Stroke and basic med.

Tom, legal answer, yes, as long as you have not had any of these conditions associated with the stroke. Plus, your doctor needs to be comfortable signing off on it.

good to see you again.
  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
  • 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.
  • A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
    • Myocardial infarction;
    • Coronary heart disease that has required treatment;
    • Cardiac valve replacement; or
    • Heart replacement
 
BFlynn posted the answer. The follow up question is, are you safe to fly? The answer to that depends in part on the cause of your stroke. And that’s between you and your doctor.
 
Tom-D said:
I had a stroke in 2017. ( Aphasia) I have been stroke free since then.. I lost my ability to speak, I now have regained that ability.
Click to expand...
Hoo-rah for you! Good to see you posting again, now please tell me how you cured the aphasia. I'm medical POA for a close friend suffering from it.
 
What about this:
  • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
Anyway, glad to have you back.
 
Isn't there a satisfactory explanation?

I'll point out that light sport is open too without a medical exam.
 
flyingron said:
What about this:
  • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
Click to expand...

And what did Congress mean by "satisfactory"?

A medically valid diagnosis?

or

A medically valid diagnosis plus treatment sufficient to reduce the risk of incapacitation to normal?

or ?​

Anyway, glad to have you back.
Click to expand...

Amen!
 
flyingron said:
What about this:
  • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
Anyway, glad to have you back.
Click to expand...


That is a problem in eyes of some. The stroke was the cause which in my mind was the medical explanation. According to Dr Chien, (at least in 2018), you have to know the cause of the stroke, which the exact reason is often not known.

I am speaking from personal experience, I had a stroke in 2016, waited two years and jumped through the hoops to get my full medical back. I got my basic med but was advised that I didn’t meet the requirements based on the above. My flying plans included planes outside of what is allowed by basic med so I didn’t pursue the matter further.

Good luck and let me know if I can be of any help.
Jim
 
Palmpilot said:
And what did Congress mean by "satisfactory"?

A medically valid diagnosis?

or

A medically valid diagnosis plus treatment sufficient to reduce the risk of incapacitation to normal?

or ?
Click to expand...


PCP: "I'm satisfied. Are you satisfied?"
Pilot: "Yep, I'm satisfied."
PCP: "Sounds pretty satisfactory to me. Where do I sign?"
 
Topper said:
That is a problem in eyes of some. The stroke was the cause which in my mind was the medical explanation. According to Dr Chien, (at least in 2018), you have to know the cause of the stroke, which the exact reason is often not known.

I am speaking from personal experience, I had a stroke in 2016, waited two years and jumped through the hoops to get my full medical back. I got my basic med but was advised that I didn’t meet the requirements based on the above. My flying plans included planes outside of what is allowed by basic med so I didn’t pursue the matter further.

Good luck and let me know if I can be of any help.
Jim
Click to expand...
Basic med depends on what your doctor says, not what any other doctor says.
 
Lindberg said:
Basic med depends on what your doctor says, not what any other doctor says.
Click to expand...
What if the FAA decides that the statute requires you to get a one-time SI? It seems like there is a lack of case law on that.

Of course, I'm not an attorney, so I have no expertise on legal interpretation.
 
Am I safe to fly ?
Good question, I haven't flown since 2017. ??
My Dr. feels that aphasia was caused by high Cholesterol. Cholesterol blocks the tiny blood vessels in the brain. when the brain cells die things quit.
I am on medication for that ( ? sp) I still have a speech impediment and my voice has changed. You must learn to talk again. So you never get over that.
I have no other limits other than the speech.
I thank you for the kind responses, buy my participation here will be very limited.
Thanks again
Tom D.
 
Palmpilot said:
What if the FAA decides that the statute requires you to get a one-time SI? It seems like there is a lack of case law on that.
Click to expand...
How would the FAA ever have the occasion or opportunity to make that determination? When you do basic med, this info isn't sent to the FAA. So how could the statute intend for the FAA to make that determination?
 
Last edited:
Good to see you back.

A doc I know had a stroke and flies C-180.

I think the aerobatics has been dropped though.
 
Lindberg said:
How would the FAA ever have the occasion or opportunity to make that determination? When you do basic med, this info isn't sent to the FAA. So how could the statue intend for the FAA to make that determination?
Click to expand...


People continue to think of Basic Med as a sort of "Class 4" FAA medical. It isn't. Basic Med is not an FAA medical at all; rather, it's an alternative to having an FAA medical. It's strictly between the pilot and the pilot's own physician.

If that physician determines that he cannot sign the Basic Med form because the applicant has one of the conditions requiring a one-time SI, then an AME and the FAA get involved. Not before.

Apart from the one-time Class 3 requirement, it's really more akin to Sport Pilot and its driver's license requirement (in fact, Basic Med also requires you to have a US driver's license). With Sport Pilot, if your physician determines that you're blind in one eye and can't see out of the other (for example), you might have to surrender your driver's license and would no longer be able to fly. The FAA aeromedical folks have no involvement.
 
Lindberg said:
Basic med depends on what your doctor says, not what any other doctor says.
Click to expand...
Yes and no. The doctor completing your BasicMed comprehensive medical exam can sign off your exam but that does not necessarily mean that you're in compliance with 14 CFR 68.9 in order to actually operate under BasicMed.

The doctor doing your exam is not making any assessments as to whether you have medical conditions that require a one-time special issuance. That's on you, the airman, to determine. Certainly you could ask your doctor if in the doctor's opinion you don't have a condition that requires a one-time SI, but ultimately compliance is on you, not the doctor.

As to what "without satisfactory cause" means, as Palmpilot noted, there's no case law to my knowledge on the topic.
 
Lindberg said:
How would the FAA ever have the occasion or opportunity to make that determination? When you do basic med, this info isn't sent to the FAA. So how could the statute intend for the FAA to make that determination?
Click to expand...
I don't know, but people have reported receiving "it appears you do not qualify for BasicMed" letters from the FAA. :dunno:
 
Half Fast said:
People continue to think of Basic Med as a sort of "Class 4" FAA medical. It isn't. Basic Med is not an FAA medical at all; rather, it's an alternative to having an FAA medical. It's strictly between the pilot and the pilot's own physician.

If that physician determines that he cannot sign the Basic Med form because the applicant has one of the conditions requiring a one-time SI, then an AME and the FAA get involved. Not before.

Apart from the one-time Class 3 requirement, it's really more akin to Sport Pilot and its driver's license requirement (in fact, Basic Med also requires you to have a US driver's license). With Sport Pilot, if your physician determines that you're blind in one eye and can't see out of the other (for example), you might have to surrender your driver's license and would no longer be able to fly. The FAA aeromedical folks have no involvement.
Click to expand...
Sounds like you copied and posted one of my old power point slide :)

BasicMed is essentially Sport Pilot medical eligibility... plus an exam, some online training, some attestations, and a list of conditions that divert you back to medical certification path.
 
Palmpilot said:
I don't know, but people have reported receiving "it appears you do not qualify for BasicMed" letters from the FAA. :dunno:
Click to expand...
Those letters go out when someone completes the online training course and attestations, but has either never had a medical, their last medical was revoked, or their last application for a medical was denied.
 
Brad Z said:
The doctor doing your exam is not making any assessments as to whether you have medical conditions that require a one-time special issuance. That's on you, the airman, to determine.
Click to expand...


True, but it's unreasonable to expect the non-physician airman to know enough on his own to make that determination. Therefore, he's dependant upon his examining doctor to advise him and provide enough info so he can determine whether a condition falls into the SI requirement.

If a state-licensed physician tells the airman, "We understand the cause of this stroke and have sufficiently mitigated the issue, and you're sufficiently recovered, that I'm not concerned about you operating a vehicle including your airplane," then who is the layman pilot to doubt him?

Basic Med seeks to provide the airman with information, through the physical exam every 4 years and the course every 2, that he can determine whether he's safe to fly. As far as I can tell, there's no requirement for the Basic Med pilot to seek out info beyond those two sources.
 
Half Fast said:
True, but it's unreasonable to expect the non-physician airman to know enough on his own to make that determination. Therefore, he's dependant upon his examining doctor to advise him and provide enough info so he can determine whether a condition falls into the SI requirement.

If a state-licensed physician tells the airman, "We understand the cause of this stroke and have sufficiently mitigated the issue, and you're sufficiently recovered, that I'm not concerned about you operating a vehicle including your airplane," then who is the layman pilot to doubt him?

Basic Med seeks to provide the airman with information, through the physical exam every 4 years and the course every 2, that he can determine whether he's safe to fly. As far as I can tell, there's no requirement for the Basic Med pilot to seek out info beyond those two sources.
Click to expand...
But the airman has to ask. The state licensed physician has no idea that 68.9 exists, and is not obligated to evaluate the airman in consideration of 68.9.

For example, you could have had a medical that expired in 2008. In 2009, you had a received a stent. In 2022, you appear before a state licensed physician for a BasicMed exam, having fully disclosed the stent. That physician may be perfectly happy with signing off your CMEC. However, you might not be aware that a stent is considered evidence of "coronary heart disease that has required treatment" and requires a one-time SI.

if you aren't familiar with 68.9, and don't ask the doc, and the doc doesn't know enough about BasicMed to inform you, then you may think you're in compliance with BasicMed when in fact your not.

Now if you ask, and your doctor says you're in compliance with 68.9, then that's evidence in your favor if an enforcement action were to ever take place. But ultimately, the FAA makes the call on compliance with the regulation, regardless of what the doctor says. But as noted, there's no case law on any of this. I suspect it would have to be a pretty blatant case before FAA attorneys would even consider trying to pursue a 61.3 violation as a result of non-compliance with 68.9.
 
Brad Z said:
I suspect it would have to be a pretty blatant case before FAA attorneys would even consider trying to pursue a 61.3 violation as a result of non-compliance with 68.9.
Click to expand...


I suspect what you suspect is true. I doubt the FAA would take a chance on an unfavorable ruling setting a precedence, so they would only go there if it were blatant, and even then only if there were external pressures driving it (like the pilot crashed into a busload of child patients en route to Shriner's hospital).

Basic Med seems to be working well, so why mess with it? I wish the FAA would take a lesson and allow any state-licensed physician to do a class 3 plus add anything not on the one-time SI list to CACI. It would unclog the system if only revenue pilots had to go through AMEs and OKC.
 
Brad Z said:
But the airman has to ask. The state licensed physician has no idea that 68.9 exists, and is not obligated to evaluate the airman in consideration of 68.9.

For example, you could have had a medical that expired in 2008. In 2009, you had a received a stent. In 2022, you appear before a state licensed physician for a BasicMed exam, having fully disclosed the stent. That physician may be perfectly happy with signing off your CMEC. However, you might not be aware that a stent is considered evidence of "coronary heart disease that has required treatment" and requires a one-time SI.

if you aren't familiar with 68.9, and don't ask the doc, and the doc doesn't know enough about BasicMed to inform you, then you may think you're in compliance with BasicMed when in fact your not.

Now if you ask, and your doctor says you're in compliance with 68.9, then that's evidence in your favor if an enforcement action were to ever take place. But ultimately, the FAA makes the call on compliance with the regulation, regardless of what the doctor says. But as noted, there's no case law on any of this. I suspect it would have to be a pretty blatant case before FAA attorneys would even consider trying to pursue a 61.3 violation as a result of non-compliance with 68.9.
Click to expand...
It sounds like what's required is a good-faith effort on the part of the airperson.
 
Palmpilot said:
It sounds like what's required is a good-faith effort on the part of the airperson.
Click to expand...
What it really requires is for the airman to understand the peculiarities of operating under BasicMed. It's not like the 3rd class medical, where if the doc issues the medical, you're good to go.
 
Brad Z said:
As to what "without satisfactory cause" means, as Palmpilot noted, there's no case law to my knowledge on the topic.
Click to expand...
Precision is important when discussing laws and regulations, and this one says, "without satisfactory medical explanation of the cause . . . " If I wanted to know if an event has a "satisfactory medical explanation of the cause," I know exactly who I'd ask.
 
Brad Z said:
What it really requires is for the airman to understand the peculiarities of operating under BasicMed. It's not like the 3rd class medical, where if the doc issues the medical, you're good to go.
Click to expand...
That, too.
 
Topper said:
According to Dr Chien, (at least in 2018), you have to know the cause of the stroke, which the exact reason is often not known.
Click to expand...

Great standard for FAA medicals. But FAA standards are not yours and your doctor's standard.
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top