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Old Nov 17, 2011, 1:11 am
  #1  
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Traveling with disabled children

I have a friend who will be flying internationally in March with her husband and three children. One child has Rett Syndrome, no communication, hand use and can't walk independently. She will be traveling in/with a wheelchair. The other two have seizure disorders that are controlled with diet. Their food has to be weighed and they need exact nutrition facts as well as oil with each meal.

In addition to doctors letters about medications, food and liquids, do they need to fill out MEDIF forms for all three children and get them pre-clearance to fly? The child in a wheelchair has no significant medical needs, except her wheelchair and walker. The other two are stable, except their seizures which are mostly controlled through diet and medication.

My friend wanted to pre-warn the airline that her non verbal child may make noise and fuss during the flight because it is a new experience and she may not be happy, but I am not sure that is a good idea. She isn't terribly loud and it would make it sound like she would be bothering others to the extent that she shouldn't be allowed to fly. It isn't like they are going to be able or willing to help just because they were warned, are they?

I am trying to help her make the journey as smooth as possible, but they are dealing with a lot.
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Old Nov 17, 2011, 4:19 am
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Hi Liba.

My son has cerebral palsy and he is Star Alliance Gold, which says we do travel quite frequently.

He has reduced mobility and travels with his own wheelchair. He also has sensory issues which means it took him some flights to get used to traveling by air.

We have had all sort of experiences and I can honestly tell you it all comes down to where they will be flying and which airline they will travel with.

If they are going to the U.S. any airline will be fine, as they all have to comply with CFR 14 Part 382. If they experience any problem they must immediately ask the airline to put them in touch with the CRO. All airlines flying from/to the U.S. must have a Complaint Resolution Official on duty at all times they are operating a flight.

If they are headed elsewhere it can be a completely different story. EU Regulation 1107/2006 is widely ignored, mostly because it is basically unenforceable. In the UK the Department For Transport is still "working" to transfer civil enforcement powers.

I am having a case against BAA for an accident occurred at LHR T1 on August 15 and my solicitor is following a different legal framework because of what I told you.

Please bear in mind that Emirates and Qatar Airways do not return personal wheelchairs to users during stopovers if the passenger is checked through its final destination.

Qantas has restrictions on the number of wheelchair bound pax per flight. At the other side of the spectrum Singapore Airlines offers an outstanding service to disabled passengers. This is out of my own experience.
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Old Nov 17, 2011, 4:44 am
  #3  
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Thank you!

They are flying Iberia, which from my understanding was taken over by British Airways. All of their disability travel information on their website says: "iberia.com
This content and the rules found therein are provided by and apply on the services of: British Airways"

I assume that that means they will need to contact the same people for preflight travel clearance, if it is necessary, that we did when we fly British Airways. They were pretty easy to work with when I was traveling with a child who needs medical oxygen, feeding pump, etc.

Their flights are from Tel Aviv to Madrid to New York and back.

Do you think they need to fill out the MEDIF forms for all three children? http://www.britishairways.com/cms/gl..._Medif_123.pdf

Thanks!!

Liba
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Old Nov 17, 2011, 4:52 am
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The little known IATA Res 700 sets common rules to all airlines for the transport of what they call "incapacitated" passengers.

2.2 MEDICAL CLEARANCE
REQUIRED
A medical clearance by the medical department/advisor of the
Member in contact with the passenger, shall be required:
2.2.1 Whenever the Member in contact with the passenger(s)
(or person delegated by the Member) has received information
that any passengers:
2.2.1(a) suffer from any disease which is believed by such
Member or person to be actively contagious and communicable,
or
2.2.1(b) who, because of certain diseases, or incapacitation
may have or develop an unusual behavior or physical condition,

which could have an adverse effect on the welfare and comfort
of other passengers and/or crew members, or


The rule I highlighted refers to what could the behaviour of the child be because of the new experience.

Their best bet is to indeed contact the airline (do contact Iberia) and explain the case. Tell them to note down the day, time, and name of the person they spoke to. Just to be on the safe side.
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Old Nov 17, 2011, 9:32 am
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On the flight segment to the US, DOT Part 382 rules would apply. 382.23 prohibits airlines from requiring customers with disabilities provide a medical certificate, with certain exceptions for oxygen dependent customers, customers using a stretcher/incubator etc. It can be assumed that requiring a MEDIF form to be filled out would be in direct violation of 382.23. There is an ambiguous line in the law that states a medical certificate can be required for customers whose medical condition is such that there is reasonable doubt that the individual can complete the flight safely, without requiring extraordinary medical assistance during the flight. The airlines, namely European airlines, can be picky about the "safety" of the customer and may claim the children may require extraordinary care enroute. That would require a medical certificate be provided to clear the children for the flight.

I would suggest taking a nonstop flight from TLV to the US rather than a connecting flight. It would relieve a bit of stress off the family and allow for a more pleasant experience. Also, since the flight would be directly to the US, then DOT Part 382 would apply. As it is, DOT 382 would not apply on your friends itinerary between TLV and Madrid, only on the segment from Madrid to the US.

US carriers tend to allow people to travel with fewer restrictions than the European/Asian carriers, so I would suggest booking one fo the US carriers nonstop flights.

Hope that helps. I wish your friends luck.
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Old Nov 17, 2011, 9:57 am
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I agree with Hardyflyer on the direct flight being the best possible option. However, should this not be possible, I do recommend contacting the airline at least 72 hours prior to the flight.

Also, your friends should check if all flights are operated by the same airline or some by Iberia and others by BA.

I have direct experience that sometimes information isn't properly passed along between partner airlines.

In a perfect world all this shouldn't be necessary, but we live in a very imperfect world.
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Old Nov 17, 2011, 10:18 am
  #7  
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They are in for a mess then. They are flying TLV-MAD on ElAl, MAD-JFK on Iberia, JFK-MAD on American Airlines, and MAD-TLV on Elal. They are flying with a group of 18 people and the tickets are already purchased.

One of the children with seizures is very hyper and can't sit still for long, so they thought the layover might be a help.
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Old Nov 17, 2011, 10:47 am
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Not necessarily.

It just requires a little more time with preparations.

If I were the one traveling I would start by contacting ElAl to get my first and last leg sorted. Here is a link to the ElAl website covering special needs: http://www.elal.co.il/ELAL/English/A...ecialNeeds.htm

Once that is sorted I would contact Iberia. Then, I'd give a call to AA to be on the safe side.

My stepson usually travels BA/AA during the summer. Even though he doesn't have special needs he travels as unaccompanied minor. I know first-hand we always call both airlines to make sure everybody is up to speed because we know that despite the alliance, communication between AA and BA isn't necessarily flowing as one would hope.

They have time to get all this done. I would get on the ball right away. Traveling with special needs children can be challenging so the sooner one tries to get as many variables off the checklist, the better.
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Old Nov 17, 2011, 12:03 pm
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One thing that may be a saving grace here. All the airlines that they are traveling on have code-share agreements with AA. If, and I emphasize if, they happen to be ticketed on AA code-share flights, meaning the flights are operated by Iberia and El Al, however were sold as AA flights, then DOT 382 would hold true even on the flights operated by the foreign carrier. This is outlined under DOT 382.7 That could assist in getting thru this issue.

I would suggest calling AA's reservation line and ask to speak with one of their special assistance coordinators. Since AA code-shares with each airline your friends are flying on, they should be able to assist with any issues you might be encountering with the actual operating carriers. I'm attaching the write up they have on AA's website about their helpers---
Special Assistance Coordinators
Within our Reservations Department, an exclusive team called "Special Assistance Coordinators" facilitates your travel. Specially trained to arrange for the special needs of customers with disabilities and/or medical conditions, they document your reservation concerning your special service requests to alert our airport staff. In certain circumstances, if you have requested special assistance at the time of making your reservation, they will contact you by telephone prior to departure to ensure all advance medical paperwork requirements or special assistance requests are arranged. For this reason, it is helpful to have a valid, complete telephone number available within your reservation.

Although not required to do so, our customers with disabilities advise us that pre-arranging for special assistance helps travel proceed more smoothly. Assistance from a Special Assistance Coordinator is arranged for at the time of booking with an AA Reservation Representative or with your Travel Agent upon identification of your service request.
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Old Nov 17, 2011, 12:09 pm
  #10  
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They were booked on Iberia. I wonder if AA would help anyway. It sounds like they have to contact all three anyway.

Thanks.
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Old Nov 17, 2011, 12:12 pm
  #11  
 
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HardyFlyer,

Since 2009 compliance to Part 382 is mandatory for all airlines flying from/to the U.S., irrespective if flights are code-shared or operated on behalf of a U.S. airline.

However, like you corrected pointed out, the leg Tel Aviv - MAD is not covered. It could be only if the stop in MAD was part of the same flight and the same flight number applied to the last leg, but this is not the case for these guys.
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Old Nov 17, 2011, 12:13 pm
  #12  
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UKBob64 Thank you for your reply and link as well. I am passing the information on!
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Old Nov 17, 2011, 2:52 pm
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Originally Posted by UKBob64
HardyFlyer,

Since 2009 compliance to Part 382 is mandatory for all airlines flying from/to the U.S., irrespective if flights are code-shared or operated on behalf of a U.S. airline.

However, like you corrected pointed out, the leg Tel Aviv - MAD is not covered. It could be only if the stop in MAD was part of the same flight and the same flight number applied to the last leg, but this is not the case for these guys.
True....and also the TLV-MAD leg would be covered under 382 as well if the flight were booked as a code-share on a US carrier. That's the tricky part for the US carriers to comply with as they have no control over the foreign airlines aircraft or services yet the DOT requires compliance with DOT 382 if their code is placed on the flight on the customer is booked on the US carriers flight operated by another airline. Confusing as all heck. Details under 382.7(c). When pushed on the subject, I'm sure most US carriers would fail to be in compliance with this provision.

382 for the foreign carriers is only required to be complied with on their own flights to/from the US. It's the US carrier who has to have compliance on the foreign carriers portion between two foreign points. Clear as mud?
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Old Nov 17, 2011, 9:30 pm
  #14  
 
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Originally Posted by Liba
I have a friend who will be flying internationally in March with her husband and three children. One child has Rett Syndrome, no communication, hand use and can't walk independently. She will be traveling in/with a wheelchair. The other two have seizure disorders that are controlled with diet. Their food has to be weighed and they need exact nutrition facts as well as oil with each meal.

In addition to doctors letters about medications, food and liquids, do they need to fill out MEDIF forms for all three children and get them pre-clearance to fly? The child in a wheelchair has no significant medical needs, except her wheelchair and walker. The other two are stable, except their seizures which are mostly controlled through diet and medication.
We're talking ketogenic diet, right?

I think that is going to be the hardest part of the trip.

First, I would not reveal to the airlines that the children have seizures. I have heard of pax being refused carriage for potential seizures, so as the condition seems to be under good control, don't invite trouble and tell the airlines about it. [FWIW I think it was a Canadian airline that refused the pax, but not positive on that]

I would instead carry doctor's letters with very strong wording, such as "this child has a life-threatening medical condition well controlled by use of prescribed therapeutic agents, including but not limited to liquid medications (i.e. the oil) and a medically managed diet, and therefore must travel with adequate food supplies not only for the expected duration of the trip but sufficient extra in case of unexpected delays" and "it is crucial that this child's medical diet be kept cold by means of chemical ice to prevent spoilage during a long flight" and similar sentiments. Their doctor might prefer a different wording, that's just my off-the-cuff way of conveying what they need.

It goes without saying that the kids can/should eat nothing provided by the airline, because you can't trust airlines to actually get medical diets right: speaking from experience here, folks.

If the family is traveling with a group of 18, are they the only special needs kids? Will the parents be able to count on extra hands, etc? They might request the child who might make noise to be seated in the middle of the group, so that those around her would be aware/sympathetic to her needs.
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Old Nov 18, 2011, 2:58 am
  #15  
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CDTraveler thank you for the advice. They most certainly are on ketogenic diets, and it is my friends biggest worry. Their seizures are pretty well controlled, no grand mal, with medications and diet, but the family is also at a point where seizures aren't an emergency. They don't run to the hospital even for GM seizures, they medicate and treat and call the neurologist. Generally they are caused by diet getting messed up (it is really hard with kids!) so sticking to their diet on the trip is extremely important to avoid seizures on the plane.

It would be hard to see their list of medications and diet needs and no realize that they have seizure disorders though. We also had to list each medication by name, especially the liquid ones, in our clearance letters when we flew with my tube fed, oxygen dependent child. They almost took away our hand sanitizer because it wasn't specifically listed in our letters. If the MCT oil isn't specifically listed, won't they run the risk of it being confiscated? That would be disastrous.

Thank you so much for the tips and things to think about!!
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