FAA Completes New Medical Rule

[gbigs]

Every 48 months you are required to have a comprehensive medical review with your doctor, and disclose these conditions on an FAA form.  You are swearing to that effect. If you disclose a cardiac (or other listed condition) you are required at that point to get an SI, just as if you held a third class medical.   If you lie on the form, you are subject to certificate revocation, just like if you lie on any other FAA medical form.  I don't think "just lie" is a strategy for success here.

 

You are in no way required to communicate with the FAA about your medical condition especially not under oath.  It works the same as Sport Pilot..honor system.....there is absolutely no connection between your doctor, you and the FAA regarding your medical status.  That is the entire point of these reforms.....Once you start to fly under this rule you are flying exactly the same as a Sport Pilot except you are flying larger, faster aircraft and can fly a IMC below 18k feet.

[Doug G.]

I think there are two different definitions of "honor" going on here.

[FlyingMonkey]

You are in no way required to communicate with the FAA about your medical condition especially not under oath.  It works the same as Sport Pilot..honor system.....there is absolutely no connection between your doctor, you and the FAA regarding your medical status.  That is the entire point of these reforms.....Once you start to fly under this rule you are flying exactly the same as a Sport Pilot except you are flying larger, faster aircraft and can fly a IMC below 18k feet.

 

Simply not true, this is NOT the same as the Sport Pilots rules.  Sport pilots don't have any requirement for a physical, ever, nor do they ever have to fill out an FAA medical form.  Under BasicMed you have to do both, and there is a requirement to attest on that form that you have not lied or omitted any medical condition.  Of course you can lie anyway.  If you are discovered, you will lose your license.  It happens all time on other FAA medical forms that have the exact same language.  

 

If you have one of the psychological, neurological, or cardiovascular conditions noted, you must, at the time of diagnosis, get an SI, at least once.  Your only other options are to drop back down to Sport Pilot Rules or stop flying,  Those are your options.  If you think I'm wrong about any of this, stop just saying what you think or wish were true and quote the portion of the AC that backs you up.  The language in the AC is typical of other FAA documents and it crystal clear.

 

Lying is always possible, but we're arguing about the requirements, not about what you might get away with if you are deceptive.

[Tom Baker]

This is from the final rule. I highlighted the important words to make it clear.

 

A. Requirements of Section 2307 of FESSA

Section 2307(e)(1) of FESSA states that an individual who has qualified for the third-class medical certificate exemption under subsection (a) of section 2307 and is seeking to serve as a PIC of a covered aircraft shall be required to have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate if that person has any of the following: (1) a mental health disorder; (2) a neurological disorder; or a (3) cardiovascular condition.

 

So, what does it say? Even though you have already qualified, if you have any of these 3 conditions you must go through the special issuance process to be able to act as PIC under the provisions of this rule. 

[Runtoeat]

I attended a FAA Safety Forum today.  One of the sessions dealt with medical issues.  There were two of the local AME's presenting.  The AME doctors said that the part of the new BasicMed that many pilots don't know about or understand is that there must be a physical exam done by their personal physicians and these doctors will be required to verify the pilot being examined has passed those tests indicated.  If there are heart problems, neurological problems, etc., the family physicians will be asked to verify the pilot/patient is able to fly. The AME doctors presenting today said that this is SOP for them and that they know how to handle the paperwork and procedures needed to deal with these issues.  The AME's indicated to us that family physicians have never dealt with this will need to study the FAA's forms and spend a lot of time to understand what is required of them.  The AME's said that should there be complicating factors such as diabetes, heart disease, cancer or neurological, probably all family doctors will seek testing and expert opinions from specialists before the family doctors will sign their names verifying the pilot has passed his physical and is fit to fly. The BasicMed will require a physical examination to be performed by physicians who are not familiar with the process (as AME doctors are) and this process must be repeated every few years. There was also a side discussion between the two AME's today where they discussed liability insurance.  It seemed that the AME doctors talked about being granted a special "stay out of jail" liability insurance by underwriters due to this group of doctors dealing solely and directly with the FAA.  These AME's discussed the issue of family physicians not getting this special treatment by underwriters and so one's family doctor may be reluctant to perform the BasicMed physical exams if there is the possibility of being sued should one of their pilot patients have a medical related air accident. 

[gbigs]

I attended a FAA Safety Forum today.  One of the sessions dealt with medical issues.  There were two of the local AME's presenting.  The AME doctors said that the part of the new BasicMed that many pilots don't know about or understand is that there must be a physical exam done by their personal physicians and these doctors will be required to verify the pilot being examined has passed those tests indicated.  If there are heart problems, neurological problems, etc., the family physicians will be asked to verify the pilot/patient is able to fly. The AME doctors presenting today said that this is SOP for them and that they know how to handle the paperwork and procedures needed to deal with these issues.  The AME's indicated to us that family physicians have never dealt with this will need to study the FAA's forms and spend a lot of time to understand what is required of them.  The AME's said that should there be complicating factors such as diabetes, heart disease, cancer or neurological, probably all family doctors will seek testing and expert opinions from specialists before the family doctors will sign their names verifying the pilot has passed his physical and is fit to fly. The BasicMed will require a physical examination to be performed by physicians who are not familiar with the process (as AME doctors are) and this process must be repeated every few years. There was also a side discussion between the two AME's today where they discussed liability insurance.  It seemed that the AME doctors talked about being granted a special "stay out of jail" liability insurance by underwriters due to this group of doctors dealing solely and directly with the FAA.  These AME's discussed the issue of family physicians not getting this special treatment by underwriters and so one's family doctor may be reluctant to perform the BasicMed physical exams if there is the possibility of being sued should one of their pilot patients have a medical related air accident. 

 

No non AME doctor will spend the time to learn anything the FAA wants or requires (and they are not liable for anything in regard to flying).  Remember, regular docs carry malpractice insurance and there will be no clause in that expensive product that covers a doc doing one of these exams wrong. 

 

May 1 is  D-Day..... let the chaos begin.

[Buckaroo]

This is turning out to be another government blunder!

 

I'll stick with my drivers license medical!

[Tom Baker]

I attended a FAA Safety Forum today.  One of the sessions dealt with medical issues.  There were two of the local AME's presenting.  The AME doctors said that the part of the new BasicMed that many pilots don't know about or understand is that there must be a physical exam done by their personal physicians and these doctors will be required to verify the pilot being examined has passed those tests indicated.  If there are heart problems, neurological problems, etc., the family physicians will be asked to verify the pilot/patient is able to fly. The AME doctors presenting today said that this is SOP for them and that they know how to handle the paperwork and procedures needed to deal with these issues.  The AME's indicated to us that family physicians have never dealt with this will need to study the FAA's forms and spend a lot of time to understand what is required of them. 

 

I'm not sure whether this is scare tactics by the AME's wanting to maintain their spending cash flow or if they don't understand the new rule.

If there are cardiovascular, neurological, or mental health issues that require treatment a pilot must get a special issuance medical from a AME. Also for the mental health disease you must see a state licensed physician every 2 years instead of 4.  The family physician will not be dealing with the FAA. All the family physician will do is an examination using the FAA form, and attest that you are healthy based on that examination.  

[Runtoeat]

I thought about the "scare tactic" angle.  IMHO, the BasicMed is designed to provide a simpler and lower cost choice for pilot exams and this will perhaps take business away from the AMEs.  The AMEs at the session indicated that they each do about 2,500 flight exams yearly (average of 48 per week!) and they indicated they charge about $125 to $150 per exam.  These exams are a mixture of Class 1 thru Class 3.  Additionally, these doctors do CDL (trucking) exams and might even do other special medicals.  I looked up AMEs for Michigan and, to my surprise, there are 78 listed.  Although the two AMEs at the FAA safety session said they no longer have family practices, I am thinking that there is a portion of the 78 AMEs in Michigan that still do.  Perhaps it may not be a problem for pilots in most states to be able to find family physicians for their BasicMed exam.

[gbigs]

My last two AME exams cost $100.  A physical exam from a GP is usually twice that....so the idea that using a private doc is cheaper is not true.  Since the liability is a problem for GPs and the forms are long and tedious...it would seem few would do these things.  That will mean AMEs will increase their business possibly...they will now be examining under BasicMed rules too.

[FlyingMonkey]

Can't speak for most doctors, but I have a long and friendly relationship with my doctor, and he'd absolutely sign any form attesting to my health suitability to pilot an airplane.  I think a lot of this with hinge on what kind of relationship you have with your doctor.  If he only sees you every 48 months as required and only knows your name by looking at your chart, then yeah there might be reluctance there to sign you off. 

[FredG]

I think a lot of doctors will be nervous about signing the form for people who have chronic illness (other than the deal-breakers of mental health, neurological, and cardiovascular disease).  Those illnesses include diabetes, high blood pressure, hepatitis C, asthma requiring ongoing treatment, etc etc.  For a perfectly healthy person, it's no problem, obviously.  

 

Occupational medicine clinics with docs who do this kind of certification for firefighters, law enforcement, CDL, and lots of other occupations may embrace these medical evaluations as another profit center, but who knows.

 

I do think that Andy is correct - a long-term relationship with a physician may well be valuable in this process.

 

If I recall correctly, the medical form is not yet available.  Its content will be relevant.

[FlyingMonkey]

 

 

If I recall correctly, the medical form is not yet available.  Its content will be relevant.

 

I thought it was included in the Advisory Circular, but I might be remembering incorrectly.

[Tom Baker]

While the form may not be available yet, the things the exam must include are listed in the final rule. Gbigs posted a link to the final rule on page 1 of this thread

[gbigs]

I thought it was included in the Advisory Circular, but I might be remembering incorrectly.

 

The reason this does not go into effect till May 1st is due to getting the forms done and other slow government details.

[Tom Baker]

The reason this does not go into effect till May 1st is due to getting the forms done and other slow government details.

 

And it may not go in effect then, due to one of Trump's executive orders.

[FlyingMonkey]

And it may not go in effect then, due to one of Trump's executive orders.

 

True, he has put a suspension on new federal regulations, even ones relaxing older regulations!

[Runtoeat]

The reason for the following comment was related to Andy's point about finding a family doctor.

 

"Although the two AMEs at the FAA safety session said they no longer have family practices, I am thinking that there is a portion of the 78 AMEs in Michigan that still do.  Perhaps it may not be a problem for pilots in most states to be able to find family physicians for their BasicMed exam."

 

All is interesting conjecture until the full rules come out and feed-back starts coming in from the non-AME doctors who might be doing the exams.  Hopefully, the current LSA medical rule allowing use of a valid driver's license will remain the same and those pilots, like myself, who are content to remain Sport Pilots will not be affected in the future.  I would hope that the new BasicMed rule does turn out to be a good option for those who elect to use this.

[gbigs]

True, he has put a suspension on new federal regulations, even ones relaxing older regulations!

 

Trump signed three things today, none of them reg cuts (not yet).  

 

1. end Obamatrade (TPP)

2. stop international abortion funding

3. halt all new fed hires (will eventually cut 20% of fed workforce).  

 

Trump will be slashing regulations but that's across the board and won't be for a few weeks.  The Democrats are holding up many of his cabinet confirms right now slowing the eventual downsizing of the EPA, the privitization of NPR, and the end of the National Endowment of the Arts.

 

And Trump yesterday signed an end to the individual mandate for Obamacare easing small business concerns and laying the foundation for full repeal which will be soon.

 

The May 1 deadline was set by the FAA when they issued their new rule.

[FredG]

Remind me, what does NPR, the NEA, the TPP, and abortion have to do with flying, CT aircraft, or medical examinations?

 

Right, nothing.  

 

The thing I can't stand about this web site is that the more things change, the more they stay exactly the same.

[FredG]

OK, there is a medical examination form included in Appendix A.

 

Reading the special issuance question, there appear to be many more conditions listed on the FAA page of guidance for AMEs for which a special issuance is needed than are listed among the conditions which cannot be approved by the examining physician under BasicMed.  

 

So, for pilots with an FAA medical who - during the up to 10 years following their FAA medical examination - developed an illness that would require a special issuance for an FAA medical but is not listed on the BasicMed list of prohibited conditions (such as insulin-dependent diabetes or depression requiring SSRI medication [see Section 8.2 of the basic med rule]), it appears that the state-licensed medical physician can, if he/she "...is satisfied that the applicant does not present any medical evidence that the applicant is not safe for flight", sign the form and allow the pilot to fly under the BasicMed program.

 

For some pilots, this will let them continue to fly without getting a special issuance when their only prior options were to either attempt to get a special issuance (and risk losing all pilot privileges) or resort to Sport Pilot status and fly with their DL.

 

The wildcard, still, is how many physician will be willing to sign the BasicMed form for pilots who would have required a special issuance under the old rules.  Again, I suspect that many doctors will be hesitant to sign under these circumstances.

 

(My comments about BasicMed are based only on my reading of the rule and are provided solely for purposes of discussion.  Do not rely on my comments to make any safety of flight decision nor to chose any particular medical certification option.)

 

 

[WmInce]

I opine that the FAA's Alternative Pilot Physical Examination and Education Requirements, is not in the spirit of what Congress, AOPA and EAA intended. The law was passed, but the details were surrendered to the discretion of the FAA. Go figure.

 

The resultant product is not a big shocker.

What did folks really expect?

I for one, am not surprised of the outcome.

[Andy]

It certainly is not how it started out; the original submissions by AOPA and EAA were pointing to the DL medical, educational courses, and pilot self-certification (already required) only.  From my viewpoint, the big turnaround happened after the Airline Pilots Association (ALPA) came out opposed to it, with nonsense arguments about increased risk.  That engendered enough political opposition in Congress where opposition solidified and the changes were made to get the bill through.  I would not doubt there was some opposition within the FAA itself, but they have implemented the rule almost word for word from the law, so I don't feel you can put too much scorn at their feet.

 

I was at a safety seminar this past weekend where the FAAST guys briefed this, and one thing got my attention even though I had gone through the rules.  They're saying you can't act as a safety pilot under these rules, which seems like a ridiculous legalistic twist when you can act as a pilot under IFR.  

 

Additionally, one of the briefers didn't think his doctor would sign off on it because he was so risk adverse.  I have voiced that opinion as well; this is not the same as a sign-off to go back to work, and I'm not convinced this going to be as big a "pass" as it's been portrayed.  Since I do qualify and can make  run at it, I plan on doing so later this year; but I also have some doubt my doctor will be hesitant to sign not because of my medical condition but because she's not an AME and may have some uncertainty about how it sets her up for a lawsuit if anything happens.  I guess we'll see.

[FlyingMonkey]

 

 

The wildcard, still, is how many physician will be willing to sign the BasicMed form for pilots who would have required a special issuance under the old rules.  Again, I suspect that many doctors will be hesitant to sign under these circumstances.

 

 

 

One thing folks with skittish doctors can try, is to include with the form a letter signed by the pilot (and their spouse) relieving the doctor of liability in the case of a medical condition causing a problem with flight.

[FlyingMonkey]

I opine that the FAA's Alternative Pilot Physical Examination and Education Requirements, is not in the spirit of what Congress, AOPA and EAA intended. The law was passed, but the details were surrendered to the discretion of the FAA. Go figure.

 

The resultant product is not a big shocker.

What did folks really expect?

I for one, am not surprised of the outcome.

 

I agree, I think that organizational inertia caused the FAA to go for "minimum disruption" to their existing processes.  It probably would have been better if Congress had chosen to "ride herd" with the FAA and given them a complete list of requirements that specifically excluded items like the previous medical and SI requirements.  

 

Oh well, PBOR III anybody?