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Old 17th Jun 2017, 17:19   #1 (permalink)
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Grounded due to historical issue, case taking months at CAA

Hello

I am currently working towards my CPL/IR, and have completed my ATPL examinations and about half of my hour building.

Unfortunately, when I came to do the Class 1 medical in March of this year, I was grounded.

Two to three years ago (while in possession of a class 2 certificate and a PPL, but not actively flying) I went through a bit of a rough patch due to various personal difficulties and underwent a course of cognitive behavioural therapy. As there was no actual specific diagnosis (the therapy was aimed more at addressing some unhelpful OCD - oriented symptoms that didn't actually indicate a full blown clinical diagnosis) and I was at no point medicated I didn't report anything to my AME or the CAA. Flying was also the last thing on my mind at the time, and I didn't resume flying until late last year in fact.

It wasn't until I was filling out the pre-assessment form for the Class 1 (MED 160 I think?) and it asked for very specific details on anything on my medical history (including psychological background) that I started to think that not notifying the CAA of my previous therapy at the time may have been incorrect. I contacted the AME that issued my Class 2 and he confirmed this, so I disclosed full details on the form and submitted the reports when I went to the AeMC the next day for my Class 1.

Although the AME who examined me stated there would be no change in my certification (although my Class 1 application was deferred to the CAA), a week after the appointment I got an email stating my Class 2 had been suspended too (effectively grounding me). A letter from the CAA shortly after confirmed this, and asking me for my written comments on a possible non-declaration issue and for my complete medical records.

I complied with this, writing a grovelling letter of apology/explanation and submitting my complete medical records at the beginning of April. I've been waiting since, and unfortunately progress has been painfully slow. I've attempted to contact my (Class 1) AME on several occasions but cannot get through as the admin staff insist that until there is a final decision at the CAA they cannot provide me with any further information.

I've pestered the CAA multiple times a week by phone since then and it seems my case is progressing, but extremely slowly. My records weren't reviewed by the consultant psychiatrist until about a week ago for example. There seems to be a lot of back and forth while memos are sent between staff members and typed up and sent back to be signed off etc. I appreciate the CAA aeromedical department have to work a large caseload with what they have (no different to licensing...), but this has completely scuppered my flight training plans and if it continues much longer could completely derail my commercial career due to training deadlines and commitments elsewhere.

Do I have any grounds here for a complaint? I appreciate that at the end of the day I wouldn't be in this mess if I had declared my medical history when I was supposed to, but it was a genuine mistake. I have been grounded for over 3 months now and the case has been with the CAA for as long as that.

I have asked that a priority be that my Class 2 is reinstated while I wait for my Class 1 application to be considered separately if it means I can get back to my hour building and starting my IR (which doesn't require a Class 1) more quickly, but I am not sure it will make any difference.

Would appreciate any advice!

Thanks
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Old 15th Jul 2017, 11:02   #2 (permalink)

de minimus non curat lex
 
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For those who are thinking about professional flying remember that defined time limits apply from the time you successfully pass EASA written exams.
The clock starts to tick.....
The moral of the story is to obtain the initial CLASS ONE medical prior to the groundschool phase.
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Old 15th Jul 2017, 14:31   #3 (permalink)
 
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It does seem a little harsh that CBT prior to Class one issue causes big problems but I know that CBT after issue is much less serious. How come?

They (well, one CAA doctor) tried to prevent my initial Class 1 due to childhood asthma even though I had servred as a pilot in the Navy!

Sadly there sometimes seems little rhyme or reason to such decisions, it is up to the whim of the particular quack who had control of your file and like mine if he is ex RAF and has an irremovable bug up his arse about asthma and flying than flying you will find hard to achieve.

Keep at them politely but firmly to find out if there really is a medical impasse or just a paper jam. If the former think about getting an aviation specialist second opinion. (PM me if you need a contact)

Good luck.

btw, three months isn't really a long time for the CAA medical people...
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Old 15th Jul 2017, 15:02   #4 (permalink)
 
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I'm surprised by this. I received CBT whilst my Class 1 medical was valid; in fact it was my AME who arranged it. I continued working and the CBT did its job.
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Old 17th Jul 2017, 11:55   #5 (permalink)
 
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Hi Navy……

(not as good as it used to be, is it ?!)

>> btw, three months isn't really a long time for the CAA medical people… <<

My bloke ex-RAF too. Took SIX months after a routine medical (over 65 then) to show there was nothing wrong with me after he made a fuss about a wrinkle on a voluntary 15 min. Bruce Protocol. How do we speed ‘em up ? Pigs might...etc etc.

Do these guys actually know what goes on in an aeroplane ? I’m far more relaxed in an aircraft than on the M25.
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Old 17th Jul 2017, 12:06   #6 (permalink)
 
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Quote:
btw, three months isn't really a long time for the CAA medical people...
I think TBF as I understand it a lot of the CAA medical stuff is now farmed out to external consultants so timescales can be very variable.

I had dealings with them recently and from my dossier hitting the CAAs desk to me getting an OK back by snail mail took just over a week....sounds like I was lucky.
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Old 17th Jul 2017, 22:41   #7 (permalink)
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Thanks for the input guys.

I coincidentally did finally receive a response this morning. Unfortunately it was way worse news than I was expecting.

They state that due to a single episode of what they refer to as delusional and paranoid thought over four years ago, I am assessed as unfit for all classes of medical certification. The letter is very short, with nothing in there about what I need to do next to regain certification (other than the standard line about appeals).

The episode was very brief and coincided with an extremely difficult period in my life, during which I was not flying. The symptoms never resurfaced and the ensuing CBT treatment was aimed only at the OCD-type symptoms that endured thereafter. There was never any official diagnosis of paranoid or deluded thought by any of the specialists I saw after the episode either.

I am just waiting to hear back from my AME regarding the next steps, unfortunately they also have proven quite difficult to get in touch with. The AME who issued my class 2 was much better.

Anyone have any experience with appeals and how long they take?
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Old 18th Jul 2017, 08:38   #8 (permalink)
 
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I am afraid the issues center on the two words - paranoia and delusional. You need to determine where these diagnoses have come from. Unless the CAA's psychiatrist has 'made them up' they most likely have come from your original notes and therefore the psychiatrist you were under at the time. You might be advised to discuss this with your original psychiatrist to see if he is willing to review and amend his opinion at that time in the light of your subsequent progress.
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Old 18th Jul 2017, 10:49   #9 (permalink)
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Many thanks for your response, that confirms what I suspected.

The terms were used in reports from initial assessments I had prior to my course of treatment, but were definitely not stated diagnoses. They referred to the assessor's initial impression but all later reports confirmed I was simply experiencing an onset of obsessive compulsive tendencies. The CAA however seem to have focused on the passing reference to delusional thought in the earlier (preliminary) reports and ignored the fact that latter reports do not mention this.

Unfortunately getting in touch with those earlier assessors has proven to be impossible due to the passage of time, so I guess I would just need to base my appeal on the grounds that the later, more detailed and up to date reports do not raise the issue of delusional thought.

I have asked my AME for advice on the matter but so far no luck. Am I right in saying the AME should be the first port of call for advice in these matters?
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Old 18th Jul 2017, 14:31   #10 (permalink)
 
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Sorry to be a killjoy but 'terms used in reports' are diagnoses! I think you will have an uphill struggle to get someone to state they were wrong based on a current examination. You may not be suffering from them now, but the CAA I suspect isnt really focused on that

You state this was three years ago. That is a blink of an eye in medical terms. You can be put back in touch with the psychiatrist or unit you were under at that time. Your GP is your friend and indeed should have a set of reports. The hospital notes by law must be disclosed to you unless they would cause you harm which does not seem to be the case. The doctor(s) can be traced.

good luck
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Old 18th Jul 2017, 18:03   #11 (permalink)
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Thanks again Radgirl, that clarifies things.

Even if what I experienced could genuinely be described as deluded thought, given that it was a one-off transient response to some of the most extreme stress I had ever experienced, am I right in understanding it shouldn't be an obstacle to certification? The CAA guidance material on psychiatry states the following:

Quote:
Class 1

(d) Schizophrenia, schizotypal or delusional disorder

Applicants with an established schizophrenia, schizotypal or delusional disorder should only be considered for a fit assessment if the licensing authority concludes that the original diagnosis was inappropriate or inaccurate or, in the case of a single episode of delirium, provided that the applicant has suffered no permanent impairment.
I can recount only one extreme example of obsessive compulsive behaviour which could possibly be described as delusional and it was the single instance referred to briefly by the aforementioned report. As far as I can tell from my amateur understanding of the definition it could be described as a delirium - so shouldn't it be possible to work around it given it happened once only? I can recall only one instance of it being that bad and can find only one example in my medical reports (I had to source from my GP and submit to the CAA my entire medical records, so I still have copies of everything).

The CAA say in their letter I have a "history of deluded thought", but I cannot understand if they consider the one instance of it to qualify as a "history" or if they seem to believe there are multiple occurrences. I guess the above GM is a starting point though so would appreciate any feedback on whether or not I've understood it correctly!
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Old 18th Jul 2017, 21:09   #12 (permalink)
 
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AME is the only way to go initially when dealing with the CAA.
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Old 19th Jul 2017, 10:03   #13 (permalink)
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That was my impression, but my AME got in touch by phone yesterday in response to my queries via email and was pretty adamant it wasn't his job to answer the above questions and that it wouldn't make a difference anyway since it's the CAA I need to convince.

I have tried asking questions directly to the CAA but repeatedly get told to ask my AME instead. There is also the issue of my AME asking questions and finding things out on my behalf - the CAA have told me several times if I want further details on the progression of my case or on how the medical officer came to the conclusions they did then my AME should be making these enquiries for me as "doctors can talk to doctors", but as a pilot I am not allowed direct contact with any of the medical officers. However my AME yesterday made it quite clear that he was not going to act as what he described as my advocate or representative at the CAA.

There seems to be a difference in opinion between my current AME and the staff I talk to on the phone at the CAA over an AME's role. Although to be honest the AME who issued my Class 2 was far more forthcoming with advice and finding things out for me.

I guess I could ask my GP on a few things that only require a medical opinion, but it's far from ideal as it would still be better to have access to someone with knowledge on the certification process and workings of the CAA.

I get the feeling that the guidance material on the CAA website is hardly comprehensive, is there somewhere I can officially go to for advice on making appeals?
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Old 19th Jul 2017, 12:20   #14 (permalink)
 
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Oh dear oh dear

If the CAA have put their instructions in writing send them to the AME. Otherwise inform him. If he still refuses you will need to inform the CAA the AME is refusing to carry out his duties. you could cc the CMO at the CAA. you can even escalate to the GMC but this is just daft. The CAA need to be told the AME is not playing ball and send him clear instructions to comply.

noflynomore is correct - this has to be resolved via the AME and CAA. You cant go second guessing the CAA
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Old 19th Jul 2017, 13:13   #15 (permalink)
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Thanks, I did bring up the issue with the CAA a number of times on the phone since the case began when calling to ask about progress etc, but no specific action was suggested/taken other than to simply oblige my request for information while making it clear it should really be my AME doing this.

I think I will take some time to try and determine how I want to take this forward, gather my thoughts and find out exactly what questions I need the answers to then put them all in an email to my AME rather than phoning. The added delays obviously are excruciating given the potential (career ending) ramifications of all this but I guess it's better to have it all in writing for the avoidance of doubt given there is a suggestion the AME is failing to act on his duties.

My main concern obviously is now timing given that not only do I have to worry about missing originally intended training dates and losing currency, but also the three year ATPL exam expiry date (never believed this would be an issue, given I was aiming to finish one year before). Looking through the CAA's appeals policy document, it appears I am now at the "AMS Secondary Review of Fitness" stage. It states that the case will be looked at by a different CAA medical assessor and also by an independent specialist adviser. My understanding is the assessment process undertaken by the second CAA assessor will be similar to that of the first (i.e, looking at it afresh) - I'm guessing therefore there's a danger the whole thing could drag on just as long? It took about 14 weeks for this decision to come through from the date I submitted the CAA's requested information.
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Old 20th Jul 2017, 09:44   #16 (permalink)
 
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Change your AME. Go see the fella I PM'd you about. If he can't help no one can.
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Old 23rd Jul 2017, 14:49   #17 (permalink)
 
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If it helps this discussion at all - and for general reference ................ these AME's are human and humans make mistakes (for want of a better word).

There seems to be an issue with correcting mistakes once they are made - or even admitting to mistakes in the first instance.

I have seen absurd errors on medical files: conditions that did not exist; medications that were never prescribed that necessitate grounding. How do these errors happen?

Diagnosis and clinical decisions should be based on established facts.

There is a lot at stake here: firstly comes safety. After this there is folks careers and pay. Perhaps this is why when the (inevitable?) mistakes happen, those RESPONSIBLE for their mistakes are afraid - or perhaps too proud - to admit to these errors.

As noflynomore suggested - perhaps a change of AME. Technically they are employed by you. If they don't do their job to your satisfaction, employ someone who does.

And don't forget to 'data-protect' the old AME out if you feel they have been unprofessional or unhelpful.

Best wishes.
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Old 26th Jul 2017, 02:28   #18 (permalink)
 
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Until you find an AME willing to advocate for you with the CAA, you won't get anywhere.

Since Andreas Lubitz deliberately crashed an Airbus, CAAs are much more cautious with any whiff of a psychiatric diagnosis.

Ultimately you may have to find another CAA. The US AOPA has an excellent medical group that advocates effectively with the FAA, for one example. Other AOPAs may not be as well resourced, but could offer an educated guess on your chances and refer you to an appropriate AME.

You would have to run your medical file by an AME in that country to see if there's any hope, preferably before jumping through the immigration hoops.

There is the possibility that you would not get a Class 1 medical until you have been flying for a while.
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Old 26th Jul 2017, 12:09   #19 (permalink)
 
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So RbF your advice to a UK resident is

1 get a working visa and residency in the US as a pilot but without a medical

2 fly as a pilot without a medical

3 hope you can then get a medical

Thank you for your advice
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Old 26th Jul 2017, 14:10   #20 (permalink)
 
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Oh no RG,

If CS finds a UK medical is impossible, he might be able to find another country (not necessarily the US) where the authorities there would consider issuing him a medical.

Possibly he might not be granted a class 1 medical right away, but may be able to obtain a class 2, 3 or 4 medical that would allow him to fly in a not for hire capacity.
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