More Change at FAA medical

Sierra1 said:
Still waiting I assume?
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Oh, I misunderstood you. In my post I was saying it took ~2-3 months to satisfy the FAA and have them confirm my medical, so if the new rules had been in play then I would have been grounded for that time waiting for the process to play out.

I don't know if that experience can be extrapolated to predict how much delay applicants should expect when the new rule goes into effect. I thought that's what you were asking.
 
Look at how more “efficient” they will look when instead of have a massive backlog of applications under review they have a giant number of “processed” denials when asked for numbers, not to get political, and I am an inclined to always be suspicious person of reasons for randomly large changes of policy, especially when it’s a large slow moving gear system, but with coming looms of the hangman’s axe from the DOGE and one of its main guys involved with it having publicly expressed his dislike and (is resentment going to far?) of the faa they might be doing their best to cover their rear ends when it comes time to sit across from a congressional committee and justify their numbers?
I’m probably wrong, but it was the first thought that popped in my head when I read the op
 
Jim_R said:
Oh, I misunderstood you. In my post I was saying it took ~2-3 months to satisfy the FAA and have them confirm my medical, so if the new rules had been in play then I would have been grounded for that time waiting for the process to play out.

I don't know if that experience can be extrapolated to predict how much delay applicants should expect when the new rule goes into effect. I thought that's what you were asking.
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Ah I gotcha, yeah was curious how long from your request for more info” was from them getting the info and getting your medical. I guess I missed it in the first post about it.

Seems really cruddy they are going to deny so many outright. If they come back I don’t see how it’s going to save them much time or work, but carries a high cost to those denied.
 
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One effect might be to drive more people to Basic Med. Perhaps that's one of the goals they have in mind. That would definitely reduce the FAA workload.
 
Even that program has to be unscrewed, ref the having needed a faa medical since 2006 or whenever…
 
Tools said:
Even that program has to be unscrewed, ref the having needed a faa medical since 2006 or whenever…
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Well, good point...since this new policy only affects new applicants, BMed doesn't help. Nevermind.
 
catmandu said:
Hmmm, maybe we should do an X campaign to point DOGE to the FAA Aerospace Medical Certification Division.

And I can't believe I just typed that as a person in their 7th decade.
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there might be better low-hanging fruit to tackle first.
 
kyleb said:
Any idea why the change?

FAA thinks AME's are passing candidates without testing them?
Numerous accidents/incidents driven by undiagnosed color blindness?
Someone in the FAA's brother-in-law owns the franchise for the testing equipment?
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This one seems positive. How many complaints have we seen about faded books, the wrong kind of lighting, burned out bulbs, or hunting for an AME who has the right kind of test? Now it will be consistent.
 
GoFlightMed said:
* Any current pilot with a color vision restriction MUST take one of the new digital tests.

- If they pass, the restriction will be removed


* Airmen with existing medical certificates are NOT required to undergo additional color vision testing unless:
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This is a positive change for airmen, and intended to result in fewer, but more accurate, failures. Why else would they include the above two provisos?
 
Half Fast said:
Not unless the video displays are consistent. That will require monitors that are periodically calibrated and certified.
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Pretty sure it's designed to be done on an iPad, which should provide reasonable consistency. Presumably other tablets would also fall within an acceptable range of color accuracy.
 
Lindberg said:
This is a positive change for airmen, and intended to result in fewer, but more accurate, failures. Why else would they include the above two provisos?
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Interesting, at every medical renewal, active duty and civilian, I've had to go through the flip charts for color blind tests. Old faded charts, every type of lighting imaginable, and always passed. Sometimes they tried to trick me, that's a duck, not a number.
 
AvNavCom said:
Pretty sure it's designed to be done on an iPad, which should provide reasonable consistency. Presumably other tablets would also fall within an acceptable range of color accuracy.
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“Reasonable consistency” isn’t an improvement. Even with an iPad, display brightness and room lighting will matter. That’s not any better than the plates.

To do this correctly will require a calibrated display viewed under a dark hood, or calibrated display goggles. Maybe that’s what they will require but I doubt it.
 
Half Fast said:
“Reasonable consistency” isn’t an improvement. Even with an iPad, display brightness and room lighting will matter. That’s not any better than the plates.

To do this correctly will require a calibrated display viewed under a dark hood, or calibrated display goggles. Maybe that’s what they will require but I doubt it.
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I promise you that Dr Waggoner is entirely and comprehensively aware of these issues (as, I'm sure, are any competing programs), as are the medical folks at the FAA. They're not stupid people and in many cases have an almost terrifying level of expertise. Guidance and requirements for room lighting and display brightness are built into the protocol (at least the one I saw), and the color accuracy of major devices is well-known. I'm not privy to the details, but I very much doubt that your concerns have been neglected in the decision to make this change.
 
The reality, at least according to my AME is that there is little reason to repeatedly test for color vision. Either you (genetically) have it or you don’t - it doesn’t change.
AvNavCom said:
I promise you that Dr Waggoner is entirely and comprehensively aware of these issues (as, I'm sure, are any competing programs), as are the medical folks at the FAA. They're not stupid people and in many cases have an almost terrifying level of expertise. Guidance and requirements for room lighting and display brightness are built into the protocol (at least the one I saw), and the color accuracy of major devices is well-known. I'm not privy to the details, but I very much doubt that your concerns have been neglected in the decision to make this change.
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Maybe so. But what’s the reason for changing something that seems to be a non-issue.
 
That’s the rub… I’ve never contended they were stupid. Never thought they are out to get me (or anyone…).

So WHY do they keep failing so bad? I presume the fault comes at some level AFTER the practical and smart experience.

And the modus operandi of failure seems consistent across their spectrum: safety, operations and mechanical. It’s impressively bad.

It’s a legitimate and heartfelt WTF? I really do believe the lack of REAL consequence is causal.
 
Tools said:
That’s the rub… I’ve never contended they were stupid. Never thought they are out to get me (or anyone…).

So WHY do they keep failing so bad? I presume the fault comes at some level AFTER the practical and smart experience.

And the modus operandi of failure seems consistent across their spectrum: safety, operations and mechanical. It’s impressively bad.

It’s a legitimate and heartfelt WTF? I really do believe the lack of REAL consequence is causal.
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What consequence do you propose?

Without going into details, I occupy a similar position in my organization and changing aeromedical policy is very, very hard. Not only inertia, but the fact that there are a LOT of people involved in the process who are not aeromedically trained and often not aviation or medically trained at all. There are always edge cases. There's always the tension between the most conservative, safe option vs the more liberal option which may increase risk. Policy is usually intertwined with other policy (some of which is controlling) and therefore can't be changed without a massive lift at multiple levels of government. The amount of inertia in policy is tough to fight, and entrenched interests may dictate (literally) policy incongruent with what otherwise appears obvious and reasonable. There's certainly some merit to the idea of being agile and flexible, but the law of unintended consequences invariably means that every change has teeth in some direction, and it doesn't take long for people to start screaming about safeguards and more restrictive policy when something bad happens.
 
kyleb said:
Any idea why the change?

FAA thinks AME's are passing candidates without testing them?
Numerous accidents/incidents driven by undiagnosed color blindness?
Someone in the FAA's brother-in-law owns the franchise for the testing equipment?
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They are. As an AME I routinely find class I long term big league pilots that have had problems or genetic conditions that have been present for a long time and never documented. At this time the FAA is 22,000 charts behind in reviews ( last yr it was 25,000) and it can now take an easy 6 to 8 months before a deferred medical is approved. I do not like the idea of having to spend more money on equip when if we use what we have properly it would or should not be needed. But it is what it is. Years ago I never deferred pilots - there was no need to, now everyone comes in with problems that we can not issue.
 
BillTIZ said:
Interesting, at every medical renewal, active duty and civilian, I've had to go through the flip charts for color blind tests. Old faded charts, every type of lighting imaginable, and always passed. Sometimes they tried to trick me, that's a duck, not a number.
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Me too. But there's a spectrum.
 
The normal consequence of breaking the law?

When they refuse to follow THEIR OWN rules, like not issuing when FARs are complied with. When using “discretion” in violation of the federal register. Most jobs have consequences for doing this sort of stuff, they seem not to have them.

These violations cost careers, untold amount of lost income, and all sorts of intangibles.

And this doesn’t even approach just doing poorly, and simply blaming on being understaffed…. we’ll let that slide for the more obvious stuff.
 
Tools said:
The normal consequence of breaking the law?
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Report Fraud Hotline | DOT OIG

Report Fraud, Waste & Abuse The Office of Inspector General (OIG) maintains a Hotline for receiving allegations of fraud, waste, abuse, or mismanagement affecting U.S. Department of Transportation (DOT) programs or operations. Allegations may be reported 24 hours a day, seven days a week by DOT...
www.oig.dot.gov www.oig.dot.gov

If you have any evidence of what you claim, I encourage you to submit it. Help to make the change you believe is necessary.
 
I do. And I’ve tried other venues, will try this one. Thanks!
 
Bob Noel said:
there might be better low-hanging fruit to tackle first.
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There is indeed a lot of low hanging fruit.

But elimination of the 3rd class medical is pretty low on the tree. As is holding the FAA to the 15 disqualifying conditions that were instantiated through the rule making process. The hundreds of other reasons they require an SI (looking at you prostate cancer and sleep Apnea) should stop unless they go through the rule making process.
 
Wasn’t the whole apnea panic the fallout from an airline crew falling asleep because of their schedule? It was easier to blame apnea and claim that pilots far and wide are a grave danger if they’re even slightly overweight according to a 1950s insurance company chart.
 
jbarrass said:
There is indeed a lot of low hanging fruit.

But elimination of the 3rd class medical is pretty low on the tree. As is holding the FAA to the 15 disqualifying conditions that were instantiated through the rule making process. The hundreds of other reasons they require an SI (looking at you prostate cancer and sleep Apnea) should stop unless they go through the rule making process.
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Elimination of the third-class medical would have ICAO implications for anyone wishing to fly outside of the USA. Even a close friend and ally like Canada doesn't recognize BasicMed, despite efforts at getting that approved. It's never as simple as it seems.

For SI conditions, I encourage you to look the USAF Aeromedical Waiver Guide. I reference that one because while it is obviously USAF-focused, it includes some very nice discussion on the aeromedical implications of various conditions, along with appropriate references. Sleep Apnea--one of the conditions you cite--is discussed beginning on page 847. A pertinent excerpt:

"Various neuropsychologic deficits are associated with OSA, mainly in the areas of memory, attention, and executive tasks that require planning, shifting or constructive abilities. Individuals with OSA have decreased ability to initiate new mental processes and to inhibit automatic ones, in conjunction with a tendency for preservative errors. They are also affected with deficits of verbal and visual learning abilities and reduced memory spans. Neurocognitive deficits vary considerably from one individual to another. In the ACS experience, impairment is very rare with mild to moderate OSA, but is more common with severe sleep-disordered breathing. Depressive symptoms are common in OSA, with prevalence as high as 24-45%."

Let's put you in charge and get rid of OSA as an SI condition as you suggest. A mishap occurs in which the PIC has OSA. The families of the deceased sue, with their lawyers referencing the above. The questions are how you determined whether he was adequately treated, that he was safe to fly, and how you fulfilled your mandate as Federal Air Surgeon to ensure that all pilots are aeromedically fit to fly. Please remember to preface all of your responses with "Your Honor" or "Senator".

There is no way for every single possible medical condition to go through a rule-making process. That's why broad authority for decision-making is delegated to the FAS, and (less broadly) to AMEs via standard protocols.

BasicMed is frankly a shocking development and never could have occurred without Congress pushing it (and ultimately taking responsibility, although I don't think they understood that). It essentially allows most pilots to do all the normal flying they would ever do, without having to face FAA scrutiny more than once. Take the win!

Edit: Link for convenience and reading pleasure.
 
Tools said:
I do. And I’ve tried other venues, will try this one. Thanks!
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Awesome. And I want to be clear that I wasn't trying to be flippant or dismissive. Violations of the law or abuses of power, particularly if they're affecting people's livelihoods, should be aggressively investigated and resolved.
 
AvNavCom said:
Elimination of the third-class medical would have ICAO implications for anyone wishing to fly outside of the USA. Even a close friend and ally like Canada doesn't recognize BasicMed, despite efforts at getting that approved. It's never as simple as it seems.
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Those wishing to fly outside the US could get a class 2. Not an insurmountable thing. But the real need isn't to eliminate class 3; it's to drop the requirement to have an FAA medical prior to getting Basic Med.


AvNavCom said:
Let's put you in charge and get rid of OSA as an SI condition as you suggest. A mishap occurs in which the PIC has OSA. The families of the deceased sue, with their lawyers referencing the above. The questions are how you determined whether he was adequately treated, that he was safe to fly, and how you fulfilled your mandate as Federal Air Surgeon to ensure that all pilots are aeromedically fit to fly. Please remember to preface all of your responses with "Your Honor" or "Senator".
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The same is true for every physician who approves a pilot for Basic Med and I have not yet heard of it being a problem. All the hand-wringing over SIs is mostly bureaucratic butt-covering by people who face zero consequences for the delays and expenses they cause pilots. There's no downside at all for an OKC bureaudoc to deny a medical, to demand more tests, to delay and delay and delay.
 
Half Fast said:
Those wishing to fly outside the US could get a class 2. Not an insurmountable thing. But the real need isn't to eliminate class 3; it's to drop the requirement to have an FAA medical prior to getting Basic Med.




The same is true for every physician who approves a pilot for Basic Med and I have not yet heard of it being a problem. All the hand-wringing over SIs is mostly bureaucratic butt-covering by people who face zero consequences for the delays and expenses they cause pilots. There's no downside at all for an OKC bureaudoc to deny a medical, to demand more tests, to delay and delay and delay.
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Preach! Those are the most salient and critical observations of the irrational and nonsensical approach by the FAA. There are literally tens of thousands of pilots that would not pass the class 3, but are flying under basic med and before the FAA had the chance to screw them. Traditional GPs are signing off on those pilots and history is showing that the basic med pilot is no less safe than the class 3.

The ONLY way to reduce the backlog is to get rid of class 3 or allow AME’s more authority and immunity to issue medicals at their discretion.
 
AvNavCom said:
Elimination of the third-class medical would have ICAO implications...
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I’ve said this as a response for many years here and few know or care about the ICAO aide of the house or that the FAA forced ICAO’s acceptance of the third class medical as ‘conforming’.

I *think* the more elegant solution is to remove the pre-requisite third class medical for BasicMed. That kills off/creates parity for the sport pilot DL medical.

Leave the trigger for an SI in BasicMed though as a ‘nod’ to AMCD.
 
catmandu said:
Hmmm, maybe we should do an X campaign to point DOGE to the FAA Aerospace Medical Certification Division.

And I can't believe I just typed that as a person in their 7th decade.
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Good idea.

The only question is, would a 33% across the board reduction in headcount increase the backlog time by only 33% or would it more than double it?
 
bbchien said:
And it’s not liberalizing in the least:

FAA announced at a grand rounds that eff. 1 Jan, if not everything that the FAA needs to approve the airman is present, they will issue a denial early. No more “please within 60 days send……”. It will be followed with a “for further consideration” letter. This locks the airman’s file for any issuance in the field.

Also after Jan 1, the color dots, & the farnsworth lantern will be gone. Vision screening for new applicants or upgrade applicants will be via a subscription internet service and the only thing we can issue after a fail is 3rd Class not valid for IFR or flight at night”. AMEs will have to pay for these subscriptions and so…the cost of a medical goes up….

This will be published in the AME Guide, at the very end of Dec.

And so it goes…..

B
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Hey Dr. Chien,

I wanted your opinion or feedback if you are able to offer any. I worked with a HIMS AME over the course of almost a year gearing up to submit for a 1st class medical. I had chiari decompression surgery October 23', past adhd diagnosis and a GAD diagnosis from talk therapy. A few other things came up in my medical record that had to be addressed (mild asthma, heart murmur). My HIMS AME and I essentially gathered every medical record possible (he then went through it all), we worked on getting updated imaging for neuro, updated visits with all of my doctors/past therapist, full heart work up, pft test, I did a preemptive HIMS Neuropsych Eval/cogscreen. If it was something that needed to be addressed or would flag a response from the FAA for "more information" we worked on getting it done prior to submitting. We also made sure everything got the 90 day window. If he felt it would need to be addressed he had me do whatever he felt the FAA would ask for.

We did the exam in mid July and since then I've sat under "Transmitted" in Medxpress. Several calls to the FAA with being told it's under review, it's on the physicians desk and the latest from the RFS, is my file is on several physicians desk (due to the different things needing review) and the reason for not updating in the system is since no correspondence has been made to me. Also RFS said the backlog is very high right now. I knew this going in that I would be waiting awhile.

I lost my AME recently due to retiring. Found a new one, but they aren't going to show as my new AME until a new exam is done. The RFS said do not do a new exam until a decision is made as it will throw out any work I've currently done.

1. If it reaches the 1 year mark, does everything I did go out the window and need to be redone? The neuropsych eval and cogscreen/battery tests alone cost me over $8k. I did very well on the eval and the report was very favorable and addressed all neuro and psych related history.

2. Is it possible no correspondence has been made since I preemptively provided basically all documentation under the sun the FAA may have needed. Granted I know they can always ask for more.

3. Should I contact you directly and pay for a consult to give you a better understanding about my case?
 
Lindberg said:
Then people who can't meet the class 2 vision standards aren't allowed to fly internationally?
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Right. All two people who could fly into Canada with class 3 vision standards but can’t meet class 2 will be stranded in the US.

So for their sake, and the sake of the Canadian economy, let’s keep Class 3, but persuade Congress to drop the Basic Med pre-req.
 
It's clear the intention is to make bold decisions that cut about 1/3 of the spending while increasing personal liberty.

It's not about doing more with less, it's about doing less with less.

Eliminating the 3rd class entirely is a good start with very very minimal risk. Even the FAA has concluded the accident rate due to medical incapacitation using Drivers licenses, BasicMed, or none at all is not statistically significant. Define it as a drivers license medical. (ICAO pilots can make arrangements and should not block the rest of us). There would be an immediate and significant improvement in wait time for the remaining pilots since CAMI now has many less cases to deal with. .

Another goal is to reduce duplication. The rest of DOT has a medical already, replace the 2nd class with a DOT physical. Duplication is not value added.

The 1st class medical has legs and given the public reliance on air transport makes some sense. But they should be required to use the rulemaking process to come up with a transparent list of disqualifying conditions. No tax dollars should be spent doing SI on Prostate cancer etc.

Change is hard, but it's time.....
 
jbarrass said:
It's clear the intention is to make bold decisions that cut about 1/3 of the spending while increasing personal liberty.

It's not about doing more with less, it's about doing less with less.

Eliminating the 3rd class entirely is a good start with very very minimal risk. Even the FAA has concluded the accident rate due to medical incapacitation using Drivers licenses, BasicMed, or none at all is not statistically significant. Define it as a drivers license medical. (ICAO pilots can make arrangements and should not block the rest of us). There would be an immediate and significant improvement in wait time for the remaining pilots since CAMI now has many less cases to deal with. .

Another goal is to reduce duplication. The rest of DOT has a medical already, replace the 2nd class with a DOT physical. Duplication is not value added.

The 1st class medical has legs and given the public reliance on air transport makes some sense. But they should be required to use the rulemaking process to come up with a transparent list of disqualifying conditions. No tax dollars should be spent doing SI on Prostate cancer etc.

Change is hard, but it's time.....
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“It’s time” is absolutely right. The data shows it. The FAA is over regulating the not for hire GA population via the class 3. Let pilots’ Drs. handle the load of existing class 3 and basic med and AMEs handle 2 and 1. This is a total no brainer.
 
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