AircraftOwner Online

 I was diagnosed with rheumatic fever when I was five years old. When I was in medical school studying rheumatic fever, I just did not remember having all the signs and symptoms described in the text books. I searched my hospital records on microfilm and realized I never had rheumatic fever and confirmed that with my pediatrician who was fortunately still in practice. However, it was an incredible chore to get this mis-diagnosis off my medical record but absolutely hell to get off my medical and life insurance records.

    Now think what would have happened with the FAA! I would have probably been required to have a cardiology consultation, an echocardiogram, and other expensive testing to prove a negative. In addition to money, it would take a lot of time and paperwork collection.

    I have pilots come into my office on a regular basis carrying diagnoses on their record for conditions they have never experienced. Seizures are a classic example.

    Many people pass out when they see blood and many times, will jerk their arms and legs for a short period during the brief unconscious period. Non medical observers may report this as a seizure and unfortunately, this may become part of a medical record. However, it is incumbent on any treating physician to ask the appropriate questions to insure that it was a seizure as opposed to a “vasovagal” reaction that many do experience when they see blood. Those questions may be simple ones like “was the person confused when they came to” (in medical terms, was there a post ictal period). If there was no post event confusion, it is unlikely to have been a seizure. However, if it goes into the record as even a possible seizure, driving ability may be in jeopardy and flying is out.

    Physicians may or may not understand the importance of certain diagnosis on pilots. There is, for instance, a big difference between a “bad headache” and a true “migraine headache.” A true migraine syndrome is usually disqualifying for flight. Once “migraine” is in the pilots’ medical record, he may have to spend lots of time and money to prove that he does not have migraines.

    Depression is another common diagnosis that is thrown around by physicians without attention to the collateral damage it may cause. When your family doctor says to take this Prozac because “it will make you feel better during your divorce,” look out because you will feel worse because you are grounded.

    How do you avoid miss and over diagnosis? Always ask your doctor if they are sure of the diagnosis enough to testify at your NTSB appeal hearing. That usually gets them thinking about the potential consequences.

    Pilots may also call their AME and ask if the medication that has been recommended is copasetic with the FAA. I recently had a pilot ask me about a medication that was recommended for a non hearing affecting ringing in his ears. The medication was a tri-cyclic antidepressant and is used in this case to “calm” the auditory nerve. If he had consented to the medication, he would be grounded. When he stopped the medication, he would have to prove it was not for depression by providing medical records and a letter from the treating physician at a minimum.

    From a medical record point of view, George Orwell is alive and well. Unless you pay cash for every visit at any individual medical office or facility and never tell any insurance company about those visits, those encounters will all show up at some point in a national data bank when you buy medical or life insurance. (Not giving the correct Social Security number and birth date helps as well.) Once in the data bank, every insurance company you apply to will have opportunity to see the records.

    Are there people out there who do this? Absolutely. If they get caught by an insurance company, their claims could be denied. Do they get caught if they do it right? Not very often.

    What about those folks who do not report medical issues to the FAA?  Since that is a federal offense, it is more than a denial of an insurance claim. It is a potential fine and jail time. Do people omit items on their FAA medical? All the time. Do they get caught? Rarely. Is it worth the risk? You will have to answer that question for yourself.