 is due Jan 2027 but he will do BM if the SI becomes too costly or time consuming. I didn’t see the therapist requirement, but I didn’t read his personal blog either.
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I actually linked the wrong reddit thread about an autism SI, here is the correct one: https://www.reddit.com/r/flying/comments/z9ty6r/after_2_long_years_of_fighting_ive_been_approved/. Farther down in the comments you'll see he needs to submit biweekly therapy reports to his AME
 
@redbaron it looks like the request for every other week therapy sessions and biannual report to AMCD happened at the 12 month interval from doing the original examination. So those therapy sessions went on for basically 12 months until he received his SI / C3, 2 years after the original application. Without seeing the other pages of his SI letter, specifically the Airman / AME instructions, it’s hard to say whether the every other week therapy sessions and reporting are an ongoing requirement of his SI. It’s seems odd that they would grant the SI if the Airman still needed “therapy” and if he did, timely enforcement would be difficult. OP may have explained it later in his thread, but I didnt see it while scanning.
 
We focus on FAA medical certification so we cannot provide advice with regard to switching to Basic Med, particularly if there are ongoing SI requirements the FAA expects to see.
 
Anthem said:
this was not the discussion. The discussion was when the medical was valid - and to immediately go to basic med (while the medical with SI was valid ) and as I and others have confirmed - they can pull it if you don’t comply with the si terms if it’s ongoing.
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Scenario: You're issued a Special Issuance Authorization with a Special Issuance Medical Certificate. Immediately after issue, you get on Basic Med. In this scenario, you have BOTH a Part 67 airman medical certificate AND Basic Med (Part 68).

As long as your Part 67 medical certificate is valid, Basic Med or not, you MUST comply with the terms of the Special Issuance Authorization.

From the Domingo Letter -

However, once the special issuance medical certificate has expired and the airman is not in the process of seeking a new special issuance medical certificate, additional medical information is not reasonably needed for certification under 67.401. Consequently, the Federal Air Surgeon may not withdraw the Authorization based on the airman's failure to provide information "not reasonably needed by the Federal Air Surgeon for certification under this section". If an airman does not hold a special issuance medical certificate and has no application pending, there is no need for the Federal Air Surgeon to request information necessary to determine whether the airman meets the standards for special issuance medical certificate.

Authorizations often have a longer duration than the associated special issuance medical certificate. These longer durations are for internal FAA administrative purposes and aid the Office of Aerospace Medicine with the processing of special issuance medical certificates under 67.401. The Authorization's longer duration period conveys no independent medical privilege as evidenced by the requirement for an airman to demonstrate that he remains qualified for a new special issuance medical certificate when the current special issuance medical certificate expires. As such, an airman's responsibility to comply with the terms of an unexpired Authorization - including a term that requires regular submission of medical information - terminates when the associated special issuance medical certificate expires. Because there is no reasonable basis for requiring an airman in those circumstances to provide medical information that is not needed for determining medical certification under 67.401, the FAA would not have a basis to withdraw the Authorization.

The above interpretation is consistent with the purpose of Basic Med, to allow an airman who can meet alternate requirements to fly without holding a medical certificate. Both the enacting legislation, FAA Extension, and Security Act of 2016, which directed the FAA to establish Basic Med, and the implementing regulations under 14 CFR part 68, however, provide specific situations in which an airman with an ongoing or new medical condition must apply for an Authorization before operating or continuing to operate under BasicMed. Additionally, an airman operating under BasicMed may be asked to provide medical information to the FAA under 14 CFR part 68. Part 68 allows the Administrator under certain circumstances to require an individual to provide additional information or history so that the Administrator may determin whether the individual is safe to continue operating under BasicMed. Moreover, an airman is still under a duty to ensure he is not operating an aircraft when he has conditions making him medically unfit. Because alternative avenues are provided to collect information, it does not appear that Congress, who mandated BasicMed, wanted an airman to be beholden to continued requests for information related to a prior Authorization after the most recent special issuance medical certificate has expired and the airman is not in the process of seeking a renewed special issuance medical certification.
 
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@Anthem I did not get the impression that anyone was suggesting that one NOT comply with the conditions of the SI medical certificate SIMC) and use BM to circumvent needing a medical cert.. Of course one must fulfill all the obligations of the SIMC until it is expired then one can continue with Basic Med. The point of getting BM while still under the SIMC is to have a seamless process under which one could continue flying without an ineligible period while waiting to complete the BM process after expiration of the SIMC. One does not need to wait until the SI authorization is expired.
 
Anthem said:
Exactly and all true. But as I pointed out - this is NOT the discussion from above. The discussion is they get an SI and do not finish complying with the SI and go straight to basicmed. What people are not getting is that /Some/ SI’s have continuing conditions during the validity of the SI. And those must be followed or the si medical can be revoked. You can state that it can’t be revoked after expiration which I agree with. But the argument above was that someone could go immediately to bm and not have to worry about revocation while the SI was valid - which isn’t the case. I never said what you said wasn’t true. Just didn’t apply to the current question that was asked
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You keep saying "SI", but you're leaving out the "authorization" and "medical certificate" qualifiers. "SI" is the umbrella term that encompasses both. This creates confusion because of the SI Authorization and SI medical certificat being two separate documents, and these two documents have vastly different expiry dates. Thus it is unclear when you speak of the "SI" expiring without qualifying which you are speaking of, be it the authorization or the accompanying medical certificate.

Thus I felt the need to clarify.

While you can have BM and SI medical certificate at the same time, the SI Authorization must be complied with until the accompanying SI medical certificate expires, and the airman must not be in the process of obtaining another SI medical certificate (comply until the most recent MedXpress application no longer has standing to be on the safe side). Only then can you continue to fly on BasicMed with no obligation to comply with the SI Authorization terms.
 
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craig d said:
are you saying there are SI’s where some type of compliance is required before the NVA date on the certificate? I’ve never seen that, I can’t imagine AMCD having a pilot on the honor system for providing a report. I’m thinking of the expiration of the actual certificate, not the expiration on the SI (which could be 2-3-4 years down the road). If you’re on SI / AASI and just let your certificate expire, I don’t think you’ll get a denial for not keeping with the requirements of the SI letter. That seems like it would defeat the purpose of BM for most pilots who are on it?
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From the Domingo letter -

"Authorizations often have a longer duration than the associated special issuance medical certificate. These longer durations are for internal FAA administrative purposes and aid the Office of Aerospace Medicine with the processing of special issuance medical certificates under 67.401. The Authorization's longer duration period conveys no independent medical privilege as evidenced by the requirement for an airman to demonstrate that he remains qualified for a new special issuance medical certificate when the current special issuance medical certificate expires. As such, an airman's responsibility to comply with the terms of an unexpired Authorization - including a term that requires regular submission of medical information - terminates when the associated special issuance medical certificate expires. Because there is no reasonable basis for requiring an airman in those circumstances to provide medical information that is not needed for determining medical certification under 67.401, the FAA would not have a basis to withdraw the Authorization."

As stated above in the Domingo letter, the Authorization's longer duration period conveys no independent medical privilege, and the airman's responsibility to comply with the terms of an unexpired Authorization - including a term that requires regular submission of medical information - terminates when the associated special issuance medical certificate expires. The FAA would not have a basis to withdraw the Authorization as there is no reasonable basis for requiring an airman who no longer holds a valid special issuance medical certificate to provide medical information that is not needed for determining medical certification under 67.401.
 
I have to agree with Jon Wilder on my understanding of the whole thing. The requirements of the SI must be followed while the medical is valid and only during that time. You can get basic med as soon as you have a valid medical, assuming you qualify at that time. SI medicals usually expire in 6 months regardless of class (my experience anyway). The SI authorization is usually much longer (years). So if you comply with the SI requirements while you hold the medical and then let the medical expire…you can still fly basic med as long as you obtained it while you were in compliance. The FAA cannot revoke a medical that has expired or deny a medical that has not been reapplied for.
 
So I'm just curious to know how the FAA deals with an SI related to one of the disqualifying conditions for Basic Med vs. an SI related to a condition that would NOT disqualify someone from operating under Basic Med. Sleep apnea, for instance, is not listed as disqualifying for Basic Med, and presumably it is up to the evaluating physician to make the determination. On the other hand does an airman with a prior mental health disorder who required HIMS involvement to obtain a Special Issuance have the same option to let it expire and then seek a Basic Med pathway?
 
dbahn said:
So I'm just curious to know how the FAA deals with an SI related to one of the disqualifying conditions for Basic Med vs. an SI related to a condition that would NOT disqualify someone from operating under Basic Med. Sleep apnea, for instance, is not listed as disqualifying for Basic Med, and presumably it is up to the evaluating physician to make the determination. On the other hand does an airman with a prior mental health disorder who required HIMS involvement to obtain a Special Issuance have the same option to let it expire and then seek a Basic Med pathway?
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Yes, he does. He has already won the necessary SI via HIMS.
(i wonder how many of our congressmen are taking Prozac?)
 
dbahn said:
I'm not sure how what conditions are limited in that explanation. Why the use of the term "One SI" on the FAA website information pages?

View attachment 118612 View attachment 118612
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What it's saying is that "If you have or develop any of these conditions, you need to have been issued at least one special issuance medical certificate in order to establish eligibility under BasicMed".

The whole premise of BasicMed is to allow those with no medical certificate under Part 67 to fly under Part 68 so long as you meet the following requirements -

(a) been issued a medical certificate under Part 67 on or after July 14th, 2006
(b) have not had their most recent medical certificate denied, suspended, nor revoked
(c) hold a valid and current driver license in their home state
(d) do not fly aircraft with a maximum certificated gross weight of 6,500 lbs
(e) do not carry more than 5 passengers

If your most recent special issuance medical certificate has been denied, suspended, or revoked AND/OR your special issuance authorization has been withdrawn (which would also revoke your current special issuance medical certificate), OR your driver license is expired, suspended, or revoked, you are ineligible to fly under BasicMed.
 
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Jon Wilder said:
If you hold a special issuance medical certificate for a condition that is not listed, ...... you are ineligible to fly under BasicMed.
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No, no, no! 100% incorrect. It’s exactly the opposite. Those are the only conditions that require a 1-time SI. If you have held a medical and subsequently develop some unlisted condition (sleep apnea, for example), you can go to Basic Med without getting an SI first. If you have an SI medical for sleep apnea (or some other unlisted condition) you are free to let it expire and use Basic Med.

That’s why so many of us have switched to Basic.
 
Half Fast said:
No, no, no! 100% incorrect. It’s exactly the opposite. Those are the only conditions that require a 1-time SI. If you have held a medical and subsequently develop some unlisted condition (sleep apnea, for example), you can go to Basic Med without getting an SI first. If you have an SI medical for sleep apnea (or some other unlisted condition) you are free to let it expire and use Basic Med.

That’s why so many of us have switched to Basic.
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And here's another twist along those lines. Say a perfectly healthy person sustains a concussion in a bicycle accident, is seen in the ER and discharged. If that person is then to apply for (or even renew) a medical certificate, he is required to report the ER visit and the "Unconsciousness for any reason" on his 8500-8 form (18 c). When that's reported he slips into the FAA loss of consciousness protocol which defers approval for a minimum of 6 months depending on a number of factors and leads up to a Special Issuance regardless of those factors. However, even though his current medical is in effect (technically he needs to self ground) that person can go for Basic Med, disclose the injury to the evaluating physician and be legal to fly under Basic Med if the physician deems him to be able to operate safely. That physician is guided by the FAA's own definition of neurological disorders with respect to the Basic Med exclusions:

  • A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
    • Epilepsy;
    • Disturbance of consciousness without satisfactory medical explanation of the cause; or
    • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
And there's another reason many of us have switched to Basic Med. You can take care of your own health without ending up on the FAA's treadmill and risking long term or even permanent grounding. That list of diseases and conditions for which an airman can seek evaluation without risking the pitfalls is very long.
 
Jon Wilder said:
I corrected my post above.
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No, your last sentence in that post is incorrect.

This:
If you hold a special issuance medical certificate for a condition that is not listed, ...... you are ineligible to fly under BasicMed.​
is simply untrue.
 
Half Fast said:
No, your last sentence in that post is incorrect.

This:
If you hold a special issuance medical certificate for a condition that is not listed, ...... you are ineligible to fly under BasicMed.​
is simply untrue.
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Corrected
 
We may be doing a bit of apples and oranges here. There seems to be confusion over the reach of the Domingo memo. So let's be somewhat specific and see what our medical experts (@bbchien @lbfjrmd @WingmanMed) say about this scenario.
  • In January 2020, the pilot receives a HIMS-based SI authorization and 3rd class certificate. The SI Authorization has HIMS compliance conditions.
  • The SI authorization expires October 31, 2026
  • The initial third class medical expires March 31, 2020.
  • The pilot has complied with the conditions of the SI and obtains a second medical certificate which expires September 30, 2020.
  • The pilot decides the program is too expensive and allows the current third class medical to expire. Doesn't go back to an AME to renew.
  • After the current third class medical expires, the pilot ceases participation in the program. FAA withdraws the SI authorization for non-compliance.
May the pilot turn to BasicMed?

I think the problem with Domingo is that it doesn't really address this situation. The "normal" SI authorizations I've seen may have conditions for medical certificate reapplication but not for continued validity of the SI authorization. For example, a melanoma SI might have a 2-year authorization with 6-month medical certificate limits. There may be requirement for an updated report if the pilot applies for another medical within the SI authorization period. But failure to get those reports and letting the thrid class certificate expire only means no new medical certificate. But it does not mean the withdrawal of the SI itself. I think that's the type of situation Domingo addresses. The pilot in that situation - expired medical but no withdrawn SI - can go to BasicMed.

The HIMS SI is different in that the Authorization has conditions for the continued validity of the authorization, not just conditions for the issuance of a new medical certificate during the authorization period. It requires continued compliance with HIMS conditions or, as it says, "your Special Issuance will be withdrawn." Unlike the "normal" SI, the HIMS SI has requirements to retain the validity of the authorization. Don't comply, and FAA withdraws the Authorization itself. And as the BasicMed rules say, to be eligibal for BasicMed, the pilot must "Not have had his or her most recently issued medical certificate (if the person has held a medical certificate) suspended or revoked or most recent Authorization for a Special Issuance of a Medical Certificate withdrawn."
 
Although LOC (loss of consciousness) needs to be reported, that in and of itself does not force a deferral.

The details around the LOC event will allow the AME to decide the proper course. One of the AME options (depending on the details) is issuance of the medical certificate upon the conclusion of the exam by the AME.
 
midlifeflyer said:
We may be doing a bit of apples and oranges here. There seems to be confusion over the reach of the Domingo memo. So let's be somewhat specific and see what our medical experts (@bbchien @lbfjrmd @WingmanMed) say about this scenario.
  • In January 2020, the pilot receives a HIMS-based SI authorization and 3rd class certificate. The SI Authorization has HIMS compliance conditions.
  • The SI authorization expires October 31, 2026
  • The initial third class medical expires March 31, 2020.
  • The pilot has complied with the conditions of the SI and obtains a second medical certificate which expires September 30, 2020.
  • The pilot decides the program is too expensive and allows the current third class medical to expire. Doesn't go back to an AME to renew.
  • After the current third class medical expires, the pilot ceases participation in the program. FAA withdraws the SI authorization for non-compliance.
May the pilot turn to BasicMed?
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The Domingo letter addresses the scenario perfectly.

Authorizations often have a longer duration than the associated special issuance medical certificate. These longer durations are for internal FAA administrative purposes and aid the Office of Aerospace Medicine with the processing of special issuance medical certificates under 67.401. The Authorization's longer duration period conveys no independent medical privilege as evidenced by the requirement for an airman to demonstrate that he remains qualified for a new special issuance medical certificate when the current special issuance medical certificate expires. As such, an airman's responsibility to comply with the terms of an unexpired Authorization - including a term that requires regular submission of medical information - terminates when the associated special issuance medical certificate expires. Because there is no reasonable basis for requiring an airman in those circumstances to provide medical information that is not needed for determining medical certification under 67.401, the FAA would not have a basis to withdraw the Authorization.
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Domingo states specifically that the FAA would not have a basis to withdraw the Authorization because there is no reasonable basis for requiring an airman who does not hold a current special issuance medical certificate under 67.401 to provide medical information that is not needed for determining medical certification under 67.401.

What is more, the Authorization's longer duration period conveys no independent medical privilege as evidenced by the requirement for an airman to demonstrate that he remains qualified for a new special issuance medical certificate when the current special issuance medical certificate expires. This states that as long as you can demonstrate that you remain qualified for a new SI medical certificate at the time the current SI medical certificate expires, the Authorization cannot be withdrawn for non-compliance AFTER the most recent SI medical certificate is expired and the airman is not currently seeking another SI medical certificate.

This is precisely what Dr Bruce is referring to in regards to "complying with the Authorization to the letter up to and through the date of expiration of the current SI medical certificate". The airman's responsibility to comply with the terms of an unexpired Authorization - INCLUDING A TERM THAT REQUIRES REGULAR SUBMISSION OF MEDICAL INFORMATION (HIMS AME reports fall into this category) - terminates when the associated special issuance medical certificate expires.

In your example, assuming the airman maintained compliance up to and through the expiry date of the SI medical certificate, and because the airman's responsibility to comply with the terms of an unexpired Authorization terminates when the associated special issuance medical certificate expires, the FAA would not have a basis to withdraw the Authorization due to non-compliance AFTER the current 3rd class medical certificate expires. Therefore, yes, the airman may turn to BasicMed.
 
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