..and that's the unintended consequences with many of these rules that are meant to help and protect us
I bet there are many people who don't go the doctor strictly for fear of what will be found and potentially be disqualifying
There's the rub.
I didn't renew my medical certificate for years following my 1985 HIV diagnosis because I knew the FAA had concerns about the virus crossing the blood brain barrier causing what was called "AIDS Dementia." However, as late as 1999, the MCSPT for AMEs stated categorically
"Applicants who are Human Immunodeficiency Virus (HIV) positive who have not had symptoms and are not on medication, even for prophylactic use, are eligible for certification. Once they are on medication, or show symptoms of Acquired Immune Deficiency Syndrome (AIDS) related diseases, they will NOT be considered for certification."
So, there was a choice: not take my lifesaving medications and die, or take my medications and live, but according to the MCSPT not be able to obtain a medical certificate.
In 1997, after I had been on the HAART cocktail of medications and off disability for a year, and my viral load was undetectable, my CD4+ cell count was normal, liver, kidneys, blood pressure, cholesterol, and other blood work parameters were normal, I read that the FAA was issuing special issuance medical certificates for HIV infected pilots on antiretroviral medications. I called the Western-Pacific regional FAA office in Los Angeles and was told that in order to qualify, I'd have to send all of my medical records for the past ten years to CAMI, and in 9 months to a year they'd get back to me and let me know if I qualified. I specifically asked what the medical criteria were to qualify, and was told that was confidential information not available to the public.
With the conflicting information of what was still being published in the MCSPT on one hand and the tepid acknowledgement that it might be possible to get a special issuance on the other hand, I feared that I might be arbitrarily disqualified. So yes, I lied on three successive 3rd class medical applications. I acknowledged that in my interview with the DOT-IG special agents who presented me with the emergency order of revocation in March, 2005. Coincidentally, I had recently come across a PowerPoint presentation by Quay Snyder of Virtual Flight Surgeons that contained the medical criteria for the FAA HIV protocol along with a letter from Warren Silberman, D.O., then the Manager of the Aerospace Medical Certification Division, encouraging HIV infected pilots who had previously concealed their infection
"to reveal previously unreported medical conditions, including HIV seropositivity, to the AMCD on future Airman Medical Certificate applications. Pilots are encouraged to report these conditions and their treatment at the earliest possible date and on all future applications.
Concerns about adverse administrative and medical certification actions for previous concealment of the medical conditions are unjustified in the overwhelming majority of cases. My policy is not to report previous erroneous completions or falsifications of medical applications to the FAA Securities Division for enforcement actions if several conditions are met. These conditions include:
1) Pilots initiate reporting of the condition themselves, through their Aviation Medical Examiner (AME) or other medical certification specialty services such as their union aeromedical advisors and independent services.
2) Complete past medical information is revealed and FAA AMCD protocols for evaluation of specific medical conditions are documented to evaluate current medical status.
3) There is no history of an aviation accident or incident, positive test for illegal substances or outside report of compromised aviation safety as a result of the previously unreported medical condition.
Medical certification determinations are made on the basis of the pilots’ current medical status based on complete evaluations and documentation. Periodic evaluation and reporting of medical conditions is required for continued certification. Deterioration of medical conditions or adverse effects of treatment may result in loss of medical certification until the medical status improves.
Information regarding a pilot’s falsification of a medical application that is reported as a result of discovery following an aircraft mishap, or by anonymous reports through the FAA "Hot Line" for possible pilot violations of the Federal Aviation Regulations, does not have the same protection from adverse actions against the pilot’s medical and/or pilot certificates.
The AMCD has worked closely with the Aviation Medicine Advisory Service and Virtual Flight Surgeons to expedite processing of HIV seropositive pilots’ petitions for Special Issuance Authorizations for medical certification. The importance of providing complete information for review can not be over overemphasized in the AMCD’s ability to rapidly process medical applications. I encourage pilots to engage the assistance of experienced aviation medicine specialists when reporting complex medical conditions and administratively sensitive cases."
I met the S.I. criteria for special issuance (with the exception of taking the CogScreen-AE) in 1997, and have met them ever since. As part of the recertification, I took the CogScreen and scored in the 50th to 95th percentile on the Taylor Aviation tests normed against ATPs employed by U.S. carriers 3 to 8 years younger than I.
I was in the process of preparing my medical records to self-report in order to afford myself of the proffered protection from adverse actions when I received the call from the DOT-IG investigators to meet with them about "irregularities in my FAA medical certification." I met with them the following morning and they presented me with the revocation order. I immediately surrendered my airman and medical certificates.
I showed them a copy of Dr. Silberman's letter, but they were unmoved. Too late. Of course it's OK for them to violate the law.
The rest is history.
