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Thread: Holding FAA Medical and BasicMed Certificates at the Same Time?

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    WindOnHisNose's Avatar
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    Holding FAA Medical and BasicMed Certificates at the Same Time?

    Can you hold an FAA medical certificate and BasicMed at the same time?

    Absolutely, and you should.

    Granted, at first blush it does seem unnecessary to do so. After all, you are healthy and don’t have any major medical problems. You aren’t a smoker, not a major drinker and you might have a tiny weight and balance problem, but you think you are healthier than most of the other pilots who tell hangar lies with you out at the good old hangar. Life is good. Until you hit some unexpected turbulence.

    I would like to tell you a tale of two aviators (both fly for one of the major airlines), one of you who has a valid 1st class FAA medical and one of you who has a valid 1st class medical but also a BasicMed certificate.

    All is going well for you…

    Until the day you find out that you have some pain that isn’t like the usual discomfort you have after doing some heavy lifting around the farm, and you choose to go to the doc because something just isn’t right. The doc gets a chest xray and an EKG…both of which are normal…but a call comes from the radiologist to your doc and they want to do a different study on you. They think you have an aortic aneurysm that is unrelated to the pain you have been having, but you need to report it to the FAA (your doc happens to be your AME) and you receive a letter from the FAA with a request for additional testing that must be submitted in the next 60 days, or you will need to surrender your medical certificate.

    Until the day that you notice a little lump on the side of your face, just at the jaw line. You go to the doc and he examines you and is a bit concerned, sending you to see a surgeon for evaluation. The surgeon performs a biopsy which comes back a pretty nasty form of cancer. Your FAA medical is no longer valid, as you have a disqualifying condition.

    Until the day that you notice that you have some blood in your urine, and you call your doc, go in for a quick office visit. You are asked to give a urine sample which confirms blood in your urine and you are referred to a urologist. She does a biopsy which returns as a low grade bladder cancer. You have a disqualifying condition.

    Until the day that you notice that your heart seems to unexplicably seem to race. You tell your wife and she insists that you go see your doc, and you do just that. The doc listens to your heart and you are diagnosed with tachycardia. Off you go to a cardiologist, who diagnoses you with atrial fibrillation and they want to work you up for this. You have a disqualifying condition.

    Until the day when you go in for your annual wellness exam, and the doc dons the rubber glove, feels your prostate to be a bit enlarged. He orders a PSA which comes back elevated. The urologist sees you, performs a biopsy and the results show prostate cancer. You have a disqualifying condition.

    Until the day that you feel a lump in your breast. You are not sure if you are imagining something, so you go to your doc and they also feel the lump, ordering a mammogram, then an ultrasound-directed biopsy is performed, confirming breast cancer. You have a disqualifying condition.

    Until the day that you notice a bit of a tremor that has seemed to be getting worse. You see your doc and they do some testing which confirms Parkinson’s disease. You have a disqualifying condition.

    Disposition
    The pilot with the 1st class medical must self-ground for these conditions and remain on the ground until he/she submits supporting information to the FAA and, eventually, will get an FAA medical certificate. It will take time. This pilot will be able to go out and look at their super cub, will be able to fly it with a friend provided the friend is a qualified pilot acting as pilot-in-command. This pilot cannot fly for the airlines.

    The pilot with the 1st class medical and BasicMed must self-ground, also, and cannot fly for the airlines. This pilots BasicMed allows him to notify his certifying physician of the condition and, if given the green light, can not only go out to gaze upon that beautiful super cub, but also legally fly it. This pilot will also eventually get the medical certificate reinstated, but it will take several months to do so. In the meantime, this pilot is flying to Johnson Creek, to New Holstein, to Triple Tree.

    I hope you can see the advantages of holding both the FAA medical and the BasicMed certificate.

    See you at New Holstein.

    Randy

  2. #2
    Cub Builder's Avatar
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    Good explanation Doc. Thank you for a good piece of unsolicited advice.
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    jimcrawford01's Avatar
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    Best Advice, Ever!
    For a small amount of effort, you may save a huge amount of potential aggravation. No need to ask how I know this.
    Thanks Randy. No, really, THANK YOU!
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    slackass's Avatar
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    I was wondering this very thing. Thanks for the info and I will be seeing you at NH. Thanks Randy!
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    WindOnHisNose's Avatar
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    For those of you who are considering doing the BasicMed thing at New Holstein, please go to the thread regarding this and register and get your forms in so I can review them and get you scheduled.

    Thanks for the kind words, gentlemen! The strategy for holding a BasicMed AND a 3rd class medical is such a no brainer...

    Randy

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    Bill Rusk's Avatar
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    Awesome thread Doc. Thank you!!

    Bill
    Very Blessed.
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  7. #7
    Alex Clark's Avatar
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    GOOD INFO!!

    I need to renew my 2nd class and it would be a good idea at my age to add a basic med.
    IF I can find somebody in my part of Alaska who knows how to do one.
    The local clinic tried to charge one of my student pilots $300 for an exam.
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    skywagon8a's Avatar
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    Quote Originally Posted by Alex Clark View Post
    GOOD INFO!!

    I need to renew my 2nd class and it would be a good idea at my age to add a basic med.
    IF I can find somebody in my part of Alaska who knows how to do one.
    Alex, I took the forms to my personal physician who does my annual wellness exam. She looked it over and said "sure I'll sign that" and she did. No extra fee, nothing. Then I just took the AOPA course on line. Done. Total cost zip, thank you medicare.
    N1PA
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    hotrod180's Avatar
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    Quote Originally Posted by skywagon8a View Post
    Alex, I took the forms to my personal physician who does my annual wellness exam. She looked it over and said "sure I'll sign that" and she did. No extra fee, nothing.....
    Too bad it's not always that easy.
    I know people who's personal doc refused to do BasicMed.
    My AME did a BasicMed exam for me shortly after it came out (may 2017).
    He charged me the same as he does for a 3rd class, seems logical as it's pretty much the same exam.
    I ha
    ve heard of some AME's who refuse to do BasicMed, I don't understand that at all.
    Cessna Skywagon-- accept no substitute!
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  10. #10
    WindOnHisNose's Avatar
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    Quote Originally Posted by hotrod180 View Post
    Too bad it's not always that easy.
    I know people who's personal doc refused to do BasicMed.
    My AME did a BasicMed exam for me shortly after it came out (may 2017).
    He charged me the same as he does for a 3rd class, seems logical as it's pretty much the same exam.
    I ha
    ve heard of some AME's who refuse to do BasicMed, I don't understand that at all.
    Unfortunately, I understand this issue. AME’s feel threatened, the poor babies. They were coached by the FAA to be fearful of things like BasicMed before the term BasicMed was coined. Like sheep they have dutifully followed the party line, making uninspired predictions like ”the airplanes will be falling out of the sky” (I kid you not...direct quote from an FAA refresher I attended 5 years ago). Never mind that the Light Sport category experiment has provided ample evidence that relaxing standards did not, in fact, result in airplanes falling out of the sky. The proverbial AMA of aviation medical examiners, the CAMA, flat out lobbied hard to block BasicMed. I don’t see them becoming enlightened any time soon. In fact, the AME organization and the FAA are scheming to make BasicMed go away by collecting any data they can to justify doing away with this wonderful BasicMed.

    Frankly, I am embarrassed by my fellow AME’s posturing on this issue. For a group of professionals to ignore solid data so as to maintain the status quo is unconscionable. Mark Baker and AOPA are to be congratulated for revitalizing general aviation through very, very hard work and perseverance.

    Kudos to your AME, hotrod180. You are lucky to have him as your AME and your personal physician.

    That’s how I feel bout that...

    Randy
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    Quote Originally Posted by WindOnHisNose View Post
    Can you hold an FAA medical certificate and BasicMed at the same time?

    Absolutely, and you should.

    Granted, at first blush it does seem unnecessary to do so. After all, you are healthy and don’t have any major medical problems. You aren’t a smoker, not a major drinker and you might have a tiny weight and balance problem, but you think you are healthier than most of the other pilots who tell hangar lies with you out at the good old hangar. Life is good. Until you hit some unexpected turbulence.

    I would like to tell you a tale of two aviators (both fly for one of the major airlines), one of you who has a valid 1st class FAA medical and one of you who has a valid 1st class medical but also a BasicMed certificate.

    All is going well for you…

    Until the day you find out that you have some pain that isn’t like the usual discomfort you have after doing some heavy lifting around the farm, and you choose to go to the doc because something just isn’t right. The doc gets a chest xray and an EKG…both of which are normal…but a call comes from the radiologist to your doc and they want to do a different study on you. They think you have an aortic aneurysm that is unrelated to the pain you have been having, but you need to report it to the FAA (your doc happens to be your AME) and you receive a letter from the FAA with a request for additional testing that must be submitted in the next 60 days, or you will need to surrender your medical certificate.

    Until the day that you notice a little lump on the side of your face, just at the jaw line. You go to the doc and he examines you and is a bit concerned, sending you to see a surgeon for evaluation. The surgeon performs a biopsy which comes back a pretty nasty form of cancer. Your FAA medical is no longer valid, as you have a disqualifying condition.

    Until the day that you notice that you have some blood in your urine, and you call your doc, go in for a quick office visit. You are asked to give a urine sample which confirms blood in your urine and you are referred to a urologist. She does a biopsy which returns as a low grade bladder cancer. You have a disqualifying condition.

    Until the day that you notice that your heart seems to unexplicably seem to race. You tell your wife and she insists that you go see your doc, and you do just that. The doc listens to your heart and you are diagnosed with tachycardia. Off you go to a cardiologist, who diagnoses you with atrial fibrillation and they want to work you up for this. You have a disqualifying condition.

    Until the day when you go in for your annual wellness exam, and the doc dons the rubber glove, feels your prostate to be a bit enlarged. He orders a PSA which comes back elevated. The urologist sees you, performs a biopsy and the results show prostate cancer. You have a disqualifying condition.

    Until the day that you feel a lump in your breast. You are not sure if you are imagining something, so you go to your doc and they also feel the lump, ordering a mammogram, then an ultrasound-directed biopsy is performed, confirming breast cancer. You have a disqualifying condition.

    Until the day that you notice a bit of a tremor that has seemed to be getting worse. You see your doc and they do some testing which confirms Parkinson’s disease. You have a disqualifying condition.

    Disposition
    The pilot with the 1st class medical must self-ground for these conditions and remain on the ground until he/she submits supporting information to the FAA and, eventually, will get an FAA medical certificate. It will take time. This pilot will be able to go out and look at their super cub, will be able to fly it with a friend provided the friend is a qualified pilot acting as pilot-in-command. This pilot cannot fly for the airlines.

    The pilot with the 1st class medical and BasicMed must self-ground, also, and cannot fly for the airlines. This pilots BasicMed allows him to notify his certifying physician of the condition and, if given the green light, can not only go out to gaze upon that beautiful super cub, but also legally fly it. This pilot will also eventually get the medical certificate reinstated, but it will take several months to do so. In the meantime, this pilot is flying to Johnson Creek, to New Holstein, to Triple Tree.

    I hope you can see the advantages of holding both the FAA medical and the BasicMed certificate.

    See you at New Holstein.

    Randy
    Thank you this info. Can you get a Basic Med after you self notify and apply for a special issues for a 3rd class. If your doctor gives you a green light. The wheels of the FAA flight surgeon are at a snells pace. It been over 90 days since the info was submitted. They just keep asking for more info.

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    WindOnHisNose's Avatar
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    AK_56, thanks for the post.

    You are in a bit of no man's land right now. In my opinion, you are now entirely committed to getting the Special Issuance. If you are denied you cannot go BasicMed nor transition to Light Sport. If you are granted a Special Issuance you should run, not walk, to your doc to get a BasicMed.

    In retrospect, it is my firm opinon that if you had a valid 3rd class medical and experienced a medical condition that is disqualifying for an FAA medical, but is not one listed as being disqualifying for BasicMed you could have chosen to let your FAA medical lapse and get a BasicMed certificate. Once you pull the trigger for a SI, however, you are committed.

    I hope this helps. Others will learn from your experience, and I appreciate you posting here. Best of luck to you.

    Randy

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    I'm in the same spot, submitted in Feb. and they are still playing. There isn't anything else they can ask for now after several request and still waiting. They made the statement they were backlogged because of the government shut down.
    This is a difficult situation for me being I live in a fly in village in Alaska. We fly our food and essentials in and I've kept the flying to a min. Waiting for a special issuance. The best part is my wife is a pilot ,so she is PIC when we fly. I will be getting a basic med. immediately after the SI comes thru. So five months and counting.

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    WindOnHisNose's Avatar
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    Algonquin, you inspired me. Please see the thread in Medical Matters entitled “FAA Backlog for Special Issuances: Turning Lemons Into Lemonade”.

    I hope this helps. Please let me know your thoughts.

    Randy

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    algonquin's Avatar
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    Thanks Randy, a close friend is a AME for a long time and he keeps me calmed down and told me not to call in a rant,lol, so in the mean time I’m stuck on the boat fishing. This weather up here has been CAVU for around 6 weeks straight so worst things have happened to me. I’m getting ready to test fly a Husky I’ve rebuilt but that’s on hold until the SI comes thru. Glad I’m retired.

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    WindOnHisNose's Avatar
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    I am copying this from another thread. Gordon had a question regarding disposition of medical problems under BasicMed. He hits on an important topic that I think needs to be addressed. Basically (pun intended), he is wondering how I can do BasicMed to the standards of the FAA, yet sign off on BasicMed for things that are clearly disqualifying by the FAA medical standards (forgive me if I misrepresented your question, Gordon).

    Gordon, thanks for the question. I know this is not clear to you, and not entirely clear for me.

    Here is my thought on this. There are many medical conditions that are disqualifying for an FAA medical, but not for BasicMed. The disqualifying conditions for BasicMed are clearly written in the law, and have been listed on other threads.

    When I agree to provide an FAA examination I am simply a “measurer”. I review the medical history that you provide, I perform the physical examination to the standards of the FAA. If I feel all findings (medical history and physical examination) qualify you as a recipient of the FAA medical certificate I can issue your medical certificate. If I have any question about either the medical history or physical examination findings I can defer. I have never issued a denial, and I choose, rather, to defer if there is a significant problem. When the exam is entered into FAA system the results can be reviewed by the FAA medical folks and they can support the medical certificate (no action on their part), or they can ask you for more testing/information (to be provided within a certain number of days), or they can deny. That safety net is meant to detect any errors made by the AME. With the FAA medical examinations I am not your physician, and I am not bound by the physician-patient relationship.

    When I agree to provide a BasicMed examination you and I have entered into a physician-patient relationship. This changes they dynamics greatly from a risk management point of view. The way I practice medicine, and my medical judgement, is injected into the this relationship.

    I have chosen to perform the physical examination exactly in the same manner as is demanded by the FAA for their medical examination. This protects me, in my opinion, should there be any question regarding how I might choose to certify under BasicMed. If I find your blood pressure to be elevated above FAA standards I will refer you to a physician who deals with hypertension. If you do not meet FAA standards for vision, I will refer you to a physician to be evaluated and treated. If you have any other physical findings that make me feel that I should “defer” you, I would do so by “referral” to a physician.

    When I review your medical history under BasicMed I am reviewing it from the perspective of your physician. While I am aware (by virtue of my status as an AME) of what is disqualifying for the FAA, I am also aware of what is disqualifying for BasicMed. There is a very large difference between the two, with many medical conditions that are acceptable under BasicMed that would be grounding by the FAA medical certification.

    Some of the medical conditions that may be permitted under BasicMed may be such that I, as your physician, should be treated before I am willing to sign the BasicMed checklist. Now, you may disagree and feel that you can safely operate an aircraft, but I may not. Under BasicMed, if I am not willing to sign you have the prerogative to go to another physician to see if they would be willing to sign, and if they are, good for you!

    I just know that at the end of the day I am not going to sign off on a BasicMed if I feel it unsafe for you should I do so, just as the FAA will not sign off on a medical certificate if they feel it unsafe to do so. The difference lies in the judgement of your physician. When I wear my FAA AME hat, I have many more limitations to consider. When I wear my BasicMed hat I have more discretion in deciding if your medical problems might make you too risky to take my grandkids up for a flight.

    I hope this helps a bit.

    Randy
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    Another consideration might be whether the FAA would, after further testing, almost certainly approve issuance of a medical.

    As an example, I was diagnosed with malignant melanoma. Turns out the lesion was deeper than the FAA allows, although the surgeon ensured safe margins and biopsy of the sentinel lymph node verified the disease had not spread. As a result, the FAA wanted me to have extensive additional testing (full body MRI, brain scan, independent reviews, etc) for a special issuance, each year for five years. My Dermatologist, who found the disease (and saved my life) said bullshit to all this additional testing., and in fact called the Regional Flight Surgeons office about this. Didn’t work.

    This was before Basic Med, so my options were to pay big bucks for unnecessary tests, or go light sport. I chose the latter.

    Under Basic Med, my doctor could, after consulting with my dermatologist, issue a BM to me, since melanoma is not one of the conditions requiring an SI under BM. And, frankly, the FAA would almost certainly issued me anSI if I’d done the (expensive) tests.

    Dr. Randy did in fact complete my BM exam. By that time, five years had passed since my surgery, with no recurrence of the disease. So, by FAA rule, I could pass a medical without a special issuance.

    I’ll let Randy state how he would have dealt with my situation had five years had not passed by the time of my exam.

    Theres a pretty big difference in risk , it seems to me, between a melanoma caught in time and treated and, for example, a cardiovascular event.

    The FAA Aeromedical Branch could care less whether I ever fly again, frankly. To them, I’m just another pile of papers.

    To folks like Dr. Corfman, that’s not the case. I think his approach to Basic Med is intelligent and will help ultimately to allow BM to continue for years to come.

    MTV

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    I provide basic med exams for same price as a dot physical.
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    Quote Originally Posted by mvivion View Post
    To folks like Dr. Corfman, that’s not the case. I think his approach to Basic Med is intelligent and will help ultimately to allow BM to continue for years to come.
    YES! I had no idea I could hold a Basic Med and my 1st class at the same time. Randy contacted Jim and I and encouraged us to have both, which I now have done. It is comforting to know I have the Basic Med in my back pocket if I run across a health condition that grounds me from flying the "work plane", but isn't disqualifying as far as flying my own plane under Basic Med. THANK YOU, Randy, for suggesting this. It never would have otherwise crossed my mind.

    Sarah
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    Just got my BasicMed in addition to my 2nd Class... Helo pilot job pays the bills (well... sort of...) and PA-12 for fun... Little nervous to see my AME in Feb 2020 as I once casually mentioned Basic Med to him and he was very against it. My guess is that perhaps he is losing money from the 3rd class guys? No idea... He stated that there were 3 - 4 accidents caused directly by Basic Med. No way says me... I plan on printing the FAA FAQs that state you can hold the a Medical and Basic Med as I know it will come up.

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    180Marty's Avatar
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    Little nervous to see my AME in Feb 2020 as I once casually mentioned Basic Med to him and he was very against
    Maybe consider a chiropractor in West Virginia,North Carolina, or Ohio but many more states too!!!!
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    algonquin's Avatar
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    Well the saga goes on, they approved my SI on July 9th and as of today my AME was told they hadn’t mail my medical certificate yet. They said they were busy but said they would email me the approval.��

  23. #23
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    Quote Originally Posted by daedgerton View Post
    ..... Little nervous to see my AME in Feb 2020 as I once casually mentioned Basic Med to him and he was very against it. My guess is that perhaps he is losing money from the 3rd class guys? …...
    I did my Basic Med exam 2 years ago with the same AME I'd done my last couple of 3rd classes with.
    He charges the same amount for either exam.
    So the only way your doc is losing money from Basic Med is if he's declining to do them.
    Cessna Skywagon-- accept no substitute!
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  24. #24
    WindOnHisNose's Avatar
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    Quote Originally Posted by daedgerton View Post
    Just got my BasicMed in addition to my 2nd Class... Helo pilot job pays the bills (well... sort of...) and PA-12 for fun... Little nervous to see my AME in Feb 2020 as I once casually mentioned Basic Med to him and he was very against it. My guess is that perhaps he is losing money from the 3rd class guys? No idea... He stated that there were 3 - 4 accidents caused directly by Basic Med. No way says me... I plan on printing the FAA FAQs that state you can hold the a Medical and Basic Med as I know it will come up.
    Thanks for sharing your experience. His statement regarding "3-4 accidents caused directly by BasicMed" is entirely unsubstantiated, and is a scare tactic, imho. I would suggest you don't rattle his cage and go elsewhere for your BasicMed.

    Randy
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    They do lose money, since first, you can get it from your family doctor, and second, you only need one every four years! With a declining pilot population, some AMEs will surely be looking at a different customer base.

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