Another medical question: neuropathy

[jedi93]

So in the 2024 AME guide it list neuropathy. One topic says neuropathy without functional limitations the AME can issue. The other block says neuropathy with weakness/numbness and physical limitations must be deferred. My question is, isn’t neuropathy weakness, numbness and pain in the simplest form?

I broke a 5th metatarsal bone many years ago. It causes me pain from walking and but no numbness or weakness and can fully manipulate the rudder pedals in all flight maneuvers. If I happen to one day get VA disability for say
moderate pain that’s controlled by NASIDS
How would an AME view this? Would it be an issue or a defer?

 

[Jim_R]

My question is, isn’t neuropathy weakness, numbness and pain in the simplest form?

I don't know the medical textbook definition, but colloquially maybe "weakness, numbness, and/or pain".

The neuropathy in my feet is very mild numbness that I don't even notice unless pressure is applied. The neuropathy in my uncle's feet is painful and includes loss of sensation in the soles that means he doesn't have good feedback on what his feet are doing. He's fallen a couple of times because of it.

There's a wide range for the effects of neuropathy. I would say mine falls in the category of "without functional limitations". My uncle's...not so much.

 

[jedi93]

I don't know the medical textbook definition, but colloquially maybe "weakness, numbness, and/or pain".

The neuropathy in my feet is very mild numbness that I don't even notice unless pressure is applied. The neuropathy in my uncle's feet is painful and includes loss of sensation in the soles that means he doesn't have good feedback on what his feet are doing. He's fallen a couple of times because of it.

There's a wide range for the effects of neuropathy. I would say mine falls in the category of "without functional limitations". My uncle's...not so much.

Mind if I ask if you have a 1st class with the mild numbness you have? I’ve wondered if mine got to that point down the road how the FAA sees it.

 

[Jim_R]

Mind if I ask if you have a 1st class with the mild numbness you have? I’ve wondered if mine got to that point down the road how the FAA sees it.

Sorry, I can't help you there. Due to other medical situations, I opted to let my Class III lapse because I foresaw that at some point in the future I would be denied unless I went through a great deal of hassle. I'm currently flying under Basic Med.

 

[jedi93]

Sorry, I can't help you there. Due to other medical situations, I opted to let my Class III lapse because I foresaw that at some point in the future I would be denied unless I went through a great deal of hassle. I'm currently flying under Basic Med.

Thank you for the insight. Maybe one of the AMEs on here will chime in.

 

[dbahn]

"Neuropathy" in medicine is like "corrosion" in cars. It's common, more common with age, sometimes hard to even detect, and can range from having little or no effect to severe impact. The devil is in the details, but from what you're describing it's a peripheral neuropathy associated with an injury, and probably involving just a sensory (not a motor) nerve. The FAA is more concerned about function (as they should be) rather than whether your foot hurts or not. Even if you are given a disability benefit from the VA it could still be a yawner for the FAA.

 

[jedi93]

"Neuropathy" in medicine is like "corrosion" in cars. It's common, more common with age, sometimes hard to even detect, and can range from having little or no effect to severe impact. The devil is in the details, but from what you're describing it's a peripheral neuropathy associated with an injury, and probably involving just a sensory (not a motor) nerve. The FAA is more concerned about function (as they should be) rather than whether your foot hurts or not. Even if you are given a disability benefit from the VA it could still be a yawner for the FAA.

Thanks for the response. However, I’m leary of how the VA would word it if I’ve received a disability. Say I tell the VA I have moderate foot pain from the fractured 5th metarsal that never healed properly that I’ve lived with for years. They give me 10% or whatever for that and might discover or say I have neuropathy as well, which I’m not even sure how it’s diagnosed, when all I say is moderate pain in right foot.

 

[Eldorado]

Seems like it would depend upon what disability you are claiming the neuropathy is causing. If that disability is affecting your ability to drive, but not fly? You might be opening up a can of worms, or maybe you just need a waiver to demonstrate it does not affect your flying. I also believe the FAA would want to know the etiology and future prognosis of this neuropathy.

 

[dbahn]

Thanks for the response. However, I’m leary of how the VA would word it if I’ve received a disability.

I'm not sure that the wording is all that critical with respect to the FAA, even though it might have specific meaning with the VA benefits. Either way, from what you've described I'm guessing that it won't be a problem, but I also wouldn't trust my opinion if I was worried. There are AMEs on this board and AMEs wherever you live, so trusting them is definitely more prudent.

Seems like it would depend upon what disability you are claiming the neuropathy is causing. If that disability is affecting your ability to drive, but not fly? You might be opening up a can of worms, or maybe you just need a waiver to demonstrate it does not affect your flying. I also believe the FAA would want to know the etiology and future prognosis of this neuropathy.

Keep in mind that disability refers to employment, as opposed to impairment which refers to activities of daily living. So the VA can issue a disability benefit for a condition that doesn't otherwise have a significant effect on your other activities, such as flying. The FAA is interested in the impairment aspect, which is why there are many pilots who check that box, report the disability benefit and are routinely medically certified.

Again, this is a question for an AME. I'm only voicing my personal opinion, but a few years ago there were many airman caught lying on their medical applications when the FAA accessed the VA records as both were federal agencies.