CPAP denial under BasicMed?

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Crewchief

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Crewchief
Let me preface this saying my GP hasn't faced a BasicMed request prior to my recent yearly physical. She denied approving my medical based on Commercial Driver Licensing requirements, she says, do not permit use of a CPAP and "if DOT denies a CDL, I certainly don't believe FAA would allow a pilot to use CPAP." I will be visiting an AME after this in hopes of finally acquiring my PPL.
My question is: have any other aspiring aviators run into this situation? Is it a matter of an uninformed or inexperienced doctor not familiar with regs/laws, etc. or is she correct to deny approval for CPAP use?
 
I think your GP is working too hard on this.

CPAP use is approved as treatment of OSA by DOT for a CDL, it's also approved by FAA (part of DOT) for pilots.

As long as you have an SI for your OSA, then FAA says you are good.

edit:

I got this from the Basic Medical instructions to the physician:

>>>
2. The state-licensed physician must perform a comprehensive medical examination
addressing all items in SECTION 3 of this checklist. The physician completes the “Physician’s Signature and Declaration” if the physician determines that he/she is not aware of any medical condition that, as presently treated, could interfere with the individual’s ability to safely operate an aircraft.
<<<

I added the highlight.

edit, edit:

And the physician is signing -

>>
... I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft.
<<<
 
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I received a Special Issuance Class 3 medical when I started flight training. I have since switched to BasicMed. Have been using a CPAP for quite a few years.
 
Also, if you still want to pursue BasicMed, try a local "Doc in the Box" clinic that does physicals for CDL, Sports, Camps, Schools as its main business. The Basic Med Exam is not that different in its execution. The main difference the examining state licensed physician signing the document stating that based on the history and exam, he/she finds says you are able to safely operate a GA aircraft.
 
Matthew said:
As long as you have an SI for your OSA, then FAA says you are good.
Click to expand...

You don't even need the SI because, with the exception of the "Big 3", the FAA renders no opinion one way or another on your medical conditions when you are qualifying under BasicMed.
 
bflynn said:
You don't even need the SI because, with the exception of the "Big 3", the FAA renders no opinion one way or another on your medical conditions when you are qualifying under BasicMed.
Click to expand...
Don't you need a valid medical first? (unless you already had one in the last 10 yrs) So you'd still need an SI for that, wouldn't you? I guess if you had a valid medical, then got the OSA diagnosis and went ahead and then got the Basic Medical before you went through the SI... Yeah, that probably would work.
 
Crewchief said:
Let me preface this saying my GP hasn't faced a BasicMed request prior to my recent yearly physical. She denied approving my medical based on Commercial Driver Licensing requirements, she says, do not permit use of a CPAP and "if DOT denies a CDL, I certainly don't believe FAA would allow a pilot to use CPAP." I will be visiting an AME after this in hopes of finally acquiring my PPL.
My question is: have any other aspiring aviators run into this situation? Is it a matter of an uninformed or inexperienced doctor not familiar with regs/laws, etc. or is she correct to deny approval for CPAP use?
Click to expand...


Have you already held a class 3 medical? Basic Med is only an option if you've held a class 3 medical after July 2006. If that's not the case, you'll have to see an AME and do a class 3 physical first, and that will require an SI for the CPAP.
 
"Finally acquiring my PPL?" Have you previously held an FAA medical?

Sleep disorders and sleep disorder treatments are not disqualifying in the BasicMed rules.
 
Matthew said:
Don't you need a valid medical first? (unless you already had one in the last 10 yrs) So you'd still need an SI for that, wouldn't you? I guess if you had a valid medical, then got the OSA diagnosis and went ahead and then got the Basic Medical before you went through the SI... Yeah, that probably would work.
Click to expand...

Ummm yes, which the OP said he had.

If OSA/CPAP use develops after the last medical date, a SI is not required for basicmed
 
Depends on what state you're in. Some are hell on sleep apnea. The DOT is harsher on high blood pressure than the FAA, go figure.
 
benyflyguy said:
Your right. OP doesn’t need a new doc just have an educated conversation. They are dead wrong. You can have osa treated with cpap and in fact good docs will check that you are compliant with its use before issuing cdl.
Click to expand...

It may just be easier to get a new doc to sign the paper than try to educate the first one... ;)
 
I use cpap. The FAA got worse every year with 3rd class, so I went basic med. My Doc knows about the cpap. She did a DOT exam and was happy to sign off.
 
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AggieMike88 said:
Also, if you still want to pursue BasicMed, try a local "Doc in the Box" clinic that does physicals for CDL, Sports, Camps, Schools as its main business. The Basic Med Exam is not that different in its execution. The main difference the examining state licensed physician signing the document stating that based on the history and exam, he/she finds says you are able to safely operate a GA aircraft.
Click to expand...

I did my Basic Med at the local urgent care, across the parking lot from walmart.
 
I have a buddy who is a trucker and gets his medical just fine with a CPAP. That doc must not do many DOT physicals.
 
A lot of technicalities ... Ideally you have a 3rd class with a OSA SI then go to B Med. But finding a doctor to sign the dang thing would work too.
 
The CDL Trucker physical places are great for this. The CDL exam covers every single point on the basic med form except the non-digital anus inspection.

I'm terrified of what could be "nonqualifying for purposes of flying airplanes" and discovered with a peek at one's anus. I feel like it was added to BasicMed just to mess with pilots.

The CDL exam comes with a "turn and cough" exam and a free doc cupping your balls. I was not prepared for that, and would have chosen better underpants had I known. Heh.

I now have my trucker medical. No idea when/where that will come into play, but hey, something extra for the $90. :)
 
schmookeeg said:
The CDL Trucker physical places are great for this. The CDL exam covers every single point on the basic med form except the non-digital anus inspection.

I'm terrified of what could be "nonqualifying for purposes of flying airplanes" and discovered with a peek at one's anus. I feel like it was added to BasicMed just to mess with pilots.

The CDL exam comes with a "turn and cough" exam and a free doc cupping your balls. I was not prepared for that, and would have chosen better underpants had I known. Heh.

I now have my trucker medical. No idea when/where that will come into play, but hey, something extra for the $90. :)
Click to expand...
I got to turn my head and cough and it wasn't even a doc that makes his living on DOT physicals.
 
While I enjoyed the prostate exam and her ladylike demeanor, a new physician is in my future. I held a 3rd class in 98 but didnt maintain my instruction. The AME from days of yore is either dead or most certainly retired and the AME at the airport has a disconnected phone making the next known in Hartford, CT but Ill not be detered.

Chocks n pins, 629.
 
Crewchief said:
While I enjoyed the prostate exam and her ladylike demeanor, a new physician is in my future. I held a 3rd class in 98 but didnt maintain my instruction. The AME from days of yore is either dead or most certainly retired and the AME at the airport has a disconnected phone making the next known in Hartford, CT but Ill not be detered.

Chocks n pins, 629.
Click to expand...
If the last time you held an FAA medical certificate was 1998, then you're going to have to renew that before you will be eligible for BasicMed, because among other things, the law says that you have to have held a valid medical certificate at some point since July of 2006.
 
schmookeeg said:
I'm terrified of what could be "nonqualifying for purposes of flying airplanes" and discovered with a peek at one's anus. I feel like it was added to BasicMed just to mess with pilots.
Click to expand...
It wasn't "added" to BasicMed; it's in there because it's included in an exam for a third-class medical certificate, and Congress just copied that. The difference is that the AME instructions for an FAA medical exam say that the anal exam can be omitted based on medical history or something like that. I think it was just an oversight that Congress didn't include the AME instructions in the legislation that created BasicMed.
 
Palmpilot said:
It wasn't "added" to BasicMed; it's in there because it's included in an exam for a third-class medical certificate, and Congress just copied that. The difference is that the AME instructions for an FAA medical exam say that the anal exam can be omitted based on medical history or something like that. I think it was just an oversight that Congress didn't include the AME instructions in the legislation that created BasicMed.
Click to expand...

Interesting. I've only had a few 3rd class exams, and a few 2nd class, but my anus never entered into any of the conversations -- neither it's history, nor its condition. I assume my assorted AMEs just omitted it for lack of interest. :)

If we can amend it back to optional, then the CDL will perfectly cover Basic Med. Seems efficient.
 
schmookeeg said:
Interesting. I've only had a few 3rd class exams, and a few 2nd class, but my anus never entered into any of the conversations -- neither it's history, nor its condition. I assume my assorted AMEs just omitted it for lack of interest. :)

If we can amend it back to optional, then the CDL will perfectly cover Basic Med. Seems efficient.
Click to expand...


And therefore in violation of the common guidelines for all federal agencies.
 
schmookeeg said:
Interesting. I've only had a few 3rd class exams, and a few 2nd class, but my anus never entered into any of the conversations -- neither it's history, nor its condition. I assume my assorted AMEs just omitted it for lack of interest. :)

If we can amend it back to optional, then the CDL will perfectly cover Basic Med. Seems efficient.
Click to expand...
Actually, I can't imagine anyone's Basic Med being invalidated if it came out that the physician didn't examine their anus. Remember that the signoff is done at the physician's discretion, and the FAA doesn't even see the completed checklist. All discretion and responsibility is on the physician's head, and there's no FAA involvement at all (which is why some physicians are squeamish about doing Basic Med at all, and that may be a valid concern).

Full disclosure: my exam was done by an AME, who just didn't check that particular box, and signed me off anyway. I'm not worried.
 
schmookeeg said:
Interesting. I've only had a few 3rd class exams, and a few 2nd class, but my anus never entered into any of the conversations -- neither it's history, nor its condition. I assume my assorted AMEs just omitted it for lack of interest. :)
Click to expand...
None of the AMEs that I've used have looked or mentioned it either. I think it's the lack of history that's being used a reason for not looking. Personally, I don't care whether they look or not. If there's anything amiss that would be evident on visual inspection, I presume that the doctors who do colonoscopies would say something.
 
bflynn said:
Ummm yes, which the OP said he had.

If OSA/CPAP use develops after the last medical date, a SI is not required for basicmed
Click to expand...
Thank you. I didn't know that. I think my last medical was July 2007, and I was diagnosed with Sleep Apnea last year. I haven't been flying since 2007, so I've never renewed my medical, but plan to when I restart flying lessons.
 
Crashnburn said:
Thank you. I didn't know that. I think my last medical was July 2007, and I was diagnosed with Sleep Apnea last year. I haven't been flying since 2007, so I've never renewed my medical, but plan to when I restart flying lessons.
Click to expand...

If you had a valid medical in July 2007, no need to renew it. Just do Basic Med. No risk of denial and much less hassle.
 
Crewchief said:
Let me preface this saying my GP hasn't faced a BasicMed request prior to my recent yearly physical. She denied approving my medical based on Commercial Driver Licensing requirements, she says, do not permit use of a CPAP and "if DOT denies a CDL, I certainly don't believe FAA would allow a pilot to use CPAP." I will be visiting an AME after this in hopes of finally acquiring my PPL.
My question is: have any other aspiring aviators run into this situation? Is it a matter of an uninformed or inexperienced doctor not familiar with regs/laws, etc. or is she correct to deny approval for CPAP use?
Click to expand...
FAA does not control this sort of exam, so what you get is variable.
 
Crashnburn said:
Thank you. I didn't know that. I think my last medical was July 2007, and I was diagnosed with Sleep Apnea last year. I haven't been flying since 2007, so I've never renewed my medical, but plan to when I restart flying lessons.
Click to expand...

Validate your medical date. The cutoff was July 2006, but if you're really 2007, then you're good.

Basicmed is not an FAA medical and not subject to the rules for FAA medicals. Basicmed is an alternative means of certification. There are three categories of conditions (neurological, cardiac and psychological) which force you back into an FAA medical, but otherwise everything else is between you and your doctor.
 
bflynn said:
Validate your medical date. The cutoff was July 2006, but if you're really 2007, then you're good.

Basicmed is not an FAA medical and not subject to the rules for FAA medicals. Basicmed is an alternative means of certification. There are three categories of conditions (neurological, cardiac and psychological) which force you back into an FAA medical, but otherwise everything else is between you and your doctor.
Click to expand...
Actually, if you were issued on or after July 2004 you're good for a basic. It only has to have been valid on July 15, 2016.
 
Good catch. I always miss that valid part. 2004 for a 2 year medical, 2001 for a five year. They had 5 year medicals then, right?
 
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