Where Do I Begin?! Special issuance

[Boomer7200]

Hello all,
I have never gotten an AME examination before and am in need of one in the next year.
I had a procedure 3 years ago that will require me to get a special issuance and some cardiac tests done. I have reached out to several AME’s and doctor Bruce and have all confirmed this.
I am wondering what my next steps should be to get a special issuance as I have been advised to not even go to an AME yet. I need the medical as soon as possible, but don’t know where to go from here.

Thank you for the help!

 

[murphey]

Get the list of tests, either get the tests done, or if already completed, get detailed documentation as specified by the AMEs and Dr Bruce. Then when you have everything on paper, got to one of the AMEs for a CONSULTATION to make sure you have all your ducks in a line.

If anything is missing or more info needed, go get it.

Then and only then, go to the AME for the actual exam.

 

[Boomer7200]

Get the list of tests, either get the tests done, or if already completed, get detailed documentation as specified by the AMEs and Dr Bruce. Then when you have everything on paper, got to one of the AMEs for a CONSULTATION to make sure you have all your ducks in a line.

If anything is missing or more info needed, go get it.

Then and only then, go to the AME for the actual exam.

The only thing is that I have gotten mixed responses to what tests I MIGHT need which will be at least a couple thousand. I don't feel like spending thousands of tests I'm not sure what I need to get.

 

[Clip4]

Special issuance as soon as possible vs whats going to happen and how long it will take

 

[AggieMike88]

The only thing is that I have gotten mixed responses to what tests I MIGHT need which will be at least a couple thousand. I don't feel like spending thousands of tests I'm not sure what I need to get.

Then go back to Dr. Bruce for the "official" list instead of muddying the water by talking to other AMEs who lack the multitude of shipping containers full of "been there, did that, and got the airmen certified in the first throw" tee shirts.

Regarding the cost... unfortunately it's a known fact that aviation is hazardous to your wealth.

If a few small thousand to obtain your medical certification is causing you to balk. . . Well, you were prepared to spend $9,000-ish to obtain your pilot certificate, right? Then more AMUs (Aviation Monetary Units, or $1,000) on exercising your newly earned privileges to go on hamburger flights and new cross country destinations.

If flight is what you want, then the dollars spent to get your medical done right the first time is just a wee drop in the big aviation scheme of things.

 

[Boomer7200]

Special issuance as soon as possible vs whats going to happen and how long it will take

As soon as next august is much needed as I am accepted as a flight operations student starting this spring.

 

[Boomer7200]

Then go back to Dr. Bruce for the "official" list instead of muddying the water by talking to other AMEs who lack the multitude of shipping containers full of "been there, did that, and got the airmen certified in the first throw" tee shirts.

Regarding the cost... unfortunately it's a known fact that aviation is hazardous to your wealth.

If a few small thousand to obtain your medical certification is causing you to balk. . . Well, you were prepared to spend $9,000-ish to obtain your pilot certificate, right? Then more AMUs (Aviation Monetary Units, or $1,000) on exercising your newly earned privileges to go on hamburger flights and new cross country destinations.

If flight is what you want, then the dollars spent to get your medical done right the first time is just a wee drop in the big aviation scheme of things.

True, but I am not worried about the flight training cost, I am going for ATP so I know the money will be used wisely. It's the fact of wasting the money on useless tests, but I see what you mean.

 

[AggieMike88]

As soon as next august is much needed as I am accepted as a flight operations student starting this spring.

Spring as in March/April?

If so, ya better get busy, laddie. First time Cardiac SI are doable on the first go when all of the right documentation is provided and formatted so the mid-level minion can process. However, it is not a quick process.

 

[AggieMike88]

True, but I am not worried about the flight training cost, I am going for ATP so I know the money will be used wisely. It's the fact of wasting the money on useless tests, but I see what you mean.

If Dr. Bruce says a certain test is a must to get you squeezed through the SI keyhole and not get you stuff in deferment hell, then how can it be called useless?

 

[murphey]

The only thing is that I have gotten mixed responses to what tests I MIGHT need which will be at least a couple thousand. I don't feel like spending thousands of tests I'm not sure what I need to get.

Don’t spend the money, guaranteed you’ll never get a medical. Guaranteed you’ll never fly.
There are no shortcuts.

Once again, get the specific list of tests from Dr Bruce.
Get pricing on those tests.
Decide if flying is worth it or not.
If not, consider changing majors to Art History.

 

[Boomer7200]

Spring as in March/April?

If so, ya better get busy, laddie. First time Cardiac SI are doable on the first go when all of the right documentation is provided and formatted so the mid-level minion can process. However, it is not a quick process.

I’m aware, I’ve already had a Holtor completed and EKG’s completed in the last year. My condition was harmless as it was just SVT. My doctor put no restrictions on me and I had the procedure to get rid of the annoyance that it wasn’t. I’ve had multiple cardiologist appointments since saying i am perfectly fine. It’s not like I have any heart disease and I’m only 19 and physically active. The need for an echocardiogram as I was suggested seems a bit much as it condition has no affect on the blood flow or heart structure. During the ablations there was a continuous echo and X-rays completed on my heart each time and the surgeon said I am in perfect shape and my SVT was cured.

I am just in disbelief that this could be such an issue seeing that I’ve been checked thoroughly at least 3 times since my procedures 3 years ago, and I never had restrictions at anytime before the procedures. My surgeon said the the procedure wasn’t even needed if I didn’t want it.

 

[Boomer7200]

I found this on aopa and it’s been 3 years since my last ablation and I have had all these tests completed. Also SVT is favorable for an issuance of any class medical. Should I be fine?

 

[murphey]

You’re not paying attention, so please stop arguing. Aggiemike and Dr Bruce have given you the direction you need.
1) Stop being difficult. You’re dealing with the FAA which is not always logical.
2) Get the list of tests as per Dr Bruce.
3) if you’ve already had the tests, then you need written documentation and reports from the doctors. If you hven’t had those tests, now’s the time.
4) are you sure you have everything?
5) good, now make an appt with an AME that is an expert in dealing with these issues. Not every AME is experienced in these complicated medicals that need an SI.
6) Your opinion about this is irrelevant, you’re dealing with the FAA. Get used to it.

 

[Boomer7200]

You’re not paying attention, so please stop arguing. Aggiemike and Dr Bruce have given you the direction you need.
1) Stop being difficult. You’re dealing with the FAA which is not always logical.
2) Get the list of tests as per Dr Bruce.
3) if you’ve already had the tests, then you need written documentation and reports from the doctors. If you hven’t had those tests, now’s the time.
4) are you sure you have everything?
5) good, now make an appt with an AME that is an expert in dealing with these issues. Not every AME is experienced in these complicated medicals that need an SI.
6) Your opinion about this is irrelevant, you’re dealing with the FAA. Get used to it.

Right.. I’m sorry, just frustrated. I’m not used to the strictness of the government I guess. Again, thank you for all your help and advice, it is much appreciated.

 

[Clip4]

Right.. I’m sorry, just frustrated. I’m not used to the strictness of the government I guess. Again, thank you for all your help and advice, it is much appreciated.

You have a history of heart problems and are going “for ATP” which would authorize you to pilot a plane with hundreds of passengers and you don’t understand the strictness of the government. This might not be your profession. You going to be dealing with a lot of strictness throughout your training,

 

[Rushie]

I remember when I was 19 and started finding out about all the tentacles of government meddling in my business. It’s quite a shock. As a kid you imagine once away from mom and dad you will be free. Not so. Cut the kid a break. The best thing he could have done is come here. Now if he will take our advice and do what Bruce sez...

 

[AggieMike88]

@Boomer7200 ... a few things to become aware of

That you will answer yes to the medical history question of cardiac issues sets off all sorts of klaxons, warning bells, sirens, and red flags in the mind of the medical certification branch of the FAA. Because of the way they operate, be it fair or not, the FAA places you at the "he is unfit" end of the spectrum to start. It is on you to supply the required documentation and reports from doctors and laboratories to prove you belong at the "I am okay, situation well managed" end of the spectrum. The FAA rightly has a firm stance on the various debilitating conditions since a sudden overwhelming reoccurrence of the condition while operating an aircraft puts your life and the life of your passengers at severe risk.

Be ready for this SI to have a one year renewal term with a requirement to repeat many if not all of these tests at each resubmission. So each year, well before the month the expiration month, you need to have the time and money to do the tests and gather the reports. But some good news is, if you submit lots of years of "no bad changes", then there is the chance the FAA will reduce how frequent you must submit.

You mention doing some of the tests "in the last year". This has me thinking it was in the first part of 2019 or earlier. Those tests may not be admissible to the FAA due to their concept of recency. They want the examinations and tests to be within the last 90 days. Consult with Dr. Bruce about this, but it is likely the Holter and the EKG you mentioned,a and perhaps other tests, will need to be repeated.

Since you want to be a professional aviator, be sure you fully understand FAR §61.53 and how it applies to you.

 

[lbfjrmd]

At some point you have to pick your Senior AME, consult with him ... and apply!

 

[SoCal 182 Driver]

I am wondering what my next steps should be to get a special issuance as I have been advised to not even go to an AME yet.

Boomer - Hire Dr. Chien or Dr. Fowler. Follow advice TO THE LETTER. Otherwise, you risk stepping on some sort of FAA landmine that will make a difficult situation even more difficult, or impossible. Don't try to navigate these waters yourself.

 

[Boomer7200]

You have a history of heart problems and are going “for ATP” which would authorize you to pilot a plane with hundreds of passengers and you don’t understand the strictness of the government. This might not be your profession. You going to be dealing with a lot of strictness throughout your training,

Thanks for your sarcastic, unneeded comment.

 

[Half Fast]

I am wondering what my next steps should be to get a special issuance as I have been advised to not even go to an AME yet.

Okay, here are your next steps:

Next step #1 - contact either @lbfjrmd (Dr. Lou Fowler) or @bbchien (Dr. Bruce Chien) and ask one of them to handle your case.
Next step #2 - write out a check payable to either Dr. Fowler or Dr. Chien in the amount requested.
ALL REMAINING NEXT STEPS - do exactly what the doctor tells you. This will almost certainly entail visiting other doctors for more tests and writing more checks. It will end with a visit to Dr. Fowler or Dr. Chien to conduct your FAA exam and submit the paperwork. Then you will wait. And wait. And wait.

There is no other way proven to work.

 

[Boomer7200]

@Boomer7200 ... a few things to become aware of

That you will answer yes to the medical history question of cardiac issues sets off all sorts of klaxons, warning bells, sirens, and red flags in the mind of the medical certification branch of the FAA. Because of the way they operate, be it fair or not, the FAA places you at the "he is unfit" end of the spectrum to start. It is on you to supply the required documentation and reports from doctors and laboratories to prove you belong at the "I am okay, situation well managed" end of the spectrum. The FAA rightly has a firm stance on the various debilitating conditions since a sudden overwhelming reoccurrence of the condition while operating an aircraft puts your life and the life of your passengers at severe risk.

Be ready for this SI to have a one year renewal term with a requirement to repeat many if not all of these tests at each resubmission. So each year, well before the month the expiration month, you need to have the time and money to do the tests and gather the reports. But some good news is, if you submit lots of years of "no bad changes", then there is the chance the FAA will reduce how frequent you must submit.

You mention doing some of the tests "in the last year". This has me thinking it was in the first part of 2019 or earlier. Those tests may not be admissible to the FAA due to their concept of recency. They want the examinations and tests to be within the last 90 days. Consult with Dr. Bruce about this, but it is likely the Holter and the EKG you mentioned,a and perhaps other tests, will need to be repeated.

Since you want to be a professional aviator, be sure you fully understand FAR §61.53 and how it applies to you.

I really appreciate this, thank you.

 

[PaulS]

Thanks for your sarcastic, unneeded comment.

There was nothing sarcastic about that comment. It's reality, accept it and do what is asked of you or prepare for lots of disappointment.

 

[murphey]

Thanks for your sarcastic, unneeded comment.

Boomer....we’ve been saying the same thing to you, Clip was merely more specific.

Get over it. If you can’t handle it here, you won’t handle it during rigorous flights, exams and checkrides.

 

[Half Fast]

Boomer....we’ve been saying the same thing to you, Clip was merely more specific.

Get over it. If you can’t handle it here, you won’t handle it during rigorous flights, exams and checkrides.

Not to mention during employment.

 

[Stewartb]

Getting the SI isn't near as big a deal as the uncertainty of your first SI application makes it seem. Go sit down with an AME and make a plan. They'll need records from your cardiologist and they need to be presented correctly. If your cardiologist has other pilots under their care and knows how to play the game? Better yet. You already posted the FAA Aeromedical requirements. That's exactly what you should expect to provide.

That's a pirep as I maintained a cardiac SI for several years. The first one was scary. After that it was a piece of cake.

 

[dbahn]

Boomer....we’ve been saying the same thing to you, Clip was merely more specific.

Get over it. If you can’t handle it here, you won’t handle it during rigorous flights, exams and checkrides.

It's easy to get over what happens here, and most of us have had to do it to some extent.

Getting over a careless pathway to medical certification can be a whole other problem. Once CAMI has you in their tentacles it's hard to get loose. You can do it, but typically it involves a lot more expense than it would have cost to take the advice given here and do it correctly the first time.

 

[Boomer7200]

There was nothing sarcastic about that comment. It's reality, accept it and do what is asked of you or prepare for lots of disappointment.

Getting the SI isn't near as big a deal as the uncertainty of your first SI application makes it seem. Go sit down with an AME and make a plan. They'll need records from your cardiologist and they need to be presented correctly. If your cardiologist has other pilots under their care and knows how to play the game? Better yet. You already posted the FAA Aeromedical requirements. That's exactly what you should expect to provide.

That's a pirep as I maintained a cardiac SI for several years. The first one was scary. After that it was a piece of cake.

Thank you!

 

[Stewartb]

FWIW, when I got my first SI I had a year left on my medical and didn't require a new exam. AOPA helped me understand what was needed ( just like the page you posted), I asked my cardiologist to do the tests required after the waiting period, gathered the records, and turned them in to my RFS with no help from an AME. I had my SI in a week. The RFS office was very helpful. If you're unclear about what they want? Call the RFS's Program Manager and ask. There's nothing to fear. I talked to mine every year at renewal time to make sure my paperwork went through the system smoothly. Its mostly an administrative shuffle.

 

[lbfjrmd]

Okay, here are your next steps:

Next step #1 - contact either @lbfjrmd (Dr. Lou Fowler) or @bbchien (Dr. Bruce Chien) and ask one of them to handle your case.
Next step #2 - write out a check payable to either Dr. Fowler or Dr. Chien in the amount requested.
ALL REMAINING NEXT STEPS - do exactly what the doctor tells you. This will almost certainly entail visiting other doctors for more tests and writing more checks. It will end with a visit to Dr. Fowler or Dr. Chien to conduct your FAA exam and submit the paperwork. Then you will wait. And wait. And wait.

There is no other way proven to work.

I surely appreciate the referrals, but there are many senior AME's not on forums that can handle complicated certifications. And at risk of receiving forum umbrage, I do not necessarily view the FAA as the bogeyman. Then again, I think my approach to these problems has been honed by experience, same which many AMEs across the fruited plains have!

 

[flyingron]

Talk to the docs, but understand this. Unless, this is something the AME can do an AASI on (unlikely), you're not getting a medical by spring. The backlog is nearly six months long at this point.

 

[James331]

You’re dealing with faa “doctors” who have the full power and protections of the federal government, but who the real medical community would likely consider somewhere between out of date to straight quacks.

I’d set your expectations accordingly

 

[Boomer7200]

Thank you for everyone’s help I do appreciate it greatly. Just made an appointment with my primary care doctor and will be getting these tests completed before any AME visit. Going to make sure I bring in everything I can to help my case, as I now understand I can’t cut any corners here. Looks like I’ll be receiving an SI by June/July which is completely fine, as long as I will be able to fly one day!

 

[murphey]

Thank you for everyone’s help I do appreciate it greatly. Just made an appointment with my primary care doctor and will be getting these tests completed before any AME visit. Going to make sure I bring in everything I can to help my case, as I now understand I can’t cut any corners here. Looks like I’ll be receiving an SI by June/July which is completely fine, as long as I will be able to fly one day!

Again....do not go blindly into the AME office. Take all the paperwork and go for a CONSULTATION. If the AME refuses a consult, find another AME. At the consult, have the AME review everything. If the AME finds anything amiss or missing, you have the opportunity to go back to the doctor and remedy the problem(s).

Then and only then, go to the AME for the official medical.

 

[bobmrg]

To emphasize what Murphey said above....do not let the doctor's nurse begin to fill out any kind of FAA form...a consult is just a conversation with no record (and a bill).

 

[SoCal 182 Driver]

Thank you for everyone’s help I do appreciate it greatly. Just made an appointment with my primary care doctor and will be getting these tests completed before any AME visit. Going to make sure I bring in everything I can to help my case, as I now understand I can’t cut any corners here. Looks like I’ll be receiving an SI by June/July which is completely fine, as long as I will be able to fly one day!

Boomer...before doing any tests, which then become a part of your permanent record, I strongly urge you to retain Dr. Chien or Dr. Fowler to guide you through the process. A wrong test, or even a stray comment by a doc in your records, could derail you. You need to listen to the good advice that you're getting here. Don't go rogue. Hire an expert before doing anything else, and follow their advice to the letter.

 

[Stewartb]

All the AME does is submit the cardiologist's records. Don't get too intimidated by all this advice. Your cardiology records are the key, and odds are that one of the docs in your cardiology clinic is experienced with pilot stuff.

 

[murphey]

I surely appreciate the referrals, but there are many senior AME's not on forums that can handle complicated certifications. And at risk of receiving forum umbrage, I do not necessarily view the FAA as the bogeyman. Then again, I think my approach to these problems has been honed by experience, same which many AMEs across the fruited plains have!

Very true, but the two of you are the only Senior/Super/Wonderful AMEs most of us know. There's one in Boulder, CO but he's stopped doing Class 3s a few years ago, other than his current patients. How to do find these Senior AMEs? AFAIK the FAA list doesn't separately identify them.

What's the secret password?

 

[dbahn]

All the AME does is submit the cardiologist's records. Don't get too intimidated by all this advice. Your cardiology records are the key.

But for everybody who needs a medical exam, the more you know about the medical pitfalls the more control you have over your own doctor in recording them in a way that's not damaging. This is particularly true now with coding pitfalls, which are very complex and often not performed by the doctor but by a coding specialist using the doctor's notes, and usually in a way to maximize reimbursement without actually being fraudulent.

 

[Stewartb]

That has no bearing on the topic. I'm addressing all this scare advice from guys I'm betting never have gone through the process. This young man is concerned and asked for guidance. I'm trying to provide some from the been there-done that perspective.