Appealing CAA refusal???

[Capewell]

I have just had my initial application for a class 1 medical refused.

This was due to suffering mycoplasma encephalitis eight years ago. I made a full and quick recovery etc.

Apparently this makes my chance of another seizure 1% and it has to be 0.1% to get issued a certificate without an OML....

Luckily, I am married to a doctor and she is on the case but if any of you can give me some advice on mounting a successful appeal I'd be very grateful.

[parkfell]

You need to find a specialist in this field accepted by the CAA who challenge the original decision.
If you were referred to a specialist before their original decision, then you will probably have an uphill struggle.
EEG normal?

[Capewell]

Hi, sorry for the slow reply,

I have seen a specialist since the initial refusal who has done a review of my case based on all of the material generated from my stay in hospital. He has managed to access this as he works in the hospital I was admitted to. He one of the country's leading experts and also sits on the CAA panel. His opinion is that I did not have encephalitis and have no more chance of another seizure than a normal person.

The CAA initially assessed me as unfit based on about 10% of the information relating to my case. Despite me providing them with the contact details of the consultants involved they made no effort to contact them or request more information from me.

I accept that it is my job to provide them with the information but I had tried to access my medical records through my GP, the few pieces of paper that I received from her, I provided to them. I eventually managed to get hold of all of my medical records which were gathering dust in an archive by asking a friendly medic to get them for me!

I am now in the appeals process which seems to be moving at glacial speed. The original aeromed GP sat on my report for two weeks before deciding to send it to someone else to look at.

Anyone reading this please dont make my mistake and ensure you keep hold of a copy of all of your medical records and do not submit anything to the CAA until you are sure that you have all information relating to your case.

Dealing with NHS and CAA bureacracy is very frustrating...

[Fursty Ferret]

My advice would be to get your medical records, see your GP, and seek a private referral to a specialist. You need their opinion as to the risk of you having another seizure and whether it genuinely is less than 0.1%.

If they say yes, ask them to write to the CAA on your behalf and tell them this. Obviously there's a cost to this, but it's the only way. In my experience, the CAA will defer to a specialist opinion. This is how I got my class one shortly after a fairly invasive eye operation.

[Capewell]

I managed to see one of the countrys leading experts about a month ago who did a review of all of my notes and concluded that I am of no more risk of a seizure than anyone else. I sent this all off to them immediately afterwards and have only just been contacted to come in for my inital medical while they ponder all of my notes. I'm sure I'll have to go for more tests but things are looking more positive for now.

[Sir George Cayley]

I find the Medics there to be very professional and keen to pass people not ground them. I think they are evidence based and risk assess accordingly so if you have a strong case that should be enough.

Not that it will have any bearing on how you are treated you might care to know they will be told if the section is to be outsourced just before Christmas :confused:sad:

SGC

[Radgirl]

I am sorry the difficulties you are experiencing have been magnified by issues accessing your notes. For others in this situation, the best course is to write to the hospital not your GP who is already massively overworked. The hospital may charge you for photocopying but, with a few specific exceptions, all patients have a right to access their complete notes.

[Capewell]

I have worked in the public sector for the last sixteen years so they have my sympathy. I dont feel victimised or anything, its just a bit frustrating that they deemed me unfit based on an SHO's discharge summary rather than look at the full picture.

As far as getting your notes goes there is usually quite a wait. I'd advise anyone to request and keep a copy of everything. you never know when you are going to need it.

The way the NHS manages information is a shambles but that isn't the fault of the medics who mostly do an excellent job.

[olympus]

I find the Medics there to be very professional and keen to pass people not ground them. I think they are evidence based and risk assess accordingly so if you have a strong case that should be enough.

I agree with Sir George. I'm now retired but I had a couple of quite serious medical episodes during my service as a professional pilot and at no time did I think that the CAA medicos were doing anything other than their very best to get me back in the air. (The then head of the CAA's medical branch was flying with my airline as an F/O and regularly flew with me but I'm sure any pilot would be treated the same.)

[gingernut]

You probably need to nail down the terms such as "seizure."

[eason67]

Keep going and don't give up old chap!!

Get your paperwork together. If your CAA doctor refused the initial issue then this should go to the CAA who should then consider it. If they then refuse, you can ask them to look again and at the same time provide extra evidence.
This should be reviewed by a different person than the one who did the first assessment, NOT the same person.
If this is the refused you can go to appeal, where you are in full entitlement to attend with whoever you wish. The panel should have no one on it who has been involved so far, and some of them will need to be experts in the field of medicine in which you are being refused a medical issue.:ok:
There are some great CAA docs out there and I doubt any of them refuse a medical on grounds other than cautious or obvious reasons. Some even offer to help with getting your medical sorted. If you are not happy with the CAA doctor you used, find another who will. There are lots of good guys out there.
In the end...it depends how badly you want it. It sounds like you know where you stand medically.
By the way, the CAA Medical Dept is worked off its feet. They do get things wrong. :)

[Capewell]

Thank you for your support!

I am battling on but it is very demoralising trying to deal with medics who do not answer emails and refuse to talk to you on the phone.

I'm sure the CAA are busy but it does then seem a bit odd that they employ doctors who are only actually in work one or two days a month...

[eason67]

I think you stand a really god chance based on what the specialist you saw said. Plus, he's on the CAA panel. If they have only looked at 10% of the details you gave them, then they haven't been thorough.

[Notoc]

Can you recommend your leading aviation medical specialist.

I have a friend who's revalidation after surgery is due.

Thanks

[Bad medicine]

Please read the top of the forum. We can't allow recommendations or endorsements of individual practitioners, as some jurisdictions regard this as advertising, whether practitioner knows about it or not.
Cheers,
BM

[cavortingcheetah]

A couple of points spring to my unqualified mind.
As far as I know, the CAA medical department will not discuss medical matters on the telephone, nor will they conduct email correspondence relating to anything. They have a protocol which demands that all medical material be in slow mail written form.
Fairly recently a policy or rule, or what have you, was initiated such that an initial Class I will not be issued with an OML.
You should send them absolutely every report you have that works in your favour especially recent ones, all in neat chronological order. Keep copies or send those instead, they seem to accept them. Any CT scans, EEGs and any other test results, for which you may have to pay yourself, might help.
You could have a look through this link and others you might find to see on what protocol basis they are making their decision.

Guidance for Medical Certification of aircrew | Medical | Personal Licences and Training (http://www.caa.co.uk/default.aspx/default.aspx?catid=49&pagetype=90&pageid=13769)

I've always found the CAA medical department at LGW to be extremely helpful in the end result notwithstanding the navigational exercises required to arrive there.

[Capewell]

They will communicate by email though you have to send them a signed letter authorising this.

I have recounted this saga to friends who are medics in the NHS and they are absolutely appalled at the glacial speed they work at and their poor communication with patients.

The whole thing seems to have been put in the 'too difficult' box. In six months all I have managed to do is go down to Gatwick to pee into a cup and take some bizarrely unscientific hearing test where one of the AME's whisper random words to you and you repeat them back!

I dont really want to comment on this any further as I have only seen progress by writing a letter of complaint to the chief medical officer and am considering taking it futher if its not resolved by the end of the year.

Perhaps I have just been unlucky with the AME who was initially assigned to me?

[helimutt]

well there are AME's out there who I feel shouldnt be involved with the CAA. I have suffered for a long period of time due to the actions of one of them, who will most certainly be getting a nice legal letter sent to him once this farce is completed.

Don't give up hope. Fight to the last. It's worth it. Im a year in now and have my full medical back but it has been a total ball-ache.!!!

[ExSp33db1rd]

CAA decisions defy all logic.

When I retired to NZ I applied to the NZ CAA for a NZ ATPL based on my still valid , but without recent experience, UK ATPL. This was refused on the grounds that NZ doesn't recognise a UK Instrument Rating. The fact that I had flown British ( and other ) registered 747's IFR between Christchurch and Auckland on many occasions counted for nought, I was forbidden to fly IFR in a Cessna in my local area. ( I am a volunteer - i.e. unpaid - SAR pilot for the local Coastguard Air Patrol ) As we almost never fly at night - can't see anyone in difficulty on the water - or bad weather, same reason, a VFR CPL was all I needed, and that was grudgingly granted, but I had to talk them out of returning to the UK, at their suggestion, to fully re-validate my UK ATPL before they would issue their CPL - won that one after a local flight test and NZ CPL Law exam.

In 1999 I returned to the UK to fly for 6 months and revalidated my UK ATPL but had to visit the CAA Med. Section at Gatwick following a question about a recent ECG. The UK CAA Cardiologist dismissed the ECG question as irrelevant but took my blood pressure. Geez ! Did you come around the M-25, you're not driving home the same way, are you ? Licence suspended but details forwarded to my NZ doctor for investigation, as I was about to return to NZ.

My NZ AME wired me up with a monitor, and ultimately could find no evidence of high blood pressure, or any reason for the rogue result in London ( M-25 ? ) and sent the results back to Gatwick. The same cardio. restored my licence and said he could offer no explanation for the now normal result - maybe it was because I was now stood on my head ? he said !! A CAA official with a sense of humour !

At age 75 I renewed my NZ CPL with a new Class 1 Med. Cert. but solely due to my age the NZ CAA demanded a stress ECG and the consultant cardio. emulated the UK CAA one, ie. "You're not driving home, are you ? " and 2 weeks later I was the proud possessor of two arterial stents.

The NZ CAA promptly grounded me for a year ( that didn't stop me flying microlights, for which the medical standard is that of an 80+ car driver issued by a GP not an AME and and the CAA have marginal control over the issue of microlight licences ) and after a year they told me never to darken their doorstep again with regard to a CPL, and even demanded stringent, and expensive annual tests for the maintenance of a PPL.

At this point I told them what to do with their PPL and obtained a then new RPL - Recreational Pilot Licence, for which the medical standard is that of a commercial driver with passenger endorsement, e.g. a bus driver, again issued by a GP. This enables me to still fly the Coastguard Cessna 182 but with only one crew member. I can die and kill one passenger but not four. Did I mention CAA logic ? but I'm not complaining, and neither would you if you were in trouble at sea and were spotted by only two pairs of eyes instead of four.

In demanding the stress ECG at age 75, the CAA may well have saved my life, so I shouldn't be ungrateful, but at the time my AME issued you with my new Class 1 cert. I could legally have still flown a 747, subsequently a problem was found, it was fixed, so I'm now in better shape than when that medical cert. was issued, but I can't now hold even a PPL.

As a pilot my problems were found and fixed - how many drivers hurtling towards you at a closing speed in excess of 140 mph have ever even been near a doctor ?

Makes you think.

[ExSp33db1rd]

CAA decisions defy all logic.

When I retired to NZ I applied to the NZ CAA for a NZ ATPL based on my still valid , but without recent experience, UK ATPL. This was refused on the grounds that NZ doesn't recognise a UK Instrument Rating. The fact that I had flown British ( and other ) registered 747's IFR between Christchurch and Auckland on many occasions counted for nought, I was forbidden to fly IFR in a Cessna in my local area. ( I am a volunteer - i.e. unpaid - SAR pilot for the local Coastguard Air Patrol ) As we almost never fly at night - can't see anyone in difficulty on the water - or bad weather, same reason, a VFR CPL was all I needed, and that was grudgingly granted, but I had to talk them out of returning to the UK, at their suggestion, to fully re-validate my UK ATPL before they would issue their CPL - won that one after a local flight test and NZ CPL Law exam.

In 1999 I returned to the UK to fly for 6 months and revalidated my UK ATPL but had to visit the CAA Med. Section at Gatwick following a question about a recent ECG. The UK CAA Cardiologist dismissed the ECG question as irrelevant but took my blood pressure. Geez ! Did you come around the M-25, you're not driving home the same way, are you ? Licence suspended but details forwarded to my NZ doctor for investigation, as I was about to return to NZ.

My NZ AME wired me up with a monitor, and ultimately could find no evidence of high blood pressure, or any reason for the rogue result in London ( M-25 ? ) and sent the results back to Gatwick. The same cardio. restored my licence and said he could offer no explanation for the now normal result - maybe it was because I was now stood on my head ? !! A CAA official with a sense of humour !

At age 75 I renewed my NZ CPL with a new Class 1 Med. Cert. but solely due to my age the NZ CAA demanded a stress ECG and the consultant cardio. emulated the UK CAA one, ie. "You're not driving home, are you ? " and 2 weeks later I was the proud possessor of two arterial stents.

The NZ CAA promptly grounded me for a year ( that didn't stop me flying microlights, for which the medical standard is that of an 80+ car driver issued by a GP not an AME and and the CAA have marginal control over the issue of microlight licences ) and after a year they told me never to darken their doorstep again with regard to a CPL, and even demanded stringent, and expensive annual tests for the maintenance of a PPL.

At this point I told them what to do with their PPL and was granted a then new RPL - Recreational Pilot Licence, for which the medical standard is that of a commercial driver with passenger endorsement, e.g. a bus driver, again issued by a GP. This enables me to still fly the Coastguard Cessna 182 to "Microlight Rules " i.e. with only one crew member. I can die and kill one passenger but not three. Did I mention CAA logic ? but I'm not complaining, and neither would you if you were in trouble at sea and were spotted by only two pairs of eyes instead of four.

In demanding the stress ECG at age 75, the CAA may well have saved my life, so I shouldn't be ungrateful, but on the day my AME revalidated my CPL with a new Class 1 cert. I could legally have still flown a 747, subsequently a problem was found, it was fixed, so I'm now in better shape than when that medical cert. was issued, but I can't now hold even a PPL. Did I mention CAA logic ?

As a pilot, my problems were found and fixed, but how many drivers hurtling towards you at a closing speed close to 140 mph have ever even been near a doctor ?

Makes you think.

[Capewell]

Ignorance is bliss! 1700 people were killed on UK roads in 2012...

After complaining I seem to have been assigned another AME who seems to have a good work ethic. He even phoned me the other day!!!!

Hopefully I will get this all sorted out before I get kicked off the FPP. The impression that I've gained in the last six months is that it seems to be run much like a flying club for retired GP's

I too was told I had a high blood pressure reading and had to get my missus to take it again when I got home. Her take was that they hadn't followed the hypertension society guidelines for measuring blood pressure. On their website it clearly says you should be in a sitting position and wait at least five minutes without speaking before recording the pressure. Mine was taken lying on the couch with no warning.

I was always brought up to respect those in authority and that would include doctors however this experience will make me a far less 'compliant' patient in the future...

Thanks for the supportive comments, I won't give up!

[Fire and brimstone]

Advice 1:

If you do anything else, get your medical records. Preferably, get THEIR medical records on you.

They hate telling you anything, so this way you know as much as they do.

You will probably have to pay £50 for this, and they will take 21 days (the max allowed).

Advice 2:

Read EVERYTHING. If you have been flying a while, there will be pages and pages of crap, and some nuggets of information.

The mistakes on mine were staggering. Errors, wrong information fed in by AME's, etc.

One medical a few years ago, I apparently lost 6cm off my height, only to grow back the next year? Why did they not question this?!

Advice 3:

Data protection - get them to put it right.

Advice 4:

Purchase deck-chair, and wait a very long time for anything to happen.

DON'T GIVE UP.


To be honest, the wrong information that goes in can seriously affect your career. I think the law needs changing so you see it before it is put on file. Electronic reporting makes this worse, as there never is a piece of paper they put in your hand.

[Capewell]

Well I got there in the end, but only after a lot of arsing around...

For the benefit of anyone reading this in the future, the best advice I can give from my persepective would be;

1. Obtain all of your medical records and keep your own copies
2. Go and see your own specialist. Try and get a consultant from a recognised centre of excellence rather then a district general hospital.
3. Make a complaint in writing if you think they are taking an unreasonable amount of time. I eventually had to send a couple of weary letters to the chief medical officer to get things moving.
4. Be polite to the admin staff that answer the phone, they will actually help you out if you are nice to them and need stuff passing to the AME's more quickly.
5. As per the other good advice on this thread, DONT GIVE UP!!!

[VANJ]

Same boat: Which AME did you use?
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Last edited by VANJ; 8th Aug 2016 at 09:23.

[Gordomac]

"Exsp33............." er, can't manage the rest but, look, in reply to "You are not driving home are you?" I would have been impressed with ; " Of course I'm driving home............I am to sick to walk ! "