To Give, or Not to Give... the MedXpress Number

[Scottman]

What is the current practice when applying for your first medical (in many years)? I've heard people suggest withholding the application number from the AME until you are sure you're going to pass. Is this a standard thing? Won't the doctor think it's unusual/get put off that he has to examine me before I give him everything?

How many of you do this?

Thanks in advance!

 

[Clip4]

If you have a medical condition you believe may result in the application being deferred or denied, set up a consultation first. Otherwise the AME can simply refuse to examine you without the number. Be prepared to pay for both the consultation and the exam.

 

[Scottman]

Ok, thanks. Don't have anything I'm aware of. Just doing a lot of reading and people saying unless you're sure, then withhold. Thanks, @Clip4

 

[AggieMike88]

Ok, thanks. Don't have anything I'm aware of. Just doing a lot of reading and people saying unless you're sure, then withhold. Thanks, @Clip4

If you are not 100% certain you will be issued, request that the AME do the exam as a consultation. If the AME or staff refuse, find a different AME.

If the AME agrees, complete the MedXpress, print it, and cut off the confirmation from the bottom. This provides the AME with all of the information on the form, but prevents the staff or the AME from "accidentally" making the exam go live. Expect to pay the normal fee for the exam.

If he says he cannot issue, then continue to withhold the confirmation number and discuss in detail why he cannot. Find out if the deficiencies can be overcome and by what means. Also find out the exact process that happens once you have all the documentation he is asking for, especially if the result means deferral and additional review at OKC or Washington DC.

If after the consultation examination the AME says he is able to issue your certificate before you leave, then surrender the confirmation number so the AME can "open" the file, make his entries, and print your certificate.


Doing a thorough physical exam with your regular physician is always a good place to start. Tell him or her that you are planning to get an FAA medical certificate, provide them any info they need, and ask that you be checked over to determine if there are any items that would throw you under the FAA bus. If there are, fix them before seeing an AME, or at least be ready to get appropriate documentation from this doctor to satisfy the FAA.


If ever any doubts, seek the advice, education, and guidance of a properly qualified flight surgeon before submitting anything to the FAA. This step alone may save you loads of money, time, and frustration over "bombing into the office" like Dr. Bruce describes.

 

[PeterNSteinmetz]

[QUOTE="AggieMike88, post: 2788938, member: 6978]"but prevents the staff or the AME from "accidentally" making the exam go live. [/QUOTE]

This actually happens - and can cost you months or years of delay and thousands of dollars.

 

[Skip Miller]

@Scottman

What is the current practice when applying for your first medical (in many years)? I've heard people suggest withholding the application number from the DME until you are sure you're going to pass. Is this a standard thing? Won't the doctor think it's unusual/get put off that he has to examine me before I give him everything?

How many of you do this?

Thanks in advance!

AME.

=Skip

 

[Doc Holliday]

So there are AME’s that will do the exam, and if the person passes, then they enter the number into the system? And conversely, if the applicant fails, nothing gets entered?

Wow.

 

[azure]

So there are AME’s that will do the exam, and if the person passes, then they enter the number into the system? And conversely, if the applicant fails, nothing gets entered?

Wow.

I don't think anyone said that in this thread, though I'm sure there are AMEs that do that. The consultation is supposed to be just that - a discussion of the patient's history. That said, there is nothing keeping the AME from doing an exam identical to the real 3rd class exam (along with the consultation) before telling the airman that he can issue. My understanding (based on a discussion on the Red Board) is that technically, the exam done before taking the application live is a trial run, and the real exam has to be done afterward.

 

[Doc Holliday]

If the AME agrees, complete the MedXpress, print it, and cut off the confirmation from the bottom. This provides the AME with all of the information on the form, but prevents the staff or the AME from "accidentally" making the exam go live. Expect to pay the normal fee for the exam.

If he says he cannot issue, then continue to withhold the confirmation number and discuss in detail why he cannot. Find out if the deficiencies can be overcome and by what means. Also find out the exact process that happens once you have all the documentation he is asking for, especially if the result means deferral and additional review at OKC or Washington DC.

If after the consultation examination the AME says he is able to issue your certificate before you leave, then surrender the confirmation number so the AME can "open" the file, make his entries, and print your certificate.

I don't think anyone said that in this thread, though I'm sure there are AMEs that do that. The consultation is supposed to be just that - a discussion of the patient's history. That said, there is nothing keeping the AME from doing an exam identical to the real 3rd class exam (along with the consultation) before telling the airman that he can issue. My understanding (based on a discussion on the Red Board) is that technically, the exam done before taking the application live is a trial run, and the real exam has to be done afterward.

Maybe I misread the first quote above.

Never ceases to amaze me what I read on these forums.

 

[schmookeeg]

Maybe I misread the first quote above.

Never ceases to amaze me what I read on these forums.

What is your particular objection? Ever take a practice test? Same idea.

 

[Doc Holliday]

What is your particular objection? Ever take a practice test? Same idea.

Practice test is one thing. But filling out a medexpress, taking the identifying number off it, taking the exam and giving the number only if one passes........

Hmmmm.....maybe before taking a practical one should fill out iacra, but not give the DPE the FTN or application number until the individual is sure he passed.....

Carry on folks.....some things just shouldn’t be discussed on open forums.

 

[Greg Bockelman]

Practice test is one thing. But filling out a medexpress, taking the identifying number off it, taking the exam and giving the number only if one passes........

Hmmmm.....maybe before taking a practical one should fill out iacra, but not give the DPE the FTN or application number until the individual is sure he passed.....

Carry on folks.....some things just shouldn’t be discussed on open forums.

So you are not in favor of a consultation? Because that is essentially what this is. Fill out the form, go see the Doc informally and if the Doc sees no issues, go live. Seems like a completely rational thing to do if there is any questions at all about the ultimate outcome.

 

[Doc Holliday]

So you are not in favor of a consultation? Because that is essentially what this is. Fill out the form, go see the Doc informally and if the Doc sees no issues, go live. Seems like a completely rational thing to do if there is any questions at all about the ultimate outcome.

If you say so.

Perhaps one of the AME’s on the forum will give his take on it.

 

[Greg Bockelman]

They do it on a regular basis, Doc.

Did you ever take practice FAA written tests before you took the real thing? Same idea.

 

[azure]

What is your particular objection? Ever take a practice test? Same idea.

I tend to agree with @Doc Holliday on this that it certainly smells like a cheat, since the outcome of the "real" physical exam isn't likely to be any different than that of the trial run (except maybe for the BP measurement). But I believe very few airmen flunk the physical unless they have a known issue. It's usually the history that causes trouble, and I really don't see any problem with a pure consultation before taking the exam live. My AME in MI did this for me at least a couple of times.

 

[Doc Holliday]

They do it on a regular basis, Doc.

Ok. I would like to hear an AME’s take on it. Perhaps one will chime in.

 

[Brad Z]

They do it on a regular basis, Doc.

Did you ever take practice FAA written tests before you took the real thing? Same idea.

This is more akin to doing a mock check ride with a DPE, and if the candidate meets the ACS, the DPE opens up the 8710-1 in IACRA and issues a certificate.

 

[Velocity173]

So if you fail the consultation, are you not gonna have to spend the same amount of time and money as if you failed the real thing? Still gonna have to fix the deficiencies one way or another.

 

[Doc Holliday]

This is more akin to doing a mock check ride with a DPE, and if the candidate meets the ACS, the DPE opens up the 8710-1 in IACRA and issues a certificate.

Yep. And if a DPE did that, it would probably be his last check ride.

 

[Greg Bockelman]

So if you fail the consultation, are you not gonna have to spend the same amount of time and money as if you failed the real thing? Still gonna have to fix the deficiencies one way or another.

True that, but if you fail the real thing, your Sport Pilot option goes out the window.

 

[TCABM]

I tend to agree with @Doc Holliday on this that it certainly smells like a cheat, ...I really don't see any problem with a pure consultation before taking the exam live. My AME in MI did this for me at least a couple of times.

Very similar to my last FAA exam, which is the first time I’ve flown on an FAA medical in decades. Did a consult, figured out what was needed. Brought everything in, teetered on documentation in my records that I needed to produce. Found it in the office and was issued. Had I not been able to retrieve it, deferral and wait.

So if you fail the consultation, are you not gonna have to spend the same amount of time and money as if you failed the real thing? Still gonna have to fix the deficiencies one way or another.

Not necessarily; it may simply be documentation one already has, but doesn’t have with them.

I see no issues with a pure consult, records review, whatever one wants to call it and then come for a follow up to make sure all is in order. Then start the live and get issued in office.

It’s like Doc Bruce says, submit it all up front to minimize the delay.

Other AMEs don’t necessarily endorse that philosophy.

 

[SkyDog58]

@Scottman


AME.

=Skip

You mean Designated Mechanic Examiners don’t do medicals?!

 

[schmookeeg]

I tend to agree with @Doc Holliday on this that it certainly smells like a cheat, since the outcome of the "real" physical exam isn't likely to be any different than that of the trial run (except maybe for the BP measurement). But I believe very few airmen flunk the physical unless they have a known issue. It's usually the history that causes trouble, and I really don't see any problem with a pure consultation before taking the exam live. My AME in MI did this for me at least a couple of times.

Unlike, say a checkride with a DPE which has serious financial costs (plane rental, endorsement, and most DPEs I know are many multiples of an AME)... at least someone got to a doctor to sniff out their issue, rather than playing turtle with it?

I dunno. It seems the objection is that they've combined the consultation and the exam. I sorta get why that's skeezy, but it's also "practical" in my opinion. The costs of flunking a medical are very high and everlasting, so one would naturally want to guard against it.

 

[Velocity173]

Very similar to my last FAA exam, which is the first time I’ve flown on an FAA medical in decades. Did a consult, figured out what was needed. Brought everything in, teetered on documentation in my records that I needed to produce. Found it in the office and was issued. Had I not been able to retrieve it, deferral and wait.


Not necessarily; it may simply be documentation one already has, but doesn’t have with them.

I see no issues with a pure consult, records review, whatever one wants to call it and then come for a follow up to make sure all is in order. Then start the live and get issued in office.

It’s like Doc Bruce says, submit it all up front to minimize the delay.

Other AMEs don’t necessarily endorse that philosophy.

Ok, I can understand that but I think that information could also easily be obtained with an online search. Find out what you’d need to bring in for the “live” physical.

 

[azure]

Ok, I can understand that but I think that information could also easily be obtained with an online search. Find out what you’d need to bring in for the “live” physical.

In some, many cases, yes. But there are certainly conditions where, unless you know to consult the AME's Guide, it's perhaps not so easy. For example, IBS-C is a SI, but I haven't seen that anywhere in any official documentation. The conditions for a history of skin cancer (let's say squamous cell) to be issuable might be hard for most people new to the FAA system to find as well.

 

[TCABM]

Ok, I can understand that but I think that information could also easily be obtained with an online search. Find out what you’d need to bring in for the “live” physical.

Dude, with all the stuff DoD flight surgeons stick in your records, you’d be surprised.

If I had not had access to exam notes thru Tricare On Line, that I could print out in the office, I was getting deferred, because the exam was ‘live’.

 

[PeterNSteinmetz]

Ok, I can understand that but I think that information could also easily be obtained with an online search. Find out what you’d need to bring in for the “live” physical.

I think it really does take an expert to interpret the history in light of the FAA requirements these days. There are a lot of snafus and gotchas that can show up.

Always do a consult first.

 

[Velocity173]

I think it really does take an expert to interpret the history in light of the FAA requirements these days. There are a lot of snafus and gotchas that can show up.

Always do a consult first.

Yeah and you can find many AMEs online that will save you the money of going in and doing a consult. If the OP doesn’t plan on answering yes to any of the questions on the 8500, it’s an easy 30-45 minute in and out process. If yes, then get online and ask Doc Bruce or others if it’s an issue before going in.

 

[Velocity173]

If you think you can’t pass the eye exam then by all means do a consult to memorize the eye test.

 

[PeterNSteinmetz]

If the OP doesn’t plan on answering yes to any of the questions on the 8500, it’s an easy 30-45 minute in and out

I wonder what fraction are like that nowadays? I suppose for younger people there could be a fair number.

The only other caution for people to be aware of, which has been mentioned by others, is that if you are denied, then you are potentially locked out of other recreational options, such as light sport, or will need to do a potentially expensive special issuance.

I will certainly always advise my students to do a consult, either as a separate visit or work with a AME who can do sequential visits for a lower cost.

 

[Tarheelpilot]

In my opinion you’re either getting a medical exam or a consult. I have done consults with AME’s and I never completed the medexpress form.

After the consult I scheduled another visit for my medical. If I’m completing an application I’m going for an exam.

I think the “I’m here for a consult but if it’s all good here’s my app number” is kinda bs too.

 

[BeJimmiefer]

I agree a visit is in order there are many reasons where those symptoms could occur but since Im not a vet I wouldn’t want to speculate or give out the wrong information. I don’t know what the standard fee for an e-visit is but it would be worth it.

 

[Velocity173]

I wonder what fraction are like that nowadays? I suppose for younger people there could be a fair number.

The only other caution for people to be aware of, which has been mentioned by others, is that if you are denied, then you are potentially locked out of other recreational options, such as light sport, or will need to do a potentially expensive special issuance.

I will certainly always advise my students to do a consult, either as a separate visit or work with a AME who can do sequential visits for a lower cost.

Well if it’s a 3 with nothing in the remarks or SIs, I think it’s realistic. This year’s 2 I was in and out in 35 minutes with even a little chit chat with the doc.

I’m sure a 1 would be at least an hour but never had one outside the military equivalent. If the OP was going that route I would say to definitely do their homework before hand because there are many trip ups when you’re looking at an exam with over 100 questions.

 

[Scottman]

@Scottman


AME.

=Skip

Oops. Sorry, yes, AME

 

[Scottman]

Very similar to my last FAA exam, which is the first time I’ve flown on an FAA medical in decades. Did a consult, figured out what was needed. Brought everything in, teetered on documentation in my records that I needed to produce. Found it in the office and was issued. Had I not been able to retrieve it, deferral and wait.

Wait... If there are any questions at all, like the AME wants to see a letter from your Chiropractor that your back is okay, then they HAVE to defer you right away? There is no... "Email me a letter from your doc tomorrow and then I'll submit and issue?"

 

[AggieMike88]

Wait... If there are any questions at all, like the AME wants to see a letter from your Chiropractor that your back is okay, then they HAVE to defer you right away? There is no... "Email me a letter from your doc tomorrow and then I'll submit and issue?"

I think I recall from past discussions that the AME can press the pause button for a very short amount of time, allowing you chase bits of paper if needed.

But once the MedXpress file is officially opened in the system, the AME must take action within the time frame put on him/her. So if pausing to chase paper is allowed, but you don't return by the deadline, expect the file to be updated with the information he/she has, and closed/submitted to the FAA.

 

[TCABM]

Wait... If there are any questions at all, like the AME wants to see a letter from your Chiropractor that your back is okay, then they HAVE to defer you right away? There is no... "Email me a letter from your doc tomorrow and then I'll submit and issue?"

I don’t know the answer to that specific question.

What I do know is that when I was sitting in Bruce’s office, he said ‘produce the notes from that visit or I have to defer’. I asked if I could fax them from home later that day; the answer was no.

So I hopped on the internet, accessed my records and sent him a PDF to print so he could submit it.

 

[Salty]

I don’t what the issue is with hiring an experienced professional (a licenced AME) to consult with in order to prepare for your exam with an AME (which may immediately follow the consult). That’s all we’re talking about here. Nothing skivvy about it. Pretty smart IMO.

 

[azure]

I don’t know the answer to that specific question.

What I do know is that when I was sitting in Bruce’s office, he said ‘produce the notes from that visit or I have to defer’. I asked if I could fax them from home later that day; the answer was no.

So I hopped on the internet, accessed my records and sent him a PDF to print so he could submit it.

Thank God for patient portals! Not all offices that provide them upload visit notes, so you were lucky.

I'm a little puzzled though, since I could swear it was Bruce who said once that the AME does have some wiggle room time-wise, something like 24 or 48 hours... maybe there was another reason he couldn't let you fax it from home. (Or maybe the rules have changed, as that was quite a while ago now.)

 

[azure]

I don’t what the issue is with hiring an experienced professional (a licenced AME) to consult with in order to prepare for your exam with an AME (which may immediately follow the consult). That’s all we’re talking about here. Nothing skivvy about it. Pretty smart IMO.

I agree that there's nothing skivvy about doing a consult prior to the exam. Where things get a little gray is if the AME also conducts a mock exam before the real exam, and I think it goes over the line if he just does the exam before entering the code. Though I could be wrong, my understanding is that that would be strictly verboten.