Complex Medical Deferral w/Intl Move Triage

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johnnyholding

Filing Flight Plan
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Aug 25, 2023
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Johnny Holding
Hey Pilots and Aviation/Medical Professionals!

I've read many threads in this forum where members have taken time to help fellow pilots regain their wings after deferrals or less than ideal medical reports. My situation has proven to be unique enough that I'm starting a new thread. There are many details that would result in a wall of text so for the sake of brevity I will start by submitting a high-level timeline of the events that are most relevant to my situation.

Fall 2002
Started attending a large flight school undergraduate program in Daytona Beach to fulfill my life-long dream of becoming a Airforce fighter pilot.​
Obtained 1st class medical and student pilot certificate.​
Fall 2004
Obtained Private Pilot License.​
Started Instrument Rating.​
Spring 2005
Got to Instrument Check-Ride but weathered out for remainder of semester.​
Last logged flight to-date occurred end of April 2005.​
Fall 2005
Student lenders would no longer issue loans covering full-time course and flight training.​
Came to terms that I loved aviation but wanted a different career path.​
Was extremely immature and did not accept this change in course like an adult. I was heartbroken.​
Was involved in a DUI minor accident with a minor injury claim, blew .21, and was put on ROR.​
Failed ROR drug test for Cannabis.​
Spring 2006
Failed Probation drug test for Cannabis.​
Convicted of DUI from Fall 2005. (single event)​
Fall 2007
Graduated with Bachelors of Science and a Minor.​
Winter 2008
Fulfilling obligation from graduating with mounting debt, attended Air Traffic Management (ATM) hiring process for controller position.​
ATM AME deferred 1st class medical (more on this) due to the infractions from 2005 to 2006.​
Winter 2008 to August 2023
Didn't continue pursuing ATM, didn't have the follow-up money, owed loads in debt, and truthfully didn't feel the career was my path in life.​
Started career in software engineering, achieved highest level positions in the field, and eventually founded several companies.​
Paid most of the debt off, take on Fortune 100 and 500 clients for my business.​
Planned move to Panama City, Panama with partner in life.​
Goal leaving flight school was to return to general aviation but not for hire. Love was still there but in a different form.​
Before move to Panama, restarted process by setting up a flight review and medical so that I would be current in Panama and could begin flying in general aviation there.​
Called FAA to figure out details for filing Form 8500-9, was told that in 2008 I had passed the medical but all ATM applicants get deferred until hired.​
Filed on 8500-9 my history above and indicated a 1st class medical pass in 2008 (now believe this was wrong; it had been 15 years and recollecting the entire conversation/process was difficult).​
August 2023
AME appointment, 2nd class medical, led to a deferment due to all the above history (rightfully and mostly expected; this connected the dots for the ATM "deferral").​
Researched the entire HIMS process, many stories here, and timelines.​
Here we are.​
​
Additional Considerations
I'm moving to Panama before 2024. My plan was to fly general aviation there but applied for second class to attend Commercial training in an effort to validate safer flying skills. This experience resurfaced many memories and experiences from nearly two decades ago that I had mostly forgotten.​
I didn't stop having drinks with friends after 2008 for a long time but more and more started loathing alcohol.​
4 years ago, decided to do a healthy year without any alcohol or other unhealthy habits and haven't had anything since. Didn't realize how much I really disliked alcohol, I'm too old to waste my time in life and have dedicated myself to a life of sobriety since. Partner doesn't drink ever either.​
Zero infractions have occurred since 2006 (~17 years).​
​
I'm now trying to figure out what my options are for getting a Special Issuance Medical or better so I can start to fly general aviation again. I'm on a limited timeline for physical presence in the United States due to a move to Panama before end of the year. I've emailed Dr. Bruce Chien and am awaiting a response. Taking the drug tests, evals and whatever else is only a burden of cost at this point, I will not fail, but might be impossible abroad if there is an issue with testing from another country.

Thank you if you've made it this far!

Anyone have an idea of how this pilot can get his wings back?
 
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I think that working with a knowledgeable senior AME is your best path forward. Hopefully Dr. Bruce can help out.

However, I'm pretty sure that the FAA will want monitoring, at a minimum, and will defer you into HIMS. If they let you do things from another country, great! If not, like you said: traveling back to the US to do testing is only a burden of cost. The BAC of 0.21 is the hangup: to the FAA CAMI, that's indicative of tolerance and long-term abuse which, for them, doesn't just "go away." They're definitely of the motto "[don't] trust, but verify."

I think you're in for a long haul and quite a wait based upon the wait times I see for drug and alcohol cases. Some not-insignificant costs associated with monitoring and potentially travel.
As someone who had 19 year-old (at the time) drug and alcohol issues who has since gotten his PPL and jumped to Basic Med, I think it was worth the headache and expense.
 
@allPrimes thank you for taking the time to read through all that and respond. Congratulations on working through all the hurdles and getting back up in the air!

Most of BasicMed would be more than satisfactory for the flying I'd like to do... FL180 maybe lower than desired passing through some South American mountain ranges. Still a world better than deferred or disqualified!

The BAC of 0.21 is the hangup: to the FAA CAMI, that's indicative of tolerance and long-term abuse which, for them, doesn't just "go away." They're definitely of the motto "[don't] trust, but verify."
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I get it and respect it. This isn't a field or activity where significant errors are acceptable.

Based on my HIMS reading I don't think, living abroad, perhaps without access to FAA AME HIMS practitioners, has a realistic opportunity at proving eligibility. Substance testing can be frequent and I believe also random which is near impossible to accomplish from Panama if there aren't accepted doctors or facilities to perform these tasks within the country. I did find that "AWH currently has offices for our FAA Senior Representatives in Panama City, Panama" which maybe means there could be some support in the region. I haven't given up full hope there can be something arranged from Panama but with the "Step Down" program I see established in 2020, it appears impossible to establish full reinstatement without frequent trips around the USA.

I am going to check with the Autoridad Aeronáutica Civil (AAC) about medical considerations and perhaps a deferment locally. Both the FAA and AAC offices are super close to my new home. There might be a HIMS-like program within Panama that will allow me to at least qualify for a Panamanian medical and pilot's license. Almost all of the flying I was planning would be outside the United States with the exception of training. I have no idea if the FAA attempts to restrict flight medical access globally even if abiding by an international HIMS-like program.
 
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johnnyholding said:
Most of BasicMed would be more than satisfactory for the flying I'd like to do... FL180 maybe lower than desired passing through some South American mountain ranges. Still a world better than deferred or disqualified!
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I haven't heard of Panama accepting BasicMed.
 
Palmpilot said:
I haven't heard of Panama accepting BasicMed.
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Good point. Not sure that'd even apply outside the US.

I'm going to attempt a Panama medical exam while disclosing the US history and see if there is either a deferral option there or they'll just issue a medical and let me flight train in Panama.

Simultaneously, I'll do my best to find a suitable option to prove sobriety and the mistakes of the past have stayed in the past to the FAA. This is where I was hoping to reach Dr Bruce Chien.

Ideally, I can get issued a medical in the states and also obtain a Panamanian Private Pilots License.
 
johnnyholding said:
I'm going to attempt a Panama medical exam while disclosing the US history and see if there is either a deferral option there or they'll just issue a medical and let me flight train in Panama.
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Does Panama already know of your DUI? I know from relatives that Canada takes historical DUIs extremely serious to the point of making it difficult to cross the border. Maybe check first without informing them and find out if this would be opening an even bigger can of worms?
 
Mongoose Aviator said:
Does Panama already know of your DUI? I know from relatives that Canada takes historical DUIs extremely serious to the point of making it difficult to cross the border. Maybe check first without informing them and find out if this would be opening an even bigger can of worms?
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I've purchased a place there and been there 5 times now. I do have an attorney there who has indicated it will not be a problem. The residency application requires a full FBI background check.

I don't know the impact of that on an aviation medical though.
 
Mongoose Aviator said:
Does Panama already know of your DUI? I know from relatives that Canada takes historical DUIs extremely serious to the point of making it difficult to cross the border. Maybe check first without informing them and find out if this would be opening an even bigger can of worms?
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A personal anecdote: I have a single DUI from 1999. In 2008, I travelled to Canada for a professional conference, the first time I had travelled to Canada since my DUI. I was concerned I was going to be turned away at the border but the border officer didn't even bat an eye. It's possible that my DUI was early enough to have not shown up on any computerized systems, but who knows?

Another--not personal--anecdote: The Alcoholics Anonymous International Conference was held in Toronto a few years ago. I've heard stories about a lot of folks being turned away at the border. Another international AA conference is being held in Vancouver in 2025. There's already a page about how to gain entry to Canada to the international convention with a past DUI.
 
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The main problem you are going to have is proof of Sobriety. FAA wil not accept lab tesst fro this from a non US located lab, as in many parts of the world, you can puchase a negatige ETG or PETH report. You might look into SOBERLINK. EVER HIMS evaluator & FAA, require substantiation of sobriety.
 
bbchien said:
The main problem you are going to have is proof of Sobriety. FAA wil not accept lab tesst fro this from a non US located lab, as in many parts of the world, you can puchase a negatige ETG or PETH report. You might look into SOBERLINK. EVER HIMS evaluator & FAA, require substantiation of sobriety.
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Hi Dr Chien!

Oh awesome, SoberLink looks like an option for me; hopefully, this can fully replace any urinalysis testing due to my geographical location. Panama might still require this for their avaition medical qualification.

I guess this would mean still entering a program with a US based HIMS medical professionally willing to work with a patient remotely? Psychiatrist as well?
 
The HIMS AME does not HAVE to meet you until application, but then meets are every six months. the HIMS Psychiatrist has to in person at least the odd numbered evaluations……
 
OK, thanks again Dr Chien.

How often are the in-person psychiatrist evaluations?

With a max of 30 days in the states per calendar year, I'm starting to be convinced the best option is use that money to get certified in Panama.

If requiring many trips to the states, working with the FAA is just not a viable option while living abroad.
 
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UPDATE - Sat 10am

Just got hand delivered a certified notice from the FAA requiring a 10 panel drug test in 48 hours as I was minutes away from getting into my truck and driving from Austin to Houston for a Monday morning appointment with the Panamanian consulate.

I have no idea how to find an accredited drug test agency or business in Houston. Notice said I may need to contact AME to setup the appointment but it's Saturday and that AME is in Daytona Beach, Florida.

Anyone know how I can find a drug testing center in Houston that will accept me as a walkin?
 
Are there any common drug testing centers like quest or labcorp accepted?

Anyone know the type of testing center required?

I've been searching for "DOT Part 40 10 panel drug testing."
 
UPDATE - Sat 7pm

Calling 247onsite was super helpful. Their services are usually reserved for an accident where immediate testing is required; however, an individual I spoke with gave me a few testing locations and phone numbers to call.

I have my test setup and will make the 48hr cutoff required.

Thanks @flyingron !
 
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