Subdural hematoma: physician obligated to inform FAA when patient is a pilot?

Unregistered said:
We got derailed over my wording "I still have 2 years on my medical"... and Doc Bruce correctly pointed out that I don't have a valid medical right now anyway. That's when he jumped the shark IMO and didn't try to understand my question. I *know* I can't use this medical but I was asking about what happens if I'm ready to apply for recertification before my next 3rd class date. Two cases: with the old medical still on the books, and after it no longer exists. What happens to my schedule of 3rd class exams if I surrender my medical?

Yes I know that's a hell of a risk for a possible convenience advantage (not having to see my AME first to get recertified) and I will probably end up cancelling my medical anyway - but I would like to know if there is ANY advantage to keeping it, especially since at this point I don't know how the initial interaction with my lawyer is going to play out. Surrender may prove unnecessary, and there is still time. It doesn't take more than a few minutes to surrender my cert from a nurses station.

Please, those of you telling me to "take a deep breath" and "leave emotions out of it" - tell me where have I been illogical about this? I think I'm pretty well on top of the risks and am leaving myself solid outs. The only place I see where emotion might be coloring my decisions is not wanting to engage Dr. Bruce any more about this. Even so, I don't think productive conversation is possible as he refuses to engage with my questions.
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That was me telling you to take a deep breath. I don't think you are being illogical at all. I do think you are POd at the doc's comment that you may not be all there and I'm trying to tell you that the comment coming from a doctor should not be taken as an insult. You need to get over it.

As for the Doc, from what I've seen of him he will help you and does not hold grudges on this stuff. He gave you specific instructions to follow and a compelling case as to why he is correct.

In my mind, were I you, I probably wouldn't like it either, but I would do what he says because it makes sense.

As far as your medical timing I don't see how it matters. You turn it in then you reset. You are talking about $100 for another exam..... sounds like that is small change compared to the other tests that you are going to need, hopefully those are covered by insurance.
 
PaulS said:
That was me telling you to take a deep breath. I don't think you are being illogical at all. I do think you are POd at the doc's comment that you may not be all there and I'm trying to tell you that the comment coming from a doctor should not be taken as an insult. You need to get over it.
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I'm already "over it", but am not inclined to talk to Doc Bruce again about this, even if I end up taking his advice.
As far as your medical timing I don't see how it matters. You turn it in then you reset. You are talking about $100 for another exam..... sounds like that is small change compared to the other tests that you are going to need, hopefully those are covered by insurance.
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It's not the money for the exam, it's the availability of difficult case AMEs. As far as I can tell they don't exist out here. There might be one 250 miles away (not sure, that's just the nearest major metropolitan area) but that's still a long way to drive and unless he is really one of the truly good guys, my AME would still be a better choice (since he IS one of the best and he already knows me).
 
You seem to think you can prove up on a special issuance mid-term without an AME. Why do you think you'd need a "difficult case" AME if you choose to start from scratch?
 
Stewartb said:
You seem to think you can prove up on a special issuance mid-term without an AME. Why do you think you'd need a "difficult case" AME if you choose to start from scratch?
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No, WITH THE HELP OF a difficult case AME, even as a mid-term SI. As I think in your case, the mid-term SI doesn't generally require physically visiting the AME, if the AME is well-connected online. I've gotten that kind of mid-term SI using my current AME before, as well. But I wouldn't even think of undertaking this without a difficult case AME, whether mid-term or via a fresh application.
 
In my case I gathered all the required tests and records and dealt directly with my RFS. The tests and records are from my specialists and we went over the FAA requirements together to assemble the file. I never talked to an AME at all.
 
I think you are getting a little ahead of yourself here. First of all, you medical is invalid even though you still possess that piece of paper, so the piece of paper doesn't really matter. You may find it hard to part with, but that looks like your safest option if you want to preserve SP choice in case the bozo doctor goes ahead with notifying the FAA and the FAA decides to act.

Since you have not consulted with an AME yet, except for Dr. Bruce on the RB, you don't know what will be necessary in order to get your medical back. It could be that you would need to be seen by an AME even if you don't turn in your medical. It could be that your condition requires a long wait period. The FAA takes brain surgery (even near-brain surgery) seriously. You won't know these things until you consult with an AME. Of course, this also depends on how you recover. So good luck with your recovery. It sucks that this doctor has given you some extra stress that you don't need right now.
 
Unregistered said:
I'm already "over it", but am not inclined to talk to Doc Bruce again about this, even if I end up taking his advice.

It's not the money for the exam, it's the availability of difficult case AMEs. As far as I can tell they don't exist out here. There might be one 250 miles away (not sure, that's just the nearest major metropolitan area) but that's still a long way to drive and unless he is really one of the truly good guys, my AME would still be a better choice (since he IS one of the best and he already knows me).
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No offense intended, but I consider a long drive or a short commercial flight to be kinda trivial things to be worrying about in the context of your overall situation, considering both the good parts (like the fact that you're still alive and cognizant of the world around you) and the bad (like the months of difficult rehab that you face).

I mean, really, in the big scheme of things, is a long drive really that bad a thing? Hell, it may do you some good if it goes through some nice countryside.

I'm no longer an AOPA member and therefore can't read the thread on the RB, but from others here have said, I'd also lean toward surrendering your medical and mooting the whole issue. It's useless paper at the moment anyway. It also preserves SP for you with nothing more required than a talk with your doc about it, and the process of getting the medical back would involve nothing more than the long ride to the AME (in addition to whatever tests would be required in any case).

Try putting that long drive or short flight into perspective in the totality of your situation, and see if it changes anything in your thinking. That's my advice, and it's worth every penny you paid for it.

Get well soon.

Rich
 
One of the best and hardest working doctors in the AME biz is telling you the straight truth about what provides the highest likelihood of getting back into the air once you're healed and have a solid neurocog eval. Yet you're getting stubborn over hurt internet feelings.

Did you not catch the part that he has helped 50-ish pilots recover from the same issue you have after they suffered parachute and motor vehicle accidents?

Yet you continue to argue over keeping in your possession a the physical representation of your flying privileges, creating the jeopardy of losing them, when the simple act of sending in that bit of paper/plastic will preserve those privileges.



OP, you are really starting to sound like a toddler sitting in a poopy diaper. “Yeah, I know it smells bad, but it’s warm and it’s mine. I’m just gonna sit here.”

When one of the top five AME's tells you to "Get up outta the mess!" and how to do it, then Get up outta the mess!

-------------------------------------------------------

If you're not going to listen to him, and just remain with your stubborn 4-year old because of the way Doc Bruce communicated his message, then I'll sign off of this thread with...

Bless your ever loving little heart
 
Everskyward said:
Since you have not consulted with an AME yet, except for Dr. Bruce on the RB, you don't know what will be necessary in order to get your medical back. It could be that you would need to be seen by an AME even if you don't turn in your medical. It could be that your condition requires a long wait period.
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One item Doc Bruce is saying will be required is the full blow neurocog eval. And the long timers here know how intense and expensive that is, and even then, it's not a "100% pass and guaranteed return to flying status".

Doc Bruce also said that of the airmen he has helped through this, doing the neurocog after 12 months is a waste of time and money. Doing the eval at 24 months has a much higher chance at success. So his long wait period is that long, if not a bit more.
 
AggieMike, save the "tough love" tactics for someone who really needs them. I'm not arguing ANYTHING. I'm trying to get INFORMATION. Have you read the entire thread? I've said at least a couple of times that I'm leaning towards surrendering my medical as Doc Bruce advises, but I'm also inclined to wait a couple of days to see if the letter from my lawyer does any good.

Rich, you raise a good point. Maybe I shouldn't worry about the drive in the scheme of things. But I really, really hate long road trips and, depending on the car, often find them physically painful. The less I say about how much I hate the TSA the better, but the aluminum tube would be the better option vs a 500+ mile road trip.

One point that I haven't brought up but is in the back of my mind is whether the FAA's revocation would be limited to medical certificate anyway. Remember that the rehab director is talking about reporting me (implicitly or explicitly) as a rogue pilot with access to an airplane. What if they do an emergency revocation of my pilot certificate? Even if they don't, does the rehab director's impression of me as a "serious threat" go into my file at OKC once the medical certificate no longer exists?
 
Sorry, but you keep pushing back on any sensible advice. So you are argumentative. And this thread is turning into troll territory. Poopy diaper quote applies and you've alienated another possible ally.

Thread set ignore. Becoming too troll like.
 
Unregistered said:
. . . .

One point that I haven't brought up but is in the back of my mind is whether the FAA's revocation would be limited to medical certificate anyway. Remember that the rehab director is talking about reporting me (implicitly or explicitly) as a rogue pilot with access to an airplane. What if they do an emergency revocation of my pilot certificate? Even if they don't, does the rehab director's impression of me as a "serious threat" go into my file at OKC once the medical certificate no longer exists?
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That's probably a better question for your lawyer. I'd ask the lawyer if it might make sense to provide a reason for voluntary cancellation of your medical if that's the way you decide to go. (You're not required to provide a reason, by the way.) The reason would be simply that you are self-grounding pending recovery from your condition, which you anticipate will take between six and 24 months.

I think that would temper any emergency revocation considerations. If the record is already in your file, and the doctor makes his report, I think they'd just shrug and file it. You already will have grounded yourself. There would be no emergency, hence no need for emergency action.

I'd check with the lawyer first, though.

Rich
 
Unregistered said:
...Even if they don't, does the rehab director's impression of me as a "serious threat" go into my file at OKC once the medical certificate no longer exists?
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I asked on the RB, and got this answer: It gets filed. But since there is no cert and no application for a cert, there is nothing to do and there is no action taken.

It just takes up electrons.
 
Unregistered said:
...Yes... IF he acts, which he has already said he will not do until I go home. So there is time still to examine all courses of action and their consequences, and that's what I'm doing.

If the rehab guy complies with the letter from my lawyer (and I can afford to follow through, still not clear), none of this is necessary. Otherwise, if he remains intransigent, or if it's going to cost me an arm and a leg just to get the letter, I'm strongly considering faxing my certificate to OKC marked VOID. According to Dr. Bruce that is as good as mailing in my certificate, and it's the quickest way to get the job done (avoids the PO slowness in this part of the country)...
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While Bruce did suggest the fax as an alternative, I got the impression that he thought sending in the physical certificate would provide a higher degree of certainty that it would be accepted.

I also noticed that he said it could take the FAA as long as seven business days to process the return of the certificate. You have indicated that you were scheduled to go home at the end of next week, which is seven business days from today, so if it were me, I would be sending the physical certificate in today, by the fastest means available. Wanting to preserve the sport pilot option, I would not want to gamble.

I would also not consider the slim hope of avoiding a 500 mile trip to get recertified as justifying the risk. He quoted the FAA's certification manual, which says that it typically takes two years to recertify after a subdural hematomal, and since you only have two years left on your current certificate, it doesn't sound like there's anything significant to be gained by holding onto it.
 
Well I've had a major setback. My lawyer isn't my lawyer anymore. Conflict of interest for the firm: turns out one of the other partners has a lawyer-client relationship with the rehab agency director.

He recommended an alternative counselor, who I contacted this afternoon by voicemail (still no call back). But this guy has ZERO experience with aviation law, and I don't know how much experience he has with the case the agency's lawyers are basing their position on.

For sure it's going to take him time to get up to speed on the case, and if Palmpilot's impression is correct, I no longer have time to delay. I'll have to trust a colleague to mail my certificate in to OKC, probably this Friday. I'm thinking I should probably do the faxed void cert image thing first, just to claim the initiative on this, but I'm not sure whether that really gains me anything.

Damn. It's always something. :(
 
Matthew said:
I asked on the RB, and got this answer: It gets filed. But since there is no cert and no application for a cert, there is nothing to do and there is no action taken.
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Yes, but what happens when an application for a cert appears in the system?
 
Unregistered said:
Yes, but what happens when an application for a cert appears in the system?
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(My non-AME guess, based on Do Chein's responses)

The same thing that would always happen - you get a letter from FAA that tells you what you need to do in order to get recertified.

You'll just have a letter in your file that says, "This guy is a menace to society", and it comes in when you don't have a certificate for FAA to do anything about. Your recertification letter from FAA tells you what you need to do to prove to them that you are no longer a menace to society, and it's the same thing you have to do whether that note is in your file or not.
 
It gets worse. :(

I'm being transferred to the main hospital for tests related to a possible surgery complication. So I'm leaving my certificate with the rehab center's security and have emailed instructions to my colleague. This is exactly the way I did NOT want to do it, but there doesn't seem to be any alternative.

Wish me luck everyone, this will probably be my last post for a while.
 
Unregistered said:
It gets worse. :(

I'm being transferred to the main hospital for tests related to a possible surgery complication. So I'm leaving my certificate with the rehab center's security and have emailed instructions to my colleague. This is exactly the way I did NOT want to do it, but there doesn't seem to be any alternative.

Wish me luck everyone, this will probably be my last post for a while.
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Hang in there, hopefully it is nothing. I'll say a prayer for you.
 
Good luck on your recovery. Hope this new issue is nothing serious.
 
Just catching this thread. Hoping your new issue isn't too serious and you are recovered and back with us soon.
 
I strongly suspect that there are not more than three or four lawyers in the country who know more about how the FAA handles medical issues than Dr. Bruce and other experienced Senior AMEs.

What Dr Bruce will charge you for expert advice is a small fraction of what even a mediocre lawyer will charge to give you bad advice.

Send Dr. Bruce an email, tell him you want to pay him for his advice, and then do what he tells you.

This is not an issue a lawyer can help with.
 
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But it appears the OP received that advice and rejected it. I don't understand his resistance. His medical was invalidated by his health issue, and he will not be eleigible for reinstatement until after it would have expired anyway.

The preemptive move of turning in his medical has no downside, and being at the mercy of the rehab facility's doctors and lawyers has every possibility of an extremely negative outcome.

Using the excuse of not wanting to drive or fly to his AME's office is odd to say the least.
 
Unregistered said:
It gets worse. :(

I'm being transferred to the main hospital for tests related to a possible surgery complication. So I'm leaving my certificate with the rehab center's security and have emailed instructions to my colleague. This is exactly the way I did NOT want to do it, but there doesn't seem to be any alternative.

Wish me luck everyone, this will probably be my last post for a while.
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3393RP said:
But it appears the OP received that advice and rejected it. I don't understand his resistance. His medical was invalidated by his health issue, and he will not be eleigible for reinstatement until after it would have expired anyway.

The preemptive move of turning in his medical has no downside, and being at the mercy of the rehab facility's doctors and lawyers has every possibility of an extremely negative outcome.

Using the excuse of not wanting to drive or fly to his AME's office is odd to say the least.
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Actually, I think he did take the advice. I hope he is ok, I don't think he's posted in a couple days.
 
3393RP said:
But it appears the OP received that advice and rejected it. I don't understand his resistance. His medical was invalidated by his health issue, and he will not be eleigible for reinstatement until after it would have expired anyway.

The preemptive move of turning in his medical has no downside, and being at the mercy of the rehab facility's doctors and lawyers has every possibility of an extremely negative outcome.

Using the excuse of not wanting to drive or fly to his AME's office is odd to say the least.
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I'd defy the rehab guy on the principle of the matter at this point. As I've stated before, if you really wanted to give rehab director a hard time over this, you could.... Blatant willful negligence is inexcusable from a medical professional who should know better.
 
Doggtyred said:
I'd defy the rehab guy on the principle of the matter at this point. As I've stated before, if you really wanted to give rehab director a hard time over this, you could.... Blatant willful negligence is inexcusable from a medical professional who should know better.
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I think you missed that the doctor was acting at the direction of the rehab center's lawyers, and it appears they are going to follow through with their threats to 'expose' the OP. He isn't going to win the battle.

While the OP made the appearance of capitulation by saying he was going to have his "colleague" send his medical to OKC, I doubt that happened just by the vibe of things.

Just a weird deal all around.
 
I didn't miss the fact that the doctor/director has errant and ineffective counsel. The OP's privacy might be violated, but there most certainly is satisfaction to be gained by him in the end if he chooses. He should have called this asshats bluff and followed through when able.

Surrendering the medical is moot, because its invalid anyways, and he's got no apparent stated intention to fly with this invalid medical. That does not render moot the fact that his medical information is private, and it is not permitted to be disclosed in the manner the director intended to. Thats actionable. In many forums.

At the bare minimum this could result in disciplinary action against the doc, by his state board, which goes in the national provider database and follows him forever. One minor entry there is a hiccup.. two... a trend.. three is a pattern.
 
Doggtyred said:
I didn't miss the fact that the doctor/director has errant and ineffective counsel. The OP's privacy might be violated, but there most certainly is satisfaction to be gained by him in the end if he chooses. He should have called this asshats bluff and followed through when able.

Surrendering the medical is moot, because its invalid anyways, and he's got no apparent stated intention to fly with this invalid medical. That does not render moot the fact that his medical information is private, and it is not permitted to be disclosed in the manner the director intended to. Thats actionable. In many forums.

At the bare minimum this could result in disciplinary action against the doc, by his state board, which goes in the national provider database and follows him forever. One minor entry there is a hiccup.. two... a trend.. three is a pattern.
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So... if OP plays his cards right, maybe he can get a new airplane out of the deal?

Rich
 
I think the OP could approach this at least two different ways; concentrating on recovery and forgetting about the medical for awhile (that would be me), or perhaps the OP would benefit by having something to focus on by fighting the doctor/lawyers. :dunno:

In any case, the approach the OP takes is up to him or herself.
 
I hope this works out for the OP. Scary medical issue. Good luck, we're thinking of you.
 
3393RP said:
I think you missed that the doctor was acting at the direction of the rehab center's lawyers, and it appears they are going to follow through with their threats to 'expose' the OP. He isn't going to win the battle.

While the OP made the appearance of capitulation by saying he was going to have his "colleague" send his medical to OKC, I doubt that happened just by the vibe of things.
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OP here. It happened. I have the certified return receipt in hand to prove it.

The complication turned out to be an infection at the surgical site. They opened it up, irrigated the infected parts, and started me on a 4-6 week course of IV antibiotics. They also removed a "bone flap" (part of the skull bone) and as a result, I have to spend most of my time lying completely flat to avoid something called "syndrome of the trephined". I was in the hospital for 2 weeks and am now back in rehab (a different rehab facility than before). After another 2-4 weeks I will be back in the hospital to have a prosthetic bone flap put in, then hopefully my ordeal will be over.

Thanks to everyone for the concern and well-wishes.
 
Good luck with the recovery, OP. Glad to see you are well enough to be posting again.
 
Unregistered said:
OP here. It happened. I have the certified wreturn receipt in hand to prove it.

The complication turned out to be an infection at the surgical site. They opened it up, irrigated the infected parts, and started me on a 4-6 week course of IV antibiotics. They also removed a "bone flap" (part of the skull bone) and as a result, I have to spend most of my time lying completely flat to avoid something called "syndrome of the trephined". I was in the hospital for 2 weeks and am now back in rehab (a different rehab facility than before). After another 2-4 weeks I will be back in the hospital to have a prosthetic bone flap put in, then hopefully my ordeal will be over.

Thanks to everyone for the concern and well-wishes.
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Wow, great to hear from you and that you are doing well. We were concerned, get better.
 
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