Medical Waivers - Lesson Learned

[terrykohler]

Things I've Learned Along the Way:
1. The FAA will provide you with a guidance letter detailing requirements - Give them EXACTLY what they want.
2. Provide your personal physician with the FAA guidance letter - highlighting key points may be helpful.
3. If your personal physician insists on doing it his way in terms of paperwork or format, see rule #1
4. If discussion with your personal physician doesn't result in EXACTLY what you need, GET A NEW PHYSICIAN.
5. One of the key elements required is likely a LETTER to the AME from your personal physician summarizing all tests and attesting to your fitness. Clinical notes and stand-alone lab reports won't likely cut it.
6. Put together a "packet" for the AME with all FAA requested documentation. A cover with a table of contents won't hurt.
7. Make sure YOU have copies of everything.
8. For heart issues that require a Bruce Stress Test, make certain you go a minimum of 9 minutes. The tech administering the test may ask you if you want to stop once you've reached target rate - if it's less than 9 minutes, the FAA may not accept the results.

My first waiver (for stent placement) resulted in waiting about 4 months beyond the required down time. This was all the result of a non-cooperative cardiologist. Unfortunately, the FAA started the clock when I first submitted my application - this resulted in the medical being good for only about 8 months.
Solution this year was a new Cardiologist (early June). Examination, all testing completed and summary letter in hand as of this Monday. AME visit yesterday. New medical/waiver good for another 12 months. Trip to family camp on the shore of Lake Superior this weekend- a perfect ending.

Terry, CFI
RV9A N323TP

[RickWoodall]

Enjoy the flying and family time Terry.

Nice to hear your flying.

[novipilot]

After living with the waiver for 8 years, my take on the whole thing is that the FAA will always want way more than necessary and the result will be huge and expanding out of pocket costs for required testing that your insurance will not be willing to absorb. I've simply switched to LSA and am happy as can be. I make about 4 trips a year to my own doctors, and feel that they know way more about my present condition than someone sitting at a desk in Oklahoma City looking at paperwork. As pilots, we are supposed to self certify ourselves as fit every time we fly.

Write your Senators and Congressional reps all the time, and lets get on with current legislative proposals to do away with 3rd class medicals.

[rv7boy]

Terry, your documentation and recommendations are very much appreciated. They should be very useful for those yet to go down this path. After going through two heart surgeries, one for mitral valve repair and then one for mitral valve replacement, over five years ago, I can report that my experience each year has only gotten better. The first year I had to do the treadmill stress test, the 24 hour Holter monitor, the echocardiogram , the EEG, lab work, the cardiologist report, and the family physician report. The only problem I had was with my family physician trying to submit lab work that was over 90 days old the first two times I submitted my annual information. His secretary didn't like me telling the doctor that the FAA won't accept old lab reports. I do send all my submittals to AOPA medical for their review before taking them to my AME.

Contrary to the previous poster, my submittals have gotten easier. Fewer tests are required (only echo, EEG and cardiologist report) and now my AME is permitted to do a field approval which means I walk out of his office with my Class III Special Issuance. In previous years, after seeing the AME, who specializes in Special Issuances, I had to wait at least two to three months for the FAA to send my Special Issuance. My cutoff every year is March 31st, which means that regardless of when the FAA, or AME, approves my SI, it is only valid until March 31st of each year. I think one year it was June 30th before I received my SI.

I do realize things may change, and admit to often thinking about building a 12.

[az_gila]

1. The FAA will provide you with a guidance letter detailing requirements - Give them EXACTLY what they want.
2. Provide your personal physician with the FAA guidance letter - highlighting key points may be helpful.
3. If your personal physician insists on doing it his way in terms of paperwork or format, see rule #1
4. If discussion with your personal physician doesn't result in EXACTLY what you need, GET A NEW PHYSICIAN.
5. One of the key elements required is likely a LETTER to the AME from your personal physician summarizing all tests and attesting to your fitness. Clinical notes and stand-alone lab reports won't likely cut it.
6. Put together a "packet" for the AME with all FAA requested documentation. A cover with a table of contents won't hurt.
7. Make sure YOU have copies of everything.
8. For heart issues that require a Bruce Stress Test, make certain you go a minimum of 9 minutes. The tech administering the test may ask you if you want to stop once you've reached target rate - if it's less than 9 minutes, the FAA may not accept the results.


I would also add -

BEFORE #1 - Talk to your AME first and then create/get the items on the rest of the list.

For items 2 to 5 - Write the letter from the Doctor to the AME yourself and have the Doctor sign it. Talk to your AME first and make sure any phrasing he wants to see is specifically contained in the letter.


I had a bit of a scare after a colonoscopy, but working with my AME and writing the letter for the Doctor I got my medical straight away - it did need a call to Oklahoma City in the middle of the exam to get approval from the duty FAA doctor.

In my case the magic words were -

The cancer was in-situ and was removed.
No further treatment is scheduled.

The doctor signed the letter but I think it got him a little worried - and I had a CAT scan and then a PET scan performed in the week after he signed it...


A NOTE FOR ALL OF US OLDER GUYS -

Don't delay having a Colonoscopy - they are useful!

[rv7boy]

Originally Posted by az_gila

...I had a bit of a scare after a colonoscopy, but working with my AME and writing the letter for the Doctor I got my medical straight away - it did need a call to Oklahoma City in the middle of the exam to get approval from the duty FAA doctor...

Gil, I almost spit out my Dr. Pepper on this sentence. Upon my first reading, I had visions of you calling Oklahoma City in the middle of your colonoscopy!

I would have to say I was not in any shape to talk to anyone during my colonoscopy. In fact, when I came to, after the anesthesia, I embarrassed my wife with some of the things I said to the nurse! She would still be embarrassed today if I remind her of it. I was saying things after the procedure that I was thinking BEFORE the procedure!

Seriously, Gil, you do make a good point about us older guys getting colonoscopies. My first one was 10 years ago, and I'm scheduled for another one next month.

[Shortfinal]

Great advice, all of it. I'd add that if you're an AOPA member, they have a desk and excellent staff who are right up to speed on these issues. I'm preparing surgery packages for the AME per their direction.

[Mike S]

Originally Posted by Shortfinal

Great advice, all of it. I'd add that if you're an AOPA member, they have a desk and excellent staff who are right up to speed on these issues. I'm preparing surgery packages for the AME per their direction.

Yes. Do take them up on this service.

If you are not an AOPA member, then for the medical service alone you should join.

[rv7boy]

Originally Posted by Mike S

Yes. Do take them up on this service.

If you are not an AOPA member, then for the medical service alone you should join.

Mike, I'm trying to hit the "LIKE" button but just realized I'm not on Facebook now. I see some of my VAF friends report that they don't use the AOPA medical folks for various reasons, but after going through my surgeries, I consider the very small cost just part of the aviation budget at my house.

[Mike S]

When I had to do the SI for my CPAP, I used their services to make sure all the paperwork was taken care of. The AME looked it over and stated "you will get your ticket" but I have to send all this into Oklahoma City.

I waited for a month and nothing from FAA, so I called the AOPA and talked to them.

ONE HOUR. That is all it took after talking to AOPA. One hour and I had an email with my medical cert. In fact the email arrived before I got the call back from the lady at AOPA letting me know that she had spoken to FAA, and I should be getting my medical in a day or two.