DAME Newsletter - August 1999

Access to aviation medicine information through CASA website
Electronic lodgement of medical examinations and reports
Important impending changes
Requirement for Aviation Reference Number (ARN)
Additional delegations sought for DAMEs
New procedures for lodgement of ECGs
Instantaneous feedback to DAMEs
Reapplications due
AMSANZ membership
Fees for examination of CASA staff
Acknowledgement of receipt
CASA database problems
DAME Feedback
The future

Access to aviation medicine information through CASA website

CASA's home page was recently redesigned. As a result, access to the DAME / DAO List, DAME Handbook, this and previous Newsletters now requires selection of 'Pilots, operators' then 'aviation medicals' then the individual listing(s). Aviation Medicine Section has requested that a more obvious access path should be provided as soon as possible.

The first revision of the website's version of the DAME Handbook should be available through the site within the next two - four weeks. It contains important information of which all DAMEs and DAOs should be aware, including:

revised flowchart for age related requirements for all classes of medical certificates; and
a number of textual clarifications, intended to remove ambiguities.

Pending consultation with industry, the foreshadowed new requirement for ophthalmological examination and report on Class 2 medical certificate holders at the first medical examination after age 60 and at intervals of five years thereafter, will NOT proceed until all usual requirements (CASA Notice of Proposed Rule Making) have been completed.

Electronic lodgement of medical examinations and reports

Aviation Medicine Section has been advised that the updated CASA computer system should have "dummy" forms available for trialling by DAMEs and DAOs by mid-October. We expect to introduce formal electronic lodgement of examination results and reports by early November.

In order to lodge examination and report forms and supplementary documentation with CASA electronically, DAMEs and DAOs will require the following, as a minimum:

computer running Windows 95, 98 or NT;
Internet Explorer 4 or 5 or equivalent web browser;
modem connection and Internet access; and
flat bed document scanner.

DAMEs / DAOs who are not already so equipped should give this matter early attention as CASA will only briefly have any capacity to continue accepting the existing hard copy report forms, whose production will be discontinued once electronic lodgement is available. Further staff reductions within Aviation Medicine Section, a reconfiguration of our office space and the decommissioning of the existing OCR based technology used for data capture preclude any ability to continue present manual processing of reports etc.

Important impending changes

This advance notice should allow DAMEs / DAOs, their staffs and the applicants they examine to prepare for systemic changes planned to accompany or shortly follow the change to electronic lodgement. The most important of them concern the absolute need for ARNs, delegation of additional powers and responsibilities to DAMEs, DAME / DAO access to medical data on applicants held by CASA and new procedures for lodgement of ECGs.

Requirement for Aviation Reference Number (ARN)

Future communication with CASA's computer system will require identification through an ARN. DAMEs and DAOs who do not already possess an ARN should complete and return the accompanying application as soon as possible. This application must be mailed, as CASA is legally obliged to retain a signed copy. Those DAMEs who already have an ARN should advise details to Aviation Medicine Section immediately. Note that DAME / DAO numbers will be retained for Aviation Medicine Section's internal administrative purposes, but that all DAMEs / DAOs will also need an ARN.

It will be impossible to lodge the new electronic medical examination and report forms without quoting the applicant's ARN. This will principally affect first-time examinees beginning flying training. Flying schools will be separately notified of this new requirement, but DAMEs' and DAOs' reception staff who take bookings for aviation medical examinations will need to ensure that applicants have an ARN and bring it with them when they attend for examination.

Additional delegations sought for DAMEs

Aviation Medicine Section will propose amendments of Civil Aviation Regulations so as to empower DAMEs to undertake applicants' case management more effectively. The intended sequelae of the specific changes to be sought are as follows.

CAR 5.04: DAME authorised to permit an applicant to perform aviation duties for up to two months without possession of a current medical certificate. (Existing power continued).
CAR 6.05: DAME authorised to accept applications on CASA's behalf from applicants requiring Class 1 or 2 medical certificates. (New delegation).
CAR 6.06: DAME authorised to revalidate an existing medical certificate for up to two months, on a single occasion only; to recommend issue of a medical certificate for a stated period; or to recommend that a medical certificate should be refused, with grounds detailed. (Existing power considerably extended).
CAR 6.07: DAME authorised to inform applicants, in writing, of grounds for refusal to issue a medical certificate. (New delegation).
CAR 6.08: DAME authorised to specify any limiting conditions for inclusion on an applicant's medical certificate, per descriptions contained in DAME Handbook. (New delegation).
CAR 6.09: DAME authorised to accept and process applications for issue of special medical certificates. (New delegation).
CAR 6.10: DAME empowered to arrange necessary investigations, consultations and reports, assess results, then recommend issue of a special medical certificate. (New delegation).
CAR 6.11: DAME empowered to proceed as under 6.10, then to refuse issue of a special medical certificate, providing written advice of reason(s) to applicant. (New delegation).
CAR 6.12: DAME authorised to recommend issue of a special medical certificate which is subject to one or more limiting conditions consistent with applicant's medical condition(s), per descriptions contained in DAME Handbook. (New delegation).
CAR 6.15: DAME authorised to extend the validity of an applicant's existing medical certificate for up to two months, on a single occasion only. (Existing power continued).
CAR 6.16: DAME to be formally required to inform Aviation Medicine Section when he/she becomes aware of any significant changes in the medical condition of a medical certificate holder who consults him / her, where the medical condition will last for at least 30 days or 7 days, depending on the class of licence held by the examinee. (Current informal arrangement to be formalised, so as to protect DAME from any risk of litigation over disclosure).
CAR 6.17: DAME authorised to require applicants to undergo or obtain relevant investigations/consultations whenever there is any doubt concerning the applicant's fitness for continued medical certification. (New delegation).
CAR 6.18: DAME authorised to suspend an applicant's medical certificate and to provide written advice to the applicant concerning the grounds for suspension. (New delegation).
CAR 299: DAME authorised to accept notification of applicant's change of address on behalf of CASA. (New delegation).

In all cases where DAMEs exercise these delegations, they will be required to inform CASA (Aviation Medicine Section), by electronic means, within one working day.

Whenever DAMEs are required to provide written advice to applicants, they will be able to do so by means of CASA standard letters which can be downloaded from the CASA website.

DAME / DAO access to medical data which are held by CASA concerning examinees

Once the DAME or DAO logs onto CASA's new Medical Records System (MRS) and enters the applicant's ARN, all medical data concerning the applicant received by CASA since 1991, except for CASA internal documents and any others which are witheld by specific, rare blocks imposed by Aviation Medicine Section, will be accessible to the examiner. This should greatly facilitate DAMEs' case management of examinees.

Note: there are privacy and legal implications in making these data so generally available. Anticipated safeguards include read-only access for examiners and specific prior warnings to examinees through CASA publications and other channels and by the examiners and their staffs that requesting and undergoing a medical examination for the purpose of obtaining a medical certificate from CASA will constitute consent by the applicant for the medical examiner to have access to the medical information held by CASA.

New procedures for lodgement of ECGs

These do NOT apply until electronic lodgement of medical examination and report forms is available.

Whenever there is a currently notified requirement for an ECG to accompany an applicant's medical examination and report form, the DAME will transmit a scanned image of the ECG and report at the same time as lodging the electronic examination report, or as supplemental information later if the ECG is not available at the time of the examination. Self-reporting ECG machine tracings remain acceptable, but DAMEs who do not have access to these machines should arrange for applicants to have ECGs, subsequently reported by a physician or cardiologist, prior to examination so that the DAME has the ECG and its report available to lodge with the electronic medical report.

(If a medical report is lodged without a required ECG, the DAME will be electronically prompted to obtain the required investigation and report at the time of lodgement. An ECG which is not accompanied by a report - either self-reading or by a physician / cardiologist - will similarly induce a prompt to the DAME to supply the deficiency. Reports which are not accompanied by a required ECG [or other required document] will be held in a pending queue and will not result in production of a medical certificate until the deficiency has been remedied).

Instantaneous feedback to DAMEs

The new MRS will not accept lodgement of an incomplete form without the DAME's / DAO's explicit endorsement that deficiencies are unavoidable and will be remedied when additional data become available.

Upon electronic lodgement of an examination and report, the DAME will receive immediate advice of the resulting status of the applicant's fitness for medical certification, including advice that a medical certificate will be issued. The DAME can then convey this information to the applicant.

Normal ranges will be specified for all numerical data fields and it will thus be impossible for a DAME inadvertently to key in nonsensical values such as BP 1300/45, height 1823 cm., etc. Fields such as BMI and ldl/hdl ratios will be calculated automatically.

The new electronic report will be extremely user-friendly, Windows based and equipped with numerous prompts to assist DAMEs. It should take no longer to complete than the existing multiple paged hard copy forms, even for a DAME approaching it for the first time.

Reapplications due

All DAMEs who were originally appointed before 1 July 1995 were recently contacted and invited to apply for reappointment. Part of this process involves DAMEs' formal acknowledgement and acceptance of the terms under which DAMEs have been appointed since 1995. Unfortunately, some Responding DAMEs have not returned the required undertaking with their applications for reappointment. Reappointments will NOT be made without a signed undertaking, and Aviation Medicine's DAME Liaison Officer has now to contact the non-compliant DAMEs concerned. If you have not yet responded to the invitation to apply for reappointment, and wish to do so, please ensure your signed undertaking accompanies your application!

AMSANZ membership

DAMEs are reminded that maintained membership of the Aviation Medical Society of Australia and New Zealand is a requisite for appointment / reappointment for Australian and New Zealand domiciled DAMEs. Anyone who has overlooked this requirement in 1999 should contact the AMSANZ Secretariat to remedy the omission. The 1999 subscription is $60.

AMSANZ Secretariat
PO Box 4022
BALWYN EAST VIC 3129

Fees for examination of CASA staff

Aviation Medicine has recommended that the usual fees approved by CASA for medical examinations and tests performed on its staff members should be those published each year in the AMA's List of Medical Services and Fees. Separate advice will be posted on the CASA home page when the recommendation is approved.

Acknowledgement of receipt

DAMEs who receive this Newsletter by direct e-mail, plus any others who have e-mail address of which they have not informed CASA, are invited to acknowledge receipt directly to our DAME Liaison Officer at urban_ma@casa.gov.au

Other DAMEs, having arranged for downloading the Newsletter and having digested its contents, should return the acknowledgement notification posted to them, by mail or by fax, to the nominated address.

CASA database problems

Aviation Medicine Section's existing IT system is very close to its 'use by' date, so the forthcoming changes above detailed appear most welcome and necessary. Unfortunately, the present system may not allow identification of all DAMEs / DAOs who have notified CASA of their e-mail addresses. So if you are one who has done so and this comes to you by conventional post, please accept our apologies in advance. Such problems should be overcome in the near future.

DAME Feedback

DAMEs are invited to contact Aviation Medicine Section at any time re any concerns or suggestions arising from their duties. E-mail contact is preferred, with messages addressed as shown in the preceding paragraph.

The future

CASA expects that the new arrangements for electronic lodgement of medical examinations and reports and for greater involvement of DAMEs in case management of applicants for medical certification foreshadowed in this Newsletter will benefit both examinees and DAMEs. Staff of Aviation Medicine Section will be happy to assist DAMEs who experience any difficulties with the new system.

The information in this Newsletter is forwarded for information and to facilitate future consultation with all concerned.

Best wishes, until next time

Peter Wilkins
Acting Director, Aviation Medicine

Aviation medicals