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ADHD/ASD and CASA medicals

Old 16th Oct 2022, 23:25
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I wonder what medical condition someone has when he or she is unable to admit to doing something completely inappropriate – even unlawful - and instead goes to extraordinary lengths in an attempt to cover up what was inappropriately or unlawfully done. Whatever condition it is, CASA seems to have an uncanny ability to employ people with that condition in Avmed these days.

So the sick ‘joke’ has been ‘magicked’ out of the form. That’s one small step in the right direction.

But naturally there’s no commentary on the CASA website as to why the form was changed nor any public ‘traceability’ of what changes were made and when. Move on, nothing to see here (and hopefully we’ll fool people that there was nothing ever to be seen). But…

Let’s set aside – for a moment – the issues arising from unqualified people being asked to do an “examination” of someone for medical purposes – note that the instructor is declaring – on pain of criminal liability – that, among other things, “[t]his report embodies my examination correctly” [italics added].

Let’s also ignore – for a moment – that the subjects of the “examination” would have some considerable difficulty in meeting the competence standards of the licence being sought, as a consequence of some of the behaviours the unqualified person is looking for and reporting on.

The form is still a piece of crap that is evidently based on some else’s professionally produced questionnaire intended for a different context but modified by Avmed, based on Avmed’s bright ideas. I’ll bet folding money that whoever produced the original questionnaire would be appalled at the context in which it is now being used by Avmed. (And of course it’s OK to ignore the laws of IP when pursuing the noble cause of aviation safety.)

“This form is to be completed by the applicants flight instructor or lecturer…”. Oh dear. Someone in Avmed must have been running about or climbing excessively rather than concentrating when possessive apostrophes were being taught.

The instructor is to look for and report on behaviours such as the applicant being “inpatient waiting for take-off”. Oh dear. Someone in Avmed must have been running about or climbing excessively rather concentrating when prefixes and dictionaries were being taught. (Maybe “inpatient” is a Freudian slip. But I’m not qualified to diagnose such things.)

And when competent people with good attention spans start a list with: “I declare that:”, each thing on the list finishes a sentence that starts with those words. But here we have: “I declare that…I hereby certify…”. “I declare that … I consent…”. “I declare that … I acknowledge…”. This is the work of someone who is failing to pay close attention to details. I declare that I hereby certify that I consent to and acknowledge that I’m … not sure what I’m doing. But I do know that I’m committing an offence if whatever I’m doing is … whatever.

Apparently the ‘applicant’ is a pilot or air traffic controller applying for a CASA Medical Certificate. But question 1 has been drafted on the basis that the applicant could be a “Legal entity”. I’m not aware of any company being a pilot or an air traffic controller. Perhaps Avmed now issues medical certificates to corporate entities?

This is the product of the solemn deliberations of people – paid lots of money - who actually believe they’re contributing positively to the safety air navigation. But for this form, the skies would be filled with pilots, and ATC centres would be filled with controllers, who:

Fail to give close attention to details or make mistakes in theory lessons, school work, work, pre-flight preparations, in flight instruction or other activities

Have difficulty sustaining attention in theory lessons, in-fight instruction, tasks or play activities

Do not seem to listen when asked questions in theory lessons, in-flight instruction or when spoken to directly

Have difficulty prioritising tasks or activities eg. During pre-flight preparation

Inappropriately organise cockpit tasks

Often lose things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)

Misplace or leave behind items eg. headsets, slide rules, maps, flight plans.

Forget to replace fuel caps, pitot tubes etc.
[I’ve never replaced a pitot tube. Hmmm, maybe I have ADHD.]

Do not follow through on instructions given.

Have difficulty completing lessons.

Do not pay attention to or follow through or complete checklists or tasks appropriately.


You couldn’t make this stuff up.
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Old 17th Oct 2022, 00:24
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Originally Posted by Ladloy View Post
All this does is prevent pilots with underlying adhd or mental health symptoms seek treatment because of the risk of losing their jobs. Are they more of a risk by not seeking treatment to protect their livelihood?
I would suggest that someone who is already a qualified or commercial pilot is not at any elevated risk of an accident as a result of their condition, as they've already been assessed to the standards required. But should they then be diagnosed, AvMed gets involved and all hell breaks loose - even though they've "already met" the relevant standards! Just because their behavioural symptoms now "have a label" does not change the fact they have met, and presumably continue to meet, the applicable standards of a P/C/ATPL holder.

And there lies the problem... Watching a colleague go through the heartache and get sidelined for 6 months when they were diagnosed with ASD as an adult - and that's 'just' a train driver, it didn't involve AvMed! - would be enough to put me off disclosing anything to anyone ever again. How TF is that "safe"? The culture of fear CAsA have created as the regulator strikes at the very heart of safe aviation.

In any event, you'd probably find most specialised or inherently technical fields have a lot of people that would meet the "book" definition of being Autistic - hell, I was curious and so I googled a couple of online assessments and honestly answered them before typing this post and the outcome was "These results indicate that...you have a strong likelihood of being autistic." and for the second one: "Your score was 45 out of a possible 50. Scores in the 33-50 range indicate significant Autistic traits (Autism)."

Guess I'd better print out a stack of Form 420's for my next BFR, even though I've been flying for 25 years and routinely operate some of the biggest trains on the planet! Because of course, an "autistic" person can't be trusted to safely do the same things as a normal person without filling out this questionnaire....
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Old 17th Oct 2022, 07:55
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As I've mentioned earlier on this thread. some of my best students have been on the spectrum.

Whenever I have seen any of the behaviours described on the form it has been the "pushy dad" syndrome where dad decides little Johnny, usually at the age of around 13, is going to be a pilot and little Johnny is dragged to flying lessons in which he is NOT INTERESTED and plays up on purpose..

I have yet to have a student excessively climbing unless practising short field take offs with obstacles. I presume that is what they mean?

CASA would have grounded Neil Armstrong who seemed to have many AS traits, which is why he was able to achieve what he did. (I'm not going to use the D as it is not a "disorder" except in the minds of people who are uncomfortable being in the company of highly intelligent people who may or may not be a little eccentric)

I now have to tell people now (usually the pushy parents) that if Johnny is on any kind of mind altering medication (just because his personality doesn't fit their expectations) then he is unlikely to get a medical, as that form is a legal minefield.
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Old 17th Oct 2022, 20:10
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The idiot who inflicted this form on aviators has forgotten at least two problems::

1. The instructor is not a qualified medical professional.

2. The instructor will have her own bias which is uncompensated, ie:

- “does not seem to listen”

‘does not follow through”

”unprepared”

”difficulty prioritising”

”difficulty with…theoretical aspects”

”loses things”

”forgetful”

”easily distracted”

””may fidget”

”overactive….socially”

“restless, distracted,…, .energetic, ……talks excessively, …..and so on…..

COMPARED TO WHAT?????

‘Where are the objective standards for each of these descriptions? There aren’t any. Furthermore some of these behaviours could easily be a result of personality mismatches between instructor and student on many levels.


If CASA knew what they were doing, it might be possible to set objective standards and control for personal differences by using independent assessments by a panel of instructors, but that itself brings in new set of biases as well as the time involved.


Which begs the question; how relevant is an amateurish score on some spectrum to the job of piloting an aircraft?Is this another example of Avmeds quixotic and useless behaviour. How many ATSB reports narrow the cause of an accident to ADHD?

CASAs approach to alcohol and color blindness are equally suspect.


Last edited by Sunfish; 18th Oct 2022 at 19:35.
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Old 24th Nov 2022, 00:36
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I submitted this FOI request to CASA today:

"All documents containing, in whole or part, information about or recording any one or more or all of:
  • the catalyst for the decision to remove the sentence: “Hopefully does not get out of seat in flight!” from CASA Form 420
  • the process through which that decision was made
  • the individuals involved in that process, including the individual who made the decision
  • the matters taken into consideration or discussed, or both, by those individuals in the course of the process and in making the decision
  • the implementation of the decision after it was made, including the process through which the Form 420 without the sentence: “Hopefully does not get out of seat in flight!” replaced the version of the Form with that sentence on CASA’s website.
Subject to one exception, I do not request access to the name, work email address or work or mobile phone number or other personal information of any official. The exception is that I seek access to the names of the individuals involved in the decision making process and the decision the subject of this request. I do not request access to any personal information of individuals who are not officials. For the purposes of this request “official” has the same meaning as in the Public Governance, Performance and Accountability Act 2013."
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Old 25th Nov 2022, 04:50
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It's circumstances like these that created the saying "you have to self medicate to aviate".

Have a DAME and a Dr. They're two completely separate things in the real world unfortunately.


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Old 25th Nov 2022, 10:44
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There is no way an instructor should be making any medical assessment of a student other than their ability to function in the duties presented to them, ie 'sir you have no arms and the plane is not equipped for your abilities'. They are not qualified in anyway to make accurate medical diagnoses or even conduct a physical or mental assessment other than the obvious and can be prejudiced in findings based on personal experience rather than objective analyses. Once somebody is highlighted as suspect by someone that is not qualified what then happens? will they have to proceed through countless hoops to prove fitness, when they have already been through a medical examination for that exact purpose.

I've seen enough instructors that have ruined students dreams through incompetence in teaching and blaming the student for being lazy and lacking motivation and other issues. You then want to arm these individuals with the ability to tarnish somebodies medical history without any professional qualifications.

Does a driving instructor have to assess mental fitness?

Seriously the government needs to take its focus from weeding out the problem individuals and deal with whats causing the issues in the first place, but that's an unpleasant discussion they don't want to deal with.
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Old 26th Nov 2022, 05:53
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I have done one of these assessments, I can't remember the exact questions on the form but it wasn't a negative bias type of thing, it asked to make assessments on the candidates task management etc. The fellow was issued a medical after the assessment was done, not sure how he has gotten on since.
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Old 26th Nov 2022, 10:40
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My God! This is a legal minefield. Avmed may be protected but an instructor filling in a form with zero expert experience to diagnose a medical condition? Seriously? A smart kid starts seeing adverse attention after flying with instructor blogs. Someone says form 420. I don't think you will expect a pat on the back and say "ah well, that's it then" You guys better have deep pockets or bloody good professional insurance.
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Old 26th Nov 2022, 21:30
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........My late partner was an experienced and well loved teacher at a major private school. She had one student observed over about three years who was a 'problematic" performer. ADHD was mentioned. His parents organised flying lessons for this brat. By chance I observed him at flying school a few times. He was not a diligent student pilot either - attitude problems including laziness and attention to detail.

He now flies for Qantas. Work that one out.
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Old 26th Nov 2022, 23:03
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Originally Posted by OZBUSDRIVER View Post
My God! This is a legal minefield. Avmed may be protected but an instructor filling in a form with zero expert experience to diagnose a medical condition? Seriously? A smart kid starts seeing adverse attention after flying with instructor blogs. Someone says form 420. I don't think you will expect a pat on the back and say "ah well, that's it then" You guys better have deep pockets or bloody good professional insurance.
Spot on, OBD.

If an applicant is refused a medical certificate by Avmed, is otherwise hindered in their career aspirations or the subject of indefinite Avmed micromanagement, on the basis of considerations including the content of an unqualified person’s “examination” - that’s the word used in the form - that person could find themself in the middle of a time consuming and stressful controversy.

If I were a flying instructor, I’d be sticking to my instructor knitting rather than participating in Avmed’s thought bubble schemes. And that’s even if Avmed manufactured consent, from or on behalf of the applicant, to the “examination”.
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Old 26th Nov 2022, 23:06
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Sunfish, it sounds like he got over his ‘perceived’ childhood issues and got on with his life. Good on him!
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Old 26th Nov 2022, 23:18
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Yes, it appears that the person to whom Sunfish referred is very lucky that Mr and Mrs Sunfish didn’t fill out and submit a CASA Form 420 recording their “observations”.
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Old 26th Nov 2022, 23:34
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Problem that AvMed has now is the more they ask questions of the mental state of the general pilot body the more they will find the truth that over half pilots flying will be diagnosed with what in todays terms would require them specialist attention. How many pilots post Covid can say that they havn't had anxieties or possible depression during the lockdowns. That then requires AvMed to request specialist assurances from all affected pilots as well as vetting those responses for further issues. At what point do they just adjust the regulations and allow a GP or DAME to just assess your fitness on presentation.

As opposed to what was suggested to tell AvMed nothing, the opposite would be the end of AvMed, if every pilot flying told the complete truth about their thoughts and mental state. Throw in every chest pain and head ache you've had in the last 20 years, lost moments during a few drinks in 1982, grandfather was a serial killer with severe cardiovascular disease and suicidal tendencies.. etc. They would have to ground about 2/3rd of all flying pilots. Instead of playing the question game and answering what you think is right.

Assuming ADHD and its like has been around for a while now, there has to be many pilots flying with the condition, possibly undiagnosed and untreated. I mean I've seen Chief pilots asking where they left an Aircraft, is that like losing ones toys?

I think the truth of the matter is that the current delays in processing may just be that pilots are being more honest than ever about health issues and AvMed is having a minor cardiac event trying to deal with it.
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Old 27th Nov 2022, 00:56
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My God! This is a legal minefield. Avmed may be protected but an instructor filling in a form with zero expert experience to diagnose a medical condition? Seriously? A smart kid starts seeing adverse attention after flying with instructor blogs. Someone says form 420. I don't think you will expect a pat on the back and say "ah well, that's it then" You guys better have deep pockets or bloody good professional insurance.
If that is aimed at my post, there was no diagnosis of anything, the pilot had declared his condition to CASA, CASA wanted an assessment of the pilot's performance whilst in flight. The assessment was like any of the hundreds I'd done every day. No more, no less. When he presented to me he showed me the form, I looked at it and thought, yes, I can assess that as it's written. To not assess him would have left him grounded.

If in my assessment I thought he had problems I would have assessed it that way.

If as an instructor you assessed behaviours that were not consistent with pilot licence privileges you'd shut up and say nothing? Like, not my problem, I'm not a doctor?
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Old 27th Nov 2022, 01:05
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I recall an aero club contacting CASA about increasingly erratic behaviours from a flight instructor. CASA made investigations and cancelled the instructors medical.

The cancellation caused the instructor to get treatment for his 'problem.' The pathway back for him was lengthy. He eventually secured employment in a regional.

So what does CASA do? Nothing? Or something?
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Old 27th Nov 2022, 01:46
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I still don't like the idea that an Instructor be involved in deciding medical outcomes without trained knowledge of how these conditions manifest. Assessment forms are a very clumsy way of determining anything. Sounds more like AvMed passing the decision buck to somebody who does not understand the consequences if things get ugly. Two majors ways it can haunt you, one, they dont get a medical and blame you, two, they get a medical and down the track injure somebody or damage property as a direct result of their condition. Then the witch hunts begin.

The decision of medical fitness should be up to the specialists involved in the treatment. If CASA does not like that specialists report, they can ask for a second opinion from another specialist.

As far as dangerous behavior that's a completely different thing. If somebody displays deteriorating mental fitness to the point its an obvious hazard to their workplace they need to be removed from the workplace and treated accordingly until fit to return.
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Old 27th Nov 2022, 01:50
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Originally Posted by tossbag View Post
If that is aimed at my post, there was no diagnosis of anything, the pilot had declared his condition to CASA, CASA wanted an assessment of the pilot's performance whilst in flight. The assessment was like any of the hundreds I'd done every day. No more, no less. When he presented to me he showed me the form, I looked at it and thought, yes, I can assess that as it's written. To not assess him would have left him grounded.

If in my assessment I thought he had problems I would have assessed it that way.

If as an instructor you assessed behaviours that were not consistent with pilot licence privileges you'd shut up and say nothing? Like, not my problem, I'm not a doctor?
You’re missing the point, tossbag.

Your expertise is in assessing whether a person meets the competence standards or not. You can and should be doing that, whether or not the person presents with CASA’s thought bubble form. As you say, if you “thought he had problems” you “would have assessed it that way”. As soon as you are part of a process through which a medical issue is identified as being the cause of the ”problems”, you are at risk of finding yourself in the middle of a time consuming and stressful controversy. But it is your choice.
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Old 27th Nov 2022, 01:57
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Originally Posted by 43Inches View Post
Problem that AvMed has now is the more they ask questions of the mental state of the general pilot body the more they will find the truth that over half pilots flying will be diagnosed with what in todays terms would require them specialist attention. How many pilots post Covid can say that they havn't had anxieties or possible depression during the lockdowns. That then requires AvMed to request specialist assurances from all affected pilots as well as vetting those responses for further issues. At what point do they just adjust the regulations and allow a GP or DAME to just assess your fitness on presentation.

As opposed to what was suggested to tell AvMed nothing, the opposite would be the end of AvMed, if every pilot flying told the complete truth about their thoughts and mental state. Throw in every chest pain and head ache you've had in the last 20 years, lost moments during a few drinks in 1982, grandfather was a serial killer with severe cardiovascular disease and suicidal tendencies.. etc. They would have to ground about 2/3rd of all flying pilots. Instead of playing the question game and answering what you think is right.

Assuming ADHD and its like has been around for a while now, there has to be many pilots flying with the condition, possibly undiagnosed and untreated. I mean I've seen Chief pilots asking where they left an Aircraft, is that like losing ones toys?

I think the truth of the matter is that the current delays in processing may just be that pilots are being more honest than ever about health issues and AvMed is having a minor cardiac event trying to deal with it.
My observation is that an ever-increasing number of people legitimately fear an overreaction by Avmed to the ever-increasing number of conditions that Avmed considers to be aero-medically relevant, and are telling DAMEs as little as possible, if anything, about something that could be seized upon by Avmed.

The most recent demonstration of the CASA executive’s disconnection from or denial of reality on matters Avmed occurred just last Friday. During a Senate Estimates hearing, this exchange occurred:
Senator: Do you believe that there may be a perverse incentive for a pilot not to report that they have suffered an adverse event if they report an event they are putting their financial livelihood at risk?

Ms Spence: No Senator.

Senator: You don’t?

Ms Spence: No Senator.
Let’s pause there, and think about that answer to that question.

I’ve met a few public officials who are lazy. I’ve met a few public officials who lack common sense because they’ve had little experience in the real world. But I’ve never met a public official who is downright stupid, especially at the levels reached by Ms Spence.

Someone who will put their financial livelihood at risk if they report something has no incentive not to report? Pull the other one, it plays Jingle Bells. Let’s not forget that Avmed’s intervention often involves the imposition of expensive (and dangerous) tests which qualified professionals consider to be unnecessary or unjustified.

The Alice In Wonderland journey continued:
Senator: How does CASA detect pilots who may have a medical problem if they have not self reported to CASA?

Ms Spence: Can you repeat the question, sorry Senator?

[Senator repeats the question. Ms Spence appeared to me to be nonplussed.]

Mr Marcello[sp?] intervenes: So as I said before, Senator, medical certificate holders are required to see an examiner on a regular basis….
Oh dear.

I don’t know which would worry me more: That they actually believe that seeing a DAME on a regular basis results in the detection of all “medical problems” that a pilot has not self reported; or that they know it doesn’t but would prefer not to be honest about it.

It’s lucky that many pilots are able to, and do, maintain their fitness while evading Avmed’s damaging overreactions to the objective risks of “medical problems” that are not reported to DAMEs or CASA. The real safety problem arises when a person does not seek expert advice ‘when in doubt’ about something, for fear that it will get back to Avmed somehow. I have had numerous conversations with individuals in those circumstances, all of whom hold medical certificates. But CASA evidently believes or would prefer to pretend they don’t exist.

(The above quotes are my transcript of the video of the 25 Nov 22 RRAT Estimates hearing, from about the 12:14 mark in the video. The video is here: https://www.aph.gov.au/Watch_Read_Listen The Hansard has yet to be published. I will correct the above if there are errors in my transcript.)
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Old 27th Nov 2022, 02:09
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Having ADHD didn't stop Scott Kelly becoming an astronaut and making four flights, prior to that he was a US Navy pilot flying F-14's and a test pilot, he says he got into the system before ADHD was "invented".


Why is Avmed even needed to give you a tick, they have laid down the requirements and surely your DAME can see if you pass or not. CASA delegates the responsibility for your checkrides, why not medicals?

Last edited by megan; 27th Nov 2022 at 02:39. Reason: Avmed bit
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