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If time and money aren't and issue and you want to be proactive, its completely reasonable to start working with a HIMS AME and initiate monitoring - quarterly meetings with HIMS AME, 14 drug tests in 12 mo, twice weekly AA meetings etc. Do you have a solid HIMS AME?

It's been my experience that every case is a little different. How high were the BAC's? How long ago were the DUI's? I've had some patients require the entire HIMS process and others that just require 3-4 months of monitoring and then certification. I'd recommend just following the requirements...

Strongly disagree. My last Fast Track ADHD patient had his certificate in hand less than 2 months from the day we met and I explained the process. I issued him the certificate without deferral on day of exam. And he could have gotten it done sooner if it wasn't for some personal travel plans...

I checked my magic 8 ball and it said "Ask again later" But tbh, I'm not sure why everyone is so focused on this point. It's not that difficult to just reach out to a HIMS AME and ask them for a few names in a specific geographic area. I get this request all the time and don't charge anything...

Each HIMS Psychiatrist is different in terms of their approach here. There is not a bonafide referral system between HIMS providers, but many of the different providers form professional relationships when they use them a lot. I collaborate a lot with my HIMS psychiatrists and...

Like Bruce already said, you may be a candidate for the new ADHD Fast Track (just went live in Oct/Nov 2023)! The criteria are: - No symptoms/treatment in last 4 years - No history of any other psychiatric diagnosis PRO TIPS: - Have a convo with your AME before completing the Med Express, and...

All of the HIMS psychiatrists I use in my local area (SLC, Utah) seem to vary their price based on what is being evaluated/required. There may be some that charge a flat fee for all evals, but this has not been my experience.

Are you sure you're working with a HIMS AME or is this perhaps just your AME? Any HIMS AME should be well aware of this process and give you the contact info for HIMS psychiatrists in your areas of interest. As stated several times above, it is definitely true we are prohibited from...

Hey Iggy, a lot of good advice above, but I'd suggest you have your current AME call the FAA in OKC and discuss your case with the doc of the day. That should get you some answers. GL Also...Neuro and neuropsych consults will typically happen at the FAS office in DC and this adds a lot of time...

I agree with Douglas about securing an appointment with a neuro-ophthalmologist if there is diagnostic uncertainty. That said, if in fact you do have pseudotumor cerebri/benign intracranial hypertension (BIH), you will require a special issuance. After satisfying all of the...

Bruce, regarding your comment "Decision path 1 (discontiuaition ) will not be available to her with a history of being on it for >5 years, or if there have been periods of off meds, then back on ("recurrence")" is this explicitly stated anywhere or just been your experience as a HIMS AME over...

I'm a little confused about the described case. This is an airman/applicant current on an antidepressant or has history of use? This has been my experience over the last year: For a simple Pathway 2 antidepressant case it will be about 6 months for decision on special issuance once a full...

Hey, HIMS AME here. I'll try my best to unpack and unconfuse this policy, but keep in mind it's all VERY new and I'm still learning the intricacies myself. Here is a BLOG POST I wrote about the policy when it first came out. Here is a link to the disposition table for FAA Policy itself. A...

Just let your AME know. They can easily modify.

Final review generally means the analyst has reviewed the package for completeness and it is now pending the review by the physician or specialist for a final decision. In some cases, they will determine that other information is still needed during the final review. Also to consider it...

Yes, HIMS AME here. We have a parallel column to write our own notes next to your comments. We also can change almost all of the data in the Med Express you entered and can just write 'marked in error' or 'forgot to disclose' etc...NBD.

If you had only the DUI alone (> 5 years ago and BAC < 0.15) the AME could issue the certificate on day of exam as long as you provided supporting documentation that would get uploaded to your Med Express for FAA review. Given the subsequent abuse/possible dependence on ETOH and concurrent use...

Agree with all of this. The FAA will commonly require 2-3 months minimum of 'monitoring' with a HIMS AME before consideration of any special issuance. Also, Birds of a Feather is a great peer support program for just pilots!

NO, this policy would not apply to deferred patients...BUT The FAA just released a new policy on 26 June that offers a Fast Track specifically for those currently deferred for mental health conditions. This could potentially help you, but the criteria are tight. Check it out...

1. Your AME can easily get an extension with a simple email to the regional office. Otherwise, you can call and get the extension. Also, I try to tell my airmen not to worry so much about the deadline. If you bust the deadline, you will receive a 'failure to provide' (FTP) letter, but it just...