It's not a policy exception - it's confirming fit to fly, similar to the cast item mentioned upthread. If one claims they can't wear a thin piece of cloth, it makes sense to confirm they won't have issues with the air difference after takeoff.

With such concern for privacy, it can't possibly be someone on Facebook!

Let's see now. "Many laws regulate the privacy of medical information. Although they offer some protection, on the whole they operate more for the benefit of ensuring the flow of information throughout the health care industry than ensuring the privacy of individuals.”

https://www.eff.org/issues/law-and-medical-privacy

How do you get that from 382.19 (c) (1):
In determining whether an individual poses a direct threat, you must make an individualized assessment, based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence, to ascertain:
(i) The nature, duration, and severity of the risk;
(ii) The probability that the potential harm to the health and safety of others will actually occur; and
(iii) Whether reasonable modifications of policies, practices, or procedures will mitigate the risk.

It seems pretty cut and dry that any time a passenger asks for a policy exemption (dress code) due to a disability, the carrier is allowed to, at a minimum, make the determination of direct threat. They absolutely can ask for a medical opinion if the passenger is asking for a specific policy exemption, especially as it relates to communicable diseases. They can even ask for a supplemental medical opinion if they don't like the opinion provided by the passenger. It is the request for accommodation that enables the assessment, which is not profiling of passengers. 382.21 makes it clear that the assessment clause applies in cases of communicable disease.

So basically:
1. The passenger requests a policy exemption due to a disability, and this allows the airline to make an individualized assessment
2. The airline is allowed to assess if this exemption is a direct threat to other passengers
3. In making this assessment, they can rely on public health authorities (who recommend the use of masks), and then determine if a communicable disease is likely to be spread as a result of the policy change, i.e., does the passenger have COVID or not
4. Since it must be an individualized assessment, they can rely on their own medical experts to make the assessment (the phone/video screen) and may even make a supplemental assessment if the passenger has a medical certificate for the exemption

From 382.23:
You may also require a medical certificate for a passenger if he or she has a communicable disease or condition that could pose a direct threat to the health or safety of others on the flight.
As a carrier, you may require that a passenger with a medical certificate undergo additional medical review by you if there is a legitimate medical reason for believing that there has been a significant adverse change in the passenger's condition since the issuance of the medical certificate or that the certificate significantly understates the passenger's risk to the health of other persons on the flight.

It is a policy exemption, DL requires all passengers to have masks. Only if a passengers requests accommodation based on disability is one not required. While I understand the concern you post at end, the ACAA doesn't allow them to require it. The ACAA only allows it in a very few, very specific situations. Also people flew perfectly fine for decades without masks. You cant all of a sudden say if you can't wear a mask that some how you aren't fit enough to fly.

No one has said they can't make a determination. However to require a medical evaluation/ fitness to fly certificate requires falling under very specific criteria. YES, they can require IF the patient states they have CV19 or symptoms of CV19. Unless they have reason to believe the passenger has a disease they can't.

As for public health authorities, note the following directly from CDC, which is also included in every public health order.

Quote:

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Originally Posted by CDC

Cloth face coverings should NOT be worn by children under the age of 2 or anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.

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This is the problem here; the guilty until proven innocent really bothers me. It’s like everyone is a suspect! Seriously I’d rather just have a rapid COVID test at the gate and if negative; leave me alone I’m not wearing a mask! If positive, send me home!

It appears you don't know how the virus works, but the science shows that asymptomatic people spread the virus. Rapid covid testing of each passenger clearly is not a viable option. If you don't want to wear a mask, stay home. Bye.

If in return for not wearing a mask you can show a negative test from the past 3 days, i would seriously consider it for a long haul flight

Suppose I were to show up for a DL flight with a boarding pass for a middle seat (perhaps on a BE fare) and demand that someone else be moved involuntarily or offloaded so that I can get an aisle seat. As part of my discussion with DL staff, I assert emphatically that if I am forced to sit in a middle seat for more than twenty minutes, I will temporarily become paralyzed from the neck down and also rendered unable to communicate for several hours. DL would be well within their rights to require a medical assessment by DL medical staff/consultants or a fit to fly certificate form a medical professional who is treating me (or both) to determine whether it would be safe for me to travel alone without a a companion assistant to help me to evacuate the aircraft in an emergency. I don't look sick, but what I have voluntarily disclosed to DL employees raises questions about whether I am fit to fly.

BTW, I recall some previous publicized incidents involving other USA carriers where a family was denied boarding and required to present a fit to fly certificate for rebooking when kids showed symptoms of lice and IIRC measles. In those cases, presumably the illness or medical condition was obvious even to an untrained observer.

I wear the "cool flow" N95s respirators with the valve. They're design to filter out abestos, mold spores etc and the valve opens one-way only when you breathe out. These same valves are also built into 3Ms gas respirators and N100s and P100s. The user can easily insert a small piece of paper towel, napkin or a coffee filter around the interior of the N95 or N100 to diffuse the outgoing expelled air to exit only through the fabric of the respirator. The valve will never open. However, not possible with gas/particulate or p100 respirators, since there's no fabric involved.

When did anyone say that not wearing a mask is automatically not fit to fly? This is Delta seeing that someone is bringing an issue up related to breathing right before boarding a flight where the air is different in the sky vs the ground.

The requirement is new, but if someone presents a health issue that could cause a medical emergency onboard, Delta is within their right to confirm that person is fit to fly. There is no discrimination here, if a passenger says that they cannot breathe with a light bandana folded in half over their face, it could very likely be due to a severe respiratory issue. It makes sense that the airline wants to check that the person will not have a medical issue during the flight due to the thinner/drier air.

Until we fix our testing system that will be difficult. But otherwise I partially agree. I would still wear a mask in boarding but once seated with nobody next to me would remove it.

The rapid antigen tests are still fairly unreliable, but might be good enough for this purpose. The pcr tests are backlogged for over a week in general, so can not get one from 3 days pre travel.

I have been looking for a vacation while things are still cheap, and the inability to get a pcr test in 2 days is a showstopper for many places (usually they want 3 days, but we need some time to coordinate it),

yes at least remove the mandatory mask thing in that case and make it optional or recommended. I guess the USA is the epicentre of the outbreak so really strict about masks but in the uk people are finding it really funny they are making it mandatory while during the peak the government said no need for masks!

On British Airways if you are exempt and explain it politely to the cabin crew they do not challenge you further which is the polar opposite of what Delta is trying to do here

This is the issue. In these cases the airline had knowledge the person had a communicable disease/condition that could effect being medically fit. It was perfectly ok thus to require a clearance to fly.

In the case here DL has no knowledge of you having any sort of communicable disease/unfit medical condition. Thus they have no grounds to require a medical clearance.

For example, a diabetic whose been having low blood sugar. They request an accommodation due to having low blood sugar lately. They dont say anything about having low blood sugar. Thus airline has no grounds to require a medical clearance. If however during course of request they state its because of low blood sugar, then airline has grounds to request clearance.

Same with mask policy. If they say I need accommodation and make no mention of having a communicable disease then there's no grounds under ACAA to ask/require medical clearance. If OTOH they say it's because my breathing is impaired due to CV19/TB/etc or shows signs of such then they can be.

You're missing the point flying without a mask before CV19 no issue was raised about the person being medically fit. You cant all of a sudden say that the same set of conditions the next days raises concern. If OTOH they had been saying those with Asthma pre CV19 had a fitness concern, then raising the same objection now would be ok.