Why is BiPolar disqualifying?

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

  1. Henning

    Henning Ejection Handle Pulled

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    That's all they need to prove you lied. Better to just ignore the requirements and fly with no license and medical than to fraudulently obtain the documents. If you want to insure, you invalidate it anyway, and potentially add insurance fraud to your problems. Planes are cheap as chips these days, and there are quite a few people flying outside the rules, it's not like there's a big chance of getting caught.
     
  2. azure

    azure Final Approach

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    If you fly enough, someday you will get ramp checked...
     
  3. Henning

    Henning Ejection Handle Pulled

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    29 years and over 2500 hrs and it hasn't happened yet. Besides, there's not much they can do about it. The punishment available for being unrated is significantly less than for falsifying documents.
     
  4. azure

    azure Final Approach

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    If that's what they go by, the system is well and truly broken and most of us should be living in fear of a knock on the door. Heck, when I was in my early 20s I saw an old cardiologist on the edge of senility who, without running a single test, declared that he had "to be careful with you because you have coronary heart disease". Does that mean I was supposed to have disclosed a history of CAD?

    Someone has a bad headache, complains to their doctor, who codes it as a "migraine" without saying anything to the patient, who now has a "history of migraine". Five years later he starts taking flying lessons, but doesn't disclose the visit to the AME because it was outside the time frame. He goes on to solo, gets his IR and commercial, then it gets caught by QA or after a prop strike and they take away all his certificates for failure to disclose.

    If that's truly the kind of game they play, then it's yet another sign that the bureaucracy is out of control and needs to be trimmed back - drastically. :yesnod:
     
  5. azure

    azure Final Approach

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    It's happened to lots of people though. I missed getting ramped at 3W2 by a few days once. And they'll tell you not to do it again, and if you still fly, then the punishment gets more severe.
     
  6. Unregistered

    Unregistered Guest

    I think that is actually a good idea. Buy a plane for cash and just fly anyway. I just need to find someone that will teach me. Better to beg for forgiveness than ask for permission.
     
  7. SbestCFII

    SbestCFII Line Up and Wait

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    My point is that the reference addresses Airmen collectively and doesn't differentiate between any specific certificate holders. It states Airmen should not fly while using either the medications listed in both the "do not issue" and "do not fly" sections. I can't reasonably infer any ambiguity in the wording that would support a different interpretation.
     
  8. JHW

    JHW En-Route

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    For me, once so far in 25 years, and that was at an airport with lots of people and pavement. I'd say that risk is pretty low.
     
  9. SbestCFII

    SbestCFII Line Up and Wait

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    Not so much an example of controlling the bureaucracy as much a making sure that you medical data is accurate. It that example, it was the doc that would have hosed you, not the FAA...right?
     
  10. pilot1956

    pilot1956 Pre-Flight

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    Scott, you are choosing to impose your own belief on the regs. Guidance regarding issuance of a medical certificate is not relevant to those who do not have a medical certificate. As noted by another poster, you should call the Light Sport Division and ask them.
     
  11. azure

    azure Final Approach

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    My point is that having a bogus diagnosis code somewhere in someone's medical history should not "hose" them. The only way to prevent that is to ask for the diagnosis codes used after every doctor visit. That might work today, and in the future, but not everyone knows from an early age that they are going to be a pilot, or what it entails. So what about that visit 20 years ago? Suppose you go through this exhaustive search and find a code that is totally off the wall, a clear case of creative billing. How do you propose do get it corrected? This is 20 years ago and the doctor has retired. Now what?

    I really think that's putting an undue burden on the airman, and the need to even attempt it shows that the bureaucracy has too much power.
     
  12. Henning

    Henning Ejection Handle Pulled

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    incorrect, it is not irrelevant, it is just unenforceable. You can choose to kill one person along with yourself so long as you don't charge them money for it. The insurance payouts for LSA/SP are limited and the actuaries have enough information to accurately set premiums to maintain profitability. The main purpose of the FAA is to assure that the actuaries are working from valid assumptions. GA has liability limits typically at or below $1MM and hull exposures much less. This is not a critical industry and losses are easily calculated (for actuaries at least, those guys are scary smart with statistical analysis) and appropriate premiums set.

    It's the aircarrier industry where Strict Liabilty with basically unlimited exposure exists. That is where the FAA needs to, and does, expend the vast majority of their resources. That s why the FAA just isn't touching enforcement of LSA/SP. The recommendation for the do not take list is valid for any airman. If you hold and/or exercise the priveledges accorded a medical, you have an obligation to honor those recommendation and choose the proscribed actions. If you are operating under SP privileges you have no such obligation; the realities behind the recommendations and prohibitions are not invalidated though, so the relevance is still there.

    It's a matter of "accepted and calculated losses."
     
    Last edited: Jul 12, 2015
  13. Henning

    Henning Ejection Handle Pulled

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    Take an Alaska vacation, plenty of people will teach you. If you are dedicated you'll be good for solo stage in a couple weeks, from there you're safe to teach yourself.
     
  14. RJM62

    RJM62 Touchdown! Greaser!

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    What you're missing are the words "without clearance from the Federal Aviation Administration (FAA)" in the first section of the instructions for the "Do Not Issue" section. There's also a similar statement in the last bullet regarding newly-approved medications where the AME is directed to "contact the RFS or AMCD for guidance on specific applicants."

    The significance is that the unacceptability of the medications in the "Do Not Issue" list did not come down from Sinai. There are exceptions for some of the medications; but for those seeking a medical certificate, "clearance from the Federal Aviation Administration" must first be obtained.

    For someone seeking a medical certificate, this usually would mean deferring the airman or requesting an SI. For airmen flying under SP, the FAA simply and explicitly doesn't want to know. If the airman contacts the FAA, they will tell the airman to talk to their doctor about it. That, in effect, replaces the whole SI process for those who are using the "DL Medical." FAA explicitly does not get involved with those decisions for people whose flying does not require a medical, period.

    Regarding the "do not fly" medications, however, we are in agreement. Those medications are mentioned in a context that has to do with flight fitness, not certification eligibility; and they are grounding for all airmen within the time frames prescribed.

    Rich
     
    Last edited: Jul 12, 2015
  15. Henning

    Henning Ejection Handle Pulled

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    Remember, there were two reasons to adopt LSA/SP rules. One is to comply with ICAO treaties we are signatory to. Luckily the FAA got a twofer out of it and that was to put the guys operating 2 person flights in "fat ultralights" under excemptions in Pt 103 at the time for training and demonstration for sale flights through some formalized and properly supervised training program. That is all SP is for, just get some minimum training to haul a passenger, and provide a small infrastructure to vet SP instructor applicants to a minimum standard.
     
  16. Mason

    Mason Pattern Altitude

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    Well said.
     
  17. SbestCFII

    SbestCFII Line Up and Wait

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    I still don't see that first section as relevant to the "Do not fly" section. As written, it is clearly states under the "do not fly" section:

    "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."

    I can see why a pilot would rationalize a different interpretation when they're taking a prohibited medication because they're an SP and don't hold a medical. However, this paragraph doesn't have any bearing on the issuance of a medical certificate. It unambiguously states that "Airmen," should not fly while taking medications listed in either section. I think the guidance here literally means exactly what it says. The first bullet applies to an AME's issuance of a medical, while the second bullet, applies to everyone.

    Taking the other position would be implying the inverse, that someone not holding a medical certificate is OK to fly while taking anti-seizure medications, psychotropic medications, opiates, benzos, barbiturates, amphetamines, etc. or anything else on the prohibited list. Anyone taking medication(s) on the "do not issue" can't realistically self-certify their fitness to fly, nor does the lack of medical certificate mean that there are no medical standards that apply to the SP. If you're a "Airman," the list of prohibited medications still applies, whether the pilot follows that advice or not.

    Big Lou maybe flies SP because he thinks it OK to do that while taking Oxycontin and Lyrica for his chronic back pain. In fact, Lou shouldn't be flying at all. Not because when he crashes he'll make all GA pilots look bad for flying while taking controlled substances, but because he's making it more dangerous for all of us sharing the airspace with him.
     
  18. Henning

    Henning Ejection Handle Pulled

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    Of course it's rationalization, it is however legal rationalization as the FAA has put the responsibility for medical certification squarely on "Self". So long as they never denied you before, they have no liability with regards to you flying with whatever medical or mental condition; so long as one can keep a driver's license the actuaries have a base line competency and capability to work with.
    It's a big sky, and I have had close approaches with thoroughly, medically, vetted military pilots. I don't see where these people who want to fly really increase my exposure to any particular degree.

    Everybody has the freedom to fly at some level, and the lower the level the less damage one can produce. No one survives life, GA doesn't change the statistic with pt 103 and 91 accidents combined. In the total they are all rare events, and the aviation events that involve injury or death outside the aircraft occupants are a rarer still subset of those rare numbers. And the non fatal accidents far outweigh the fatal.

    I'm cool with people with SP privileges, or 103 for that matter, flying around in a light craft self certifying they are good to fly, even if they really aren't. Anything in the 4 seat range is really ok by me, even light twins. I'll share the skies with them, no worries. I just don't want them in the front seat of the plane where I'm in the back is all.
     
  19. SbestCFII

    SbestCFII Line Up and Wait

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    Well said. I support allowing the driver's license standard for recreational privileges, hopefully with everyone following the guideline. My point is that, whether or not pilots adhere to them, that the "do not fly" guidelines concerning medications apply to all Airmen, regardless of whether they have a medical or use a driver's license. I know people will ignore them, just like people conceal medical conditions from an AME so as to not be denied a medical. Here in Afghanistan, I also see people concealing serious medical problems that would make them ineligible for working good-paying contractor jobs here. The motivation to not follow rules or engage in outright fraud always has a gain...usually fun or profit. We can't protect people from themselves. We just don't want to extend the potential for harm to others, however low that potential might be.

    Oh...I like your quotes...
     
    Last edited: Jul 13, 2015
  20. pilot1956

    pilot1956 Pre-Flight

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    Scott. No one disagrees with your point about "do not fly" meds. The difference is for "shall not issue" meds.

    Re your statement, "We just don't want to extend the potential for harm to others, however low that potential might be." is not correct. We extend potential harm all the time when the risk-benefit ratio warrants doing so. If we want to minimize potential harm fully, we would only allow professional drivers to drive cars and allow nobody to fly private airplanes. A very low potential for harm is not reason to deny a right (or privilege) to large numbers of people.
     
    Last edited: Jul 13, 2015
  21. RJM62

    RJM62 Touchdown! Greaser!

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    Scott,

    Let me clarify something: I never said any of this made sense. I'm simply telling you what FAA's policy is and has been, and what the Light Sport Aviation Branch will tell an airman if they were to call and ask about it. The answer will be, "Talk to your doctor about it."

    Our disagreement is the result of your trying to make sense of it. Stop trying to make sense of it, and it will make sense.

    If you simply can't stop trying to make sense of it, then start with this mantra:

    The FAA does not want to know.

    Repeat that a few times, because it's central to making sense of all this. And no, I'm not even being sarcastic. I'm serious.

    Now understand that in the United States, the specific regs related to SP and LSA were the result of abuses of Part 103, particularly the EAA and USUA training exemptions. Part 103 itself came about because FAA very desperately wanted nothing to do with hang gliders and other tiny flying machines that evolved from hang gliders. They so emphatically wanted nothing to do with them that they created an entire world beyond their own purview, called it Part 103, and stayed as far the hell away from it as they possibly could.

    FAA so categorically wanted to distance themselves from anything having to do with tiny flying machines, in fact, that they further created the EAA and USUA training exemptions -- exemptions from exemptions, because all of Part 103 is an exemption when you get right down to it. That's how badly FAA wanted to stay away from that world: They created exemptions to an exemption to allow people with no FAA certifications whatsoever to provide paid flight training -- all intentionally outside of FAA's own purview.

    Are you getting a sense for how strongly FAA wanted nothing to do with Part 103 operations? Okay, good.

    The problem that came about was that some EAA and USUA instructors started blatantly abusing their respective exemptions by offering what were essentially paid sightseeing rides to the general public by calling them "flight training." These operators could be found all over rural America during tourist seasons, usually setting up shop on airstrips both real and improvised along roads that were heavily traveled by tourists.

    The problem with this was not that the instructors were breaking the law. Rather, the problem was that in most cases, it wasn't clear whether or not they were breaking the law. As long as the receipt said the money was paid for an "introductory flying lesson," the instructors were within at least the letter of the exemptions. How could the instructor know in advance that the "student" would not want to continue "training" after the "introductory lesson?"

    Nonetheless, no one complained much about these abuses until some of the flights augured, at which time FAA had to hold their noses and get involved. The public, it was decided, had a reasonable expectation that someone holding himself out as a flight instructor would have some sort of FAA certification, and that the aircraft used for such instruction should have to meet some sort of minimal airworthiness standards besides being too lightweight for the FAA to care about.

    FAA had to make those assumptions true: and so the SP rule was born. It defined certain standards for pilots, instructors, and light sport aircraft, with the specific objective of eliminating the EAA and USUA exemptions and the abuses thereof.

    To sweeten the package, it did come with some bennies for the former 103 guys: Pilots would be able to carry a passenger, pilots and instructors would get "real" pieces of plastic from FAA saying that they were "real" pilots and instructors, and they'd all be able to fly bigger machines (and machines with N-numbers, at that!) that didn't look so much like winged lawn chairs.

    The problem (or at least one of the problems) with the idea was that many (or possibly most) of the EAA / USUA instructors and pilots were not eligible for medicals. There had to be some medical requirement. The question was how to come up with one that allowed ineligible pilots to magically become eligible, while allowing FAA to remain ignorant and unaccountable.

    The idea of a Fourth Class medical was briefly discussed, and was as rapidly dropped as a hot rock. The possession of any sort of FAA medical paper whatsoever could mean that the FAA knew about deficiencies in the airmen's health, which could possibly mean they might theoretically be held accountable if the airman (or more importantly, their passenger / student) died due to some in-flight medical problem. Obviously that was a no-go. Accountability was a deal-killer.

    The idea of a self-signed medical cert countersigned by an airman's own doctor was also discussed and scrapped because no non-AME in his right mind would sign off of someone's fitness to fly. AME's are protected in various ways, most notably the fact that no AME in history has ever signed off on someone's fitness to fly. They only certify that the airman doesn't appear to suffer from any of the bazillion things that would be disqualifying. That is all the AME certifies to, not that the airman is actually fit to fly. It's an objective judgement, not a subjective one; and it helps insulate the AME from liability.

    The problem was that many -- possibly most -- of the EAA / USUA guys did, in fact, suffer from one or more of the bazillion disqualifying afflictions. Some were even rumored to have hangnails! So an AME could not sign them off; and a non-AME would have to be insane to do so.

    What ultimately was decided was that in addition to having to possess state drivers' licenses (which at least suggested that they weren't totally blind the last time they renewed), SPs and SP instructors would be "advised" to discuss their health with their personal doctors. But no record of these discussions would ever be reportable to FAA, nor would FAA ever get involved in answering questions about the medical eligibility of pilots using their drivers' licenses as medicals.

    The FAA explicitly, emphatically, and categorically did not want to know: and they still don't.

    Indeed, FAA carefully crafted the rules and interpret them in such a way as to make sure that they never know. They intentionally distance themselves as far as possible from any SP-related medical questions. They merely "advise" -- not even "require," which might suggest urgency -- that SPs consult with their own doctors about questionable medical fitness issues which can include literally every conceivable medical problem for which the FAA might ever issue an SI -- or not.

    The FAA categorically washed their hands of everything medically-related where SPs are concerned, and they have no intention of ever dirtying them.

    As cynical as my explanation may seem, I basically agree with the FAA's approach. In fact, I'd like to see it applied to domestic RP and PP operations, as well, possibly with weight and number of pax restrictions. The one change I would make would be a requirement that people using the "DL Medical" see a doctor once a year for a non-reportable physical exam. The combination of the DL and the receipt for the exam would constitute the medical.

    The physical exam would have to be non-reportable because, remember, the FAA does not want to know. But at least SPs and others whose medical condition might be less-than-perfect would have to darken a doctor's doorstep once a year in order to keep flying. I think that's reasonable. Also, in most states doctors are required to notify the DMV if a patient becomes unfit to drive; so the mandatory annual doctor visit would at least suggest that the SP hasn't become too blind, senile, or sickly to drive themselves to a doctor's office once a year, much less fly light aircraft. The loss of the DL would effectively ground the pilot, making the physical an indirect safety check even thought it would be non-reportable.

    (Oh, by the way, the only medication I take is metformin, not any antipsychotics or the like. That's not to say that I wouldn't benefit from them, but I don't take any.)

    Rich
     
    Last edited: Jul 13, 2015
  22. Stevel

    Stevel Pre-takeoff checklist

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    Rich, thank you for writing this up. I have pieced together this exact explanation in my mind over the years, but have never seen it all in one neat package. I intend to use this as my go-to reference on the subject.
     
  23. RJM62

    RJM62 Touchdown! Greaser!

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    Thank you, but please don't do that. There may have been a tad of cynicism injected here and there in my account.

    Rich
     
  24. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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    And, while part 67 gives the Federal Air Surgeon the authority to issue / deny / whatever when it comes to medical certificates, the FAA did not create any rule that gives the Air Surgeon any authority w.r.t. non-medical required operations (from 103 to gliders to s.p.).
     
  25. Stevel

    Stevel Pre-takeoff checklist

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    The folks that I would be sharing this with should be able to detect that and come to the appropriate understanding. I'm primarily trying to talk some sense into folks who can have some influence over another group within our local UL and LSA community.

    The latter group is egregiously abusing the training environment in ways that the FAA isn't trying to stop, but that add HUGE potential liabilities to our USUA club. An accident or two would completely ruin us locally, and if this is going on elsewhere, it could also prompt additional crackdowns and more restrictive rules on the training environment.

    They basically took the behaviors that got the Part 103 training exemptions eliminated and transferred them over to the SP regime (only they don't actually follow the new regulations either). I am trying to get them to knock it off, or failing that, to take it somewhere else.

    This is one of the two issues that have kept me on the club's board for a fifth year now. It is a worse-than-thankless, uncompensated position that I would prefer to be done with. If I were compensated for my time on these two issues, it would have paid for both of my planes, my hangar, and hangar rents.
     
  26. RJM62

    RJM62 Touchdown! Greaser!

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    Roger that. I often wonder who's going to succeed in destroying both 103 and SP first: Those on the outside, or those on the inside. :no:

    Rich
     
  27. Blatham489

    Blatham489 Pre-takeoff checklist

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    Back to rented mules
    5 pages (I searched, couldn't find it) and not ONE wise guy has chimed in with something like:

    "because there can only be one PIC"
    ?

    I'm disappointed, this crowd's getting too serious.
     
  28. pilot1956

    pilot1956 Pre-Flight

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    Rich, thanks for a clear explanation.
     
  29. Henning

    Henning Ejection Handle Pulled

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    There is a bit of a mess there, but it is manageable because PT 103 has no training requirements I recall. Self taught 103 pilots are all over the place, and it's really not that tough. Yes, they eliminated the 2 place exemptions for craft that did not meet 103 requirements because the community abused those exemptions. I may even be guilty of some exemption abuse flying rides under the 'demonstration for sale' exemption in an MXII. The problem was that there were too many accidents and fatals with the second person, and the operations weren't properly accounted for under insurance law and Homeowners insurance policies were being sued against under the liability parts by the family of the passenger. It was a bit of a mess as well, and that was the mess the FAA needed to address.

    You can still get training in the two seat variants for ops in your one seat 103 plane without having to do the whole SP route though if you just want to get a feel for it with an instructor, but really, most all the 103 machines are slow and docile enough that training yourself following the manufacturer published program (or one of the other accepted published programs if there is none from the manufacturer) to teach yourself to fly it. Eiper used to give one book, Assembly/Flight Manual.

    SP/LSA was never intended to regulate behavior. SP was always about getting a minimum amount of standardized and supervised training on a pilot before they take a passenger. It was always about providing a stable actuarial assumption around which could be profitably packaged an insurance product to deal with the liabilities incurred. LSA was always about providing a legally defined cubby hole for the "fat ultralights" to fit into, SP to get their pilots some formal training.
     
  30. Stevel

    Stevel Pre-takeoff checklist

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    It will absolutely be those on the inside.
     
  31. bbchien

    bbchien Touchdown! Greaser!

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    Fellas, it's the law of the land. It is what it is.

    You can't have any kind of a medical if you have bipolar, because that itty bitty part of your brain that sez, "How'm I doing" is broken from time to time and there is now way to control when. Congress basically wrote that into Basic_Med as well, and I don't think there is a family practitioner in the land who would do a Basic_Med for a bipolar even if there weren't a restriction...

    To gmf1399, in the community we have the family practice "SSRI test". If you can't tell a unipolar presentation (depression), give 'em an SSRI and hold on to your hat as you're going to see full blow mania I about 2 weeks- if your patent survives that long.

    And no, you don't "outgrow" bipolar.......
     
  32. denverpilot

    denverpilot Taxi to Parking

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    Wow. That's impressive that it's that consistent.
     
  33. deonb

    deonb Pattern Altitude PoA Supporter

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    Guuaaarrd... I mean... Neeeccroo!
     
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  34. Brad Z

    Brad Z En-Route

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    Rich, I want to commend you on (mostly) correctly predicting BasicMed a year before it passed.
     
    Last edited: May 17, 2017
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  35. RJM62

    RJM62 Touchdown! Greaser!

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    Thanks.

    Rich
     
    denverpilot likes this.
  36. Ally

    Ally Guest

    What if you haven't been on meds for 6 years and your doing amazing? Are there exceptions?
     
  37. Rushie

    Rushie Pattern Altitude

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    Rushie
    If you have been told you have bipolar disorder and have not been on any meds for six years and feel you are doing amazing then I'd say either you were misdiagnosed or you are in a mania part of the cycle.

    To my knowledge there are no exceptions with the FAA. If you have a bipolar diagnosis the only way to get certified is to unring that bell, really hard and expensive. It means proving the diagnosis was wrong in the first place.
     
  38. bflynn

    bflynn En-Route

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    Brian Flynn
    To catch up on the conversation, I scrolled to the top of the page to read...and then saw Henning posting. Odd deja vu until I realize how necroed this thread was.
     
  39. Kenny Phillips

    Kenny Phillips Cleared for Takeoff

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    But it's still relevant.
     
  40. Half Fast

    Half Fast En-Route

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    I started to reply, "Well it is and it isn't" but I decided to resist the temptation as I'm fighting off one of my manic swings....