Caution! Long and detailed! No apology given. It can't be addressed in any lesser of a post....
Now, with LSA, we have no AME on whom to rely, just the individual and his doctor. Since the FAS has already said in writing what the standard is (that the individual and his/her physician decide that the otherwise-disqualifying condition "would (not) interfere with the safe performance of sport piloting duties,"), if the person's own doc won't agree to say that, I do not see the FAS's standard as being met. In that case, as I see it, for me to permit that person to solo would be the same as allowing someone with no medical to solo a non-LS airplane.
Attaboy, Ron! (feels strange saying that to an O3). Uncharted waters indeed.
Bottom line, is that the individual CFI has to feel comfortable with the condition of the student. The CFI himself is held to a somewhat higher standard as to what it grounding- he is not the "everyman pilot" he is a knowledgable pilot, and is expected to have greater knowledge of part 67 because after all he's had to read it (god I hope so), but he is still no doc.
The strange circumstance is that I being assumedly quite knowledgeable, can't write the FAS statement even if I wanted to. After the accident, I would be hounded by, "He had a condition that you knew was disqualifying under part 67, and you considered him fit for Sport Pilot duties??!!" Whereas, I might be able to mount a scientific defense in some instances (lower airspeeds, altitudes...COPD would be a somewhat defensible one, but COPD is currently a part 67 Third Class SPECIAL ISSUANCE), the cost of such defence would be just prohibitive.
Now consider the generalist, nonpilot family doc. He writes a letter saying, "OK for performance of sport pilot duties". There's a crash. Now he's getting grilled in this manner: "What are you credentials in aviaiton medicine for that statement?" "Are you even a pilot?" "Do you even have ONE semester in Aviation medicine?" "Are you an AME?" So he looks like a horses' patoot and the insuror pays out.
That is why, multiple flight schools teaching LSA students have elected for the "OK to operate a motor vehicle" statement. This is a statement that just about every doc can make, unchallenged- we do it for State DOTs all the time. Since there is no medical standard other than the 50 state drivers' license, which
is the medical standard, "OK to operate a motor vehicle" is the doc stating he meets that standard.
The Federal Air surgeon is a qualified C141 captain. Do you really think he's going to say anything less than "OK for performance of sport pilot duties"?. He's already much more knowledgable than the average student, so he has to say that. He's essentially the country's TOP AME.
Now to the reg itself:
61.53(a): Operations that require a medical certificate. Except as provided for in paragraph (c) of this section, a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person (1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or (2) Is taking medication for a medical condition that results in the person being unable to meet he requirements for the medical certificate necessary for the pilot operation.
Editor: where do you get the information for 61.53(a)2, the requirements? You get it from part 67, which lists the disqualifying conditions. You are held to that list, standard for certificate requiring operations. Of course CFIs, AMEs and PVT ASELs have differing detail understandings of part 67, but the CFI is held to having READ IT, and fifteen conditions are specified.
61.53(b) Operations that do not require a medical certificate. For operations provided for in 61.23(b)of this part
(ed. which is sport pilot), a person shall not act as pilot in command or in any other capacity as a required pilot flight crewmemeber, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.
(ed. Here there is ZERO statement of requirement for the medical certificate because there is no medical certificate involved. This is clearly a different, lower standard)
(c) Operations require a medical certificate or a valid US driver's license: For operations provided for in 61.23(c) a person must meet the provision of--
(1) Paragraph (a) of this section if that person holds a valid medical certificate issued uner part 67 of this chapter and does not hold a current and valid US Driver's license;
(2) Paragraph (b) of this section if that person holds a current and valid State Driver's license.
So clearly there is no applicability of the fifteen conditions stated in part 67, to the SP student. But there will be great discomforture to the CFI who has read part 67 (assumedly) and the student comes up with one of the conditions. That's because the CFI knows better.
Say he's got coronary disease, had an SI, good exercise tolerance but medicare just won't pay for a treadmill every year. Can the CFI evaluate that? Does he have a shadow of a chance of figuring out that Coreg is okay and Nitroglycerin is not?
That is why you have to let the FAMILY DOC write the letter, and he's NOT going to be writing OK for sport pilot duties, the guy has NO experience nor credentials to do so!
Bottom line: The airman has to have the motor vehicle letter AND the CFI has got to be comfortable with his level of knowledge of the Airman's health situation. It's probably better that he limits it to the fifteen part 67 conditions.
You have to have BOTH or you have NO TRAINING.
Since there is no medical branch looking in on you, you'll get pretty uncomfortable with the decisionmaking of the guy with PTSD, and you'll know something is odd and you WON'T sign him off. This is where the CFI is effectively the "Operational Airman Evaluation", and like some many FSDO rides for monocularity, untreated undiagnosed ADD, if the airman can convince the CFI he can do the job, and subsequently the DPE-LSA Examiner, he's good to go.
Ron's sense is correct. They deleted the wing flight surgeon, rather than create a fourth class medical. It was one of many decisions they could have made. "OK to operate a motor vehicle" is all you're going to get.