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Special Issuance Medical Woes....

Brantel

Well Known Member
Let me start by saying that this thread should not turn into an FAA bashing thread or into some other mess that breaks Doug's rules.

The statement I am making below is just a statement of the facts of my particular situation and is intended to be educational for anyone that may follow in my footsteps with similar health issues.

It sure is frustrating to have waited over 3 months for the FAA to reply to a letter where you properly informed them of having to have a new cardiac stent implanted and when they finally did respond, they order you to surrender your current medical, formally deny your authorization for a special issuance medical and then tell you if you contact them and ask nicely, they will be kind enough to inform you what hoops you will have to jump thru in order to get your SI reauthorized.

So I guess there is still hope but the process is surely not easy and I have no idea what they are going to request and how expensive this is going to be.

I have little choice now but to at least try to regain my SI authorization and then make the decision on what to do moving forward. It is even more frustrating that I may have built a very nice airplane that I am not going to be legal to fly very much longer and inevitably I may have to make the decision to possibly sell the airplane and take on the risk/liability associated with that process. My goal would be to retain my ability to fly as a light sport pilot and possibly build an RV12 or similar.

I would never fly as PIC of any airplane if I felt like I could not complete the flight safely. I take this business seriously. I have always tried to be as open and honest as possible with the FAA and have always tried to follow their SI rules as closely as possible. However at some point someone like me must realize that the cost associated with being able to fly PIC as a Private Pilot start to outweigh the benefits and the bank account.

Thanks for listening VAF family!
 
Are you an AOPA member??

If so, have you gotten their medical folks involved?

Sorry to hear about this.................:(
 
Best wishes

Brian, read that you completed the Dopey Challenge in January. I couldn't have done that on my best day. Hope you get that medical back soon! John
 
Feel part of your pain

Brian,

I feel part of your pain. I usually get a nuclear stress test each year to provide the FAA the paperwork/video that satisfys them that I am not a safety threat after my bypass 5 years ago. Take some comfort in that you at least have flown the plane you built. I am still working through some squawks before my airworthiness inspection. I have my latest third class until December and hope I am flying it by then. I have a RV-12 in my garage that I am co-building with my brother so I can fly sport pilot and end this madness with the FAA. It is frustrating when you are open and staying on top of a medical concern and end up being a victim of the system. You will need to get your medical back before you will be able to fly sport pilot now. Shame they couldn't get the pilot rights legislature passed through before now. My 9A will probably go on the market come December.
 
Guys thanks for the references.

I would not say that my situation is all that abnormal or more "difficult" than the average cardiac SI case.

Most all of the resources out there exist to help the professional pilot. One even admits that if you are not a professional, there is little that can be done to speed up the process. Apparently pro pilots get a pass to the front of the line. I guess if I were a pro pilot I would be glad for that but not so much since I am not.

I have been successful in the past with interpreting the FAA's correspondence and rules and following them. If it were not for the cost, pain and agony around all the testing and the huge amount of time spent waiting on them to respond, I would not consider the SI process that painful or hard to understand/comply with. Usually I am the one educating the AME on what they want to see. Strange but I am a detail oriented engineer so I guess that matters in this case.

The last thing I can afford (or am willing to add to the already high cost of this process) is to add additional cost to this process and most of the help resources out there don't guarantee anything and for the most part have no power to speed up the process that I can tell.
 
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Sorry to hear this. I recommend contacting Dr. Bruce Chien who is a CFII and specializes in complex FAA Medical's. If anybody can help you Dr. Bruce can.

Good luck.

:(

A local stent-equipped pilot went to Illinois to Dr. Chien and was satisfied with the results. Apparently Dr. Chien can expedite stuff at the same speed as the professional pilots you mention.

Time to use up your airline miles to see a AME... :)
 
A local stent-equipped pilot went to Illinois to Dr. Chien and was satisfied with the results. Apparently Dr. Chien can expedite stuff at the same speed as the professional pilots you mention.

Time to use up your airline miles to see a AME... :)

Not according to his website....

Quote:

"
The current difficulty is that the agency is strapped with resources for about 15,000 special issuances, with about 30,000 in system. Thus the response to any document or inquiry, by OMB report, averages 62 working days, or about 85 calendar days. Thus it become important to "get it right" on the first pass.
Since mid 2014, the rules for getting file approval have tightened. There is now no such thing as a telephonic approval on a nonrevenue applicant. "
 
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Not according to his website....

Quote:

"
The current difficulty is that the agency is strapped with resources for about 15,000 special issuances, with about 30,000 in system. Thus the response to any document or inquiry, by OMB report, averages 62 working days, or about 85 calendar days. Thus it become important to "get it right" on the first pass.
Since mid 2014, the rules for getting file approval have tightened. There is now no such thing as a telephonic approval on a nonrevenue applicant. "

As Az-Gila stated: "He can expedite stuff at the same speed as the professional pilots you mention." That the FAA doesn't do "telephonic approvals for nonrevenue applicants" is a different issue and out of Dr. Chien's control. That is why he states: "So it becomes even more important to "get it right" on the first pass...." With his help I got it right the 1st time with no "down time".

:cool:
 
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Another recommendation for Chien

Call him. He specializes in this area. It is what he does every day. Direct line to FAA, knows how to cut through the red tape.
 
Doc Bruce will also tell you up front whether you are completely screwed or not... or exactly how screwed you are.
 
Information.....

It is difficult to not bash the FAA a little, even mildly. Case in point. Two years ago I was experiencing some heart palpitations while traveling. (Driving to and from Oshkosh) I was drinking far more coffee and had far more soft drinks than normal. You can see where this is going. On the way home I got concerned and called the cardiologist I visit every year. Got an appointment for the next day.

They did a work up and determined that I the heart palpitations were a result of the excess caffeine. I had several tests including an EKG, nuclear test resting and stressed and ecco. Absolutely no issues. BP was 118 over 74. I was cleared to return to work. Palpitations went away after getting back a normal consumption of caffeine. (one cup of halfcaf a day).

A few months later I disclosed this event on the app for my Class 1 physical. My AME cleared me and the paperwork submitted. A few months later, I get a letter requiring additional documentation with a 3 week due date. I visited my Cardiologist again and got the necessary paperwork. He has many choice words for the FAA since he deals with this daily.

All paperwork submitted. About a month later I get a new medical, Special Issuance. A letter also advised I had to have a stress test and include all paperwork with the application for my medical. This was done and everything submitted. Finally after two years of SI, I was released from that anchor.

My frustration and that of my Cardiologist and AME, despite clear documentation that nothing was wrong, the FAA still hit me with a SI. My AME said that they likely will do that for 2 years. It seems they have to have the last word despite factual information that everything is fine.

I always recommend that pilots go to their GP a month or two ahead of their FAA medical to get a good top to bottom physical. Not a bad idea anyway but if there are any medical landmines going on, it provides you with options so you don't get denied.

Hang in there Brantel. It is frustrating but never give up and never let them have the last word. Document and submit.
 
No harm in calling I guess...

Thanks guys.

Bruce has his airport office at Mt Hawley here in Peoria. My friend is finalizing his 10 there so I can stop by if you wish in a couple of days.

If you come by airline, let me know so help on ground transpo etc can be provided.
 
And they wonder why some people don't want to talk about their medical issues...
 
Brian----I feel your pain, really I do. There had to be a better way. No bashing anyone, or anything, but I see the FAA's side too. They dont have enough people to process all the SI apps. And thats a good thing, because more of 'us' ( me included ONE DAY) are or will be flying, and thats good for aviaton.

We all certainly hope that you can get back in the air with your beautiful RV.
Tom
 
Brian, I am sorry to hear about your situation. I will be flying around this summer and I will put you on my list of people to visit.

Hang in there!

:eek: CJ
 
My wife had an issue. It is amazing how many times you have to have a doctor say "She is COMPLETELY healed, no symptoms expected again" for the FAA (original specialist refuses to do it anymore on principle). Our local jiffy-lube style AME does not want to touch anything 'special' so we travel to Peoria every two years. Wham bam, Bruce gets it done, just his normal fee for a physical. Good excuse for an RV trip, plus we get to write it off at $1.29 per statute mile!
 
Brian----I feel your pain, really I do. There had to be a better way. No bashing anyone, or anything, but I see the FAA's side too. They dont have enough people to process all the SI apps. And thats a good thing, because more of 'us' ( me included ONE DAY) are or will be flying, and thats good for aviaton.

We all certainly hope that you can get back in the air with your beautiful RV.
Tom

I find it very difficult to see the FAA's side to this nonsense. Sure, they don't have enough people. But, the issue is the policies they have created. When a Dr. or specialist says you have no condition or are fully recovered with no further complications expected, they will not accept that and demand that under-staffed specialists provide their own opinion. I could see a certain level of oversight to confirm the Dr's opinion, but dragging on for years and requiring tests that the medical community deems senseless is just crazy and exists only to promote the bureaucracy

I honestly don't even see the value in the oversight, as most all of the risk of fraud is in the Pilot not reporting vs the Dr.s cheating on reports.

Larry
 
Sorry to hear this. I recommend contacting Dr. Bruce Chien who is a CFII and specializes in complex FAA Medical's. If anybody can help you Dr. Bruce can.

Good luck.

:(


THIS!!!

I'm just finishing up the process with Dr Chien. He's VERY reasonably priced, and he REALLY knows the system... along with all the tricks to expedite things as much as possible in the bureaucracy that is the FAA Medical Division.

I can't recommend him enough!
 
Brian, after all the hard work you've done to improve your health and build a beautiful airplane, what a kick in the head. AOPA and EAA could use your story as a plea for 3rd class medical reform. Best wishes & good luck on this!
 
Trying to keep this thread on track and not have it go to a place that breaks the rules.

My purpose for posting is to not only inform my friends here that have kept up with me over the years what is going on with me but to also let folks see what can happen and how it can significantly affect your ability to enjoy your RV you may be building or have built.

Just like choosing to become a professional pilot, building an RV is no small task and can tie up massive amounts of money. Most people are one doctor's visit away from being declared unfit to fly. If that happens you are stuck with having to make tough decisions.

So glad that I never chased the dream of becoming a professional pilot because if I had, my investment would have been worthless and I would be basically forced with changing careers mid-life. Not good! Sitting here with a huge investment in an awesome airplane is also not good! My family sacrificed much during the build of that plane.

While I have been flying on a SI medical since my original 2 stents in 2008, this third stent caught me by total surprise. After keeping BP and cholesterol under control for almost 10 years, losing 135lbs 2 yrs ago, running crazy distances, etc. getting hit with another blockage was hard to accept.

I don't want to bash the FAA, just educate others on how the process works and then let them make up their own mind about whether or not change is needed.

Will report more as details unfold but since it takes about 3 months of waiting in between exchanges, it could take a while before I know more...

I have contacted Dr Chien with my situation and details and am awaiting his reply to see if there is anything he can do other than what I have already learned to do over the past several years renewing my SI medical.

On a lighter note: I am planning to run my second full marathon Sunday in Knoxville...:p Ironic hu?
 
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I had a doctor in the cardiac division at Oak city tell me, Del you need to understand that the first priority of a federal employee is to protect their job.
We will not sign or approve anything unless someone has signed or approved
it ahead of us. ( Sad ) I have been dealing with SI for 14 years.
 
AOPA and EAA could use your story as a plea for 3rd class medical reform. Best wishes & good luck on this!

To the general public, a guy with 3 coronary stents sounds like a heart attack waiting to happen. Probably not the best poster child for 3rd class reform :(. The opposite, in fact: "See? Without the requirement for a 3rd class medical, people like this would be flying airplanes and crashing into schools with children!"

But this is beatable. Good luck, Brian!
 
I think the key is finding the right AME, specifically one that does lots of SI. I had always viewed AME's as the enemy until I attended a forum at Oshkosh about SI. I think Dr Chien was on the panel. They suggested consulting an SI-friendly AME well-prior to the FAA exam to get the ducks in a row. It's been working for me. I carry a 2nd class after being treated for afib in 2011. I use Dr. Richard Hecker in Bulverde, TX. He likes to do SI and has a mission to keep us flying. About 75% of his exams are SI. I got on to him from a CAF buddy. Others like him and Dr. Chien are out there. Ask around in flying groups and with commercial pilots. Find one and talk. It's confidential and normally free, at least the initial. FWIW, AOPA was worthless to me. YMMV
 
To the general public, a guy with 3 coronary stents sounds like a heart attack waiting to happen. Probably not the best poster child for 3rd class reform :(. The opposite, in fact: "See? Without the requirement for a 3rd class medical, people like this would be flying airplanes and crashing into schools with children!"

But this is beatable. Good luck, Brian!

Yes you are correct in my opinion. Perception around this stuff is usually very different from reality. It would be easy to exploit this and play to the fear in the general public.

In reality who is safer to act as PIC? Someone who sees a cardiologist twice a year, routinely completes proactive diagnostic testing and understands their heart health like the back of their hand or the guy that won't go to the doctor for fear of losing their medical (or they lie on their application)?
 
Trying to keep this thread on track and not have it go to a place that breaks the rules.

On a lighter note: I am planning to run my second full marathon Sunday in Knoxville...:p Ironic hu?

Not really, but kinda. Certainly not by chance but by hard work and committed effort. You have obviously worked super hard to achieve the capability to run marathons and do all the other cool physical challenges you've told us about. You are an inspiration to so many (me) by what you've achieved by losing the weight, keeping it off and fighting to maintain your privilege to fly. It takes great strength and character to do what you have done.

Life is full of obstacles. This is another one you have to figure out how to overcome. Fortunately, based on the many positive responses, you're not alone. You have friends and associates to encourage you and cheer you on.

There is a process. Hold them accountable to it.

Based on your past performance, you will overcome.

You go Brian!
 
So here is an update on where I stand with Dr. Chien.

I have had a detailed email conversation with him regarding my situation. He was very quick to respond with a couple more questions and possible alternatives.

Based on my answers, he was unable to state that working with him would save me much if any time vs me just doing what I have always done for the last 8 years on an annual basis; representing myself by being very careful to send them exactly what they ask for the first time.

The bottom line is that he says there is currently no option for expediting 3rd class medicals. It seems that only "Revenue" cases can possibly be expedited. He also stated that even he cannot call the FAA and represent me for at least 30 days after they receive all requested followup documentation.

The alternative would have been using the regional flight surgeon as a time saver. Unfortunately my region does not have a cardiac authorized reviewer so Dr. Chien said that option won't work for me. :(

I mailed the letter back today requesting re-authorization of my special issuance medical. I will update the thread when they respond to tell me what hoops I must jump before consideration can be made. Anyone want to take odds on how long that simple task will take?:confused:
 
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In reality who is safer to act as PIC? Someone who sees a cardiologist twice a year, routinely completes proactive diagnostic testing and understands their heart health like the back of their hand or the guy that won't go to the doctor for fear of losing their medical (or they lie on their application)?
Absolutely right. And that's a much better point to use in combatting the 3rd class medical. Pilots suffering everything from impotence to lupus are refusing to see a doctor for fear of losing a certificate.
 
Absolutely right. And that's a much better point to use in combatting the 3rd class medical. Pilots suffering everything from impotence to lupus are refusing to see a doctor for fear of losing a certificate.
Very, very true.

My cardiologist tells me I have a much lower risk now (with no chance of ever seeing an FAA medical certificate with my name on it again) than I was on the day my last one was issued, when apparently I was a ticking time bomb just waiting for the MI to happen.

Go figure.

Hang in there, Brian. As a bonus, even if it takes a while to get the SI - if the current PBOR2 provisions should ever pass, as unlikely as it may seem some days, YOU should be fine if you're able to get the SI one last time. Think if it as your "golden ticket". And at least your conversation with Doc Bruce was better than mine, that's a good sign. "It can't be pushed through any faster" is better than "Sorry, you're hosed".
 
Absolutely right. And that's a much better point to use in combatting the 3rd class medical. Pilots suffering everything from impotence to lupus are refusing to see a doctor for fear of losing a certificate.

This is, I believe, the key argument for third class Medical reform. The drafted legislation proposal requires bi-annual medical checkups with your family doctor. I don't know about others, but my GP provides a MUCH more comprehensive physical than my AME with a far higher probability of finding real issues with my health. This legislation forces pilots to address real issues, while allowing us to fly with non-issues. Any argument can easily be made that more life-threatening issues will be found and dealt with under this program.

We need to help the general public understand that the current Medical Review process organically uncovers almost nothing other than eyesight issues. It is simply a process of reporting on conditions found by other Doctors and can be easily dodged by not seeing Doctors or specialists. Forcing pilots to identify and deal with medical issues is far more productive in keeping the skys safe as the current system is punishing the wrong people.

Larry
 
Based on my answers, he was unable to state that working with him would save me much if any time vs me just doing what I have always done for the last 8 years on an annual basis; representing myself by being very careful to send them exactly what they ask for the first time

Exactly my experience. Send them what they ask for and you will have the shortest turn around. Either do it yourself of get help by an organization or connected doctor to ensure you are sending them what they ask for.

Absolutely right. And that's a much better point to use in combatting the 3rd class medical. Pilots suffering everything from impotence to lupus are refusing to see a doctor for fear of losing a certificate

I have written this into every letter I have sent to my congress people about PBOR1&2.

I used to lose 3 months out of the year, where I could not fly, just waiting for the FAA to agree with my cardiologist. Best thing that happened was 5 years ago I graduated to a AME assisted special issuance. Still need all the requested paper but now No waiting for Oklahoma City to respond back.
 
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The bottom line is that he says there is currently no option for expediting 3rd class medicals.

I have no idea...but....If you would apply for a second class medical could you expedite it? My second class medicals revert to third class after 1 year.
 
So here is an update on where I stand with Dr. Chien.

I mailed the letter back today requesting re-authorization of my special issuance medical. I will update the thread when they respond to tell me what hoops I must jump before consideration can be made. Anyone want to take odds on how long that simple task will take?:confused:

One of the things Dr. Chien was telling me is that for all physical mail received by the FAA, they put it thru a 2 week "decontamination" process. Then apparently there is also added delay when they mail forms back to you because of the mail contractor. Not sure how accurate this is, but any correspondence you can do thru fax may help expedite things a bit. So if you can pop back to 1988 and grab a fax machine, you may save some time!
 
One of the things Dr. Chien was telling me is that for all physical mail received by the FAA, they put it thru a 2 week "decontamination" process.

I don't believe that's true. Maybe a few years back with the the people lacing letters with poison issue. More likely now a standardized excuse from the FAA. Someone in Oklahoma sent me a letter after my last medical; They didn't like one of my answers and asked for a clarification. I sent a reply letter and had a letter back from them approving my already issued Medical in well under 2 weeks from the time I dropped it in the mail.

On the flipside, on the previous medical the Dr's secretary goofed up the printing of the certificate (apparently the FAA program only let the AME have one try at printing) and told me to call the FAA to have them issue it. It took three month and 10 phone calls to get it.

Larry
 
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To the general public, a guy with 3 coronary stents sounds like a heart attack waiting to happen. Probably not the best poster child for 3rd class reform :(. The opposite, in fact: "See? Without the requirement for a 3rd class medical, people like this would be flying airplanes and crashing into schools with children!"

You're probably right, unfortunately. I just can't get past the fact that if a stent or 3 enables a guy to run marathons, it shouldn't disqualify him from flying his 2-place airplane for recreation. :(
 
Yeah the medical issues are a real pain.

1. I had a kidney stone years ago. I reported it... Became a big mistake. The FAA wanted me to have a Cystoscopy. The ME said it was a waste of time. My personal Doc said it was a waste of time. The Urologist doing it said it was a waste of time. My Doc buddies said it was a waste of time. FAA required it so I had to do it. It, of course, found nothing.

2. I am a diabetic. Type II, became diabetic while in the Army. My personal Doc had me on Glipizide. Worked GREAT. My fasting blood sugars were low 90's every day. BUT the FAA will not let me fly on Glipizide. So I have to take metformin when I wanted to start flying again. I was taking 5mg Glipizide, now taking 3000mg of metformin and it is not as nice to my stomach. Blood sugars are 120-130 in the AM now.

So I have had to go through procedures that were worthless and use drugs that are LESS effective than what my primary care Doc wanted.

But hey, the FAA is happy and I get an SI that I have to apply for every YEAR.
 
I just checked the FAA list of approved drugs for Diabetes and Glipizide is on the list. Don't understand why it's not approved for you.
 
I just checked the FAA list of approved drugs for Diabetes and Glipizide is on the list. Don't understand why it's not approved for you.

Maybe it has been added since then? I have an appointment with my ME Friday, I'll talk to him about it.

Thanks.

The point about the camera up shoved up my privates being a waste of time still stands ;)
 
So even though I can't fly my RV yet due to waiting on the FAA, I did complete my second full marathon yesterday on a very tough course for folks like me.... I am slow but persistent!
 
So even though I can't fly my RV yet due to waiting on the FAA, I did complete my second full marathon yesterday on a very tough course for folks like me.... I am slow but persistent!

Tell the FAA guy questioning your health and fitness to fly to follow you on your next marathon. That would be something to see!
 
The Marathon

Brian,

I looked up your result in the Marathon Guide website. Congratulations on finishing the marathon.
 
Good News!

Update:

After being forced to return my medical certificate (fully expected and not unreasonable) and receiving the "You have been denied" letter from the FAA in late March which was a response to me informing them of receiving a new stent in my heart in December, I obtained confirmation that I have a new medical certificate on its way to me this week!

Important tips for those that come behind me:

  • Don't wait on them to tell you what to do. If I had, I would still be waiting because to date they have never responded to my request for re-authorization of my special issuance medical. Do your homework as most disease protocols are listed on their website with the exact requirements needed for each class of medical and what they will require. Get that stuff done and send it to them proactively.
  • Be as precise and complete as possible. You will have to force your doctors to comply. Dot every i and cross every t. Check, double and triple check your documents to ensure that you have exactly what they want per the protocols listed online. When I submit documents directly, I always organize them, put a sticker on every page with my name and PI#, include a table of contents and a cover letter.
  • If your special issuance is canceled and or denied, don't forget that you must formally request in writing for it to be reauthorized. They don't tell you this up front and you can waste months on this fact alone.
  • Call them every week to get an update. Sometimes this can cut days out of the process because the desk clerk can let you know what that letter in the mail says. Waiting on the USPS can add weeks to the process. Call your regional office as they are sometimes not as busy and I think they are actually FAA employees. Seems to me the contact number for OKC goes to a contractor hired to answer the phone. (not sure on that one).
  • Get help from someone that can call the FAA on your behalf. My understanding is that this is either your AME or someone you hire that is in that business. If your AME is not stellar, good luck and you better find someone else! The hired route can be very expensive for the services they actually provide since you are the one that has to do all the work anyway. Someone that has privileges to call on your behalf may or may not be able to speed up the process but at least they can get past the front desk and let you know where you really stand and what is really going on.
  • Always send your documents via certified mail and get a return receipt. Call and check to ensure they acknowledge receipt of the documents.
  • Make legible copies of everything you send them! If it gets lost your hosed! If they lose it your hosed! MAKE COPIES!

That is all I can think of right now. I am sure there is more but starting with those tips will help out a bunch. Obviously each persons situation is different and your results may vary. Finding an AME with lots of experience with the SI medical process would be key. Unfortunately none exist fairly local to me. Next time I will be traveling to the closest one that has a great reputation in this area.

Now all I have to do is get current again....My BFR is due so that is good timing. Condition inspection is in progress.

Looks like I will make it to Osh afterall!

:D
 
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Awesome!

Good going, Brian. Persistence & patience pays off. Your experience will be valuable to others.

Blue skies!
 
Brantel is spot on. I dealt with a special issuance for several years. Getting the documentation from your specialist before going to see your AME is vital, so is promptly responding to OKC when they ask for info. After several years of having a SI medical, out of the blue, on renewal they sent me a regular class III. The system works, but you must stay attentive.
 
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