Class 3 Medical

A

Austin Parker

Guest
I am wondering if any one with a 3rd Class medical has ever had the FAA investigate there medical and if so why ? I am not really looking for everyone’s ethical opinion just facts was there medical ever looked at and why. If so what process was used. I am very aware of consequences and also very aware that many people forget to list stuff. I appreciate your honesty and understanding
 
Yes.
“The quality assurance Branch has become aware of of an inflight issue which reasonably provides cause for reexamination of you fitness to hold a second class medical certificate. Please within 60 days provide the following:
(1) Hims psychiatry and psychology evaluation
(2) all records from you psychiatrist, psychologist or any other practitioner who you have seen in the past five years
(3) personal statement....
(Eight items total)......”

..taken from a letter that the airman brought to me just a month ago.....
 
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I have seen it a few times..

in one, something important was answered "no" on a current application, but answered "yes" previously. One would "think" the pilot would be more careful or that the FAA would chalk it up to an error, but investigations can result in strange things.

In another, the pilot had an accident, resulting in significant injuries. The result was something similar to the language Bruce cited.
 
bbchien said:
Yes.
“The quality assurance Branch has become aware of of an inflight issue which reasonably provides cause for reexamination of you fitness to hold a second class medical certificate. Please within 60 days provide the following:
(1) Hims psychiatry and psychology evaluation
(2) all records from you psychiatrist, psychologist or any other practitioner who you have seen in the past five years
(3) personal statement....
(Eight items total)......”

..taken from a letter that the airman brought to me just a month ago.....
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I would like to know what sort of "inflight issue" triggered that one!
 
Three words: "Operation Safe Pilot."
 

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  • DOT-IG Memorandum re Operation SafePilot.pdf
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Austin Parker said:
I am wondering if any one with a 3rd Class medical has ever had the FAA investigate there medical and if so why ? I am not really looking for everyone’s ethical opinion just facts was there medical ever looked at and why. If so what process was used. I am very aware of consequences and also very aware that many people forget to list stuff. I appreciate your honesty and understanding
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So what did you do?
 
bbchien said:
Yes.
“The quality assurance Branch has become aware of of an inflight issue which reasonably provides cause for reexamination of you fitness to hold a second class medical certificate. Please within 60 days provide the following:
(1) Hims psychiatry and psychology evaluation
(2) all records from you psychiatrist, psychologist or any other practitioner who you have seen in the past five years
(3) personal statement....
(Eight items total)......”

..taken from a letter that the airman brought to me just a month ago.....
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oh do share the other 5 items! “In flight issue” is very intriguing!!
 
Yep. I got one, well on a class 2 medical. Someone at the FAA doesnt understand what the definition of "cure" is. They also dont know what a prophylaxis is, and they are supposedly doctors.

I say supposedly because theres no way someone who puts MD at the tail end of their name can be that stupid.

Had to mansplain the **** out of it to her.
 
Austin Parker said:
I am wondering if any one with a 3rd Class medical has ever had the FAA investigate there medical and if so why ? I am not really looking for everyone’s ethical opinion just facts was there medical ever looked at and why. If so what process was used. I am very aware of consequences and also very aware that many people forget to list stuff. I appreciate your honesty and understanding
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I think the word you are looking for is "their"
 
bbchien said:
Austin, you can’t “get away with it” if that’s what your thinking.....
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No kidding. I mean, sure, there are people out there flying without valid medicals at all, but they usually get discovered sooner or later.
 
OK, so here's what my ordeal was. Back in early 2017 I had a blood clot in my left leg. I had surgery to remove veins. They didn't get all of the veins. So for the next year and some change I had off and on prescriptions for Norco just so I could sleep at night because I was having sporadic edema issues. I'd get a scrip for 30 pills and that would last me a couple months. I'd take 3-4 a day for 3-4 days and then not taking any for another 4-6 weeks. July of 2018 I had one final procedure which got all of the stragglers (veins) and since then I had 0 issue. No more pain management. Everything be hunkydory. My medical was in May of 2019. Being proactive, in December of 18, Dr B had me request ALL of my records from Jan 2017 ==> Dec 2018. He reviews all of the paperwork and says yeah, I'm good to go but get a letter from the vascular stating that all is well. So in March of 2019 I see the vascular and he writes me up a letter on March 4th that says:

Previous procedures performed on the patient's lower left extremity have provided a surgical cure for his venous insufficiency. He has no residual effects whatsoever. No recurrent or residual varicose veins. There are no activities which cause any recurrent symptoms either. I have no reservations whatsoever for recommending for performing all activities without limitation including operating an aircraft.
​
Dr B says this is perfect and we stow it away because he's sure that the FAA will probably ask for something. Medical goes fine. August rolls around and I get a letter from the FAA saying they are unable to establish my eligibility and ask for (and this is in bold):

A copy of the most recent office progress notes (SOAP notes) are acceptable as long as they are in electronic format.
​
So we send that in. I get a phone call from the woman at the FAA saying that the letter saying I'm cured isn't good enough. Apparently she doesn't know what the word cure means. So Dr B send in 67 pages worth of crap for them to review. Then I get another letter in September (certified mail this time)

We received your records...we need a current status regarding your treatments...including history, symptoms, diagnosis, treatment plans, OTC and prescription and prognosis.​

I'm like WTF? I already sent the letter saying I'm cured, and already sent the history. Dr B and I have some back and forth, he says to just get my doctor to write a letter. I'm pretty ****ed off, and feel like burning down the Chicago office, so as a form of catharsis I decide I'm going to write a letter as if I am my GP. In some of the 67 pages of notes there was reference to my Dr saying I have GERD. I don't. Naproxen bothers my stomach. I mentioned that. He noted it could be GERD. I don't use Naproxen, I have no issues. Also submitted a history of the prescriptions I had, and in there was an prophylaxis for malaria because I was going to East Africa. So the FAA wants that above request for the leg, the GERD, and the anti-malarial. So I write a letter and go to my Dr. He's as incredulous as I was in what the FAA was requesting. "They want what?!?!" So he says, I can write you a letter to address this, and I say "well, I can save you some time, and I have electronic copies, so if you want to change the wording to make it sound more professional, I have it on this USB stick." As he read the letter he starts smiling, gets to the end and says "Perfect! I'll sign it. I'm just a hillbilly anyway!"

Within a week they sent a letter saying I was cleared, but if I get heartburn I have to ground myself. Yeah, literally. Heartburn. Idiots.
 

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  • FAAMedicalLetter1003.pdf
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Sweet Lord, Ed. What a trainwreck. I appreciate you taking the time to tell your story, and hope you understand that "liking" it just didn't feel right! Glad you got it solved, and that as usual, Doc Bruce was there for you (us).
 
Fearless Tower said:
No kidding. I mean, sure, there are people out there flying without valid medicals at all, but they usually get discovered sooner or later.
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I doubt it. My father knew someone who never bothered to get their ticket, and flew VFR all their adult life.
 
As we have discussed here before at length, for 3rd class, it certainly appears there is no evidence it improves the safety of flight.
 
After reading that, maybe we need to change the phrase from "bear" to "Be careful poking the Ed"
 
mryan75 said:
As we have alleged here before without evidence, for 3rd class, it certainly appears there is no evidence it improves the safety of flight.
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There, fixed that for ya.
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That raises the question of whether the burden of proof should be on those who wish to allow freedoms, or on those who wish to restrict freedoms.
 
Palmpilot said:
That raises the question of whether the burden of proof should be on those who wish to allow freedoms, or on those who wish to restrict freedoms.
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And also the question of what is a freedom and what is a right.
 
Within a week they sent a letter saying I was cleared, but if I get heartburn I have to ground myself. Yeah, literally. Heartburn. Idiots.
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Joklahoma city can't admit they were wrong.

I had a false positive on the test. Every document I filed acknowledged the false positive but that subsequent testing and examination shows I never had the condition. I still spent a few years on an SI until a new AME wrote literally "THIS IS A ******** DIAGNOSIS" on the renewal paperwork. I got a grudging letter saying "OK, we agree you don't have X. However, if you ever do get X, stop flying and notify us.
 
Palmpilot said:
That raises the question of whether the burden of proof should be on those who wish to allow freedoms, or on those who wish to restrict freedoms.
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We have been through this before. The burden of proof is on he who asserts existence. In this case that is those who asserts there is a positive effect on flight safety. No good evidence for this has been adduced. Though we did see previously highly selective citation of snippets of studies taken out of context.

If people know of some good studies to demonstrate this, please post the citations.
 
Palmpilot said:
Are you saying that the only freedoms worth protecting are those which are officially recognized as rights?
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We have also debated before what the appropriate standard of evidence is when the government proposes to issue a regulation or law, and thus the ultimate threat of the use of violence if one does not comply, to enforce what they think is a good idea.

A separate moral question from the evidence based scientific question. I would submit those proposing such rules and laws should have very good evidence their rule or law will have the intended effect overall, otherwise, they should leave people the heck alone.
 
mryan75 said:
There, fixed that for ya.
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This is trying to reverse the proper burden of proof. Just because there is no evidence to disprove a statement does not imply it is true. At best it means that the statement cannot be assigned a truth value.

In the present instance, IIRC, there actually is weak, not conclusive evidence, that 3rd class medicals do not improve the safety of flight.

Lacking good evidence of the effectiveness and this weak evidence of equal accident rates, a balanced conclusion is that there is likely no effect.

That is how one reaches objective knowledge and conclusions, by considering all the evidence appropriately. One does not do so by trying to prove a pre-conceived notion and selectively citing facts, studies, and the literature.
 
@mryan75 I will add though that I applaud the effort to try and find data and studies pertaining to the question. I found some of them quite interesting.

One I am actually still undecided on how to interpret. I guess I should write these all up on a page for reference.
 
PeterNSteinmetz said:
We have been through this before. The burden of proof is on he who asserts existence. In this case that is those who asserts there is a positive effect on flight safety. No good evidence for this has been adduced. Though we did see previously highly selective citation of snippets of studies taken out of context.

If people know of some good studies to demonstrate this, please post the citations.
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Sorry but this is backwards. There is 100 years of evidentiary medical testing and regulatory history to be studied. It's actually quite interesting. And the FAA is clearly making changes based on either established or preliminary medical evidence, such as the introduction of sport pilot and BasicMed, to lighten the medical requirements and other regulatory burdens on pilots. These are both petri dishes for study of the issues we're discussing. Or take the SSRI protocols and now changes to controlled diabetes in pilots. All indicate an agency changing its policies based on facts and evidence, not the opposite.

You guys make it seem like the FAA all of the sudden established thousands of pages of aviation regulation from one day to the next based on nothing whatsoever, other than a desire to control people and ruin lives. It's frankly absurd. We all know that FAA regulations are written in blood. The same applies here. That some people are going to get unfairly and unjustly swept up in the regs is both true and unfortunate, but no law or regulation is perfect, and the fair question is, does it do more harm than good, and is the burden it places on people reasonable or not.

There are millions of words written on the subject. Entire federal departments have existed to study these matters for 7, 8 decades and more. To sit here and say it's all just made up to annoy us is not even an argument worth responding to (a lesson I still have yet to learn, apparently).

It's a worthwhile and valuable discussion, but not if we're going to view anecdote as evidence, ignore evidence we don't like, and cite evidence that doesn't exist.
 
mryan75 said:
There are millions of words written on the subject. Entire federal departments have existed to study these matters for 7, 8 decades and more. To sit here and say it's all just made up to annoy us is not even an argument worth responding to (a lesson I still have yet to learn, apparently).
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No one is saying it is all made up to be annoying, so a bit of a straw man fallacy there.

My point is - where’s the data?

If there are millions of words written on the subject at hand - namely, whether the requirement for a 3rd class medical improves the safety of flight - that should be easy, right?

But the truth of the matter is, despite fairly extensive discussion here and a reasonable amount of searching by a number of us, none has been cited here.

We have found I think perhaps 4 or 5 studies, and the weak evidence they provide is that there is no improvement in the safety of flight due to the requirement for a 3rd class medical.

Please feel free to cite more, if they are around.
 
mryan75 said:
There is 100 years of evidentiary medical testing and regulatory history to be studied. It's actually quite interesting.
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Have you found a good description of how the requirement for the 3rd class medical was introduced? I have been looking for that.

You guys make it seem like the FAA all of the sudden established thousands of pages of aviation regulation from one day to the next based on nothing whatsoever, other than a desire to control people and ruin lives. It's frankly absurd.
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Not at all what I intend to say. I think the FAA acts like a very typical government regulatory agency.

They likely have good intentions but in general regulatory agencies don’t achieve their good intentions very well due to a variety of perverse incentives. See Mises’ book “Bureaucracy” for a very extensive discussion generally.

The FAA has gradually expanded the regulations over the course of perhaps 8 decades, often in reaction to some accident or crisis, and they frankly seemed like a good idea at the time.

But the unintended side effects of these regulations often effectively negate those good intentions. That is why actual studies of the effects are needed. And why I keep asking for the data which would support the efficacy of the 3rd class medical.

It is good that we have BasicMed now as it will serve as a good test bed as well as helping. But also bear in mind that this was not really the FAA’s initiative. It was imposed on them by Congress.

We all know that FAA regulations are written in blood. The same applies here.
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Perhaps, but that is actually not a particularly good way to manage public policy. It results in knee jerk reactions, which are often over-reactions and not well conceived.

That some people are going to get unfairly and unjustly swept up in the regs is both true and unfortunate, but no law or regulation is perfect, and the fair question is, does it do more harm than good, and is the burden it places on people reasonable or not.
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Exactly! Well designed studies of appropriate cost-benefit trade offs is a much better way to look at public policy. Where is such a study that addresses the 3rd class medical requirement?

It's a worthwhile and valuable discussion, but not if we're going to view anecdote as evidence, ignore evidence we don't like, and cite evidence that doesn't exist.
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I appreciate that this round of discussion has not devolved into name calling, accusations, and selective quotation of the literature out of context. Very nice. I hope we can continue to discuss the data and studies in that manner.

What is the actual evidence that the requirement for a 3rd class medical improves the safety of flight?
 
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mryan75 said:
Sorry but this is backwards.
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Thinking about this more, I suspect this may explain some of the apparent lack of communication and incredulity expressed in the past on this subject.

I can understand how it may appear initially shocking to people that the FAA would have a regulation on the books which causes a lot of inconvenience, expense and sometimes pain for people, without serious study of the cost-benefit tradeoffs. It strikes me also as fairly outrageous.

But I think the way to understanding is to objectively focus on the data and their analysis.
 
PeterNSteinmetz said:
No one is saying it is all made up to be annoying, so a bit of a straw man fallacy there.

My point is - where’s the data?
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Here's what I find interesting, and this is both a general and specific observation. If I were truly interested in a topic, I would not make a biased effort to confirm my own opinion or predisposition, but rather - like scientific research itself, for example - try to find as much information I can about the topic, and see where that information leads me. What I see quite often, and what I truly can't understand, is people who are clearly interested in a subject but make seemingly very little effort to gather that information to begin with. In other words, rather than have an opinion and say, "if there's any information to the contrary, where is it?", I would be pretty exhaustive in my research, and by that know whether there is any contrary information to be found or not. I find it perplexing when people are interested, and the information is pretty easily accessed, and yet they still don't find it. It makes me wonder if they really are trying to find the truth about something, or at the very least actively avoiding any information which might contradict what they would like to believe.

Alas, here is that information:

https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/

And a good place to start, in my opinion, is here, with Civil Aeromedical Research: Responsibilities, Aims, and Accomplishments, from October 1962:

https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/1960s/media/AM62-20.pdf
 
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