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Senate PBOR2 Medical


gbigs

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The Senate PBOR2 was passed with a 'Nelson Amendment' that the private doctor MUST have a checklist during your annual exams.  https://www.congress.gov/bill/114th-congress/senate-bill/571/text

 

The private physician has to certify you for flight just as the AMEs did.  The AME community are well versed in government entanglements, private doctors are not and will be reticent to put their rears on the line....remember, if you flunk a medical exam for aviation you are done flying.

 

Pertient elements:
(2) REQUIREMENTS.—The checklist shall contain—
© a section, for the physician to complete, that instructs the physician—
(i) to perform a clinical examination of—
(I) head, face, neck, and scalp;
(II) nose, sinuses, mouth, and throat;
(III) ears, general (internal and external canals), and eardrums (perforation);
(IV) eyes (general), ophthalmoscopic, pupils (equality and reaction), and ocular motility (associated parallel movement, nystagmus);
(V) lungs and chest (not including breast examination);
(VI) heart (precordial activity, rhythm, sounds, and murmurs);
(VII) vascular system (pulse, amplitude, and character, and arms, legs, and others);
(VIII) abdomen and viscera (including hernia);
(IX) anus (not including digital examination);
(X) skin;
(XI) G–U system (not including pelvic examination);
(XII) upper and lower extremities (strength and range of motion);
(XIII) spine and other musculoskeletal;
(XIV) identifying body marks, scars, and tattoos (size and location);
(XV) lymphatics;
(XVI) neurologic (tendon reflexes, equilibrium, senses, cranial nerves, and coordination, etc.);
(XVII) psychiatric (appearance, behavior, mood, communication, and memory);
(XVIII) general systemic;
(XIX) hearing;
(XX) vision (distant, near, and intermediate vision, field of vision, color vision, and ocular alignment);
(XXI) blood pressure and pulse; and
(XXII) anything else the physician, in his or her medical judgment, considers necessary;

 

(ii) to exercise medical discretion to address, as medically appropriate, any medical conditions identified, and to exercise medical discretion in determining whether any medical tests are warranted as part of the comprehensive medical examination;

 

(iii) to discuss all drugs the individual reports taking (prescription and nonprescription) and their potential to interfere with the safe operation of an aircraft or motor vehicle;

 

(iv) to sign the checklist, stating: “I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual’s ability to safely operate an aircraft.”; and

 

(v) to provide the date the comprehensive medical examination was completed, and the physician’s full name, address, telephone number, and State medical license number.

 

(3) LOGBOOK.—The completed checklist shall be retained in the individual’s logbook and made available on request.

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I thought this had been rolled into the FAA Reauthorization bill which has passed the Senate; but, when it got to the House, Rep. Shuster, who wants to spin off the FAA's ATC functions into a government "non-profit" (and is dating a top lobbyist for Airlines for America which supports that change), is holding it up until he call roll his approach into the Reauthorization or pass his own bill.  We'll have to see how the fight over that affects passage.  My guess is that any action on third class medical reform will stall this year if the reauthorization gets hung up.

 

About what is there, I feel the same way Doug does...that asking your Doc to sign a "cert" may prove as problematic as getting the medical itself.  The only blessing to it is that if she/he refuses you haven't lost Light Sport which is not the case if you try to run a Class III and can't get past it.  But for a doc who doesn't know anything about aviation medicine, I can believe they may hang back from signing because of fear of liability.  Some are suggesting you show the Doc the FAR 61.53 that makes the pilot responsible to help get them past that.  Whether that might really work remains to be seen.

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As a data point, my urologist never hesitated to provide me with a letter, stating his opinion that he did not think the size and location of any kidney stones I had would present a problem for flying. That and an x-ray got submitted by my AME as part of my SI, which was never denied.

 

I think we may be overstating the reticence of a doctor to sign a form. I suppose some will, but I don't expect that most will have any problem with it.

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I thought this had been rolled into the FAA Reauthorization bill which has passed the Senate; but, when it got to the House, Rep. Shuster, who wants to spin off the FAA's ATC functions into a government "non-profit" (and is dating a top lobbyist for Airlines for America which supports that change), is holding it up until he call roll his approach into the Reauthorization or pass his own bill.  We'll have to see how the fight over that affects passage.  My guess is that any action on third class medical reform will stall this year if the reauthorization gets hung up.

 

About what is there, I feel the same way Doug does...that asking your Doc to sign a "cert" may prove as problematic as getting the medical itself.  The only blessing to it is that if she/he refuses you haven't lost Light Sport which is not the case if you try to run a Class III and can't get past it.  But for a doc who doesn't know anything about aviation medicine, I can believe they may hang back from signing because of fear of liability.  Some are suggesting you show the Doc the FAR 61.53 that makes the pilot responsible to help get them past that.  Whether that might really work remains to be seen.

 

Not quite.  If your personal doc says you are not fit to fly it's the same as an AME saying it.  You will lose your entire privilege.  If the doc refuses to sign and you doctor shop you can still end up in the same boat if your medical exam becomes known to the FAA.

 

Remember, this throws all of it into the realm of non-experienced aviation doctors and insurance companies.   The usual reaction given the litigious society we live in is the private docs and insurance companies will refuse to get involved.    If you try flying without the medical exam and get caught you will also lose your Sport license.

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Not quite.  If your personal doc says you are not fit to fly it's the same as an AME saying it.  You will lose your entire privilege.  If the doc refuses to sign and you doctor shop you can still end up in the same boat if your medical exam becomes known to the FAA.

 

 

I think it will require rulings from FAA's general counsel to make that so.

 

Are you stating if your regular doctor says "my policy is not to sign anything that could lead to future liability", you are prohibited from finding a doctor with a more reasonable mindset?  If you are saying this, please point to the regulation or proposed regulation stating this.

 

It's one thing to shop docs until one will sign off on your diabetes, gout, kidney stones, heart failure, cirrhosis, and blindness in one eye and colorblindness in the other.  It's another thing entirely to seek out a doctor willing to fill out required paperwork for you to continue flying.

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I concur with Mr Morden.  Check the language of the bill.  There is no requirement to tell the FAA about the outcome of the doctor's visit if he/she refuses to sign.  If you (Burgers) were right, then this would be worse than going after a third class medical since these docs aren't aviation docs and the liability concern is worse for them.  If your doc refuses to sign, it is not the same as a fail or disqual, especially since the doc can refuse to sign because of a fear of liability.  You simply continuing flying light sport.  You're still bound by the FAR's and having a DL.

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Not quite.  If your personal doc says you are not fit to fly it's the same as an AME saying it.  You will lose your entire privilege.  If the doc refuses to sign and you doctor shop you can still end up in the same boat if your medical exam becomes known to the FAA.

 

Remember, this throws all of it into the realm of non-experienced aviation doctors and insurance companies.   The usual reaction given the litigious society we live in is the private docs and insurance companies will refuse to get involved.    If you try flying without the medical exam and get caught you will also lose your Sport license.

 

 

 To lose your right to fly as a sport pilot on the Driver's License medical standard you cannot have had your last FAA medical denied or revoked. 

 

This doesn't preclude you getting medical attention and care to the point where you can re-apply for an FAA medical, if you have a condition which could cause your medical to be denied/revoked. If you do, and you pass it successfully then this becomes your 'last FAA medical' which you have now passed and so you can resume sport flying and when/if that 'new' last medical expires/lapses.

The PBOR2 specifies FAA medical currency within the past 10 years, or applying for a new medical. From that point it specifically does not specify annual medical visits with an AME but instead with your own private physician for their review of your medical status as far as flying safely.  That's absolutely not the same as "an AME saying it" and your stating that doesn't make it so.

 

Part of the 'bargain' in PBOR2 is that the pilot has an annual medical assessment regarding their fitness to fly which is then recorded in their logbook.

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  • 2 months later...

Now it's going to the President's desk.  

 

Does this change anything for some of you or pilots you know?  There seemed to be a consensus that medical reform would send many pilots running back to certified aircraft, and possibly have a negative effect on the light sport market.

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It would let me fly a friend's Cirrus, that he offered to loan me.

 

Might consider a partnership in a Tiger or a Mooney or the like. Hopefully with an A&P as one of the partners.

 

But for now would definitely keep the Sky Arrow - I'm kind of addicted to doing my own maintenance and inspections - plus its (relatively) cheap to fly, and most times I really don't need to get anywhere in a hurry.

 

edited to add: My Second Class Medical was valid within the 10-year time frame.

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My last 3rd class medical is within the 10 year look back period so I guess I'll need to do the online course and have my personal doctor fill out the form at my next physical.  I'm a PP with an instrument rating and will likely:

  • Night flying -- really no interest in serious flying at night but will take advantage of landing post civil twilight especially in the winter
  • VFR over the top -- comes in handy on longer flights
  • Doubtful I'll need to fly over 10K given I'm a flatlander.  Might come in handy when I finally make it out to Page.

I might dust off my instrument rating as well.  My plane is pre-2010 and is not subject to the ASTM ban on IFR flight in IMC.  My specific plane also has operating limitation that allow for very specific IMC operations (basically cutting through a layer for VFR-on-top and descending through a layer) in very specific conditions.  Doing the prep for an IPC would be part of the fun.

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ASTM allows for the manufacturer to include IMC in the operating limitations for pre-2010 (or 2011) aircraft.  An aircraft would need to comply with 91.205 as well.  I'm not aware that FD offers to alter the OL of their fleet.  You could go E-LSA then you become the manufacturer and could create new OL that included IMC.

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Yep and my flight operating limitations include:

 

B. Instrument Flight Rules (IFR) in Visual Meteorological Conditions (VMC):

I. The pilot must have the correct certificate ratings and operational currency or this approval is void.
2. All day or night VFR requirements in Item A, plus the following,
3. Comply with US FAA FAR 91.205 (Instrument and equipment requirements)
4. No forecast or known icing within 20 NM of aircraft position
5. No forecast or known lighting within 20 NM of aircraft position
6. No forecast or known thunderstorms within 20 NM of aircraft position
7. Cruise conditions are limited to IFR 'on top' VMC.
8. Climb or descent through IMC conditions only if:
a. The pilot must have the correct certificate ratings and operational currency.
b. Temperature remains above freezing level during all IMC conditions.
c. Exit location is conlirmed to be VFR VMC conditions
9. Aircraft minimum equipment includes:
a. Operational heated pitot tube
b. Alternate static source
c. Outside Air Temperature (OAT) indication
d. GPS display, with current database, (may be portable)
e. Weather display, with current subscription, (may be portable)
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