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CBS' Part 1 of Aeromedical Corruption

Old 08-25-2023, 12:28 PM
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Default CBS' Part 1 of Aeromedical Corruption

Alright folks, here it is. Part 1 of CBS' investigation into Aeromedical corruption:

https://www.cbsnews.com/colorado/new...alth-policies/

Let me know what you think!
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Old 08-25-2023, 07:44 PM
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Originally Posted by BigKetchup
Alright folks, here it is. Part 1 of CBS' investigation into Aeromedical corruption:

https://www.cbsnews.com/colorado/new...alth-policies/

Let me know what you think!
An excerpt from the above article:

In the reauthorization bill that's coming up for discussion here in September, there's only one part of it that discusses medicals, and what it says is the FAA needs to put together a round table to discuss the modernization of the regulations. There is no time limit on it," LoRusso explains. "I would not be surprised if five years from now, we're sitting here talking about how they still have not yet formed that roundtable."
​​​​​​​

And that’s probably correct, because as little actual data as the FAA may have to support their policies, there is even less to change them. As a general rule those who practice psychiatry and psychology are positively inept at doing scientific studies. Only about 40% of such studies are even REPEATABLE because of poor study design and inept researchers. That doesn’t mean that only 40% are correct, the actual percentage is likely lower than that. It has been said that insanity is doing the same thing over and expecting a different result. 60 percent of psychiatric studies when repeated actually DO give a different result. That’s not insanity, it’s stupidity.


https://www.psychologytoday.com/us/b...ication-crisis


having said that, the member of Congress that pushes for any change knows damn well they will be blamed for any mishap that occurs that even MIGHT be associated with a rule change so damn few of them will have the balls/ovaries to change the existing law.

And once again, why do you call this corruption?

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Old 08-26-2023, 12:05 AM
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Originally Posted by Excargodog
An excerpt from the above article:



And that’s probably correct, because as little actual data as the FAA may have to support their policies, there is even less to change them. As a general rule those who practice psychiatry and psychology are positively inept at doing scientific studies. Only about 40% of such studies are even REPEATABLE because of poor study design and inept researchers. That doesn’t mean that only 40% are correct, the actual percentage is likely lower than that. It has been said that insanity is doing the same thing over and expecting a different result. 60 percent of psychiatric studies when repeated actually DO give a different result. That’s not insanity, it’s stupidity.


https://www.psychologytoday.com/us/b...ication-crisis


having said that, the member of Congress that pushes for any change knows damn well they will be blamed for any mishap that occurs that even MIGHT be associated with a rule change so damn few of them will have the balls/ovaries to change the existing law.

And once again, why do you call this corruption?


It’s not corruption, BigKetchup has an ax to grind about being treated how he feels is unfair even though he has lingering TBI issues 20 years on and has been fully and completely medically disqualified from flight.
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Old 08-26-2023, 01:13 AM
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The gist of the emotional appeal by the article is about fairness, not safety, and there is no insinuation of corruption. None. The inference by the original poster that the FAA's aeromedical division is corrupt is unfounded, and a lie, and the original poster continues to spew these lies to support his failed bid for medical certification, without presenting anything whatsoever to back himself or herself up.

Those who have disqualifying medical conditions, according to the article, are dissuaded from seeking needed medical attention, because their disqualifying medical condition might (wait for it!) disqualify them.

Disqualifying medical conditions don't exist as a monument unto themselves, but based on safety concerns. A medical condition isn't just about a snap-shot in time, but the potential of that condition for the duration of the medical certificate: thus, the applicant may be okay right now, but must also be expected to remain so for the validity period of the certification. One may be suicidal; simply because one isn't actively in the process of killing one's self at the moment of the medical exam doesn't mean that tomorrow one won't try. This isn't a good look for one in an airplane. Consequently, one who is suicidal, or has a history of of suicide attempts, or is considering suicide may not be the best candidate to be an active pilot. If one argues that it's unfair, and that the suicidal person is afraid to seek medical help for being suicidal, in case it affects medical certification, that's a self-defeating argument. The individual shouldn't hold medical certification. It's akin to a professional robber suggesting he doesn't want to seek a good gunsmith for the firearm he uses to commit the crime, because he's afraid it might affect his criminal career. It's an idiotic argument to suggest that one who isn't medically qualified might be prevented form seeking help, in case his or her deception is revealed, and he or she loses the medical certificate.

Likewise, the argument that only treatments involving drugs should be reported to the FAA is hollow and stupid. Many conditions may not require medication; they are no less disqualifying and no less a hazard, medication or not.

Playing the heartstrings with emotional appeals of PTSD, personal tragedy, or other impetus for emotional, mental, or psychological issues is good theater, but a fear of seeking help for a disqualifying condition does not indicate FAA corruption. The airman who has a condition which should or would disqualify him or her from flying may be afraid to admit or reveal the condition, for fear of being disqualified, but that airman is an airman by deceit and subterfuge. (S)he shouldn't be flying, and is hiding a disqualifying condition. Should an alcoholic be considered a victim, afraid to reveal alcoholism, for fear of being found out; for fear of losing medical certification? If I'm having constant angina, severe headaches, or other problems that might diisqualify me, am I a victim of a "corrupt" FAA because I"m afraid to reveal my disqualfying condition? Is the "corruption" that I might not be able to hold a medical if I reveal my condition? Perhaps I shouldn't hold the medical certification in the first place, with a disqualifying condition.

Is it fair that not everyone can hold a FAA medical certificate? Fair's got nothing to do with it, and thus is the crux of the failure of the original poster to make his or her point.
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Old 08-26-2023, 07:15 AM
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Originally Posted by BigKetchup
Alright folks, here it is. Part 1 of CBS' investigation into Aeromedical corruption:

https://www.cbsnews.com/colorado/new...alth-policies/

Let me know what you think!
The application is black & white. The lives & physical/emotional fitness of those required to submit them, anything but. Evidence of corruption (topic)…when, where? Delay and uniformity gaining deviation approval, a growing issue. Goes without saying, applicants caught rolling the dice by nondisclosure of RX treatment will be punished without regulatory pity.
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Old 08-27-2023, 06:11 AM
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Originally Posted by BigKetchup
Alright folks, here it is. Part 1 of CBS' investigation into Aeromedical corruption:

https://www.cbsnews.com/colorado/new...alth-policies/

Let me know what you think!
It would appear the Washington Postis pushing the story of pilot corruption a whole lot more than your story of FAA Aeromedical corruption:



I think any hopes you might have had of someone taking on the FAA about liberalizing mental health issues just went down the cr@pper…
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Old 08-27-2023, 06:32 AM
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No offense, so please don’t take it that way, but I don’t want to ride in the back if someone up front has a disqualifying condition.
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Old 08-27-2023, 09:01 AM
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Just read through the WP article, and I gotta call BS on the Army pilot wrt his sleep apnea. My case, moderate OSA. Also, retired vet with a VA disability rating with multiple conditions, every single one of which is documented on my medexpress 8500 every 6 months. All of my VA and FAA paperwork is above board, well documented and my SA special issuance is now just an annual paperwork drill with some periodic retest requirements. Was/is it a PIA to do it right? Yes. But if there’s anything that my 35+ years of flying has taught me is that airtight paperwork is important and that you will eventually get caught pencil whipping. Nothing confusing about Sleep Apnea and the FAA at all, it’s a downer and you need to comply with the process to get “up”. Vets that attempt to play the system and get caught just serve to paint the rest of us in a poor light.

As far as his other point that the system is “unfair” in that VA & DOD medical records are accessible to the FAA and civilian records are not, I agree 100% and submit that the FAA should have access to civilian healthcare records. As a practical matter, the challenges of getting civilian healthcare records on a single, accessible database standard are prohibitive.
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Old 08-27-2023, 12:24 PM
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The FAA Aeromedical folks would be a lot more effective if they weren't such bureaucratic idiots. It's such a hassle to get special issuance medicals sometimes that I can understand why some pilots hide it. I knew a major airline Captain who hid the fact he was diabetic. Now that's one issue it's not that bad to get a SI for, I know because I went through the process.

But here's a really stupid one: In 2004 about a month after my medical my Doc discovered an area on my head that turned out to be malignant melanoma. Plastic surgeon cut it out and had the lab verify they got it all. Close call but easily handled. I was lucky it hadn't metastasized. I was at the Plastic Surgeons for less than an hour, not a big deal. So after a few days I went back to flying. 5 months later it was time for a new medical. I called the nurse at my AME's office and asked how to handle this. She said call the FAA but instead I called AMAS. The Doc there called me back and told me I had been flying illegally. Any cancer is grounding until the FAA sees the diagnosis, treatment, and prognosis. Excuse me for using common sense. So I had to stop flying (with little to no sick leave) for about 6 weeks and submit a letter from my Doctor. Total bureaucratic stupidity.
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Old 08-27-2023, 05:01 PM
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Originally Posted by AirBear
Excuse me for using common sense. So I had to stop flying (with little to no sick leave) for about 6 weeks and submit a letter from my Doctor. Total bureaucratic stupidity.
No, ignorance is no excuse, and you acted in ignorance. Had you done due diligence at the time of the cancer discovery, diagnosis, and treatment, you would have known that it was reportable and required further paperwork. Instead, you decided you knew best, returned yourself to service illegally, then got caught with your pants down. You could have done it right, but you figured you knew best. Turned out, you didn't. It cost you.

You could have begun that paperwork at the time, but you didn't. That's not FAA corruption or bureaucratic stupidity. At best, it's laziness on your part, but the truth is that you chose ignorance, thought you knew best, and acted without a valid airworthiness certificate (because you didn't meet the criteria, with the cancer diagnosis). You can blame it on the FAA, but you were wrong then, and you're wrong now to blame the FAA. Blame yourself.

I've flown with aviators who had kidney stones. They returned themselves to service and off they went. Some chose to report it, some reported it at the next medical, some never said a word. I stopped an individual from getting in his single seat airplane and set him down agains some ground equipment, and called an ambulance. He was cold, clammy, vomiting, complaining of chest pain, and struggling to breathe. Based on his actions at the time, I suspected a kidney stone, but he went to a clinic, where cardiac was ruled out, and a determination made that he did have a stone. He passed it, and returned to service. He didn't tell his AME. By doing so, he was acting illegally, and no longer airworthy; his medical certificate wasn't valid for his use.

I had a kidney stone, got AME's (two) involved, and ended up medically grounded for three months; the FAA needs evidence that the airman is stone-free and can be expected to remain so, with x-rays and the works. I ended up with a stent, three surgeries, and was finally cleared. It was time consuming and expensive, but took only three months. Perhaps I could have gotten away without the hoops, but then I'd have been illegal, and failure to report is an offense that can result in enforcement action. There's no penalty for taking a medical leave; there's a big black mark for enforcement action. Far better than to take a little time off, if needed, do the paperwork properly, be transparent and report, than to let it turn into something later.

The FAA provided AME's with a worksheet took to address PTSD by applicants. It isn't required to be turned in with exam paperwork; it's strictly for AME guidance, but it's notable as an example of a very common condition, and one that's used to garner disability pay, and one that's included in the Washington Post article as an example by subject airmen in that report (and the original poster's link). https://www.faa.gov/ame_guide/media/...lfortheAME.pdf

That tool provides seven basic questions, asked of the applicant, and of the AME, in determining whether the airman can be issued a medical, or whether the matter needs to be deferred to the FAA aeromedical division, in Oklahoma City. Ultimately, regardless of how the airman answers, the AME still has full discretion to defer; there is no automatic issuance, and the airman is not entitled to issuance; medical certification, like airman certification, is a privilege, not a right.

The seven questions listed are:
1. Is there any additional mental health diagnosis other than PTSD? (Including but not limited to depression, anxiety, ADHD, substance disorder.)

2. Is there any history of suicidal (or homicidal) ideation or attempt(s) ever in the individual’s life?

3. Have there been any symptoms of PTSD (such as: re-living, avoidance, or increased arousal) within the past two (2) years?

4. Has the individual taken medication or undergone psychotherapy for the PTSD in the past two (2) years?

5. Is there any history of the individual being limited by the PTSD in performing the functions of any job (aviation related or not)?

6. Are there any elements of the history (such as: nature of the triggers, social dysfunction) which cause you to question whether the PTSD is in full remission or is of aeromedical concern?

7. Do you have ANY concerns regarding this airman or are unable to obtain a complete history?
While the airman applicant could lie about any of the line items, the AME has final authority to determine if he's willing to issue the medical certificate. If any question results in a "no," the AME must defer the medical application. The questions aren't just about whether the applicant is experiencing a problem at the time of the exam: the AME is required to determine if the applicant can be expected to be free of PTSD-related issues for the duration of the medical certificate, including whether the airman might be exposed events or things that might trigger the PTSD. The evaluation tool also includes three applicable notes, giving guidance to the AME:

Notes:

The AME should elicit what triggers the PTSD episode(s). If the airman has recently been exposed to their triggers (such as smells or loud noises), do they continue to react to these triggers? The AME should also take into consideration the likelihood of the triggers being encountered when flying or in everyday life. If the AME is unsure of any of the above criteria, the diagnosis, or severity - DEFER and note in Block 60

a For additional information on PTSD see: https://www.nimh.nih.gov/health/publ...ost-traumatic- stress-disorder-ptsd

b AMEs should pay specific attention to cockpit or flight-specific PTSD triggers. Has the airman changed jobs or occupations to avoid triggers or due to symptoms? Do they have any current accommodations for school or work due to PTSD?

c In the past 24 months, has the airman been given an increase in VA PTSD benefits or is there evidence of social impact such as divorce or severe isolation?

This decision tool is for AME use; it does not have to be submitted to the FAA.
If the question arises of whether the airman with PTSD should admit it to the FAA, or if the airman is afraid to admit his PTSD for fear of losing or being unable to obtain a medical certificate, this isn't a meaningless paper dance. If the airman is qualified, not a problem. If the airman is not medically qualified, then the applicant is afraid of revealing a disqualifying condition for fear of being disqualified. This is about safety and legality: both standards must be met. If the airman isn't medically qualified, then he isn't legal to hold medical certification, nor should he. The AME must determine, in order to issue, that not only is the airman safe and legal at the time of the exam, but can be expected to remain so throughout the duration of the certificate, or the AME cannot issue the medical certificate and is required to defer. If the AME feels he has not received the whole story, he is required to defer. An instructor may not sign off a student who is not ready. A mechanic may not sign off work that is not airworthy. An AME may not issue a medical to someone who is nor medically fit and worthy to hold that certification.

As flight instructors (most of us are, or have been one), when we sign off a student for solo, we're not just looking at their last trip around the pattern; we're anticipating the next and we use our judgement to determine if we feel they will be safe moving forward. The AME has no less a professional and legal obligation.

If you don't want to find yourself high-centered down the road, be transparent at the time, do your research, don't make assumptions and don't ignore problems and assume all you need do is report them later.

Recently I had surgery. I contacted the AME in advance, detailed what was going on, and received confirmation that I wouldn't need to report this surgery until my next medical exam. When I arrived for that exam, I brought the surgery reports and all my medical paperwork, with copies for the AME and it was easily handled. Had it been something requiring further evaluation and documentation, I'd have had that started and underway early, being fully informed in advance. I took some of that documentation back to the employer to show I was legal to return to work, having only taken my regular days off. In this case, I missed no work. In the former case cited with the kidney stones, I missed three months of work, but was handled and the matter closed working with my AME, and I returned to work; by the time the next medical exam rolled around, it was nothing more than "Previously Reported, No Change."

Don't blame the FAA if you don't take the time to get educated on your condition and the requirements that surround it, at the time. Don't blame the FAA if your condition requires deferral: it's a medical standard. Don't blame the FAA if additional documentation is required, and certainly don't blame the FAA if the condition is determined to be disqualifying. The FAA is charged, after all, by an Act of Congress, to set and maintain the standards of safety and certification. if one has a disqualifying condition, it's unfortunate, and perhaps not even fair, but the standard isn't about fairness. It's about safety and legality not only on the day of the examination, but for the duration of the certificate. Until one meets that standard, the medical certificate cannot be issued, or must be issued with limitations, or a waiver obtained based on the merits of the documentation submitted.
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