Am I in compliance with BasicMed?
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Answered By AOPA
I went to my primary MD for a physical last week.  He completed Section 3 of FAA 8700-2 and signed the physician's declaration.  I took the online course and printed the certificate.  However, I later noticed the MD had not checked items #19 and #20 on the checklist.

Next to #19 he wrote "No apparent defects, not objectively tested" and next to #20 he wrote "Appt at Ophthal" (because I told him I had my annual appointment scheduled for later in the week).  When I returned the form to ask if he would consider checking the boxes he wrote back "At a minimum this typically requires simple audiometry but may be more stringent for a commercial pilot" (referring to the fact that I do hold a commercial pilot certificate, but not understanding that I can fly non-commercially with BasicMed).

Note: the form just lists "Hearing" with no guidance for the MD ... I believe he could have checked it based only on the fact that we were conversing normally through COVID masks from opposite sides of the room ... but the form gives no standard.

The form instructs the MD to "Review all sections of the checklist ...", which presumably he did.  The declaration attests that he "... discussed all items on the checklist ...", and he did sign it.  Nothing instructs the MD to actually check each item's checkbox.
Question #1: Is my signed FAA 8700-2 form in compliance with BasicMed since there are 2 unchecked boxes?
Question #2: How can I use BasicMed with the MD deferring to specialists.

I called the Pilot Information Center and received 2 different answers. First, I was told that I was fine since it was a mistake that #19 and #20 were included on the form because there is no standard for either one.  When I called back to see where I could find that in writing I was told I should probably go back to the MD and ask him to check the boxes since there was no official guidance on unchecked boxes.
12 Replies
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AOPA Staff Answer
Each box on the checklist does need to be checked. The CMEC is not officially complete until then. Section 68.5(b) requires the physician to conduct the comprehensive medical examination in accordance with the checklist, check each item specified during the examination, and address, as medically appropriate, every medical condition listed and any medications the individual is taking. Some doctors do refer the pilot to an eye doctor or hearing specialist for evaluation and then once they can show the physician the evaluations they will check off. But you are correct with the hearing. if the physician doesn't have any concerns then he can check off the box. The CMEC does refer the physician to the AME guide for further consultation. Here's the link to the hearing techniques:  https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/exam_tech/item49/et/

There aren't any vision standards as far as visual acuity goes but you do have to meet your state's standards to hold a drivers license. If your doctor wants to compare your ophthalmologist's evaluation with the FAA standards for 3rd class he could.  https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/VisualAcuityStandards.pdf
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Be careful what question you bring up for official answer. Ron and I both recall the guy who asked FAA for clarification as to what constituted "known icing conditions" which cost GA flyers about 4 years.  The answer was essentially "cloud, in winter".

I'd do the CMEC over.
And it's a nonissue as to whether you are conducting a flight under Basic or under 3rd class.  It's what you declare (within the known limitations).
 
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Thank you Gary, I appreciate the thought you put into your post.

I believe FAR 68.5 (b)(2) could easily be construed to mean “… physician must check (i.e. examine: the MD “checked” my hearing and “checked” my vision, etc.) each item specified …” given that the FAR says he “must” do it … and the CMEC only states he is to “address” each item.  The meaning of "check" is "address" because the FAA tells the MD what is expected of him via the instructions on the CMEC … the FAA should know the MD is going to follow the CMEC instructions without researching the FARs!

If you are correct that the CMEC checkbox is just there to satisfy the requirement that the ears/eyes were “examined” then, I would argue, the MD’s qualifying text on that line item should equally satisfy that requirement, even absent a checked box.

My MD initially told me he did not “do pilot physicals” anymore … I had to talk him into completing the CMEC.  I have already gone back to ask him to reconsider checking the boxes along with adding qualifying text … he added qualifying text but still refused to check the boxes.  I think I have exhausted that channel, those two checkboxes on my form will never be checked now.

Your post holds the opinion that I am not in compliance unless all boxes are checked, even though the MD wrote on the form that he examined each unchecked item and even though he signed the statement that, given all the items on the checklist, he believes I am safe to operate an aircraft.

So, if I assume I am not in compliance, here are my options as I see them:
  1. Find another MD willing to do the whole CMEC (which defeats the FAA’s goal of having pilot’s Primary MD complete it and makes it look like I am shopping for an MD … because I am!)
  2. Get a statement from my Ophthalmologist and go to an Audiologist to get a full blown hearing test (will that be acceptable as the boxes will still not be checked, FARs don't address supplemental specialist opinions)
  3. Get a Class 3 medical (introduces a new problem: if I have both BasicMed and Class 3, which one am I flying under … both?)
Maybe I should fear the FAA more … but as I stated in a prior post, my real fear is an insurance company finding a reason to deny a claim.

I believe Ronald Levy is correct in requesting that AOPA get a legal (not medical) opinion from the FAA.

 
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The language in FAR 68.5 (b)(2)  states that "The physician must check each item specified during the examination."  This is the only location of explicit language regarding the disposition of the check boxes on the form, so to be totally in compliance per the regulatory language, all the boxes must be checked. I know there are situations where doctors don't have the equipment to do an eye exam or for whatever reason don't want to check that box because there was no "eye exam" done.  But in fact, a cursory eye exam to check for any obvious problems is certainly within the scope of a regular physical exam, although not necessarily to the extent that an optometrist or ophthalmologist would perform. 

The CMEC Section 1 instructions to the Individual and State-Licensed Physician in item 2 states, "The state-licensed physician must perform a comprehensive medical examination addressing all items in the Section 3 of this checklist. The physician completes the "Physician's Signature and Declaration" if the physician determines that he/she is not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft." 

The check box is there just to satisfy the requirement that the eyes were "examined" and that the doctor determined that there is not a condition that could interfere with safe operation of the aircraft.  The extent of the "examination" is up to the physician doing the exam.  Hopefully, this adds some clarity to the lively discussion we had.  
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1147 Posts
This is a legal question, not a medical one, so you need an answer from the legal people.  Maybe Boomer can get AOPA's legal people to get an answer, but it must come from the lawyers, not the doctors.
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Boomer, go with Crump. He's right on this one.  (Formerly Gary's BAMA advisor) 
The doc signed.
The form at the end of the course, can be filled out truthfully.
It there is a liabilty issue it's on the doc.

Dr Bruce