Anxiety & depression history leading to medical issues

F

Flyingsausage

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I recently received a letter from the FAA stating that they cannot confirm my eligibility for a medical application. I'm very confused about this situation, as I received my medical five months ago without any concerns from my AME. Prior to this latest medical issuance, I have held two other medicals. Each time, I reported that I had a history of anxiety and depression as a teenager. Each time, the AME confirmed it would not be an issue (I have used two different AMEs). I'm confused as to why I am suddenly receiving this letter from the FAA, when I've held a medical for the last 5 years and my history of anxiety and depression was never a concern previously. How can it suddenly be a concern after 5 years?

The letter is requesting I provide every medical document that details any treatment I received, any history of suicidal thoughts or tendencies, any medications, any diagnoses, any treatment plans, etc.. Unfortunately, I'm not even sure if these records still exist. I was treated for these issues as a teenager. I'm now in my mid twenties. Physicians in my state are not required to keep medical records past 7 years, so I'm not sure if the documents are even available. Even more so, I'm worried if I do manage to get a hold of the documents that there could be something in there that would cause concern. I have never attempted suicide or self harm, but there was one occasion in middle school of me feeling suicidal. It was so long ago and I was just a kid so I'd imagine it can't be that big of a deal, but I also don't know how the FAA responds to such things. The concept of losing my medical over the way I felt when I was 13 seems insane to me. I have tried calling my AME but he isn't available until the end of the week to discuss the situation.

Has anyone been in a similar situation? If so, what was your course of action? What's the likelihood of me having my medical revoked over these issues? How is it that my application can be in question after already being issued the medical?
 
What they are basically saying is the AME that issued your certificate probably should have and they want more information before revoking your current certificate.
 
The bad news is that you don't have a choice now but to give the FAA what they want, otherwise they will revoke your medical. Do not miss the 60 day response window and request extensions if necessary to get them documentation on time.

The good news is that depending on how the records look and how long ago this was, there is a long and expensive but available road for you to keep your medical. @bbchien will be along shortly to tell you that if you have a history of recurrent disease, untreated and unmodified, the FAA will 100% deny your medical. That means if you had anxiety and depression for more than 6 months and have done nothing about it since then, the agency thinks you're off the rails and won't issue. HOWEVER, there is also an unwritten rule at the FAA that if it has been 10 years since any symptoms or medications and you can document good mental hygiene from coaches, supervisors, coworkers etc. that whatever you had is probably in remission. The only way to accomplish this is with a HIMS AME and you will likely need at least a HIMS Psychiatrist consult ($2000-5000 depending on complexity) and possibly a HIMS neuropsych (i.e. cogscreen, $2-3000). Depending on what is in the record and what medications you were given there is a more remote but possible chance you could continue on SSRI path 2 where you continue to take a medication. No way of knowing what path is the right one to take without the whole history. You'll probably need to start calling pediatrician offices and whatever pharmacies might still have prescription records.

Either way you need a better AME on your side ASAP and most likely a HIMS AME.
 
Clip4 said:
What they are basically saying is the AME that issued your certificate probably should have and they want more information before revoking your current certificate.
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Correct! I have seen airmen with such and was surprised that the FAA has not taken action. I simply state that problem in number x block has been previously reported by the airman. In this case ...all I can say is the
FAA finally noticed..
 
Start collecting all the medical records you can find (including all your pharmacy records) if there's anything questionable in there, track down a good HIMS AME. If they don't exist, get a statement from your physician's records department/office that your records no longer exist.
 
redbaron said:
The bad news is that you don't have a choice now but to give the FAA what they want, otherwise they will revoke your medical. Do not miss the 60 day response window and request extensions if necessary to get them documentation on time.

The good news is that depending on how the records look and how long ago this was, there is a long and expensive but available road for you to keep your medical. @bbchien will be along shortly to tell you that if you have a history of recurrent disease, untreated and unmodified, the FAA will 100% deny your medical. That means if you had anxiety and depression for more than 6 months and have done nothing about it since then, the agency thinks you're off the rails and won't issue. HOWEVER, there is also an unwritten rule at the FAA that if it has been 10 years since any symptoms or medications and you can document good mental hygiene from coaches, supervisors, coworkers etc. that whatever you had is probably in remission. The only way to accomplish this is with a HIMS AME and you will likely need at least a HIMS Psychiatrist consult ($2000-5000 depending on complexity) and possibly a HIMS neuropsych (i.e. cogscreen, $2-3000). Depending on what is in the record and what medications you were given there is a more remote but possible chance you could continue on SSRI path 2 where you continue to take a medication. No way of knowing what path is the right one to take without the whole history. You'll probably need to start calling pediatrician offices and whatever pharmacies might still have prescription records.

Either way you need a better AME on your side ASAP and most likely a HIMS AME.
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I did take antidepressants and anxiety meds during treatment which lasted a few years, but I have not taken medication for anything of the sort for about 6 years. There was never a time in which I stopped meds and had to go back on them. Eventually, I just stopped taking them because I didn't think it was necessary. Honestly, I don't think the meds were ever necessary.

The letter from the FAA does not say anything about a HIMS AME or Psychiatrist being necessary at this point. Is it still best to get in contact with one even prior to knowing if I need to? Would I be better off getting an aviation lawyer?
 
I doubt this will be a hims case since you are on no medication now and I assume you feel you are psychiatrically normal. Just send the information they asked for.
 
Flyingsausage said:
I did take antidepressants and anxiety meds during treatment which lasted a few years, but I have not taken medication for anything of the sort for about 6 years. There was never a time in which I stopped meds and had to go back on them. Eventually, I just stopped taking them because I didn't think it was necessary. Honestly, I don't think the meds were ever necessary.

The letter from the FAA does not say anything about a HIMS AME or Psychiatrist being necessary at this point. Is it still best to get in contact with one even prior to knowing if I need to? Would I be better off getting an aviation lawyer?
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Especially because you were on medication for an extended time, this does require more detailed information per the FAA guidelines. You were unfortunately dealing with AMEs who didn't do you any favors. The letter from the FAA should be pretty specific in what they want. However, given that you have had treatment, they will still want more.

I recommend against using an aviation attorney as they cannot help you, but they will most definitely charge you a lot of money. Your best bet is to seek the help of a well trained AME or aviation medicine consulting service to help you respond and prepare for the follow on request from the FAA that will occur. The AMEs listed here have good reputations. Aviation medicine consulting companies include my own, AMAS and Pilot Medical Solutions.
 
You'll need a current status report from an expert- that would be a community psychiatrist. Psychiatrists are able to take that "DETAIL" history containing all the nuances that "load" the likelhood of recurrence.

The sad part is, that under the current reimbusement system, to do an assessment means little pay and a lot of risk for the psychiatrist. Most insurance service psychiatrists will decline to do this assessment, therefore. That would leave you with the off insurance psychiatrists, aka "Forensic psychiatrists" that run about $2,500 fo this sort of work, or if you are fortunate enough to have a HIMS AME, mabe even a HIMS psychiatrist (who is known to the FAA and speaks with known authority.

Gather up your entire record as best you can.. IF a record is not avaiable, make you you get a letter that says so! A ten year pharmacy "dump" of everything the company ever dispensed to you is a usuful proxy for records no longer kept (most states are "Seven-year medical record" states). This is a long battle. I agree with the prior posters who noted the deficits by your prior AMEs. And IMO "PMS" isn't going to be of much value. Most active HIMS AMEs have a team that is credible "at the ready". But none of this is quick nor cheap.

Andreas Lubitz taught us that.
 
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