Advice on HIMS Program

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Al1606

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Al1606
Hello Everyone,
First and foremost, I wanted to thank everyone that comes on and shares.
It has been a tremendous amount of help. I have posted in the past and was hoping to get some advice.
Specially from some of the senior HIMS AMEs.
Here is a recap of my story:

DUI conviction 24 years ago. Blew a .11.
DuI arrest 12+ ago, no conviction, dismissed, and fully expunged. I understand the FAA does not weigh in on expungements. BAC was 0.11.
Applied for a Medical in 1/17/2023 and got deferred.
Sought help from a local HIMS AME.
Saw a HIMS Psychiatrist. Report was really good. I do not meet DSM V criteria, but due meet the FAA definition of dependency.
HIMS AME initial to FAA with pretty much same report as above.
Started monitoring using SOBERLINK on my own. This was late FEB 2023.
Started AA and Smart Recovery meetings at least 3-4 a week.
Saw HIMS AME 4 more times with all positive reports to the FAA. Stating again that I don’t meet the DSM V dependency criteria.
that
Did aftercare with PHD specialist. He wrote a letter stating that I far exceeded anything that was expected and I do not have a substance use disorder.
Volunteered and completed and IOP with a PHD specialist. He wrote a letter stating that I do not have a substance use disorder.
Had a 10 panel random drug screening with negative results.
MY HIMS AME contacted the FAA multiple times and they agreed that I don’t need to do a COG Screening or another HIMS Psychiatrist report.
MY HIMS AME talked to one of the doctors at OSHKOSH and he stated hat I now need to do a COG Screening, another HIMS Psychiatrist eval and continue aftercare.
I got a copy of medical records with notes. It clearly states by one DR that the COG Screening and HIMS Psychiatrist report is not necessary.
I now have set up the COG Screening for late September.
I completed a SMART Recovery facilitator 30 hour training and I am now a certified SMART Recovery facilitator.
I now have almost 6 months of proven sobriety.
I have provided the FAA with all records, documents, arrest records, etc…

I am just stuck, frustrated, and don’t know what else I could be doing.
I did all this without a single requirement or correspondence from the FAA other than they need records from the arrests.

Any words of guidance would be much appreciated.

Thanks.
 
Two events in a lifetime is dependence. You'll need two years of proven sobriety at least and anything else AAM-300 decides to make up for you. The FAA doesn’t care what anyone besides the FAA says. Also, going through all of that without FAA approval could be seen as an admission of substance dependence…

Its like Vegas Vacation,

Give them half of your money and they’ll take you out back and kick you in the nuts

The only thing you can do is come back tomorrow and try again.
 
Keep doing what you are doing and be patient. The FAA desires 2 years of proven sobriety. My triggering events were 30 years ago and I have a very long term active recovery program. I am close to 18 mos since my deferral with a regular AME and still waiting. I did as you did and saw a HIMS Psychiatrist preemptively and had letters from my sponsor and others with whom I fellowship with in recovery meetings. The HIMS AME stated he had not seen any of his patients that prepared but the wheels at CAMI turn slowly...yet they do turn. Be patient and persevere.
 
JustSomeGuy73 said:
Two events in a lifetime is dependence. You'll need two years of proven sobriety at least and anything else AAM-300 decides to make up for you. The FAA doesn’t care what anyone besides the FAA says. Also, going through all of that without FAA approval could be seen as an admission of substance dependence…

Its like Vegas Vacation,

Give them half of your money and they’ll take you out back and kick you in the nuts

The only thing you can do is come back tomorrow and try again.
Click to expand...
That's a pretty strong definitive statement. "2 events in a lifetime is dependence"
Please back that up with some supportive literature. back it up the hyperbole please.
 
bigbird said:
That's a pretty strong definitive statement. "2 events in a lifetime is dependence"
Please back that up with some supportive literature. back it up the hyperbole please.
Click to expand...
I think the poster is referring to how AAM considers two events.
 
By the way everyone ever involved in HIMS should read the congressionally mandated study just out by Senator Jeanne Shaheen's office in NH.
It is not out in print yet but an advanced copy is available here: https://nap.nationalacademies.org/c...-programs-in-commercial-aviation-safety-first
read the entire study carefully and you might be enlightened to just how far FAA and HIMS don't want any outside reviews of their practices.
The recommendations from the committee align current medical standards and not that of the FAA unpublished internal policies.
Check out.
Appendix C
Communications between the Committee and the FAA, HIMS,
ALPA, and Congressional Staff
as an example of the programs stonewalling techniques.
Also the incredibly low response from pilots to comment on the efficacy of HIMS was best addressed by their statement on page 5-12
"the committee never received indications that HIMS and​
its administering organization, Air Line Pilots Association–International (ALPA), ever​
distributed the link or sought pilot participation."​

I hope that this brings lots of discussion and I urge all pilots that may have insight to share with the authors, to do so.
I have yet determined how best to submit my experiences to the committee.
I'll reach out to Senator Shaheen's office and publish the results shortly.
-t
 
bigbird said:
Agreed.... but that states to DEFER
Click to expand...
Yes...and then we know where that leads to. Typically a denial with the HIMS option for SI. Hopefully the study you cite in your other thread leads to practical changes in the process.
 
bigbird said:
By the way everyone ever involved in HIMS should read the congressionally mandated study just out by Senator Jeanne Shaheen's office in NH.
It is not out in print yet but an advanced copy is available here: https://nap.nationalacademies.org/c...-programs-in-commercial-aviation-safety-first
read the entire study carefully and you might be enlightened to just how far FAA and HIMS don't want any outside reviews of their practices.
The recommendations from the committee align current medical standards and not that of the FAA unpublished internal policies.
Check out.
Appendix C
Communications between the Committee and the FAA, HIMS,
ALPA, and Congressional Staff
as an example of the programs stonewalling techniques.
Also the incredibly low response from pilots to comment on the efficacy of HIMS was best addressed by their statement on page 5-12
"the committee never received indications that HIMS and​
its administering organization, Air Line Pilots Association–International (ALPA), ever​
distributed the link or sought pilot participation."​

I hope that this brings lots of discussion and I urge all pilots that may have insight to share with the authors, to do so.
I have yet determined how best to submit my experiences to the committee.
I'll reach out to Senator Shaheen's office and publish the results shortly.
-t
Click to expand...
The reason why alpa refuses to share or change anything related to HIMS is so that all their “henchmen” aka HIMS Ames neuropsychologists, psychiatrists, social workers and other support staff is they are making a FORTUNE off of it. The amount of money someone can make from just being a HIMS ame is absolutely insane. There are HIMS Ames out there charging $500-$600 an hour and charge by the minute. It is so corrupt and needs actual oversight from someone either than the faa or alpa. Some of these people should be arrested for conspiring and succeeding in taking peoples careers and livelihood away from them. It has profound effects on pilots and their family’s. Read up on karlene petit and you’ll see the corruption and abuse of using mental health for airlines to get rid of “problem” pilots that just want to fly and have a safer airspace system. There should be a system in place for pilots to report HIMS professionals that are crooked but the faa protects them and just doesn’t care.
 
I appreciate everyone's comments.
I have done everything I humanly can. I have my COG screening set up and my 2nd HIMS Psychiatrist exam.
Thus far I am in the $20K range. All along, 4 doctors include two FAA HIMS AME's have proven to the FAA that I don't meet DSM-V criteria.
Do I have to physically wait 2 years, or will and SI be issued with conditions.
In my medical file notes it does clearly state "SI consideration will be granted if a formal IOP is completed at a minimum".
I have now done the IOP and Aftercare. Both formal from a PHD and my HIMS AME sent them the report.
 
Al1606 said:
I appreciate everyone's comments.
I have done everything I humanly can. I have my COG screening set up and my 2nd HIMS Psychiatrist exam.
Thus far I am in the $20K range. All along, 4 doctors include two FAA HIMS AME's have proven to the FAA that I don't meet DSM-V criteria.
Do I have to physically wait 2 years, or will and SI be issued with conditions.
In my medical file notes it does clearly state "SI consideration will be granted if a formal IOP is completed at a minimum".
I have now done the IOP and Aftercare. Both formal from a PHD and my HIMS AME sent them the report.
Click to expand...
It sounds like if you give them what they want and you have negative drug screenings you’ll get your medical certificate. I don’t think you’ll need 2 years. I’m not a HIMS ame but from my 5 years in the HIMS program I’ve seen dozens of airline pilots get there medical back in 6-8 months.
 
George S said:
It sounds like if you give them what they want and you have negative drug screenings you’ll get your medical certificate. I don’t think you’ll need 2 years. I’m not a HIMS ame but from my 5 years in the HIMS program I’ve seen dozens of airline pilots get there medical back in 6-8 months.
Click to expand...
Thank you for the words of encouragement.
The sad thing about this is that I am a 3rd class medical. I am not in the airlines. This is not my living. I did all this for my love of aviation. I paid over $20K to multiple doctors, attroneys, SOBERLINK, etc, and not a single response in over 6 months.
I took a proactive approach and did everything I could. I wish they would just give me a straight forward answer and let me know what to do.
Did I mention over 600+ negative SOBERLINK tests. I have a very successful business and SOBERLINK was much more efficient for me.
 
Al1606 said:
Thank you for the words of encouragement.
The sad thing about this is that I am a 3rd class medical. I am not in the airlines. This is not my living. I did all this for my love of aviation. I paid over $20K to multiple doctors, attroneys, SOBERLINK, etc, and not a single response in over 6 months.
I took a proactive approach and did everything I could. I wish they would just give me a straight forward answer and let me know what to do.
Did I mention over 600+ negative SOBERLINK tests. I have a very successful business and SOBERLINK was much more efficient for me.
Click to expand...
you most likely will not hear from them until at least 8 months. I would recommend contacting your representative or senators office and tell them the faa is not telling you anything and that it’s been over 6 months. I know of some people whose application took SIGNIFICANTLY longer to be processed.
 
its interesting that people think a doctor charging $500 is criminal and corrupt. . . . if you dont think a licensed doc makes close to 1m (gross), you're the delusional one. Thats assuming fully booked out for 2000+ hours a year (or 50 weeks at 8 hrs/day).

Thats the irony - people dont realize the actual cost of human labor being billed out these days are. Pilots making $250k-$300K per year or approximately $350-$400 per hour is totally fine. But a doc works way more hours and every day than a pilot with their on day and off days is criminal and corrupt. . . . But the reality is that most pilots cant make it through med-school and residency. . . You dont want to start with how many people who say they cant learn things this way, they are visual learners, and everything else. . . Docs generally dont get that choice - they went to school and learned the hard way.
 
Anthem said:
its interesting that people think a doctor charging $500 is criminal and corrupt. . . . if you dont think a licensed doc makes close to 1m (gross), you're the delusional one. Thats assuming fully booked out for 2000+ hours a year (or 50 weeks at 8 hrs/day).

Thats the irony - people dont realize the actual cost of human labor being billed out these days are. Pilots making $250k-$300K per year or approximately $350-$400 per hour is totally fine. But a doc works way more hours and every day than a pilot with their on day and off days is criminal and corrupt. . . . But the reality is that most pilots cant make it through med-school and residency. . . You dont want to start with how many people who say they cant learn things this way, they are visual learners, and everything else. . . Docs generally dont get that choice - they went to school and learned the hard way.
Click to expand...
Average doc makes $350K, not 1m.

 
I spent 14 years of continuous higher education at no to minimal income to obtain my degrees/specialty certification. I was very fortunate to have family fund the educational costs for most of the path so I was one of the few of my colleagues that entered private practice without educational debt but many did incur a couple of hundred thousand dollars of debt in 1990's $$$. Now days upwards of $350-400K student loan debt is common. You bet I don't have an issue with an AME charging $500/hr. That being said, (and as much as I think the aeromedical division is flawed in its process) no one is making a fortune off of the exams.
 
The costs are not a major factor for me.
Neither is being 100% compliant. Being stuck in Limbo with zero responses and then when your HIMS AME get's two different requests is a concern.
I just wish they had a list of task items they wanted us to complete. I already had one COG Screening scheduled until Dr. Teague noted that it was not necessary.
The the next doc says: "Well we will want to see a COG screening and a second HIMS psychiatrist report".
How can they go back on their word and just waste peoples' time like this. Just does not make much practical sense coming from Medical Professionals.
 
Anthem said:
its interesting that people think a doctor charging $500 is criminal and corrupt. . . . if you dont think a licensed doc makes close to 1m (gross), you're the delusional one. Thats assuming fully booked out for 2000+ hours a year (or 50 weeks at 8 hrs/day).

Thats the irony - people dont realize the actual cost of human labor being billed out these days are. Pilots making $250k-$300K per year or approximately $350-$400 per hour is totally fine. But a doc works way more hours and every day than a pilot with their on day and off days is criminal and corrupt. . . . But the reality is that most pilots cant make it through med-school and residency. . . You dont want to start with how many people who say they cant learn things this way, they are visual learners, and everything else. . . Docs generally dont get that choice - they went to school and learned the hard way.
Click to expand...
Most doctors make nowhere near 1million. I have multiple physicians in my family and if you combine their salary they still don’t make that. Where did you come up with that? The average a HIMS ame charges per hour is around $200. You think dr chien charges $500/hr? If anyone can command that much it would be him and he doesn’t do it because he actually cares about getting people back in the air and not being a pig.

If a doctor was paid 500/hr for actually practicing REAL medicine, and not this fake aviation medicine garbage then I would absolutely agree that they should be paid $500/hr, but they don’t. The average salary for a hospitalist in Florida is 215-225000 a year working seven on and seven off for over 12 hours each shift.
 
George S said:
Most doctors make nowhere near 1million. I have multiple physicians in my family and if you combine their salary they still don’t make that. Where did you come up with that? The average a HIMS ame charges per hour is around $200. You think dr chien charges $500/hr? If anyone can command that much it would be him and he doesn’t do it because he actually cares about getting people back in the air and not being a pig.

If a doctor was paid 500/hr for actually practicing REAL medicine, and not this fake aviation medicine garbage then I would absolutely agree that they should be paid $500/hr, but they don’t. The average salary for a hospitalist in Florida is 215-225000 a year working seven on and seven off for over 12 hours each shift.
Click to expand...
You guys are stuck on “salary”. I’m saying that doctors will “gross” over 1m in billings. I should probably have made that more clear. But most any established doc will net bill over 1m for their practice. Now what they net after wards - absolutely is lower. I didn’t just use “take home pay”.

But that doesn’t change the concept that people have of what is charged. Whether that’s attorneys, docs or psychiatrists. If you are trying to get in to a profession that bills out at 350-400 / hour - and calling another profession that bills out at 500 is corrupt - you’re just way off base.
 
Al1606 said:
All along, 4 doctors include two FAA HIMS AME's have proven to the FAA that I don't meet DSM-V criteria.
Click to expand...

You have made this statement about DSM V multiple times. Are you aware that the FAA uses DSM IV? I'm guessing you are aware, and if so, have you looked up whether you meet the standards for dependence according to DSM IV?
 
Anthem said:
. . . . if you dont think a licensed doc makes close to 1m (gross), you're the delusional one...
Click to expand...

Gross ≠ Collection Rate ≠ Fully Loaded Labor Cost ≠ Gross Pay ≠ Net Income. Billing rate ≠ negotiated rate paid

For the sake of argument, let’s take an independent practitioner billing $1M/year. That GP is below the average for GPs of $1.7M billed annually and $3.8M across providers among 18 specialties according to the 2023AMN Healthcare Billing Report. AMN states up front that the billing rate is relatively meaningless as collection rates of 50% seems to be a good average.


P.10 suggests salary is somewhere between 5% and 15% of billings.
 
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What @TCABM states is a fairly accurate assessment. If I had to rely solely on reimbursement by contract with insurance companies and Medicare/Medicaid the collections would be about 10-15% above my true overhead. For the time and financial investment made to perform the services I preform and the associated stress and liability, if I only was paid 15% on my efforts, before taxes mind you, I would not have chosen my profession. I would have pursued a better paying career that is less stressful and did not require such a long time investment for entry. However, I do not rely upon insurance contracts and my income is at a level that does make the above mentioned detractors worth it. I am very fortunate in that respect. I mean, hell, I can afford an airplane and time to p**s and moan on an aviation forum :) .
 
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Without getting in to the actual specifics - the point I was trying to make was that someone calling out someone as corrupt for charging $500 / hour for services was kind of rich when they were trying to be in the professional pilot profession - where they charge $350-400 per hour for senior pilots….. but somehow that’s ok.
 
Anthem said:
Without getting in to the actual specifics - the point I was trying to make was that someone calling out someone as corrupt for charging $500 / hour for services was kind of rich when they were trying to be in the professional pilot profession - where they charge $350-400 per hour for senior pilots….. but somehow that’s ok.
Click to expand...
It’s not just about some HIMS ame trying to milk all the money they can out of you. You could be in excellent recovery have a sponsor and work all 12 steps and if a HIMS Ames does not simply like you they can ruin your chance of regaining a medical. Did you look up karlene petit? She is a prime example of what happens if the airline wants to get rid of you. Multiple HIMS ame and HIMS psychiatrists were paid off by the airline to give her fake diagnoses of various mental health issues to push her out of delta. This is just what has been reported in the news. Going to any random HIMS ame on the faa list is like gambling. This is the corruption I’m talking about and it’s rampant in HIMS.

On a side note, you can’t really compare a pilot getting paid $250,000+ a year from a publicly traded billion dollar airline vs a HIMS ame charging a jobless individual over $500-600/hr and is trying to make ends meet and support an entire family.

www.seattletimes.com

Seattle pilot fought back after Delta ‘weaponized’ mental health rules

When Delta grounded her after securing a bogus bipolar diagnosis, Seattle-based pilot Karlene Petitt fought back. She resisted. And she won.
www.seattletimes.com www.seattletimes.com
 
You are using the example of where delta weaponized the ame to try to get rid of someone they didn’t want. But yet - I imagine you and many others would kill to work for that same company, right ? Doesn’t seem to stop anyone from wanting to work for delta……

But the reality is the situation is that the FAA would actually prefer not to have to deal with the HIMS and si process. And believe it or not - the majority of the public Is potentially the same. They don’t want airline pilots that had prior drug or alcohol abuse problems, or history of suicide or depression. On or off drugs. Would the public prefer a group of pilots that don’t have potential anxiety and depression problems or a group that needs to take random drug tests to prove their alcohol and substance problems are in remission ?

But
 
Anthem said:
Without getting in to the actual specifics - the point I was trying to make was that someone calling out someone as corrupt for charging $500 / hour for services was kind of rich when they were trying to be in the professional pilot profession - where they charge $350-400 per hour for senior pilots….. but somehow that’s ok.
Click to expand...

Most airline pilots don’t bill for services provided and most of them are interchangeable widgets participating in an agreed to labor agreement with their employer. The airline sells a contract for carriage and may not even cover it’s expenses on a per fare basis. Most pax aren’t captured by a requirement to fly on a plane flown by a specific crew, most pac don’t fly as the only pax with tailored, high touch service, either.

Apples and walnuts; makes a great salad, but entirely different things.
 
TCABM said:
Most airline pilots don’t bill for services provided and most of them are interchangeable widgets participating in an agreed to labor agreement with their employer. The airline sells a contract for carriage and may not even cover it’s expenses on a per fare basis. Most pax aren’t captured by a requirement to fly on a plane flown by a specific crew, most pac don’t fly as the only pax with tailored, high touch service, either.

Apples and walnuts; makes a great salad, but entirely different things.
Click to expand...
Absolutely. So interchangeable widgets billing at 350-400 per hour is any more or less corrupt than a more highly educated profession billing at 500 ? Just because you don’t like the profession or like the reason they are there doesn’t make them corrupt or not corrupt. And calling one example out - where that ame was weaponized by the very employer that most still want to work for and justifying the corruption call……

And to be clear. I am not a doctor or hold any advanced degrees. Nor do I work for or desire to work for an airline. And furthermore, I actually hold an SI on my medical (though not HIMS based).
 
Anthem said:
Absolutely. So interchangeable widgets billing at 350-400 per hour is any more or less corrupt than a more highly educated profession billing at 500 ? Just because you don’t like the profession or like the reason they are there doesn’t make them corrupt or not corrupt. And calling one example out - where that ame was weaponized by the very employer that most still want to work for and justifying the corruption call……

And to be clear. I am not a doctor or hold any advanced degrees. Nor do I work for or desire to work for an airline. And furthermore, I actually hold an SI on my medical (though not HIMS based).
Click to expand...
This wasn’t a case of just one ame that was being used against a pilot. It was an entire team of HIMS Ames and HIMS psychiatrists that are supposed to be independent and provide work for delta and alpa. The psychiatrist that made up the fake bipolar diagnosis lost his medical license. There are MANY cases of this same thing happening. Only this one has made it to the news. Just because people still want to fly for delta doesn’t make it ok that doctors and airline admin falsify data to get rid of pilots that do not have anything wrong with them
 
George S said:
This wasn’t a case of just one ame that was being used against a pilot. It was an entire team of HIMS Ames and HIMS psychiatrists that are supposed to be independent and provide work for delta and alpa. The psychiatrist that made up the fake bipolar diagnosis lost his medical license. There are MANY cases of this same thing happening. Only this one has made it to the news. Just because people still want to fly for delta doesn’t make it ok that doctors and airline admin falsify data to get rid of pilots that do not have anything wrong with them
Click to expand...

It also doesn’t justify painting with brooms, either. Someone who is applying for their first Class 3 won’t have Part 121 company limitations out on them.

The OPs scenario is for an initial Class 3; it appears his frustration is with FAAs lack if response despite his proactivity.
 
My issue is the back and forth with no clear direction.
As I mentioned before, I took this on all on my own and from reading.
We did everything less the COG screening in under 6 months.
Multiple calls with the FAA with my HIMS AME and not a clear answer. Rather, two conflicting answers.
I have been 100% compliant.
If any docs our there or anyone else could give some words of encouragement, that would be great.
 
They sent me an initial letter over 7 months ago asking for the standard court records, arrest records, DMV records etc.
I took it upon myself and did the following in the last 7 month:

1. HIMS Psychiatrist EVAL. Looks good. No major issues. Recommended 14 UA in 12 months.
2. HIMS AME Initial eval. Looks good, same as above.
3. Started soberlink monitoring with my AME. 600+ Negative test results for over 6 months.
4. Attended 105 AA and Smart Recovery meetings with proof of attendance and a log. Submitted my log to my AME.
5. Did and IOP.
6. Did and Aftercare.
7. 10 panel drug screening with negative reulsts.
8. I now have my COG Screening set up which my medical records show was not necessary, now they are saying they want it.
9. MY HIMS AME wrote them 4 letters stating how well I am doing and that I am 100% compliant and not a dependent.

Yet, nothing.
 
Al1606 said:
They sent me an initial letter over 7 months ago asking for the standard court records, arrest records, DMV records etc...
Click to expand...
Has the FAA been provided each specific item they asked for in the letter?
 
TCABM said:
Has the FAA been provided each specific item they asked for in the letter?
Click to expand...
100%. To a "T".
I also had MY HIMS AME verify they got everything.
I also followed with calls to confirm.
Just very frustrating.
 
The FAA will review the information you sent whenever it floats it's way to the top of the pile. You will eventually get another letter asking for more information, offer to enter HIMS with a set of requirements, OR an issued medical (if you are very very lucky). This wait time can be several months for 1st, 2nd class medicals or many many months for 3rd. You just have to hang tight and wait for further instructions. Be patient and work the process as directed. Don't be surprised if it takes 18 months or longer.
 
skywalker09 said:
The FAA will review the information you sent whenever it floats it's way to the top of the pile. You will eventually get another letter asking for more information, offer to enter HIMS with a set of requirements, OR an issued medical (if you are very very lucky). This wait time can be several months for 1st, 2nd class medicals or many many months for 3rd. You just have to hang tight and wait for further instructions. Be patient and work the process as directed. Don't be surprised if it takes 18 months or longer.
Click to expand...
I understand. They should not ask for anything else. We have been extremly proactive and my medical files show this.
The only possible thing they could as for is an inpatient, which I cannot do with my business.
 
Al1606 said:
100%. To a "T".
I also had MY HIMS AME verify they got everything.
I also followed with calls to confirm.
Just very frustrating.
Click to expand...

Waiting for a decision is the hard part.
 
The docs can chime in, but by all accounts, this seems to be a 12 month process
 
Anthem said:
The docs can chime in, but by all accounts, this seems to be a 12 month process
Click to expand...
The FAA literally can't get out of its own way sometimes, i.e. they have created the backlog, and the failure to reduce the backlog just creates more backlog.

There's no shortcut for someone like the OP, who seems to have done everything possible and is extremely unlikely to be any higher risk to the public than the average pilot who drinks occasionally (like most people) but just remains un-trapped by the FAA's nets so far.
 
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