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Major Change Beginning January 1, 2025, Will Drive Many AMEs to Reconsider!

WindOnHisNose

BENEFACTOR
Lino Lakes MN (MY18)
Late last evening I received an email from Mike Vivion that caused me to have a sleepless night...

A family medicine doc, David B. Wheat MD, AME, from Mississippi, wrote a letter to his pilots (he does about 400 exams per year) after he became informed about changes that go into effect January 1.
David Wheat MD letter.webp


Those changes were outlined in a relatively new program (the FAA calls it "AME Grand Rounds"), in which monthly updates are provided for CME credit to AMEs. The December FAA Ground Rounds that is causing many of us to consider calling it quits is available for each of you to watch...and I encourage you to do so... at
.


To see what changes go into effect with regard to color vision, watch 0-15:00 minutes. You will see that we, as AMEs, are required to no longer use the traditional color vision chart and that we will be required to use one of 3 computer-generated color tests (which are timed...3 seconds per image, I believe) for new applicants, or for those seeking to go from 3rd class medicals to 2nd or 3rd class. The cost to gain access to these tests is not insignificant ($3000 to buy the one of the programs, or a monthly fee). For me, as a pilot, I am appalled, in that I didn't realize this was such a huge issue! I have not needed to deal with receiving/interpreting light gun signals EVER in 9000 hours of PIC!

The YouTube between 15:00 and the end, is even more troublesome, AND YOU NEED TO WATCH THAT SEGMENT! When a pilot comes in for exam, and we defer, that pilot will receive a "denial and reconsideration" letter from the FAA, unless the AME has uploaded all the necessary testing and information that would be required for granting a Special Issuance. "How is a pilot to know what information they need to bring present?" you ask? That information is contained in the Guide for Medical Examiners, available on the FAA website, so if you have developed a condition that grounds you (e.g., cardiac stents, myocardial infarction, transient ischemic attack (TIA), loss of consciousness, many cancers) since your last FAA medical you MUST bring that in to your AME for the examination! Should you not "preflight" your FAA medical exam with your AME, and you give the confirmation number to your AME, your AME must defer and you will immediately be denied. What happens if you bring in what you (or your AME) thought you needed to provide and the AME uploads that data and if the FAA decides it is incomplete you will receive a denial letter!

Here are the slides from that presentation:
Deferral What Next 1.webp


Deferral What Next 2.webp

Deferral What Next 3.webp


Deferral What Next 4 AME action.webp

Deferral What Next 5 Unacceptable Meds.webp


Deferral Summary.webp


This will place a burden on you and your AME. You are encouraged to provide your supporting information to your AME for uploading into the FAA system, rather than to mail in the data (mailing in adds at least a month to the process). That may not be a problem for AMEs who have a staff to help them, but for me (chief cook and bottle washer) I am just not liking that process. Regardless of big support staff or not, this will increase costs.

What if you accurately determine exactly what the FAA wants for said condition, you bring that with you to your AME and he/she does the exam and uploads the necessary information? You will not receive a denial letter. My concern with this is that it is my experience that the Guide for Medical Examiners is not always clear on what needs to be submitted, and it is also my experience that the FAA often does not accept the interpretation of the local, board-certified cardiologist, for example, and wants more data or repeat testing. Denial letter to follow, with the new rules.

As pointed out by Dr. Wheat, this will drive many of us out of providing FAA medical exams, and it is already a challenge to find AMEs. For those AMEs who continue to provide FAA medicals it will likely drive up the cost of providing that service. For me, I already to a phone call to preflight each and every pilot who wants to schedule a medical exam, be that for FAA or BasicMed, but the days of just showing up with your confirmation number are over...lest you fall into the trap of being deferred...which means automatic denial if all is not in order.

What does denial mean? Well, for starters, you are grounded. Can you regain your FAA medical? You sure can, but it will take time and money...probably lots of both. Can you go BasicMed? Nope. Can you say "screw it, I'll to Light Sport"? Nope. Your only choice, once denied, is to regain at least a 3rd class medical and a Special Issuance, and then you can go BasicMed (if you can find a doc to do that!) or LSA.

This is very bad news, folks, and only adds to the concern I've voiced on Supercub.org with the 2024 FAA Reauthorization Bill (signed into law May 2024) which gives the FAA total access to your medical records when you provide your electronic signature (confirmation number). Q: Why didn't AOPA fight the latter concern? A: They negotiated, giving up on the medical record issue in exchange for significant increase in aircraft weight parameters for those (few) of us who fly Caravans or Kodiaks. I continue to feel this was a bad deal.

Listen to the calm, authoritative tone of the presenters of the Grand Rounds, as they "splain" why these change were made and soon to be put into action. We, as pilots, should be outraged.

Many thanks to Mike Vivion for calling this to my attention. I have confirmed the concerns, as noted above, and suggest you do, too.

Doc R
 
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Friends, I just tried clicking on the link to re-watch the video of the Grand Rounds (in which the changes were announced, and from whence the screen shots posted previously were derived) and it has been blocked by the FAA. It is my guess that significant questions have been raised and that information is now in locked down mode.

Doc R
 
Friends, I just tried clicking on the link to re-watch the video of the Grand Rounds (in which the changes were announced, and from whence the screen shots posted previously were derived) and it has been blocked by the FAA. It is my guess that significant questions have been raised and that information is now in locked down mode.

Doc R
Worked fine for me just now...
 
Thanks, SJ! You are correct, regarding VPN being the reason for my inability to see the video. Thank you!

Doc R
 
I can't help but wonder if we are fixing a problem that does not exist. Are there a significant number of mishaps, fatalities due to medical issues? And will this new program fix that. My guess is that there are very few, if any, mishaps directly attributable to medical issues. It's like the FAA insistence on the EKG for class one medicals, and yet the EKG is a very poor way to predict heart attacks.

Sounds like we need to get AOPA motivated to ASK the question. "Are medical issues where we need to focus our resources?"

Bill
 
I posted about this too, the color vision test is a subscription for like $20-30mo and requires a iPad, I do like that color vision testing now follows some version of logic and is a one and done with no further re tests

Yes removing options for different color vision testing is dumb, especially as there have been zero crashes where color vision made a difference, but for how much many AMEs make compared to the level of liability they enjoy doing FAA medals, if buying another iPad and having a cheap subscription breaks them, I think there must have been other issues at play for them as well.

Based on the FAAs own study, they even found zero difference in “safety” between 3rd class and basic, and the difference between a 3rd and a 1st is minimal. If we use logic and history changing all class of medical to a basic med exam model would be miles safer and also allow the taxpayer to save tons of money by nearly eliminating FAA aeromed division.

But the FAA is a loud and proud logic free zone


As for AOPA, they are the NRA of aviation, they supported forced ADSB trackers for god sakes lol



Good summery of at least the color vision part


One of the “new” color vision systems


Also goes to show, in 2024 America one need to understand putting something on your medical record should be avoided like putting something on a criminal record, any medical diagnosis can and will be used against you in a court of administrative “law”
 
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I was asked by a physician friend, who is also heavily invested in aviation in Minnesota, as to what precipitated the changes. Here is my response to him.

It seems that with the new FAA reauthorization bill came an opportunity for the FAA attorneys to weigh in again. My experience with attorneys is that one party retains an attorney to draft an agreement, it goes to the other "sides" attorney, who makes a few "important" changes, it goes back to the other attorney, who does the same...and on and on.

Regardless, the FAA's attorneys interpreted the law such that the FAA would be liable in the time period between deferral and the time that a decision is made by the FAA to deny or grant the medical. That time, as you know, can take several months, and the FAA is unwilling to consider that their overreach (imho) is the major contributor to this problem. It is easier to just say NO...Deny.

Second, the FAA acknowledges that the delay in making a decision is too long and wishes to decrease the delay. There are several factors that contribute to this, in addition to the overreach (which they have likely have zero intention of lessening).

The FAA feels that it is convenient to transfer research on what is required for approval/special issuance from the FAA to the AME and the pilot. Hence, the decision to transfer responsibility to determine what testing is required for a given medical problem to the pilot and the AME. This makes it necessary for the pilot and the AME to research the Guide for Medical Examiners and make that determination. This is challenging for the AME, in that the Guide is not particularly easy to navigate...even with the medical training...and even more daunting for the pilot (who likely has limited, if any, medical training).

Until recently the FAA required all supporting/requested documents be mailed to them directly. The records then sit in some poor person's cubicle for a considerable length of time (the Regional Flight Surgeon's office acknowledges about 30 days) before it is scanned into the pilot's file. The decision maker then has access to the files and determines if that person can grant the medical certificate, or if it needs to be kicked up to a higher authority. That process takes time (months), and the higher authority (advisory board, which meets quarterly in most cases) makes the final decision. The FAA has decided to expedite that process by recommending that the records be provided to the AME so that the examiner's staff would be responsible for scanning in those records, then upload them to the pilot's file. This transfers significant workload to the AME and that workload is performed by the AME's staff (in my case I am the chief cook and bottle washer). This can be frustrating for the AME (I speak from experience) when it is discovered that the file size for upload is exceedingly small and is rejected if too large. This is dealt with by scanning in the documents in small groups, then uploading by category. Can the pilot directly upload the files? No, as they do not have access to their file (understandable). This problem will be significant, in that I do not appreciate doing the scanning and uploading into the FAA system, and I don't have the staffing upon which to transfer this responsibility.

Both of these changes (denial and record processing) cause undue burden on the pilot and AME, and cause me to reconsider what I am willing to do to placate the FAA.

At last count, there were over 50,000 pilots who have escaped from the FAA medical certification (sort of) and gone to BasicMed. One would expect that this would significantly decrease the workload on the FAA, but that is apparently not the case. I would argue that the cumbersome system that has been put into place by the FAA is responsible for this and, rather than turn to introspection and reform, they have chosen to make these changes that are very convenient for the FAA, but not so much for the pilots and the AMEs.

Wishing you a Merry Christmas and a Happy New Year!


Doc R
 
I posted about this too, the color vision test is a subscription for like $20-30mo and requires a iPad, I do like that color vision testing now follows some version of logic and is a one and done with no further re tests

Yes removing options for different color vision testing is dumb, especially as there have been zero crashes where color vision made a difference, but for how much many AMEs make compared to the level of liability they enjoy doing FAA medals, if buying another iPad and having a cheap subscription breaks them, I think there must have been other issues at play for them as well.

Based on the FAAs own study, they even found zero difference in “safety” between 3rd class and basic, and the difference between a 3rd and a 1st is minimal. If we use logic and history changing all class of medical to a basic med exam model would be miles safer and also allow the taxpayer to save tons of money by nearly eliminating FAA aeromed division.

But the FAA is a loud and proud logic free zone


As for AOPA, they are the NRA of aviation, they supported forced ADSB trackers for god sakes lol



Good summery of at least the color vision part


One of the “new” color vision systems


Also goes to show, in 2024 America one need to understand putting something on your medical record should be avoided like putting something on a criminal record, any medical diagnosis can and will be used against you in a court of administrative “law”
Spot on! Thanks for sharing your experience and your thoughts. Regarding your statement "...understanding putting something on your medical record..." readers may want to visit the thread "Know Thyself...Do You Know What Is In Your Electronic Medical Records?"

rsc
 
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Mark Cook, board member of the MN Pilots Assn, forwarded this letter written to the Federal Air Surgeon regarding the changes discussed in this thread. We have written our support, as well, on behalf of Minnesota pilots.

Industry letter 12 13 2024 1.webp

Industry letter 12 13 2024 2.webp

Please contact your local and regional aviation organizations and lend your support to have the imminent change postponed until "further review".

rsc
 
IMG-5838.jpg
came across this about the color vision part




Mixed blessing, lots of good logic on not retesting color vision, but shame they are removing different testing methods, especially as there has never been a crash actually caused by color vision issues
 
This good news in my email box this morning from the FAA...

FAA Statement on Postponement of Medical Denial Process Change

The Federal Aviation Administration (FAA) will postpone the implementation of a process change for individuals applying for an airman medical certificate with incomplete exams and paperwork after receiving feedback from aviation stakeholders. The process of issuing initial denials set to take effect on Jan. 1, 2025, will be postponed until March 1, 2025. The decision to implement this change was not associated with the FAA Reauthorization Act of 2024, but the need to provide immediate answers to airmen regarding the medical certification process.

Postponing allows the FAA additional time to educate the pilot community and to host a listening session with various aviation associations in early January.

Disclaimer: Do not reply to this email. Please contact your Regional Flight Surgeon’s office for questions regarding this decision.

I will provide suggestions on who/how to contact the FAA with regard to support to rethink this decision. The Minnesota Pilots Association has provided support as an advocate of the letter that was sent from a large number of influential groups, including AOPA, asking for reconsideration of this directive.

Stay tuned...

Doc R
 

This: "allows the FAA additional time to educate the pilot community and to host a listening session with various aviation associations in early January." gives me pause. The only thing I see is, the FAA has extended the effective date to March 1st. On that date they will place their previously stated rules into effect regardless of what legitimate opposition may be presented to them. I've seen this type of action in the past. They will let us spout off all we want, but......the rule is going to be done their way anyway.

If able (not needing class 1 or 2) go Basic Med now while you can, and be prepared to take advantage of the new proposed Sport pilot reduced restrictions.
 

This: "allows the FAA additional time to educate the pilot community and to host a listening session with various aviation associations in early January." gives me pause. The only thing I see is, the FAA has extended the effective date to March 1st. On that date they will place their previously stated rules into effect regardless of what legitimate opposition may be presented to them. I've seen this type of action in the past. They will let us spout off all we want, but......the rule is going to be done their way anyway.

If able (not needing class 1 or 2) go Basic Med now while you can, and be prepared to take advantage of the new proposed Sport pilot reduced restrictions.


From how I read it sounds like it was the aviation industry / pilots who had to “educate” the FAA.
 
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