Primarily for general aviation discussion, but other aviation topics are also welcome.
By Lefty
#1694181
Firstly Hurrah, I've got my medical fully reinstated after a short illness.
Secondly, in going through this process I've had to learn how the system works - and the minor error / omissions that can cause it to fail - or be delayed.

To get your medical back after a temporary suspension or an OSL (Operational Safety Limitation) - the CAA require the consultant / other specialist treating you to submit a report - detailing your condition, treatment and short / long term prognosis etc. The CAA publish a one page "Specification for Reports (General)" - which lists the minimum the CAA expects your specialist to provide in the report.

I am told that in practice however, doctors frequently fail to cover all of the items listed on the sheet - causing you to back around the houses several times to get every question answered.

Armed with this info (and being in a hurry to get my medical back) I transcribed all the topics listed on the specification - into a report format - with spaces for the consultant to simply hand write in his replies to each of the questions.

This (a) ensured that he did it there and then before I left the consulting room (rather than (at some time in the future), dictate something to his pa who wold eventually type it up and post it) and (b) ensured that he actually put a either a reply - or "Not Applicable" against everything listed on the CAA spec. sheet.

Of course for some conditions the CAA may still ask for more info, but in my situation, I was told that ensuring that every question was answered clearly first time around - made it much easier for my AME and the CAA to process my medical.

Lastly, I need to say a big thank you to my AME, Dr Marion Marshall, who has really gone the extra mile (several times over) to help me get back flying as quickly as possible.
WelshRichy, Grey Beard, Hawkwind and 4 others liked this
#1694217
That you were able to produce a document which served the purpose, by yourself , highlights the reason so many appear to be antagonistic towards the CAA . One could argue that this is a clear case of obstruction by omission.

Just because they're not obliged to make it easy for all involved, doesn't mean it's right!
From your post, I get the impression that the "guidance -notes" have to be sought- out. then the Medical -practitioner has to be cajoled to jump through all the hoops. We read, so often, of these broken systems, where, for instance, Licence- applications go round in never-ending circles, each time ending at the bottom of an unacceptably large pile, whereas, a check-list approach, such as yours, produces a simple, rapid and correct result.....of course, this approach results in a cheaper, quicker turn round for the "customer" but it reduces "their" revenue and eliminates a load of useless and pointless "job -creation".

I would like to think they would adopt your idea and apply it to all issues where a submission has to be made, with multiple parts. but that would be an admission that they didn't run their "business" efficiently and in the "customer's" best interests, wouldn't it? :thumright:
Katamarino, NickS liked this
#1694287
Well done. I wish I was having your sort of luck. I was diagnosed with a fairly common spinal condition last October and my medical was immediately suspended pending a consultant's report. This duly arrived and it mentioned "a very small risk of incapacitation if there is a neck injury". This has sent the CAA into a panic and I can now only fly with a safety pilot once I have completed a medical flight test with an examiner, even though the report makes it clear that I have no loss of strength, mobility or anything else and that I am essentially asymptotic.

The AME then requested a further report on the risk of incapacitation. The consultants reply, sent directly to my AME, said the risk is so small that no data is available and then chucked a really big spanner in the works by saying I had loss of feeling in my hands. This is complete and utter rubbish and I managed to get an amended report the next day but clearly doesn't help me at all.

At the moment I'm still waiting to do a medical flight with an examiner, for what good it'll do me, and I'll take it from there but my AME doesn't seem particularly supportive. It's very frustrating, to say the least.
By Lefty
#1694302
jaycee58 wrote:Well done. I wish I was having your sort of luck. I was diagnosed with a fairly common spinal condition last October and my medical was immediately suspended pending a consultant's report. This duly arrived and it mentioned "a very small risk of incapacitation if there is a neck injury". This has sent the CAA into a panic and I can now only fly with a safety pilot once I have completed a medical flight test with an examiner, even though the report makes it clear that I have no loss of strength, mobility or anything else and that I am essentially asymptotic.

The AME then requested a further report on the risk of incapacitation. The consultants reply, sent directly to my AME, said the risk is so small that no data is available and then chucked a really big spanner in the works by saying I had loss of feeling in my hands. This is complete and utter rubbish and I managed to get an amended report the next day but clearly doesn't help me at all.

At the moment I'm still waiting to do a medical flight with an examiner, for what good it'll do me, and I'll take it from there but my AME doesn't seem particularly supportive. It's very frustrating, to say the least.


Another reason to create a report form is that you get to read the questions - and identify any answers which, if phrased incorrectly, could result in the your current situation. By sitting in front of the consultant whilst he completes the form, you can ensure that he doesn't use language that could be misinterpreted by the CAA. It cost me an extra (private) consultation fee, but I was able to ensure that my consultant, whilst being scrupulously honest and accurate, did not use language that could agitate the authorities.
#1694334
Lefty wrote:
Another reason to create a report form is that you get to read the questions - and identify any answers which, if phrased incorrectly, could result in the your current situation. By sitting in front of the consultant whilst he completes the form, you can ensure that he doesn't use language that could be misinterpreted by the CAA. It cost me an extra (private) consultation fee, but I was able to ensure that my consultant, whilst being scrupulously honest and accurate, did not use language that could agitate the authorities.


I didn't know about the report form so thank you for that. This could have been useful after my cataract operations last year as it took 3 attempts before I finally got a report specifying the type of replacement lenses I had, despite me making it clear that this was essential information. With regard to my current problem, the consultants first report was written, or dictated, while I was with him. The subsequent report was via a written request by my AME to the consultant. Fortunately, this report was cc'd to me as otherwise a report saying I had lost feeling in my hands would now be with the CAA. I've still actually got no idea what has been said between the CAA and my AME either. I'm unsure as to whether I have the right to ask the CAA to show me evidence that justifies their decision (anyone know?).

I'm still hopeful that I can get my class 2 back and I'm carrying on with my CPL theory exams as if that's going to happen but it could well end up as money down the drain. If I can't get a medical I really don't know what I'll do as bimbling about with a safety pilot really isn't my idea of fun. However, thanks to me being scrupulously honest with the CAA, there's a good chance my retirement career as an FI has hit a brick wall before I've barely started.
#1694339
I am always saddened if people report communication difficulties, as this compounds to the stress around certification issues.

@jaycee58 Your AME will be able to share with you what has been discussed and of course are you entitled to know what is held in your file.

I am sure that I am not perfect (Mrs FD reminds me regularly) but I try to be as clear as possible with pilots and fellow clinicians as to what is required so that I or the CAA can make the appropriate decision within the regulatory framework given.
#1694342
Thank you, FD. I'll be seeing my AME within the next month or so hopefully I'll be able to get to the bottom of things. It's very frustrating to be stopped from flying for what appears to me, my GP and my consultant, to be a fairly minor problem that can be left alone for the foreseeable future as the risk of surgery far outweighs any benefits.
User avatar
By kanga
#1694495
cockney steve wrote:That you were able to produce a document which served the purpose, by yourself , highlights the reason so many appear to be antagonistic towards the CAA . One could argue that this is a clear case of obstruction by omission.

Just because they're not obliged to make it easy for all involved, doesn't mean it's right!
.., a check-list approach, such as yours, produces a simple, rapid and correct result.....of course, this approach results in a cheaper, quicker turn round for the "customer" but it reduces "their" revenue and eliminates a load of useless and pointless "job -creation".

I would like to think they would adopt your idea and apply it to all issues where a submission has to be made, with multiple parts. but that would be an admission that they didn't run their "business" efficiently and in the "customer's" best interests, wouldn't it? :thumright:


:evil:

I don't know if this was being deliberately provocative, but I'll respond anyway.

a. such feedback as I've heard from or about the medical professionals in CAA medical branch has suggested that they are generally helpful and flexible towads both AMEs and applicants
b. however, I assume that, to help them use as much as possible of their time exercising their professional skills and knowledge and judgement, their 'intrays' are filtered and sorted through support staff who have little or no relevant medical knowledge, and who must work from prepared checklists with little scope for 'judgement'. It would be surprising if it were otherwise, and reflects the inherent problem of running a 'business' or a regulatory agency using to best effect as few as possible highly trained staff in core posts and as few possible less trained support staff who may have to be moved from one support area to another
c. it is highly likely that these 'checklists' and supporting 'forms' could be improved, making life easier for applicants and checking staff, and making for faster turnround. The CAA may, indeed, well welcome suggestions for such improvement.

BUT, as ever, is there (ever) any evidence that the checklists, forms, mechanisms etc have been deliberately designed or kept 'inefficient' with the malign intent that it "reduces "their" revenue and eliminates a load of useless and pointless "job -creation". " ? In CAA Medical Branch, anywhere in CAA, anywhere in UK public adminstration .. ? Happy to be informed.
#1694578
cockney steve wrote:That you were able to produce a document which served the purpose, by yourself , highlights the reason so many appear to be antagonistic towards the CAA . One could argue that this is a clear case of obstruction by omission.

Just because they're not obliged to make it easy for all involved, doesn't mean it's right!
From your post, I get the impression that the "guidance -notes" have to be sought- out. then the Medical -practitioner has to be cajoled to jump through all the hoops. We read, so often, of these broken systems, where, for instance, Licence- applications go round in never-ending circles, each time ending at the bottom of an unacceptably large pile, whereas, a check-list approach, such as yours, produces a simple, rapid and correct result.....of course, this approach results in a cheaper, quicker turn round for the "customer" but it reduces "their" revenue and eliminates a load of useless and pointless "job -creation".

I would like to think they would adopt your idea and apply it to all issues where a submission has to be made, with multiple parts. but that would be an admission that they didn't run their "business" efficiently and in the "customer's" best interests, wouldn't it? :thumright:


Can I just interject some reality into your suppositions, or is that breaking netiquette rules?

I cannot speak for all AMEs but in my practice all reports are read by me and I know that at the CAA all reports are reviewed by Nurse specialists and AME (Called Medical Assesors there).

All regulations, guidance material, report guidance etc etc is on the CAA website - I can tell you that from doing medicals for pilots of a lot of EASA countries that the CAA website is easy to navigate and the requisite Information can be located and downloaded. Where there is anything not clear the AME can ring the CAA and get further guidance.

For reports there is guidance, apart from general guidance there is a also guidance for specfic conditions. An example, chosen randomly, thereof can be found here:

https://www.caa.co.uk/WorkArea/Download ... 4294973481

I'll make a bold statement here, any competent clinician in that speciality would should be able to understand what is required, those who don't are probably in the wrong job. In fact I think that most patients can fill out the essentials.

Being on the receiving end of reports regularly I can share that common issues are:

No report produced - the Pilot is assured that the report will be done and send to the AME. No report arrives - who gets the blame, you guessed it! So I advise pilots, you get the report and get it to me. Then it is clear who has or hasn't done what.

No report is produced but copies of clinical communication between say GP and Hospital Team are given. Those documents do not give the Information required. No Information received more needs to be requested resulting in frustration and delays.

Wrong test done or test not done in accordance with ICAO/EASA/CAA requirements. Test needs to be redone, at extra cost, time and rustration.

My consultant/doctor/nurse says it is OK. Unfortunately the decision that you are OK is made by the CAA and/or AME. For that they need the information. No information means no decision.

Add to that the notion that all the extra work should of course be done FOC, of course.

And so on....

:D

Often it goes well and without any problems of course, but when it doesn't it can be a right royal pain.

Added to that, the treating clinicians, are always great as they have cured/fixed the problem and the AME/CAA is the hurdle to get back to normal/before, so we start off several leaps behind the treating team!

All good, and most AMEs are active fliers so we know how important it is to pilots to get back to flying, crumbs some of us have even had to jump through those same hoops to get back in the air!

But don't talk rubbish please.

:D
kanga, patowalker, kui2324 liked this
#1694644
I'm really pleased that you posted that link, FD. The form states that to get a class 2 there has to have risk of incapacitation of 1% or less. I didn't know this. Would this apply to any medical condition, not just oncology? So far my consultant has only said the risk is very small and either will not or cannot put a figure on it. In his words "the data does not exist".

Personally, I would regard 1% as "a bit high" but if that's what the CAA are happy with then it gives me some encouragement.
#1694655
@jaycee58

That goes for everything.

It is a 1% risk of capacitation whilst exercising the privileges of the medical certificate. They are not interested in people keeling over when engaged in other activities!
#1694663
Thank you, FD. That really is quite encouraging. My consultant considers that there is only a risk in the event of neck injury and I'm not really planning to get one of those while flying. If I injure it by stuffing the aircraft in, well the flight's over anyway :D .