Medical Cert Issues
 

Hi all
Just after a bit of advice. I recently sat my medical exam and the DAME was happy with everything and re-validated my medical cert for 2 months stating there were no issues to be concerned about.

However I received a letter from casa stating they want Alcohol bloods, I inquired with them as to why and they told me that during the questionnaire regarding alcohol use they use a scoring system, and anyone who scores above 3 automatically gets sent for alcohol bloods. I have scored a 4. I don't really know why this is. I answered all the questions honestly and didn't think I was one to be classed as having a drinking problem. I answered no to all "the ever had a DUI, ever had a drink at work, do I ever consume more than 6 drinks in one sitting, e.t.c". The only thing I did state is that I have 2-3 drinks 2-4 times a week (again just being honest). I don't know if that was enough to score me a 4 or if my DAME ticked the wrong box somewhere.

It is a class 2 for a PPL(A). I received the letter on Monday and had blood taken that evening, however I was at a childs birthday the Sunday before where the alcohol was flowing freely and I had a couple (3 beers so around 4 std drinks over 4 hrs). I haven't had a drink since receiving the letter. 2 of the 3 blood test have come back, the full bloods came back normal, the liver function tests came back with some slightly elevated numbers (I can provide details if anyone knows what they mean) which from what I have read are very sensitive and can be not only be from recent alcohol consumption (not alcohol abuse) but can also be from some meds and even smoking, as well as early signs of liver problems. I'm still waiting on my carbohydrate-deficient transferrin test results, and from what I understand that is the real alcohol abuse test but again can be elevated from recent consumption (again, not abuse). Now when I went for my medical I had a talk to the DAME about my smoking and she prescribed Zyban which is a stop smoking drug which I was on and had not smoked for around 2 weeks when I did my blood tests, however I was using nicotine patches on the DAMES advice to increase my chance of success.

The other problem I have is it takes about 2 weeks to get into see my DAME, and my medical runs out on 22/9. Anyone ever had any experience with a similar situation? I'm just trying to figure out weather to give them my current blood test results with them being slightly elevated and get back inthe air ASAP or wait a week or 2 without drinking and have more blood taken and give them clean test results. And do you think this is the sort of thing that CASA are going to give me a hard time about for months/years to come (i.e am I stuffed?).

Any help/advice appreciated.

The message here is to be very careful with the responses on these medical forms.


An innocent response can trigger the sort of over reaction that the CASA medical branch is increasingly becoming well known for.


Practical interpretations are a thing of the past for as long as the existing (and out of touch) Head of Aviation Medicine remains employed.

I had a chat to an old instructor about this, when I told him my situation his first words were "oh no", then he suggested in future to re-evaluate my definition of honest.

You now know for next time ...

Yes I do!...

I really feel for you and the predicament you are now in. Avmed are a law unto themselves and have been known to disregard leading SPECIALIST advice regarding pilot health risks. This may take a long time to resolve, and follow you around as you predicted. It may have a detrimental effect on your career for a long time to come.

Here's some advice I gave last time this subject came up ...

I have two doctors, a DAME for aviation medicals and a GP for other stuff. :ok: A sad indictment on the Avmed section of CAsA.

Have you got a link for the last time this came up, nothing turned up in my search.

Oh I already have a non aviation career, flying is (was?) for pleasure, think I might buy a boat.

I have PM'ed him but he hasn't been online for a few weeks, anyone know what the outcome for Dogman (The OP in that thread) was? His profile still lists him as a pilot so hopefully all went well.

Renewal of Medical Certificate
 

It would seem that CASA do not trust the DAME's to conduct aviation medicals. In my case I was honest, some may say silly, enough to be honest when questioned about visits to hospital. I had the treatment recommended by the Urologist in whose care I have been for years. All subsequent tests have shown I no longer have any issue. The DAME, my regular GP, the Urologist and the treating Specialist all advise me they can see no reason my Medical Certificate (Class 2) should not be renewed.

CASA insist on having reports from an Oncologist before reviewing their decision. For me it is not worth the cost involved to take the chance that CASA may relent. It is a case of CASA owns the ball.....!

My DAME doesn't even ask the questions!
He just looks at me and goes...NO,NO,NO,NO,YES,NO,NO,NO,NO
:uhoh:

I just paid $50 and emailed a request to have my medical cert extended. I feel so dirty.

This happened to a bloke at work after he was 'too honest' on the medical questionnaire. He had the blood test and assumed that would be the end of it, turned out his liver tests showed areas of concern and CASA decided he was a full blown alcoholic despite several specialists giving him letters to say he had a genetic liver issue which results in elevated liver results. Basically he was off work for 9 months as despite the specialist evidence CASA were not happy bunnies and stated it was up to him to 'prove he wasn't an alcoholic'.

End of the day the lesson is, be very very very careful how you answer those questions.

The only thing between innocent punters and the 30,000 death plunge is Our Saviour: The PMO. (Blessed be the PMO!)

There is 'recent medical research' to show that most aviation accidents and incidents are caused by undiagnosed medical problems. These problems are obvious to Our Saviour (Blessed be the PMO!) but hidden to mere specialists and other medical practitioners with combined experience of centuries.

In order to be saved thou must disclose every aspect of your personal life and undergo intrusive tests, so that Our Saviour (Blessed be the PMO!) can reach the divine satisfaction and mercifully certify mere mortal aviators. The weak and lame are miraculously saved, by the laying on of conditions.

Sinners who doubt Our Saviour (Blessed be the PMO!) beware! Thy lack of faith shall be construed as a failure to meet the medical standard, and thee shall be doomed to expensive tests, long delays and, ultimately, litigation.

There endeth the lesson.

Haha priceless!

The latest review of CASA has found that the industry is "actively disengaging with the regulator", gee, I wonder why?

I think there is a change coming up whereas you will fill out the questionnaire on line and then present to the Dame and he/ she just does the medical renewal, logs on and ads to your file which is then processed by Avmed

Creampuff,


"Not the Messiah: He's a Very Naughty Boy." :ok:

Sorry I_Con, should have read you post properly. First para ... Class 2 medical. Your chosen (non-aviation) career may yet be safe, if CAsA do not ring or write your employer in the meantime. After all, they did send that CVD letter to employers recently!

Due the plethora of recent anecdotal evidence, I have decided at my next medical, I shall declare myself a young, non-smoking, fitness fanatical teetotaler. The only thing I may not get away with is my age; my DAME has known me a looong time. :{

It's ok I'm self employed, they can send me all the letters they want, I'm usually too drunk at work to read em anyway:ok:

So doing some research into this (and not coming up with much) I have stumbled upon this. apparently a DAME can issue a class 2 medical on the spot. Anyone ever heard of this? It's news to me.

My advice, once you hit the geriatric age, CAsA considers that is around 55,
go do a premedical medical. Your DAME should be able to give the result figures that get you screwed under the CAsA point system.
You doctor as apposed to DAME can then proscribe the right chemicals to ensure your blood results are those of a sixteen year old athlete and bob's your uncle.
The questionnaire ??? "Lie through your teeth" but it wasn't me said that!!

Some advice with hindsight
 

Hi guys.....you may remember me from such posts as http://www.pprune.org/pacific-genera...e-problem.html

To answer and help I Con out, here are the results of what happened to me.

I wont go over the whole lot (see above link), but basically I answered the FAST test too honestly and scored a 3........letter from CASA requesting bloods and liver function etc in order to process my Class 1.

Blood tests were completed stat, and forwarded to the GP who did my medical. Unbeknowst to me the GP's office did not forward the results to CASA........so 4 weeks later and getting very close to the 2 month medical stamp extension cut off I phone the av med section only to learn that they never received the results. If I remember correctly that was a Friday, so I quickly scanned and emailed the results to Canberra. Phoned back Monday only to learn that the DAME in charge of checking these things only works for CASA on Tues and Thurs as he has a private practise on the other days - I couldn't believe it?? Here we are paying as a collective $$$$ for our medicals to be assessed and processed and yet they don't employ a fulltime DAME.

Anyway long story short, my test results were fine and full Class 1 issued.

The whole experience left a bad taste in my mouth, and made me realize that many (most) pilots aren't telling the DAME's the truth out of fear of losing their medicals (livelihood) for an extended period, or perhaps straight away. Its certainly not ideal but we (Pilots) are again having to modify our behavior to cater for an imperfect system.

Good luck I Con.......all I can say is that it has not come up again on my further 2 medicals.

Cheers

DM

Another big issue with medicals is the use of medications such as antidepressants. I know for a fact that there are many pilots taking antidepressant medications but not declaring this on their medical form in fear of having a permanent mark against their name which could haunt them in many years to come.

CASA would clearly prefer to have pilots with mental health issues like depression go undiagnosed and untreated rather than have pilots who are seeking the appropriate treatment for their illness.

Lets just hope that the day that CASA automatically gets access to your medical records never comes...

Dogman, do you mind if ask what your blood test results were? You can pm if you like.

My GGT is at 56 with slight elevations in some other areas of the liver function test.

Hey Con, that link above doesn't seem to work. I'm just curious to read it.

I'm on my iPad at the moment but see if this works

http://www.casa.gov.au/scripts/nc.dll?WCMS:STANDARD::pc=PC_101960
and
http://www.casa.gov.au/scripts/nc.dll?WCMS:STANDARD::pc=PC_101965

Or go to casa.gov.au and enter "dame handbook" into the search there. When you find the dame handbook it's all in chapter 12.

From the above link:

Cheers mate. Looks like the links are being corrupted by smilies. :p

Medical Certificates
 

Despite my age I was very disappointed that CASA did not accept the result of my Class 2 Medical examination by the DAME. I have to accept that CASA is the final arbiter. Reading some of the posts on this thread makes me wonder "How would those who advocate lying about a condition they believe could lead to losing their medical feel if one of their peers was responsible for the death of one of their family members, as a result of not being truthful"?

It is easy to be a "rebel" on an anonymous forum. I would hope that the situation might be different in real life.

Well seeing as this is apparently about alcohol and we're all confessing......my name's Stkybeke and I'm an alcoholic however I'm now clean. It's been 18 minutes since my last drink !!!:E

Interesting discussion.


I am 73, have one or two drinks at the end of every day and declared this to my DAME. I have had no issues with my Class 2 medical. There must be a difference somewhere. Maybe it s not the drinking?.

In the case of mental disorders such as depression & anxiety, would you prefer that someone gets medical treatment for the illness and doesn't declare it to CASA, or suffer in silence and let it go undiagnosed whilst still continuing to fly?

I know which I think is the more sensible (and safer) option.

Old Fella: In fact, you don't have to "accept" CASA is the "final arbiter". The current system is the result of a choice. A different choice could be made.

The rules could just set the objective standards and expert medical practitioners and specialists could be left to make the decision on whether the candidate meets the standard.

Even under the current system, the AAT can change CASA's decision and, in the case of medical certification in particular, a far greater proportion of CASA's decisions are being changed by the AAT than was the case e.g. a decade ago.

The recent change in approach to colour vision deficiencies demonstrates to me that the increasingly intrusive and disruptive activities of CASA Avmed are not based on any credible data. All I see is some relevance-deprived zealots on a medical crusade, wrapped in the flag of 'aviation safety', doing more damage than good.

Old fella, were you an insurance salesman once? Why pick the absolute worst case scenario for something eh?

I have seen time and time again medicals knocked back for minor reasons despite the DAME saying no problems. AVMED, refusing to believe the doctor then say it is a problem and send the applicant on a specialist runaround. The specialist then concurs with the doctors opinion and the medical is granted.

I have recently watched a class 2 applicant spend, literally thousands of dollars on specialists to prove what his doctor clearly stated was OK in the first place. Some private pilots don't have these funds. There is no guarantee it won't all happen again when this applicant needs a renewal.

Get off your high horse and realise the system is faulty. AVMED are doctors who don't see patients and don't trust other doctors.

I don't advocate lying for anything and I am fortunate enough to pass all my medicals easily. Some folk are worse off than me but they aren't going to drop dead in the next few years either.

Drink more than a few drinks = liver function test
Smoke one ciggy in the last year = lung function test
Admit ever trying cannabis even 20 + years ago = ongoing drug testing
Take any med for any long term condition = visiting a specialist
Admit a single driving breath test fail = liver function test

All this when the DAME can identify 99% of the time whether there is a problem or not.

Not that I want to get into an argument with this, but I think the situation of people lying to their DAME is CASA's own doing. I have been lurking here for quite some time (look at my join date) and have seen all the CASA bashing statements coming from everyone. Up until 2 weeks ago I though they were all a bunch whiners with nothing better to do, hey I was just a PPL who never had any issues with CASA so what was everyone's problem. Then I got my letter, then I did some research, now I am scared! Scared that they are going to take away the thing I love doing the most (with my clothes on atleast) all because I was too honest (and judging by the comments here, an obvious stand out as I'm the only pilot that drinks). Now I can understand CASA's concern, hell I don't want to share the circuit with someone who has that much of a drinking problem they cant abstain for a day to go flying. But the problem is CASA don't approach these cases in a rational manner.
or
These are statements said in this thread.

Now I am in the situation of having to play my cards just right to prove (read, satisfy) to CASA that I do not have an alcohol abuse problem (something any DAME would be able to determine if required, with a couple of visits and urine or blood tests, and without the heart ache). If I stuff this up its going to be months of aggravation dealing with CASA, why would anyone want to do that if it could be avoided by one single word, NO instead of YES, especially those who make a living from flying.

So, as Creampuff said, I beleive CASA are "...doing more damage than good..."

I have admitted to being a smoker at my last two medicals, should I book the test now or wait for the letter once the drunk issues are sorted.

You should have already had it, its the blow into a thingy test ...

You know what, I would love nothing more than if there was a CASA doctor or approved representative that I could sit down with and discuss my test results and get this sorted in a 20 minute appointment, if only they existed right.

Now how do I express sarcasm on an internet forum? Maybe this emoticon will do it :ugh:

Nope never, unless casa are reading this then yes, weekly. I have the lungs of a 16yo :)

once didn't read the form the doctor had given me and gave a weekly total instead of the daily one which it requested.

That lead to a very confused conversation for a few mins. Until my error was discovered.

It was agreed though that a daily number was a bit silly as it really doesn't work if you don't drink when working the next day as a pro pilot.