Originally Posted by
KRviator
I know a train driver who was diagnosed with ASD as an adult and spent 6 months off the road having to redo his medical with the Company CMO (who apart from the bare minimum, has zero psychology training it turns out). Apparently as part of the assessment she asked him to remember 5 words at the start of her assessment and he had to repeat them at the end. When it came time to, he got 1 out of 5, and she was stunned. "Don't you think that's a serious problem? I told you, you had to remember those 5 words!"
His answer was along the lines of "Nope, 5 meaningless words in an interview to determine if I can do the job I've been doing for the last 13 years mean nothing to me. But I can tell you down to the milimeter the track gauge in each state of Australia, can tell you how how many volts the main alternator can put out, I can tell you the compressive or tensile force limits of our wagons and can mentally calculate how much force in tonnes I'm putting into the front coupler based on traction horsepower. For anything I need to remember I either write it down, or put it in my phone." From what he told me, she wasn't particularly impressed with his answer, but nonetheless signed him off Fit for Duty - Unconditional. His psych obviously had no problems with him doing rail safety-critical work!
So said Train Driver recently decided to upgrade from a C2 Basic to a C2 so he can get his twin and NVFR ratings. Being a conscientious bloke, he does the right thing and tells CAsA he's on the spectrum (
Biiiiiggggg mistake....). Never been a problem before, even with the C2Basic, if the GP's happy with his abilities, he flies. And has done since he was a teen, apparently. Apart from the above kerfuffle with the company doc, he's had no problems since he got diagnosed.
Anyways...not-so-promptly he gets the following response...
Originally Posted by The Cretins Against Sensible Aviation
Request for Further Information
Thank you for your recent application relating to your Civil Aviation Medical Certificate. To continue your medical assessment, we would be grateful for further information regarding your Asperger's Syndrome / autism spectrum disorder (ASD). Your specialist/DAME/GP will be able to provide this information and help you arrange any required tests.
CASA needs to ensure that your condition and/or its treatment do not pose a risk to aviation safety. There is a concern that premature or ill-considered actions may threaten the safe operation of aircraft. Restlessness and excessive movement can cause distraction, and impaired attention would affect multi-tasking and situational awareness.
** Please be advised that CASA will not be able to assess your fitness for any medical certificate until you have been stable off stimulant medication (if applicable) for at least six months, subject to satisfactory reporting.
In accordance with regulation 67.180(2)(d) of the Civil Aviation Safety Regulations 1998 (CASR), I require you to authorise the release of the following information and/or documents in order to assess your fitness for a medical certificate.
As described in CASA’s Clinical Practice Guidelines,
CASA requires:
1) a report from your
treating Psychiatrist with respect to:
- DSM V diagnosis – detailing inclusive and exclusive criteria, and any diagnosed comorbidities
- Current clinical status, including symptoms and current psychosocial and functional impact of condition
- onset of condition
- symptoms, including any of suicidal ideation, psychosis, mania or anxiety
- psychosocial and functional impact of condition
- details of any hospital assessment
- results of neuropsychological testing of attention and concentration
- treatment, response to treatment and side effects
- date of cessation of medication
- Ongoing management plan
- Prognosis
- Follow-up plan
2) from your GP, copies of your medical records from diagnosis to current date
3) a copy of the past
3 Years of your Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) history.
FOR UP TO 3 YEARS: Your MBS records can be downloaded directly from your medicare online account via the MyGov website. Your PBS records may be requested from the Department of Human Services. (see
https://www.servicesaustralia.gov.au...ation-releases)
4) copies of
academic records and employment history
5)
National Criminal History from the Police. (Check online for how to request a copy of your "National Police Check" in your State or Territory)
6) copies of any special investigations performed such as QEEG or neuropsychological testing
7) Previous specialist reports if available
Being a fairly intolerant-of-idiots kind of bloke and ****ty that CAsA seems to imply Autistic people are inherently prone to be suicidal, he did a bit of digging and came up with this as his reply. And I love it!
He's OK'd me posting it here, but I've anonymised it a little bit just in case...Apparently he just sent this, a letter from his GP saying "Yes, he has ASD, Yes I signed him off for his last medical, so what's the problem?" a couple of pages of his log showing the BFR's and a letter from work saying "Yes he is in fact a train driver, and has been for X decades"... No psych reports, no police check, no MBS history.
Good morning,
I am in receipt of your letter in which Dr Whatsisname requires the provision of supporting documentation in terms of my diagnosis of Autism Spectrum Disorder.
Firstly, it appears Dr Whatsisname has confused ASD (Autism) with ADHD (Attention Deficit Hyperactivity Disorder) as Autism alone is not typically treated with medication, except where required for comorbidities (anti-psychotics for example) which is not the case in this instance, and certainly not with stimulants as referred to in your letter. Furthermore, despite Dr Whatisname's claim, Autism is not referenced in CASA’s Clinical Practice Guidelines in any manner, however, ADHD is, which in turn suggests the provision of the information Dr Whatsisname has requested.
This is an important point as Dr Whatsisname requires a report from my treating psychiatrist – and I am not now, nor have I ever been – referred to, or attended a psychiatrist for any condition, whatsoever. As such, I am unable to comply with point 1 of his letter. In addition to being unable to provide a report from my psychiatrist, the psychologist who diagnosed the condition passed away several years ago and the relevant records are no longer available.
Furthermore, it appears Dr Whatsisname has overlooked the fact that I have already been issued a Civil Aviation Medical Certificate, a C2 Basic, issued by my GP, 12 months after my diagnosis of Autism, as it is not a disqualifying condition to holding an AustRoads Commercial Licence medical, please refer to the attached correspondence from the GP regarding this in addition to a copy of the certificate itself.
In addition to the above previously-issued CASA Medical Certificate, since January 2018, I have undertaken an RAAus BFR in February 2018, a RAAus endorsement flight test in February 2018, a GA BFR in February 2020 and another GA BFR in August 2022 (refer logbook extracts). One would reasonably question whether 3 different CFI’s would agree with my condition “posing a risk to aviation safety”.
As you will note from the attached employment records, I have been employed as a Train Driver continuously for nearly 20 years, an inherently safety-critical role where attention and the ability to remain focussed and undistracted are paramount.
I trust the attached information is sufficient to demonstrate my diagnosis of Autism Spectrum Disorder does not pose a risk to aviation safety.
From what he tells me, he got a reply that simply said
Thank you for your email correspondence and the reports. They are sufficient to assess your condition of Autism Spectrum Disorder.