Medical Wait Time!

Half Fast said:
I’m sure that’s how they view it but I think it’s BS. Congress made it possible for 80,000 pilots to go onto Basic Med and no longer burden OKC. Aeromed could reduce their workload dramatically if they’d expand the CACI list and delegate more authority to AMEs.

But bureaucracies don’t behave that way. They cling to power and try to enlarge their empires. Their answer is always “we need more money.” It’s never about finding a way to get the job done within the available resources.

This will continue until some bureaucrats get fired for not doing their jobs.
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FYI…I’m sending letters to every member of the Aviation Safety, Operations and Innovation Subcommittee outlining the need to update the existing means of processing deferrals.

With the proliferation and preponderance of “diagnoses” and prescribed medications for ADHD, anxiety etc, this is going to put an increasing % of applicants into the deferral process. This will only exacerbate the already bottlenecked process.

There is absolutely zero reason HIMS AMEs cannot handle the 90%+ of deferrals that are ultimately approved and a bureaucrat saying “I don’t want that to happen” isn’t a good reason not to do so.
 
Some of the existing issues I plan to communicate to the current Aviation Safety, Operations and Innovation Subcommittee regarding deferrals (specifically for SSRI) - if you care to add any of your own comments, I will incorporate into my letters:

  • All correspondence is via certified mail
  • From the date of the FAA’s certified letter addressing the deferral, you have 60 days to supply the FAA with the requested information, which can include expensive psychological and neuropsychological evaluations and/or other items, or risk not complying with the FAA’s request and thereby having to start the process entirely over
  • The FAA has no legal obligatory timeline to respond to the applicant and/or come to a conclusion/resolution
    • I, myself, have been in this process for over a year and likely looking at another 12-18 months if the existing process is maintained, as is likely
  • There are only 2-3 individuals at the FAA’s Washington D.C. office performing the final review of the AMEs report, which includes the exact same items that the AME has already reviewed
    • This is for the entire population of individuals also in deferral for the use of SSRI
  • There is no differentiation or separate/streamlined paths between the malady under review
    • i.e. an applicant with situational anxiety(me) is put into the same review queue as an applicant with severe depression and suicidal idealization
    • i.e. an applicant who has reported to a physician that they socially drink/drink to relieve work stress but doesn’t have a record of legal or personal/work issues related to alcohol (me) is put into the same review queue as an applicant with 5 DWIs and/or an illicit drug use/arrest record

The first and most obvious remedy being allowing those already approved FAA HIMS AMEs to themselves issue deferred medical certificates via standard issuance or special issuance. The HIMS AMEs review the same items/evaluations as the D.C. Drs., and the HIMS AMEs actually compile all of the FAA requested information and provide their own report based upon those evaluations, as well as have the benefit of actually interacting, observing and medically evaluating the applicant.

I’ve read statistics that 90%-97% of all medical deferrals are ultimately approved, leading one to conclude that this backlog, bottleneck is an issue of the FAA’s own making and perhaps there should even be an evaluation of what medical conditions should even require a deferral.



Members of the Aviation Safety, Operations and Innovation Subcommittee in case anyone cares to reach out to them:

Tammy Duckworth, Ill. (Chair)
Jon Tester, Mont.
Kyrsten Sinema, Ariz.
Jacky Rosen, Nev.
John Hickenlooper, Colo.
Raphael Warnock, Ga.

Jerry Moran, Kan. (Ranking Member)
John Thune, S.D.
Roger Wicker, Miss.
Dan Sullivan, Alaska
Todd Young, Ind.
 
Half Fast said:
I’m sure that’s how they view it but I think it’s BS. Congress made it possible for 80,000 pilots to go onto Basic Med and no longer burden OKC. Aeromed could reduce their workload dramatically if they’d expand the CACI list and delegate more authority to AMEs.

But bureaucracies don’t behave that way. They cling to power and try to enlarge their empires. Their answer is always “we need more money.” It’s never about finding a way to get the job done within the available resources.

This will continue until some bureaucrats get fired for not doing their jobs.
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Yup. And in fact, their budgets have increased every single year. Lass work for more money.

It's called ‘Parkinson’s Law’
 
jbarrass said:
Yup. And in fact, their budgets have increased every single year. Lass work for more money.

It's called ‘Parkinson’s Law’
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How much have their budgets expanded relative to both inflation and workload?

Just saying you’d expect budgets to go up over time in absolute dollars. Almost every number with a $ in front of it goes up over time.
 
AKiss20 said:
How much have their budgets expanded relative to both inflation and workload?

Just saying you’d expect budgets to go up over time in absolute dollars. Almost every number with a $ in front of it goes up over time.
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Has their workload really increased, other than them increasing it on their own by asking for more and more documentation? 80,000 Basic Med pilots have been removed from their workload.

And they could reduce their workload even further by delegating more authority to AMEs.
 
Half Fast said:
Has their workload really increased, other than them increasing it on their own by asking for more and more documentation? 80,000 Basic Med pilots have been removed from their workload.

And they could reduce their workload even further by delegating more authority to AMEs.
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I didn’t say workload has increased or decreased. I asked if their *inflation adjusted budget* has increased or decreased *relative to their workload*. I don’t know whether their workload has increased, decreased, or stayed the same, but hypothetically (totally making up numbers) if their absolute budget changed (increased) by 1.1x, their inflation adjusted budget changed (decreased) by 0.9x, and their workload changed (decreased) by 0.9x then that would be totally reasonable even though their budget increased in absolute terms.

Furthermore, workload is workload even if you don’t agree with it. I don’t always agree the work my boss says I should do is valuable, but I still gotta get paid to do it.
 
AKiss20 said:
Furthermore, workload is workload even if you don’t agree with it. I don’t always agree the work my boss says I should do is valuable, but I still gotta get paid to do it.
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True, but if you're overworked should your boss' only reponse be to say "Send more money?" Shouldn't your boss also look for ways for the organization to be more efficient or to shed workload? Should he let clients wait and wait and wait, sometimes for years, because you're overworked?

I haven't yet seen OKC do anything besides beg for more funds. They're not looking for solutions; they're looking to enlarge and further entrench an empire.
 
Half Fast said:
True, but if you're overworked should your boss' only reponse be to say "Send more money?" Shouldn't your boss also look for ways for the organization to be more efficient or to shed workload? Should he let clients wait and wait and wait, sometimes for years, because you're overworked?

I haven't yet seen OKC do anything besides beg for more funds. They're not looking for solutions; they're looking to enlarge and further entrench an empire.
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Exactly!
 
I'm not saying it's wise to throw more $$S but I will point out that pre pandemic there were 430,000 pilots. now there are 820,000. Basic med is old news (2106).

Everyone is forced to do more, with less.
 
Mostly True. In 2019 there were 664,565 and in 2023 there were 806,970 pilots.

Specific details from the FAA are here.

Almost all the growth is in Student Pilots so it's fair to say it is a bunch more work for CAMI since none of them are eligible for Basic Med yet.

The growth in student pilots is a good reason to be optimistic about GA me thinks.
 
jbarrass said:
Almost all the growth is in Student Pilots so it's fair to say it is a bunch more work for CAMI since none of them are eligible for Basic Med yet.

The growth in student pilots is a good reason to be optimistic about GA me thinks.
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In my experience, most are students are foreign and will return to their country, they may be in the database but aren’t really active after they finish their training. I don’t think that is going to help USA GA.
 
Dr. Northrup recently told the NBAA in a Q and A that the current medical deferral backlog has been reduced from a year to three months. (October 24, 2024)

I received a denial letter with a "reconsideration" section which advised that for reconsideration I should submit a Neuropsychiatric and Neuropsychological exam. (I see a therapist, no medication and had submitted a full psychiatric evaluation ...but not from an FAA certified physician.)

I worked with my AME to find a HIMS Neuropsychiatrist and HIMS Neuropsychologist...spent $5500...and received favorable reports INCLUDING a positive cogscreen.

I applied again, marked that my medical application had previously been denied, got a new physical and submitted my HIMS Neuropsychiatric and HIMS Neuropsychological packet which both recommend that I be admitted to the HIMS program and continue seeing a therapist with a report to my AME once a quarter for updates.

Both reports had a version of this statement:

"Contingent upon enrollment in the HIMS Program and compliance with all its requirements,
it is my opinion that Mr. [redacted] is clear from a mental health perspective at this time for
medical certification. There are no other current psychiatric concerns of aeromedical
significance."
------------------

That was all submitted with a letter requesting reconsideration and a new medical application in the second week of September...and now I wait...

I called the RFS last week and was advised that it would be a minimum of 5 to 7 months before my packet is sent to Washington, DC again.

We'll see, I guess. It just takes time.


Timeline:
I initially applied for a First Class Medical October of 2022...

deferred for mental health related reasons.

provided Psychiatric Evaluation (non-FAA) and Blood pressure update in April 2023.

deferred to Washington, DC.

denied with reconsideration criteria April 2024.

new application, HIMS Neuropsychiatric and Neuropsychological evaluations and letter request for reconsideration submitted September 2024...

Currently "under review" since mid-October 2024
 
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Whiskey_Tango_Hotel_2024 said:
Dr. Northrup recently told the NBAA in a Q and A that the current medical deferral backlog has been reduced from a year to three months. (October 24, 2024)

I received a denial letter with a "reconsideration" section which advised that for reconsideration I should submit a Neuropsychiatric and Neuropsychological exam. (I see a therapist, no medication and had submitted a full psychiatric evaluation ...but not from an FAA certified physician.)

I worked with my AME to find a HIMS Neuropsychiatrist and HIMS Neuropsychologist...spent $5500...and received favorable reports INCLUDING a positive cogscreen.

I applied again, marked that my medical application had previously been denied, got a new physical and submitted my HIMS Neuropsychiatric and HIMS Neuropsychological packet which both recommend that I be admitted to the HIMS program and continue seeing a therapist with a report to my AME once a quarter for updates.

Both reports had a version of this statement:

"Contingent upon enrollment in the HIMS Program and compliance with all its requirements,
it is my opinion that Mr. [redacted] is clear from a mental health perspective at this time for
medical certification. There are no other current psychiatric concerns of aeromedical
significance."
------------------

That was all submitted with a letter requesting reconsideration and a new medical application in the second week of September...and now I wait...

I called the RFS last week and was advised that it would be a minimum of 5 to 7 months before my packet is sent to Washington, DC again.

We'll see, I guess. It just takes time.


Timeline:
I initially applied for a First Class Medical October of 2022...

deferred for mental health related reasons.

provided Psychiatric Evaluation (non-FAA) and Blood pressure update in April 2023.

deferred to Washington, DC.

denied with reconsideration criteria April 2024.

new application, HIMS Neuropsychiatric and Neuropsychological evaluations and letter request for reconsideration submitted September 2024...

Currently "under review" since mid-October 2024
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I have a buddy that works for SWA that went to that same deal. It’s 3 months ONCE it gets into the hands of the reviewer. Still closer to a year total wait for GA pilots. Closer to 6 months for airline pilots.

Good luck!
 
UTLonghorn_1979 said:
I have a buddy that works for SWA that went to that same deal. It’s 3 months ONCE it gets into the hands of the reviewer. Still closer to a year total wait for GA pilots. Closer to 6 months for airline pilots.

Good luck!
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I just got done with a Class III medical that had been deferred to FAA-OKC in April 2023 for melanoma. First records package was sent for review in Jul 2023, no response received from FAA until Mar 2024 when a second records package was requested and sent in Apr 2024. Denial received in May 2024.

I don't think they read anything I sent them for review.
 
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brtsvg1 said:
I just got done with a Class III medical that had been deferred to FAA-OKC in April 2023 for melanoma. First records package was sent for review in Jul 2023, no response received from FAA until Mar 2024 when a second records package was requested and sent in Apr 2024. Denial received in May 2024.

I don't think they read anything I sent them for review.
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Was it a complete denial or was it "to request consideration"?
Also: has it been 10 years since your last treatment? (I have no idea if this is a thing, just...I see the 10 years a lot as a sort of "demarcation" of time.)
 
Whiskey_Tango_Hotel_2024 said:
Was it a complete denial or was it "to request consideration"?
Also: has it been 10 years since your last treatment? (I have no idea if this is a thing, just...I see the 10 years a lot as a sort of "demarcation" of time.)
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Complete denial. My melanoma removal was about 3 years ago now, which made it about 18 months prior to Class III exam last year.
 
brtsvg1 said:
Complete denial. My melanoma removal was about 3 years ago now, which made it about 18 months prior to Class III exam last year.
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If it was me, I'd write a letter requesting reconsideration and ask for a SODA.

I'd include a more recent status update from my doctor along with an oncologist statement of both your remission and your prognosis for five year and ten years based on your cancer type's survival rate.
 
Whiskey_Tango_Hotel_2024 said:
If it was me, I'd write a letter requesting reconsideration and ask for a SODA.
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I did send in a 5 page appeal requesting reconsideration and a SODA, it went nowhere.

it might be too much to share here, but was your MRI negative?
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Yes, brain MRI was negative.

Fortunately, I did have a Special Medical Test Flight in Oct and did receive my SI Class 3 medical, so for the meantime I am happy and this issue is over.

Its just sad that for the average guy like me the turnaround is 1.5 years, start to finish. But I still think that they didn't read a thing I sent them for review. I also think that the Class III applications must be out-prioritized by the Class 1 and Class II applications. Just wishing "Good Luck" to anybody who has to go through this unfortunate and lengthy review process.
 
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