TBI residuals
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Answered By AOPA
In 1981 I suffered a concussion while in the navy. I was given a week of bed rest and sent back to the boat. I seemed to be ok though over the years I've had problems keeping jobs due to not being able to complete tasks on time. I have had no trouble getting my 3rd class medical, and have functioned quite well in the cockpit. Two years ago, my new wife who is a Nurse Practitioner, asked me if I had ever had a head injury and I told her of the concussion. She told me that she thought I might have TBI and so I underwent extensive testing. Since the original injury was when I was in the Navy I ended up getting disability from the VA. My main problem is that I have memory issues due to hyper compartmentalized memory. It had never seemed to affect my flying though. Will I be able to get my 3rd class? Should I just do basic med? To get a third class (or second) what will I need to do?
9 Replies
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AOPA Staff Answer
This is a link to the FAA's Guide for AME's. It will provide you with the details of why it is need, who can do it, etc...however, it will not give you specifics on the testing to avoid "studying" for the test and protect the outcomes. You will see the explanation of who can give the test and a link to a list of FAA doctors who administer it.

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/neurocog/

Be certain the doctor understands this is for your information only. As Dr. Chien suggested, a consult and you have not submitted an FAA application.
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A lot will depend on the exact diagnosis they gave you when you underwent that "extensive testing".  At the very least, you're going to have to answer "yes" to questions 18x and 18y (and maybe 18c if you were knocked unconscious in 1981), and your application will almost certainly be deferred to Oklahoma City rather than issued on the spot by the examining AME.  I'm pretty sure that memory issues will make the FAA nervous, but Dr. Bruce Chien is the expert on that sort of thing, and he'll probably be around later tonight after he gets off work. Letting him know the exact diagnosis will help.

As for going Basic Med, it's not clear when you got your last FAA medical certificate, or whether that was before or after you got that diagnosis and started getting disability pay.  One thing the FAA won't like is if you didn't mention any of this on any medical certificate application you made since you got hurt in 1981.  Assuming no issues there, then the question is whether your last medical was effective at any time since July 14, 2006.  If so, then Basic Med is an option.  If not, then you're going to need a medical certificate issued once before you can go Basic Med.
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Dan, you’ll have to do an FAA neurocognitive evaluation, and outscore the bottom 15th percentile of decile age matched pilots...the award will provoke the demand for same. Probably worth doing it privately (no application); sort of a “know B4 you go......
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The diagnosis was TBI with anxiety. I was also diagnosed with migraines, though less than one per month and adequately controlled with Ibuprofen. I know that I mentioned the original concussion on the first med I had after I got out probably around 1989 or 1990. I was not diagnosed with TBI residuals until 2 years ago. My last 3rd class was in 2014 and expired in 2016. I am fairly certain that I would get above the bottom 15%. It's not that I don't make new memories, I have a very good memory, if I can find it. My memory is like a giant chest of drawers with different sets of memories in each drawer. If the drawer is open I have very good recall. If the drawer is closed I might not be cognoscente that the memory exists. It sometimes takes something to remind me what drawer to open. While I am flying, the flying drawer is always open since I am in the airplane. The problem comes in situations that I am interrupted from what I was doing and when the interruption is taken care of I sometimes have no recollection of what I had been working on until I find something that will jar my memory, like finding the document that I was working on. This then opens that drawer and I fully remember all of the details of what I had been doing. However, as I said, while flying, the flying drawer is always open so I have never had a problem.
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How would I do the FAA neurocognitive evaluation privately? What is the specific test that I would need to do? Thanks.
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"TBI with anxiety"? That anxiety part pushes another FAA hot button, which may require even more medical investigation.  Bruce can tell you more about that.  As for Basic Med, since your last medical was within the Basic Med window and expired without being suspended or revoked, Basic Med is an option.  The only question is whether you can get a physician to sign the paper.
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Ron is correct. that moves you into a severe TBI and FAA will not let that one go without, in addition a HIMS psychiatry evaluation. You are now up in the 6K range.  I would suggest Basic med given that you are not having second career aspirations.....
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They only list the TBI as being moderate. The anxiety is only mild anxiety. If it makes any difference.
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Doesn’t really...sigh.