Medical Adventures: from BasicMed to Second

[Ed_Wischmeyer]

Over the past few months, I've learned a few things that will probably help other RVers avoid unnecessary troubles with the FAA medical folks.

My adventures started in December when I had an aura, as in optical migraine. This is a temporary blockage of a small portion of your vision, and it usually goes away on its own promptly -- as it did in my case. This is not uncommon and is usually not a big deal. (I'm 73 years old, somehow...)

The optometrist's receptionist said not to worry about it as I had an appointment coming up in a month, and that was sort of correct, but the optometrist was much more concerned.

He referred me to a cardiologist and I got the whole treatment: EKG, two week heart monitor, and an echo cardiogram. The optometrist also referred me to get the carotid arteries checked. My family doctor saw all these referrals and she in turn referred me to a neurologist and I got a brain MRI. They didn't find anything. Of significance, that is, some minor stuff but also age related cerebral atrophy. I tell my friends that means that my jokes won't improve. I was also got a field of view test, to make sure that there were no gaps in my vision. All these test results were normal. Not perfect, but normal.

In conversations with two pilot friends with cardiac issues, I heard interesting stories. First, that if the FAA wants test results to resolve any medical issues, those tests need to be less than 90 days old. Also, the FAA will not grant Special Issuance to BasicMed, only to third class or better. And one friend was told by the FAA Oklahoma City that he needed some cardiac test but, unfortunately, that test is obsolescent or worse and nobody around him performs that test any more. They also wanted test results from events dating back 70 years...

So, on BasicMed, the AOPA medical folks said that none of this had to be reported to the FAA. On the other hand, since I've had all these tests done, and they're all looking good, why not go for a second or a third class medical and put any possible issues to rest – especially if the FAA was to later decide that some expensive test(s) needed to be redone when it’s time for BasicMed renewal.

I went to a Senior AME and gave him all these test results. If I had wanted to pay for it, I probably could have gotten a First Class medical. Anyway, the information will go to the FAA on Wednesday, looking for oral approval to issue a second class. Worst case, they’ll take 90 days to review all the data, but in the meantime, I’m still well qualified for BasicMed.

The important part here is that he is not a plain vanilla AME, he is a Senior AME and knows the FAA system and people. He knows what phrasing to use to keep the FAA medicos from salivating at sloppy writing. This contrasts with the experience of a friend (mentioned above), who hired a big company to handle his cardiac condition with the FAA. They did nothing except submit all his information to the FAA without telling him, and without reviewing or explaining the information, IIRC. The FAA responded unfavorably in his case.

Your mileage will undoubtedly vary, but if you’re facing medical concerns that might threaten your flying, there are smart ways to handle the situation. And it can be expensive – with a discount, my Senior AME charged me about the same as five third class medicals, plus the fee for the Second Class. But he will see this through, whatever it takes.

You get what you pay for.

[Auburntsts]

Originally Posted by Ed_Wischmeyer

Over the past few months, I've learned a few things that will probably help other RVers avoid unnecessary troubles with the FAA medical folks.

My adventures started in December when I had an aura, as in optical migraine. This is a temporary blockage of a small portion of your vision, and it usually goes away on its own promptly -- as it did in my case. This is not uncommon and is usually not a big deal. (I'm 73 years old, somehow...)

The optometrist's receptionist said not to worry about it as I had an appointment coming up in a month, and that was sort of correct, but the optometrist was much more concerned.

He referred me to a cardiologist and I got the whole treatment: EKG, two week heart monitor, and an echo cardiogram. The optometrist also referred me to get the carotid arteries checked. My family doctor saw all these referrals and she in turn referred me to a neurologist and I got a brain MRI. They didn't find anything. Of significance, that is, some minor stuff but also age related cerebral atrophy. I tell my friends that means that my jokes won't improve. I was also got a field of view test, to make sure that there were no gaps in my vision. All these test results were normal. Not perfect, but normal.

In conversations with two pilot friends with cardiac issues, I heard interesting stories. First, that if the FAA wants test results to resolve any medical issues, those tests need to be less than 90 days old. Also, the FAA will not grant Special Issuance to BasicMed, only to third class or better. And one friend was told by the FAA Oklahoma City that he needed some cardiac test but, unfortunately, that test is obsolescent or worse and nobody around him performs that test any more. They also wanted test results from events dating back 70 years...

So, on BasicMed, the AOPA medical folks said that none of this had to be reported to the FAA. On the other hand, since I've had all these tests done, and they're all looking good, why not go for a second or a third class medical and put any possible issues to rest – especially if the FAA was to later decide that some expensive test(s) needed to be redone when it’s time for BasicMed renewal.

I went to a Senior AME and gave him all these test results. If I had wanted to pay for it, I probably could have gotten a First Class medical. Anyway, the information will go to the FAA on Wednesday, looking for oral approval to issue a second class. Worst case, they’ll take 90 days to review all the data, but in the meantime, I’m still well qualified for BasicMed.

The important part here is that he is not a plain vanilla AME, he is a Senior AME and knows the FAA system and people. He knows what phrasing to use to keep the FAA medicos from salivating at sloppy writing. This contrasts with the experience of a friend (mentioned above), who hired a big company to handle his cardiac condition with the FAA. They did nothing except submit all his information to the FAA without telling him, and without reviewing or explaining the information, IIRC. The FAA responded unfavorably in his case.

Your mileage will undoubtedly vary, but if you’re facing medical concerns that might threaten your flying, there are smart ways to handle the situation. And it can be expensive – with a discount, my Senior AME charged me about the same as five third class medicals, plus the fee for the Second Class. But he will see this through, whatever it takes.

You get what you pay for.

I would have gone for an AME consult first before having the AME hit transmit in MedExpress because once he/she does you can’t unring the bell. That way you can decide with your physician if the condition would be something that would ground you under BasicMed, FAA medical disqualifying, or that you might need to pursue an SI for under an FAA medical. The other reason is if you get an official FAA medical denial, you just disqualified yourself from BasicMed. YMMV…

[N40ES]

My (Maybe misguided) understanding is if you have been denied any medical then you no longer qualify for Basic Med. Isn't this a dangerous path you are on? Others may clarify.

[Ed_Wischmeyer]

Originally Posted by Auburntsts

I would have gone for an AME consult first before having the AME hit transmit in MedExpress because once he/she does you can’t unring the bell. That way you can decide with your physician if the condition would be something that would ground you under BasicMed, FAA medical disqualifying, or that you might need to pursue an SI for under an FAA medical. The other reason is if you get an official FAA medical denial, you just disqualified yourself from BasicMed. YMMV…

I did all that.

CLARIFICATION: I had all the test results before I went to the AME. All of the MDs told me that all the results were normal, so there was very little risk of a denial. And AOPA said that none of this had to be reported for BasicMed. I was just covering my bases and then some.

[Auburntsts]

Originally Posted by Ed_Wischmeyer

I did all that.

Good. It wasn’t clear to me that you did an AME consult first before you had the AME officially submit the application.

[RV7A Flyer]

I have to ask: why? If you were flying under BasicMed, and everything came back normal, why not just keep doing what you were doing? Why run the risk that the FAA will deny your Class III or Class II medical, thus locking you out of BasicMed AND a regular medical, and putting an abrupt halt on your flying?

Just because you *can* do something doesn't mean you should. Good luck, I hope they don't deny your application. Let us know what happens.

ETA: I guess this is the part that confuses me:

why not go for a second or a third class medical and put any possible issues to rest – especially if the FAA was to later decide that some expensive test(s) needed to be redone when it’s time for BasicMed renewal.

The FAA doesn't decide such a thing at BasicMed renewal. You go to a doctor, and they either do or don't sign off on the checklist. Nothing goes to the FAA, there's nothing for them do decide (yes, I know that when you do the on-line training, some info goes to them like the date of the physical and the doc's license number, but NOT any results, positive or negative).

[Brantel]

I would have not done anything if you did not need the class II or class III. Too risky no matter what AME you go to.

One thing I have learned after almost 20 years of dealing with OKC and the special issuance process, it’s not done until it’s done once it is in the FAA’s hands. Don’t count your chickens yet. You will be very lucky to get results in the time frame you mentioned.

Also, the FAA could care less about the interpretations of test data by non FAA doctors. They will draw their own conclusions on the results. Each specialty will be taking a look at all your test.

I also don’t understand why the senior AME charged you so much for doing his job. There is nothing difficult about your case for him to justify that. Heck it sounds like he deferred the decision anyway. I have had AME’s that have inside connections at the FAA help me for free and got good results.

[rmartingt]

Originally Posted by Ed_Wischmeyer

one friend was told by the FAA Oklahoma City that he needed some cardiac test but, unfortunately, that test is obsolescent or worse and nobody around him performs that test any more. They also wanted test results from events dating back 70 years...

Sorry you and your friend are having to go through this painful process. It's stuff like this that makes me wonder... what are we saving ourselves from with this? What good is this? The FAA just announced it's hiring double-digit numbers of people to sit in OKC because younger pilots are coming in with far more "treated mental health conditions"--i.e. things like ADD/ADHD, or things that in past generations everyone just ignored, and people still developed into functioning adults--but someone went to do the right thing and now they're getting punished for it. What "maybe possibly could theoretically potentially conceivably happen" event are we worrying about with third-class medicals and private pilots, especially when people with denials get right back in their cars and are at 1000x the risk exposure (due to time behind the wheel and proximity to others) just driving around in their normal day? How many millions and millions of tax dollars are we wasting on extremely remote chances instead of trying to go after things that, you know, actually cause accidents on a regular basis and/or might actually make real, measurable safety improvements?

Originally Posted by Ed_Wischmeyer

The important part here is that he is not a plain vanilla AME, he is a Senior AME and knows the FAA system and people. He knows what phrasing to use to keep the FAA medicos from salivating at sloppy writing. This contrasts with the experience of a friend (mentioned above), who hired a big company to handle his cardiac condition with the FAA. They did nothing except submit all his information to the FAA without telling him, and without reviewing or explaining the information, IIRC. The FAA responded unfavorably in his case.

Stuff like this shouldn't take knowing the right people and the right words and picking the right OKC desk jockey who woke up on the right side of the bed that day.


Hopefully MOSAIC drops before it's a concern for me and it's beneficial. But otherwise I think I have one third-class left and I'll aim to get it done as close to my 40th birthday as possible. After that, it's basicmed for me.

[M McGraw]

I have a question for the OP and VAF group. I currently carry a first Class medical because of my career. When I retire the Basic Med hold great interest for me. However, I am hearing stories that Basic Med can be an issue for insurance companies as we exceed 70 and 80 years old. What has been the experience of this group?

[jcarne]

Originally Posted by RV7A Flyer

"why not go for a second or a third class medical and put any possible issues to rest – especially if the FAA was to later decide that some expensive test(s) needed to be redone when it’s time for BasicMed renewal."

The FAA doesn't decide such a thing at BasicMed renewal. You go to a doctor, and they either do or don't sign off on the checklist. Nothing goes to the FAA, there's nothing for them do decide (yes, I know that when you do the on-line training, some info goes to them like the date of the physical and the doc's license number, but NOT any results, positive or negative).

Bingo. Many people have this misconception (including doctors) that the FAA can and will change things or demand tests. Not only is this not true there are only a handful of medical conditions explicitly called out in BasicMed as needing an SI if they develop.