Am I in compliance with BasicMed?
Votes
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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Thanks for replying so quickly ... however I am still getting conflicting information ... here is the other response I got from AOPA:

Gary Crump (AOPA)
Aug 7, 2020, 10:23 AM EDT

yes, you're fine with the form.  the FAA created the 8700-2 form based on the existing medical application form and didn't make the necessary modifications to it to adapt it for BasicMed.  Your doctor's notations are fine and you are good to go.

Best regards,

Gary Crump, Director
PIC Medical Certification
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... also, I just read the CFR and see that it indeed does say the checklist items are to each be checked ... but what does "check" mean?  "Inspect" or "place a checkmark"?  Assuming the latter, the MD does not research the CFRs ... and nothing the 8700-2 or related FYI docs published instruct him to do so.
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Basic Med is relatively new, and everyone is still learning about it.  The fact that AOPA's own staff differs on their reading of the issues reinforces that.  However, I think these are legal questions, not medical, involving interpretation of 14 CFR 68.7, and require an official answer from the FAA's Office of the Chief Counsel.  I suggest AOPA use its connections there to obtain a reliable answer to these questions.

That said, as a CFI, I would never sign a document requiring that I certify that I had covered all areas on an FAA list while leaving some of the boxes unchecked.  I see too much chance of a liability issue arising later if something happened involving one of the areas with no check in the box.  I would never want to have a plaintiff's attorney asking me, "Mr. Levy, you say you covered all these areas but you left some of the boxes unchecked.  How do we know you actually covered all those areas properly if you didn't check all the boxes on the form?  Did you not really cover them, or was that just a careless omission?  And if it was careless, how do we know you weren't equally careless about everything you did?"  I can't think of any good answer to that question, and I'd think a state-licensed physician  would know better than to crawl out on such a legal limb by leaving boxes unchecked.
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Thank you Ronald ... and I agree it would be beneficial for the AOPA to get clarification.  My concern is not so much for the FAA to take action against me (since their guidance is not tight) ... my concern is that my insurance company will use the unchecked boxes as a basis to say I shouldn't have been flying with an invalid medical and deny a potential claim.
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To be honest, I think your physician is more on the hook with this than you are, and I'm surprised he signed what amounts to a blank check.  Y'see, if you have the original sheet (as you should), there's nothing to prevent you from checking the boxes yourself and then claiming they were checked when you received the signed document from the physician.  Then he's on the hook if something bad happens and it's later determined you really did have a vision or hearing problem which contributed to the bad result.  And that's another reason why as a CFI, I don't sign for training or endorsements with blank spaces remaining in the entry.
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Exactly ... despite not checking select boxes, presumably in order to limit his liability, he signed a blank check statement that reads "I certify that I discussed all items on this checklist ...".  He certified the whole list was discussed!  And not trying to be funny, but we never discussed my anus.  There are many other terms on the list that are not in my vocabulary, so I don't know if they were discussed or not.  He is on the hook for that and the courtroom drama would be as you scripted.

However, the FAA or insurance company will say the pilot makes the final go/no-go decision and that I should have known the paperwork was not copacetic.
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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

 
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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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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.