PILOT PROTECTION SERVICES JULY MEDICAL MAILBAG

QUESTION: I have been under a special issuance for several years now because I had a heart valve repair.  I want to go to BasicMed, and have reviewed the medical conditions that require a special issuance. Heart valve replacement is one of the cardiac conditions that must be special issued, but valve repair isn’t mentioned.  Does that mean I can let my special issuance expire and go to BasicMed now?

ANSWER: The short answer is yes, you can, but you raise a point that needs further explanation. You are under a special issuance now for the valve repair. You may also have other conditions that you didn’t mention that could be included under the Authorization for Special Issuance, but you are already eligible for BasicMed because the FAA has granted you the special issuance for the valve repair. This would also be the case if you had had a valve replacement, one of the conditions that does require a one-time special issuance before applying for BasicMed. If the FAA was aware of and had previously granted the SI for the valve replacement, you would be eligible for BasicMed.
However, as you observed, valve repair is not one of the cardiac conditions that requires a one-time special issuance before qualifying for BasicMed. In the case of a mitral valve repair, for operations that require a medical certificate, the FAA now allows for office issuance by the AME under the CACI (Conditions AMEs Can Issue) policy. So for Basic Med, the examining physician can sign your Medical Examination Checklist form if you are stable and doing well. It’s a good idea, too, to have a report from your treating cardiologist summarizing your history and current status to aid in being signed off as BasicMed qualified.

QUESTION: Can a person who has chronic lymphocytic leukemia (CLL) qualify for a medical certificate?  I’m a rusty pilot and have been out of aviation for years but want to get back in the air.

ANSWER: First of all, welcome back! If you haven’t already, you might consider attending one of our Rusty Pilot seminars held throughout the year. Depending upon how long you’ve been away from aviation, a lot may have changed, and the seminar will get you back up to speed in a fast-paced few hours that you will really enjoy! 
CLL, as the name suggests, is a chronic condition where certain white blood cells, the ones that help protect the body, are dividing and being pushed out into the circulation from the bone marrow where they are made in a disorderly manner. It can often be controlled for many years.
The FAA allows certification for airmen with a history of CLL that has been successfully treated, so if you are undergoing chemo or radiation therapy or any other treatment regimen, complete all treatment first and get at least 30 days of recovery following treatment. You will need a thorough, detailed status letter from your oncologist or treating physician indicating what you were treated for, how you were treated, what your current status is, including ongoing treatment plan, if any, and prognosis. You will also need appropriate lab results including a CBC done within the last 90 days. If the labs and doctor’s report are favorable, you will likely be issued a medical certificate under special issuance, valid for one year at a time, with a request for a follow- up annual status report and lab work. 

QUESTION: I have not flown for several years. My last airman medical was completed in 2009. I was injured while skiing about 5 years ago, fracturing the tibial plateau and required two operations, once shortly after the accident to insert metal to fix everything and then a year later to remove them. I am now completely recovered and wonder about obtaining a Class 3 Medical.
 
ANSWER: Thank you for writing. As we know, many enjoyable pursuits carry risks and we are glad you have made a good recovery. For those not in the know, the tibial plateau is the top of the major bone in one’s lower leg and can be a nasty fracture. Because it constitutes part of the knee joint, it can lead to later problems with arthritis so keep an eye on that and ensure you keep your weight under control and strengthen your leg muscles. 
As for getting back into flying, there are steps as referenced in the letter above concerning the “Rusty Pilots.” If indeed you want a Class 3 rather than go the BasicMed route, all you need to do is answer the questions on  MedXpress (https://medxpress.faa.gov/medxpress/) prior to your AME medical and have a letter from the treating physician discharging you from care. You should also have a copy of both operative and radiology reports and hospital discharge summaries to hand and share these with your AME, ensuring you keep a copy.
Good luck!