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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:
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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:
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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.