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Sat, Aug 02, 2014

FAA Spins Third Class Medical Issue

Pending Legislation Forcing Agencies Hand

Aero-Commentary By Gene Yarbrough; ANN Resident Political Analyst / Conspiracy Theorist

The FAA Agents have been out in force this week at AirVenture with up to 14 individual forums or press events all aimed at putting lipstick on the pig that is the third class medical quagmire. In three of these individual forums FAA affiliated medical doctors espoused myriad reasons supporting the FAA position, revealing a coordinated defense.

Dr. Greg Pinnell held an Aviation Medicine Update at the Whitman Field FAA Safety Center. Dr. Pinnell explained that new regulation changes are allowing AME’s to issue third class medicals in the face of many ailments that required a deferment in the recent past. Conditions AME Can Issue (CACI) is a new program that allows your flight surgeon to issue a third class medical and included 10 conditions that usually would have disqualified or outright denied a medical, including high blood pressure, arthritis, and glaucoma. AME Assisted Special Issuance is also a new program that allows your AME to play a larger, more influential roll in the medical certification decision making process. Serious medical conditions such as heart attack, certain cancers, diabetes and substance abuse are now relegated to the local level after initial medical issuance by FAA. However, this relaxation of procedures does little if anything to assist NEW medical certificate issuance due to the continued requirement for initial decision from Oklahoma City, but it is a welcomed relief and hopefully will provide a more sensible route to the all important, if impotent, third class medical.

Dr. Pinnell reported that, to date, there have been 3 confirmed fatalities attributed to medical issues, with possibly a fourth within the LSA category over the last 10 years. An incredibly small number compared to the number of flight hours in that category over the same time period. Dr. Pinnell agreed that fatalities from medical causes are extremely rare even when looking at the data from all classes of medical certificates issued. When asked if he agreed that a drivers license-based medical standard provided an equivalent or similar level of safety as a non special issuance third class medical, Dr. Pinnell stated he did not agree. He said when drivers licenses from all the States are considered, there is a large disparity in what medical requirements must be met to be issued a drivers license. This explanation seems logical on its face. However, the reporting requirements imposed on any doctor provide a better level of surveillance than a visit to an unfamiliar doctor every three years; if a doctor treats a person for a condition that endangers their safe operation of a motor vehicle they are obligated by law to report that condition to the state issuing the drivers license, this is the part that seems to be completely missed or ignored by the FAA. Therefore, the level of safety may not be glaringly apparent up front but is implicit ... and significantly better ... than the status quo. Dr. Pinnell did admit that the third class medical as it exists does not provide a meaningful, durable level of safety, and recommends a medical certification scenario similar to what Australia uses, i.e. a national standardized driver’s license that would share relevant medical information via a centralized database.

Dr. Bob Achtel hosted a forum on Protecting Your Medical Thursday morning. After reviewing several disqualifying medical conditions Dr. Achtel recommended strategies to preserve your current medical and facilitate an easier recertification process including preparing for your exam as if it were a typical school exam, compiling and reviewing all the necessary paperwork and test reports expected in light of your particular condition(s) before visiting your doctor, correcting problems before seeing your AME, and scheduling a non-flight exam physical. When questioned as to whether the AME is obligated to report any disqualifying conditions found on a non-flight physical, Dr. Achtel affirmed the Physician-Patient confidentiality provisions supersede other regulations.

Later Thursday Dr. Michael Berry held a conference on Hot Aero-Medical Topics. Dr. Berry reviewed the hierarchy of the FAA Medical Branch and how medical appeals processes coursed through the agency up to and including review before the United States Supreme Court, if necessary. Dr. Berry suggested that a General Accounting Office review of medical certification procedures resulted in recommendations being handed down which mandated alleviation of issues that bottlenecked and frustrated the issuance of medical certifications. Out of those recommendations came the Conditions AME’s Can Issue (CACI) program which relegates certain medical conditions that your local AME can immediately issue within his own jurisdiction. Also coming out of the GAO recommendations is the AME Assisted Special Issuance (AASI) program that allows your AME a more direct and influential role in medical certification. Under AASI your AME will request and submit required supporting documentation and facilitate expediting a medical application with his own evaluation. The FAA medical division has finally delegated meaningful responsibility to those that are in the best position to make a determination based on your particular condition and observed abilities.

According to Dr. Berry, of the 382,990 medical applications received in 2013, 10% were deferred for Special Issuance, 3405 (.9%) were flatly denied, 3193 of those were denied due to lack of required information (effectively abandoned) and 212 were denied despite having all information included. 37,172 special issuance medicals were granted. These numbers suggest that the FAA medical division is committed to finding every way possible to issue a medical certificate, and Dr. Berry echoed the sentiment. Despite these notable statistics, the fact remains that applying for a medical certificate is a gamble that has serious cost implications, and with potentially major hurdles to clear. This, coupled with the potential loss of the opportunity to operate under the Light Sport Airman certificate if one is denied a medical certificate is enough threat to keep most from approaching their AME even at a “non-official” level for fear of losing any prospect of flying.

FAA Administrator Huerta was met at Forum Pavilion 7 Thursday by throngs of interested members anxious for any scrap of information about regulatory changes. Huerta, in typical and expected bureaucratic manner, managed to say much but delivered little in the way of useable information. After a rambling speech that covered everything from ADS-B issues to the part 23 rewrite, only briefly touching on the third class medical issue most were there for, the administrator answered benign questions from the audience only flirting around the 400 lb gorilla in the room.

Jack Pelton, EAA Chairman, pandered to Huerta with obviously non-confrontational pre-negotiated questions clearly designed to allow Huerta off the hook. One could almost feel the palpable tension in the air as folks wanted to know more about what nefarious activities were being conducted within the halls of 800 Pennsylvania Ave. Huerta briefly mentioned that he signed a draft NPRM earlier in the week on the third class medical issue, that it was handed off to the Department of Transportation for Executive Review and would eventually wind up in the Office of Management and Budget for final review. Reticent to discuss any particular details about the pending legislation, Huerta stated that the proposed rule is expected to be opened for public review and comment “in the fall of this year.” Dealing with the dragon is always tricky at best.

According to Dr. Berry’s forum referenced above, which occurred after the “Meet the Administrator” gathering earlier in the day, the FAA has had “All hands on Deck” writing the NPRM since January 2014. Which brings into question why the FAA waited nearly two years after the initial AOPA/EAA petition to eliminate the third class medical via exemption? Dr. Berry sold the idea that the recent impetus for regulatory change or procedural relaxation is due to internal efforts to improve the landscape of medical issuance thereby creating peace and good will toward the flying public via the benevolence of the FAA task masters. The timing suggests this is a gut-churning reaction to the General Aviation Pilot Protection Act (GAPPA) proposed by Congressman Rokita which, if passed, would demand much more in the way of freedoms of personal aviation than what FAA is willing to surrender. Perhaps the confrontational system afforded us by our founding fathers, in that the people are the masters and commanders, will prevail, and our precious civil liberty of pursuing our passion of flight will be preserved. Only time will tell, this will be an interesting wrestling match between those firmly ensconced in a deleterious bureaucracy and those that have the ability to vote and impeach, if necessary.


FMI: http://www.faa.gov/regulations_policies/rulemaking/recently_published/


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