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BASIC MED - Unintended Consequences?

terrykohler

Well Known Member
While I still seem to run into the occasional pilot who thinks that Basic Med is some sort of government plot to dump costs and liability onto the private sector, I?ve come to the conclusion that for many pilots like me, it?s a godsend.

For the better part of the past 45 years, I?ve carried a second class medical. I?ve never worked in the aircraft industry or as a professional pilot, but for about a 20 year period, my then-employer had me and a Cessna Turbo 210 added to the company?s aviation department insurance (also covered were a Citation and its full time crew). In addition to the coverage, they also had me doing recurrent training, which I discovered was also a good thing.

Along the way, just for kicks, I picked up commercial and flight instructor tickets, both of which are little used. Even after I exited that business, I held onto a second class medical (I bought the 210 from the company when I left). Within a couple of years, I discovered that the 210 was REALLY expensive to operate without the ability to expense its use. The 210 was sold and I found a path back into aviation thru the experimental world. Along with launching N323TP in early 2004, I also converted my medical into Third Class.

While I was typically having a thorough physical done every year to that point, once I converted to the Third Class I found myself limiting the information I put on the FAA forms to the bare essentials, and doing the same with the AME. Don?t look for anything, just cover what you have to, and give me a new ticket. Apparently, this worked fine for my flying, but it didn?t really address any issues with my overall health. Turns out that ignorance was not a good game plan.

At the continued insistence of my eldest daughter, a physician in the Navy (no Leah, you can?t give Dad a physical) as well as my hospital-employed wife, by about 2010, I caved in and found a REALLY good personal physician. Back to open discussion, full blood work, EKG and poking/prodding every year. In spite of this, my information flow to the FAA remained on a need-to-know basis.

Armageddon came a few years ago during a routine physical when my doc informed me that my stress test had been bought to the attention of a cardiologist. The following day, I had a stent implanted in my LAD.
The ?fun? with the FAA and my medical began almost immediately. Wait 6 months, submit blood work, EKG, nuclear stress test, cardiologist?s letter, etc. and wait? and wait. Overall, I missed the better part of a year?s flying (a two week government shutdown added three months to the backlog). Oh yeah, and my new S.I. was dated back to the time of application, not time of receipt. Once everything was squared, I found that by submitting a detailed packet each year (about 40 pages, including table of contents and all test tracings), a new Special Issuance was secured in short order.

Fast forward to this year, when my AME informed me that a full FAA review was again in order and would require up to about 3 months for a new S.I. Certificate to be issued. Unfortunately, I had been operating under the assumption that the shelf life of all of my medical tests was 60 days, so under the best of circumstances, I?d be grounded once again and then have about a 10 month certificate before having to do it all over again.

BASIC MED to the rescue. I contacted my family doc, sent him all the FAA paperwork to review, took the online AOPA review, got the physical done, and was issued a certificate good for 4 YEARS.

THE REALLY GOOD NEWS HERE - I?m still getting a very thorough physical every year (including full cardio workup). More importantly, the guy that controls my flying privileges knows ALL of my medical issues and history, as he should. Hopefully, continuing to be proactive with my health rather than reactive, will keep me flying longer and living longer. I don?t know if that was intended with the introduction of Basic Med, but it sure works for me.
Terry, CFI
RV9A N323TP
 
Your medical story is very similar to mine and I agree Basic Med is a Godsend for folks like us.

I imagine the wait time for SI may go way down now that many of us can bypass that process but who knows. Likely they will just fire all the temp doctors they have been using and go back to only staffers which may net out the same delays.

I am convinced that my fear of the FAA totally had the opposite effect that they were trying to accomplish with the third class and SI medical process. If I had not been so scared of them, I would have been treated much earlier in life! I am also convinced that they are creating opportunities for the situation they are trying to prevent. (sudden pilot incapacitation)

It is so nice to be able to be open with your PCP/Cardiologist and not fear that you will be grounded by bureaucracy and paper pushers.

Don't get me wrong, I am not against being grounded when you need to be grounded but if my Cardiologist and PCP clear me (people I know and trust and can talk to face to face), I could care less what some guy in OK City thinks about my condition when he only knows what he reads on a report.
 
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I understand...

Yep,

My path to a Third Class Special Issuance medical certificate was different than yours but I can fully appreciate your experience. Because of a leaky mitral valve I had to go the S.I. route about ten years ago and then go through the hoops and waiting period after mitral valve replacement surgery in 2009. For the last seven years, I have never felt the annual submittals and reviews in Oklahoma City added anything but a waiting period to the annual testing and review by my cardiologist. My cardiologist said they were not asking for anything more than what he was routinely doing. Plus the extremely rigid submittal requirements (for both format and content) specified by the FAA were onerous.

I am very happy to be on BasicMed.

Thanks for sharing your experience.

Don
 
Sometimes it still doesnt work--

Since I've never held or been denied a 3rd class medical, I started the process back in March. Yep March. Just recently received a letter from Ok city requesting MORE information in addition to the extra paperwork we had to send in because of the surgery incident of 2 years ago.

Basic Med would have been great if I had had a 3rd class, but in order to use Basic med, I have to have a 3rd class to start with.

You know-----I'm wondering if the hassle is worth it--

Tom
 
It is Tom - keep plugging

Keep plugging at it Tom. Once you get your approval you can put it behind you and get your bird in the air with you in it. Some of us had to deal with Oklahoma on cardio issues and the hoops we had to go through each year as well as the cost. I like others see my PCP physician each year as well as bi-annual visits with my cardiologist to stay on top of my health and it seemed insulting when I had my third class dealing with the FAA. The money I would have to spend on the nuclear stress tests to send the results in that they want can buy a lot of avgas. That is all behind me now and I am just looking ahead. Terry and I talked about BasicMed when he graciously flew down to Ohio to help me get more ready to fly my plane.
 
I know Mike, and lot of the VAF member have expressed support on this. The bad part is if I do get denied, then LSA is out too.
Its strange, because my AME had my records, a VERY recent CBC blood work, and a report of the incident.

We'll see

Tom----my 7 is kinda on hold for the moment
 
The bad part is if I do get denied, then LSA is out too.
I call it the "aviation death penalty". If you don't even try for a medical, you're fine -- but if you try and get denied, even for something that would be fine for flying LSA, then you're completely screwed. I guess it doesn't have to make sense, it just "is".

I would need an SI to qualify for BasicMed, but there's a substantial probability I'd get an SI denied. So, I fly light sport.

And on the topic of this thread, if I hadn't been worried about a bunch of extra paperwork and hassle with the third class medical that I did have, I'd have likely seen my doctor a few days before my MI and saved a trip to the ER. I didn't have any of the symptoms that I had heard associated with an oncoming heart attack, but I felt "funny" for a few days. But, no way I was going to go to the doc if it wasn't necessary.

Unintended consequences indeed.
 
And on the topic of this thread, if I hadn't been worried about a bunch of extra paperwork and hassle with the third class medical that I did have, I'd have likely seen my doctor a few days before my MI and saved a trip to the ER.

Another fine example; third class medicals have killed more pilots than they have saved.
 
I started the process back in March. Yep March. Just recently received a letter from Ok city requesting MORE information . . .

Tom - Suggest you get some expert help involved in obtaining your special issuance. I had a similar problem when I first attempted to renew my 3rd class as a special issuance, with several requests from the FAA for additional information. I finally contacted the very helpful folks at UTMB Aerospace Medicine ( https://www.utmbhealth.com/services/aerospace-medicine/services ) who were able to help me navigate the requirements and obtain my SI in fairly short order.

Suggest you give them a call at (409) 747-9176 and talk to Johnene Vardiman. She will help you get started with one of their physicians.

Good luck.
 
Tom - Suggest you get some expert help involved in obtaining your special issuance. I had a similar problem when I first attempted to renew my 3rd class as a special issuance, with several requests from the FAA for additional information. I finally contacted the very helpful folks at UTMB Aerospace Medicine ( https://www.utmbhealth.com/services/aerospace-medicine/services ) who were able to help me navigate the requirements and obtain my SI in fairly short order.

Suggest you give them a call at (409) 747-9176 and talk to Johnene Vardiman. She will help you get started with one of their physicians.

Good luck.

EAA has a medical advisory council that helps EAA members with FAA med issues. They helped my with an SI related to a cerebral hemorrhage. Yah.
They know the phone numbers and people to call to 'check in' on the status of things. Worked great for me.
 
EAA has a medical advisory council that helps EAA members with FAA med issues. They helped my with an SI related to a cerebral hemorrhage. Yah.
They know the phone numbers and people to call to 'check in' on the status of things. Worked great for me.

I believe Dr. Mather of UTMB is on the EAA medical advisory council.
 
Same here. Had a 3rd Class, started flight training, then money (as in the lack of) and later some health issues, both me and a family member, sidlined me from my flight training. Then Basic Med comes along, and with the 10 year since you had a medical clock about to run out, I get my Basic Med approved and I'm back in the saddle!

No, Basic Med wasn't the medical reform we all hoped for, but it'll work!

Happy as a clam, now if I can only come up with the cash for an RV-8! :D
 
Nuclear stress test tomorrow morning, so this thread is very timely.

All indications are that I am headed for an angiogram next (doctor doesn't trust the results of the Nuc Stress Test, but makes me spend $2400 in deductible because insurance generally doesn't like doctors going straight to the angiogram - fodder for another thread on a different forum).

So before I got too down about this, I called AOPA to talk to their medical section and asked how the FAA feels about stents. She went straight to the special issuance protocol and never said a word about Basic Med.

I really do not want to start an argument or contradict anyone. But perhaps someone could chime in if they have more info on this. My last 3rd class medical was earlier this year and I passed no problem. This new medical issue of mine has come up since then, and it was my understanding that some medical issues transcend the new Basic Med. I would love to know if light sport and Special Issuance are my only options if a stent is required.

Thanks,
 
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If Your Cardiologist is Familiar with FAA Paperwork...

I forget all this is right at our fingertips. Thanks, Carl, for sending me to the source.
Jon
...as soon as he's willing to clear you, get your "package" together and get with your AME. He'll need to give you the normal exam, but will need to forward the cardio stuff to OK City for review. IIRC, The stand down time after a cardiac event is six months, but the FAA will take about 3 months to do their thing. You'll need to coordinate thru the AME as your tests and documentation is time-limited. Once you have a S.I., I'd suggest going immediately to your PCP for a Basic Med exam and cert. While it's good for four years, another cardio event or other disqualifier will require another S.I.
If your cardiologist is not familiar with dealing with Uncle Sammy, let me know and I'll send you a copy of one of my SI Table of Contents and Cardiologist's letters. Lack of familiarity on the part of my first cardiologist cost me months of extra downtime.
Terry, CFI
RV9A N323TP
 
Jon
...as soon as he's willing to clear you, get your "package" together and get with your AME. He'll need to give you the normal exam, but will need to forward the cardio stuff to OK City for review. IIRC, The stand down time after a cardiac event is six months, but the FAA will take about 3 months to do their thing. You'll need to coordinate thru the AME as your tests and documentation is time-limited. Once you have a S.I., I'd suggest going immediately to your PCP for a Basic Med exam and cert. While it's good for four years, another cardio event or other disqualifier will require another S.I.
If your cardiologist is not familiar with dealing with Uncle Sammy, let me know and I'll send you a copy of one of my SI Table of Contents and Cardiologist's letters. Lack of familiarity on the part of my first cardiologist cost me months of extra downtime.
Terry, CFI
RV9A N323TP

The good news is that the wait time for stents was reduced to 3 months down from 6 months a few years ago.

Keep in mind that the FAA will not accept test results that are from test completed before the required wait time has elapsed and as Terry mentioned test results can expire while laying on someone's desk at OK City....

I am unaware of any requirement forcing anyone to get another SI if they have another cardio event that was previously covered by a SI that was not revoked, suspended or denied. New qualifying conditions not covered by the original SI would require another SI be obtained.
 
My advice is to be very careful. A stent by itself is not a big deal. However, if you have any remaining arterial blockage of 70% or more -- like one they can't get to for a stent, but doesn't pose enough risk to justify surgery -- you really do not want to apply for an SI without consulting an AME like Dr. Bruce Chien, or a group that specializes in this kind of stuff. I was really glad I spent the hundred bucks or so to get my records looked over before applying for an SI that almost certainly would have been denied.
 
All good info and advice. Thank you all, and all the best to you, Terry (thread starter), and everyone for whom Basic Med has been a godsend.
 
Basic Med

As an AME for 18 years and also a pilot I have advised the majority of my class 3 special issuances to go the Basic Med route. Many have chosen to do it through me rather than their primary.
if it has been over 10 years or a special issuance will be required I discuss what is necessary and in some instances recommend going the sport pilot route instead of trying for the Special Issuance.

Alan Mekler MD
RV 10 N668G
 
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