RAA Medical - Proposed changes

[eightyknots]

I know of no move to change the RAAus medical standard.Yes, it is the same standard as you need to drive a car in, in our case, NSW.

 

I guess we will have to wait and see what they come up with but like you, I have no knowledge of it being a problem.

 

I could be wrong but I'm thinking that some Pilot Cert holders make the health declaration without even knowing exactly what the standard is and may deliberately not ask their GP for fear of being given the wrong answer. I know of people who make a declaration to the NSW RMS (drivers licensing office) so that they can continue to drive either knowing that they might not meet the standard. If you have a 5 year licence and you have any material change in your health standard during the 5 years you are obliged to "self-report". Plenty of people do not do that.

 

Like you, I agree a guide would help RAAus members be better informed when making the declaration. I could see it coming out as one of the new fangled RAAPs.

The problem is that once a "Guide" is in place, before long it becomes more than just guidelines: it will morph into a strict "Policy".

 

Does anyone on the Forum think that this rumoured (or proposed) increased medical standard for RA-Aus is linked to the increases in Maximum Take Off Weights? We're up to 600 kg. In my opinion, it this becomes heavier, we will get heavier medical requirements.

 

 

[facthunter]

The weight of the plane should have little to do with it. Perhaps the number of passengers might . More lives in your hands etc but the medical goes back to selecting crew in the first world war, at the time of recruitment. rather than preventing loss of control. Nev

 

 

[Frankus1aust]

Don I don't mind the idea of having a "guide" form with info on it BUT if changing our standards to more align with a drivers license standards (isn't that what our declaration already is?) has us ending up with anything similar to the rpl one it will be a disaster.Is there evidence of this being a problem?

Regarding medicals and evidence, in Victoria a holder of a heavy vehicles license with a medical issue is required to have an annual specialists health report to Vic Roads. Such a rule for an RAA license would be a slight imposition for the pilot but it would add an extra layer of insurance and liability risk mitigation. Not to mention confirm health status for the pilot,

 

 

[Vev]

Regarding medicals and evidence, in Victoria a holder of a heavy vehicles license with a medical issue is required to have an annual specialists health report to Vic Roads. Such a rule for an RAA license would be a slight imposition for the pilot but it would add an extra layer of insurance and liability risk mitigation. Not to mention confirm health status for the pilot,

Hi Frankus

 

I must say I disagree with this philosophical approach.

 

I say there are no planes falling out of the sky owing to medical conditions what would have been predicted by imposing another layer of medical review... indeed the number of medical related issue over the past decade is statistically so small it almost doesn't count. I argue there is virtually no risk to mitigate that the current system does already do well, which is evident by the lack of incidents.

 

In my view your suggested approach is more likely to drive real medical conditions underground and not get treatment owing to fear someone will find out ... I think the whole medical review is a nonsense and counter productive. I think this new approach could ground a bunch of people that pose no threat to themselves our their pax.

 

In reality if I wake up tomorrow morning and feel unwell (lets say cold) I simply don't fly ... I do not require a medical examiner to tell me to do this and a medical examination done 12 months ago won't predict a future medical condition...

 

One is much better to have an open a relationship with one family doctor and manage ones own health issues.

 

Cheers

 

Vev

 

 

[SDQDI]

I couldn't agree more Vev.

 

We see in other countries the regulators are slowly winding back the medical requirements for private pilots so why should we increase ours (RAA) when there is not an obvious need for it?

 

 

[docjell]

Short answer is that the intent of RAAus looking at health standards is to assist members to make an informed medical declaration. If you mak a false or careless declaration and are, subsequent to an incident, seen to have had a medical issue that should have been taken into account in making your declaration you risk issues with your insurer and CASA. RAAus will be the very least of your problems. Considering you probably carry liability insurance of $10 million or more, you need to be prepared to cough up a sum as large as that if you make a false or negligent declaration.There is no need nor desire to change the Pilot Cert medical standard.

 

Every year I go to my GP for a thorough examination. Anyone over 55 who does not do that might consider the wisdom of their health care strategy. As one of the by-products of that examination, my GP consults the checklist for the issue of an ordinary drivers licence in NSW. He then provides me with a statement of meeting the standard required for issue of a drivers licence in NSW. I submit a copy to RAAus. Out of respect for the well being of myself and my passengers, I am very happy to go through that process.

Hi Don- interested in your post as an ex-GP, and now a staff specialist anaesthetist and hyperbaric medicine specialist for the past 15 years. You motives are very honourable but unfortunately there is very little to be gained from the "thorough examination" annually that is not picked up by a good history and a few very basic tests- Blood pressure, urine analysis, and perhaps a routine haematology and chemical pathology screen. Excercise tolerance is probably the most sensitive test we have- far more important most screening tests. Having said that - all we are really concerned about as pilots is the chance of sudden incapacitation as P1, and almost nothing we do as doctors can predict this. Epilepsy, unstable ischaemic heart disease, tendency to unheralded black-outs (Stokes Adams attacks) are some of the obvious "no no's and therefore reasonably render then participant unfit to drive, or fly. But as for the rest? My squash playing,cross country running non-smoking 50 year old cousin .dropped dead from a cerebral aneurysm. If I hade examined him the day before he would have passed 100%

I have been practising medicine for 40'years and have never been able to predict a healthy outcome from a 'normal physical ' examination. Physical signs demonstrate ongoing pathology confirm the diagnosis made during the history taking. They are not usually predictive in any way.

 

I agree that "fitness to drive" more than covers the requirements

 

 

[Keith Page]

Thank you Docjell, that was a great post that will leave a few looking for answers.

 

As you said - what is around the corner can not predicted with out history, warning signs, could be the answer.

 

KP

 

 

[old man emu]

Regarding medicals and evidence, in Victoria a holder of a heavy vehicles license with a medical issue is required to have an annual specialists health report to Vic Roads. Such a rule for an RAA license would be a slight imposition for the pilot but it would add an extra layer of insurance and liability risk mitigation. Not to mention confirm health status for the pilot,

That heavy vehicle driver medical requirement applies to all States and Territories. The problem with a broadly defined "medical issue" is that the office workers see a medical issue declared on an application for a licence or authority and from that day forward, the applicant is a marked person.

 

For example, in 2006 I succumbed to stress caused by the actions of my superiors pursuing a policy of ridding the NSW Police of those who would be the beneficiaries of a really good superannuation scheme, which had operated since 1928. Anyway, I became depressed and went off with depression and anxiety.

 

Ten years on, I've got over depression and anxiety and lead a pretty happy life, although the doctor who is supposed to be monitoring me hasn't been available to see me for ages. So I still pop a happy pill each day.

 

The upshot of this is that when I fill out the form for my annual transport medical I put down the medication I'm taking and the reason for it. Now the licensing authority is asking for reports from psychologists so they feel safe to renew my various licences so I can work.

 

No one has asked if I'm still feeling like I did in 2006. My file must have "DEPRESSIVE MENTALITY" in big red letters stamped across it. And I think that ink is indelible.

 

You'll notice a link to a report on the Home page of this site which reports that mental health issues are not being reported. Simply, it's because if you are unwise enough to make an honest declaration, the authorities immediately class you as a psychotic homicidal maniac, likely to use a form of transport to maim and kill innocent members of the public.

 

Old Man Emu

 

 

[eightyknots]

Hi Don- interested in your post as an ex-GP, and now a staff specialist anaesthetist and hyperbaric medicine specialist for the past 15 years. You motives are very honourable but unfortunately there is very little to be gained from the "thorough examination" annually that is not picked up by a good history and a few very basic tests- Blood pressure, urine analysis, and perhaps a routine haematology and chemical pathology screen. Excercise tolerance is probably the most sensitive test we have- far more important most screening tests. Having said that - all we are really concerned about as pilots is the chance of sudden incapacitation as P1, and almost nothing we do as doctors can predict this. Epilepsy, unstable ischaemic heart disease, tendency to unheralded black-outs (Stokes Adams attacks) are some of the obvious "no no's and therefore reasonably render then participant unfit to drive, or fly. But as for the rest? My squash playing,cross country running non-smoking 50 year old cousin .dropped dead from a cerebral aneurysm. If I hade examined him the day before he would have passed 100%I have been practising medicine for 40'years and have never been able to predict a healthy outcome from a 'normal physical ' examination. Physical signs demonstrate ongoing pathology confirm the diagnosis made during the history taking. They are not usually predictive in any way.

I agree that "fitness to drive" more than covers the requirements

My father-in-law went for his annual checkup with his GP mid-morning one day in 2012. Later that morning he decided to do some tidying up in his back yard in readiness for his mowing contractor to do the lawn. The mowing contractor found him dead. He died of a heart attack only a few hours after the GP told him that his health was "great".

 

 

[DonRamsay]

The problem is that once a "Guide" is in place, before long it becomes more than just guidelines: it will morph into a strict "Policy".Does anyone on the Forum think that this rumoured (or proposed) increased medical standard for RA-Aus is linked to the increases in Maximum Take Off Weights? We're up to 600 kg. In my opinion, it this becomes heavier, we will get heavier medical requirements.

Firstly, there is no move to increase health standard requirements for RAAus.

 

Secondly, there is absolutely no suggestion in the papers being put to CASA to get equality with the RPL in MTOW. The RPL minimum health standard is supposed to be a Drivers Licence medical - but It simply isn't. As we all know most RAAus pilots could get a Class 2 easier than an RPL medical (RAMPC).

 

RAAus already has a "strict policy" regarding the RAAus Health Standard and how the declaration can be made and who needs a note from a doctor to say they pass rather than just self declare. There is no proposal to change that legal requirement.

 

I would be prepared to put money on the fact that more than one car driver of a certain age does not report to their car driver licensing authority (RTA/RMS/VicRoads, etc.) that they no longer meet the health standard required. They of course risk severe financial loss if they have an accident and their insurer declines their claim and the other drivers claim. I think it would be as safe a bet that some RAAus pilots either deliberately or inadvertently do the same thing with regard to not reporting a significant change in their health standard to RAAus. We probably all know somebody with a GA licence who has pushed that envelope for as long as they can get away with it.

 

Don

 

 

[DonRamsay]

Regarding medicals and evidence, in Victoria a holder of a heavy vehicles license with a medical issue is required to have an annual specialists health report to Vic Roads. Such a rule for an RAA license would be a slight imposition for the pilot but it would add an extra layer of insurance and liability risk mitigation. Not to mention confirm health status for the pilot,

I held a Heavy Vehicle licence from 1970 until I gave it up last November - essentially I can't see myself ever driving a truck again.

 

There are several conditions like heart disease, diabetes, stroke etc. that can make you unfit to drive or fly. These are listed on the form that calls for your self declaration each time your pilot cert is renewed. This is not new.

 

I get a GP to do the assessment for me each year and he then writes a note for me and I use that as my health declaration statement for RAAus and for the Drivers Licence declaration. Not that difficult nor expensive. If you have to do it for your car licence you have to do it for your pilot cert. Simple as that really.

 

 

[DonRamsay]

Thank you Docjell, that was a great post that will leave a few looking for answers.As you said - what is around the corner can not predicted with out history, warning signs, could be the answer.

KP

Why would it leave anyone "looking for answers"?

Are you seriously proposing that the E&LAAA will have no requirement for a health standard?

 

I agree with every word of docjell's post but neither he nor I write the laws, pass them through the parliament nor give royal assent nor make the Regulations under the Act.

 

The fact is that there is a laid down medical standard that requires RAAus pilots to self-declare their fitness to fly and, if they have certain conditions, have them assessed (and treated) by a medical practitioner.

 

And while Doctors cannot predict certain outcomes, running a few tests each year (especially as we age) are useful in identifying possible issues and for managing existing conditions.

 

One thing for sure is that without any evidence (like blood and urine test results) a doctor would have no basis on which to manage your health or predict anything.

 

 

[SDQDI]

I get a GP to do the assessment for me each year and he then writes a note for me and I use that as my health declaration statement for RAAus and for the Drivers Licence declaration. Not that difficult nor expensive. If you have to do it for your car licence you have to do it for your pilot cert. Simple as that really.

The way you word this confuses me a little Don. I have never had to go to the GP to get assessed for my drivers licence. I think that would be a huge backwards step to introduce something like that as mandatory in RAA.

 

I don't mind if people do it voluntarily but certainly would strongly oppose it otherwise.

 

Having said that you finish with "If you have to do it for your car licence you have to do it for your pilot cert. Simple as that really." Which I assume means that you are Not suggesting mandatory GP visits?

 

 

[FlyingVizsla]

Driver's licences are a State issue, each State has their own regulations. In Qld drivers over a certain age must be medically assessed each year, and this is the certificate we supply to RAA. Other States are different. That's part of the problem - what is OK in WA may not be in Qld. CASA went to the National Heavy Vehicle medical standard for RPL because that was the only National health standard for operating a vehicle - a bit of overkill plus their 'extras' for flying.

 

 

[frank marriott]

Driver's licences are a State issue, each State has their own regulations

When the States(well 5 of them anyway) signed an agreement for national road rules and replaced the Traffic Act with the TORUMS Act & Regulations in about 1999 they should be the same even though a State Act.

 

W.A. & N.T. didn't sign and A.C.T. I don't know but they are 'different' in a lot of ways not just traffic regs.

 

 

[FlyingVizsla]

When the States(well 5 of them anyway) signed an agreement for national road rules and replaced the Traffic Act with the TORUMS Act & Regulations in about 1999 they should be the same even though a State Act.W.A. & N.T. didn't sign and A.C.T. I don't know but they are 'different' in a lot of ways not just traffic regs.

That's mainly road rules (giving way to Left/Right). Each State has its own legislation around ancillary issues such as vehicle inspections (annual in NSW not required in Qld), medicals (every year for 75yrs+ in Qld, not in others), medical standard - each State makes its own determination on health standards for car drivers. Where there is "proof" RAA prudently request a copy - we send the medical certificate (not the full medical) to them at their request. The Qld licence which you can renew for up to 5 years, is dependant on holding the annual medical.

 

 

[frank marriott]

Sue

 

Have a read of the TORUMS legislation. Act, road rules regs, drivers lic regs, fatigue management regs and the list goes on.

 

Anyway makes no difference to the output from the current RAA approach, so not worth researching.

 

 

[eightyknots]

I held a Heavy Vehicle licence from 1970 until I gave it up last November - essentially I can't see myself ever driving a truck again.....

Hopefully you will be fit to fly light aircraft for many more years!

 

 

[Keith Page]

Why would it leave anyone "looking for answers"?Are you seriously proposing that the E&LAAA will have no requirement for a health standard?

I agree with every word of docjell's post but neither he nor I write the laws, pass them through the parliament nor give royal assent nor make the Regulations under the Act.

 

The fact is that there is a laid down medical standard that requires RAAus pilots to self-declare their fitness to fly and, if they have certain conditions, have them assessed (and treated) by a medical practitioner.

 

And while Doctors cannot predict certain outcomes, running a few tests each year (especially as we age) are useful in identifying possible issues and for managing existing conditions.

 

One thing for sure is that without any evidence (like blood and urine test results) a doctor would have no basis on which to manage your health or predict anything.

No Don........ The answer is answered in docjel's post.... the post needed to be read to be understood. Not read to make comment.

I will write the answer for you.. Just because one goes for a yearly full medical is not a guarantee will they make it through till next year the answer is a big fat "no" as no one can see what is around a corner. All what the post said.

 

KP

 

 

[DonRamsay]

. . . I have never had to go to the GP to get assessed for my drivers licence.

That's because you have never been diagnosed with diabetes, ischemic heart disease, stroke, or other serious conditions that would prevent you from being able to declare to the RMS that you are fit to drive a car in NSW. If you did have one of the qualifying conditions then you would be required to get a medical clearance to drive your car.

 

I think that would be a huge backwards step to introduce something like that as mandatory in RAA.

The RAAus health standard is the same as for holding a car drivers licence in in NSW. No medical required as long as you don't have one of the listed conditions.

 

I don't mind if people do it voluntarily but certainly would strongly oppose it otherwise.

Nobody does it voluntarily. Before I had a condition that was on the list I still got a check-up from my GP every year but didn't get him to write to RAAus or the RMS - no need.

 

Having said that you finish with "If you have to do it for your car licence you have to do it for your pilot cert. Simple as that really." Which I assume means that you are Not suggesting mandatory GP visits?

Absolutely not suggesting perfectly healthy RAAus pilots go to a GP to get cleared to drive a car or fly with RAAus.

There is an age

 

The Ops Manual ver 7.1 (latest release) sets out health standards and certification required at section 2.16:

 

"Applicants for the issue of a Certificate are required to have a health standard equivalent to that required for the issue of a private motor vehicle driver licence in Australia"

 

RAAus asks you to supply:

 

"a signed RAAus medical declaration that they meet the health standard, or an RAAus approved equivalent"

 

It does not ask you to go to a GP or other medical practitioner unless:

 

"if an applicant’s medical status includes one of the following conditions,

 

the person must provide RAAus with a statement from their doctor (GP)

 

of meeting the health standard, or provide a copy of a valid motor vehicle or heavy vehicle General Medical Assessment Report from an Australian road and transport authority, whatever called, or provide a copy of the CASA Recreational Aviation Medical Practitioner’s Certificate (RAMPC) or higher medical certificate; (my emphasis)

 

(i) Epilepsy; or

 

(ii) Diabetes (Type 1 or 2); or

 

(iii) A heart condition / disease or paralysis; or

 

(iv) Mental illness (medicated or otherwise); or

 

(v) Becoming 75 years of age or older; or

 

(vi) Any other medically significant safety related condition."

 

So, there is no move to change what has just been published in Ver 7.1 of the Ops manual. Nothing has changed and nothing is proposed to be changed regarding RAAus health standard.

 

If anything, the GA medicals for pilots who fly not-for-reward are likely to be amended to look more like the RAAus medical standard than the other way around.

 

Don

 

 

[DonRamsay]

No Don........ The answer is answered in docjel's post.... the post needed to be read to be understood. Not read to make comment.I will write the answer for you.. Just because one goes for a yearly full medical is not a guarantee will they make it through till next year the answer is a big fat "no" as no one can see what is around a corner. All what the post said.

KP

No to what?

 

Do you mean "No there will be no medical because no one can see what is around a corner"?

 

As your favourite Queenslander says "Please explain?"

 

Don

 

 

[Bruce Tuncks]

Don, it is hard to disagree with your posts as you are an intelligent person with the best interests of us pilots in mind. And you are probably right given the awful regime we live under.

 

But I have to say that I hate the nanny state idea of telling me that flying might just be a danger to me or to the kindergarten that they say ( without evidence) I will surely crash into.

 

The fact is that it is 4 times as dangerous, on mortality figures, to be inactive as it is to fly.

 

 

[Frankus1aust]

Hi FrankusI must say I disagree with this philosophical approach.

 

I say there are no planes falling out of the sky owing to medical conditions what would have been predicted by imposing another layer of medical review... indeed the number of medical related issue over the past decade is statistically so small it almost doesn't count. I argue there is virtually no risk to mitigate that the current system does already do well, which is evident by the lack of incidents.

 

In my view your suggested approach is more likely to drive real medical conditions underground and not get treatment owing to fear someone will find out ... I think the whole medical review is a nonsense and counter productive. I think this new approach could ground a bunch of people that pose no threat to themselves our their pax.

 

In reality if I wake up tomorrow morning and feel unwell (lets say cold) I simply don't fly ... I do not require a medical examiner to tell me to do this and a medical examination done 12 months ago won't predict a future medical condition...

 

One is much better to have an open a relationship with one family doctor and manage ones own health issues.

 

Cheers

 

Vev

Yes that is true and I am referring to the "refer to refer to CASA Avmed board type issues" like type 1 diabetes and the more potentially problematic conditions. Vic Roads seem to have a way more sensible approach in that if a specialist in the condition says you're ok, then Vic Roads give you the license. No need to convene a Spanish Inquisition.