Honesty with medical examiner?

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3dpilot1973
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Honesty with medical examiner?

Post by 3dpilot1973 » Sat Sep 22, 2018 8:47 pm

I am trying to get my recreational pilot license, and would need to pass the medical exam for a Category 4.

I know I will pass all of the physical aspects of the test, I am in great shape and have had no problems that would affect my ability to fly. I DO however have bipolar disorder. I know this is a tricky issue and in most cases will deny me my license. But are these based on a case by case basis? I was diagnosed at age 11 (too young for a proper diagnosis in my opinion), and I am almost 31 years old now and have never had an incident. After trying a various medications for a few years, I found one that worked called Lamotrogine (originally developed for patients with epilepsy, but has had amazing results with bipolar disorder). I've been taking that medication since age 14 onward. So I know it's safe to assume that it works and based on my track record has had 0 side effects that would impair my judgement. These are all things I would like to be taken into account. But does that even matter to them? Is it an automatic fail?

Now as to honesty with the examiner...I hear that many people omit certain details that may get them disqualified. From what I understand it is a crime and that's the last thing I need in my life, I'm not trying to make things worse. But how would the doctor know? I could stop taking the medication for 5-7 days until it's out of my system just in case. But I'd be more concerned about them finding medical records from my regular physician. Usually when I need a prescription filled, I just go to my local clinic and just say "In need a 90 day refill, everything is going well, no problems". I don't actually see a therapist. But still, that information is now in my medical record. So for example, if lied about the bipolar disorder, would they do their due-diligence and dig through my medical records? Is there a database where it is all stored where they could just look that up?

I'm from the states, and that info is protected, and can only be shared from doctor to doctor with my consent. I don't know how it works in Canada, I've been living here 5 years now so I'm not familiar with how it works here.
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photofly
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Re: Honesty with medical examiner?

Post by photofly » Sun Sep 23, 2018 11:34 am

But are these based on a case by case basis?
Yes. Transport Canada doesn't have an interest in stopping people from flying when it's safe. But they're the experts on that, not you.
But how would the doctor know? I could stop taking the medication for 5-7 days until it's out of my system just in case. But I'd be more concerned about them finding medical records from my regular physician. Usually when I need a prescription filled, I just go to my local clinic and just say "In need a 90 day refill, everything is going well, no problems". I don't actually see a therapist. But still, that information is now in my medical record. So for example, if lied about the bipolar disorder, would they do their due-diligence and dig through my medical records? Is there a database where it is all stored where they could just look that up?
When you apply for a medical, you have to give TC permission to access your records from regular physician. Under section 6.5 of the Aeronautics Act, you are also obliged to tell your physician that you hold a pilot licence, and the physician is obliged to tell Transport if you have any disqualifying conditions. There are stiff fines for you, and for your physician for failing to do so.

The system is mostly based on honesty, but in the background, by applying for an aviation medical you have already deemed to give your consent for the release of your records (Aeronautics Act 6.5(6)).

Do yourself, and the rest of us, a favour, and tell the truth. *We* don't want you flying around in the air with us, if you have to lie about your medical condition to do so.
I'm from the states, and that info is protected, and can only be shared from doctor to doctor with my consent.
I can tell you how it works, in Ontario, for instance. According to the Personal Health Information Protection Act, your consent is needed to release personal health information, except as permitted or required by law. Since the doctor is required by law to disclose your information, your consent is not needed.

I should also tell you that this is very much the same in most jurisdictions. Your rights of privacy are trumped by the requirements for public safety.

You should also know what happens when you do have a right to privacy and you restrict your doctor from releasing information, such as to an insurance company. When a Health Information Custodian withholds from disclosure records that you have requested be withheld (it's called a "lockbox") they will make that fact known to the recipient. Usually they will add a statement to the effect of "these are the records for the disclosure of which I have the patient's consent. There are other records which are relevant which I have been instructed not to disclose." The recipient can then make up their minds. On this basis, your insurance company will be able to refuse you coverage as they know you're not being forthright, even if they don't know the details.

I'm going to repeat the most important point: we and your passengers do NOT want you flying if you have to lie to get a medical to do so.

Here is a page from Transport Canada that you should read:
https://www.tc.gc.ca/eng/civilaviation/ ... al-740.htm
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Schooner69A
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Re: Honesty with medical examiner?

Post by Schooner69A » Sun Sep 23, 2018 3:49 pm

3dpilot1973

You are never cured of the bipolar disorder; you can only manage it. I am pleased that your medication has worked for you for seventeen years and I hope that it continues to do so in the future.

However, my wife is also bipolar having been diagnosed over thirty years ago. Although basically stable now, there have been "incidents" over the years.

As I mentioned, you can't be cured, you just manage the disease. And you can live a full and happy life while doing so. There are just some things which you should not consider - flying being one of them.

The following is from Part IV of CARs: Personnel Licencing and Training:

4.3 An applicant shall have no medical history or clinical diagnosis likely to interfere with the safe operation of an aircraft as follows:

(a) a convulsive disorder, fits, recurrent fainting, severe head injury, post traumatic syndrome, severe headaches or migraines;
(b) psychiatric illness;
(c) alcohol or chemical dependence or abuse;
(d) a personality or behaviour disorder that has resulted in the commission of an overt act;

Therefore, I would still go for a medical, but I would be upfront with the Medical Examiner...
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digits_
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Re: Honesty with medical examiner?

Post by digits_ » Sun Sep 23, 2018 3:57 pm

photofly wrote:
Sun Sep 23, 2018 11:34 am


You should also know what happens when you do have a right to privacy and you restrict your doctor from releasing information, such as to an insurance company. When a Health Information Custodian withholds from disclosure records that you have requested be withheld (it's called a "lockbox") they will make that fact known to the recipient. Usually they will add a statement to the effect of "these are the records for the disclosure of which I have the patient's consent. There are other records which are relevant which I have been instructed not to disclose." The recipient can then make up their minds. On this basis, your insurance company will be able to refuse you coverage as they know you're not being forthright, even if they don't know the details.

I'm going to repeat the most important point: we and your passengers do NOT want you flying if you have to lie to get a medical to do so.
I'm not disputing anything you wrote, but I am curious if (how?) the government/insurance companies can know who your doctor is? Or which doctors you have consulted?

For example, you go to doctor A for your childhood, then you move and start going to doctor B. Does doctor B have access to your full medical history? What if you don't mention you went to doctor A before? What if you get your medical and you only mention doctor A or doctor B?

I for one can't recall that a Canadian medical examiner has ever asked me which doctor I visit.
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photofly
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Re: Honesty with medical examiner?

Post by photofly » Sun Sep 23, 2018 5:10 pm

digits_ wrote:
Sun Sep 23, 2018 3:57 pm

I'm not disputing anything you wrote, but I am curious if (how?) the government/insurance companies can know who your doctor is? Or which doctors you have consulted?
They don't know, unless they ask. Insurance companies will make enquiries if you want life insurance, disability insurance, and sometimes when you make claims.
For example, you go to doctor A for your childhood, then you move and start going to doctor B. Does doctor B have access to your full medical history?
They may ask, and (in Ontario and proably other provinces) Doctor A can release your records to Doctor B under the principle of "Circle of Care", unless you explicitly say you don't want that to happen. ("Lockbox")
What if you don't mention you went to doctor A before?
Then Doctor B will never know and your records don't go. Just as if you told Doctor A not to release your records to Doctor B. Most likely Doctor B will be unable to give you the same quality of care, but it's your decision and your loss. They're your records, and it's your health. The records can only be disclosed with your consent, or where permitted or required by law. But if you allow only part of the records to be disclosed, you can't hide that fact. Disclosure without consent really comes into play for (eg) administrative uses, quailty assurance, programme planning, when there are public health issues, risks to your safety of that of some other individual(s), children at risk, or a law otherwise requires it.
What if you get your medical and you only mention doctor A or doctor B?
You're required to answer the questions on your medical declaration truthfully.
I for one can't recall that a Canadian medical examiner has ever asked me which doctor I visit.
They don't generally ask, unless they have a reason to. One of the questions is have you visited any doctor in the period since your last medical, and if so, what for. If they later find out that you lied on your declaration - that you said you didn't have bipolar disorder, you're not taking any medication and you didn't visit a doctor in the last year, you're in deep shit.
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digits_
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Re: Honesty with medical examiner?

Post by digits_ » Sun Sep 23, 2018 6:06 pm

Thank you!
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3dpilot1973
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Re: Honesty with medical examiner?

Post by 3dpilot1973 » Sun Sep 23, 2018 6:59 pm

Thanks for the advice. I have an appointment tomorrow to discuss with an examiner off the record. I'm in the process of renewing my work permit anyways so I can't actually do the full medical exam until after that happens. Hopefully I can just ask him some general questions.
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herrybraun
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Re: Honesty with medical examiner?

Post by herrybraun » Tue Sep 25, 2018 12:23 pm

I remain always honest with my medical examiner and to be remain always fit with my this honesty policy. I thinks everyone has to share their all body problems with professionals.
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JohnShaw
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Re: Honesty with medical examiner?

Post by JohnShaw » Fri Dec 21, 2018 3:45 am

3dpilot1973 wrote:
Sun Sep 23, 2018 6:59 pm
Thanks for the advice. I have an appointment tomorrow to discuss with an examiner off the record. I'm in the process of renewing my work permit anyways so I can't release of Dbal max actually do the full medical exam until after that happens. Hopefully I can just ask him some general questions.
How did your meeting go? And what have you decided? I would suggest sticking with honesty as hiding your medical condition is not safe for you as well as others.
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garyjones
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Re: Honesty with medical examiner?

Post by garyjones » Fri Nov 22, 2019 12:07 am

JohnShaw wrote:
Fri Dec 21, 2018 3:45 am
3dpilot1973 wrote:
Sun Sep 23, 2018 6:59 pm
Thanks for the advice. I have an appointment tomorrow to discuss with an examiner off the record. I'm in the process of renewing my work permit anyways so I can't release of best hard pills actually do the full medical exam until after that happens. Hopefully I can just ask him some general questions.
How did your meeting go? And what have you decided? I would suggest sticking with honesty as hiding your medical condition is not safe for you as well as others.
thanks for the suggest sticking ...
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ayseven
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Re: Honesty with medical examiner?

Post by ayseven » Sat Nov 23, 2019 8:52 pm

Just a bit to consider: there is no off the record with the CAME. They are bound by ethics.
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rotorspeed
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Re: Honesty with medical examiner?

Post by rotorspeed » Sun Dec 01, 2019 3:19 pm

CAR quoted incorrectly above part IV licensing
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