Having issues with Medical?

[Nomedical]

Hello Avcanada,

I am a Canadian ATPL holder for the last 15 years and have been working in Canadian aviation, as a pilot, for close to 20 years.

5 years ago my Category 1 medical was not renewed due to an unfit status. In that 5 years I have seen Neurologists, Neuropsychologists, Ophthalmologists, Cardiologists and Orthopaedics to name a few. I have seen all the specialists at the request of Transport Canada Civil Aviation Medicine.

Initially it took me 2 years to get all the tests they requested completed. Once done and submitted I was deferred to the AMRB which assessed me as unfit. In each item they assessed me as unfit for I had already sent them medical documentation that refuted this. I appealed this decision and was given another laundry list of tests to have completed before they would reassess me. It has taken another 2.5 years to have those tests completed. All of these test were normal and I had green lights from all my specialists which included letters stating I was fit to fly in their professional opinion.

Transport Canada again denied my medical and has asked me to repeat a few of the tests despite these tests being normal. So my cycle continues. I am at a loss of what to do. If they keep asking me to repeat the same medical tests and are expecting different results well, isn't that Einsteins definition of insanity?

Any advise would be appreciated but that's not why I am here. I am here to collect other similar situations, where professional pilots have been given the run around by our regulator. I am not asking you to disclose any personal information about you as an individual but I am looking for specific details. I would appreciate a PM if you are uncomfortable posting publicly. I am hoping to see a trend that I can then take directly to TC and ask for an explanation or perhaps directly to the Canadian human rights commission.

I've heard of an increase in number of complex medical applications and this increase has coincided with change from 60-65 for mandatory retirement (No PIC in US airspace after 65). I am wondering if they have are over policing.

Remember their mission is: to ensure aircrew and air traffic controllers are medically fit, to close gaps in scientific knowledge of Canadian aviation medicine, to promote health and safety in the field of aviation and to prevent aircraft accidents due to medically related human factors.

It seems recently they have taken a stance in over policing. So much so that the aviation telephone switchboard message even states "we are currently reviewing a large number of complex medical applications, as such the 30 day service standard does not apply" I am thinking that they are dealing with a large number of complex medical applications that they have created. The overall health of Canadians has not changed that dramatically in the last decade or so, so has civil aviation medicine changed instead?

[FL030]

It's difficult to give advice on your situation without knowing Transport Canada's side of why they are denying you.

[SpaceBalls]

Try Dr. Brendon Adams
He helps a lot of complicated cases

[whistlerboy02]

Honestly, a two crew medical should be simple for anyone to get. I hope Covid showed that extending the renewal dates made sense and didnt effect safety.

[JBI]

Did you appeal to the TATC?

And, do you have assistance through an cAME who does ONLY aviation medicals?

[rigpiggy]

Foipop a copy of your 5802file. TC is required to give you everything including notes, emails etc..... Then follow up.

[Nomedical]

It's difficult to give advice on your situation without knowing Transport Canada's side of why they are denying you.

That's were I am coming from as well, it's difficult for me to continue getting referrals to repeat exams, scans and tests when I don't know why they're denying me my medical when the last round of exact same tests came back as normal.

Did you appeal to the TATC?

And, do you have assistance through an cAME who does ONLY aviation medicals?

My CAME has been helpful but not the type of help where he/she will see me without making a appointment for a medical. To be honest where I live there are not a lot of options for CAME's and most CAME's in my area do not have much experience with complex medicals.

Basically a CAME will complete a TC Medical examination report, if you do not meet the standard in the report your MER is deferred to the RAMO. 4 years ago I attempted to contact my RAMO for the entire year via email and telephone. The only response I received from my RAMO was an email saying "effective Monday I am no longer with Transport Canada" I was never once contacted by her otherwise.

With regards to the TATC - 4 years ago when I was initially denied my CAT 1 medical and sent a failure to renew letter, they had reasoning for it that made sense to me. rThey requested additional documents and deferred it to the AMRB. I felt it wasn't necessary to take it to TATC and that if I did the TATC would side with TC.

I haven't been issued a failure to renew since. My file was recently reviewed by the AMRB and I have yet to receive a failure to renew but was issued a letter from my RAMO requesting repeat of the same tests despite my previous tests being normal.

To further add fuel to the fire I was recently discussing my issues with TC to another experienced pilot. That pilot was sent a letter this year saying basically "he we messed up but you haven't had a valid medical since 2021, go get this laundry list of tests completed" this captain has been flying the entire time. TC is that behind in medical processing. I was also told that Prairie Northern is approximately 2 years behind in medical processing, so if you haven't received your $50 medical processing fee invoice the last couple years or months it's because they haven't processed it yet.

[Nomedical]

As well... When I review the Civil Aviation Medical Examiner Handbook, for my type of injury, it states "...may return to full duties by five years. An EEG and neuroimaging should be undertaken at that time" I have sent them this and more, with Neuropsychological evaluations to determine if I have and cognitive deficiencies - which I do not. Despite this I am being told to submit an additional sleep deprived electroencephalogram (EEG), they do not want the interpretation from the neurologist that reviews the EEG, they want the raw data to interpret it themselves which to me is a slippery slope as I no longer trust or have any faith in TC civil aviation medicine. As well they want me to complete a MoCA, which I have already done and came back as normal to better than normal.

Why don't I want TC interpreting my raw data? Doctor A may interpret this data differently than doctor B or doctor C. I believe that a bias already exists on my file and therefor am uncomfortable having TC interpret that data alone. I don't even think they should be asking for the raw data and only be asking for non-bias interpretations from 3rd party doctors with no vested interest in one diagnosis or the other.

[Nomedical]

What I am ultimately looking for on this thread is stories from any other pilot struggling with TC medicals either posting here or via PM.

I believe there has been a shift at TC and they're looking for reasons not to issue vs issue a cat 1. This is a dangerous road if true, %99 of a recurrent medical is about self disclosure and if pilots sense or see this shift there will be no self disclosure and we will end up in a bad spot.

[JBI]

I lost my medical for about 14 months, a different RAMO at a later date reviewed my file and his exact quote was "it's ridiculous you lost your medical in the first place". I'm guessing that the RAMO that initially pulled my medical was the same one who pulled yours (former Atlantic/Overseas RAMO who left TC in 2019).

With regard to the TATC, I have noticed that an application in front of the TATC tends to get your file to the top of the pile.

With regard to a specialized doctor, there are a number of doctors across Canada who solely deal with Transport medicals - Dr. Gilmore in Maple, Ontario and Dr. Adams in Springbank, Alberta come to mind. They understand the politics of TC. After I got my medical back with no issues over the next year, TC sent a letter saying "oh, by the way, you need to do this other test before we'll renew your medical." Medically speaking, the test actually had little value and my specialist doctor was literally shocked that they asked for it. Nonetheless, I spoke with one of the above mentioned doctors who outlined that the easiest way for a bureaucratic institution like TC Civ Av Medicine to deny your medical is if you don't do a requested test. The Doctor advised "do the test and if you fail, then argue why it's a useless test" - thankfully I passed the test and it wasn't an issue.

If it's your livelihood at stake, it is worth the time to travel to see those specialist aviation doctors. They're not lawyers, but can help guide you on your strategy. If you work for an ALPA carrier, they will provide referrals to a specialist aviation doctor which they have on retainer.

As for the TATC, once you have all your tests, specialist's opinions etc. lined up and you feel you've checked off all the boxes in the CAME booklet, go get another Medical Exam. That's a decision of TC that's able to be appealed to the TATC.

With regard to the general purpose of your post, I agree with you completely. It used to be that it seemed that TC would work with candidates to take proper steps to ensure they were safe to fly with a significant number of medical conditions. Now, however, it seems that TC takes the position "You're not safe to fly unless you can prove that you're safe to fly". I would never wish what I went through on my biggest enemy. It was awful. I definitely think that this harsher attitude by TC will ultimately make aviation less safe as pilots will be less forthcoming with issues that may crop up. This is the exact opposite thing that we should want.

I'd recommend reading through https://canliiconnects.org/en/commentaries/73594 as well as the same lawyer's commentary here https://canliiconnects.org/en/commentar ... pletePos=4 it likely wouldn't hurt to reach out to Adam at his firm https://apstrom.ca/about/ He's a smart guy who very much cares about pilots being treated fairly. yes, lawyers are expensive (not sure about Adam's rates), but for something like this, I'd argue it's worth it.

[Aviatard]

Tyler Brooks is the head of civil aviation medicine at TC. All TC email addresses have the form firstname.lastname@tc.gc.ca. You need to communicate with Dr. Brooks.

[Nomedical]

Foipop a copy of your 5802file. TC is required to give you everything including notes, emails etc..... Then follow up.

Tick that box. I made that request 2 years ago and a couple days ago, after reviewing the entire file I found some "interesting" items. For example the RAMO deferred it to the AMRB. Maybe I'm wrong but I believe when you defer something to a board you're doing that to have them make a decision based on their collective knowledge and experience maybe, I don't know. So I found it odd when the RAMO emailed the AMRB giving them a small 1 paragraph description, that was not accurate, of my injuries. She concluded the email with something to the effect of "...Looking for medical lenience, but I don't think he's fit" I thought that remark was kind of like a judge telling the jury to go deliberate but he would seem them soon because the defendant is clearly guilty.

I'm guessing that the RAMO that initially pulled my medical was the same one who pulled yours (former Atlantic/Overseas RAMO who left TC in 2019).

Ahhh… you poor poor soul. You had the pleasure of dealing with Dr. Heather Langille.

Try Dr. Brendon Adams
He helps a lot of complicated cases

Where is he located?

Tyler Brooks is the head of civil aviation medicine at TC. All TC email addresses have the form firstname.lastname@tc.gc.ca. You need to communicate with Dr. Brooks.

I'll give him a try. If he even responds he is %100 ahead of the game. I have actually read that he is a great Dr who looks for reasons to give medicals and not take them. I also believe he is now the reason it is possible to hold a category 1 medical if you've been diagnosed with depression and properly medicated. I think it's a 2 year wait.

it is really interesting because 1 of the tests they are asking me to get now I had gotten in 2019. In 2020 when Dr. Brooks emailed me as acting RAMO he explained that type of test doesn't necessarily mean anything. Yet I provided them 3 additional ones and now they want another. Make your mind up TC, it means something or it doesn't.

[co-joe]

Dr Brendan Adams is at YBW aeromedical clinic. Good dude, a pilot himself, has two partners that are both fantastic people.

https://www.aviationdoc.com/

[W5]

I second the opinion on Dr.Brendan Adams. Great guy, and helped me out once upon a time.

[Bluerun]

My situation. Over four months trying to deal with sleep apnea. All the info they required has been forwarded to show the situation has been resolved. Took over 100 days for anyone in the Edmonton office to even look at the file. In the past have had the RAMO work with and tell me his interest was to get me back in the cockpit. The current model(policy) seems to be working at keeping folks out of the aircraft for as long as they can. Your very right the talk in the industry is tell your CAME nothing so you don't have to deal with a TC review. We are moving into very unsafe water. Good luck. The system is broken!!

[W5]

They changed RAMO's in Edmonton. The old one still contracted for TC for a while, but the new one (about 2 years now)has been on a warpath.
Out of the blue I did get a notice that my medical was suspended. Seeing as I am too old to give a damn I just went on with life. Without putting up with TC's BS ever again.
Saves me a lot of money and aggravation.

[PilotDAR]

I had a failure to agree with the TC doctor, which lasted about seven months. My CAT 1 was restricted to "as or with copilot" which is pretty useless for flying my single controls airplane which I keep at home. Zero flexibility on that with TC - no imagination on their part. 'Did some flying with a well know poster here, we both survived it! To accomplish that flying was a two hour drive into Toronto - where am I a greater risk to public safety; flying my two seat airplane over farm fields solo? Or driving in Toronto traffic?

I got some great advice from a retired (other nation) airforce doctor, which sent me down a rather precise logic path. I passed all the tests requested by TC with no problem whatever. Ultimately, TC boiled it down to their belief that I had suffered a head injury during an accident. I had not suffered a head injury. Once I provided the hospital record which said that my head had not been injured, coupled with a battery of passed tests, TC had no path other than to remove the restriction to my medical. Personnel Licensing were awesome, literally same day service on new stickers!

It was a ridiculous irony (which I eagerly rubbed into the TC doctor) that between the time the became aware that I had been injured (and my CAME had renewed my CAT 1 - how TC found out), and the time they actually restricted my CAT 1 was more than two years, and I had flown 250 hours as PIC, including several test flights in a Caravan with non pilot TC staff aboard as my test witness passengers.

I was really disappointed in the TC medical staff through this event - common sense was nowhere to be found, and I was polite while asking for it!

[Nomedical]

Well it's been an interesting couple weeks. After requesting everything I could think of through the access to information act, I received an email from TC that was along the lines of: "civil aviation medicine would like to have an informal conversation with you to answer any questions you may have. If that satisfies me will I withdraw my information request". I had to reply with my consent for them to contact me. I said yes, contact me but I still want all the information I requested as I believe the human rights commission will want a copy of everything to go along with the complaint I filed. I also told them they had 5 working days to contact me or I withdraw my consent. That's my service standard. I've since tried calling and emailing the RAMO - CRICKETS. I NEED A JOB AT TC - you literally don't have to do a thing and you get enough money to live plus a pretty sick pension.

[DHC2dooer]

Myself and 5other pilots I know of…..there are more…..in the Prairie Region are experiencing the same run around and delays.

Without going into great detail ….over the period of 16 months …..I have had every medical test as it relates to opthamology cardiology and neurology ….twice….All tests have come back negative.All specialists and the CAME i use recommended my privileges be reinstated.

My issue are the delays and complete lack of communication on the part of the RAMO.The people in the Edmonton office are doing their best to keep me informed but are limited in the information they can provide.

The RAMO does not return phone calls or emails. She has received all my tests and specialist reports/recommendations.My file has been sent to the AMRB for their recommendation….they apparently reviewed the file sent their response back to the RAMO….SHE MUST NOT HAVE LIKED SOMETHING AND SENT IT BACK FOR A SECOND OPINION FROM THE COMPLETE BOARD…..That is where it sits now with no date planned for AMRB to meet.

This info did not come from the RAMO….all second hand…NO DIRECT COMMUNICATION FROM THE PRINCIPAL PARTY.

I have since learned ….from this forum who heads up the TC Medical dept and have tried to phone and email him……nothing yet.
I have requested from the RAMO a complete copy of my file from the last year and a half.Nothing yet.

Does anyone have any info on the AMRB……Who are they ….how often do they meet and when…..how many are there and who are the appointees….who are the accountable to.

THE BIGGEST ISSUE IS COMMUNICATION……..THERE IS NONE….WTF

DHC2

[Nomedical]

Myself and 5other pilots I know of…..there are more…..in the Prairie Region are experiencing the same run around and delays.

Without going into great detail ….over the period of 16 months …..I have had every medical test as it relates to opthamology cardiology and neurology ….twice….All tests have come back negative.All specialists and the CAME i use recommended my privileges be reinstated.

My issue are the delays and complete lack of communication on the part of the RAMO.The people in the Edmonton office are doing their best to keep me informed but are limited in the information they can provide.

The RAMO does not return phone calls or emails. She has received all my tests and specialist reports/recommendations.My file has been sent to the AMRB for their recommendation….they apparently reviewed the file sent their response back to the RAMO….SHE MUST NOT HAVE LIKED SOMETHING AND SENT IT BACK FOR A SECOND OPINION FROM THE COMPLETE BOARD…..That is where it sits now with no date planned for AMRB to meet.

This info did not come from the RAMO….all second hand…NO DIRECT COMMUNICATION FROM THE PRINCIPAL PARTY.

I have since learned ….from this forum who heads up the TC Medical dept and have tried to phone and email him……nothing yet.
I have requested from the RAMO a complete copy of my file from the last year and a half.Nothing yet.

Does anyone have any info on the AMRB……Who are they ….how often do they meet and when…..how many are there and who are the appointees….who are the accountable to.

THE BIGGEST ISSUE IS COMMUNICATION……..THERE IS NONE….WTF

DHC2

Requesting your complete file from the RAMO does nothing google access to information and request it through the federal government, they must provide it to you.

Communication is the exact issue at TC Medicine. No one communicates and there is a complete lack of empathy. It’s actually fracking noots that they are in the CIVIL SERVICE SECTOR and need to be reminded to actually work for us.

Email your MP, if theyre conservative that’s even better. When you email your MP cc the RAMO and Pablo. It also doesn’t hurt to cc someone with an email that ends in law firm.

[DHC2dooer]

I have requested it from TATC as well since I have an open file on this matter…..I won’t get it until all my hearing is confirmed! I’ll take you advise and try your suggestion!

[firstnamecoloue]

Add me to the pile.

6 years ago I was diagnosed with an eye condition which can cause progressive deterioration of visual acuity. But there’s a surgery to stop the progression. In consultation with the Ontario RAMO at the time, I had the surgery and was declared fit after the 6 week post-op ophthalmology consultation.

At the beginning of this week, I got a letter in the mail demanding updated reports to go along with my last medical report (from last year, no less), and informing me I cannot fly. Reports provided, and now I learn that the AMO who has my file has submitted them to the AMRB.

I have 20/20 and 20/15 corrected vision. There’s been absolutely no change to my condition in 5 years. There’s no more of a risk that I suddenly lose my vision than anybody else. What the @#$! is going on?

Who’s the YYZ area go-to for this sort of thing? Trevor Gilmore?
I am at a loss. And going on STD.

[Nomedical]

Add me to the pile.

6 years ago I was diagnosed with an eye condition which can cause progressive deterioration of visual acuity. But there’s a surgery to stop the progression. In consultation with the Ontario RAMO at the time, I had the surgery and was declared fit after the 6 week post-op ophthalmology consultation.

At the beginning of this week, I got a letter in the mail demanding updated reports to go along with my last medical report (from last year, no less), and informing me I cannot fly. Reports provided, and now I learn that the AMO who has my file has submitted them to the AMRB.

I have 20/20 and 20/15 corrected vision. There’s been absolutely no change to my condition in 5 years. There’s no more of a risk that I suddenly lose my vision than anybody else. What the @#$! is going on?

Who’s the YYZ area go-to for this sort of thing? Trevor Gilmore?
I am at a loss. And going on STD.

Make a complaint with the human rights commission if canada. The more we put out complaints in writing to the proper authorities the faster TC will hit their radar.

[cykj]

I had a CAT 1 medical appointment in May 2022 after being off for several years. I didn't expect to pass it but needed to know what tests they required.
It took until last week to get a response. The Ontario office is useless. I was able to get a real person by phoning the Winnipeg office.

[Nomedical]

I had a CAT 1 medical appointment in May 2022 after being off for several years. I didn't expect to pass it but needed to know what tests they required.
It took until last week to get a response. The Ontario office is useless. I was able to get a real person by phoning the Winnipeg office.

Ontario, Quebec and Atlantic Région do NOT MONITOR phones. This was told to my Prairie Northern Region. If you want to talk to someone in civil aviation medicine you must call Prairie Northern OR Pacific. Otherwise you’re SOL. They won’t check voicemail either.