Hypothetically speaking ... SI type event while on Basic Med?

[Lindberg]

According to 14 CFR 68.9(a), an SI is required in order to serve as pilot in command under BasicMed if there has been "A transient loss of control of nervous system functions without satisfactory medical explanation of the cause." What is the standard for what is to be considered "satisfactory" in that context, and where is that defined?

It's defined by whether the licensed physician performing the exam finds the explanation satisfactory, i.e., adequate. Not whether SGOTI is satisfied by it. So the doc says, "Yep, TIA adequately explains that," or "No, TIA doesn't adequately explain your symptoms." And you proceed from there. But if he says the former, TIA is not a condition that requires an SI under Basic Med.

 

[bbchien]

He's got to get the SI.
Or you will get the attached letter. Certified so that you can't say, "you didn't know".

 

[Lindberg]

View attachment 90111

He's got to get the SI.
Or you will get the attached letter. Certified so that you can't say, "you didn't know".

Which of the requirements in that letter will the friend not have met?

 

[Palmpilot]

It's defined by whether the licensed physician performing the exam finds the explanation satisfactory, i.e., adequate. Not whether SGOTI is satisfied by it. So the doc says, "Yep, TIA adequately explains that," or "No, TIA doesn't adequately explain your symptoms." And you proceed from there. But if he says the former, TIA is not a condition that requires an SI under Basic Med.

View attachment 90109

What if the diagnosis adequately explains the symptoms, but the condition diagnosed is highly likely to recur? Do you think an SI would be required, or not?

 

[Volzalum]

I thought the OP’s hypothetical already had BasicMed? He met all of the requirements when he got it. In this hypothetical friends case, if he is on BasicMed, where does it say he has to go back to a 3rd Class?

 

[Palmpilot]

I thought the OP’s hypothetical already had BasicMed? He met all of the requirements when he got it. In this hypothetical friends case, if he is on BasicMed, where does it say he has to go back to a 3rd Class?

§68.9 Special Issuance process.

(a) General. An individual who has met the qualifications to operate an aircraft under §61.113(i) of this chapter and is seeking to serve as a pilot in command under that section must have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate for each of the following:
​

I'm not an attorney, but the above passage from the regulations says that a person who "has met" the qualifications for BasicMed (i.e., past tense) must have an SI if they have one of the conditions described and want to serve as pilot in command. So even though they have already qualified under BasicMed rules, if they now have a condition that requires an SI, they can't now act as PIC unless they get the SI. And I don't think there is any way to do that without applying for at least a third-class medical certificate.

 

[Half Fast]

View attachment 90111

He's got to get the SI.
Or you will get the attached letter. Certified so that you can't say, "you didn't know".

Bruce, a few questions regarding this part:

"A review or your airman records indicates that you do not meet one of more of the above requirements."​

1) If the statement in the letter is true, why doesn't the letter state which specific requirement is not met and why?

2) For a pilot on Basic Med, what records would the FAA have available for their review that would indicate this? It's not like any medical records get submitted under Basic Med; the pilot retains the form and physician's signature.

3) What prompts the FAA to send such a letter in the first place?

 

[Lindberg]

What if the diagnosis adequately explains the symptoms, but the condition diagnosed is highly likely to recur? Do you think an SI would be required, or not?

No. I already showed you what would happen in that situation.

 

[Lindberg]

I thought the OP’s hypothetical already had BasicMed? He met all of the requirements when he got it. In this hypothetical friends case, if he is on BasicMed, where does it say he has to go back to a 3rd Class?

It doesn't. The only way you get there is by paraphrasing the reg or jumping to conclusions. You can't get there by actually reading the regs.

 

[Volzalum]

I don’t think you get there since you are already under BasicMed, with some expiration date in the near future (less than 4 years). Under Basic Med you:
1) Ground yourself in your self certification
2) You go back to your physician that authorized your BasicMed and show him the BasicMed criteria and let him determine based on the new information if he would still certify you or not.

If he says it meets the criteria for not certifying then you are back in class 3 with SI space with 24 months of no reoccurrence.

If he says it is has satisfactory medical explanation, you now how information to self certify and that doctor should renew your BasicMed at the next time if nothing else has come up. In this case, the FAA is never involved.

 

[bflynn]

Don’t be playing word games here. “Satisfactory” does not mean explainable, it means acceptable. A TIA falls under the neurological section of the BasicMed exceptions. The BasicMed certification is no longer valid. It’s back to 3rd class and a SI.

More than that, a TIA is a warning that you’re headed for a full stroke. Time to hit the panic button with your doctor and do the things needed to get healthy.

I’m done here.

 

[Everskyward]

Don’t be playing word games here. “Satisfactory” does not mean explainable, it means acceptable.

I was thinking that too. The wording in the reg could have been better...

 

[Lindberg]

Don’t be playing word games here. “Satisfactory” does not mean explainable, it means acceptable.

No, it means "adequate."

 

[bflynn]

No, it means "adequate."

Ok, adequate to be considered healthy to fly.

If you claim that it merely means explained then you claim that section has no real meaning. By your logic, any neurologic syncope including seizures and full strokes would be acceptable as long as the doctor can put a name on it. That's clearly wrong.

I thought I had ignored this thread.

 

[Palmpilot]

No, it means "adequate."

Adequate for what purpose? Adequate for the purpose of identifying the medical condition, or adequate for the purpose of determining whether an SI is required?
The language in the regulation was actually written by Congress in Public Law (PL) 114-190. Courts consider the intent of Congress when they decide what laws mean. Arguing that Congress intended "satisfactory" to mean solely that the condition had been adequately identified is wishful thinking, IMO.

 

[Half Fast]

Adequate for what purpose? Adequate for the purpose of identifying the medical condition, or adequate for the purpose of determining whether an SI is required?
The language in the regulation was actually written by Congress in Public Law (PL) 114-190. Courts consider the intent of Congress when they decide what laws mean. Arguing that Congress intended "satisfactory" to mean solely that the condition had been adequately identified is wishful thinking, IMO.

The problem isn’t with the meaning of “satisfactory.” The problem is that the regulation only requires “explanation of the cause.” I don’t care whether you think it should say adequate or acceptable or whatever, the operable term is “explanation.”

It’s quite a stretch to say “explanation” means “successful treatment” or “non-recurring.”

Pretty dumb wording but that’s Congress for you.

 

[Stewartb]

Let's say an airman who's flying on Basic Med has some kind of event that would trigger needing to get a Special Issuance if said airman was on a Third Class medical.

What's the process?

So, asking for a friend of course ...

BasicMed requirements for one time SI medicals are very clear. If the pilot has one of those conditions while on BasicMed he's required to self ground and pursue the one time SI third class medical before he can requalify for BasicMed.

 

[Volzalum]

BasicMed requirements for one time SI medicals are very clear. If the pilot has one of those conditions while on BasicMed he's required to self ground and pursue the one time SI third class medical before he can requalify for BasicMed.

Where do they say that?

 

[Palmpilot]

The problem isn’t with the meaning of “satisfactory.” The problem is that the regulation only requires “explanation of the cause.” I don’t care whether you think it should say adequate or acceptable or whatever, the operable term is “explanation.”

It’s quite a stretch to say “explanation” means “successful treatment” or “non-recurring.”

It's less of a stretch if you say "satisfactory explanation," as Congress did. However, I would at least agree that it is ambiguous, which is why it's necessary to look to intent.

The fact that Dr. Chien says the OP's friend needs an SI also makes it less of a stretch. He has more experience with and knowledge of FAA medical issues than any of us. And he cited the same clause that we are discussing.

Pretty dumb wording but that’s Congress for you.

The U.S. Code and the Code of Federal Regulations have lots of ambiguous wording, which is part of what keeps our court system busy.

 

[Palmpilot]

BasicMed requirements for one time SI medicals are very clear. If the pilot has one of those conditions while on BasicMed he's required to self ground and pursue the one time SI third class medical before he can requalify for BasicMed.

Where do they say that?

§68.9 Special Issuance process.

(a) General. An individual who has met the qualifications to operate an aircraft under §61.113(i) of this chapter and is seeking to serve as a pilot in command under that section must have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate for each of the following:
​

That sure looks to me like a plain-language statement that the pilot has to get an SI in order to act as pilot in command if he has one of the listed conditions.

 

[WDD]

1) I'm sorry for your friend. Sounds like he or she hates to give up flying.
2) Big Kudos to your friend for being honest with the facts as he/she sees them and especially for having the discipline and maturity to make a hard choice. If he/she feels it has crossed the line for safe flying, then that has to be respected.
3) We'll all be there one day. Sounds like your friend is a stand up guy / gal.

 

[jbarrass]

The question is "satisfactory" as determined by who?

1-The Pilot?
2-The treating Physician?, or
3-A paperwork bureaucrat in OKC who is not capable of even examining the patient?

 

[Volzalum]

The question is "satisfactory" as determined by who?

1-The Pilot?
2-The treating Physician?, or
3-A paperwork bureaucrat in OKC who is not capable of even examining the patient?

that was my question too. If the physician signing off the BasicMed feels it is satisfactory addressed such that it does not meet B.iii criteria, then he does not need an SI. In this case he never has to go back to the FAA unless the doctor feels it is without satisfactory explanation.

 

[Palmpilot]

that was my question too. If the physician signing off the BasicMed feels it is satisfactory addressed such that it does not meet B.iii criteria, then he does not need an SI. In this case he never has to go back to the FAA unless the doctor feels it is without satisfactory explanation.

So what are you saying, that you could hand the physician a copy of the statute or reg and expect him to be able to tell you whether an SI is required?

 

[bbchien]

Well in this case it depends on you ability to never get ramped, never get called into the hotline, never **** off the Air Traffic Organization. ‘Cause then they will pull your insurance codes, dates, subpoena the records, and your entire convenient lie unravels. Then you lose you pilot certificate, just like the “4 delta pilots indicted” and the “27 pilots indicted”. Then like our own poster Stanmore Cooper, who falsified...it led to a Living he-l for himself...I’ll have no sympathy.

V, and JB: .....so it’s okay to be a liar of convenience, until you get caught. This is why Basic will eventually fail. So sad. You’re not doing “the whole of pilots”, any favors. You’ve just exposed what you Really are. So Sad.

...to Greg Kainz, I’m so sorry about your friend, but for all of us there is a time to hang up the spurs......what we know about TIA and RIND and stroke, is that once you have one, for the next two years, the chance of a stoke is elevated about fourfold....

 

[Lindberg]

Adequate for what purpose? Adequate for the purpose of identifying the medical condition, or adequate for the purpose of determining whether an SI is required?

The former. It is an adequate explanation.

The language in the regulation was actually written by Congress in Public Law (PL) 114-190. Courts consider the intent of Congress when they decide what laws mean. Arguing that Congress intended "satisfactory" to mean solely that the condition had been adequately identified is wishful thinking, IMO.

It's not, because that's literally what it means.

You seem to be under the impression that I'm saying the friend can fly as long as the TIA adequately explains the symptoms. I haven't said any such thing. There are provisions for flying under Basic Med with a diagnosed neurological condition, which I've quoted in this thread. If the physician feels the symptoms are adequately explained, those provisions still must be complied with. But those are different from requiring an SI.

 

[Volzalum]

I have not said to lie about anything. I am asking where it says the FAA is the one that makes the determination of satisfactory explanation for a given case.

As of yet, the OP’s friend does not seem to have any explanation for the incident, as the results were indeterminate, but in following the regulations, where does it say that you have to send anything to the FAA if you doctor decides you have a satisfactory explanation?

All of the answers appear to be that there is no such thing as a satisfactory explanation without an SI. The regulation says an SI is needed when the event is without a satisfactory explanation.

the individual most definitely needs to ground themselves, and needs to work with their doctors to determine if they can attain a satisfactory explanation. And based on that answer follow the regulations accordingly.

 

[Lindberg]

The problem isn’t with the meaning of “satisfactory.” The problem is that the regulation only requires “explanation of the cause.” I don’t care whether you think it should say adequate or acceptable or whatever, the operable term is “explanation.”

It’s quite a stretch to say “explanation” means “successful treatment” or “non-recurring.”

Right, because it doesn't mean that. Whether there's an adequate explanation doesn't answer the question of whether you can fly; it only answers the question of whether you need an SI.

 

[Lindberg]

All of the answers appear to be that there is no such thing as a satisfactory explanation without an SI. The regulation says an SI is needed when the event is without a satisfactory explanation

This is the crux. Everyone saying he needs an SI are reading the reg to make the phrase "without satisfactory medical explanation of the cause" redundant. You can't do that. It's a basic canon of statutory interpretation that those words mean something.

 

[Palmpilot]

The former. It is an adequate explanation. It's not, because that's literally what it means.

In your opinion. I don't think that dictionary definitions of words are a reliable indicator of how the feds interpret their own laws and regulations.

You seem to be under the impression that I'm saying the friend can fly as long as the TIA adequately explains the symptoms. I haven't said any such thing. There are provisions for flying under Basic Med with a diagnosed neurological condition, which I've quoted in this thread. But those are different from requiring an SI.

No, I'm not saying that. I'm saying that you're mistaken about what the process is for determining whether an SI would be required in order to keep flying as PIC in this case.

 

[Palmpilot]

This is the crux. Everyone saying he needs an SI are reading the reg to make the phrase "without satisfactory medical explanation of the cause" redundant. You can't do that. It's a basic canon of statutory interpretation that those words mean something.

I'm not saying that phrase has no meaning. I'm saying it has a different meaning than you are.

 

[Lindberg]

In your opinion.

Which is worth more than what you paid for it. But believe whatever you want to believe.

And the "friend" seems to want to need an SI. If that's what floats his boat, so be it.

 

[Lindberg]

I'm not saying that phrase has no meaning. I'm saying it has a different meaning than you are.

You're saying anyone who has a neurological condition that might interfere with flying duties needs an SI under 68.9(a). If that were true, then 68.9(d) would be completely unnecessary.

 

[Palmpilot]

You're saying anyone who has a neurological condition that would interfere with flying duties needs an SI under 68.9(a).

That's not true. I'm not saying that there can't be "a satisfactory medical explanation of the cause" for "a transient loss of control of nervous system functions." For example, I know someone who fainted on the dentist's floor after having a wisdom tooth removed many years ago. He has reported this on every FAA and BasicMed form, and neither the FAA nor any of his AMEs has required an SI because of it. I don't think that the accuracy of the explanation would have been enough by itself to achieve that result. I think it's because the explanation is not one that would imply a risk of fainting while flying, and because it's the only time in his life that he has ever fainted.

 

[Palmpilot]

Which is worth more than what you paid for it. But believe whatever you want to believe.

I don't have any desires in the matter. I discuss interpretations of FAA regulations because I enjoy it, and because as a pilot, I have a responsibility to understand and follow the rules to the best of my ability. When it comes to understanding how the FAA interprets aviation medical laws and regulations, I think that Dr. Chien's experience and knowledge is worth a lot more than either your opinion or mine. Even if I thought that either he or the FAA was wrong, proving it tends to be risky and expensive.

And the "friend" seems to want to need an SI. If that's what floats his boat, so be it.

I didn't get that impression. I thought he just didn't want to take the risk of a recurrence of the symptoms while flying.

 

[Volzalum]

I guess technically, if the Doctor is not able to satisfactory explain the issue, after some time to make sure of no repeat occurrence (some time between the pilot and his doctor), the pilot could also switch to SportPilot since he has done nothing to get disqualified yet, if he reaches the conclusion for himself that he needs an SI to be able to fly under BasicMed again.

 

[Palmpilot]

I guess technically, if the Doctor is not able to satisfactory explain the issue, after some time to make sure of no repeat occurrence (some time between the pilot and his doctor), the pilot could also switch to SportPilot since he has done nothing to get disqualified yet, if he reaches the conclusion for himself that he needs an SI to be able to fly under BasicMed again.

I think that's true if he holds a valid driver's license and meets the requirement of 61.53(b).

 

[gkainz]

double posting this here and in Hangar Talk ... today I resigned from my flying club and begin a 24 month grounding, with hopes of re-evaluating my medical situation in 24 months or so.

Fortunately, my flying club has a deferred resignation, which will hold my flying credits on account for me, in the event I believe I am able to, and choose to fight the fight to re-instate my medical again (assuming I have no other issues during the next 24 months). If it looks like I have a chance at re-applying for a med again, I can then apply for membership with the club, and come back in with sort of "head of the line privileges" against other applicants.

Guess I need to pull the batteries from the Lightspeeds...

 

[DaleB]

Totally off the path of all the previous replies, but I personally know three people who have had a TIA. One is a pilot and is now flying under Sport Pilot privileges, no medical. Naturally he and his doctors have discussed his flying, I don’t know the details as it’s not my business but he’s been flying since I was in grade school.

One of the others, a non pilot, was pretty scary... 29 YO male in exemplary health. Most interesting was the final diagnosis. Wasn’t a TIA, according to the doctors; it was a “complex migraine”. No idea how that was diagnosed, or whether there would be any practical difference as far as an FAA medics is concerned.

 

[Ted]

Greg, I'm sorry to hear that this has happened to you and I hope that it's just a matter of being overly cautious, more than anything hoping that what you had wasn't actually a TIA (and thus not have the higher risk of another TIA/stroke in the coming years for your own health).

Best of luck and hope the doctors are able to keep you on the right path. My grandparents suffered from events that in retrospect we believe were TIAs, but it was before the term was coined. I'm pretty sure my mom is suffering from TIAs as well, but she's in denial and from what she tells me (I don't trust her version) the doctors don't think she has them.

Anyway, point is, if it is what's happening, I'm glad that it was caught at a minor state and hopefully can be prevented in the future.