Special Issuance to Basic Med

[Beat]

What are the specifics on how to transition from SI to Basic Med?

I have a SI and Third Class med.

Do I simply let that expire and then get a Basic Med?

UPDATE: I got my answer. I apologize for asking a question that was already answered many times in these forums.

 

[WannFly]

AOPA Tool for your answers - Fit to Fly Selector Tool - AOPA

 

[Lindberg]

Do I simply let that expire and then get a Basic Med?

Yes.

Do I have to alert my HIMS AME that I am not returning?

No, but you don't want anyone to send anything to the FAA that makes it seem like you're applying for a new medical. So if he does that regularly, you might want to tell him to stop.

 

[Beat]

Yes.No, but you don't want anyone to send anything to the FAA that makes it seem like you're applying for a new medical. So if he does that regularly, you might want to tell him to stop.

Thanks. Seems odd to just no longer show up for these medicals and now I get to stay with my doctor.

 

[Rcmutz]

I recently had my SI renewed for the next 6 years. I have debated going basic med. it is not the cost of the Class 3, but as you said, the yearly paperwork that needs to be filed for my OSA. My challenge is we just moved and I have a new primary care physician, so I need a couple of years to establish a relationship and then see if we will sign the basic med paperwork for me at my annual full physical.

 

[bflynn]

Thanks. Seems odd to just no longer show up for these medicals and now I get to stay with my doctor. I think the AME only acts if I show up. Too busy to do any extra work if it does not get started by a MedXpress form. So, if this gets me away from lifetime monitoring and reporting on the SI, I'm relieved.

What is the SI for and do you have more than an SI?

I've think I've read in the past where someone in HIMS because of an abuse problem has been identified as unqualified to fly, period. Your SI allows you to fly with monitoring. Your medical and your SI can expire, but you are still identified with a lifelong abuse problem and not qualified to fly, something that Basicmed cannot change.

I may have misread that.

 

[bflynn]

Normally, yes.

At some point, you were given a letter that sent you to HIMS. Did that letter identify you as having alcohol abuse? If so, there might be more to this. Letting your medical/SI expire may generate a letter to you stating that as someone with a known abuse problem, you are unqualified to fly (regardless of the medical program).

I think asking is a good step. I'd ask about going to sport pilot, which is a driver's license medical. If you can do that, you can fly under basicmed too.

I'm just trying to be cautious here. Like I said, I have a vague memory of having read that somewhere, but I can't find it.

 

[Ravioli]

@bbchien should know this one

 

[WDD]

I recently had my SI renewed for the next 6 years. I have debated going basic med. it is not the cost of the Class 3, but as you said, the yearly paperwork that needs to be filed for my OSA. My challenge is we just moved and I have a new primary care physician, so I need a couple of years to establish a relationship and then see if we will sign the basic med paperwork for me at my annual full physical.

A relationship with a PCP isn't required. You're not getting married. You could go to a clinic that gives DOT physicals, etc. Any state licensed doctor will work. Actually there have been posts here of PCP's not being familiar with and not wanting to do Basic Med.

 

[Chip Sylverne]

A relationship with a PCP isn't required. You're not getting married. You could go to a clinic that gives DOT physicals, etc. Any state licensed doctor will work. Actually there have been posts here of PCP's not being familiar with and not wanting to do Basic Med.

Unfortunately I'm finding, even with a clean bill of health, that "says" in theory more easily than it "does" in practice. I had one AME tell me only my "regular doctor" can sign. The DOT doc in a boxes locally don't want anything to do with it, and my PCP can't sign because it's against corporate policy. Finally, a couple docs who would have done it 24 months ago won't now because their malpractice liability insurance excludes coverage for it.

I really hope this thing isn't strangled in it's infancy.

 

[Papa Foxtrot]

Maybe I got lucky, but my PCP shrugged his shoulders and said something like, "It's about like a summer camp physical..."

 

[Stewartb]

No reason to let a 3rd class or SI expire before going BasicMed. Get the BasicMed asap and let the standard medical expire quietly.

 

[TCABM]

...the DOT doc in a boxes locally don't want anything to do with it, and my PCP can't sign because it's against corporate policy....

There’s at least two Senior AME’s offering your choice of BasicMed or traditional FC II/II/I locally. Neither requires they be your primary care doc.

TeamCME is one nationwide doc-in-box specifically targeting BasicMed fliers. You can find their locations offering this service here: https://teamcme.com/find-faa-basicmed-examiner/.

 

[ThatOtherGuy]

Normally, yes.

At some point, you were given a letter that sent you to HIMS. Did that letter identify you as having alcohol abuse? If so, there might be more to this. Letting your medical/SI expire may generate a letter to you stating that as someone with a known abuse problem, you are unqualified to fly (regardless of the medical program).

I think asking is a good step. I'd ask about going to sport pilot, which is a driver's license medical. If you can do that, you can fly under basicmed too.

I'm just trying to be cautious here. Like I said, I have a vague memory of having read that somewhere, but I can't find it.

Substance dependence and substance abuse are distinct well defined disqualifying conditions referenced in CFR part 67. The terms are not interchangeable. Substance dependence is a lifelong diagnosis. Substance abuse is not a lifelong diagnosis, although someone who doesn't get the hint has a high likelihood of graduating to dependence.

The only manner in which BasicMed addresses substance abuse is indirectly through the self certifying and prohibition against flying with a disqualifying condition clauses. Abuse is not specifically called out, but if the airman is abusing substances as defined by 14 CFR 67.307 they have a disqualifying condition and shouldn't be flying under any class medical or BasicMed. If evidence could be produced to prove the abuse and that the airman operated, the FAA could make a case for some type of enforcement action against the airman's medical certificate and/or airman certificates.

BasicMed does specifically call out substance dependence within the last 2 years as disqualifying in 14 CFR 68.9(a)(1)(iv). The problem is when does the 2 year clock start if dependence is a lifelong diagnosis? I'm not aware of any clear current guidance on this. The waters get muddy because most medical professionals believe that simple abstinence from a substance is not the same as recovery. The most simple interpretation is you put down the bottle for 2 years and you're good, but there's not a lot of case law on this.

An airman that obtains a 1 time special issuance for substance dependence and allows their medical to lapse is eligible to fly under BasicMed. The expiration of their special issuance letter has no impact on their BasicMed eligibility. Substance dependent airmen must continue to abstain from mood altering substances. If the airman relapses, they now have a disqualifying condition again.

If the airman develops any of the other disqualifying conditions listed in 14 CFR 68.9 they must obtain additional SIs for those conditions. The gotcha is that to obtain the SI for the new condition they must prove they're entirely medically qualified. That means their substance dependence diagnosis will be evaluated and they'll have to establish that they've remained abstinent and their recovery is still stable since their last evaluation.

I've heard talk of "Don't go flying if you've got a disqualifying condition" letters as a result of DUIs reported or located through the NDR check tied to BasicMed. I don't have first hand experience with this, but it seems totally probable. They can also request additional info per 14 CFR 68.11 and could determine an airman ineligible for BasicMed as a result of the information provided. Ultimately "the administrator" has the final say and could send you a letter/take action for any reason that was determined to be in the public interest or the safety of air transportation.

 

[Chip Sylverne]

There’s at least two Senior AME’s offering your choice of BasicMed or traditional FC II/II/I locally. Neither requires they be your primary care doc.

TeamCME is one nationwide doc-in-box specifically targeting BasicMed fliers. You can find their locations offering this service here: https://teamcme.com/find-faa-basicmed-examiner/.

Where's locally? The nearest Team CME to me is 150nm.

 

[TCABM]

Where's locally? The nearest Team CME to me is 150nm.

I’m in the SAT area; there’s an AME at AUS offering BasicMed and another one seven miles from my house. For me, the nearest CME location is about the same distance though.

It took me about a week of searching and phone calls to find that info. My PCM is at a .mil facility and is prohibited by policy from doing BasicMed and it’s just a giant pain in the junk just to coax him into filling out the hypothyroidism CACI needed for my FC III.

My options right now are to either stop flying or do BasicMed. The SAT AME charges $200 for BasicMed, the AUS guy is slightly higher, and the TeamCME doc is $99. I’m scheduled with the SAt AME for BasicMed on 2 Mar and will let that carry me through for the time being, since I won’t need a FC III or II for the next two to three years (insurance policy won’t let me take the plane out of CONUS).

 

[bflynn]

The only manner in which BasicMed addresses substance abuse ...

my comments are not about basicmed, which is a topic I know well.

the issue I’m trying to remember is not related to any medical, it is a declaration by the FAA that a pilot is not qualified because of abuse problems...or, as you’ve corrected, dependency problems. If you are in hims because you are not qualified to fly period, then you cannot go basicmed either.

I don’t even know that it’s a problem, but I do know I read it. Therefore, my advice is to ask before bailing out of the regular medical system.

 

[WDD]

Does anyone know of a situation where someone went basic med and the FAA said you weren’t eligible for B Med? That could add to - help the discussion.

 

[ThatOtherGuy]

my comments are not about basicmed, which is a topic I know well.

...

If you are in hims because you are not qualified to fly period, then you cannot go basicmed either.

This is inaccurate.

HIMS is a program enacted by policy of AMCD not by regulation. There isn't a reference to the HIMS program anywhere in 14 CFR 67 or 68.

BasicMed has been enacted by regulation which trumps policy. It's very clear that an airman diagnosed with substance dependence within the last 2 years "...must have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate..." (14 CFR 68.9(a)) before they can operate under BasicMed. Once they get an SI for any of the conditions listed in 68.9 they're good to go under BasicMed so long as they meet all of the other requirements (CMEC, education course, no revoked/suspended medical certificates, no revoked drivers license etc...)

Airmen in HIMS that have been issued a special issuance ARE qualified to fly the same as any other pilot on a special issuance. They just have to comply with the terms of their SI while they hold a valid medical. The road to getting an SI for substance dependence may be different, but once the pilot has the SI it's just like any other SI issued condition. There are specific limits placed on the airman and a protocol to insure those restrictions are met.

HIMS airmen are actually granted MORE privileges under their SI issued medicals than what they get with BasicMed. BasicMed is a downgrade from privileges they already hold. Once their medical certificate expires they're not beholden to the specific terms of their SI letter, even if that letter hasn't expired. They must remain abstinent because not doing so causes them to have re-established a disqualifying condition, not because of anything in their SI letter. Again, no different than any other SI holder's mandate not to fly with a disqualifying condition.

 

[Lindberg]

the issue I’m trying to remember is not related to any medical, it is a declaration by the FAA that a pilot is not qualified because of abuse problems...or, as you’ve corrected, dependency problems.

You can never legally operate an aircraft if you know or have reason to know of any medical condition that makes you unable to safely operate an aircraft. The FAA won't issue you a medical if you have such a contrition, SI or not. The purpose of the SI is to demonstrate you don't have such a condition.

 

[bbchien]

If you have a HIMS AME sponsored SI, you have to serve out the terms of that SI until the end of the "not valid for any class after ___/__/____" date. Then you are free to do Basic. Just don't try coming back....you'll have to demonstrate continuous compliance with the terms of that HIMS SI, or start at the very beginning, again.

 

[WDD]

Does your insurance need 3rd class or will B Med suffice?

 

[Beat]

Does your insurance need 3rd class or will B Med suffice?

Interesting question. I had not thought of that.

With the time and money required to fulfill the FAA's SI, I have not had the ability to fly in two years, even though I have earned and retained my medical. Just doing all I can to jump when they say jump. Are there insurance limitations to having Basic Med? Would Basic Med deny me as a renter of a 172 or Cirrus? Or as an aircraft owner if I ever choose to own again? If I were to ever renew my CFII?

I'd hate to finally have the time and money again to fly, but then be denied by insurance. I had assumed that with so many on Basic Med.

What do you know about Basic Med and insurance limitations?

 

[WDD]

I know nothing - but others here are much smarter than I am.

 

[PaulMillner]

I really hope this thing isn't strangled in it's infancy.

Not likely! There's many thousands of us using it successfully...
I don't see where you've told us your location, but if you're in Frederick County, MD it shouldn't be a challenge... don't you know any other pilots locally? Can you call AOPA?

Paul

 

[PaulMillner]

What do you know about Basic Med and insurance limitations?

The only limitations I've seen have been for pilots over 80... in some cases, carriers are requiring 3rd class medicals every year. YMMV. Work it out with your broker...

 

[jbarrass]

I have insurance and basicmed. it was not a thing at all.

 

[Cliff]

What are the specifics on how to transition from SI to Basic Med?

I have a SI and Third Class med.

Do I simply let that expire and then get a Basic Med?

UPDATE: I got my answer. I apologize for asking a question that was already answered many times in these forums.

What's the answer because I currently have a special issuance that is valid through 2025, but I'm concerned that if I stop doing all the requirements of the special issuance, that will be reported to the FAA which would then affect my last medical which then means I don't qualify to fly under basicmed.

 

[DGlaeser]

You are the only one who ‘reports to the FAA’
I used to have to do yearly testing (heart related) - my 3rd class was only good for 1year. My cardiologist said it was not needed, but the FAA said it was…
I did my basic med exam with my doctor, and the online AOPA test before my 3rd class expired, and then my basic med took over when it did expire. That was 4 years ago. You need to take the online test every 2 years and another doctor exam every 4 years - TO THE DAY - the dr exam is not good to the end of the month!

 

[WDD]

Cliff - when does your 3rd class expire?

 

[bbchien]

You are responsible for all the terms on a special issuance until the date of the expiration of the certificate.

A HIMS AME sponsored issuance (4 pages long) means you have to continue to test and continue to do your AA or group aftercare and testing until the end date. A "sponsored HIMS issuance" has every week requirements (to maintain) and the sponsor has to report you if you do not do them-->conversion to denial.

A non HIMS special issuance- only has requirements to renew (not to maintain). If you have one of them you are free to not renew and go to basic at any time without rear of revocation.

 

[Rcmutz]

Unfortunately I'm finding, even with a clean bill of health, that "says" in theory more easily than it "does" in practice. I had one AME tell me only my "regular doctor" can sign. The DOT doc in a boxes locally don't want anything to do with it, and my PCP can't sign because it's against corporate policy. Finally, a couple docs who would have done it 24 months ago won't now because their malpractice liability insurance excludes coverage for it.

I really hope this thing isn't strangled in it's infancy.

That is my concern. If I let my SI and 3rd class expire after going Basic Med, and then have to go back to 3rd class because my Dr.’s group says he can’t do Basic Med anymore, I’m screwed! I’ll have to be back through the entire SI issuance process again, and probably another sleep study, even though I am staying on CPAP.

 

[WDD]

Why would you go back to basic med because one doctor doesn’t want to do basic med exams? A lot of people go to clinics that do class c driver license exams, etc. Any state licensed doctor can do basic med.

 

[Rcmutz]

Why would you go back to basic med because one doctor doesn’t want to do basic med exams? A lot of people go to clinics that do class c driver license exams, etc. Any state licensed doctor can do basic med.

Agree, but when the doc sticks his finger up your butt, I’d like it to be one I know! LOL

 

[Half Fast]

......and then have to go back to 3rd class because my Dr.’s group says he can’t do Basic Med anymore, I’m screwed! I’ll have to be back through the entire SI issuance process again, and probably another sleep study, even though I am staying on CPAP.

I am pretty sure that somewhere in the US you could find at least one doctor who would be willing to do a Basic Med exam. Tens of thousands of pilots have managed it.