ayavner Posted January 14, 2014 Posted January 14, 2014 Went and did my class 2 medical today, as I am considering transferring to PPL so that i can have the option of aircraft/airfield as appropriate. Also - my school in Bankstown finally got a waiver from CASA so RAA pilots can fly out of Bankstown (solo only) for the purpose of "continued training" - but it also requires a class 2. It went well for the most part however I did have to tick the box about sleep apnea, which i have and use a CPAP machine for. Doctor did alot of writing on that one! Does anyone know if that is going to cause any problems for the class 2? After spending $320 for the medical and CASA fee, I certainly hope not!
facthunter Posted January 14, 2014 Posted January 14, 2014 Good luck. My sources say there is a hardening of attitude in AVMED at the moment. Nev 1
Chocolate Posted January 14, 2014 Posted January 14, 2014 ring three weeks after DAME submission if you havent heard anything. your case will possibly go to the friday doctors committee review thingie whose name i cant remember. if it goes there ring each week to enquire politiely about what hoops they are intending for your to jump through. follow up with an email..best to keep a record of proceedings. friday conflab committee decisions to letter to you can take some time if you dont keep checking progress and getting your file taken from the bottom of the pile to the top of the pile. if all this fails and you havent made progress in eight weeks... think about contacting your local mp to help you out. be prepared to be polite and persistent and KEEP RECORDS of all of your interactions with Avmed. 1
rgmwa Posted January 14, 2014 Posted January 14, 2014 Sleep apnea is medical problem of the month with the FAA in the US at the moment, despite a lot of protests from AOPA, EAA and other bodies. No doubt CASA is watching with interest. rgmwa 2 1
ayavner Posted January 14, 2014 Author Posted January 14, 2014 Thanks guys. Hopefully given all my other numbers were excellent, and its only a class 2, they'll let me off lightly. I can understand it being a concern esp for a class 1, however I'm not flying 30 hours a week nor have any reason to fly at all unless I am feeling tip-top. Will see, fingers crossed...
facthunter Posted January 14, 2014 Posted January 14, 2014 IF you harassed or disagreed with a person who ran it some time ago you would be listed as psychologically unsuitable. NOT sure Chocolate that I would involve a local MP. They might make a point of resisting that approach. IF an MP could pressure the AVMED section it would be corruptible, wouldn't it? The best way is to question the basis (factually) of their concern, and provide firm evidence from medical experts that is provable. You may get it with conditions which if appropriate may be OK for you depending on what they are.Nev. 1
ayavner Posted January 14, 2014 Author Posted January 14, 2014 Well... early days yet... hopefully they will just have me sign something saying I'll continue to use my CPAP machine or similar, perhaps get a sleep study every x years. If its not meant to be, well I have RAAus :) Just would like the choice, is all. Plus a transferrable licence if i should find myself back in the US.
ruffasguts Posted January 14, 2014 Posted January 14, 2014 Went and did my class 2 medical today, as I am considering transferring to PPL so that i can have the option of aircraft/airfield as appropriate. Also - my school in Bankstown finally got a waiver from CASA so RAA pilots can fly out of Bankstown (solo only) for the purpose of "continued training" - but it also requires a class 2. Well... early days yet... hopefully they will just have me sign something saying I'll continue to use my CPAP machine or similar, perhaps get a sleep study every x years. If its not meant to be, well I have RAAus :) Just would like the choice, is all. Plus a transferrable licence if i should find myself back in the US. u need a sleep report mine is every twelve months Mick w
Bandit12 Posted January 14, 2014 Posted January 14, 2014 If in doubt, get their reasons in writing, approach your GP to explain the situation and ask to be referred to an appropriate specialist for another expert opinion. I believe that AVMED are very risk aversive, so need to be overwhelmed with your evidence if anything is out of the "normal" box.
djpacro Posted January 14, 2014 Posted January 14, 2014 CASA's website has a whole page on this subject.
DrZoos Posted January 14, 2014 Posted January 14, 2014 Wont the rpl make getting a ppl a waste of time... In regards to being allowed in cta. I thought the rpl has a cta endorsement in the legislation.
ayavner Posted January 14, 2014 Author Posted January 14, 2014 Thanks found it djp http://www.casa.gov.au/scripts/nc.dll?WCMS:STANDARD::pc=PC_101529
ayavner Posted February 22, 2014 Author Posted February 22, 2014 so just as a followup... yes, they did indeed write back and say they needed a formal sleep study report so I've been in the throes of trying to get that done... a very expensive and time consuming process. Part of the problem is no one really seem to know exactly what needs to be done, so out of caution they seem to want you to do all of it.. which is getting very expensive indeed. CASA said I could do one of the at-home sleep studies, so I went in, paid the $395 for the gear and another $200 for a consultation. Then get a call the next day saying the doctor doesn't think this will suffice for CASA (despite them having said so) and now wants me to go in for the in-hospital one. I'm doing it, because it is just my luck that if I don't, then CASA will in fact come back in a month's time and say oh sorry we need you to go back and do this blah blah. No telling how much that is going to cost... and i don't seem to ever be able to tick the right box or utter the magical phrase that will have either medicare or BUPA pay for anything.. i am told I have their best coverage through my employer, yet on the rare times I do try to claim anything there is always some esoteric exception despite whatever Dr. office telling me that oh yeah, routine stuff, should be covered, yadda yadda. Anyway... will update when I finish with that, for the benefit of anyone else who may have similar experiences... hopefully it will all go well, SOMEONE will cover some or all of the expense, and I can get going on my PPL before i completely lose momentum. I only need 2 hours of instrument time, 2 more solo XC hours, and whatever time it takes me to get familiar with the new aircraft and competent to pass the test. That and the exams of course... I really am a sucker for a Quest....
pmccarthy Posted February 23, 2014 Posted February 23, 2014 A bad consequence of the CASA inflexibility is that people with serious sleep apnea allow it to go undiagnosed and untreated because of the hassle diagnosis would cause with a Class 2. Apnea leads to cardiac problems. I reckon more people are dying unnecessarily from this than would die from falling asleep at the stick if CASA allowed treated sufferers a Class 2. 1 1
ben87r Posted February 23, 2014 Posted February 23, 2014 Well good luck from me!! I had a hell of a time getting mine (C1) and a HUGE expense (read thousands and thousands) but, after 6 months they finally got their act together and issued it and I've not had a problem since, wasn't for sleep apnea mind you, was for a heart related issue. I've just renewed mine for the 3rd time and they have just used the previously submitted documents. As for the cost! NOTHING is covered if related to an aviation medical. I even had to pay for the blood test 1
facthunter Posted February 23, 2014 Posted February 23, 2014 Don't believe the RPL is available to you. Your only chance is the class 2. Unless you tick all the boxes straight off the RPL doesn't work for you. I believe a lot are getting through on a non disclosure basis, so what sort of BS outcome is this? IF you get every possibility checked by the medical system, forget it, even though that is the correct thing to do as a responsible person. Your medical history will rule you out, even though some tests favour you being clear.. I hope AOPA will do something about this sometime in the future. I have been following the progress of this for years and I know what went on at the last finalisation of the rules. Am I pissed off?. You betcha. Nev 1
ayavner Posted February 23, 2014 Author Posted February 23, 2014 Yeah, the temptation is just to tick the boxes since you know the "correct" answers... which I think is a bad road to send people down. It should really be a non-issue, I was diagnosed in 2009, and so far have managed not to fall asleep at the wheel or stick or at work, thanks to my CPAP machine (which I hate). I'm happy wtih a class 2 for now, just want to get my PPL so I can have more options and experience more of aviation.
facthunter Posted February 23, 2014 Posted February 23, 2014 I think you have landed on their latest fad, unfortunately. Nev
motzartmerv Posted February 24, 2014 Posted February 24, 2014 Good luck mate. i picked this thread up late, but i would have been able to tell you they would rake you through the coals for this. The first one will be the difficult one, then (if they issue) it will be a report at every renewal etc. I have a calaceal divasticulem (wrong spelling) which is basically a kidney stone. I have a class 1 medical, and every year, without fail, i have to under go a CT scan of the entire area.. Several doctors have commented that this is incredibly un healthy for someone my age, to be 'radiated' at such high doses every year. But CASA keep replying, well if you want te medical, you have to have the scans. Even though, and this is my favourite part, the urologist I use is one of the best in the country and he is adamant that it poses no problem. HE recommended that I only need an ultrasound..But the CASA doctors (a GP) over rides the specialist decision. Recently a firnd of mine (22 years old) had a heart anomaly found. A leading (st vnicent hospital) heart specialist reported zero significant factors for a pilot. CASA over rode him and forced her through a battery of tests. She lost her medical for 6 months,. EVEN THO the specialist said there was NO issue.. Why do these CASA doctors think they know better then a leading professor in the field?
frank marriott Posted February 24, 2014 Posted February 24, 2014 It is a wonder that the AMA doesn't do something. Over ruling DAMEs and Specialists must be an insult to the professionals in their trade.
Jaba-who Posted February 24, 2014 Posted February 24, 2014 Sadly there have been a litany of cases over the past few years where specialists have been over- ridden by the CASA "not-even" GP. Some of the decisions make no clinical sense at all. Ayavner, I'm curious. Have CASA stipulated you must do the sleep study with your CPAP machine on? Make sure you do it with the CPAP . Cos essentially once you have the machine on (and if its working properly) then you won't have sleep apnoea - that's why you use it). Take it off and your OSA will return and your tests will show you have OSA and then you'll have to do a second one with the CPAP. Chances are if you go to your friendly sleep study centre they will want to do it first with the CPAP off because they are in the business of diagnosing OSA (obstructive sleep apnoea). Only once they prove its there do they do them with CPAP on. Double the cost to you.
ayavner Posted February 24, 2014 Author Posted February 24, 2014 Thanks guys... yeah unfortunately I think i am stuck in this. CASA haven't stipulated anything, they just asked for a "formal sleep study" and both times I called, they said that the at-home one is fine for what they want. However, the sleep doctor I've ended up with has decided he is more comfortable having me do the in-hospital one instead - probably for the reasons you mentioned jaba-who... really sh*ts me off, i already KNOW i have it, and I'm already under treatment! i don't see the benefit here, as the best they are going to do is agree with me that I have it, and perhaps line me up with a newer/better machine. But I didn't need that expense right now, and will probably use up the money I had earmarked for my PPL (how's that for irony?). So J-W in your opinion, when i go to do the sleep test should I make sure and tell the Dr that i want them to put the mask on in the middle of it once they see that I have OSA? That way they could demonstrate the condition AND show that the treatment is effective all in one go. That's how they did it when i was first diagnosed, but that was in the US. Grateful for everyone's thoughts here! Andy, that blows me away... for a kidney stone??? Lucky me, to end up in the cross hairs of their cause du jour....
Jaba-who Posted February 24, 2014 Posted February 24, 2014 Ok - just to fill you in - I'm a specialist doctor and although its not completely in my field ( I'm a specialist anaesthetist) it is tangentially and more importantly i know how practices work and how often people get bumped around for great expense and poor results when what they need does not fit the "usual" pattern ( and these sorts of scenarios where we are paying for everything and CASA wants specific things, not sensible diagnostic management, are just those unusual pathways I am talking about) Something you must remember is that very little of the requirements of CASA health stuff are based on sound realistic medical principles. They are based on very conservative arse-covering principles. It's something of a game. They make rules to protect themselves and we as pilots are the ones who suffer. so the first rule is NEVER EVER give them more than they ask for. You must by law give them what you are required to give but you have no requirement to give them any more than that. So if they ask for, or say, a home test is enough then that's all you should give them. Giving them anything more is just giving them ammunition to take something away from you. Firstly before you go for the sleep study I'd touch base with CASA if you havent already and double check what they mean by a formal sleep study, reminding them you have had one, that you already have the diagnosis and you are already on a CPAP machine (and do they want the study repeated with the CPAP on?) and confirm that the home test you mentioned is in fact enough. Sounds pedantic but this could save you 1000s of dollars for the cost of a phone call. If you can - Get it in writing, an email is fine, so you can show your sleep specialist. ( I'm curious to know what the home test consists of. I assume just a pulse oximeter with some sort of recording of your oxygen saturations but I remain curious) also curious as to how much the sleep guy has to be involved if you do a home study? If CASA says they are happy with a home one then don't let your sleep guy jump to the next level without a good reason. "Preferring" to do sleep centre based on is not a good reason. Tell him that CASA have said they want a home one. Be pleasant and friendly but point out to that you are doing this for a "CASA follow up for an additional level of medical not for initial diagnosis nor management and they have stipulated you can do a home test." Further, mention that medicare or your fund will not be covering any of this cost so you need to be sure that they are doing the tests CASA wants, ( and remind him they want a home sleep study). Get a full quote for the cost of each and tell them you have to look at whether you can afford the cost of a formal study. I have patients give me sob stories all the time and I fall for them pretty much all the time ;-) Ensure if you speak to the sleep practice that any decisions are made by the doctor - you'd be surprised how often the nurse, receptionist or practice manager makes decisions that affect people clinically without the doctor even being aware. When they hear the words sleep apnoea they may automatically follow a predetermined pathway and assume you will have certain things done when in fact CASA may want/be happy with something different. As for whether to do a mask-less first half then a mask on second half - that's dependant on what CASA want. Since some people only desaturate at certain times of night and since waking in the middle may mask some events, some centres prefer to do a full nights readings without mask and then a full night with. But honestly we know you have OSA without a mask - there is no reason why you should be subjected to another mask-less test for any time. The information required is what happens while you are wearing a mask. Hope that helps. 1 3 4
ayavner Posted February 24, 2014 Author Posted February 24, 2014 Mate thank you very much for the extra insight... that definitely helps.. i might just need to go with a different outfit. I'll call CASA in the morning and triple-check (again) whta their requirements are, then may just need to find a different place so I can start over on the front foot...
ruffasguts Posted February 24, 2014 Posted February 24, 2014 Mate thank you very much for the extra insight... that definitely helps.. i might just need to go with a different outfit. I'll call CASA in the morning and triple-check (again) whta their requirements are, then may just need to find a different place so I can start over on the front foot... \casa did not require me to have any special tests only a report from my specalists who reads a 6 month period of downloads from my machine checkwith casa this download may be what casa call a home test Mick W
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