Medical Denied, Need advise

[dannyk11135]

Hello all, my name is Daniel and I'm an Aviation Engineering student at The Ohio State University, I'm going into my 4th year. For as long as I can remember Ive always wanted to be a pilot but unfortunately obtaining a medical is the only thing currently in my way. My initial application got deferred by my AME based on an automatically deferrable condition that of 'any history of Epilespy.' I went through the avenues prescribed by the FAA and I completed their neurology exams with a physician and provided them with many EEGs, MRIs, and in-patient (nonemergent) long-term monitoring. The first set of documents I sent them was not enough, so I effectively sent them my entire chart. Long story short they denied my medical a few weeks ago and now according to them my next step is to appeal to the NTSB. All of my doctors and more importantly, my nuerologists have explicitly claimed I am fit to fly in writing. My epilepsy was childhood and an episode never occurred when I was awake, only when sleeping. I have a little bit less than 60 days to respond at the time of writing. Has anyone here with a neurological concern had to deal with obtaining a medical through appealing with the NTSB, any advice? Do I get an aviation lawyer, AOPA, etc..? Any help is appreciated, it would be a dream shattered if I am unable to obtain a pilot's license in my lifetime.

 

[GeorgeC]

For as long as I can remember Ive always wanted to be a pilot but unfortunately obtaining a medical is the only thing currently in my way. My initial application got deferred by my AME based on an automatically deferrable condition that of 'any history of Epilespy.'

Bummer, should have considered sport pilot.

Do I get an aviation lawyer, AOPA, etc..? Any help is appreciated, it would be a dream shattered if I am unable to obtain a pilot's license in my lifetime.

These other threads may be helpful:
https://www.pilotsofamerica.com/community/search/search?keywords=epilepsy&c[title_only]=1

GeorgeGPT summary:
https://www.faa.gov/ame_guide/media/Epilepsy.pdf
3 years off meds and 10 years seizure-free.

 

[bbchien]

If a single seizure event occurred the ages between three months and 5 years, no evlauation is required. However you'll have to get effective testimony that this is the case, and unless you still ive at home AND your mom has medical training, that means a NEUROLOGIST.

But it sounds like there was seomthing more recent. then the crieria is: If single seizure, unprovoked and no treatalbe medical explanation, you need 4 years, the last 2 years off all meds, and at the end of whcih is the complete neuro. evaluation.

If you've had two, and really have epilesy, therefore, the period is 10 years serizure free of medication for at least the last 3 years.

Sounds like you may have been outside of those bounds ? All your docs saying "fit to fly", I'll bet have zero idea of the aviation standard above so the FAA it sounds like self-discrediting doctors.

 

[midlifeflyer]

“Fit to fly” by a non-aviation physician, even a board-certified specialist in their field, is an occupational assessment, not a regulatory one.

It may be essentially what a physician who signs off on BasicMed with a “yes” in a Q18 box is doing, but when it’s one where the FAA is making the decision, the FAA is looking for data.

 

[Half Fast]

“Fit to fly” by a non-aviation physician, even a board-certified specialist in their field, is an occupational assessment, not a regulatory one.

It may be essentially what a physician who signs off on BasicMed with a “yes” in a Q18 box is doing, but when it’s one where the FAA is making the decision, the FAA is looking for data.

You are correct, of course, but the next question should be whether the FAA’s regulatory assessment results in better safety than the occupational assessment in Basic Med. Data so far says it doesn’t.

The emperor has no clothes.

 

[midlifeflyer]

You are correct, of course, but the next question should be whether the FAA’s regulatory assessment results in better safety than the occupational assessment in Basic Med. Data so far says it doesn’t.

The emperor has no clothes.

There are a number of conditions where OK City gets its panties wadded, leaving specialists scratching their heads in wonderment.

 

[Half Fast]

There are a number of conditions where OK City gets its panties wadded, leaving specialists scratching their heads in wonderment.

Likely because the OKC docs aren't specialists in anything except bureaucracy. If they were brain surgeons they'd be practicing brain surgery, instead of working in dead-end civil service jobs.

 

[UTLonghorn_1979]

Likely because the OKC docs aren't specialists in anything except bureaucracy. If they were brain surgeons they'd be practicing brain surgery, instead of working in dead-end civil service jobs.

It would be interesting to know the % of people in medical issuance decision making positions that aren't able to fly themselves due to disqualifications...

 

[bbchien]

No it wouldn't. They are a "by criteria organization". It's the CRITERIA that need to change.
However understand that they are "tight" becuase they are going to issue you a year ahead of your problem....and so they need to be pretty sure it isn't going to worsen in that period.

The best example of this are the drug and alcohol guys. We have to monitor face to face, in 3 month intervals (as well as ~every 25 days "Pee in the cup").

 

[Half Fast]

It's the CRITERIA that need to change.

Bruce, who determines the criteria?

 

[bbchien]

Per PBOR 2009: "The Federal Air surgeon, on best availalbe external medical advice".

Now think about the debacle after the Yitzak Jacoby accident, envision the Majority leader at the Senate press podium declaiming for the cameras: "I want to have the bureaucrat who allowed that man to fly his prersonal aircraft into my district, igniting several automobiles and killing constituents, in front of my committee on Tuesday". Is it any wonder the criteria are rather stringent?

Think Kimberly Cheatle. Remember her?


(With apologies to Walt Kelly: "I have met the enemy and he is us")

 

[Gess]

I got this far:

"Hello all, my name is Daniel and I'm an Aviation Engineering student at The"

and stopped reading.

Just kidding, good luck with your issue.

 

[Racerx]

Is appealing the FAA decision to the ntsb a thing?

 

[bbchien]

It takes $500,000 to raise a minimal offense @ NTSB. And the FAA will oppose it with all their resources for if they do not prevail they "cannot govern". Think about how to comply, instead....unless you can hire ten exeperts of your own and clock a team of attornies @ $400. It's the AMERICAN way.....

When Chevron filters down to the Agency, you will be paying the same for the expert witnesses to file friend of the court briefs. And then you will be 10 years older.

Try something else.

 

[UTLonghorn_1979]

Per PBOR 2009: "The Federal Air surgeon, on best availalbe external medical advice".

Now think about the debale after the Yitzak Jacoby accident, envision the Majority leader at the Senate press podium declaiming for the cameras: "I want to have the bureaucrat who allowed that man to fly his prersonal aircraft into my district, igniting several automobiles and killing constituents, in front of my committee on Tuesday". Is it any wonder the criteria are rather stringent?

Think Kimberly Cheatle. Remember her?


(With apologies to Walt Kelly: "I have met the enemy and he is us")

I don't understand the reference to the Jacoby accident...it looks like he lied on his application about meds for headaches. Also says his attitude indicator failed 90 seconds into flight in hard IFR conditions and was an ex Israeli Air Force Pilot...what are we suggesting here by the post?

 

[midlifeflyer]

Per PBOR 2009: "The Federal Air surgeon, on best availalbe external medical advice".

Now think about the debale after the Yitzak Jacoby accident, envision the Majority leader at the Senate press podium declaiming for the cameras: "I want to have the bureaucrat who allowed that man to fly his prersonal aircraft into my district, igniting several automobiles and killing constituents, in front of my committee on Tuesday". Is it any wonder the criteria are rather stringent?

Think Kimberly Cheatle. Remember her?


(With apologies to Walt Kelly: "I have met the enemy and he is us")

People sometimes talk about this in civil liability terms, but it's really about the political ramifications.

 

[bbchien]

I don't understand the reference to the Jacoby accident...it looks like he lied on his application about meds for headaches. Also says his attitude indicator failed 90 seconds into flight in hard IFR conditions and was an ex Israeli Air Force Pilot...what are we suggesting here by the post?

Before all that was known the majority leader made "hay" out off it for the benefit of the press. For a medical officer to be put up before congress in that manner, would be career ending. Get it now? "I have met the enemy and he is us!" (google "Pogo, Walt Kelly").

Do you know who Kimberly Cheatle is/was? Have you googled her yet?

 

[midlifeflyer]

Is appealing the FAA decision to the ntsb a thing?

Yes it's a thing. Unless things have changed since I last handled a medical denial, the denial documents will even include information on how to appeal. But the likelihood is that, even if all the money for the expert testimony it requires is available (probably exceed the lawyer fees), it's usually going to be a losing proposition.

 

[UTLonghorn_1979]

For a medical officer to be put up before congress in that manner, would be career ending. Get it now?

Kind of like how the existing FAA practices for evaluating certain diagnoses is "career ending" for many commercial pilots...ironic.

Do you know who Kimberly Cheatle is/was? Have you googled her yet?

Of course, no need to Google, I watched the entire hearing...she's an idiot and a liar and deserved to lose her job.

 

[Half Fast]

Per PBOR 2009: "The Federal Air surgeon, on best availalbe external medical advice".

Now think about the debacle after the Yitzak Jacoby accident, envision the Majority leader at the Senate press podium declaiming for the cameras: "I want to have the bureaucrat who allowed that man to fly his prersonal aircraft into my district, igniting several automobiles and killing constituents, in front of my committee on Tuesday". Is it any wonder the criteria are rather stringent?

Think Kimberly Cheatle. Remember her?


(With apologies to Walt Kelly: "I have met the enemy and he is us")

But Bruce, that misses the point. The point is that their criteria are not accomplishing any real improvement in safety, and the evidence is found in the Basic Med data. And I really don't see what difference the criteria make if the pilot is going to lie on the application anyway, as Jacoby did.

 

[Half Fast]

...it's usually going to be a losing proposition.

I have a slight amount of hope, probably misplaced, that this might change a little in decades to come now that Chevron has been tossed out. We've begun to see some BATFE rules getting tossed already (forced reset triggers, for example).

 

[UTLonghorn_1979]

But Bruce, that misses the point. The point is that their criteria are not accomplishing any real improvement in safety, and the evidence is found in the Basic Med data. And I really don't see what difference the criteria make if the pilot is going to lie on the application anyway, as Jacoby did.

Exactly! I posted this on another forum, better suited here. Every specialist/observer or otherwise outside of the FAA realizes the existing practices for certain deferrals are completely nonsensical. For whatever reason, the FAA, and some people on this forum, are the last to acknowledge this. FAA has the most stringent standards, for instance, for SSRI/mental health deferrals, and yet other countries with less stringent and more reasonable have equivalent or better safety records.

https://www.faa.gov/sites/faa.gov/files/Mental_Health_ARC_Final_Report_RELEASED.pdf

 

[midlifeflyer]

For whatever reason, the FAA, and some people on this forum, are the last to acknowledge this. FAA has the most stringent standards, for instance, for SSRI/mental health deferrals, and yet other countries with less stringent and more reasonable have equivalent or better safety records.

I don't know too many on this forum who agree with the FAA's sometimes draconian certification criteria.

But there is a basic problem when we start comparing the US to other countries. Over the decades, I've noticed that "we should use them as an example" and "what they do doesn't apply to us" will often be said by the same people, varying with the issue being discussed.

 

[UTLonghorn_1979]

I don't know too many on this forum who agree with the FAA's sometimes draconian certification criteria.

Seems many on this forum that don't find themselves on my end (deferral/decline 18 month waiting time to get decline decision - reconsideration after more evaluations, reports, $ and another 12-18 months waiting) don't think there's an issue with the FAA. Many of the responses to my raised issues on this forum are "you shouldn't be up in the air...," " you have a problem with authority...," or "it's their sandbox, you have to play by their rules." I'm playing by their rules, the issue is many don't and they are still flying while pilots that are honest with their situation are grounded.

But there is a basic problem when we start comparing the US to other countries. Over the decades, I've noticed that "we should use them as an example" and "what they do doesn't apply to us" will often be said by the same people, varying with the issue being discussed.

I agree it doesn't make sense in some examples. However, when it comes to safety, and we already have ample evidence from the BasicMed/class 3 reform to show otherwise, why would the FAA not implement the same protocols as other countries when those practices show an equal or better result?

 

[midlifeflyer]

I agree it doesn't make sense in some examples. However, when it comes to safety, and we already have ample evidence from the BasicMed/class 3 reform to show otherwise, why would the FAA not implement the same protocols as other countries when those practices show an equal or better result?

I don't disagree with your bottom line, but you don't think the differences in the US pilot population in terms of sheer numbers, culture, and attitudes is not subject to the same, "but that's not us" analysis as, say, universal medical care or firearms restrictions where "other countries show an equal or better result"?

No, I'm not going to argue those. explanation doesn't mean approval. Just pointing out how easily the 'copy them because it works' fails. Heck, outside the scientific and engineering disciplines, we can't even manage to go metric.

 

[UTLonghorn_1979]

I don't disagree with your bottom line, but you don't think the differences in the US pilot population in terms of sheer numbers, culture, and attitudes is not subject to the same, "but that's not us" analysis as, say, universal medical care or firearms restrictions where "other countries show an equal or better result"?

No, I'm not going to argue those. explanation doesn't mean approval. Just pointing out how easily the 'copy them because it works' fails. Heck, outside the scientific and engineering disciplines, we can't even manage to go metric.

I'm not sure I follow the "culture and attitudes" comment, but the sheer numbers of pilots would certainly, one with any common sense would think, cause the FAA to reevaluate how they process the ever increasing % of applications they receive each year, with an increasing % of required deferrals due to aging population of pilots and, to quote the FAA, fact that "16-25 year-old population entering the educational system to become tomorrow’s professional pilots have a high incidence of treated mental health conditions, to include Attention Deficit Disorder/Attention-Deficit/Hyperactivity Disorder (ADD/ADHD), Major Depression and Autism Spectrum Disorder."

Maybe I'm naive, but I'm pretty sure safety standards wouldn't (or shouldn't) change with a population size, but rather based on results. Any one that travels on airlines based in other countries have a vested (life or death) interest in those standards being adequate.

Universal medical care and firearm restrictions are a VERY different matter, but I understand your point as well.

 

[bbchien]

The point is, our politicians grandstand, no matter what the actual causation (Jacoby accident). Very distressing to a well informed (career) medical officer who then becomes VERY cautious.

And our politicians underfund the safety system, so one wonders “what is actually real”.

The speaker of the house has chosen the “not another dime” philosophy and it has ramifications.“The american people have not experienced a commercial part 121 death in 14 years”, raises the question “how many losses do we have to have b4 we stop stripping the system?”

4 years ago there were 420,000 pilots. There are 720,000 today. Same budget in less valuable dollars.

“Oh and BTW, you guys need to police Boeing…”

 

[Half Fast]

The point is, our politicians grandstand, no matter what the actual causation (Jacoby accident). Very distressing to a well informed (career) medical officer.

The point is that OKC docs should be establishing criteria on the basis of sound medical principles and not on the basis of bureaucratic a$$ covering.

And I haven’t seen yet any evidence that OKC is making any changes to improve cost efficiency or throughput. No effort to find better ways of doing things.

 

[UTLonghorn_1979]

The point is that OKC docs should be establishing criteria on the basis of sound medical principles and not on the basis of bureaucratic a$$ covering.

And I haven’t seen yet any evidence that OKC is making any changes to improve cost efficiency or throughput. No effort to find better ways of doing things.

Agreed! Much of this is an issue of the FAA's own making in regard to mental health items; which is my "crusade."

FAA:

"It's not like we've had the ability to transmit data via facsimile for 50 years and email for 20, but hey(!!), let's keep sending information back and forth via snail mail! ONLY once we receive it in the mail should we scan it into our own electronic system in OKC or DC, which by the way can't even perform word search functions...even though any individual can purchase Adobe reader on their own PC/MAC to perform such word searches.

Oh, and let's treat every medical case as if it's the absolute worst case scenario so we needlessly create more work, follow ups and monitoring needs for pilots. This way we can create an incredibly long backlog, but ultimately approve 90%+ of applicant delays we've created. And let's definitely not differentiate between ATPs flying a 777 vs. a light sports pilot flying a Cessna 150 on deferral standards/reconsideration requirements, treat those the same as far as medical testing and scrutiny required!!

Let's then complain that we're overworked and ask for more $ but not change anything. Man, I love this job."

 

[bbchien]

The point is that OKC docs should be establishing criteria on the basis of sound medical principles and not on the basis of bureaucratic a$$ covering.

And I haven’t seen yet any evidence that OKC is making any changes to improve cost efficiency or throughput. No effort to find better ways of doing things.

Bob, you’re….blind (no offense). I get called at 7:30 pm from the officers who are working their mandatory voluntary OT at their base rate.

Their peers have left. The chairs are empty. Who wants to commit a lifetime of federal work when the legislators are lookin for scapegoats. All of this started with secretary Pena (google him) “we will tolerate no accidents!” A zero fatal environment means we can only go ONE DIRECTION and its not sweetness and light.

The fact that you and UT cannot recognize a more sophisticated complex view of the speaks volumes. You are NOT IN A POSITION TO SEE THIS.

Remember I gave you good advice.
UT you are not going to change the planet.

You need to stop grinding the axe and concentrate on “filling the relevant squares”.

I wish you peace.

 

[UTLonghorn_1979]

The point is, our politicians grandstand, no matter what the actual causation (Jacoby accident). Very distressing to a well informed (career) medical officer who then becomes VERY cautious.

And our politicians underfund the safety system, so one wonders “what is actually real”.

The speaker of the house has chosen the “not another dime” philosophy and it has ramifications.“The american people have not experienced a commercial part 121 death in 14 years”, raises the question “how many losses do we have to have b4 we stop stripping the system?”

4 years ago there were 420,000 pilots. There are 720,000 today. Same budget in less valuable dollars.

“Oh and BTW, you guys need to police Boeing…”

Other than the Jacoby incident, which I'm still not clear on what actually caused the accident (failed instruments in hard IFR or headache medication), your points are geared towards commercial ATP concerns. Valid. However, to treat the recreational, sports pilots, private pilot in the same manner as the commercial ATP doesn't make any sense. ATP population as of 12/31/23 was 174K, in 2018 it was 164K...I ain't so good at math, but that's 6% increase over 5 years by my math. Total pilots for same timeframe was 807K vs. 633K...which the overwhelming majority being student pilots (not sure where you're getting your pilot figures from). And while the commercial ATP cases should take priority in the interest of commerce, it still doesn't make any sense that it takes 12-18 months for these pilots to be cleared for "vanilla" deferral reasons.

As I said before, we either lower the piloting standards and push unqualified (but otherwise FAA "approved" physically and mental healthy) pilots through the system, or fix the process and invite and retain experienced and qualified pilots by getting the FAA into the 21st century on technology and medicine. I prefer the latter.

 

[UTLonghorn_1979]

Bob, you’re….blind (no offense). I get called at 7:30 pm from the officers who are working their mandatory voluntary OT at their base rate.

Their peers have left. The chairs are empty. Who wants to commit a lifetime of federal work when the legislators are lookin for scapegoats. All of this started with secretary Pena (google him) “we will tolerate no accidents!” A zero fatal environment means we can only go ONE DIRECTION and its not sweetness and light.

The fact that you and UT cannot recognize a more sophisticated complex view of the speaks volumes. You are NOT IN A POSITION TO SEE THIS.

Remember I gave you good advice.
UT you are not going to change the planet.

You need to stop grinding the axe and concentrate on “filling the relevant squares”.

I wish you peace.

Then people in positions like yours need to "man up" (no offense) and call out the absurdity that we will EVER have a 100% success rate for ANYTHING. As I've said at least 5 times now, my primary grudge is with the logistical process, not the scrutiny itself.

I'm thankful that specialists of all sides put together the ARC report, it addressed virtually everything I've questioned as illogical and outdated and currently practiced by the FAA before I knew this report existed. I hope and pray the FAA isn't as obtuse as I assume and proceeds with these recommendations.

https://www.faa.gov/sites/faa.gov/files/Mental_Health_ARC_Final_Report_RELEASED.pdf

 

[Dana]

No government or bureaucracy ever voluntarily relinquishes power or downsizes.

And

"Pournelle's Iron Law of Bureaucracy states that in any bureaucratic organization there will be two kinds of people:

First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.

Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.

The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization."

 

[Clip4]

I don't know too many on this forum who agree with the FAA's sometimes draconian certification criteria.

But there is a basic problem when we start comparing the US to other countries. Over the decades, I've noticed that "we should use them as an example" and "what they do doesn't apply to us" will often be said by the same people, varying with the issue being discussed.

I don’t think many outside this forum who would agree a >90% approval rate for medical certificates applications is draconian.

This site hears from the most severe cases and it gives the false impression is there is a high percentage that don’t qualify - there isn’t.

 

[bbchien]

Then people in positions like yours need to "man up" (no offense) and call out the absurdity that we will EVER have a 100% success rate for ANYTHING. As I've said at least 5 times now, my primary grudge is with the logistical process, not the scrutiny itself.

I'm thankful that specialists of all sides put together the ARC report, it addressed virtually everything I've questioned as illogical and outdated and currently practiced by the FAA before I knew this report existed. I hope and pray the FAA isn't as obtuse as I assume and proceeds with these recommendations.

https://www.faa.gov/sites/faa.gov/files/Mental_Health_ARC_Final_Report_RELEASED.pdf

Okay. Can you actualy name anybody beside this writer who has actually changed federal policy? I've done it twice, the first time in 2010 with three other co-peitioners and we got the ON SSRI policy. It took 4 years.

The second time was last fall which increaseed the authority of the HIMS MAE and shortened HIMS stepdown.

But you wouldn't know about any of that, would you? I think you need to "man down, fil the square and get what you are trying to get, done. And Get it right on the first pass. oer the other sting

So, want to tell me about "Manning up" again?

Peace Bro.

 

[midlifeflyer]

I don’t think many outside this forum who would agree a >90% approval rate for medical certificates applications is draconian.

This site hears from the most severe cases and it gives the false impression is there are lots of them - there isn’t.

I thought that's what "sometimes" meant.

 

[Clip4]

I thought that's what "sometimes" meant.

sometimes I believe there criteria is too liberal.

 

[midlifeflyer]

sometimes I believe there criteria is too liberal.

I don't doubt there are cases like that but I really haven't seen too many examples. More of the "prove you don't have the disease if you have a genetic marker for it" and "take a $2,000 test every year even if the specialists think it's ridiculous" type of activity that was an impetus for BasicMed.

 

[UTLonghorn_1979]

Okay. Can you actualy name anybody beside this writer who has actually changed federal policy? I've done it twice, the first time in 2010 with three other co-peitioners and we got the ON SSRI policy. It took 4 years.

The second time was last fall which increaseed the authority of the HIMS MAE and shortened HIMS stepdown.

But you wouldn't know about any of that, would you? I think you need to "man down, fil the square and get what you are trying to get, done. And Get it right on the first pass.

So, want to tell me about "Manning up" again?

Peace Bro.

First off, I said people in your position, NOT you (Dr. Bruce Chien).

Second, I appreciate your efforts, as well as the AOPA, all the sponsors of the 2024 Reauthorization Bill and other groups that call out the laughable practices AT THE FAA LEVEL and push for changes. Those same people need to hold the FAA’s feet to the fire to enact the logical recommendations made by the ARC.

Third, yes I’m aware of your efforts. You mention them in multiple posts, including this one.

Lastly, as long as I pay taxes, which are substantial, and pay for the FAA salaries and budgets, I’m not manning down.

 

[bbchien]

Peace Bro.

Now a bit of ettiquette:

And per the advice of George, how about giving this string back to dannyk11135.


You known in this part of the board, we actually try to help people but you keep taking over.
Starting your own string would be more appropraite, rather than co-opting strings at every opportunity.