Medical question

A friend of mine recently had a minor heart attack and ultimately a stint procedure. He is a PP with Class 3 medical. He thinks he doesn't have to report this until his next medical. He has been flying.

I have searched Part 67 and this is definitely a disqualifying event but I can't find any, "duty to report." I know there has to be something there.

I'd hate to see this guy lose his ticket over a misconception of the FAR's.

Any information?......

Darwin, does this help?

http://www.faa.gov/licenses_certificates/medical_certification/specialissuance/coronary/

I think FAR 61.53 is the one you were looking for -

§ 61.53 Prohibition on operations during medical deficiency.

(a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:

(1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or

(2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

(b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

(c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in § 61.23(c), a person must meet the provisions of—

(1) Paragraph (a) of this section if that person holds a medical certificate issued under part 67 of this chapter and does not hold a U.S. driver's license.

(2) Paragraph (b) of this section if that person holds a U.S. driver's license.


I guess it's not a "duty to report", but rather a "duty to not act as a pilot"

I saw that

Hi Gil,

Thanks for that. I saw that section and it applies but it is typical of the FAR's in vagueness.

I could have sworn I saw a mandatory notification on issues like this somewhere.

Again, thanks!!

No mandatory reporting usually required but it requires a six month stand down then apply for a special issuance. The reg is not real clear about the reporting requirement. The FAA seems to like for the Part 121 guys to let them know but I have heard it differently from one FAA guy to the next. The requirements for the special issuance are things/tests that would be typically done by the cardiologist anyway. For any specific questions, feel free to PM me.

John
Sr. AME
RV-8

There is no required notification. However, having the cardiac event means the existing medical certificate is no longer valid at this point.

That does not mean that this person cannot fly sport pilot. If they never report anything and never seek another medical, they can, in fact, fly sport pilot (assuming they meet the other prescribed requirements).

It does not mean they cannot fly aircraft than light sport - someone else has to be on board as the PIC.

Also, probably a good idea to check the insurance policy requirements.

Dan

Mandatory reporting is required for DUIs, etc. Perhaps that is what caused your confusion.

I have personal first hand experience with this issue.....

Your friend is wrong and is in violation of the FAR's if he is acting as PIC of an aircraft that requires a 3rd class medical or above. In the past there was a mandatory 6 month grounding for stents before the test could even be done to attempt to get a special issuance medical. There has been some indication that this wait time is soon to be shortened.

If he wants to fly on a 3rd class medical, he has no choice but to go thru this process and he will be stuck with a special issuance medical as long as the current rules are in place. The typical cardiac SI requires renewal at least once a year.

Take a look at the back of any medical certificate. It specifically spells out the rules around medical deficiency.

Your friend might as well face the facts and get started with the process as it is a bunch of long red tape. After the waiting period, the FAA will ask that he submit a bunch of current test results, history, details of what happened to him, records on his hospitalization, records and actual video of his stenting procedure, doctor dictations, pretty much everything. They usually want originals where possible and are very picky! He might as well start collecting this stuff now because they will want it and it takes time to collect. They will want current test results of whatever they decide they want to see tested. Those test will not be accepted if they are done before the required waiting period and they cannot be too old either.

Once he gets em everything they want, it is a waiting game of anywhere from 3-6 months. They may even ask for more stuff once the case goes before the board.

It can be done, many have done it. I have been on a SI since 2008.

If your friend keeps flying, he is breaking the law, jeopardizing GA and most likely his insurance will not pay of something happens while he is PIC....

There is no reporting rule. But as Gil pointed out, he knows he has had a disqualifying 'event' which will require a special issuance, so he cannot legally act as PIC or a required crewmember until he does report it, and gets a waiver from his AME and Oklahoma City.
Good News: for minor heart attacks the FAA is giving out waivers pretty routinely now. I think there is a 6 month wait, and then a stress test (don't quote me on this). A former 182 partner got his class three medical back after a similar procedure. AOPA can be helpful.
Bad news: if he self-certifies that he is safe he can fly a sport plane under the sport pilot rules. But if he goes to his AME and his request for a medical waiver is refused, he cannot fly at all, not even as a sport pilot. Tough call.

In the end, the only question, I think, is when does he want to be grounded while the FAA -- in all its sequester glory -- takes its sweet time getting him back in the air -- now? Or at the next medical?

I've missed the entire flying season after my event and I'm kind of kicking myself that I waited until May to start over with the medical folks.

And still grounded, of course.

I can not see any reason to report the condition until the next scheduled medical or six months, which ever occurs last. My understanding is there is a 6 month waiting period from the medical procedure, prior to their consideration for a special issuance. Reporting it gains you nothing. If you report it you could no longer fly Light Sport category.

As others have stated. Your medical certificate is no longer valid due to this disqualifying condition. I also suspect your insurance would not be in force.

Slight clarification

Unless there has been a change since 2009, the six month waiting period is the length of time between the event and the date of any medical reports, lab work, doctor's visits, etc., not the date of the submittal. In my case, the heart valve surgery was in April, 2009, and no medical records required for the re-evaluation would be accepted if they were dated before November. It took about a month to get all my lab work, treadmill test, etc., done and then submitted. Of course, they wanted a few more reports. Then their evaluation of both my submittal and my surgery records (over 300 pages!) took more time, and by June of 2010 I had my Special Issuance.

And that was with AOPA helping me. And yes, I'd use AOPA Medical Services. I wouldn't attempt going for a Special Issuance without their help. Yes, it costs extra, but what's that compared to an annual inspection or annual airplane insurance? Ya dance to the music, ya pay the fiddler!

Bill.Peyton said:

I can not see any reason to report the condition until the next scheduled medical or six months, which ever occurs last. My understanding is there is a 6 month waiting period from the medical procedure, prior to their consideration for a special issuance. Reporting it gains you nothing. If you report it you could no longer fly Light Sport category.

As others have stated. Your medical certificate is no longer valid due to this disqualifying condition. I also suspect your insurance would not be in force.

Click to expand...

Yes there is a reason....

To get a jump start on what he is going to need to get done when the 6 months is over.

They will not give him formal directions on what they want him to submit until he notifies them. After he notifies them, it can take anywhere from a month to 3 months to hear back from them on what they ultimately want him to submit. If he waits, it will just take longer to get back in the air.

On the reverse side of Form 8500-9 (Medical Certificate) it says
"The holder of this certificate must:
Comply with the standards relating to prohibitions on operation during medical deficiency. (14CFR 61.53, 63.19, and 65.49)"

LettersFromFlyoverCountry said:

In the end, the only question, I think, is when does he want to be grounded while the FAA -- in all its sequester glory -- takes its sweet time getting him back in the air -- now? Or at the next medical?

I've missed the entire flying season after my event and I'm kind of kicking myself that I waited until May to start over with the medical folks.

And still grounded, of course.

Click to expand...

As far as flying as PIC where at least a 3rd class medical is required, he was grounded when the disqualifying event happened. Every flight he has made since as PIC where a 3rd class medical is required was illegal.

Brantel said:

Yes there is a reason....

To get a jump start on what he is going to need to get done when the 6 months is over.

Click to expand...

This is especially true since ALL of the documents he's going to be required to submit, including all medical tests and records, have to be within the preceding 90 days.

So if he waits until the medical is due, and the subsequent time it takes for the FAA to send the letter that says "hey, send us this stuff" (that was two months in my recent case), he's going to be paying AGAIN for all the stuff he's already got.

Although, as Don points out, with a heart attacking, he's going to be sitting for many months regardless.

I stand corrected

Brantel said:

Yes there is a reason....

To get a jump start on what he is going to need to get done when the 6 months is over.

They will not give him formal directions on what they want him to submit until he notifies them. After he notifies them, it can take anywhere from a month to 3 months to hear back from them on what they ultimately want him to submit. If he waits, it will just take longer to get back in the air.

Click to expand...

For most cardiac conditions it is well known what the FAA requires (testing and paperwork submittal) and can be found on the FAA website or AOPA website.

I never notified the FAA for my stent or my triple bypass. I just did the testing at 6 months and then hurriedly sent in the paperwork that was listed on the website. I then waited for OK City to send Special Issuance. If you send in what they ask on the website, SI will come with no need for back and forth communication.

Your mileage may vary based on your particular medical issue, medical history, age (I think a very big player in ease of getting SI), and thoroughness of testing and paperwork you submit.

Everyone is evaluated on a case by case basis and for cardiac cases there is no template that fits all. Sure there are some things that are common but until you notify them and they look your situation over, you will not know for sure what they will ask for. Your package won't go before the board until it is complete to their liking.

Send em as much detail as you can on the initial contact and they will be more likely to know what to ask of you for testing after the waiting period is up.

You can guess and you might get lucky or you can come clean and know for sure. Your choice...... If you are wrong it can cost you many more months of downtime.

If you are going to go for a SI, there is absolutely no downside to starting the process as soon as possible. If you are not sure you want to risk it and may want to go Sport Pilot, then you might want to wait and think about it.

Either way you are grounded for 6 months minimum (new reports are that this is getting shortened to 3 months soon) Then you can go for the SI or you can self certify and go Sport Pilot.

My situation was also easy as far as cardiac SI's go, was pretty much textbook right off the FAA website. A friend's however was a nightmare and he had all kinds of additional requirements due to his personal situation. It took him much longer to get his SI.

Ok, I am off the soapbox now. My advice is worth what anyone paid for it......take it or leave it.

I agree with everything Brian said. But one other factor to consider for heart patients is that the Cardiology board only meets maybe once a month. Unless it has changed recently, they only meet for a few days each month, so if your file is received by them at the right time you might get a much quicker turnaround than someone whose file is received a few days later.

That may have changed and the same might not be true for other conditions like cancer or brain surgery. Just sharing what I learned from my two heart valve surgeries, one to repair a defective mitral valve, and the second to replace it. So far my valve is working great, and after the initial special issuance, the yearly renewals have been pretty quick, 4-6 weeks, IIRC.

Hope this helps.

P.S. As someone's later post indicated, the usual physical exam with an AME is done every other year, based on my age.

plehrke said:

For most cardiac conditions it is well known what the FAA requires (testing and paperwork submittal) and can be found on the FAA website or AOPA website.
.
.

Your mileage may vary based on your particular medical issue, medical history, age (I think a very big player in ease of getting SI), and thoroughness of testing and paperwork you submit.

Click to expand...

Brantel said:

I respectfully disagree.

Everyone is evaluated on a case by case basis and for cardiac cases there is no template that fits all. Sure there are some things that are common but until you notify them and they look your situation over, you will not know for sure what they will ask for. Your package won't go before the board until it is complete to their liking.

Click to expand...

I think we are in agreement if you read my last paragraph and I change the first paragraph to replace the word "most" with the word "many".

After I got my first SI from OK city, they sent me a 6 year waiver allowing my AME to issue my 3rd himself. Annual treadmill, cholesterol check, cardio review (lecture), and an eye evaluation each two years. Also, the actual exam is only given every two years.

plehrke said:

I think we are in agreement if you read my last paragraph and I change the first paragraph to replace the word "most" with the word "many".

Click to expand...

Thanks for clearing that up. I kinda thought I might be misinterpreting your first paragraph. Sorry about that! Its all good....

aerhed said:

After I got my first SI from OK city, they sent me a 6 year waiver allowing my AME to issue my 3rd himself. Annual treadmill, cholesterol check, cardio review (lecture), and an eye evaluation each two years. Also, the actual exam is only given every two years.

Click to expand...

I got one of those as well the first go round. Lost it after the first year due to a false positive on the stress test. A brand new heart cath test proved the stress test was wrong but the FAA pulled my 6 year waiver. Got it back this last year.

The waiver is pretty cool if your AME actually understands what it is. Mine wants to do a full physical every year and charge me the full amount just to fwd my paperwork. We are due to go round and round again this October. I hope he has educated himself since the last time we met. I am not due for another full physical until 2015. All he is suppose to do is look at my test reports and if they fall within the limits and nothing new has happened, give me another medical certificate good for a year and then fwd my stuff to the FAA where they will evaluate it and either let my certificate stand or not.

Without the waiver or if you chose not to use it, you must send your stuff to the FAA at least a few months ahead of expiration or it will expire before they get back to you. I imagine the sequestration will have a negative impact on the wait time for this therefore I will use the waiver this year. Last year I self mailed because my waiver got pulled and my file when into a black hole for a few months. When it finally came out, I had lost a little over a month of flying as PIC. I sent the stuff in almost 3 months early!

aerhed said:

After I got my first SI from OK city, they sent me a 6 year waiver allowing my AME to issue my 3rd himself. Annual treadmill, cholesterol check, cardio review (lecture), and an eye evaluation each two years. Also, the actual exam is only given every two years.

Click to expand...

I got the same thing 2 years ago after 5 years of going through OK City every year.
This subject is actually pretty fresh for me as I did my annual treadmill last Friday and meet with my cardiologist today to "coach" him on the things to include in his letter he writes for me to give to my AME.

Sorry to be the fly in the ointment but.....
What is the moral thing to do? Having had a stent placement there is a finite incidence of clotting off the stent and having a heart attack. the incidence and risk go down with time. Do you want to be carrying you wife, girlfriend, son, etc with this increased risk? Is flying that important to you to risk others?
I would call you AME and talk with him or her knowing you are going to be grounded for a while and if all works out you will fly again.
Sorry to be pedantic, and yes I really do understand.
Just my %.02

Be careful!

When I had my heart event I was working for the FAA which made my decision pretty easy, I HAD to do it the right and legal way. First step was to take care of myself and get healthy and keep all records. Luckily my heart problem was minor and a rather short waiting period-2 months. Next was to find a GREAT AME! Dr Stephen Kramer in Frisco, TX is awesome. http://flightphysical.com/dr-kramer-s He has worked on the board in OKC for the FAA doctor panel and knows the process. Furthermore, he is a pilot who loves to fly and understands my passion for flight. Next, get a cardiologist who understands the FAA requirements and is willing to make the reports as the FAA needs them....no matter how odd and archaic the demands may be. Dr Kramer directed me to an understanding heart doctor. Lastly, do not try to hide your ailments. Medical records are easily found and the authorities will have access to these records at the most inopportune times. At best you hurt or kill yourself. At worse, you take someone down with you. Flying is grand but with it comes great responsibility.

On sport pilot-this is a major misconception. If you have a heart problem followed by a heart procedure, yes, if you are healed and physically fit, you can self certify and fly sport. However do not be fooled about what a giant responsibility this is. When you self certify, your are certifying that you KNOW you have no unairworthy health issues. In other words, if you are flying knowing you have had heart issues but have not involved the proper tests and procedures to verify that you are indeed fit to fly, and you have an accident or incident, your insurance will not pay, the FAA will come investigate you and in general, things are going to be bad. You carry a huge liability when you self certify. To me that could be financially disasterous. Not to mention the inherent personal health risk to yourself and others.

My advice? Do it right, go through the effort to ascertain you are healthy to fly and get your good AME involved soonest. The FAA is streamlining the process and making it easier and SI's lasting longer. And if the FAA board of highly experienced doctors, all specialists in that particular SI, comes back and says you should not fly, very rare these days, maybe you should not fly.

I am no longer with the FAA and am now a professional pilot and every six months I go through the pain of the process and the axiety that goes with it. But I know the risks involved and want to make sure I am fit to fly. Yah, I wish it was the way it used to be where if I walked in the docs office a few minutes later I walked out with my medical but....it is what it is, thankful I can still fly! Doing it right and legal is a good idea for any of us.

Tailwinds!

One more thought. If you fly with an expired medical, you're up for a suspension. If you lie on a medical form, it's a revocation.

A friend in Tucson went to Peoria, IL to this guy -

http://home.comcast.net/~bbchien/site/?/home/

- and came back with a medical certificate in his hand after a stent.

Lots of preliminary stuff done first, of course, but I believe a Senior AME has more abilities/rights than the usual AME in town.