Why is BiPolar disqualifying?

Discussion in 'Medical Topics' started by Unregistered, Jul 6, 2015.

  1. ralarcon

    ralarcon Pre-takeoff checklist

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    Not true, calumnious, and the definition of "professional courtesy" is inaccurate. By the way did you take your medications ? :lol:

    Cheers
     
  2. ralarcon

    ralarcon Pre-takeoff checklist

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    Totally incorrect , and misleading. Procedures are established by State Medical Boards , and Medical Quality Assurance organizations , in Hospitals, Clinics and other medical service organizations. Your posts are a representation of the large knowledge gap you have , on this issue

    Cheers
     
  3. Doggtyred

    Doggtyred En-Route

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    There is no mechanism to PRE-SCREEN someone. You don't go take a psych exam to be an MD. Not like a police officer or firefighter. If you stay under the radar or keep yourself consistently medicated then there isn't a barrier to practice.

    If you have a meltdown, or manifest a problem, or bring attention to your problem, sure... there are methods to review both at the institutional and governmental levels.

    Please.. fill in these alleged 'gaps' in my knowledge. I'd be interested in knowing how certain physicians got past all these screening procedures you allege to exist.
     
  4. RJM62

    RJM62 Touchdown! Greaser!

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    I guess it depends on the state and the school or hospital.

    A young relative of mine had to provide fingerprints, be background-checked, and take various psych tests before being admitted to medical school in New York. Then she had to be evaluated again two years later before she could actually work with patients. That's where she is now, and she expects she'll have to go through it again when she applies for her internship.

    I have no idea whether the screenings are required by the state, the school / hospital, or both.

    Rich
     
  5. pilot1956

    pilot1956 Pre-Flight

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    "If you have a meltdown, or manifest a problem, or bring attention to your problem, sure... there are methods to review both at the institutional and governmental levels."

    I think this gets at the issue. If you don't have a meltdown, and you don't manifest a problem, and you don't bring attention to your problem, then why is it relevant to anyone?

    The only thing I am advocating is a performance-based assessment of ability, not a diagnosis-based assessment of ability. Yes, I know, the person with an uncontrolled seizure disorder should not be PIC. Got it. But, for many diagnoses where either the illness or the meds might affect ability (key word is "might"), why not assess ability rather than simply deny the opportunity to all of them?
     
  6. ralarcon

    ralarcon Pre-takeoff checklist

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    "I have no idea whether the screenings are required by the state, the school / hospital, or both."

    Depending on the health care agency, hospital or clinic , state and institution, it may require a clinical and criminal background investigation at a local, state and federal level. In my case it did. A malpractice case involving a Hospital, Clinic, school or agency can get very expensive. These institutions place a considerable amount of resources into doing all that is possible to prevent bad outcomes.

    Cheers
     
    Last edited: Jul 9, 2015
  7. Doggtyred

    Doggtyred En-Route

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    I'd rather have a medicated, stable bipolar person on the controls than someone with schizophrenia or borderline personality disorders (or ANY personality disorder...)... The mood disorders can be managed.
     
  8. Doggtyred

    Doggtyred En-Route

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    Fair enough... In 20 years I've never heard med students or docs say "I have to go for my psych eval"... heard plenty say "I've got boards coming up" or "I've got interviews" or "Match day is tomorrow"... etc..

    Sure there are criminal backgrounds and credit checks... all the way from Docs to Dogcatchers. I've been fingerprinted, and references checked, double checked and triple checked... Have yet to see a healthcare background check that includes the meds you are taking, who your physicians are, and what your medical records include.
     
  9. SbestCFII

    SbestCFII Line Up and Wait

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    It's not paranoia when there are legitimate safety issues. This would be one of those cases.
     
  10. SbestCFII

    SbestCFII Line Up and Wait

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    Unless of course, you've applied for a medical and been denied. The driver's license and sport pilot are no longer an option if you've been denied. You can either let a valid medical expire, or never have had one, but if you applied and were denied...no ball game.
     
  11. SbestCFII

    SbestCFII Line Up and Wait

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    No! Regardless of the presence or absence (or relaxed standards) for the 3rd class, taking any FAA-prohibited medication on their list makes you unfit to fly. That even includes current sport pilots that have never held a medical.
     
  12. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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    Where is the list, and what regulation applies?
     
  13. pilot1956

    pilot1956 Pre-Flight

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    CFII Scott, sorry, but you have no basis to say that about Sport Pilots. The regulations say nothing of the sort. See below.

    For operations that do not require a medical certificate (when the pilot holds a valid US driver's license): "a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner." (Title 14 CFR 61.53, Prohibition on Operations During Medical Deficiency) https://www.faa.gov/about/office_or...am/ame/guide/app_process/general/prohibition/

    Don't take my word for it. Read the regulation and explain how it supports your claim.
     
    Last edited: Jul 11, 2015
  14. pilot1956

    pilot1956 Pre-Flight

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    Well, that's because doing so is a violation of the Americans with Disabilities Act. Fishing for illness (and medications) unrelated to the ability to perform the essential functions of a job is illegal.
     
    Last edited: Jul 11, 2015
  15. Henning

    Henning Ejection Handle Pulled

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    The FAA doesn't really care about PPs killing 4-6 people (the proposed Class III is a revision to allow operations of aircraft <6000lbs GW, more than that still requires one) so long as they don't have liability, eliminate the medical and you eliminate the liability. Since private ops don't have Strict Liability, we'll see these issues dealt with insurance policies and premiums. While pilots won't need a medical via the FAA, the insurance companies will likely require a medical exam to gain insurance, much as for Life Insurance, for determining premiums.

    BTW, the Class III revision is far from a "done deal" at this point.
     
    Last edited: Jul 11, 2015
  16. SbestCFII

    SbestCFII Line Up and Wait

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    Asking someone to disclose health information as part of a medical screening process is not a violation of the ADA or HIPPA either for that matter. ADA only protects persons with disabilities from discrimination because of their disability. HIPPA protects health information from release to unauthorized entities, which do not include health care personnel, health care facilities, insurance carriers and associates of these entities involved in the provision of health care service or arranging for the payment of these services.

    All that being said, if you withhold information on a medical application, you have no protection whatsoever. The medical is a requirement for the pilot certificate, it's not a job application.
     
  17. flyingron

    flyingron Touchdown! Greaser!

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    It's HIPAA. And the FAA is allowed to discriminate. People have already lost that battle in court.
     
  18. mtuomi

    mtuomi En-Route

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    Let's say you have a hand grenade. If it won't blow up, it's not manifesting a problem. But the potential is still there, and that's why I would not want one in the same room where I am.
    "It hasn't blown up in 5 years" is not proof that it wont blow up in the next 5 minutes.

    I have a relative who is bipolar, and off meds he is a great example of someone I really do not want to share airspace with. People like him going flying is a great argument why the 3rd class medical, or similar controlled medical screening procedure is a good idea.
     
  19. azure

    azure Final Approach

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    I agree with almost everything you say here - almost. As to your last sentence, do you think Sport Pilot rules are a bad idea? Remember, under current rules your relative needs only the okay of a doctor, no medical screening like a 3rd class exam, to get his sport pilot license and go share some airspace with you. (That's assuming he hasn't already been denied for a med certificate.)

    I think that if we're going to tolerate the possibility of someone with a porly controlled major mood disorder flying in the NAS in an LSA, we have no scientific basis to not tolerate that same person possibly flying a 172, an M20J or even a SR-22 in the same airspace. I'm not sanguine about either possibility but I also think such pilots will be very rare exceptions, since the majority of people who aren't stably controlled will "bomb" out of their training (pun intended) once their CFI - or heaven forbid the DPE - discovers how unstable they are. Lots of people aren't pilot material for any number of reasons, and I suspect that in most cases, they're found out during training, not in the AME's office.
     
  20. SbestCFII

    SbestCFII Line Up and Wait

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    Sport Pilots are Certificated Airmen. Therefore the guidelines and prohibitions on medications that would cause an AME to not issue a medical certificate still applies to Sport Pilot Airmen as they would to any other airmen. This is outlined in the key text from the FAA site listed below:

    Do Not Fly. Airmen should not fly while using any of the medications in the Do Not Issue section above or using any of the medications or classes/groups of medications listed below. All of these medications below may cause sedation (drowsiness) or impair cognitive function, seriously degrading pilot performance. This impairment can occur even when the individual feels alert and is apparently functioning normally - in other words, the airman can be "unaware of impair."

    The listing of medications includes all medications listed above and below the key text quoted above. You can reach the site to view in full using the URL below:

    www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/
     
  21. Henning

    Henning Ejection Handle Pulled

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    Yep, people tend to confuse 'lack of enforcement' with 'lack of prohibition'. SP is pretty much all self certifying and the FAA wants nothing to do with it or LSA certification. As long as the FAA doesn't have enforcement duties, it has no liability.
     
  22. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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    That link is for AMEs issuing medical certificates.

    Which regulation says that the requirements for a medical certificate apply to those operating under sport pilot rules?
     
  23. CT4ME

    CT4ME Cleared for Takeoff

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    Much about safe flying has to do with good ADM. My experience is that a BP person could be just a bit off their prime and their ADM abilities could be affected significantly. A review of the ADM process only confirms my thoughts
     
  24. pilot1956

    pilot1956 Pre-Flight

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    Scott, when you write "taking any FAA-prohibited medication" do you mean medicines on the "Do not issue" list or do you mean medications on the "Do not fly" list? Your term, "FAA-prohibited" is not used in the link you provided.

    Here is the applicable language regarding pilots who do not require an FAA medical certificate (I provided the link previously):

    "b. Operations that do not require a medical certificate.
    For operations provided for in 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

    c. Operations requiring a medical certificate or a U.S. driver's license.
    For operations provided for in 61.23(c), a person must meet the provisions of Paragraph (a) of this section if that person holds a valid medical certificate issued under part 67 of this chapter and does not hold a current and valid U.S. driver's license Paragraph (b) of this section if that person holds a current and valid U.S. driver's license."

    So, the critical issue is what is meant by, "knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner". I believe that requirement is not the same as taking a medication that would prevent the issuance of a Class 3 or other medical certificate. Do you have a basis in terms of FAA actions for your opinion?

    Under the requirement listed in the regs, the process changes from a checklist-based system (i.e., do you take THIS medication, do you have THIS illness?) to a performance-based system (i.e., are you able to operate the aircraft in a safe manner?).
     
  25. pilot1956

    pilot1956 Pre-Flight

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    mtuomi - poor analogy. Ultimately, we are all hand grenades, the only question is how likely are we to explode? The OP noted that he had been stable and high functioning for a long time. Is he a hand grenade? If yes, what about all the other grenades out there who are not diagnosed? Want to reduce their numbers? Stop letting anyone over the age of 40 years of age fly. You will reduce the risk of sudden incapacitation, which clearly rises with age. If you don't like that idea, then you are willing to let people at risk of exploding (your analogy) fly airplanes.

    Yes, the cut has to be made somewhere. None of us want a person with a poorly controlled seizure disorder to fly an airplane. But, none of what to be denied the opportunity to fly if we are able to do so safely. Its easy to maximize safety (only allow the biologically perfect to fly). It's harder to maximize safety and protect the liberties of persons who are not perfect specimens but are able to fly safely.
     
  26. pilot1956

    pilot1956 Pre-Flight

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    Scott, my comment about the ADA was in response to this: "Have yet to see a healthcare background check that includes the meds you are taking, who your physicians are, and what your medical records include." And, my comment was correct. I happen to hire medical doctors for a living. If I asked them to tell me their medical histories during the interview, I would be in violation of the ADA. Please ask the EEOC if I am correct.
     
  27. SbestCFII

    SbestCFII Line Up and Wait

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    Perhaps I was seeing an Apple instead of an Orange. You are interviewing for hiring for a position. Then yes you would be correct. I was looking from the perspective of a regulatory body that grants credentials (FAA for pilots, Med board for docs, etc.). In those instances the ADA wouldn't have any bearing as these are essentially licensing boards, which are different from a prospective employer...my misunderstanding.
     
  28. Henning

    Henning Ejection Handle Pulled

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    Actually, even employability can be hampered if it is an issue that affects insurability, and insurance companies have full access to your information.
     
  29. SbestCFII

    SbestCFII Line Up and Wait

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    The FAA standard I referenced applies to all certificated Airmen, Sport to ATP. The medications outlined in the reference include all medications on both the "do not issue" and "do not fly" list. In short, as a certificated airmen, light sport category, you may use either an FAA medical or a drivers license (if you haven'r been turned down for a medical), but since you are an Airman, you are essentially deemed unsuitable for flight if you are taking any medications on the "do not issue list," or unless you have waited for a recommended period after taking a medication on the "do not fly" list.

    The impression among many pilots is that, if you use the DL standard and fly only a LS aircraft, there isn't anything else to be concerned about from a medical perspective. The FAA recognizes that holding a driver's license is not a medical standard. I've practiced medicine for 19 years now and have seen people with valid licenses on numerous medications that would impair their ability to drive, and yet they still do. That's why standards like this apply to all Airmen. It provides a level of safety, and it protection for the FAA by establishing a standard they can reference in case of an incident. It is quite reasonable.

    I don't know what will happen with medical reform. I'm not keen on doing away with a basic exam altogether, as much as streamlining and relaxing the process. However, a driver's license has no worth as a fitness document. If you have a pulse and can read the street signs...therefore you can drive. People with uncontrolled diabetes, hypertension, seizure disorders, mental health issues are driving cars. Even a simple form completed by your own doctor, addressing a few obvious conditions that could make flying unsafe, and stating the your health is suitable to fly every few years (during a regular check-up) would suffice nicely for pilots exercising only sport, recreational, and PP privileges. I think that is something most everyone could get behind.
     
  30. SbestCFII

    SbestCFII Line Up and Wait

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    "Airmen should not fly..." Airmen are inclusive of all pilots in the FAA civil registry. Unless a particular group is specifically excluded, then the guidelines would logically apply to all airmen. The "do not issue," is primarily for AMEs, basically saying that applicants on these medications don't get a medical certificate without the approval of the FAA. The "do not fly," section targets airmen, noting that they shouldn't fly on any of the drugs on the "do not issue" list and sets conditions on flying after the utilization of any drugs listed under the "do not fly" section.
     
  31. pilot1956

    pilot1956 Pre-Flight

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    Scott, this is where we disagree. I see nothing that says that medications on the "do not issue" a medical certificate list disqualify a pilot when flying on a US Drivers License. In fact, the FAA could have made this explicit statement and it did not. The "do not issue" list is for issuing a medical certificate, not for flying with a drivers license. The flight privileges available to a pilot with a an FAA medical certificate are greater than the flight privileges available to a pilot who flies with a drivers license. There is no reason to believe that the medication restrictions would be the same.

    I think that the FAA wants SP eligibility to be based on performance and not a list (my opinion only). If a pilot is able to fly safely, then it really doesn't matter what medicine they take.

    Also, we have all seen people driving who should not be driving. OK. I don't think that changes this discussion.

    I agree that the "do not fly" list applies to everyone.

    Finally, if the number of years of medical practice is relevant here (and I don't think it is), then I have you beat by a large margin. BTW, my practice is heavily oriented to fitness-for-duty evaluations for safety-sensitive employment. I deal with this issue all the time in the non-aviation setting.
     
    Last edited: Jul 11, 2015
  32. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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    If FAA medical standards applied to sport pilot, then the FAA wouldn't have removed the references to a medical certificate in the medical deficiency reg. And, the FAA Aeromedical would tell you to go see an AME who would know about the bad stuff list when you have a "significant medical issue". But, no, they tell you that you should see your personal physician. Why would they do that? Do they expect your personal physician to know about FAA medical standards and "do not use" lists? That does not compute.

    I will stick with what the FAA has written.
     
  33. RJM62

    RJM62 Touchdown! Greaser!

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    You're correct, of course, but you're also wasting your time. People who adhere to that myth refuse to let it go no matter how many different ways you try to show them that they're wrong. The FAA's only published advice or opinion on any SP-related medical eligibility question has consistently been for the airman to talk it over with their doctor. Nothing more. Zero. Zilch. Nada. No mas. End of story.

    Still, there are those who simply refuse to believe that. I usually just shrug and tell them to call the FAA Light Sport Aviation Branch at (405) 954-6400 and ask them about it. That usually works, but not always: I've had a few tell self-anointed experts try to tell me that the people running the Branch don't understand the rules, either. Go figger.

    Rich
     
  34. midlifeflyer

    midlifeflyer Final Approach

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    i think the idea behind no medical exam as a requirement is tied to what the FAA sees as a low-risk situation. That, even with something that would technically result in a denial, we are able to fly for certain purposes in certain aircraft, but are being treated as adult enough to know when we would be unsafe.

    So far, anyway, the long history of gliders and the shorter history of sport pilots, suggest we are doing a pretty good job.
     
  35. Geico266

    Geico266 Touchdown! Greaser!

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    Your drivers license is your "medical". If the meds say "may make you drowsey", " don't operate machinery", etc, you should self ground and not fly.
     
    Last edited: Jul 11, 2015
  36. txflyer

    txflyer En-Route

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    Fly it like you STOL it ♦
    Bi-polar and most psych conditions come with other ramifications/manifestations usually.

    Like drug addiction, alcoholism, suicidal tendencies, and a whole range of nasties.

    I speak from experience. My Sister was schizo and bi-polar and manic-d and the whole enchilada at one time or another. She developed an addiction to prescription pain killers, had bouts with alcohol, and had an addictive personality. Obsessive/compulsive or impulsive disorder can surface. One simply cannot say "I'm bipolar and that's it" and take a pill and it's all taken care of. Psych problems are more complicated than that. jmho... :redface:
     
  37. Henning

    Henning Ejection Handle Pulled

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    As long as you go undiagnosed and self medicate with alcohol and street drugs, you're fine....
     
  38. Unregistered

    Unregistered Guest

    I have been stable on lithium for a long time no side effects. Funny thing is that if I didn't have any ethics I could just say eff it and get a medical and simply not disclose my diagnosis. Worst thing they could do is take away your certificates. I am ethical however and I won't do that. I do realize I can fly motor gliders without a medical. The biggest joke is I know there are tons of pilots out there with mental disorders that either hide it or haven't been diagnosed. Our system is completely broken and ridiculously easily to circumvent. The medical exam is a total joke basically tap your legs and listen to your hard. Nothing near what they do in Europe or asia. I bet if they used the same standards here that they did in Europe and asia thousands of pilots would be disqualified. I am no danger as I have zero desire to fly commercially I just want to fly for fun on the weekends.
     
  39. Henning

    Henning Ejection Handle Pulled

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    Actually failing to disclose/lying on the application is a felony IIRC, and the FAA has access to all your medical records thanks to Obamacare. You could however just buy a plane and fly it without a medical with little punishment power available. The only reason you need a license or medical is for a job or insurance. If you don't care about either, all you need to fly is money.
     
  40. flyingron

    flyingron Touchdown! Greaser!

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    You've been listening to Doc Bruce too much Henning. But even he didn't say what you're asserting. The ACA only gave them instant access to the billing/diagnosis codes. That however is bad enough.