AOPA Pilot Protective Services article on SI to Basic Med

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robin ardoin

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I read an article from AOPA which, summed up, suggests that allowing a Special Issuance class 3 med certificate to expire and continuing with Basic Med has led to instances of withdrawal of the SI authorization (in spite of the ‘Domingo‘ opinion of the general counsel). I’m a little confused and concerned. Even if the SI authorization was withdrawn after expiration of the SI medical certificate how could that effect one? Can they deny/withdraw the certificate after it expires??? I am facing expiry of my class 3 SI certificate at the end of the month and just completed my Basic Med requirements and submission and assumed I would be fine on BM. Calling all AME’s! @bbchien @lbfjrmd
 
AOPA is fearmongering. I'm not you of course, but I'd take that bet and go basicmed, let the class iii and si nonsense expire and go live your best life.
 
robin ardoin said:
I read an article from AOPA which, summed up, suggests that allowing a Special Issuance class 3 med certificate to expire and continuing with Basic Med has led to instances of withdrawal of the SI authorization (in spite of the ‘Domingo‘ opinion of the general counsel). I’m a little confused and concerned. Even if the SI authorization was withdrawn after expiration of the SI medical certificate how could that affect one? Can they deny/withdraw the certificate after it expires??? I am facing expiry of my class 3 SI certificate at the end of the month and just completed my Basic Med requirements and submission and assumed I would be fine on BM. Calling all AME’s! @bbchien @lbfjrmd
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I read that article too. There have been a few situations where AMCD (Aerospace Medical Certification Division, or commonly referred as "Oklahoma City") inadvertently withdrew the Special Issuance (SI) after the expiration of the medical certificate. While done in error, a couple situations I'm familiar with resulted from the airman's treating physician automatically reporting results of a periodic test to the FAA even after the airman had transitioned to BasicMed. Other cases resulted from the airman responding to a SI letter requesting a status report with medical information even though they were transitioning to BasicMed.

The good news is that in each of these cases, when the error was discovered, the FAA was able to send the airman a letter rescinding the withdrawal letter. It's rare that it happens, but when it does, it's easily correctable. It's a staff training issue, not an FAA aeromedical policy that causes this.

How to avoid it if you're transitioning from a medical with an active SI to BasicMed? Don't send medical information to AMCD if you don't want to continue your medical.

SIs typically require periodic status reports from the airman in order to keep the authorization active. AMCD has no idea whether an airman plans to continue his or her medical so the reminders are sent. When an airman has let his medical certificate expire and transitioned to BasicMed gets one of these letters, the best thing to do is to respond with a letter indicating that the he or she is not intending to renew the medical certificate and transitioning to BasicMed. Otherwise, don't respond to the letter. Sending AMCD medical information when you don't want a medical causes issues- AMCD is obligated to review all medical data they receive. Simply put: don't do it.
 
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Brad Z said:
How to avoid it if you're transitioning from a medical with an active SI to BasicMed? Don't send medical information to AMCD if you don't want to continue your medical
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…and inform your physicians in writing they are no longer authorized to send any reports to the FAA .
 
midlifeflyer said:
…and inform your physicians in writing they are no longer authorized to send any reports to the FAA .
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I'll be honest that I was genuinely surprised that a physician's office was proactive enough to send medical records without the patient's prompting; I feel like I typically have to beg and plead to get that done. Nonetheless, probably not a bad idea to inform a "helpful" medical practice to discontinue sending medical records to the FAA if that was a something you requested they do in the past.
 
Brad Z said:
I'll be honest that I was genuinely surprised that a physician's office was proactive enough to send medical records without the patient's prompting; I feel like I typically have to beg and plead to get that done. Nonetheless, probably not a bad idea to inform a "helpful" medical practice to discontinue sending medical records to the FAA if that was a something you requested they do in the past.
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It's about being proactive and what may be standard procedure in some offices. Once a note to send something is in the file, staff might well tag it for repetition. Telling them to stop is a small thing that can pay dividends in situations like this.

Not a problem but just an illustration: I had an SI for several years; fortunately, it only required me to bring the reports to my AME. But the note was there and every examination I was asked, "do you need something for the FAA?" Even with BasicMed, during my annual wellness exam, my PCP asks, "do we need to fill out that form again?"
 
Brad Z said:
I read that article too. There have been a few situations where AMCD (Aerospace Medical Certification Division, or commonly referred as "Oklahoma City") inadvertently withdrew the Special Issuance (SI) after the expiration of the medical certificate. While done in error, a couple situations I'm familiar with resulted from the airman's treating physician automatically reporting results of a periodic test to the FAA even after the airman had transitioned to BasicMed. Other cases resulted from the airman responding to a SI letter requesting a status report with medical information even though they were transitioning to BasicMed.

The good news is that in each of these cases, when the error was discovered, the FAA was able to send the airman a letter rescinding the withdrawal letter. It's rare that it happens, but when it does, it's easily correctable. It's a staff training issue, not an FAA aeromedical policy that causes this.

How to avoid it if you're transitioning from a medical with an active SI to BasicMed? Don't send medical information to AMCD if you don't want to continue your medical.

SIs typically require periodic status reports from the airman in order to keep the authorization active. AMCD has no idea whether an airman plans to continue his or her medical so the reminders are sent. When an airman has let his medical certificate expire and transitioned to BasicMed gets one of these letters, the best thing to do is to respond with a letter indicating that the he or she is not intending to renew the medical certificate and transitioning to BasicMed. Otherwise, don't respond to the letter. Sending AMCD medical information when you don't want a medical causes issues- AMCD is obligated to review all medical data they receive. Simply put: don't do it.
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Thank you also, Brad. Very informative and I can breath a sigh of relief.
 
Am in the same boat 3rd class with SI that expires end of this year. So do I let the 3rd class expire then get an exam from my DR or do it before the 3rd class expires? There is an AME here that is easy to work with. Should I go to him instead for the BM exam? The item I do not qualify for on the 3rd class are they supposed to be checked on BM? thanks
 
fast99 said:
Am in the same boat 3rd class with SI that expires end of this year. So do I let the 3rd class expire then get an exam from my DR or do it before the 3rd class expires? There is an AME here that is easy to work with. Should I go to him instead for the BM exam? The item I do not qualify for on the 3rd class are they supposed to be checked on BM? thanks
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1 - You can get Basic Med before your 3rd class expires.
2 - You could go to the AME, but it seems to me there's more chance there for a slip-up by having something sent to the FAA inadvertently. Why not use your regular physician? He probably knows more about your overall health than the AME anyway.
3 - Nothing is supposed to be checked in the Basic Med exam other than those items on the checklist.

Don't overcomplicate things. Basic Med is akin to a sports physical; it's not some sort of 4th class FAA medical.
 
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Not sure if this is relivent, I knew I would need a SI to be able to renew my class 3, I didn’t have one before but a health issue cropped up. I let the 3 expire then did the basic med, the health issue was allowed under basic med with out a SI.
 
fast99 said:
Am in the same boat 3rd class with SI that expires end of this year. So do I let the 3rd class expire then get an exam from my DR or do it before the 3rd class expires? There is an AME here that is easy to work with. Should I go to him instead for the BM exam? The item I do not qualify for on the 3rd class are they supposed to be checked on BM? thanks
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I completed the BM requirements/exam while still having an active SI class 3 med. cert.. My internist was a little unsure about the Basic Med program so I had a colleague, who is an AME and does BM exams, take care of the CMEC. I would not use my HIMS AME as the chance of something accidentally being submitted could 'screw the pooch'.
 
Hmmm... seems like my HIMS AME is of the opinion that once an airman is in the HIMS program they are not eligible for Basic Med. I did not think the reason for the SI was relevant as long as the requirements were complied with during the valid period of the medical certificate. Anyone with experience of transitioning from HIMS, class 3, to Basic med?
 
I currently hold a class 3 with SI for sleep apnea. I also hold a BM certificate. My SI is valid until 2028, so will continue with both and let the SI expire, and then go fully BM. In the meantime, Im training my PCP on BM. :) Doing both will make sure my PCP AND his practice is comfortable with BM. I have heard some stories about partners in some practices disallowing them over liability concerns. I don’t want to have to go back through a sleep study again and all the paperwork of obtaining a new SI, for now I just submit the report annually and pay my AME $130 for the Class 3.
 
robin ardoin said:
Hmmm... seems like my HIMS AME is of the opinion that once an airman is in the HIMS program they are not eligible for Basic Med. I did not think the reason for the SI was relevant as long as the requirements were complied with during the valid period of the medical certificate. Anyone with experience of transitioning from HIMS, class 3, to Basic med?
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He’s wrong.

You have to continue with HIMS until your medical expires, lest it be revoked. Once it expires, the FAA can’t revoke it even if they want to. There is nothing in the Basic Med rules about HIMS nor about maintaining an SI; just a one-time requirement for a limited list of conditions.

@Brad Z , can the FAA do anything to educate the HIMS docs and stop this sort of misinformation? In some instances it smacks of an unethical attempt by the physician to maintain a revenue stream.
 
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That is what I told them but he and his nurse hold a contrary opinion. I still plan to let it expire and continue flying under BM as all evidence points to an honest misunderstanding by my HIMS AME of the regulations.
 
robin ardoin said:
That is what I told them but he and his nurse hold a contrary opinion. I still plan to let it expire and continue flying under BM as all evidence points to an honest misunderstanding by my HIMS AME of the regulations.
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Give them a copy of the so-called Domingo letter, https://www.faa.gov/about/office_or...Domingo-AFX-1-2_2018_Legal_Interpretation.pdf .

The relevant part states:

As explained further in this memorandum, when an airman's special issuance​
medical certificate has expired and the airman is not in the process of seeking a new special​
issuance medical certificate, additional medical information is not reasonably needed for​
certification under§ 67.401. Consequently, the Federal Air Surgeon may not withdraw the​
Authorization based on the ainnan's failure to provide information "not reasonably needed​
by the Federal Air Surgeon for certification under this section[§ 67.401(f)(4)]." If an ainnan​
does not hold a special issuance medical certificate and has no application pending, there is​
no need for the Federal Air Surgeon to request information necessary to determine whether​
the airman meets the standards for special issuance medical certificate.2​
 
Half Fast said:
Give them a copy of the so-called Domingo letter, https://www.faa.gov/about/office_or...Domingo-AFX-1-2_2018_Legal_Interpretation.pdf .

The relevant part states:

As explained further in this memorandum, when an airman's special issuance​
medical certificate has expired and the airman is not in the process of seeking a new special​
issuance medical certificate, additional medical information is not reasonably needed for​
certification under§ 67.401. Consequently, the Federal Air Surgeon may not withdraw the​
Authorization based on the ainnan's failure to provide information "not reasonably needed​
by the Federal Air Surgeon for certification under this section[§ 67.401(f)(4)]." If an ainnan​
does not hold a special issuance medical certificate and has no application pending, there is​
no need for the Federal Air Surgeon to request information necessary to determine whether​
the airman meets the standards for special issuance medical certificate.2​
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I did cite that and copy them but they insist that HIMS cases are not covered by that opinion. Their office is supposed to contact the FAA for their opinion...:rolleyes:. Regardless, the "Domingo' opinion is rather lucid. I just need to convince them to not submit any further documentation on my behalf.
 
As a successful HIMS to BasicMed transitionee, I’ll weigh in on this.

Aside from them pertaining to drug/alcohol, or other mental health concerns, HIMS special issuances are no different from any other special issuance. To grant them special treatment would be to make them a punitive measure. But the HIMS AMEs don’t want you to know this.

Even the BasicMed website states you only need the one time authorization for substance abuse/dependence before you’re eligible for BasicMed.


To require the airman to stay on a medical certificate while operating on BasicMed defeats the purpose of BasicMed. Congress did not want that, and Congress overrules the FAA.

HIMS is covered by Domingo because there is no published interpretation to the contrary. Where people mess up is that when the special issuance medical certificate expires, the airmen has a responsibility to demonstrate that he/she remains qualified for a special issuance medical certificate at the time that the special issuance medical certificate expires. This requires the airman to send in the information required by the Special Issuance Authorization at the time the certificate expires.

Some airmen fail to do this. They feel that the certificate is already expired so that last bit of information isn’t necessary. But you need to show compliance with the Authorization up to and through the “Not Valid For Any Class After” date on your special issuance medical certificate.

Treat it like any other follow up appointment. Just don’t fill out a MedXpress application. This results in a renewal and you’re bound to the terms of the Authorization.

Lastly, write a letter to your AME revoking any and all authorization to share information with the FAA until such time that you decide to renew the medical certificate.
 
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Jon Wilder said:
As a successful HIMS to BasicMed transitionee, I’ll weigh in on this.

Aside from them pertaining to drug/alcohol, or other mental health concerns, HIMS special issuances are no different from any other special issuance. To grant them special treatment would be to make them a punitive measure. But the HIMS AMEs don’t want you to know this.

Even the BasicMed website states you only need the one time authorization for substance abuse/dependence before you’re eligible for BasicMed.


To require the airman to stay on a medical certificate while operating on BasicMed defeats the purpose of BasicMed. Congress did not want that, and Congress overrules the FAA.

HIMS is covered by Domingo because there is no published interpretation to the contrary. Where people mess up is that when the special issuance medical certificate expires, the airmen has a responsibility to demonstrate that he/she remains qualified for a special issuance medical certificate at the time that the special issuance medical certificate expires. This requires the airman to send in the information required by the Special Issuance Authorization at the time the certificate expires. Some airmen fail to do this. They feel that the certificate is already expired so that last bit of information isn’t necessary. But you need to show compliance with the Authorization up to and through the “Not Valid For Any Class After” date on your special issuance medical certificate.

Treat it like any other follow up appointment. Just don’t fill out a MedXpress application. This results in a renewal and you’re bound to the terms of the Authorization.

Lastly, write a letter to your AME revoking any and all authorization to share information with the FAA until such time that you decide to renew the medical certificate.
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Thank you.
 
wellknow said:
what do u need to do to show compliance?
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When you have a Special Issuance Medical Certificate, it is accompanied with a Special Issuance Authorization Letter. The Special Issuance is contingent upon compliance with everything in the Authorization Letter, and is usually in the form of submitting medical information at some time interval throughout the medical certificate life cycle.

A HIMS Special Issuance is typically a 6 month medical certificate. At 3 months, you submit everything required to be submitted per the Authorization Letter (usually AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor outlining your progress in recovery, etc). At 6 months, your medical certificate expires, and you must submit the most up to date information (current AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor) in order to renew the certificate.

At the time of special issuance medical certificate expiration, you would submit everything required per the Authorization Letter one last time. You just will not apply for a medical certificate renewal in MedXpress, nor will you do a physical.

Some people think they can just let it expire and walk away. They make the mistake of not sending in the information asked for in the Authorization Letter because “well it’s expired so I don’t have to”. But you have to send everything asked for at the time of expiration of the medical certificate. After that, you can walk away.
 
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Brad Z said:
SIs typically require periodic status reports from the airman in order to keep the authorization active. AMCD has no idea whether an airman plans to continue his or her medical so the reminders are sent. When an airman has let his medical certificate expire and transitioned to BasicMed gets one of these letters, the best thing to do is to respond with a letter indicating that the he or she is not intending to renew the medical certificate and transitioning to BasicMed. Otherwise, don't respond to the letter. Sending AMCD medical information when you don't want a medical causes issues- AMCD is obligated to review all medical data they receive. Simply put: don't do it.
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@Brad Z If the airman responds that they are not intending to renew the medical certificate and transitioning to BasicMed, is there a risk that AMCD would withdraw the special issuance authorization based on the airman's "no longer need" for it, which would then revoke BasicMed privileges?
 
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Jon Wilder said:
@Brad Z If the airman responds that they are not intending to renew the medical certificate and transitioning to BasicMed, is there a risk that AMCD would withdraw the special issuance authorization based on the airman's "no longer need" for it, which would then revoke BasicMed privileges?
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They can’t do that if the medical has expired. Brad can elaborate, I’m sure.
 
Jon Wilder said:
When you have a Special Issuance Medical Certificate, it is accompanied with a Special Issuance Authorization Letter. The Special Issuance is contingent upon compliance with everything in the Authorization Letter, and is usually in the form of submitting medical information at some time interval throughout the medical certificate life cycle.

A HIMS Special Issuance is typically a 6 month medical certificate. At 3 months, you submit everything required to be submitted per the Authorization Letter (usually AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor outlining your progress in recovery, etc). At 6 months, your medical certificate expires, and you must submit the most up to date information (current AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor) in order to renew the certificate.

At the time of special issuance medical certificate expiration, you would submit everything required per the Authorization Letter one last time. You just will not apply for a medical certificate renewal in MedXpress, nor will you do a physical.

Some people think they can just let it expire and walk away. They make the mistake of not sending in the information asked for in the Authorization Letter because “well it’s expired so I don’t have to”. But you have to send everything asked for at the time of expiration of the medical certificate. After that, you can walk away.
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great. thank u!
 
Rcmutz said:
I currently hold a class 3 with SI for sleep apnea. I also hold a BM certificate. My SI is valid until 2028, so will continue with both and let the SI expire, and then go fully BM. In the meantime, Im training my PCP on BM. :) Doing both will make sure my PCP AND his practice is comfortable with BM. I have heard some stories about partners in some practices disallowing them over liability concerns. I don’t want to have to go back through a sleep study again and all the paperwork of obtaining a new SI, for now I just submit the report annually and pay my AME $130 for the Class 3.
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Does your SI letter state you need to do another sleep study? I just got my SI letter and looks like all I need to do to keep the SI compliant is to have my doc fill out and sign a progress report, my machine report, and one other thing to be sent to the FAA. I’m old(er) so mine is not valid after 2025…so I’m going to do BM now and maintain the SI until 2025. Sure hope I don’t need to get another sleep study as I’m 99.8% compliant with successful CPAP treatment.
 
Beaker’s Flyin said:
Does your SI letter state you need to do another sleep study? I just got my SI letter and looks like all I need to do to keep the SI compliant is to have my doc fill out and sign a progress report, my machine report, and one other thing to be sent to the FAA. I’m old(er) so mine is not valid after 2025…so I’m going to do BM now and maintain the SI until 2025. Sure hope I don’t need to get another sleep study as I’m 99.8% compliant with successful CPAP treatment.
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No, my SI does not say I need to do another sleep study. My concern was if I went to BM, and let it lapse along with my Class 3, but my PCP decided not to continue to sign BM forms due to liability concerns in the future, IF I wanted to go back to Class 3, would I need another sleep study to get the SI re-issued?

Calling Dr. Bruce……
 
Depends on if the term of the "this authorization is valid through Jan 31, 2027" or some such, date has passed.



B
 
Jon Wilder said:
@Brad Z If the airman responds that they are not intending to renew the medical certificate and transitioning to BasicMed, is there a risk that AMCD would withdraw the special issuance authorization based on the airman's "no longer need" for it, which would then revoke BasicMed privileges?
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That was true in the past. But now, as long as the certificate has expired, they have no grounds for withdrawing the SI. The airman is making it clear that they intend to transition to BasicMed after the medical certificate expires.

Could they withdraw if they get your letter before your medical expired? In theory it’s technically possible under Domingo, but again they’d have no cause to withdraw unless your were currently non-compliant with the SI. In reality this has not ever happened, and if it were to happen, the withdrawal would most certainly be rescinded. Also, based on their backlog, it’s unlikely they’re ever get to your letter before your certificate expired.

Now if you send AMCD a letter stating that you miss booze and want to go BasicMed so you can start drinking again, that’s a completely different story…and might cost you your certificate. See 68.11.
 
bbchien said:
Depends on if the term of the "this authorization is valid through Jan 31, 2027" or some such, date has passed.



B
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Follow up question…. My SI just says I need to send in my annual reports. If I I keep doing that even without a class 3 medical or exam, will they will continue to re-issue the SI?
 
Rcmutz said:
Follow up question…. My SI just says I need to send in my annual reports. If I I keep doing that even without a class 3 medical or exam, will they will continue to re-issue the SI?
[/QUOTE
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No, but you could, if you wanted, return to the SI 3rd class without hassle if your return is one year prior to the date noted on the authorization.

as in, "This authorization expires March 31, 2029" whis is usually lin teh thrid paragraph of the auth letter."

1709827155502.png
 
bbchien said:
No, but you could, if you wanted, return to the SI 3rd class without hassle if your return is one year prior to the date noted on the authorization.

as in, "This authorization expires March 31, 2029" whis is usually lin teh thrid paragraph of the auth letter."

View attachment 126355
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Ok, thanks. I’ll probably go through one more renewal of the SI, and go from there. The six years should be enough to get my PCP/myself comfortable so that they won’t stop allowing him to sign the BM paperwork. My annual exam covers everything required for the BM, including the prostate exam.
 
Jon Wilder said:
When you have a Special Issuance Medical Certificate, it is accompanied with a Special Issuance Authorization Letter. The Special Issuance is contingent upon compliance with everything in the Authorization Letter, and is usually in the form of submitting medical information at some time interval throughout the medical certificate life cycle.

A HIMS Special Issuance is typically a 6 month medical certificate. At 3 months, you submit everything required to be submitted per the Authorization Letter (usually AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor outlining your progress in recovery, etc). At 6 months, your medical certificate expires, and you must submit the most up to date information (current AA attendance sheet, drug/alcohol screen results, aftercare report from your aftercare counselor) in order to renew the certificate.

At the time of special issuance medical certificate expiration, you would submit everything required per the Authorization Letter one last time. You just will not apply for a medical certificate renewal in MedXpress, nor will you do a physical.

Some people think they can just let it expire and walk away. They make the mistake of not sending in the information asked for in the Authorization Letter because “well it’s expired so I don’t have to”. But you have to send everything asked for at the time of expiration of the medical certificate. After that, you can walk away.
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How does my HIMS AME send this info in without using MedExpress/ and/or triggering the new SI for another 6 month period? @bbchien
 
He has the upload system as AME of record.

However, all HIMS medical sponsors are required to "keep up" monthly and so it something is missing I give the airman ONE positive wrning - voice contact, email that is responded to....and if nothing appears I am obligated to notify the agency for withdrawal. I don't commonly upload each month...your HIMS AME medical sponsor is your "monitoring agent" as well as advisor.

So they know that someone (known to them) is "keeping up" even if nothing is received.
 
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