[Peetwo]

Hook; line; sinker; & a parallel universe -  

Our public servant are no longer servants of the public Sandy, they are self servers.

On UP duty (yawn -   ) I note that there is a thread (currently active and not yet shutdown    ) that is endeavouring to discuss the CASA Avmed discussion paper...

Last post courtesy of thorny...

TB - "Following in from my comments in the PT61 thread, there were less than 100 responses to the letter the DAS put out".

You mean to tell me there are still 100 pilots left in Australia!!!!!
CAsA is obviously not doing its job stamping out these criminals, everyone should write to the minister and complain.

Besides thornbird's latest contribution, which risks possible moderator sanction due suspicions of sarcasm and possible CASA derogatory comment, there seems to be much confusion and scepticism on the real intent and purpose of the CASA bollocks DP...

Here is a small cross section of some of the UP posts:

---

Old Akro -

So how does CASA determine for itself that you are a fit and proper person to hold the licence?

CASA does this via a network of delegated DAME's. The trouble is that CASA neither trusts them, nor the specialists to whom they seek additional opinion, nor the drug companies who make recommendations about side effects, etc, nor indeed the FAA who publish a much more comprehensive DAME manual than CASA.

Instead CASA centralises all decision making and review, but employs people with inadequate qualifications or experience, thus they have guidelines & protocols provided. But these are inadequate, contradictory and incomplete. And none of the administrative staff will take responsibility for going outside the guidelines (more than their jobsworth). So anything that is not black & white, enters a spiral of review until the pressure for a decision finally becomes overwhelming.

All CASA needs to do is:
a) harmonise its medical standards with other Australian bodies / overseas agencies. Australian aviation does not need unique standards for blood pressure, blood sugar, etc.
b) make the DAME guidelines clear & easy (or copy the FAA one)
c) allow DAME's to have proper authority. They are well qualified, serious people, seriously, why can't they be the arbiter of who is fit to fly? They or their colleagues do it for driving, boating, scuba diving and a range of occupations. As much as we would like to think otherwise, pilots aren't a special breed.

---

Icarus2001 - I think you missed the point that Mr Approach was trying to make Akro. The DAME DOES NOT decide if you are a "fit and proper person" to hold a licence. They simply assess your HEALTH indicators against a set of standards.


Fit and proper is a whole other ball of wax.

---

Old Akro - Icarus

Got it now. But, without having read the relevant legislation, I would expect that a pretty much identical phrase appears regarding driving licences, boat licences and a whole range of other things from gun licences to explosives licences.

CASA stands alone in creating such convoluted, contradictory, ill defined medical requirements. It also stands alone in the bureaucratic structure it has created to administer this.

Other bodies find easy, cheap, efficient ways of dealing with these requirements. CASA pretty much stands alone in wanting to not delegate any authority and administer it all centrally in Canberra.

Don't believe me? Go and get a heavy truck licence (administered Nationally, but delegated to the state bodies). It involves medical requirements, skill & knowledge requirements and fit & proper person requirements. And a truck driver can do a whole lot more damage in a 40 tonne truck than I can in a 1.9 tonne light twin.

---

 Which leads me back to the TB post...     

While on the CASA Avmed DP, this was from the horse's mouth Herr Comardy in the introduction to the DP:

...Aviation medicine is complex, involving medical, regulatory and legal considerations. Mindful of this complexity, we have decided that a wide-ranging discussion paper is the best way to canvass community views about medical certification in the sport and recreation, general aviation, aerial work, air transport and air traffic control sectors alike...

...This discussion paper will form the basis for future consultation between CASA and all affected stakeholders on the issues raised and any action CASA proposes to take. Such consultation would take place through a dedicated development team, possibly leading to release of a notice of proposed rulemaking (NPRM) for industry and public consideration...

This discussion paper does not contain proposals for or draft regulations. That would be premature. What we need to do now is to identify and articulate the issues, and to begin to consider better ways to address those issues...

Hook:-

CASA intro:- “Aviation medicine is complex, involving medical, regulatory and legal considerations. Mindful of this complexity, we have decided that a wide-ranging discussion paper is the best way to canvass community views about medical certification in the sport and recreation, general aviation, aerial work, air transport and air traffic control sectors alike.”

When there is a slim chance that a submission to a ‘discussion’ paper will be weighed, measured and considered, it is worth spending the time and making the effort to provide one. This ain’t one of those times. CASA Avmed can more readily access empirical statistics from sister bodies, such as the USA and would have done so, should there be an internal desire to utilize a similar system. The data, protocols and system details have been available for donkey’s years and if there was any chance of ‘change’ then the discussion paper would be referenced to the proposed changes to system.

Line:-

CASA intro:- “This discussion paper will form the basis for future consultation between CASA and all affected stakeholders on the issues raised and any action CASA proposes to take. Such consultation would take place through a dedicated development team, possibly leading to release of a notice of proposed rulemaking (NPRM) for industry and public consideration.”

The vast majority of ‘stakeholders’ (read pitch fork wavers) have little to no acceptable expertise “involving medical, regulatory and legal considerations”. Unqualified submissions may then be disregarded with impunity. The local DAME may well be qualified to provide ‘expert’ medical opinion; but their comment on ‘legal’ and ‘regulatory’ matters will, for the reasons mentioned, be discarded as quickly as those from the ‘unshriven’.

& Sinker:-

CASA intro:- “This discussion paper does not contain proposals for or draft regulations. That would be premature. What we need to do now is to identify and articulate the issues, and to begin to consider better ways to address those issues.”

No doubt ‘irritated’ by the constant yapping of the small dogs next door – a juicy bone is lobbed over the fence; this will keep ‘em quiet and occupied for a good long while.

Any real attempt at reformation would be presented as “we have considered the FAA pilot medical system and propose to bring a similar system into law”. “This discussion paper and the attached NPRM is provided for industry and public consideration”. Anything else is simply a bollocks, cunningly designed to provide employment for a number of years and make it appear as though CASA are actually doing something.  No doubt there will be many sound, solid, well argued submissions presented, all making perfectly good sense; and it must be done. But the temptation to toss the discussion paper into the bin and never think of it again is great. In truth, ‘tis irresistible – THUD.

Toot- toot.

Last thought: perhaps a ‘discussion’ paper on how to stop CASA getting away, every time, with this sort of frivolous, time wasting, costly exercise would draw more ‘suggestions’ from ‘stakeholders’

Unfortunately the Ferryman's pessimistic post is IMO about as close to reality as you'll get.

I seem to recall that this cynical attempt by CASA, at placating the miniscule and obfuscating the IOS, was due to AOPA supporting the SAA attempt at harmonising pilot medical requirements with that of the RA_Aus  and in line with the Class 3 driver license medical concept in the US...

However, as "K" succinctly points out this is the way Fort Fumble works, get the original minor contention lost in 45 pages of weasel words and the rest is history...
      
Coming back to the "K" comment..

"..The vast majority of ‘stakeholders’ (read pitch fork wavers) have little to no acceptable expertise “involving medical, regulatory and legal considerations”. Unqualified submissions may then be disregarded with impunity. etc.."

..& the possibility or sensibility of making a submission. The trouble is CASA again cynically use lack of interest/uptake of submissions as an indicator that most sectors of the industry don't have a problem with the current Draconian 19th rule-set for pilot medical (re-)certification.

However here's a thought, why don't the TAAAF collective put up a front man/women/expert panel that truly does know what they're talking about.

Choice No1. to front up such an industry panel IMO would have to be Rob Liddell...

Reference quote from ASRR submission 69:

..Recently there has been a move for reasons that remain unclear to change the Australian regulations to be totally compliant with the ICAO medical standards. This move is without any evidence that adopting more restrictive practices will have any effect on safety but rather will discriminate against some pilots.

I now have several pilots, one of whom has over 16,000 hours of operation, most of it flying night freight in command on Boeing 727 aircraft and who in mid-career are being advised that they do not meet the standard because of their colour vision and so cannot hold the required class of licence to retain their occupation.

I suspect that due to my previous role in CASA, I seem to attract many pilots who are totally confused and despondent at their medical certification by CASA aviation medicine. This involves conditions such as head injury, hearing, cardio vascular disease and prostate cancer, where the opinions of the pilots own specialist doctors are ignored and stringent and expensive repetitive imaging and blood testing is required if the individual wishes to retain their medical certificate. On a weekly basis I receive requests for assistance by pilots with conditions ranging from renal stones to early type 2 diabetes where the pilots own specialist’s advice is ignored by CASA and further expensive or repetitive testing in required to obtain a medical certificate.

The dangerous result of CASA’s draconian regulatory measures is that now many pilots tell CASA as little as possible about any medical problems in order to protect themselves from expensive and repetitive investigations or possible loss of certification . Most pilots are responsible people and they have no desire to be in charge of an aircraft if their risk of incapacity is unacceptable. When their DAME and their specialist believe they meet the risk target for certification without endless further testing demanded by CASA and the advice of their own specialist is ignored by the regulator then the pilot’s lose confidence in the regulator.

In medical certification CASA appears to have lost sight of the fact that all pilots self-certify themselves fit to fly every day they take control of an aircraft. The only day in the year when a doctor has any control over their fitness to fly is the day that they have their medical examination.

Dr Robert Liddell..

Speaking of self-certification of pilots in a parallel hemisphere, read & weep the following flight safety briefing courtesy of another NAA the FAA...  :

Say Ahh ...A Pilot’s Guide to Self-Assessing Risk

by Tom Hoffmann, FAA Safety Briefing

In the grand scheme of aviation risk management, it is easy to focus on the more tangible and black-and-white realities of flying. For example, will my airplane clear that 50-foot obstacle at the end of the runway with full fuel? Or, is my aircraft properly equipped for night flight in instrument meteorological conditions (IMC)? A few performance calculations, handbook references, and preflight checks can usually affirm a clear go, or no-go, decision.

Where it can get fuzzy and gray is assessing the level of risk that you, as the pilot, bring to the equation. Instead of relying on calculations and hard numbers to measure risk, it requires a more internal assessment of your readiness to fly, as well as being honest with yourself and your abilities. It boils down to three basic questions you should ask yourself before any flight: Am I healthy? Am I legal? And am I proficient? This article will explore how to assess and address pilot risk in each of these areas.

Am I Healthy?

I’m a visual person. The more of something I can visualize, the better I can understand it and tuck it away in my memory banks. I’m also a firm believer in the power of acronyms and mnemonics, those memory-jogging abbreviations that are engrained in aviators’ everyday operations. While some aviation acronyms don’t always give us a good sight picture of what we’re expected to do, the “I’MSAFE” acronym is one that I believe hits the proverbial nail on the head. It offers a simple and easy-to-remember way of checking your health before every flight. Let’s break it down.

Illness — Am I Sick?

While the average 9-to-5er may bristle at the thought of calling in sick from a simple case of the sniffles, that same act of fortitude can prove

problematic when deciding to fly. In addition to dealing with the distraction of pain and/or discomfort, even common maladies like a cold are often accompanied by a regiment of over-the-counter (OTC) medications that can wreak havoc on a pilot’s ability to stay focused and clear-headed during flight. We’ll cover more on meds next, but the bottom line here is quite simple: if you’re not well, don’t fly.

Let’s say you knew in advance that your engine was only going to give you 80 percent of its best possible performance on a given day. Would you still fly? It’s the same expectation you should have for yourself — nothing less than running on all cylinders should be acceptable.

The regulations have something to say about this as well. Title 14 Code of Federal Regulations (14 CFR) section 61.53 outlines operational prohibitions for pilots when they know, or have reason to know, of any medical condition (whether it’s a chronic disease, or a 24-hour bug) that would make them unable to meet the requirements for the medical certificate necessary for the pilot operation, or — for those not requiring medical certification — make them unable to operate an aircraft in a safe manner. Although vague in design, the rule prompts pilots to use good judgment and voluntarily ground themselves when they’re not feeling up to the task of aviating.

Medication — Have I Taken Any Prescription/OTC Meds?

As we noted earlier, medications can have a clear impact on a pilot’s ability to perform. While some effects are obvious, others can be deceivingly detrimental and may vary according to an individual’s tolerance level. Among the top offenders are sedating antihistamines, in particular, diphenhydramine (aka Benadryl). In addition to being an active ingredient in many cold medications, diphenhydramine is also used as an OTC sedative and is the sedating agent in most PM pain meds.

Evidence of rising antihistamine use (as well as other OTC medications) was at the forefront of a 2014 NTSB study, in which the percentage of pilots with potentially impairing drugs found in their system after an accident was greater than 20 percent in 2012. That was more than double the rate found at the outset of the study in 1990. The most common potentially impairing drug found in this study of nearly 6,600 aviation accidents: you guessed it, diphenhydramine.

A good way to ensure the medications you use don’t impair your flying is to first check the labels. Thankfully, the U.S. Food and Drug Administration (FDA) has strict labeling standards for all OTC medications so it’s easy to make comparisons and spot any potential side effects. The FDA also has a handy, online label checker you can use too (http://labels.fda.gov). For medications that have a warning about using caution when driving a vehicle, the FAA recommends using the “Rule of 5” — waiting at least five times the longest recommended interval between doses before flying.

Labels won’t always answer all your questions so contact your Aviation Medical Examiner if you’re unsure about a particular drug or would like to know more about safer alternatives. For more information, go to http://go.usa.gov/xkMvh.

Stress — Do I Have Any Job, Money, Family, or Health Issues?

We may not always think about it, but we’re under some level of stress with almost everything we do — whether on the job, with family, or even during what’s supposed to be a relaxing backcountry camping trip. Stress can affect people differently, so it’s really important for you to have a way of gauging a clear head and a sound state of mind before taking that flight.

A brief quarrel with your spouse, while seemingly insignificant, can easily cloud your thoughts and cause you to be distracted during flight. (Been there, done that, and learned a valuable lesson!) A more severe event, like the loss of a job, or a loved one, requires even more attention and self-examination to assess whether or not you’ve been able to properly come to terms with your situation and your emotions. It may not always be the easiest thing to do — especially if others are counting on you to fly them somewhere — but delaying or postponing a flight due to stress is always a good call.

There are several ways to help manage stress and prevent it from accumulating. For starters, try maintaining a regular exercise regime and make relaxation a priority in your daily schedule; have you actually ever tried yoga? It’s a great way to combine the two.

Sharpening your time management skills can also help reduce stress by meeting deadlines and keeping those honey-do lists from growing too large. Finally, an FAA study in 2000 on the impact of stress in aviation found that the top ranked stress coping strategy among participants was a stable relationship with a partner, so don’t be afraid to bend your spouse’s ear!

To learn more about how stress can affect your performance, watch this FAA video (see below or click here) and check out the article “Stress in Flight” in the Jan/Feb 2009 issue of FAA Safety Briefing.

Alcohol — Have I Had a Drink in the Last 8 Hours? 24 Hours?

For many, “throwing back a few” can be an effective way to relax and unwind after a tough day. But if flying is on your horizon, you’ll want to reconsider your actions. Like beer and wine, the two just don’t go together. The regulations (14 CFR section 91.17) say you may not operate an aircraft within eight hours of having consumed alcohol. Given the lingering effects alcohol can have on the human body, it’s best to pad that time and wait 24 hours before flying. And if you were really in a “celebratory mood,” keep in mind that the damaging effects of booze can last 48 to 72 hours following your last drink in the form of a hangover and well after your body has eliminated all alcohol. Add in night conditions or bad weather to any of these scenarios, and the negative effects on flying can be magnified greatly.

For more information, have a look at the FAA’s brochure “Alcohol and Flying — A Deadly Combination” at http://go.usa.gov/xkFJd.

Fatigue — Am I Properly Rested?

The impact of fatigue in the aviation industry is an all-too-common phenomenon.

Although it’s rarely the singular cause of a fatal accident, the term pilot fatigue is riddled throughout NTSB probable cause reports in all segments of aviation. It’s more commonly the ugly precursor to many poor last decisions (or indecisions). As to why a simple lack of rest is not mitigated more often, some might say it’s because it can be easily remedied with coffee or an energy drink, or that it’s just something they feel is a nuisance they can power through. Both are false narratives that gravely underestimate fatigue’s disastrous potential.

In order to manage fatigue, it’s important to listen to what your body is telling you. Do you feel yourself uncontrollably yawning? Are your eyes bloodshot and bleary? Are you feeling sluggish or slow to react? Keep in mind that fatigue isn’t limited to just these more obvious signs. It’s often a more insidious problem fueled by a creeping accumulation of inadequate rest (e.g., long nights at the office, a new baby in the house, etc.) Fatigue can also be caused by physical exertion. Those first few great-weather flying days we look forward to in the spring are usually accompanied by a mountain of strenuous yard work. And while you may not typically be exposed to the long duty days and time zone shifts that a commercial pilot might have, you do have to deal with the stress of a single-pilot workload with no one to catch your mistakes.

Regardless of what causes fatigue, the important thing to know is how it can affect your performance in the cockpit and how to prevent it in the first place. The antidote here is simple: get more sleep. You may have heard it a thousand times before, but strive for eight hours of sleep per night. Easier said than done, I know. But one thing that I find helpful in measuring the quantity and quality of sleep, is wearing a wristwatch activity tracker to bed. Many are able to provide a full report of your sleep cycles, including periods of restlessness and time awake. Arming yourself with this kind of data can go a long way to more accurately assessing your fatigue level before a flight.

For more tips on combatting fatigue, see the FAA brochure at http://go.usa.gov/xkMwc.

Eating — Have I Had Enough to Eat or Drink?

Now, I know many versions of I’MSAFE use Emotion for “E,” but I think that is something we covered adequately under our discussion about Stress. Instead, we’ll use “E” to cover a subject more near and dear to my heart: eating. Eating healthy, well-balanced meals is the best way to achieve your body’s peak performance levels. Unfortunately, not every airport has a Joe’s Diner conveniently nearby. In fact, GA pilots can often go several hours past their normal mealtimes without eating thanks to weather delays or unexpected diversions. It’s always a good idea to pack a lunch just in case, or at the very least, a few healthy snacks that will tide you over. The same goes for hydrating. Drink whenever you get the chance. Dehydration can cause dizziness, confusion, and weakness and can seriously impair your ability to fly. I never fly without at least one bottle of water in my flight bag, and I always hit the water fountain anytime I see one.

Am I Legal/Proficient?

Now that we’ve reviewed some of the physical and mental hurdles an airman can face, it’s time to cover some of the legal and experiential aspects of completing a pilot risk assessment. Let’s start by addressing the fact that being legal or current is by no means an indication of being proficient when it comes to flying. The FAA sets clear standards when it comes to what’s required in your logbook before you can fly as pilot in command, within a certain time period. For a complete list of these requirements, see 14 CFR section 61.57 (http://go.usa.gov/xkM7t) as well as 14 CFR section 61.56 (http://go.usa.gov/xkMHp) for flight review requirements. However, just meeting these requirements alone is unlikely to make you a fully competent and proficient pilot. That takes additional effort.

A good start towards fine-tuning proficiency is to use a flight review as an opportunity to go outside your comfort zone. Weak on crosswind landings? Been a while since you did a short field grass takeoff or simulated an onboard fire? Then make these priority items to work on with an instructor and/or during a flight review. A review that just substantiates all the things you already have a good grasp on is not exactly time (or money) well spent.

The key to proficiency is practice. And then more practice.

There’s lots of resources, and the FAA can help you become proficient. If you haven’t already signed up to be a part of the FAA Safety Team’s WINGS Pilot Proficiency Program, I highly encourage you to do so. The program is specifically designed to help pilots become more proficient by attending safety seminars, completing training courses, and performing various flight activities. Go to FAASafety.gov for complete details.

It’s Personal

Flying is an inherently risky business. However, learning how to identify and mitigate the potential risks that a pilot brings to a flight is a significant step towards improving your odds of a safe outcome. I hope the information presented here can give you a better understanding of what to look out for and what to question before each and every flight. It can be difficult, as assessing pilot risk is a very personal process and one that requires intimate awareness of your limitations. You have to be upfront with yourself mentally, physically, and experientially. Here, honesty is not the best policy — it’s the only policy.

Tom Hoffmann is the managing editor of FAA Safety Briefing. He is a commercial pilot and holds an A&P certificate.

Meanwhile in Dunceunda land AIOS reaches epidemic proportions - "nothing to see here move on.." 


MTF...P2

[Kharon]

Curious, I had a quick scamper through the UP Avmed board. Old Akro and Lead Balloon were, as always, worth reading. I cribbed the latest offering from LB, it was worth the time to do so- HERE.

A discussion paper is just one of the usual CASA look-busy tactics to avoid doing anything.

If CASA were genuinely interested in listening to and addressing substantive issues about medical certification, it would have listened to and addressed the substance of the submissions to the Aviation Safety Regulatory Review from the associations which represent many people across the aviation spectrum on the receiving end of AVMED's capricious bullshit.

The Australian and International Pilots’ Association:
Quote:
AIPA’s most frequent and often most frustrating interaction with CASA is through the Aviation Medicine Branch. The frustrations arise due to the inconsistent administration of medical clearances and certificates, the near impossibility of being able to talk to anyone about the administration processes and, most critically, what most members report as the CASA-unique approach of disregarding practicing medical specialists’ advice in favour of “riskbased” decisions made by non-practicing medical bureaucrats.
/
AIPA is most concerned about the immediate uncertainty caused to a member when the often expensive advice and tests are considered to be acceptable by DAMES and specialists but not by the Principal Medical Officer (PMO). Where else are they to turn? The problem is often exacerbated by the turnaround times, the best of which is 28 days, but as the applicant you will rarely be made aware that the clock has not started because some component of the required information is “missing”, at least until you can break through the communication firewall to ask as to what point your certificate has progressed in the administrative sequence.

The Australian Federation of Air Pilots:

Quote:
The Aviation Medicine section of CASA in particular appears to act without due regard for the impact its decisions have on individual pilots and the industry. There is little or no communication about delays in the medical certificate renewal process or transparency about the reasons for delays occurring. Certificate holders are obliged to follow up with the section to find out why their certificates have not been renewed only to receive requests for additional medical reports and tests. The Federation has received numerous complaints from members as to the apparently arbitrary nature of decisions and the bureaucratic and incompetent processing of renewals. These delays threaten the livelihood of our members, and undermine the productivity of the businesses for whom they work. We have previously surveyed members and written to the former Minister on this issue. An overhaul of the Aviation Medicine section of CASA should be a priority. This would include additional resources, clearer processes, specified service standards and improved training of staff.

The Aerial Agricultural Association of Australia:
Quote:
One area in particular that struggles with continuous improvement is CASA’s aviation medicine branch. Examples are plentiful of questionable rulings on pilot medicals that fly in the face of genuine expert opinion (for example in cardiology) and result in the trashing of careers for no safety purpose. The ability of the branch to hide behind the facade of medical qualifications is well known in industry and under current systems, is an almost unassailable position that has drifted far from actual safety issues, or the leading non-CASA advice on medical issues.

The Aircraft Owners and Pilots Association:
Quote:
Medicals. This is probably the single biggest continuous issue that causes acrimony between GA pilots and CASA. Problems with Avmed include delays in dealing with medical assessments, rejection of DAMEs opinions, demands for ever more complex specialist reports that many would consider unnecessary, and which are then frequently ignored by Avmed itself. Avmed has unique medical opinions which sometimes do not agree with overseas experience, eg; FAA. Communication between CASA, AVMED and pilots has often been poor.

For what purpose? Most GA pilots intend to fly themselves and perhaps a few associates, mostly in VFR during daylight. Motor vehicle licencing is nothing like this, yet driving is only slightly less stressful.

CASA should rely on its own DAMEs for issue of class 2 medicals, and where specialist opinion is required, CASA should at least listen to specialist opinion.

But what would AIPA, AFAP, AAAA and AOPA members know about the interrelationship between fitness to fly and aviation safety? What would they know about the relatively recent hijacking of the medical certification process by people who evidently consider their opinions on that relationship and the attendant risks to be objective truths?

Lead Balloon is offline

Choc frog post.

[Peetwo]

Big win for AOPA & GA industry in USA -

Yesterday the FAA finally released their BasicMed ruleset for private pilot medical certification.

Reference Oz Flying:

US PPLs will be able to fly aircraft up to 2727 kg MTOW and below 250 KTAS under the new BasicMed rules. (Cirrus Aircraft)
  Read more
FAA releases BasicMed Rules
11 Jan 2017
The FAA in the US has released the new BasicMed rules for private pilots, which come into force on 1 May. Read more

And for more comprehensive summary of the development of this new rule set, via JDA - :

The Story behind the 3rd Class Medial Final Rule


Posted By: Sandy Murdock January 11, 2017

Pilot 3rd Class Medical Final Rule

BasicMed: Alternative Pilot Physical Examination & Education Requirements

The FAA issued a very short press release on its issuance of its Final Rule on the 3rd Class Medical Certificate. True to regulatory speak, the issuance bears the laborious title Alternative Pilot Physical Examination and Education Requirements or labeled by the more consumer friendly name (like B4UFly) BasicMed. Administrator Huerta (no word from Secretary Foxx; does his silence equate to acquiescence or protest by abstention?) made the following innocuous statement:

“The United States has the world’s most robust general aviation community, and we’re committed to continuing to make it safer and more efficient to become a private pilot,” said FAA Administrator Michael Huerta. “The BasicMed rule will keep our pilots safe but will simplify our regulations and keep general aviation flying affordable.”

Until now, the FAA has required private, recreational, and student pilots, as well as flight instructors, to meet the requirements of and hold a third class medical certificate. They are required to complete an online application and undergo a physical examination with an FAA-designated Aviation Medical Examiner. A medical certificate is valid for five years for pilots under age 40 and two years for pilots age 40 and over.

Beginning on May 1, pilots may take advantage of the regulatory relief in the BasicMed rule or opt to continue to use their FAA medical certificate. Under BasicMed, a pilot will be required to complete a medical education course, undergo a medical examination every four years, and comply with aircraft and operating restrictions.

A pilot flying under the BasicMed rule must: BasicMed, which was explicitly defined by Congress July 15, 2016 FAA Extension, Safety, and Security Act of 2016, as the following specific elements:

• possess a valid driver’s license;
  

• have held a medical certificate at any time after July 15, 2006;
  

• have not had the most recently held medical certificate revoked, suspended, or withdrawn;
  

• have not had the most recent application for airman medical certification completed and denied;
  

• have taken a medical education course within the past 24 calendar months;
  

• have completed a comprehensive medical examination with a physician within the past 48 months;
  

• be under the care of a physician for certain medical conditions;
  

• have been found eligible for special issuance of a medical certificate for certain specified mental health, neurological, or cardiovascular conditions, when applicable;
  

• consent to a National Driver Register check;
  

• fly only certain small aircraft, at a limited altitude and speed, and only within the United States; and
  

• not fly for compensation or hire.
  

The rule requires 77 pages to explain all of its intricacies, but AOPA has done a very good job of translating the requirements into plane (homonym for plain) speak; here is the link to the association’s explanation.

Because Congress “spake” (i.e. told the FAA exactly what to do), the FAA decided that it may issue this regulation as an immediate final rule, not subject to the normal APA notice and comment procedure:

The Administrative Procedure Act (5 U.S.C. 553(b)(3)(B)) requires an agency to conduct notice and comment rulemaking except when the agency for good cause finds (and incorporates the finding and a brief statement of reasons therefor in the rules issued) that notice and public procedure thereon are impracticable, unnecessary, or contrary to the public interest. The FAA finds that notice and the opportunity to comment are unnecessary and contrary to the public interest in this action because the FAA has simply adopted the statutory language without interpretation and is implementing that language directly into the regulations. The FAA further finds that delaying implementation of this rule to allow for notice and comment would be contrary to the public interest as to do so would delay the new privileges Congress sought to provide.

What the FAA failed to mention in its documents is WHY Congress had to write the standards for the NPRM and mandate that the FAA issue the rule by January 10,2017. This quote from the AOPA website provides very interesting, if not one sided (wait for side 2), context:


“AOPA has submitted third class medical reform petitions to the FAA since the 1970s. With the exception of the sport pilot driver’s license medical standard in 2004, the petitions fell on deaf ears. The sport pilot standard has now been in place for more than a decade—but despite its success, there was not enough support to expand it so more pilots could take a passenger and go for a ride on a Sunday afternoon in a Cessna 172 or Piper Cherokee…

How we got here

After the latest petition went unanswered, AOPA was frustrated with the lack of progress on third class medical reform. Under the leadership of President and CEO Mark Baker, the association again urged the FAA to embark on a rulemaking process. FAA Administrator Michael Huerta acknowledged the frustration and had his agency draft a rule that would make significant changes to the current medical process.

AOPA President Mark Baker made third class medical reform a priority when he came on board at AOPA in 2013. Baker represented the industry many times by testifying to Congress on reform.

AOPA President Mark Baker made third class medical reform a priority when he came on board at AOPA in 2013. Baker represented the industry many times by testifying to Congress on reform.

When regulations are written they go through what is called an ex parte process, which effectively means they are not made public until the proposed rule goes through the required approvals [SIC]. The FAA sent its notice of proposed rulemaking to the Department of Transportation, where it quietly and unceremoniously was quashed. AOPA fought back. In one of the association’s more memorable letters, Baker told DOT Secretary Anthony Foxx the association was exasperated. “The delays are particularly maddening when the proposed rule is likely so closely based on a standard that has been used by thousands of pilots for more than a decade,” Baker wrote.

With no movement from the DOT, Baker decided to take another route of action. AOPA engaged Congress on a legislative strategy and found a friend in Sen. Jim Inhofe of Oklahoma. Inhofe was interested in pushing a follow-up to his earlier and successful Pilot’s Bill of Rights, and the medical certificate language was the perfect complement to his new legislative effort. It was called the Pilot’s Bill of Rights 2. Working with Sen. Joe Manchin of West Virginia and Reps. Sam Graves, Todd Rokita, and others in the House of Representatives, the legislation was introduced in both houses of Congress on February 25, 2015. AOPA put out the call for its members to get involved. “Being involved in the process is everything,” said Jim Coon, AOPA’s senior vice president of government affairs and advocacy, and AOPA’s point man on the third class medical reform efforts.”

Jim Coon, AOPA’s senior vice president of government affairs and advocacy, and AOPA’s point man on the third class medical reform efforts.

So AOPA (EAA, GAMA, NBAA, NATA, HAI, NASAO, etc.) were made aware that the Secretary’s staff, and likely also the omniscient experts at OMB, were opposed. To deal with those bureaucratic hurdles, President Baker and his talented lobbyist went to Congress to “overrule” the bureaucrats who were not enlightened about the value of the proposed 3rd Class Medical Rule.


But what appears to be a battle between GA and the DOT/OMB {OIRA} had additional combatants/advocates.



None other than the Chairman of the NTSB, Christopher Hart (a GA pilot) has testified and mentioned opposition to the relaxing of medical requirements for pilots. In his testimony before the House T&I Committee in 2015, he (on behalf of the Board Members and staff) mentioned that “Requiring Medical Fitness for Duty” was on the Most Wanted List. In fact that concern is still highlighted in its most recent MWL.

Others, who qualify as fairly knowledgeable about the 3rd Class medical issue, opposed the Aviation Medical Examiner (AME) Association and the American Medical Association.

Another forceful, knowledgeable voice on aviation safety entered the fray. The Air Line Pilots Association initiated a last minute attack on the 3rd Class medicals reform. In the below letter to lawmakers ALPA wrote that its members have “grave concerns” about sharing the same airspace with “medically unfit pilots” who would be given “unfettered access to the national airspace up to 18,000 feet.”


REMEMBER: many, if not most, ALPA members are also GA pilots.

Now with a view of the multi-faceted debate, the reason for delay may make more sense?

The final rule includes a very cleverly written hint that the FAA staff would prefer that GA pilots retain their old Part 67 medicals (a bit of a mixed message with the citation to the enforcement powers):

The FAA notes that the use of this rule by any eligible pilot is voluntary. Persons may elect to use this rule or may continue to operate using any valid FAA medical certificate. The FAA recognizes that a pilot who holds a medical certificate may choose to exercise this rule and not to exercise the privileges of his or her medical certificate. Even though a pilot chooses not to exercise the privileges of the medical certificate for a particular operation, the FAA retains the authority to pursue enforcement action to suspend or revoke that medical certificate where there is evidence that the pilot does not meet the FAA’s medical certification standards. 49 U.S.C. 44709(a).

The FAA also explained that there will be further verbiage to help pilots and doctors understand the new rule:

To further implement this final rule, the FAA has developed Advisory Circular 68-1, Alternative Pilot Physical Examination and Education Requirements. The advisory circular describes the relief and provides guidance on how to comply with the rule’s provisions. It also includes frequently asked questions and guidance on how a nonprofit or not-for-profit general aviation stakeholder group can offer an approved course under this rule.

Another oddity is found in the details of the Regulatory Flexibility Determination. Ordinarily with the introduction of a rule which arguably reduces the level of safety (See NTSB and ALPA comments), the FAA must create a Benefit Cost Analysis to justify the diminution. The numerator of this ratio is an econometric review of the positive contributions (i.e. the reduction in the time and expenses required to get a certificate from a Designated Medical Adviser; the additional sale of aircraft stimulated by this more expansive rule). The denominator’s estimation of the possible negative consequences of allowing pilots to self-certify their health might have included the increased incidence of GA aircraft crashes/fatalities due to in-flight medical emergencies. The Federal Register notice did not include such possible consequences.

The FAA estimates potential savings to pilots, based on age and a pilot’s medical condition, from eliminating medical examinations with an AME. The elimination of these examinations will save pilots the time to complete the online medical application (MedXpress), travel time to the medical examination, the time required to complete the medical examination, vehicle operating costs based on miles traveled to the examination, and the cost of the medical examination. For pilots with special-issuances, the FAA anticipates added savings by eliminating follow-up medical evaluations, determined by their medical condition, with an AME. Additionally, the FAA will save time by reducing the number of applications reviewed for special-issuance medical certificates. Total savings are estimated at $382.9 million ($272.8 million at a 7 percent present value) over 10 years.

As with so much in Washington, what agency states in the issuance of a rule and what was truly behind it may have some degrees of variance.

 
Meanwhile in Dunceunda land this announcement seems to have prompted this tweet from the Fort Fumble's assigned 'tweeper' today... :

Do you think current medical certification needs changing? We're currently gathering feedback on possible changes: https://www.casa.gov.au/standard-page/review-medical-certification-standards …pic.twitter.com/tlvvk1av77

  ....zzzz


MTF...P2

[P7_TOM]

How good is that! pea green I am; the Americans (bless ’em) get a Bill of Rights; here in Oz we just get the Bills for the Wrongs. Don’t seem fair to me.

[Peetwo]

Shades of Poohshambolic & CVD Pilots -

In a follow up to their previous and in light of that rule, JDA now ask the broader question on whether the Federal Air Surgeon (our PMO) should stand down on several other high profile pilot medical certification cases. Of the three cases studied, two deal with the controversial sleep apnoea condition, the final outcome of which has implications here. 

These three cases also have some very disturbing similarities to the CVD Pilot issue here in Australia. Where despite much empirical evidence and the John O'Brien win in the AAT, CASA still appear to be hell-bent on dragging our pilot medical certification rules back to a Draconian rule-set more akin to the 19th century...

Courtesy JDA..  - RAC?? (RAC - Read, Absorb & Consider) :

Does Recent High Profile History suggest that the Federal Air Surgeon should consider a Stand Down to review the program?


Posted By: Sandy Murdock January 12, 2017

FAA 3rd Class Medical Standards Reform

3 Reviews of Push-Backs

The industry concerns about the need to reform the FAA’s 3rd Class Medical standards seemed unduly overwrought to the disinterested observer. The GA community expended so much effort to convince the Hill to act. Was this campaign indicative of broader aviation critique of the FAA medical policies and procedures?

Here are three reviews of recent “push backs” which may be part of the broader attack on the FAA’s Federal Air Surgeon, the third example is quite telling!
 

---

 
1. The FAA issued a policy concerning sleep apnea and again, after the Congress let the FAA know that the action failed to meet the requirements of the Administrative Procedure Act. The missive from the Hill also questioned the medical procedures prescribed. Here is a string of posts on this subject:
• December 2, 2013 – Flight Surgeon’s BMI/Sleep Apnea “Policy” is a Nightmare Rule subject to APA

Article: NBAA Supports House Bill Calling for FAA to Follow Rulemaking Process on Sleep Apnea Agency Has Suggested Policy May Be Issued Soon Without Industry Consultation The FAA Flight Surgeon has found evidence which he…

• December 12, 2013 – Flight Surgeon’s Sleep Apnea “Policy” is attacked by the Doctors who would implement it

Article: AMEs object to sleep apnea policy It is not going well for the Flight Surgeon’s attempt to establish a policy requiring overweight pilots to get sleep apnea counseling as a precondition to receiving their…

• April 1, 2014 – Flight Surgeon Rekindles the debate about Sleep Apnea Policy and Procedure

UPDATE: FAA Asks Industry to Review Sleep Apnea Guidance The FAA Flight Surgeon has reacted to the criticism of his announcement of a new medical standard for sleep apnea in a way which industry will…

• January 27, 2015 – FAA Flight Surgeon’s sleep apnea rules corrected, but procedural flaw not cured

A new pronouncement by the FAA’s chief medical official has established rules by which pilots’ health will be measured in the future. The new FAA position on sleep apnea has been well received by stakeholder.

---

 
2. Congress directed the FAA to revise its 3rd Class Medical standards and process; after a seemingly interminable review, a final rule was issued. To the casual observer, the legislative mandate seemed a bit of overkill. According to AOPA, this conflict started in 2007. The change was opposed, in varying degrees, by ALPA, NTSB, AMEs, the DoT Secretary staff and OMB’s OIRA.
 

---

 
3. Eric Friedman, Petitioner v. Federal Aviation Administration, Respondent


Eric Friedman is a commercial airline pilot, took the FAA to the United States Court of Appeals for the District of Columbia Circuit where he alleged that the FAA, Federal Air Surgeon, Respondent Federal Aviation Administration (“the FAA” or “the Agency”) acted “in an arbitrary and capricious manner in assessing his request for a commercial airline pilot’s license. Friedman has been diagnosed with Insulin Treated Diabetes Mellitus (“ITDM”), and although he holds a third class medical certificate authorizing him to pilot non-commercial flights in the United States, he seeks the first class certificate necessary to serve as a commercial airline pilot. He argues the FAA has impermissibly conditioned issuance of a first class license on ninety days of continuous blood glucose monitoring, a costly and invasive procedure not medically necessary for his care.” (quote from the Friedman Opinion [PDF])


This is what the continuous glucose monitor looks like after it is implanted on the body.


Before discussing the opinion, kudos to Circuit Judge Janice Rogers Brown for quoting a bit of aviation wisdom and a brilliant pun at the beginning of her opinion.

“I’ve never known an industry that can get into people’s blood the way aviation does.”
– Robert Six, founder of Continental Airlines

A diagnosis of ITDM generally excludes a pilot from any medical certificate issued by the FAA pursuant to 49 U.S.C. § 44703(a), Judge Brown lays out the FARs and facts of the Friedman case:

• The FAA has the discretionary authority to grant exceptions to the medical regulations contained in 14 C.F.R. § 67. See 49 U.S.C. § 44701(f).
  

• An Authorization for Special Issuance of a Medical Certificate may be provided to an applicant with a disqualifying condition “if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force.” 14 C.F.R. § 67.401(a).
  

• Regulations require the Federal Air Surgeon (“FAS”) to make his determination using standards published for each condition as set forth in the FAA’s Guide to Aviation Medical Examiners (“AME Guide”). See id. 67.407(a).
  

• For much of its history the FAA enforced a blanket ban on the issuance of medical certificates to individuals with ITDM,
  

• but in 1996 it reversed course and established criteria for pilots with ITDM to receive a third class medical certificate (but not a first class certificate).
  

• Since the policy change was adopted, there has been no medically related accident, incident, or inflight incapacitation, from any cause, of any such insulin treated special issuance pilot.
  

• In light of the strong record of third class pilots with ITDM, and in reliance on the expert analysis provided by an Expert Panel on Pilots with Insulin Treated Diabetes (“Expert Panel”)—convened by the American Diabetes Association (“ADA”) at the FAA’s request—the FAA amended its AME Guide to broaden the third class ITDM protocol to all classes of medical certificates on April 21, 2015.
  

• On April 27, 2015, Friedman submitted a completed application for a first class license to the FAA.
  

• April 30, 2015 and several times thereafter, the FAA requested supplemental information, including “any and all information that you may have that is relevant to your condition, which may include . . . (if applicable) continuous glucose monitor readings.” JA 73.
  

• The next month, Friedman inquired as to the FAA’s method for evaluating glucose testing results and stated “I do not use a continuous glucose monitor.” JA 31–32.
  

• Continuous Glucose Monitoring (“CGM”), according to the ADA, is an invasive procedure that “uses a sensor inserted under the skin to check glucose levels in tissue fluid. A transmitter sends information about glucose levels via radio waves from the sensor to a wireless monitor.” ADA Amicus Br. 14.
  

• This technique provides a “historical record of glucose levels over time” and can “provid[e] helpful information about historic trends in one’s blood sugar levels and how those levels have been affected by diet and exercise.” Id.
  

• However, CGM data is not as accurate as other blood glucose measures like fingersticks. Id. 15–16. Moreover, CGM is costly and is not covered by insurance unless medically necessary.
  

• The Expert Panel even submitted a letter in support of Friedman’s application to explain, “CGM systems have value, [but] they are neither necessary nor appropriate for making decisions on medical certification of pilots with diabetes” and are less accurate than the blood glucose data Friedman had already submitted.
  

Flight Air Surgeon Fraser, M.D., M.P.H.

The Court then dealt with the jurisdictional question of whether the FAA’s record of repeated demands for the CGM data constituted an appealable final order.
The FAA put forward the following Catch 22-like argument:

“The FAA argues Friedman’s claims are insulated from judicial scrutiny as “there is no law to apply” to the FAA’s determination. Drake v. FAA, 291 F.3d 59, 70 (D.C. Cir. 2002); see also Citizens to Preserve Overton Park, Inc. v. Volpe, 401 U.S. 402, 410 (1971). But the jurisprudence of unfettered discretion is inapplicable here. Several regulations provide the criteria upon which the FAS relies to determine whether Friedman may be granted a first-class certificate…”


Judge Brown disagreed in that the FAA had cited several specific FARs which constituted a “judicially manageable standard”.

Finally, this DC Circuit three judge panel conclusively decides:

It is not for us to say in the first instance whether or how CGM data might be of future use to the FAA in evaluating license applications. But it is clear the FAA has not borne its burden of justification. The FAA’s letters communicating its demand for CGM data to Friedman, despite his many requests for clarification, fail to articulate any rationale for consideration of the additional information. See Safe Extensions, 509 F.3d at 606 (finding no “substantial evidence” to support the FAA’s rationale where it offered “no evidence whatsoever” on the relevant issue).

Notably, the Agency does not identify any FAA statements that could be construed as explaining its denial of Friedman’s application, the determination Friedman calls upon this Court to review. Of course, there is a certain irony inherent in requiring an agency to identify reasons for a denial it never thought it issued. But “recent [D.C. Circuit] cases regarding whether agency actions qualify as orders never consider the adequacy of the record, instead asking only whether the action was final.”
…
In light of the complete absence of a relevant administrative record to review—and the inherent inequity in passing judgment on this matter without offering the Agency a chance to explain its reasoning—any analysis of the FAA’s denial would be imprudent. Accordingly, we remand this matter to the FAA to offer reasons for its denial of Friedman’s application for a first class medical certificate. Friedman’s additional allegations must await proceedings on remand.

The Court is affording the Federal Air Surgeon the opportunity to explain why he demanded the BCM after the Expert Panel opined that this data would not be more relevant than the petitioner’s submitted record of his blood readings.
 

---

 
While the FAS is considering the response to the opinion of the three Judges, it might be time for the Administrator and the Federal Air Surgeon to reconsider the standards, processes and positions on these medical issues. The recent 0-3 record (granted these are only three highlighted cases among thousands of unheralded decisions which contributed to aviation safety) should merit a Stand Down with the Administrator and the Associate Administrator for Aviation Safety to assess whether these three cases are indicative of broader issues.

MTF...P2

Ps Here is a reminder (from former DAS Oliver) of the retrograde attitude that CASA apparently still maintain (as far as I am aware), when it comes to the CVD Pilot medical certification issue, courtesy CVDPA:

[Peetwo]

Big win for AOPA & GA industry in USA -

Yesterday the FAA finally released their BasicMed ruleset for private pilot medical certification.

Reference Oz Flying:

US PPLs will be able to fly aircraft up to 2727 kg MTOW and below 250 KTAS under the new BasicMed rules. (Cirrus Aircraft)
  Read more
FAA releases BasicMed Rules
11 Jan 2017
The FAA in the US has released the new BasicMed rules for private pilots, which come into force on 1 May. Read more

And for more comprehensive summary of the development of this new rule set, via JDA - :

The Story behind the 3rd Class Medial Final Rule


Posted By: Sandy Murdock January 11, 2017

Pilot 3rd Class Medical Final Rule

BasicMed: Alternative Pilot Physical Examination & Education Requirements

The FAA issued a very short press release on its issuance of its Final Rule on the 3rd Class Medical Certificate. True to regulatory speak, the issuance bears the laborious title Alternative Pilot Physical Examination and Education Requirements or labeled by the more consumer friendly name (like B4UFly) BasicMed. Administrator Huerta (no word from Secretary Foxx; does his silence equate to acquiescence or protest by abstention?) made the following innocuous statement:

“The United States has the world’s most robust general aviation community, and we’re committed to continuing to make it safer and more efficient to become a private pilot,” said FAA Administrator Michael Huerta. “The BasicMed rule will keep our pilots safe but will simplify our regulations and keep general aviation flying affordable.”

Until now, the FAA has required private, recreational, and student pilots, as well as flight instructors, to meet the requirements of and hold a third class medical certificate. They are required to complete an online application and undergo a physical examination with an FAA-designated Aviation Medical Examiner. A medical certificate is valid for five years for pilots under age 40 and two years for pilots age 40 and over.

Beginning on May 1, pilots may take advantage of the regulatory relief in the BasicMed rule or opt to continue to use their FAA medical certificate. Under BasicMed, a pilot will be required to complete a medical education course, undergo a medical examination every four years, and comply with aircraft and operating restrictions.

A pilot flying under the BasicMed rule must: BasicMed, which was explicitly defined by Congress July 15, 2016 FAA Extension, Safety, and Security Act of 2016, as the following specific elements:

• possess a valid driver’s license;
  

• have held a medical certificate at any time after July 15, 2006;
  

• have not had the most recently held medical certificate revoked, suspended, or withdrawn;
  

• have not had the most recent application for airman medical certification completed and denied;
  

• have taken a medical education course within the past 24 calendar months;
  

• have completed a comprehensive medical examination with a physician within the past 48 months;
  

• be under the care of a physician for certain medical conditions;
  

• have been found eligible for special issuance of a medical certificate for certain specified mental health, neurological, or cardiovascular conditions, when applicable;
  

• consent to a National Driver Register check;
  

• fly only certain small aircraft, at a limited altitude and speed, and only within the United States; and
  

• not fly for compensation or hire.
  

The rule requires 77 pages to explain all of its intricacies, but AOPA has done a very good job of translating the requirements into plane (homonym for plain) speak; here is the link to the association’s explanation.

Because Congress “spake” (i.e. told the FAA exactly what to do), the FAA decided that it may issue this regulation as an immediate final rule, not subject to the normal APA notice and comment procedure:

The Administrative Procedure Act (5 U.S.C. 553(b)(3)(B)) requires an agency to conduct notice and comment rulemaking except when the agency for good cause finds (and incorporates the finding and a brief statement of reasons therefor in the rules issued) that notice and public procedure thereon are impracticable, unnecessary, or contrary to the public interest. The FAA finds that notice and the opportunity to comment are unnecessary and contrary to the public interest in this action because the FAA has simply adopted the statutory language without interpretation and is implementing that language directly into the regulations. The FAA further finds that delaying implementation of this rule to allow for notice and comment would be contrary to the public interest as to do so would delay the new privileges Congress sought to provide.

What the FAA failed to mention in its documents is WHY Congress had to write the standards for the NPRM and mandate that the FAA issue the rule by January 10,2017. This quote from the AOPA website provides very interesting, if not one sided (wait for side 2), context:


“AOPA has submitted third class medical reform petitions to the FAA since the 1970s. With the exception of the sport pilot driver’s license medical standard in 2004, the petitions fell on deaf ears. The sport pilot standard has now been in place for more than a decade—but despite its success, there was not enough support to expand it so more pilots could take a passenger and go for a ride on a Sunday afternoon in a Cessna 172 or Piper Cherokee…

How we got here

After the latest petition went unanswered, AOPA was frustrated with the lack of progress on third class medical reform. Under the leadership of President and CEO Mark Baker, the association again urged the FAA to embark on a rulemaking process. FAA Administrator Michael Huerta acknowledged the frustration and had his agency draft a rule that would make significant changes to the current medical process.

AOPA President Mark Baker made third class medical reform a priority when he came on board at AOPA in 2013. Baker represented the industry many times by testifying to Congress on reform.

AOPA President Mark Baker made third class medical reform a priority when he came on board at AOPA in 2013. Baker represented the industry many times by testifying to Congress on reform.

When regulations are written they go through what is called an ex parte process, which effectively means they are not made public until the proposed rule goes through the required approvals [SIC]. The FAA sent its notice of proposed rulemaking to the Department of Transportation, where it quietly and unceremoniously was quashed. AOPA fought back. In one of the association’s more memorable letters, Baker told DOT Secretary Anthony Foxx the association was exasperated. “The delays are particularly maddening when the proposed rule is likely so closely based on a standard that has been used by thousands of pilots for more than a decade,” Baker wrote.

With no movement from the DOT, Baker decided to take another route of action. AOPA engaged Congress on a legislative strategy and found a friend in Sen. Jim Inhofe of Oklahoma. Inhofe was interested in pushing a follow-up to his earlier and successful Pilot’s Bill of Rights, and the medical certificate language was the perfect complement to his new legislative effort. It was called the Pilot’s Bill of Rights 2. Working with Sen. Joe Manchin of West Virginia and Reps. Sam Graves, Todd Rokita, and others in the House of Representatives, the legislation was introduced in both houses of Congress on February 25, 2015. AOPA put out the call for its members to get involved. “Being involved in the process is everything,” said Jim Coon, AOPA’s senior vice president of government affairs and advocacy, and AOPA’s point man on the third class medical reform efforts.”

Jim Coon, AOPA’s senior vice president of government affairs and advocacy, and AOPA’s point man on the third class medical reform efforts.

So AOPA (EAA, GAMA, NBAA, NATA, HAI, NASAO, etc.) were made aware that the Secretary’s staff, and likely also the omniscient experts at OMB, were opposed. To deal with those bureaucratic hurdles, President Baker and his talented lobbyist went to Congress to “overrule” the bureaucrats who were not enlightened about the value of the proposed 3rd Class Medical Rule.


But what appears to be a battle between GA and the DOT/OMB {OIRA} had additional combatants/advocates.



None other than the Chairman of the NTSB, Christopher Hart (a GA pilot) has testified and mentioned opposition to the relaxing of medical requirements for pilots. In his testimony before the House T&I Committee in 2015, he (on behalf of the Board Members and staff) mentioned that “Requiring Medical Fitness for Duty” was on the Most Wanted List. In fact that concern is still highlighted in its most recent MWL.

Others, who qualify as fairly knowledgeable about the 3rd Class medical issue, opposed the Aviation Medical Examiner (AME) Association and the American Medical Association.

Another forceful, knowledgeable voice on aviation safety entered the fray. The Air Line Pilots Association initiated a last minute attack on the 3rd Class medicals reform. In the below letter to lawmakers ALPA wrote that its members have “grave concerns” about sharing the same airspace with “medically unfit pilots” who would be given “unfettered access to the national airspace up to 18,000 feet.”


REMEMBER: many, if not most, ALPA members are also GA pilots.

Now with a view of the multi-faceted debate, the reason for delay may make more sense?

The final rule includes a very cleverly written hint that the FAA staff would prefer that GA pilots retain their old Part 67 medicals (a bit of a mixed message with the citation to the enforcement powers):

The FAA notes that the use of this rule by any eligible pilot is voluntary. Persons may elect to use this rule or may continue to operate using any valid FAA medical certificate. The FAA recognizes that a pilot who holds a medical certificate may choose to exercise this rule and not to exercise the privileges of his or her medical certificate. Even though a pilot chooses not to exercise the privileges of the medical certificate for a particular operation, the FAA retains the authority to pursue enforcement action to suspend or revoke that medical certificate where there is evidence that the pilot does not meet the FAA’s medical certification standards. 49 U.S.C. 44709(a).

The FAA also explained that there will be further verbiage to help pilots and doctors understand the new rule:

To further implement this final rule, the FAA has developed Advisory Circular 68-1, Alternative Pilot Physical Examination and Education Requirements. The advisory circular describes the relief and provides guidance on how to comply with the rule’s provisions. It also includes frequently asked questions and guidance on how a nonprofit or not-for-profit general aviation stakeholder group can offer an approved course under this rule.

Another oddity is found in the details of the Regulatory Flexibility Determination. Ordinarily with the introduction of a rule which arguably reduces the level of safety (See NTSB and ALPA comments), the FAA must create a Benefit Cost Analysis to justify the diminution. The numerator of this ratio is an econometric review of the positive contributions (i.e. the reduction in the time and expenses required to get a certificate from a Designated Medical Adviser; the additional sale of aircraft stimulated by this more expansive rule). The denominator’s estimation of the possible negative consequences of allowing pilots to self-certify their health might have included the increased incidence of GA aircraft crashes/fatalities due to in-flight medical emergencies. The Federal Register notice did not include such possible consequences.

The FAA estimates potential savings to pilots, based on age and a pilot’s medical condition, from eliminating medical examinations with an AME. The elimination of these examinations will save pilots the time to complete the online medical application (MedXpress), travel time to the medical examination, the time required to complete the medical examination, vehicle operating costs based on miles traveled to the examination, and the cost of the medical examination. For pilots with special-issuances, the FAA anticipates added savings by eliminating follow-up medical evaluations, determined by their medical condition, with an AME. Additionally, the FAA will save time by reducing the number of applications reviewed for special-issuance medical certificates. Total savings are estimated at $382.9 million ($272.8 million at a 7 percent present value) over 10 years.

As with so much in Washington, what agency states in the issuance of a rule and what was truly behind it may have some degrees of variance.

 
Meanwhile in Dunceunda land this announcement seems to have prompted this tweet from the Fort Fumble's assigned 'tweeper' today... :

Do you think current medical certification needs changing? We're currently gathering feedback on possible changes: https://www.casa.gov.au/standard-page/review-medical-certification-standards …pic.twitter.com/tlvvk1av77

Update: CASA disappointed with response - err BOLLOCKS!  

Via Oz Flying... :

Aviation medical standards in Australia have been under scrutiny for years.

Aviation Community goes quiet on Medical Feedback
23 February 2017

The Civil Aviation Safety Authority has expressed concern over the lack of submissions to its Medical Certification Discussion Paper (DP).

CASA released the DP on 21 December 2016 and gave the aviation community until 30 March 2017 to comment on options to reform the medical certification regime, but has been disappointed with the number of submissions, which is thought to possibly be as low as 10 so far.

In the CASA Briefing Newsletter for February 2017, CASA said "Time is running down on the chance to have a say on the future of pilot medical certification.

"CASA needs comments from people across the aviation community on a comprehensive medical discussion paper. While some people have already sent submissions, many more are needed."

The DP sets out a range of issues and puts forward a number of options. These options range from continuing existing medical requirements to developing a new medical certificate for the sport and recreational sectors.

Read more at http://www.australianflying.com.au/lates...ESstqhz.99

MTF...P2

[Peetwo]

Update to CASA medical certification DP -  


Reference:

Hook; line; sinker; & a parallel universe -  

While on the CASA Avmed DP, this was from the horse's mouth Herr Comardy in the introduction to the DP:

...Aviation medicine is complex, involving medical, regulatory and legal considerations. Mindful of this complexity, we have decided that a wide-ranging discussion paper is the best way to canvass community views about medical certification in the sport and recreation, general aviation, aerial work, air transport and air traffic control sectors alike...

...This discussion paper will form the basis for future consultation between CASA and all affected stakeholders on the issues raised and any action CASA proposes to take. Such consultation would take place through a dedicated development team, possibly leading to release of a notice of proposed rulemaking (NPRM) for industry and public consideration...

This discussion paper does not contain proposals for or draft regulations. That would be premature. What we need to do now is to identify and articulate the issues, and to begin to consider better ways to address those issues...

Hook:-

CASA intro:- “Aviation medicine is complex, involving medical, regulatory and legal considerations. Mindful of this complexity, we have decided that a wide-ranging discussion paper is the best way to canvass community views about medical certification in the sport and recreation, general aviation, aerial work, air transport and air traffic control sectors alike.”

When there is a slim chance that a submission to a ‘discussion’ paper will be weighed, measured and considered, it is worth spending the time and making the effort to provide one. This ain’t one of those times. CASA Avmed can more readily access empirical statistics from sister bodies, such as the USA and would have done so, should there be an internal desire to utilize a similar system. The data, protocols and system details have been available for donkey’s years and if there was any chance of ‘change’ then the discussion paper would be referenced to the proposed changes to system.

Line:-

CASA intro:- “This discussion paper will form the basis for future consultation between CASA and all affected stakeholders on the issues raised and any action CASA proposes to take. Such consultation would take place through a dedicated development team, possibly leading to release of a notice of proposed rulemaking (NPRM) for industry and public consideration.”

The vast majority of ‘stakeholders’ (read pitch fork wavers) have little to no acceptable expertise “involving medical, regulatory and legal considerations”. Unqualified submissions may then be disregarded with impunity. The local DAME may well be qualified to provide ‘expert’ medical opinion; but their comment on ‘legal’ and ‘regulatory’ matters will, for the reasons mentioned, be discarded as quickly as those from the ‘unshriven’.

& Sinker:-

CASA intro:- “This discussion paper does not contain proposals for or draft regulations. That would be premature. What we need to do now is to identify and articulate the issues, and to begin to consider better ways to address those issues.”

No doubt ‘irritated’ by the constant yapping of the small dogs next door – a juicy bone is lobbed over the fence; this will keep ‘em quiet and occupied for a good long while.

Any real attempt at reformation would be presented as “we have considered the FAA pilot medical system and propose to bring a similar system into law”. “This discussion paper and the attached NPRM is provided for industry and public consideration”. Anything else is simply a bollocks, cunningly designed to provide employment for a number of years and make it appear as though CASA are actually doing something.  No doubt there will be many sound, solid, well argued submissions presented, all making perfectly good sense; and it must be done. But the temptation to toss the discussion paper into the bin and never think of it again is great. In truth, ‘tis irresistible – THUD.

Toot- toot.

Last thought: perhaps a ‘discussion’ paper on how to stop CASA getting away, every time, with this sort of frivolous, time wasting, costly exercise would draw more ‘suggestions’ from ‘stakeholders’

   

Today it was brought to my attention that at least one of the industry Alphabet advocate groups/associations has made a submission to the CASA Avmed Medical Certification DP:
AAAA Submission CASA Medical Certification Standards Discussion Paper

Introduction

AAAA recommends a significant overhaul of the aviation medical system in Australia that will deliver a similar level of safety outcomes, but which will significantly boost the efficiency of the avmed system, reduce costs, anxiety and delay and greatly improve the transparency of the process and the use of the best expert opinion in resolving more complex cases.

There are five core areas for reform:

•Improved alignment and simplification of aviation medical certification classes/requirements against the classification of operations, and consequently relevant to risk and consequence.
•Significant improvements in the management of the Aviation Medicine Branch - howsoever called - including cultural realignment to a ‘client’ model, case management and tracking, reporting and management of delays and the prioritisation of commercial licences.
•Reinforcement, increased delegation and support of the DAME system. 
•Establishment of a transparent and credible appeals process, including the ability of the candidate to nominate an expert to argue on their behalf.
•A need to consider how relevant medical information can be made available to Chief Pilots to help them fulfil their responsibilities.

---

Avmed cultural change
The attitude of the CASA Aviation Medicine Branch (or ‘team’ as it has been repackaged) is central to any discussion of lack of trust of DAMES, the inefficiency of current systems and the ongoing conflict and difference of opinion with specialists.

The branch appears to adopt a ‘we know better than you’ attitude which was the subject of considerable discussion in the ASRR Report - putting themselves above other processes, demonstrating little care concerning getting pilots back to their livelihood, and a level of arrogance in treatment of ‘clients’.

Case management and workflow
It will be critical for improved ‘whole-of-life’ (ie ‘life’ referring to the time CASA is
considering an issue before cancelling or issuing a medical) case management to ensure
the absence of any single individual within the Avmed branch does not compromise the
movement of a case to completion.

AAAA has been provided with many examples of urgent - in the eyes of pilot unable to
earn a living - medical cases stalling because a person in the branch has gone on
recreation or longer term leave and there does not appear to be an effective system to
identify that a case folder is sitting on someone’s desk and not being progressed.

This is not an ‘aviation’ or ‘medical’ problem - it is the complete absence of sensible
‘practice’ management and robust systems within the branch.

Similarly, the stalling of cases because of administrative errors on the part of CASA is at
the same time a cultural and management challenge. This problem is characterised by
failures and excuses reported by AAAA members including..

..While cultural change relies on leadership and very clear messages about what is and is not acceptable - backed up by action and attention to priorities, many of the shortcomings of the branch can only be attributed to administrative slackness that has been allowed to be perpetuated by a lack of robust systems, lack of regular reporting on achievements or delays and other KPIs and management action.

It appears that new management of the branch may be necessary to kick start such
processes with an air of urgency...

Well done AAAA, the choccy frog voucher is in the mail..

MTF...P2

Ps Will see if I can track some more Alphabet responses to the DP...

[Peetwo]

Further update (to above): Comardy happy with Avmed DP response -

Via Oz Flying yesterday... :

Aviation medical standards in Australia have been under scrutiny for years.

The Civil Aviation Safety Authority is reportedly very happy with industry feedback on the medicals reform discussion paper.

It is believed around 180 submissions were made before the deadline of 30 March 2017. Previously, CASA had expressed concerns over the lack of feedback on the issue.

Of those responders, about 50% have consented to have their submission published on the CASA website, which is scheduled to happen as early as the end of this week.

The next step, according to a source in CASA, is for the responses to be collated into one summarising report for senior management to consider.

CASA's discussion explored all aviation medical standards, not just Class 2, and proposed six options for consideration:

1. do nothing
   
2. re-assess the risk tolerances in the context of industry and community expectations
   
3. examine and streamline practices for all classes including the approach to incapacitation
   
4. extend the RAMPC so that it applies more widely in the sport aviation sector as well
   
5. develop a new certification standard for the sport and recreational sectors
   
6. mitigate the risk of change by applying operational restrictions.
   

Several large organisations including Recreational Aviation Australia and AOPA Australia made strong submissions to the discussion paper.

Read more at http://www.australianflying.com.au/lates...Hb3e1TP.99

  
Meanwhile in a parallel hemisphere the US FAA gets 'BasicMed' up and running... :

BasicMed Begins

News type: All News Items News & Updates Press Release Fact Sheet Speech Testimony Media Advisory


General aviation pilots can now prepare to fly under BasicMed without holding a Federal Aviation Administration (FAA) medical certificate as long as they meet certain requirements. They can fly under BasicMed beginning on May 1, the effective date of the January 10 final rule. It offers pilots an alternative to the FAA's medical qualification process for third class medical certificates, while keeping general aviation pilots safe and flying affordable.

General aviation pilots may take advantage of the regulatory relief in the BasicMed rule or opt to continue to use their FAA medical certificate. Under BasicMed, a pilot will be required to complete a medical education course every two years, undergo a medical examination every four years, and comply with aircraft and operating restrictions. For example, pilots using BasicMed cannot operate an aircraft with more than six people onboard and the aircraft must not weigh more than 6,000 pounds.

A pilot flying under the BasicMed rule must:

• possess a valid driver's license;
  
• consent to a National Driver Register check;
  
• have held a medical certificate that was valid at any time after July 15, 2006;
  
• have not had the most recently held medical certificate revoked, suspended, or withdrawn;
  
• have not had the most recent application for airman medical certification completed and denied;
  
• have taken a BasicMed online medical education course within the past 24 calendar months;
  
• have completed a comprehensive medical examination with any state-licensed physician within the past 48 months;
  
• have been found eligible for special issuance of a medical certificate for certain specified mental health, neurological, or cardiovascular conditions, when applicable; and
  
• not fly for compensation or hire.
  

Pilots can read and print the Comprehensive Medical Examination Checklist and learn about online BasicMed online medical courses at www.faa.gov/go/BasicMed

MTF...P2

[Sandy Reith]

With respect to those who hope for, and promote, "cultural change" as a reform that will reduce the depredations of CASA against aviation, and especially GA, I beg to differ.

Cultural change relies on personalities not law.

Can the Minister go to Aviation House and say "change your culture?".

Relying on the whim and sway of personalities for the administration of aviation, especially as it is loaded with criminal sanctions, is totally at odds with the fundamental protections (and efficiencies) of the rule of law.

Without political willpower expect no real reform and therefore the real work, to influence politicians is the only plausible way forward.

I would add that lashing out and very personal attacks, venting spleen and denigrating individuals might have some value in demonstrating the frustration we all feel but won't do much to help.

[Peetwo]

Via @OzFlying today - :

Aviation medical standards in Australia have been under scrutiny for years.

AVMED Discussion Paper - What they said
17 May 2017

Published responses to CASA's aviation medicals discussion paper (DP) are overwhelmingly in favour of adopting a self-certifying regime such as those recently adopted in the UK and USA.

CASA released the DP in December 2016, with a closing date for submissions of 30 March 2017. Submissions approved for publication were put up on the CASA website on Monday, which made up less than half of those that CASA actually received.

Many submissions contained personal medical cases that people wanted addressed, and others put forward alternative views for aviation medicals, or simply supported the Aircraft Owners and Pilots Association (AOPA) policy.

And it was not only pilots who supported self-certification; some Designated Aviation Medical Examiners (DAME) also saw it as the best way forward.

Respected DAME Dr Tony Van Der Spek pointed out that international aviation regulators had seen fit to relax medical rules, and that Australia should follow suit.

"The risk assessment procedures used by overseas regulators are very appropriate for Australian pilots and conditions," he said. "Are Australian pilots much more of a risk than their overseas counterparts? After all we fly in much less crowded airspace and we have much more benign flying conditions generally."

And it seems DAMEs are just as frustrated with CASA's Aviation Medical (AVMED) division as the pilots are.

"DAMEs bear the brunt of dissatisfaction with handling of Aviation Medicine Certification," Associate Professor Chris Andrews said. "I spend as much time answering phone calls and emails of dismayed pilots as I do in performing the assessment. I see it as a task of mine to assist pilots negotiate the AVMED system, which speaks to the implication that much is done and adopted by AVMED in a non-transparent and misunderstood, if not unreasonable, way.

"Criteria for assessing conditions are decided and not communicated – even on occasions to DAMEs, and certainly not to pilots. DAMEs are therefore somewhat in the dark, and cannot provide definitive answers to dismayed pilots.

"AVMED has lost a view of its role – AVMED is to determine the health of a candidate from a DAME interview and examination. It is not for, and has no mandate for, dictating the management of a candidate, and directions to treating practitioners in this unethical way in the guise of health promotion."

The Australian Helicopter Industry Association (AHIA) said in their submission that medical standards needed to be more appropriate to the class of operation than the current regime.

"AHIA does not support the 'one standard suits all' approach to medical certifications and believes the current system of three classes does not align with complexity of the various types of aviation activity," their submission stated. "Grouping high-volume airline passenger operations with low-volume VFR helicopter operations can eliminate some individuals who would otherwise be suitable and also makes accessing the relevant medical professionals difficult and expensive.

"AHIA would support the current Class 2 medical certification standards being applied to single engine VFR operations below 5700 kg MTOW and a higher standard for operations involving twin engine, IFR high volume helicopter passenger transport and emergency service operations."

Aero club submission were almost unanimous in their support for self-certification, unsurprising given that the result of over-stringent medical standards impact them significantly as pilots are forced to stop flying.

"In our view, CASA would do better to educate pilots to develop better health behaviours centred on their GP's qualified advice in an open and honest relationship," Peninsula Aero Club (Tyabb, Vic) stated in their submission.

"In our opinion, the AVMED system for GA private pilots is broken, its costly, ineffective and most probably counter-productive.

"The experience of RAAus and Gliding Australia medical exemptions surely demonstrates that pilots can manage their own health issues, evident by the lack of fatalities/incidents related to medical issues. Furthermore, it is our observation that other international aviation authorities are reducing their regulatory requirements as it does not support the efficiacy."

Devonport Aero Club in Tasmania is one of those that supported the AOPA policy, and spoke in tune with their Tyabb colleagues.

"Our club has seen a number of experienced general aviation pilots reluctantly sell their aircrafts and give up on aviation because they are sick and tired of the hoops they have been forced to jump through by AVMED to retain their Class 2 medical certificates.

"This is an unnecessary loss to the local aviation economy and the sad loss of an opportunity for less experienced pilots and student pilots to improve their skills and safety awareness by learning from these experienced pilots."

Alan Middleton, Queensland convenor for the Regional Airspace and Procedures Advisory Council (RAPAC) and Managing Director of Bluewater Airport near Townsville, took a more mathematical approach when it came to supporting his arguments.

"Statistical analysis doesn't support the premise that regular medical checks decrease fatal accident rates," Middleton pointed out. "Pilots that see their own doctors regularly are more likely to have trends in patient health picked up than one-off medicals performed by CASA authorised doctors (DAMEs).

"I would like to see CASA’s analysis of aircraft accidents due to medical complications as opposed to pilot error accidents. Amongst other things, this will also reveal whether pilots were on IFR or VFR flights. I am confident, as is the industry generally, that accident rates due to medical issues are extremely low (less than 1%) across both categories and thus excluding IFR pilots from medical reform rules would be discriminatory without a basis in evidence."

Aviation stalwart Sandy Reith went so far as to point out that the current medical system, ironically, could actually be bad for a pilot's health.

"The anxiety leading up to, and expense of repetitive investigations coupled with the current medical exam system is driving pilots out of GA. The anxiety caused by the possible licence loss, and the thought of having to sell one's aircraft may have a deleterious effect on pilot health. Certainly raised blood pressure is common with pilots leading up to their medical exams, known as 'white coat blood pressure'."

However, several individuals didn't respond so much to the DP, but took issue with the fact that any review was happening at all.

Brenton Rule had problems with AVMED being allowed to conduct a review of their own operations in a letter addressed directly to Acting CEO Shane Carmody.

"I am astounded but not surprised, that you have chosen to allow AVMED (the cause of all the problems) to be the ones to whom we should direct feedback on the changes to the medical system," Rule said. "I have had first-hand experience where the senior doctor on your staff refused to accept my GPs opinion and dismissed it out of hand. He quoted nebulous international (non aviation) so-called studies to back his claims. I then had to undergo more tests (at my expense) with absolutely no benefit to anyone except the bureaucracy and the lawyers.

"You need to engage an independent body or person to undertake a full review of the operations, qualifications and attitudes of your AVMED doctors, and also allow pilots' GPs to be more respected in their opinions"

Owen Bartrop provided a more simple, straightforward opinion on how to proceed.
"I find it incredible that time and money is wasted writing this review. The work has been done overseas both in the USA and Britain. Surely Australian pilots are no different medically to pilots from these two. Why not adopt their medical system instead of trying to reinvent the wheel?"

Several submissions quoted the RAAus experience, where pilots have only to satisfy conditions for driving a car to be allowed to fly. The RAAus submission, generally also supportive of self-certification for GA Recreational Pilot Licence (RPL), warns that reducing standards for the Recreational Aviation Pilots Medical Certificate (RAMPC) could advantage general aviation, with significant income ramifications that could endanger RAAus.

"[RAAus could face] potentially significant loss of revenue specifically if the RAMPC medical requirements are reduced. This could mean that the Recreational Pilots Licence (RPL) requirements will have a direct advantage over the RAAus Pilot Certificate with the possibility that members will leave RAAus to access CTA and [higher] MTOW, as has happened since CASA introduced the RPL.

"RAAus maintains its position that the RPL was an unnecessary introduction which added confusion and complexity to an already crowded marketplace. If CASA were to make accessing the RAMPC easier, it would be imperative that RAAus be given equal rights regarding accessing CTA and an increased MTOW to 1500 kg.

"This could result in a dramatic effect on the financial position of RAAus, which is a significant risk to the regulator should RAAus become unviable. If this did occur CASA would be left to manage some 10 000 pilots and 3 200 aircraft; it is questionable whether CASA has the capacity to undertake this responsibility."

All published submissions are available on the CASA website.

Read more at http://www.australianflying.com.au/lates...mzXbJ1A.99

MTF...P2

[Kharon]

"With your indulgence M’lud".

We’ve been running a quiet little survey, to do with Avmed. One of the outstanding items was the performance of the coal face troops – those who answer the phones and emails.

Now, it must be said that the telephone system could stand some improvement, the recorded messages in particular and the often long, frustrating wait to talk to a human. That is however true of nearly every automatic telephone answering system on the planet and the CASA system is actually one of the least annoying – for waiting time at least.

The outstanding result is 87% of those asked had nothing but praise for the patience and forbearance of the person who answered the telephone. More gold stars than complaints by a good margin. We should try to remember that that those people are not responsible the god awful ‘system’ nor the delays or even the decisions made. They are folk, just like us, trying to earn a living and have a life.

The Avmed ‘system’ is a bloody shambles; but the coal face troops are first class – victims of that system same as we are. Aunty Pru asks that you try, very hard to be polite  and patient with the person on the other end of the line; it ain’t their fault, they just have to live with it – 100 times a day.

Change Avmed by all means, as soon as possible – but let’s try and keep the first point of human contact as good as it is. Well done and thank you to those who must answer the telephone, 50 times - every day of the week.

Toot toot.

[Kharon]

A thief’s bargain.

P2 has provided some appreciated top cover while I have been absent and managed things very nicely, despite being short handed at the pumps. Thanks mate, great job.

It was never intended that P2 would be left short handed. P7_TOM was to have been there along with a couple of others to help out – the best laid plans eh? So what happened? Well, that is - IMO, potentially of great interest to the aviation community, pilots in particular. So, with your indulgence I will bring the matter forward for discussion. I hasten to add that we have not, as yet, had a chance to dig deeply into the subject (although we will) and that there is only supposition and hearsay to work with; well, that and recent experience. So:-

P7 toddles off for yet another routine medical. The half yearly requirement comes around pretty quickly so, off he went to do the necessary; all good. That complete he rolled up at DAME, went through the checks and, no surprise – good to go. Then the letter from Avmed – about a week later, they wanted a stress test ECG – no problem, just a $400 impost on an ever growing bill.  It’s now just two weeks after that stress ECG and TOM is the proud owner of four new heart by-pass grafts and a fashionable stainless steel zipper. Just like that. WTD.    

It has all come as a bit of a shock to be frank. P7 has held a Class 1 medical for over 45 years, a six footer, fit, strong and rarely troubled by illness – bar the odd flu. The day before the ‘Stress test’ between us we unloaded 14 metric tons of lumber off a truck (legit) carried it about 30 meters, stacked and stored it; four hours of hard graft. Cup of tea, sandwich and we worked the rest of the day framing a new roof (on the stable). What you might call a good, solid day of hard physical exercise. Glad to knock off, but just work tired – both of us. Ready to roll the next day at 0600. P7 knocked off at morning tea, showered and off he went to ECG.  Thanks for your forbearance – there is a point. P7_TOM has over the past decade had 20 ‘static’ ECG as a matter of routine; not once have those results been questioned. So far as we were concerned, he was as fit and well as it was possible to be. Not so; tests show that he had indeed had a heart attack – never a symptom, never ever a chest pain. Seems a ‘silent’ heart attack is a possibility. I ramble. Long story short; they put him on the treadmill, wired him up the declared that the ‘stress test’ could not be conducted and insisted on a ‘Echo’ stress test. This revealed the abnormality and they whisked him off for an ‘angiogram’ the very next day, all serious and concerned. The rest is history and scars.

Finally, the point. P7 asked every single qualified person (from Professors to Surgeon) why had the progressively building blockages not been picked up by the standard ECG at routine medical? The short answer is, the test is 'bloody useless' – seems it will pick up signs ‘after’ and show an irregularity but that’s about it. P7’s blockages had been developing over a number of years; and, had they been detected ‘early’ there would have been a routine ‘Stenting’ and all would be well. As it stands, TOM was lucky in that his heart had actually had time to build its own ‘by-pass’ (marvellous ain’t it) which stopped him dropping dead on the spot. Then there is final question – why would you insist on a nine minute treadmill marathon with the heart up at 200 odd BpM to determine if there was a problem? If ever anyone was going to have a heart attack it would be then. No experts here – but we know some, and on face value, there is a big question hanging over the CASA Avmed medical check procedure. Do yourself a favour, do not rely on your six month medical check as an indicator all is well. Book in, get the real tests done and hopefully you can avoid a heart attack; or get treatment early – before you too join the zipper club. Me? Oh, I booked in and had the ‘Echo’ ECG all is well; however; I may, in a couple of years book in again.  By any test, I am as fit, well and strong as most blokes, with no problems indicated on the CASA static ECG; but, so was TOM.

Time for a rethink CASA – time to join in the twentieth century version of medicine. If something as basic as heart health is treated as a box ticking exercise. My old man believed his CASA check up was all he needed; I wonder how many others are out there with medical problems unacknowledged and un diagnosed; for fear of loosing their certificate. It’s not good enough, nowhere bloody near. The ‘Echo’ ECG cost a little more than the treadmill torture; the results are priceless.

As stated, experience, hearsay and unqualified comment from me; but the ‘experts’ we have talked to all say pretty much the same thing – the CASA version of cardiac health is worse than useless – as a preventative measure.

Well, the kettle has done it’s thing and the coffee is made (from Tanna) P7 is at his work bench, making a set of draws for a restored dresser. A seven day from discharge and back to normal. Well done modern medicine and those terrific folk who put Humpty back together again. Thank you.

Toot - toot.

[P7_TOM]

How I joined the Zipper club.

Sunday - It was a lovely morning, pitched up at the houseboat early enough to avoid the preparation mayhem, snagged a mug of coffee and headed for the stable. The dogs picked me up long before I got there, obliged me to put the mug somewhere safe, sat on a log and had a good long ‘chat’ with ‘em. Clever folk, dogs, they just know stuff. The mystery of the uncooperative joints had been solved; the bench was now to be 40 mm shorter and, if I would assist the remaining four new tennons could be finished in no time. We worked in silence for a while, then – “how are you?”. It was not a casual question.

The short answer is ‘bloody marvellous’. The first week out of hospital is a bit tedious; but rest, food and quiet sorts that out and provided you are not inclined to wallow around the place, get out, breathe and don’t go too hard it all starts to work after that. I’ve been three weeks since the ‘op’ and am back to a normal pattern, which includes a days work and a dog walking; so – all good  so far.  But I have been lucky, I’ll tell you why, because if this happens to you, there are some things which matter.

For starters; make sure you are ‘fit and well’- for real. That was my first piece of luck; I’m not ‘fit’ like you would be for say a tough climb, or sailing in the Fast net; or, playing for the first XV; but I can do a days hard work or walk all day; you know the type of thing. That helped a great deal – I went in well, in reasonable condition, the body did the rest, I came out a little ‘groggy’, a bit sore and ‘weary’. But, as stated a quiet week at home was enough rest, the recovery began after that – bloody marvellous. Well done Medics, well done body. I will say – it isn’t a load of laughs and there are a few hours of it I wouldn’t wish on my worst enemy, however, it is what it is. Just try not to sneeze – that really hurts. Oh, and the ‘itching’ is murder; they seriously ‘shave’ you – furless – all over and it grows back.

The real point to my rambling on is to bring you a message, one I feel is important. I have held a Class 1 medical for over four decades. During that time I have not missed a licence medical check, in fact, given checks for the issue of overseas licences, one way or another I have passed a heap of ‘checks’ – without so much as needing a wart removed – all good. Blood pressure, cholesterol, sound in wind and limb, reading glasses now required, a little down on hearing in one ear - . In short just the usual wear and tear on a body which is ‘active’.  Not the slightest hint of impending doom, nary a whisper. First medical 2017, sound as a bell; second medical Avmed asked for a Stress test ECG. So, off I toddled to the treadmill. This is where I had my second bit of luck – a top dog Cardiologist just happened to be there and decided to watch his apprentice do the test (did I mind – course not). They wired me up and I stepped onto the belt – Whoa, calls the top dog – ‘hold on, this man has a problem”. Well they checked the electronic wizardry first (to be sure) then there was a long discussion; they decided the ‘problem’ could not be defined through the ECG but an ‘Echo’ stress test would do the trick. So, off I went. I have to say that if nine minutes on the belt the last three with the old ticker banging away at 200 BpS don’t induce a heart attack – nothing will. Test over.

In retrospect, I should have dropped dead on the belt. “Had I had a heart attack” they asked; Nope. “Ever had chest pains”; Nope. “Ever felt unwell or breathless”: Nope. “Well”, they said you have had a heart attack and the ‘widow maker’ artery is well blocked – Angiogram for you – tomorrow – be there. Ok says I.  Thus children, I entered the world of cardiac surgery.

Finally, the point. Neither I nor Avmed had the first blind clue of the condition – none, zero, zilch, nada. Seems that for at least the last five years (10 static ECG’s and blood tests) the blockages had been building up and my heart had ‘knitted’ it’s own by-pass (which is ducking remarkable, when you think about it). The long and the short of it is simple enough; for five years I could, quite legally, have had a heart attack airborne. This is no where near good enough. ‘We’ have not finished the research yet, but one thing is for certain sure; the Avmed system failed me and my passengers. This needs to be addressed. Meanwhile, spend the money make certain that all is well; had I done so, then five years ago I could have spent a day in hospital, had ‘stents’ put in and been brand new within 24 hours instead of taking a six week holiday and having my new stainless steel zipper fitted. All’s well that ends well, but it is time to take a serious look at the ‘testing’ regime CASA insist on. Clearly – it ain’t effective.

That’s all; first and final time I shall bang on about it. Thanks for your patience - if you got this far. Mind you, that first Guinness almost made it all worth while, I’ll probably never drink another one now; just in case the next is not so good (as if).

Cheers.

[Peetwo]

Over on thorny's snippets thread TB himself links to the excellent, essential reading Clinton McKenzie submission to the CASA Medical certification standards DP:

With his usual wit and biting sarcasm our old mate Clinton McKenzie nails it with an Oh so apt definition of CAsA and its regulatory processes.

From Wikipedia:
 
Noble cause corruption is corruption caused by the adherence to a teleological ethical system, suggesting that people will use unethical or illegal means to attain desirable goals, a result which appears to benefit the greater good. Where traditional corruption is defined by personal gain, noble cause corruptions[sic] forms when someone is convinced of their righteousness, and will do anything within their powers to achieve the desired result. An example of noble cause corruption is police misconduct "committed in the name of good ends" or neglect of due process through “a moral commitment to make the world a safer place to live."

Conditions for such corruption usually occur where individuals feel no administrative accountability, lack morale and leadership, and lose faith in the criminal justice system. These conditions can be compounded by arrogance and weak supervision.

His submission to a CAsA inquiry (see link below) Excellent research, combined with his undeniable brilliant analysis provides us with just why things are so screwed up in the Australian aviation world. His submission should be required reading, not just for Industry participants, but all CAsA staff and politicians.

https://www.casa.gov.au/file/183126/down...n=p6kNtcdK

 
Example page 5 under 'Colour Vision Deficiency':

---

Over

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Also for those interested here is the CASA DP webpage that provides links to over 70 other public submissions...  

Responses to DP 1707AM – Medical certification standards

We received around 160 submissions to the discussion paper from pilots, industry associations, flying organisations and medical professionals.

Please note:

• all submissions published here are done so with the permission of the individual or company who submitted the response.
  
• As this content is industry generated, some content may not meet government accessibility guidelines. If you require assistance with content, please email avmed@casa.gov.au.
  
  

• Aerial Application of Australia
  
• Australian Helicopter Industry Association Limited
  
• Aircraft Owners and Pilots Association of Australia
  
• Aircraft Owners and Pilots Association of Australia - Letters of support
  
• Airservices Australia
  
• Mr Andrew Anderson
  
• Associate Professor Chris Andrews
  
• Aircraft Owners and Pilots Association of New Zealand (AOPANZ)
  
• Aussie Flying Pty Ltd / Dr Carl Nilsson
  
• The Australasian College of Aerospace Medicine
  
• Australian Airline Pilots Association
  
• Australian Experimental Aircraft Association Chapter 1308, Inc.
  
• Mr Jim Baily
  
• Mr Owen Bartrop
  
• Jos Bonnie
  
• M.A Borgelt
  
• Leonard Borrow
  
• Ms Heather Brennan
  
• Mr Jason Briggs
  
• Mr Jim Brown
  
• Robin Chenery
  
• Mr Peter Clisdell
  
• Mr Peter Costick
  
• Colour Vision Defective Pilots Association
  
• Mr Tom Courtney
  
• Mr Owen Crombie
  
• Devonport Aero Club
  
• East Gippsland Aero Club
  
• Mr Henry H.T.Egan
  
• Mr David A Francis
  
• Ms Vicky Giles
  
• Mr Tristan Goode
  
• Mr Ike Goodwin
  
• Mr Don Gorrie
  
• Mr Richard Gower
  
• Mr Roger Hall
  
• Mr Michael Hannell
  
• Kerry Herron
  
• HIMS Australia Advisory Group
  
• Mr Colin Holloway
  
• The Illawarra Flyers Inc
  
• Mr Clive Johnson
  
• Mr Howard Jones
  
• Mr Mark King
  
• Dr Robert Liddell
  
• Mr John Lyons
  
• Mr Frank Martinelli
  
• Mr Paddy Martin
  
• Mr Greg McElvenny
  
• Mr Clinton McKenzie
  
• Mr Alan Middleton
  
• Mr Mark Narborough
  
• Mr Mark Newton
  
• Mr David Packam
  
• Peninsula Aero Club
  
• D.Prossor
  
• Recreational Aviation Australia Ltd
  
• Hudson Reid
  
• Sandy Reith
  
• Ms Beverley Roediger
  
• Mr Noel Roediger
  
• Mr Brenton Rule
  
• Mr Greg Scott
  
• Mr Neil Sidwell
  
• Sport Aircraft Association of Australia
  
• Mr Geoff Stevens
  
• Mr Richard Talbot
  
• Terry Travers
  
• Bruce Tuncks
  
• Dr. Tony van der Spek
  
• John Vevers
  
• Mr Raymond Peter Vuillermin
  

Last updated: 28 June 2017

WOW! - Talk about stakeholder engagement...
MTF...P2

[thorn bird]

"WOW! - Talk about stakeholder engagement..."

Yup P2, from what I understand all with a stake in hand ready and waiting

[Peetwo]

For and on behalf of Sandy, courtesy Duncan Morris -  


"..Let’s make our roads safe from sleepy drivers, we should all take the waking rest as described. But no I think we are signatories to International Human Rights which means torture is out.." - Sandy

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MTF...P2

[Peetwo]

Interesting recent case in the AAAT: Collins and Civil Aviation Safety Authority [2017] AATA 2564 (6 December 2017)

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REASONS FOR DECISION
          Deputy President Bernard J McCabe & Member D K Grigg
          6 December 2017
         BACKGROUND

1. Mr Collins is a 77-year-old farmer and the owner of a Cessna 182 which he uses for private flying primarily between his home in Tully and a property at Lakeland Downs. He has been flying regularly since 1992. Mr Collins told the Tribunal that he currently flies approximately 50 hours per year primarily between his 2 properties which involves a 1-hour flight time.[1] He also drives freight trucks.
   
2. In 2007 Mr Collins had surgery to repair his mitral valve[2] and every year he is examined by a cardiac specialist to satisfy the Civil Aviation Safety Authority (“CASA”) that he is medically safe to fly. Mr Collins says he has a full heart check every 12 months and has had no issues and that no one has ever suggested to him that there was an increased chance of a stroke because of the mitral valve repair.
   
3. On 7 October 2014 Dr Michael O’Rourke, Cardiovascular Specialist, reviewed Mr Collins’ electrocardiogram (“ECG”) results taken on 3 October 2014, and reported that Mr Collins was “doing very well with the biological mitral prosthesis and with his general health” and that “he is fit and well to continue with his flying and with recertification as a pilot from a medical point of view”.[3]
   
4. On 20 November 2014, as a result of his satisfactory medical examination, CASA issued Mr Collins with a Class 2 Medical Certificate.[4]
   
5. Mr Collins told the Tribunal that in or around early 2015 he was having nosebleeds while flying in cold temperatures so he decided to stop taking aspirin (because he thought that was the cause).
   
6. Mr Collins said that on 24 June 2015 he had been shopping at a hardware store when he “felt funny”. He said he ended up driving 40km home and decided he better go to his doctor the next day. He said he told his doctor what had happened and the doctor suggested he be checked. Mr Collins decided to be checked in hospital. On 25 June 2015 Mr Collins was admitted to hospital following an episode of hemianopia (a type of vision loss) and confusion.[5] While in hospital an MRI and a CT scan of Mr Collin’s brain, and an ECG, was performed to determine the cause of Mr Collins’ presenting symptoms. The tests demonstrated that “there is quite a large area of abnormal restricted diffusion seen inferiorly in the right occipital lobe consistent with evolving ischaemic infarct” and that Mr Collins had suffered a “acute right occipital ischaemic infarct” (a stroke).[6] Dr Hugh McAlister, Cardiologist, reported that the mitral valve repair was functioning normally and that no cardiac cause for the neurological event was suspected.[7]
   
7. While in hospital Mr Collins was reviewed by Dr Craig Costello, Neurologist. Dr Costello reported that:[8]
   
   1. the MRI of his brain confirmed the acute ischaemia;
      
   2. this event happened whilst Mr Collins was on aspirin; and
      
   3. the event was cryptogenic in origin.
      
8. Unknown to Dr Costello at that time, Mr Collins says that he had in fact stopped taking aspirin. Dr Costello said Mr Collins could not drive for one month and should have formal visual fields tests documented prior to returning to driving.[9]
   
9. Dr Ian Reddie, Eye Surgeon, conducted a visual field test on Mr Collins on 28 July 2015 and reported that the results showed Mr Collins had left superior quadrantanopia and that it did not represent any great impediment to his holding a private driving license.[10]
   
10. Professor O’Rourke reviewed Mr Collins again on 2 October 2015. Mr Collins told Professor O’Rourke that he was “adamant” that the stroke occurred when he was not taking aspirin. Professor O’Rourke reported that Mr Collins had no symptoms or signs relevant to his cardiovascular system and that he remained very fit and active and that he would be happy for him to maintain his pilot’s licence but “from a neurological point of view, Eric may be best waiting for 12 months from the date of his occipital infarct before he flies alone again”.[11]
    
11. On 23 October 2015 Dr Costello reported that Mr Collins had fully recovered from his stroke, had no abnormality in his visual fields and that he was continuing on his appropriate post-stroke therapy medication. Dr Costello notes that he was now aware that Mr Collins was not on aspirin at the time of his stroke and that Mr Collins had ceased taking aspirin when he was travelling in cold climates. In Dr Costello’s opinion, the risk of Mr Collins having a recurrent stroke was low, given Mr Collins was 3 months post his stroke and that he had remained on his post-stroke medications. Dr Costello reported that if Mr Collins maintains strict compliance with his medication he should be able to return to flying his private plane but that the final certification of this will be up to his Designated Aviation Medical Examiner (“DAME”) as per CASA guidelines.[12]
    
12. Mr Collins told the Tribunal that after his stroke he was prescribed a different medication, not aspirin, which softens the arteries rather than just thinning the blood. He says he only needs to be medically managed by a general practitioner, everything is stable, he only needs specialised review for the purposes of CASA licensing, and that all he has to do for his conditions is take the medication.
    
13. On 30 October 2015 Mr Collins applied for a renewal of his Aviation Medical Certificate Class 2 License.[13] In his application, Mr Collins reported to CASA that he had ceased taking aspirin and that he had a cerebellar infarct in June 2015 which was completely resolved without functional loss.[14]
    
14. Upon receipt of Mr Collins’ Aviation Medical Certificate renewal application, CASA determined that, as a result of his stroke, Mr Collin’s application required a complex case management review (“CCMR”).[15]
    
15. On 6 January 2016 the CCMR considered Mr Collins’ medical reports and the scientific literature regarding the frequency of stroke recurrence after cryptogenic strokes and decided that the risk of a recurrent stroke was unacceptable.[16] As a result of the CCMR, CASA determined that because of his condition (i.e. occipital ischaemic stroke (cryptogenic type)) Mr Collins did not meet the medical standards set out in Table 67.155 of the Civil Aviation Safety Regulations 1998 (“CASR”).[17] In CASA’s opinion, Mr Collins’ condition presented an unacceptable risk of in-flight incapacitation because there was increased risk of stroke recurrence and post-stroke seizure which could lead to an acute or subtle in-flight incapacitation. CASA said it would consider reviewing the risk assessment after 12 months post the date of the stroke.[18]
    
16. Mr Collins advised CASA that he accepted CASA’s decision and would reapply when the 12 month mandatory period had expired.[19] CASA advised Mr Collins that after the completion of the 12 month grounding period he would need to undertake a new medical certificate application examination and provide a report from his neurologist and cardiologist.[20]
    
17. Formal notice of CASA’s decision to refuse to issue Mr Collins with the Aviation Class 2 Medical Certificate was provided on 10 February 2016.[21]
    
18. On 20 June 2016 Dr Costello completed Mr Collins’ 12 month review and reported that:[22]
    
    1. since the stroke, Mr Collins had not had any further clinical neurological deficits;
       
    2. the prognosis for recurrent stroke is highest in the first year and his current risk of stroke, estimated by a variety of risk calculators, was found to be 5% over the next 4 years and 10% over the next 10 years, which is lower than the average of 18% for his age group over 10 years;
       
    3. Mr Collins’ risk of post stroke epilepsy was highest in the first year and is typically quoted between 5 and 9% in total; and
       
    4. if Mr Collins has ongoing vascular risk factor monitoring and management there would be no requirement for any further input from Dr Costello unless required by CASA.
       
19. On the 17 October 2016, 15 months after his stroke, Mr Collins was reviewed by Dr Costello again. Dr Costello reported that:[23]
    
    1. Mr Collins had not had any new neurological symptoms and remains asymptomatic;
       
    2. Mr Collins was continuing his medication; and
       
    3. there was no change in Mr Collins’ risk level, since his review in June 2016.
       
20. On 21 October 2016 Professor O’Rourke reported that Mr Collins had completely recovered from his stroke and that the episode occurred after he stopped his antiplatelet therapy (aspirin) and that, from a cardiological viewpoint, he was fit to have his flying licence renewed.[24]
    
21. On 24 October 2016 Mr Collins had a vision assessment by Dr Mark Chiang, Opthamologist, which showed “left superior quadrantanopia secondary to right occipital stroke”. Dr Chiang reported that there was no problem with Mr Collins flying from a vision point of view.[25]
    
22. On 4 November 2016 Mr Collins applied to CASA again for an Aviation Medical Certificate Class 2.[26]
    
23. On 7 November 2016 CASA proposed to issue Mr Collins with a Class 2 Medical Certificate subject to the condition that “the holder to fly with safety pilot only” (“Safety Pilot Condition”) on the grounds that Mr Collins did not meet the applicable medical standards, as set out in Table 67.155, due to the risk of recurrent stroke or post stroke seizure.[27] The requirements of the Safety Pilot Condition are that the aircraft flown by Mr Collins must be configured with side-by-side seating in the cockpit and the aircraft must have a full set of dual flying controls.[28]
    
24. On 18 November 2016 Mr Collins lodged an objection to CASA’s decision to impose the Safety Pilot Condition.[29]
    
25. Upon receipt of Mr Collins’ objection CASA determined that his application required a CCMR.[30]
    
26. On 7 December 2016 the CCMR considered Mr Collins medical reports and the scientific literature regarding the frequency of stroke recurrence after cryptogenic strokes and agreed with the CASA proposal to impose the Safety Pilot Condition on Mr Collins’ Aviation Medical Certificate Class 2 due to the increased risk of cardiovascular accident recurrence.[31] Dr Mike Seah, Senior Aviation Medical Officer at CASA, then wrote to Mr Collins and explained that, while his medical evidence supported his application for a Class 2 Medical Certificate, in accordance with CASA’s clinical guidelines[32] the indicative outcomes for a medical certificate following a stroke state:[33]
    

• [i]Applicants with residual impairment, unacceptable current risks and/or risk of myocardial infarction may not meet the required standard for medical certification[/i]
  
• [i]If a certificate can be issued, permanent annual requirement cerebrovascular and cardiovascular risk assessment may be required[/i]
  
• [i]If the certificate can be issued, permanent Multi-Crew (Class I) or Safety Pilot (Class 2) restriction may be required[/i]
  

1. In Dr Seah’s opinion, based on the medical reports:
   
   1. Mr Collins had a confirmed ischaemic stroke/cerebrovascular accident;
      
   2. Mr Collins still has a visual field defect, quadrantanopia, as a result of the death of brain tissue affected by the stroke; and
      
   3. there was an increased risk of further stroke or cardiac events particular with increasing age; and, therefore
      Mr Collins Class 2 Medical Certificate should have the Safety Pilot Condition.
      
2. On 14 December 2016 CASA decided to issue Mr Collins with a Class 2 Medical Certificate with the Safety Pilot Condition (“CASA Decision”).[34]
   
3. On 9 January 2017 Mr Collins applied for a review of the CASA Decision by this Tribunal. Mr Collins submits that the Safety Pilot Condition should not have been imposed because his medical condition and prognosis, including the risk for a future cerebrovascular accident, was not high enough to make the Safety Pilot Condition necessary to preserve the safety of air navigation.[35]
   
4. A refusal by CASA to grant a certificate is a reviewable decision and an application may be made to the Tribunal for review.[36] The Tribunal has jurisdiction to review the CASA Decision pursuant to section 25 of the Administrative Appeals Tribunal Act.
   

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[1]           The Tribunal notes that the medical certificate application form completed by Mr Collins on 10 November 2014 indicated that he had flown 60 hours in the previous 6 months, which equates to 120 hours per annum: Exhibit 1, T Documents, T 8, page 16, MRS Online Medical Examination Report completed by Mr Collins on 10 November 2014. The medical certificate application form completed by Mr Collins on 30 November 2015 indicated that he had flown 28 hours in the previous 6 months, which equates to 56 hours per annum: Exhibit 1, T Documents, T 22, page 43, MRS Online Medical Examination Report completed by Mr Collins on 30 November 2015.

[2]           Exhibit 1, T 6, page 12, Report of Dr Jacobs dated 3 October 2014.

[3]           Exhibit 1, T 7, page 14, Report of Dr O’Rourke dated 7 October 2014.

[4]           Exhibit 1, T 9, page 22, Letter from CASA to Mr Collins dated 20 November 2014.

[5]           Exhibit 1, T 12, page 27, Report of Dr Armstrong (Intern at the Mater Hospital Pimlico).

[6]           Exhibit 1, T 10, page 24, MRI Report of Dr Withey dated 26 June 2015.

[7]           Exhibit 1, T 11, page 26, Echocardiogram Report of Dr McAlister dated 26 June 2015.

[8]           Exhibit 1, T 13, page 29, Report of Dr Costello dated 30 June 2015.

[9]           Exhibit 1, T 13, page 29, Report of Dr Costello dated 30 June 2015.

[10]          Exhibit 1, T 14, page 30, Report of Dr Reddie dated 28 July 2015.

[11]          Exhibit 1, T 18, page 38, Report of Professor O'Rourke dated 2 October 2015.

[12]          Exhibit 1, T 20, page 40, Report of Dr Costello dated 23 October 2015.

[13]          Exhibit 1, T 21, page 41, Application for Aviation Medical Certificate Declaration dated 20 October 2015.

[14]          Exhibit 1, T 22, pages 42 – 48, MRS Online – Medical Examination Report completed by Mr Collins dated
             30 November 2015.

[15]          Exhibit 1, T 24, page 52, Letter from CASA to Mr Collins dated 7 January 2016.

[16]          Exhibit 1, T 23, pages 49 – 51, Complex Case Management Report dated 6 January 2016.

[17]          Exhibit 1, T 25, page 53, Letter from CASA to Mr Collins dated 13 January 2016.

[18]          Exhibit 1, T 25, pages 53 – 55, Letter from CASA to Mr Collins dated 13 January 2016.

[19]          Exhibit 1, T 26, page 56, Letter from Mr Collins to CASA dated 20 January 2016.

[20]          Exhibit 1, T 27, pages 57 – 58, Letter from CASA to Mr Collins dated 3 February 2016.

[21]          Exhibit 1, T 28, pages 59 – 61, Letter from CASA to Mr Collins dated 10 February 2016.

[22]          Exhibit 1, T 29, pages 62 – 63, Report of Dr Costello dated 20 June 2016.

[23]          Exhibit 1, T 33, page 71, Report of Dr Costello dated 17 October 2016.

[24]          Exhibit 1, T 34, page 72, Report of Professor O'Rourke dated 21 October 2016.

[25]          Exhibit 1, T 35, page 73, Report of Dr Mark Chiang dated 24 October 2016.

[26]          Exhibit 1, T 38, page 93, Application for Aviation Medical Certificate Declaration dated 4 November 2016.

[27]          Exhibit 1, T 39, pages 94 – 95, Letter from Doctor Mike Seah, Senior Aviation Medical Officer at CASA, to Mr Collins dated 7 November 2016. Pursuant to CASR 67.195, a person who does not meet the relevant medical standard can be issued a certificate to exercise the privileges of their licenses subject to any condition considered necessary by CASA.

[28]          Exhibit 1, T 39, page 97, Requirements of a Co-Pilot and/or Safety Pilot Condition on a Medical Certificate.

[29]          Exhibit 1, T 41, page 99, Letter from Mr Collins to Dr Seah, CASA, dated 18 November 2016.

[30]          Exhibit 1, T 44, page 102, Letter from CASA to Mr Collins dated 7 December 2016.

[31]          Exhibit 1, T 45, pages 104-108, CCMR dated 7 December 2016.

[32]          http://services.CASA.gov.au/avmed/guidelines/cerebrovascular_accident.asp

[33]          Exhibit 1, T 46, pages 109 – 110, Letter from Dr Seah to Mr Collins dated 7 December 2016.

[34]          Exhibit 1, T 48 and T 49, pages 112-117, Letter from CASA to Mr Collins re issue of Medical Certificate and Medical Certificate.

[35]          Exhibit 1, T 1, pages 1-2, Application for Review dated 9 January 2017.

[36]          Sections 31(1)(b) and 31(2), CA Act.

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Hmm...in light of the recently CASA introduced [color=#0066cc]Basic Class 2 medical reform, one wonders how these types of Avmed cases will be handled in the future...

Maybe the 'make work' CASA Legal Services division might suffer some rationalisation...


MTF...P2

[Peetwo]

Avmed good news story for a change -  


Via the Oz:

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Airlines pool resources with CASA, college to train aviation doctors

12:00amANNABEL HEPWORTH

A unique program to train doctors in aerospace medicine backed by the two biggest Australian carriers has generated strong interest.

Qantas, Virgin Australia, CASA and the Australasian College of Aerospace Medicine are will select three medicos to rotate over a ­series of six to eight months through CASA and the two carriers, helping them to move through the college’s aerospace medicine specialist training pathway, under the new program.

CASA principal medical ­officer Michael Drane said the plan was to develop specialists with wide training.

“One of the things that is ­really important in this realm is it’s not just a case of having doctors who are academically excellent,” Dr Drane told The Australian. “You have to be able to translate that academic skill into the practical workplace. ­Pilots work in a funny office and it’s really important that the decisions we make are practical and workable in an operational situation.”

Qantas director of medical services Ian Hosegood said the program “gives us the opportunity to expand the research/work we are doing into pilot and cabin crew health”.

“With more people than ever before working in aviation and with passenger numbers ever ­increasing, aviation medicine is a specialised field and we’re very supportive of this program.”

Virgin Australia’s group medical officer David Powell said the participants believed the program was one of the first of its type in the world.

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MTF...P2

[Kharon]

- from P7.

Gob-shite  - “Major reforms have been made to the aviation medical system which reduce red tape and provide flexibility to general aviation pilots,” Mr Gibson said. “CASA is also actively looking at regulatory support for new affordable technology that will support safer general aviation flying.”

It is a thing of wonder to me just how blind and disinterested the media can be. It also fascinates me to think a journo can be reproducing Gibson’s dribble, while there is a ‘red-hot’ whisper doing the rounds – all 'top secret' of course; except, everyone (bar the press) knows.

FWIW – here is the latest gossip. Seems that there has been a showdown – if true, then the CASA CEO has earned not only a Choc Frog and a gold star today, but a large chunk of respect. It seems, so scurrilous gossip has it: the PMO would not have a bar of the proposed changes to some medical standards for pilots – CEO Carmody declared that the changes would be made. “Well I’ll quit” says the PMO (much miffed) – “OK” says the CASA boss. Appears there is now a vacancy at the top of Avmed; perhaps a sensible, competent pair of hands can don the dreaded rubber gloves and do what is required. Peter Clem is such a man – I wonder, I just wonder if perhaps, maybe; there is a change in the wind. Is Carmody the windsock? Faithfully representing the ministerial wind – as it breaks.  MTF -? Or not. We shall see

“Silly question my dear – you must be new; even so, that glass is less than half full which, IMO, is a terrible, drained thing full of air”.  Cheers- you bet.

We'll have to wait official confirmation; but if true the I can second the Carmody Choc Frog award. Seems realistic reform is at least 'in the building'. Fingers crossed.

[P7_TOM]

The most boring post – ever.

Mostly, when folks start banging on, and on, and on about ‘their’ medical matters; I switch off after a polite listening period – seriously, it gets tedious. However, I am determined to try and get a message out to my ‘comrades in exile’ as it were.

It is nearly a 12 month now since my adventure with the big zipper. Happily, my medical is restored and life can go back to normal. But I need not have been on an enforced holiday.

“Surgery or a coffin” were the two options my good friend and eminent cardiologist offered. “Christ man” says I – “I’ve hardly had a sick day (out of the ordinary) in my life, no chest pains, nothing; fit as the butchers dog”. Two days before that pronouncement, I’d been humping 3.6 meter long 4x2’s up three stories to a roof on a mates place and then pitched his new roof; weary at the end of an eight hours stint of hard graft, but good to go next day.

Well, it seems that my ‘blockage’ was a potential killer which had very craftily built up over a number of years. The amazing thing (which blew me away) is that the body had built it’s very own by-pass around it, which kept the hydraulics  running. Stunning, amazing, awesome, etc. In retrospect, the give away was – wait for it – weight loss. Ayup, since the age of about 21, I have always weighed in at X, which for my height, is spot on. The day of the operation, I was exactly 14 Kilo’s lighter. Why? I asked the guru. It seems your body, when it needs to reduce your weight to balance the ability of your ticker, has no use for ‘fat’. It burns muscle. I know not quite technically nice, but it will suffice for the moment. Took a month of hard work to regain that muscle (and regrow my fur).

The point of this self indulgent post is simplicity itself. Not on my worst enemy would I wish the first few moments of ‘waking’ after the zipper op; it is, truly unpleasant. Had I known 10 years ago, that which I now know, I would have happily spent the brass to have an ‘angiogram. One at 50, another at 55 and the need for surgery, four miserable days in a hospital bed and a six month lay off could have been avoided. Prevention being better etc…

The Avmed system caught it before the grim reaper sprung his carefully baited trap, thank you. But, had I been more health savvy, then there would be little need to trouble anyone. Please, just think about chaps (and chapesses), a stich in time etc…..

It has ended well for me, excellent recovery and medical restored; but, if I had the time again, I’d make bloody certain all was as well as I believed it was.

Avmed have been great, there is one small criticism; no, scratch that, wrong word. I shall re phrase. It would be most helpful to both Avmed and the ‘applicant’ if there was a published checklist of the paper-work required. Along the lines of – you fell off your skateboard and busted your leg: cool; to reinstate your medical CASA requires X, Y and Z. Avmed have protocols to follow, this is understandable. You need to meet those by sourcing the documentation required. Easy as, provided you know what they need; long, slow process if you don’t.

Anyway, all's well that ends well; but seriously, don’t mess about, get the gold star check up – early.

That’s the end of this saga - #1 son has two fresh Ales pulled, one awaiting my attention; best I shut up and sup up.

Cheers.