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medical letter to justify pre-boarding for 'invisible' condition?

medical letter to justify pre-boarding for 'invisible' condition?

Old Jul 7, 19, 12:28 am
  #1  
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medical letter to justify pre-boarding for 'invisible' condition?

I don't have a physically visible disability. I'm a survivor of a Pituitary tumor, which has left me with partial Pituitary insufficiency, which - this month (it is still evolving) - leaves me with what might be called "sub-clinical hypothyroidism" or "relative hypothyroidism". It's real enough that - after a couple of months of progressive blood hormone level analyses and discussions with my endocrinologist - I am now taking thyroid hormone supplements (which will take months to balance out, and while I'll have to monitor and tweak from time to time for the rest of my life).
So I don't have adrenal insufficiency and I don't have the crises that some of my acquaintances with similar causes but different, life-threatening effects have to deal with, but I definitely have low energy days which make long lines and physically stressful situations more difficult for me, and I've got precious little tolerance left for other passengers' bad behavior and for the stress caused by most airlines these days which make it a roulette game whether your "approved carry-on" will actually end up being carried on by you, or whether the airlines' allowed-by-useless-regulators hyperconfiguration of the cabins will mean that "everyone from here back in the line has to gate-check their bags".

When practical, I pay for early boarding so I don't have to stand in crowded lines for an extra 30-40 minutes to hopefully be near the front, but even that's not always an option with airlines these days. (Strangely enough, Ryanair gets this more right than almost any of the other discount airlines; of the "major" carries, here in Europe I think only Lufthansa/Swiss actually *don't* over-configure their cabins so that each passenger with their one allowed shape and size carry-on actually can indeed carry it on, but a Lufthansa agent yesterday said something to me which suggests that even they might be going this obscene way.)

So I'm giving in to making use of my medical condition to benefit from the airline industry's practice of inviting passengers who "need a little extra time boarding" to pre-board. Here's the question, then:
  • What should I ask my doctors to write in a medical letter which basically says "I've got this invisible thing in my head, messing up my hormones, making me sometimes have really bad days, such that it's reasonable for me to get up and board early when 'people who need a little extra time ...' is called .. while avoiding a medically-ignorant airline staff member arguing "You don't LOOK like you need extra time". (And, to avoid "You should have requested wheelchair assistance". I don't need a wheelchair. I need less time unnecessarily standing in line, and I need less stress).
  • Is there industry-wide understood text that should I ask the doctor to include in this letter so that it works for most airlines?
  • How often should I get the letter re-issued by a doctor (that is, how old does it seem to be ok for a medical letter to be before an airline challenges whether it's still valid)?
  • Must I tell the airline about my 'special need' when I buy the tickets or anyway in advance of the day of flight, or could I reliably just get up when they call pre-boarding and have the letter in hand in case they challenge me?
  • Other advice?
thanks!
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Old Jul 7, 19, 12:39 pm
  #2  
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Welcome to the Disability Travel forum - probably not where you wanted to wind up.

Unfortunately I'm US-based, so I'm not necessarily familiar with what rights EU disability legislation gives you. Here in the US (and on flights that begin or end in the US, regardless of carrier) you do not need a letter of medical necessity, and while it may be helpful to request pre-boarding when you book a ticket, it's also not necessary. You are only require to self-identify to the gate agent as needing "additional time or assistance to board, stow accessibility equipment, or be seated." (14 CFR 382.93).
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Old Jul 8, 19, 12:01 am
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Thank you Katja. You're right, I'd never imagined ending up learning as much as I have learned about Pituitary tumors, Endocrine system problems, rare hormone related diseases, etc. I also never imagined the quantity and quality of helpful people from all over the world whom I'd find, among patients and doctors and friends, to make it easier. And I'm actually fairly lucky (within the realm of people who've heard the words "You have a tumor") in that its effect on me, so far, has been mostly discomfort and inconvenience, rather than threat of death or great incapacity.

I looked up the EU regulations and found, at https://europa.eu/youreurope/citizen...y/index_en.htm, a reference to "Regulation (EC) N 1107/2006 of the European Parliament and of the Council of 5 July 2006 concerning the rights of disabled persons and persons with reduced mobility when travelling by air", which among other things states:
"Q2: Is it admissible to request proof from disabled persons and persons with reduced mobility about their medical condition?

No. The Regulation does not impose any obligation on disabled persons and persons with reduced mobility to provide evidence of their disability or reduced mobility (whether medical or other) in order to justify the assistance requested. Thus, carriers are not allowed to ask for such a proof as a precondition of selling a ticket or of permitting carriage."
However, it does go on to point out two situations in which medical evidence may be required by an airline, the first of which makes perfect sense (and wouldn't apply to me):
"However, in situations where the medical condition of a passenger is such that there is reasonable doubt that the passenger can complete the flight safely without requiring assistance during the flight, an air carrier may assess whether the passenger is fit-to-fly and request information to support that assessment."
.. and the second which I could imagine running into, looking rather better than the average post-holidaymaker after his or her last-night-of-holiday binge...:
"Only where an assistance provider identifies an obvious situation of abuse should a more specific in-depth enquiry be undertaken. "
Thus, as we all have met the occasional .. person who woke up on the wrong side of the planet .. working in the travel industry, I'll still ask my doctor for a letter, but it seems that "He has a tumor which sometimes knocks him on his *ss" (or something a bit more medically correct) ought to be more than sufficient.

thanks very much,
Jay
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Old Jul 8, 19, 1:30 pm
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Regardless of whether EU or US law and regulations apply, one thing I'd suggest is to not over think or over elaborate the information you provide to airport/airline personnel. There is a service you need, pre-boarding. That's all. It doesn't matter if you look like you need it or not. If you start explaining why you need it, or what aspects of it you need, you'll go nuts, and it won't help.

My simplified example: a disabled friend reported to me that she informed the airline that she could walk up a few steps, and she was distraught when it turned out that she was expected to walk up a full flight of steps. The problem here is that to the airline, it's binary: you can walk up steps, or you can't walk up steps. Nobody is going to keep track of the fact that you can walk up three steps but not up twenty. In this case the correct answer, when asked if you can walk up steps, is "No." Keep it simple. If accepting the wheelchair, despite the fact that you can walk, is going to get you the service you need, take the wheelchair.
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Old Jul 9, 19, 1:22 am
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great advice

Thanks Katja. That's great advice.
In my case, fortunately, it is simple - I can do anything except stand in long stressful queues. So, when they call pre-boarding, I'll stand up. Fingers crossed.

Originally Posted by Katja View Post
The problem here is that to the airline, it's binary: you can walk up steps, or you can't walk up steps. Nobody is going to keep track of the fact that you can walk up three steps but not up twenty. In this case the correct answer, when asked if you can walk up steps, is "No." Keep it simple. If accepting the wheelchair, despite the fact that you can walk, is going to get you the service you need, take the wheelchair.
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Old Jul 9, 19, 10:40 am
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I have a mostly invisible disability (2 of them, actually, as life has continued its journey...).

I always request a wheel chair, and have never had a problem requiring an explanation. I've been asked appropriate things such as "can I climb stairs?", "can I walk down the airplane aisle myself", etc.
I cannot walk long distances and especially cannot stand in place for very long, so I just explain that, and have never had anyone question it, not in the USA/Canada, several countries in Western Europe, and in Japan or Hong Kong.

However, I do sometimes feel that some other passengers are staring daggers because they don't "see anything". In that respect, it was sort of easier for a few years when I had to wear one of those medical walking boots. (Back then, it always generated a huge delay at security, because they had to do the slower chemical swabs, which seemed to be triggered by a lot of false positives, leading to more swabbing. The new techniques seem far more robust/accurate, which is good for many reasons!).

For a few meds, we do carry physician letters and original scripts, but... we've never been asked for any such thing.

GC
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Old Jul 9, 19, 12:53 pm
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In neither the US nor the EU must you disclose the specific nature of the disability and why it is that the disability requires pre-boarding. Some carriers may require that you disclose the need to staff at the gate and others do not, but it makes sense to do so inasmuch as you might be the only passenger requiring it.

There is no requirement of a letter from a physician and there is no requirement that you discuss any particular issue. Thus, in your case, "I am unable to stand in long lines and require pre--boarding" is the extent of what you must and should disclose.
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Old Jul 9, 19, 1:33 pm
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I have a friend that always pre-boards because she can't stand in line for more than a few minutes. She's got a broken back, but can walk and function fairly normally, just not for an extended period of time. She at first felt bad for requesting pre-boarding, but as her condition worsened over the years, she found herself having to sit down in line suddenly, and then had a hard time getting back up, even with assistance. Pre-boarding is for people like her, it allows the regular line to function normally, while giving her enough time to make it down the jetway and into her seat without ending up completely exhausted, or on the floor. She gets wheelchair assistance only if the walk to the gate is lengthy, if not, she goes to the gate and let's the GA know that she'll require pre-boarding, b/c she can't stand for long (nothing else but that statement has ever been required). That way, they know why she's pre-boarding (and won't question her while cuing up with the pre-board customers), usually give her a seat close to the gate, and even prompt her when it's her turn.
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Old Jul 16, 19, 7:44 pm
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I always travel with my handicapped placard, just in case someone questions my need to sit in designated seating at the gate, or preboard. I can usually walk to the gate unless its long way, but if I need a wheelchair, I just smile and say its not a good day to walk.
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Old Jul 16, 19, 9:58 pm
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Originally Posted by Often1 View Post
There is no requirement of a letter from a physician and there is no requirement that you discuss any particular issue. Thus, in your case, "I am unable to stand in long lines and require pre--boarding" is the extent of what you must and should disclose.
On "bad days" I request pre-boarding at the gate before boarding has even started, so that the GA is aware there is someone who needs it. These days I keep my request very simple: "I would like to pre-board for medical reasons."

Only once ever had a problem, and that was with JetBlue at LGB. Some wheelchair pusher (not the GA) demanded that I use a wheelchair to pre-board and I refused because it wasn't just a trip down the jetway. It would have been wheelchair across the tarmac to the stairs where they strap you to a different chair and 2 guys dragged it up the stairs (like they did to an older gentleman ahead of me - THUMP, THUMP, THUMP up the stairs).
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Old Jul 20, 19, 8:39 am
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Originally Posted by Often1 View Post
In neither the US nor the EU must you disclose the specific nature of the disability .
In the EU, (at least France) you are required to have a government issued ID card which states your what your disability is. Even if you are blind with a seeing eye dog, they often ask for it - esp if you go into a grocery store
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Old Jul 20, 19, 8:56 am
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That's true in Germany, too, but we're talking about getting on to flights, not getting the disability ticket price at a museum.
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Old Jul 20, 19, 9:17 am
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Originally Posted by knownothing View Post
In the EU, (at least France) you are required to have a government issued ID card which states your what your disability is. Even if you are blind with a seeing eye dog, they often ask for it - esp if you go into a grocery store
This has nothing to do with grocery stores.

The requirements relating to disabilities are specific to commercial air carriers operating in and out of the EU (and USA).

What you have suggested is completely untrue for air travel and while you are free to show whatever you wish or to provide as much information as you wish, you need not.
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Old Jul 21, 19, 8:58 am
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Originally Posted by Often1 View Post
This has nothing to do with grocery stores.

The requirements relating to disabilities are specific to commercial air carriers operating in and out of the EU (and USA).

What you have suggested is completely untrue for air travel and while you are free to show whatever you wish or to provide as much information as you wish, you need not.
It has to do with grocery stores and air lines. The rules are the same unlike the US where apparently the Amer with disability Act does not apply to airlines. In France the rules are the same whether you are entering a grocery store with your dog or flying. You must have a government issued ID that states the disability. And emotional support etc is not considered one
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Old Jul 22, 19, 6:11 am
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Often1 is right, the EC specificially states that the traveler does not have to have a ID stating disability.
https://ec.europa.eu/transport/sites...012-171_en.pdf

Q2: Is it admissible to request proof from disabled persons and persons with reduced mobility about their medical condition? 4 No. The Regulation does not impose any obligation on disabled persons and persons with reduced mobility to provide evidence of their disability or reduced mobility (whether medical or other) in order to justify the assistance requested. Thus, carriers are not allowed to ask for such a proof as a precondition of selling a ticket or of permitting carriage.
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