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  #1  
Old 10-14-2011, 09:25 AM
Phlyan Pan Phlyan Pan is offline
 
Join Date: Aug 2010
Location: Rochester, NY
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Default Special Issuance?

So thanks to some repeated bouts with kidney stones (which I should have kept my mouth shut about according to some other pilot friends) I'll have to get a special issuance medical when I get this latest one cleared up. So those of you that have experience with SI medicals, how does this process work? How long does it usually take Oklahoma to get back to you? Does special issuance ever go away if I repeatedly show no further problems? Any insight would be very helpful. Thanks!
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  #2  
Old 10-14-2011, 09:30 AM
Mike S's Avatar
Mike S Mike S is offline
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Default AOPA Medical

If you are a member of AOPA, call them now.

If you are not already a member, call them now, and join.

AOPA has really good folks to help you through with this.

Good luck.
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  #3  
Old 10-14-2011, 09:35 AM
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Brantel Brantel is offline
 
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Location: Newport, TN
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Default

The details are different depending on your condition.

Typically a SI is only able to be issued if you are denied a regular medical. To get in line to get one, all you have to do is ask for consideration. This can be done in one step if you know your most recent application for a medical will be denied.

It takes from 3-6 months typically to get these through the first round. There are exceptions you hear about. They may issue you an authorization letter that will allow your medical examiner to write your next medical and then forward the details to them. This saves some time each year. Otherwise you will have to send the stuff in early and wait each time.

I think the question on if they ever go away depends on the condition but I may be wrong.
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  #4  
Old 10-14-2011, 10:14 AM
Phlyan Pan Phlyan Pan is offline
 
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Location: Rochester, NY
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Quote:
Originally Posted by Mike S View Post
If you are a member of AOPA, call them now.

If you are not already a member, call them now, and join.

AOPA has really good folks to help you through with this.

Good luck.
That was the advice of my local guys as well and I have done so.
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  #5  
Old 10-14-2011, 10:24 AM
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rv7boy rv7boy is offline
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Default Special Issuance

Ditto to everything that Mike and Brian (Brantel) said. It's not like you're the only pilot that ever had kidney stones. The AOPA medical staff is very good at being able to tell you what to do and what NOT to do (only give the FAA what they need, not what they don't need-my words, not AOPA's).

I've never had kidney stones, but both my dad and my son have. And I know a kidney stone attack is not a fun event. I sure wouldn't want to have one while I'm PIC.

I know you didn't ask for my opinion, but I would ignore the advice of your pilot friends. I know they meant well, but you can't take them seriously.

Special issuance is not a big deal, although I do admit when you receive the letter in the mail, the legal wording will scare the be-jeebers out of you. Perhaps some of the medical certification procedures could be improved, but it's a whole lot better system than what the FAA had 50 years ago.

Call the AOPA medical staff, and do everything they tell you...nothing less and nothing more. The first special issuance may take a little while, but once you're in the system, the renewals should be quicker, assuming you don't have a continuing kidney stone problem.

Good luck!
Don
Special Issuance since July 2010 for a prosthetic Heart Valve
P.S. this rather lengthy post was submitted before reading your most recent post.
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Last edited by rv7boy : 10-14-2011 at 10:25 AM. Reason: Added the P.S.
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  #6  
Old 10-14-2011, 10:31 AM
aerhed aerhed is offline
 
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I'm holding a new SI due to a contact cement induced heart attack. My first inclination was a cover-up. Problem was, flying on an expired medical is usually a suspension. Lying on your medical form is a revocation. So, I got a SI. Took several months and several thousand dollars, but finally got it along with a 6 year waiver thing allowing my AME to issue it directly.
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  #7  
Old 10-14-2011, 10:59 AM
Epsound Epsound is offline
 
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Location: Colorado Springs
Posts: 214
Default I went through this in OK

I did the same thing a few years ago. Now I have an SI. First, depending on your specific medical circumstances, they will require recent medical analysis of the condition and a 'letter,' not a medical progress report or SOAP report, from your Primary Care Provider (PCP); doctor, PA, or NP, not necessarily the AMI, stating 'whatever it is' is under control and won't affect your capacity to fly. MAKE SURE YOU GET THIS IN THE FORM OF A NARRATIVE LETTER ON THE DOCTOR'S OWN LETTERHEAD. Then, as long as ‘whatever it is’ doesn’t fall into the restricted category, you’ll get the SI. Don’t let this fact bother you too much. There are plenty of us who have them and continue to fly as usual.

Things are relatively easy after this. I still do my annuals every two years but am required to send them a fresh letter each year, from the PCP, restating that things are still medically 'good or under control.' Each time you get your new updated SI, your approval will be accompanied by a specific description of what will need to be in the letter; explicitly.

Also, the guys above are right. Acquire the help of the people at EAA. They are experienced in dealing with these.

Hope this helps.

Good luck.


Best,


Evans.
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  #8  
Old 10-14-2011, 11:16 AM
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Capflyer Capflyer is offline
 
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Certainly speak with AOPA first but after you can call the aeromedical division in OK City yourself. The number is (405) 954-4037. I deal with them directly and have not had any problems. Unless you have something really complicated there is no reason to pay someone else to do the same thing you can easily do yourself. When you tell them your situation they usually have a set list of guidelines for each ailment. Just follow their instructions and all will be fine. It usually takes about 90 days to get a SI but if it is something minor they will issue you a multi-year issuance that your AME can renew each year for you on the spot.
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  #9  
Old 10-14-2011, 11:36 AM
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Brantel Brantel is offline
 
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Here is some info on the rules around disqualification due to Kidney issues:

"
Decision Considerations - Aerospace Medical Dispositions
Item 41. G-U System - Urinary System



Note: A history of recent or significant hematuria requires further evaluation.
Disease/ConditionClassEvaluation DataDispositionHydronephrosis with impaired renal functionAllSubmit all pertinent medical information and status reportRequires FAA DecisionNephrectomy (non-neoplastic)AllSubmit all pertinent medical information and status reportIf the remaining kidney function and anatomy is normal, without other systemic disease, hypertension, uremia, infection of the remaining kidney - Issue

Otherwise - Requires FAA DecisionNephrocalcinosisAllSubmit all pertinent medical information and status reportIf calculus is not in collecting system or renal pelvis - Issue

Otherwise - Requires FAA DecisionCalculus 11

Renal - Single episodeAllSubmit current metabolic evaluation and status reportIf there is no residual calculi and the metabolic workup is negative - Issue

Otherwise - Requires FAA DecisionRenal ? Multiple episodes or Retained StonesAllSubmit current metabolic evaluation and status reportInitial Special Issuance - Requires FAA Decision

Followup Special Issuance?s -
See AASI ProtocolUreteral or VesicalAllSingle episode and no retained calculi, submit current metabolic evaluation and status report (Ureteral stent is acceptable if functioning without sequela)If metabolic workup is negative and there is no sequela or retained calculi - Issue

Otherwise - Requires FAA Decision
11 Complete studies to determine the possible etiology and prognosis are essential to favorable FAA consideration. Determining factors include site and location of the stones, complications such as compromise in renal function, repeated bouts of kidney infection, and need for therapy. Any underlying disease will be considered. The likelihood of sudden incapacitating symptoms is of primary concern. Report of imaging studies (KUB, IVP, or spiral CT) must be submitted in order to conclude that there are no residual or retained calculi."


Here is some info I found on what they want for AME assisted renewal of SI medicals for people with Kidney issues:

"
Special Issuances
AME Assisted - All Classes - Renal Calculi


AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations
(14 CFR) part 67.

An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR ? 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the above disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
  • An Authorization granted by the FAA;
  • A statement from your treating physician regarding the location of the retained stone(s), estimation as to size of stone, and likelihood of becoming symptomatic; and
  • A current report of appropriate imaging study (IVP, KUB, Ultrasound, or Spiral CT Scan) and provide a metabolic work-up, both performed within last 90 days.
The Examiner must defer to the AMCD or Region if:
  • If the treating physician comments that the current stone has a likelihood of becoming symptomatic;
  • If the retained stone(s) has moved when compared to previous evaluations; or
  • If the stone(s) has become larger when compared to previous evaluations."
Also take a look at this FAA Medical Bulletin for more info on Kidney stones:
http://www.faa.gov/library/reports/m...0803_color.pdf

Page 33 of this document also relates to the issue:
http://www.faa.gov/other_visit/aviat...edia/mcspt.pdf
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RV-10, #41942, N?????, Project Sold
---------------------------------------------------------------------
RV-7/TU, #72823, N159SB
Lyc. O-360 carbed, HARTZELL BA CS Prop, Dual P-MAGs, Dual Garmin G3X Touch
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  #10  
Old 10-14-2011, 08:31 PM
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dmaib dmaib is offline
 
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SI's are not necessarily forever. That depends on what the medical problem is, and how successful the treatment is. I had one for nearly 8 years due to some heart issues, but was issued an unrestricted Class I three and a half years ago, and continue to get unrestricted medicals at this time. I know two professional pilots that have had kidney stones that they reported, and both are on unrestricted Class I medicals at this time. I am pretty sure that neither one of them ever had an SI. High quality AME's worked them through the process.
I know that some will give different advice, but I would advise you to report the problem to the FAA and work with the system. Working with AOPA and having a really competent AME will be essential.
$.02 worth
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