Any hope for medical?

[MacFly]

This whole SSRI thing has created many problems in the aviation community and ruined the careers of long time pilots and enthusiastic aspiring pilots. Given the tendency of many overworked primary care doctors toward seeing a patient and approaching them with ..."don't think, just prescribe an SSRI. Next patient please....", I wonder if the FAA may be throwing the baby out with the bathwater.

Is there any data that demonstrates that SSRI's or the supposed conditions that they supposedly are supposed to treat actually does pose an aviation safety risk? Or is it a theoretical concern...?

 

[bbchien]

fair enough. For the record I would never lie. I’m not that kind of guy but mainly I just don’t want to give the life insurance company any reason to keep my money from my kids.

Here is what I am saying. The form says have you ever been treated for anxiety. I will answer yes because that’s the truth. It then asks for medical records for the past three years. Only the medications related to divorce anxiety fall within that time range. And I am not even on those any more. The rest are a year and five years beyond the three year range. Now if the examiner asks “have you been treated for anxiety any times in addition to during the divorce” then I will have to tell the truth. But I am hoping he sees yes to anxiety and yes I went to a psychiatrist for divorce related anxiety during the last two years and leaves it at that. Am I being naive or is this a possibility?

Not a possibility. You know that in the history of present illness there are references to past history. In any psychiatry H&P of course prior episodes need be noted. And even then, the FAA can see pharmacy codes, in the event that your PCP's record is sufficiently miserable so as not to meet HCFA standards.....

That would be a material omission, and you sure don't wanna go there....into "attorney world"....

A sympathetic AME would have zero influence on FAA policy and will only result in post issuance retraction and denial. Then you can't even do Light Sport Aviation. Because of what you do, you should know more than anybody, that TELLING THE PATIENT what he wants to hear DOES NOT CHANGE THE UNDERLYING REALITY.

NOT UNSYMPATHETIC. Just a realist. Who really really really knows about this situation.

Now, in the unlikely event you could get a HIMS psychiatrist to opine that, despite three episodes he does not believe you have recurrent disease- well let me tell you a story.

50 y.o guy, who founded a plumbing business. 20 employees. Sweated out every payroll for 20 years. Sleepless nights. 14 years on Prozac by a family doc....FAA thought "the only reason he could have been on the med so long, is that the prescriber (A Fam Doc) though the disease was going to recur-->ergo recurrent disease. Off meds x 3 years, the HIMS psychiatrist opined, "I find no evidence that he ever had ANYTHING. I was knocked off my rocker. Why? Because the HIMS psychiatrist are SCORED by the FAA over the years, and this HIMS psychiatrist stuck his neck out. WAYYY out.

After sitting in Washington for 20 months, I got the attachment. It's one of the toughest SI's they could imagine. I'm totally responsible BY NAME for this fellow through 7/2026.

This is because, an expert known to the FAA refused to give him any diagnosis. That is the ONLY TIME in 23 years of doing these, that this has happened. So you can tell by the term of the S.I, how uncomfortable Washington DC is about this one.

This is a shot on target from 10,000 yards. You could try- but the overwhelming odds are you report isn't going to say what this guy's said....... And we could obtain everything needed to get to such an evaluation without even touching the FAA. But I would not have my heart set on it.....

B.

 

[Utah-Jay]

Too many drugs are prescribed... PERIOD!

I went through a divorce and my primary tried to give me an anti-depressant. I laughed and said I am HAPPY, not depressed But he thought I was going through a tough time in my life. I knew I did not need them, and I knew that I would never be allowed to or at least have serious problems purchasing firearms if I took those things. Yes I was a big sport shooter in the past. Sadly the OP is now dealing with the consequences of this type of decision.

A light sport taildragger (my personal favorite) can take you cross country, but with only one passenger and it is a long slow flight. The plane I am currently flying was recently ferried from Eastern Pennsylvania to Utah, you can in fact do it.... And just think of the sightseeing opportunities flying 100mph and 2,500’AGL

Gotta look at the positives in life. Think glass half full

 

[bbchien]

Amen to that, Jay....(!)

 

[woopig]

Too many drugs are prescribed... PERIOD!

I went through a divorce and my primary tried to give me an anti-depressant. I laughed and said I am HAPPY, not depressed But he thought I was going through a tough time in my life. I knew I did not need them, and I knew that I would never be allowed to or at least have serious problems purchasing firearms if I took those things. Yes I was a big sport shooter in the past. Sadly the OP is now dealing with the consequences of this type of decision.

A light sport taildragger (my personal favorite) can take you cross country, but with only one passenger and it is a long slow flight. The plane I am currently flying was recently ferried from Eastern Pennsylvania to Utah, you can in fact do it.... And just think of the sightseeing opportunities flying 100mph and 2,500’AGL

Gotta look at the positives in life. Think glass half full

thanks for your input, man. Not sure it’s quite fair to critique my decision regarding medications when you don’t know the scenario. I watched my daughter go through two (one the result of a doctor’s mistake) open heart surgeries and watch my very emotionally difficult son crumble under the weight of his parents’ divorce. I was the newest doctor in town and struggling hard to build a successful practice and the owners were very close to shutting my clinic down as it was not producing as expected. It was a lot on my plate so I elected to take them as I wanted to do anything to I could to be the best I could be at that time for my kids. Hopefully your situation was better than mine, I’m happy for you that you didn’t need them.

 

[Utah-Jay]

@woopig

You took that the wrong way, it was a generalization of the over prescribing that goes on in the world.

 

[MacFly]

I went through a divorce and my primary tried to give me an anti-depressant.

Exactly...."don't think...prescribe an anti-depressant. NEXT PATIENT..!!"

 

[jrollf]

I was just telling a buddy of mine about this. It always seems that the FAA looks at everyone and tries to see how to keep them out of the air right? Get you paranoid about any little thing that might come up.

Agree, FAA's policies discourage, especially professional pilots, from seeking mental health when they need it, because the pilots know the are one diagnosis away from permanently losing their job.

As a result they don't see the doc when needed because if they don't go they can't get a career ending diagnosis... so who knows how many ATPs are flying severely stressed, depressed, or who knows what else, and not getting help.

 

[bbchien]

Agree, FAA's policies discourage, especially professional pilots, from seeking mental health when they need it, because the pilots know the are one diagnosis away from permanently losing their job.

As a result they don't see the doc when needed because if they don't go they can't get a career ending diagnosis... so who knows how many ATPs are flying severely stressed, depressed, or who knows what else, and not getting help.

Well, the SSRI program reduced that. There is now, a formal way to evaluation the situation(s). Prior to 2010, SSRI in use--->totally grounding. More than one episode--->You're out.

The problem is, the evaluations are exacting and are pricey. But it's NOT the end.
What FAA has difficulty with, is distinguishing the person who repeatedly comes back for pharma support, based on underlying GAD vs. the person who endures incredible amounts of stress.

 

[FormerHangie]

A) Dr. Chien doesn't think your chances are good, then they probably are not good. He would know better than about anyone else here.

B) Sport pilot is limiting in the sense that, say, driving a two seat British sports car from the 1950's is limiting. Not much room. Not really that fast. But, unless you are determined to be a truck driver, ain't a bad way to go.

Like a British sports car? Do LSAs leak oil and have dodgy electrical systems?

 

[smv]

@bbchien

Please, if you will, explain this part. "Your medical is good for 24 months, 6 months at a time"?? Does this mean that the only thing evaluated at the 6-month interval is the basis for the SI then a full-blown at the 24 month mark?

 

[ThatOtherGuy]

OP, your expectations of logic and reason when dealing with the FAA on medical issues is typical of people that haven't had the joy of spending 10's of thousands of dollars and years of their lives convincing a bureaucrat that they're safe to fly. I'm sure the cognitive dissonance is even more painful for you considering your professional understanding of medicine.

The FAA isn't interested in treating you, they're interested in not being responsible in the event you hurt someone. Thus, there's no incentive to take a risk, and every incentive to exclude you from the sky. It's the difference between regulatory medicine and actual medicine. It's not what you want to hear, but it's the truth.

The pilots/AMEs here are giving you good advice based on the reality of the flying world. If you want to fly, go sport pilot or gliders and hope that sport pilot aircraft will be expanded or the 3rd class medical will eventually go away completely.

@bbchien

Please, if you will, explain this part. "Your medical is good for 24 months, 6 months at a time"?? Does this mean that the only thing evaluated at the 6-month interval is the basis for the SI then a full-blown at the 24 month mark?

View attachment 89625

It means the medical is effectively a 6 month medical which will be reissued with a new 6 month limit after each follow up. It also means the guy holding this SI should just let the medical lapse and go BasicMed if that option fits his situation.

I genuinely believe SIs with conditions like this are a tactic to push high liability pilots to BasicMed so the AMCD can CYA. There's a side benefit that if these pilots do have a deal while flying under BasicMed AMCD can use the data to support BasicMed being a dangerous reg that was forced on them.

 

[idahoflier]

A lot of great advice already given. Go for the Sport Pilot and at least see if flying is everything you hoped it would be. For all you know you may not even like flying in which case all this agonizing over the medical is/was wasted effort. In spite of what others think, I don't see the Sport Pilot as that limiting. Based on my experience the vast majority of pilots are boring holes in the sky on weekends by themselves or with no more than one other person. Sport Pilot has that covered... Good Luck and Blue Skies!

 

[bflynn]

Go light sport. It’s still flying and a light sport airplane is as capable as a Cessna 172, except for only having two seats. Realistically, I have flown with two passengers exactly twice in 10 years. Light sport requires endorsements from a CFI to fly into large airports, but that is just a matter of training. All you need is a drivers license, no medical.

There is a campaign underway to expand the light sport definition to cover many more airplanes, so there’s a good chance that in a few years it will be nearly identical to Private except for progression.

 

[woopig]

Thank you all so much for your time and input. I’m not ignoring your glider or LSA advice, I just live in a very small town and there’s nothing like that available around me from what I can tell.

A friend of a friend is on the local AME list and is willing to speak to me for an off the record consultation, so I’m going to get his input and give this one last chance; otherwise this dream might just have to die. Again, thank you all so much for taking the time to comment.

 

[Half Fast]

By all means speak with your AME friend. But also realize that Dr. Bruce is on of the authors of the FAA’s SSRI protocol. He knows what he’s talking about and he understands how the FAA will handle this.

If you’ll settle for taking one buddy instead of two, I suspect Sport Pilot will do everything you want. Any CFI can do the training for you. If there are no LSAs in your area you might have to buy your own plane first. If money is tight, shop for an LSA eligible Ercoupe.

You can fly anywhere in the CONUS and Bahamas with a Sport ticket, daytime VFR and one passenger. Not so bad.

 

[Brad Z]

One suggestion not mentioned is having a discussion with your regional flight surgeon. They're a surprisingly useful resource for potential medical certificate applicants. I'm not going to say they're going to give you a different answer from Dr. Chien, but they're a good source for an additional perspective to determine what the path to certification may be. Good luck.

 

[Bill]

By all means speak with your AME friend. But also realize that Dr. Bruce is on of the authors of the FAA’s SSRI protocol. He knows what he’s talking about and he understands how the FAA will handle this.

The other thing to know about Dr Bruce is he doesn't need to be doing this. He could easily retire and fly off into the sunset, but he doesn't. And he doesn't because he likes trying to keep airmen in the air. So, if he thinks your case is not winnable, it's not out of vindictiveness in any way. He just believes to the best of his knowledge and abilities it isn't going to pass.

 

[woopig]

The other thing to know about Dr Bruce is he doesn't need to be doing this. He could easily retire and fly off into the sunset, but he doesn't. And he doesn't because he likes trying to keep airmen in the air. So, if he thinks your case is not winnable, it's not out of vindictiveness in any way. He just believes to the best of his knowledge and abilities it isn't going to pass.

Oh, that thought never crossed my mind. Frankly I can’t believe he gives free advice and admire him for his dedication. I know it’s hopeless since he said it is, just hard to watch a dream die when you’ve had it so long. This was my big “I’m doing things I always wanted to” goal after my divorce, and I fell even more in love on my discovery flight. Maybe I’ll get a motorcycle.

 

[Bill]

Maybe I’ll get a motorcycle.

Many of us are also motorcycle riders, must be something about leaning into turns ;-)

 

[Kenny Phillips]

I just I could do this as last resort, just seems so limiting.

Compared to ... not flying at all?

 

[Anonymous]

For whatever it's worth, Dr. B told me I had recurrent, untreated disease and was likely not certifiable. Since I wasn't interested in LSA and had nothing to lose, I went for it anyway...and the FAA saw things differently. I'm happily back to flying with a third class and SI. Not saying that's necessarily the case for you, but it does happen.

 

[woopig]

For whatever it's worth, Dr. B told me I had recurrent, untreated disease and was likely not certifiable. Since I wasn't interested in LSA and had nothing to lose, I went for it anyway...and the FAA saw things differently. I'm happily back to flying with a third class and SI. Not saying that's necessarily the case for you, but it does happen.

For something like anxiety or depression, if you don’t mind my asking?

 

[Bill]

For whatever it's worth, Dr. B told me I had recurrent, untreated disease and was likely not certifiable. Since I wasn't interested in LSA and had nothing to lose, I went for it anyway...and the FAA saw things differently. I'm happily back to flying with a third class and SI. Not saying that's necessarily the case for you, but it does happen.

That's good to know, 2nd (or 3rd) opinions never hurt. As folks have said, Dr Lou in Pensacola is another good resource.

 

[Cervieres]

Oh, that thought never crossed my mind. Frankly I can’t believe he gives free advice and admire him for his dedication. I know it’s hopeless since he said it is, just hard to watch a dream die when you’ve had it so long. This was my big “I’m doing things I always wanted to” goal after my divorce, and I fell even more in love on my discovery flight. Maybe I’ll get a motorcycle.

With a Sport Pilot Certificate + a Carbon Cub SS, you would never get bored.

 

[Lindberg]

Oh, that thought never crossed my mind. Frankly I can’t believe he gives free advice and admire him for his dedication. I know it’s hopeless since he said it is, just hard to watch a dream die when you’ve had it so long. This was my big “I’m doing things I always wanted to” goal after my divorce, and I fell even more in love on my discovery flight. Maybe I’ll get a motorcycle.

Dr. Bruce is not the final answer; the FAA is. I'm sure as a Dr. you'd never tell a patient to just take your word for it and not get a second opinion....

 

[Half Fast]

Oh, that thought never crossed my mind. Frankly I can’t believe he gives free advice and admire him for his dedication. I know it’s hopeless since he said it is, just hard to watch a dream die when you’ve had it so long. This was my big “I’m doing things I always wanted to” goal after my divorce, and I fell even more in love on my discovery flight. Maybe I’ll get a motorcycle.

The correct answer is to do both!

I started out with Sport and only upgraded to Private later. It’s not as limiting as you may think. The planes are quite capable aircraft and many people do long cross country trips in them. It requires packing similar to motorcycle touring to keep weight down (or shipping some items ahead), but it’s certainly doable.

But certainly you should also get a motorcycle.

Moderation is for monks. Too much is never enough!

 

[Anonymous]

For something like anxiety or depression, if you don’t mind my asking?

Not either of those, but another psychiatric condition, yes. I suspect the FAA's favorable stance was because I never had had a true recurrence, having never received an accurate diagnose and appropriate treatment until later in life. The thing is, and I think where the problems with a consultation comes in, is that you can't really say something's recurrent without a full psychiatric evaluation.

 

[Palmpilot]

Go light sport. It’s still flying and a light sport airplane is as capable as a Cessna 172, except for only having two seats....

Let's not oversell it. My experience with LSAs is that I can either carry a passenger, or I can carry enough fuel to actually go somewhere, but not both at the same time.

 

[WDD]

It’s the FAA - doesn’t matter if you’re in perfect mental shape. It’s the history.

Listen to the expert. If the good doctor told you it’s not in the cards - it’s not in the cards.

LSA is a fine option. Pros and Cons. Weight limited. You’re not flying with passengers. Most fly faster than a sky hawk. Hard to find any to rent, so you'll have to buy one. Most of the ones you can buy - like an rv12 or a CT - are nice and have better avionics than most legacy planes, are newer and less prone to maintenance problems.

 

[Half Fast]

Let's not oversell it. My experience with LSAs is that I can either carry a passenger, or I can carry enough fuel to actually go somewhere, but not both at the same time.

I can fly a Tecnam LSA with my wife and full fuel and still have a light bag. Leave behind a few gallons and we could carry some bags and fly for 3 hours, more than my bladder will hold out.

 

[Utah-Jay]

You can buy a Rans S-20, Just Aircraft Highlander or SuperStol, or a Kitfox and can carry two people and around 80 pounds of baggage depending on the plane’s options. 80 pounds is a lot IF you are packing lightweight items, I typically travel (Work) for 3-5 weeks at a time and my bag never weighs over 32 pounds and this includes some outdoor poor weather clothes.

One of the above planes with a Rotax 915iS will get you going at a pretty good clip, but horsepower comes at a price, the Rotax 912 ULS is a lot less cost but is 100HP compared to the 141/135HP on the 915.

Here is a link to the Rans S-20, the S-21 is faster but also a bit heavier most likely
https://www.rans.com/s-20-raven

Edited to add: Was that a thread hijack?

 

[Ken Whitson]

Let's not oversell it. My experience with LSAs is that I can either carry a passenger, or I can carry enough fuel to actually go somewhere, but not both at the same time.

That' a pretty broad brush. How about this LSA: 400 pound cabinload with full fuel (@26 gallons, i.e 5+ hours flight time, 130 mph). Or back off to 20 gals (4 hours flight time, gives additional weight for baggage allowance (2 standard sized soft-sided suitcases and more).

To the OP: It seems you have 2 choices:
1) Roll the dice on trying for a medical certificate. You may win, at the cost of a lot of dollars and a lot of delays. If you lose, you are essentially out of the game forever.
2) Go Light Sport. It will let you get into the air. There are precious few limitations: No night-flying, no flight into IMC. You can buy an older airplane, such as Aeronca, Piper Cub, Ercoupe, etc.(all of which qualify as Light Sport) in which to train. If you choose to upgrade at some later date, probably almost all of your purchase price will be returnd to you upon sale. If at some future point, your medical status is more certain, you can always consider applying for a Medical and upgrading to Private or Commercial, BUT Choice 1 may still apply.

There are a lot of remarks about how slow a LSA is. In times past, the typical cross-country was deemed to be about 300 miles. The calculated flight on such a trip between a Cessna 172 and a LSA is 6-7 minutes in favor of the 172. You are not necessarily limited to short trips; I have made a 1200 mile trip in a Light Sport. For that trip, the calculated time differce for a C172 is :14 less. For a Piper Warrior, ~20 kts. faster, 1:10 less.

But the operating expenses of an LSA is typically going to be significantly less than the Cessna C172/Piper Warrior type aircraft. Over 3 years, I am averaging 4 gph, using car gas.

BTW, I am somewhat in your situation. Every day, I wonder if this is the day I should maybe apply for a 3rd class medical. But I would have to document events going back many years, and there would be no certainty of success. So, Light Sport it is for me. And I am happy to have had the option.

 

[Palmpilot]

That' a pretty broad brush. How about this LSA: 400 pound cabinload with full fuel (@26 gallons, i.e 5+ hours flight time, 130 mph). Or back off to 20 gals (4 hours flight time, gives additional weight for baggage allowance (2 standard sized soft-sided suitcases and more)....

Which LSA is that?

 

[Ken Whitson]

Which LSA is that?

Same as @Half Fast mentioned: Tecnam P2004 Bravo. Another nice tidbit: it appears that as long as gross weight is within limits, it is nigh impossible to get out of c.g. range. I do wish that the plane had a slightly larger baggage area and more than the 44 pound baggage limit; the limit seems to less an issue of weight and more an issue the weight-bearing capability of the flooring in use.

 

[PeterNSteinmetz]

Thank you all so much for your time and input. I’m not ignoring your glider or LSA advice, I just live in a very small town and there’s nothing like that available around me from what I can tell.

No need to “let your dream die”. You can train for sport pilot with a CFI who does training in a normal certified aircraft. You will just need to solo and do the final training in a light sport and take the exam that way.

Just tell them you want to start with the training and are aiming for light sport.

And agreed that a second or even third opinion from a senior HIMS AME will likely help here, at least to put your mind at ease.

 

[bflynn]

Let's not oversell it. My experience with LSAs is that I can either carry a passenger, or I can carry enough fuel to actually go somewhere, but not both at the same time.

Depends on weight, doesn't it? A lot of old grasshoppers can carry two people, but not two people at 250 lbs each. Remember LSA is more than a Remos or a Cessna 162. It includes some old Pipers, Taylorcraft, etc.

It will be a few years yet, but LSA 2023 is coming and will almost certainly bring many new lower powered aircraft into LSA. 3000 lbs is said to be one limit, but the FAA has been evaluating this as a "power index" which takes into account stall speed, hp, Vne and other factors. It's ongoing work so it is certain to still change.

 

[skier]

Like a British sports car? Do LSAs leak oil and have dodgy electrical systems?

The good ones don’t have any electrical system.

 

[Half Fast]

The good ones don’t have any electrical system.

Neither do old British sports cars, if Lucas built it.

 

[Dana]

OK, so an LSA can't carry a bunch of people fast and far. If that's the only mission you're interested in, roll the dice and apply for a medical. But... the LSA limits will likely be increased in the next few years, though to exactly what extent is unclear. If you roll the dice now and get denied (thus losing your chance at SP), you screw yourself out of what might meet your mission in a couple of years when the limits are expanded.

By all means get a second opinion, but don't actually apply unless you have good reason to believe you'll pass.

In the meanwhile start working toward SP... even before the FAA makes any changes you may find that in the wide variety of current LSAs (including classics and experimentals that meet the LSA criteria) you might just find your flying niche. There are LSA bush planes and seaplanes, some LSAs can do aerobatics, many classic and antique airplanes qualify as LSA, etc., etc.