Couple’s Therapy and 3rd Class Medical

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anonfuturepilot

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My significant other and I have been going through some COVID relationship stresses and she’s requested we do couples therapy sessions. However, I don’t want anything to risk my plans to apply for a 3rd class medical and begin private pilot training once the pandemic is over and I’ve saved enough.

She plans to be the main “patient” and therefore will be reimbursed through insurance. Having read through other posts, there has to be a diagnosis for insurance to reimburse. This being the case, I had a few questions:
  • What “diagnosis” is this typically and will it be attributed to my medical record even if my insurance isn’t reimbursing?
  • What are the reporting requirements when going through a 3rd class for these types of sessions?
  • Related to above, will I have to fully disclose notes of these visits to an AME/the FAA?
Trying to decide whether paying cash is preferable to insurance route. Thanks in advance. Really appreciate what you all do.
 
anonfuturepilot said:
My significant other and I have been going through some COVID relationship stresses and she’s requested we do couples therapy sessions. However, I don’t want anything to risk my plans to apply for a 3rd class medical and begin private pilot training once the pandemic is over and I’ve saved enough.

She plans to be the main “patient” and therefore will be reimbursed through insurance. Having read through other posts, there has to be a diagnosis for insurance to reimburse. This being the case, I had a few questions:
  • What “diagnosis” is this typically and will it be attributed to my medical record even if my insurance isn’t reimbursing?
  • What are the reporting requirements when going through a 3rd class for these types of sessions?
  • Related to above, will I have to fully disclose notes of these visits to an AME/the FAA?
Trying to decide whether paying cash is preferable to insurance route. Thanks in advance. Really appreciate what you all do.
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You may want to see my FAA medical information page for more information and links at http://tinyurl.com/FAAMedicalInfo.

Per the FAA you should report all visits to licensed healthcare providers. Depends on the state and type of counselor if this qualifies.

Diagnosis for the insurance would often be something like adjustment disorder or relationship stress. If not your insurance, then not normally under your name in the insurance.

If you receive a diagnosis per the FAA, then they will require a psychological assessment and the forensic psychiatrist will want to see the actual session notes. You may want to advise the counselor of this issue in advance.

You are definitely one step,ahead of the game understanding the possible implications ahead of time. But as others will point out here, first take care of your health, then worry about FAA medicals.
 
From my reading in this forum, and having stayed at a Holiday Inn Express, paying cash does not remove the obligation to report a diagnosis.

If this therapy leads to any diagnosis/treatment of an ailment YOU have, it will be reportable on your medical application. If the need for this "therapy" is in any way substance related you'll be wading into some potentially deep waters. If the visit is with a "family councilor" you may skate. If it's with a Psychiatrist and the prescription pad gets your name on it.. again, the water starts rising.

The last line of the previous post says it all. Get healthy and happy, then pick up the hobby.

On a really negative note, if the therapy goes South you may not have the financial ability for this hobby for a while. Divorce lawyers will be flying on your dime. I hope it doesn't come to that.
 
It’s on the line. Would depend on the counselor’s medical credentials and diagnosis. If marriage counseling, I believe there is a specific exception, but if it turns into something else, that’s where a problem comes from.

https://www.faa.gov/about/office_or...aam/ame/guide/app_process/app_history/item19/

The applicant should list all visits in the last 3 years to a physician, physician assistant, nurse practitioner, psychologist, clinical social worker, or substance abuse specialist for treatment, examination, or medical/mental evaluation. The applicant should list visits for counseling only if related to a personal substance abuse or psychiatric condition.
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also:

https://www.pilotsofamerica.com/community/threads/relationship-counseling.114663/

https://www.pilotsofamerica.com/community/threads/question-on-counseling.104675/

https://www.pilotsofamerica.com/community/threads/complicated-medical-question.55916/

and several others.
 
Did you bother to READ the instructions?

"List visits for counseling only if related to a personal substance abuse or psychiatric condition".

Marital counselling doesn't need to be reported unless there's substance abuse or psych issues involved.
 
flyingron said:
Did you bother to READ the instructions?

"List visits for counseling only if related to a personal substance abuse or psychiatric condition".

Marital counselling doesn't need to be reported unless there's substance abuse or psych issues involved.
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At this point we are only engaged, not married - just in case that makes any difference.
 
Doesn't matter. Unless substance abuse or psych issues are involved, it's not necessary to report it (and if you did it would be a yawner for the AME).
 
anonfuturepilot said:
My significant other and I have been going through some COVID relationship stresses and she’s requested we do couples therapy sessions. However, I don’t want anything to risk my plans to apply for a 3rd class medical and begin private pilot training once the pandemic is over and I’ve saved enough.
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So you don't want to do counseling if it would make doing something you want to do more difficult. You might want to mention that during the first session. Could save a lot of time for all involved.
 
Maybe hurry up and get your Class III before the counseling and then go BasicMed?
 
So judgmental posts aside (it would save a lot of time and energy to not assume anything about other people), it sounds like going down this path won’t be jeopardizing anything in regards to the medical.

Thanks for the help, @flyingron!
 
Sometimes counselling works out that splitting up would be best. I've had that happen.
 
Brad Z said:
Honestly, I think it would be better for everyone to do a little counseling before marriage, whether they think it's necessary or not.
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upload_2021-2-2_14-9-39.gif
 
Joe_B1 said:
Will only delay things. If counseling results in a problem, he will still have to report it.
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Here's the FAA's standard. Lots of couples therapy wouldn't be reportable.

  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
 
anonfuturepilot said:
So judgmental posts aside (it would save a lot of time and energy to not assume anything about other people), it sounds like going down this path won’t be jeopardizing anything in regards to the medical.

Thanks for the help, @flyingron!
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I hadn't written anything previously, but I didn't find anything judgmental in the previous posts. We don't know you at all, so there's nothing TO judge. I kind of share the same thought/question... if a couple needs counseling from a third party that doesn't really know either one of them just to stay together, it sounds like the only chance at a successful marriage is making personal changes, and if either of you don't know what those changes are, or are unwilling to make them without being told to by a counselor, then... well.... ?

In my experience, (38 years of marriage with four years of serious dating/being together before then), the secrets to a great marriage are pretty much not a secret. Honesty, accepting that your spouse will change over your lifetime together, and accepting that there's nothing you can to about that. You either love them, stand by them, and accept them as they are, or you don't. The choice is yours. Period. Whatever a counselor tells you is temporary.
 
MuseChaser said:
In my experience, (38 years of marriage with four years of serious dating/being together before then), the secrets to a great marriage are pretty much not a secret. Honesty, accepting that your spouse will change over your lifetime together, and accepting that there's nothing you can to about that. You either love them, stand by them, and accept them as they are, or you don't. The choice is yours. Period. Whatever a counselor tells you is temporary.
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:yeahthat:

I would only add that a man marries a woman hoping she won't change, and the woman marries a man hoping he will ...

PS: I've only got 32 years of experience with an absolutely amazing wife!
 
Joe_B1 said:
Will only delay things. If counseling results in a problem, he will still have to report it.
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To whom?

With Basic Med, the list of medical visits and issues only gets reported to the examining physician, not to the FAA.

Plus, that list only goes back 3 years and Basic renews every 4, so if he does Basic and then gets counseling for a year or less, it doesn’t get on the form at all.
 
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Brad Z said:
Honestly, I think it would be better for everyone to do a little counseling before marriage, whether they think it's necessary or not.
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No disagreement. I wasn't trying to say not go to counselling together, but that if there were significant problems beforehand, it might be warning signs worth taking note of.
 
Fearless Tower said:
In many churches it’s required before the pastor will agree to perform the marriage.
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Obligatory POA thread drift. When I got married we had to go through church mandated "counseling". One day we had to take a test. Rate each of these things from most to least important. Love, Sex, Money and 7 other things. 1 to 10 scale. My finance and wife of 35 years gets a very serious expression and buckles down. I get an equally serious expression and try to think of the "school solution". We hand in our score sheets. Pastor takes a look and gets a very serious expression on his face. "How long have you two known each other?". My future wife goes ashen. Pastor says he's never seen a more incompatible couple. I'm panicked that this goofball is going to upset the train.

Suddenly a thought jumps into my brain. I ask my finance which number she used to be the most important. She says 10 because it's the biggest number. I say #1 as it's who's at the top in sports. Turns out we both answered exactly the same once the scales were adjusted.
 
I think his point is that he was asking about the counseling in regards to his medical. He wasn't asking for marriage advice. But I guess it wouldn't be POA if we didn't interject our thoughts about other info that he didn't ask for advice on.
 
BrianNC said:
I think his point is that he was asking about the counseling in regards to his medical. He wasn't asking for marriage advice.
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Well ... following the advice of the "wizards of POA" (I need to copywrite that) could save him a bunch of time, money, and possibly heartache ... or not! :rolleyes:
 
BrianNC said:
I think his point is that he was asking about the counseling in regards to his medical. He wasn't asking for marriage advice. But I guess it wouldn't be POA if we didn't interject our thoughts about other info that he didn't ask for advice on.
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Yeah, but it sounds like there are elements here that could affect his personal desire to become a pilot, which is why he even asked, and marriage will only make that significantly more difficult if there are rocky days ahead. Having put off a rating for a marriage, that I have never since obtained... I would suggest if it's that big of a deal, it might be worth getting started now and put off the marriage until he finishes. :eek:;)
 
I remember a counselor looking at me and my ex- and saying: "Why are you even here? Why are you even togetherness?"
 
Daleandee said:
I would only add that a man marries a woman hoping she won't change, and the woman marries a man hoping he will ...

PS: I've only got 32 years of experience with an absolutely amazing wife!
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It's actually worse. Wives spend an entire lifetime together trying to change their husbands...then complain "He's not the man I married". :rolleyes:

I'm at 32 years too; also amazing.

Hang 4 said:
...Pastor takes a look and gets a very serious expression on his face. "How long have you two known each other?". My future wife goes ashen. Pastor says he's never seen a more incompatible couple. I'm panicked that this goofball is going to upset the train...
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I tell all our friends that our marriage has survived because we have absolutely nothing in common...and therefore nothing to ever have an argument over. :D
 
RyanShort1 said:
I really hate myself for this, but if it was a stressor before you are legally together, I'm not sure that sounds like a keeper.
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Roger that one, I was thinking the same thing, the 3F rule may apply here, rent don't buy
 
PlasticCigar said:
That being said, you do need to be careful with the scope of the therapy and what you say. Unfortunately, the FAA hasn’t taken the most enlightened approach to mental health and it has kept pilots from seeking help when they really should due to fear of certificate action.
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It's mostly OWTs that prevent people from seeking help. It's been said here a bunch of times, and yet still people don't believe it, you can go talk to a counselor and not even report it on your medical unless you have a significant personality disorder, bipolar disorder, or psychosis.
 
PlasticCigar said:
With the current divorce rate around 50% it’s probably best to find health ways to confront issues ...
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Not disagreeing, but it's good to keep this in context. While it's true that roughly half of all marriages end in divorce, don't forget that the other half end in death.

There just isn't any happy ending to be found....

:D
 
anonfuturepilot said:
However, I don’t want anything to risk my plans to apply for a 3rd class medical and begin private pilot training once the pandemic is over and I’ve saved enough.
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Your cart may still be in front of your horse....are you 100)% sure you can even get the 3rd class medical today? Have you looked at the form. Answering yes to some of the stuff in there (question 18 I believe) may be 100x more damaging than the counseling. And perhaps the reason for the counseling (today) is a function of something you might have to say yes to (from the past)? Not trying to blame. Just making sure that you know of all hurdles and don't make a wrong assumption.
 
Didn’t expect this to blow up like this!

We’re looking to discuss a few relatively minor things not substance abuse or psychological related that have come up before we decide to continue with getting married. Ultimately, we’re both willing to accept what comes of it. In my opinion, this is much preferable to letting issues fester and find myself married for 10 years with children then have to get divorced. Seems messy.

What precipitated my original post isn’t trying to find an out, which is what some posters inferred. I’m just well aware of today’s “over diagnose” culture and want to proceed cautiously, especially as it pertains to insurance and what it could mean for my medical record. Having taken a look at these forums, it seems an entirely better idea to do the homework now rather than look back and have the could’ve should’ve attitude.

Very much appreciate everyone’s perspectives.
 
anonfuturepilot said:
Didn’t expect this to blow up like this!

We’re looking to discuss a few relatively minor things not substance abuse or psychological related that have come up before we decide to continue with getting married. Ultimately, we’re both willing to accept what comes of it. In my opinion, this is much preferable to letting issues fester and find myself married for 10 years with children then have to get divorced. Seems messy.

What precipitated my original post isn’t trying to find an out, which is what some posters inferred. I’m just well aware of today’s “over diagnose” culture and want to proceed cautiously, especially as it pertains to insurance and what it could mean for my medical record. Having taken a look at these forums, it seems an entirely better idea to do the homework now rather than look back and have the could’ve should’ve attitude.

Very much appreciate everyone’s perspectives.
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Thanks for the clarification. But please consider (and respond if you want)...can you even get the medical today...before any counseling. Any new pilot (your will be one soon) needs to answer this question carefully before they start so it has nothing to do with any potential counseling or relationship stuff.
 
Sinistar said:
Thanks for the clarification. But please consider (and respond if you want)...can you even get the medical today...before any counseling. Any new pilot (your will be one soon) needs to answer this question carefully before they start so it has nothing to do with any potential counseling or relationship stuff.
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Yes, pre-COVID I ran through the MedXPress form before planning to train summer 2020. Nothing of concern at that point, but pandemic gave me pause to start training until things are back to normal.
 
Lindberg said:
It's mostly OWTs that prevent people from seeking help. It's been said here a bunch of times, and yet still people don't believe it, you can go talk to a counselor and not even report it on your medical unless you have a significant personality disorder, bipolar disorder, or psychosis.
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Sometimes truth is stranger than fiction. Not sure who said it but it's the truth ...

"All the world is strange except me and thee ... and I'm beginning to wonder about thee!"
 
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