Got denial letter from FAA...

M

Marc Stanford

Filing Flight Plan
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Bakon Plane
Hello friends

So just about a few weeks ago I got the denial letter from the FAA stating that they cannot approve of my reapplication of a 1st class medical at this time due to ADHD, Anxiety Disorders, and neurocognitive deficiencies.

I'm happy the denial is not permanent but I don't know what to do now regarding getting it back. I now have to leave the College of Aviation and pursue another degree in the meantime until I can get my medical back.

Also my neuropsychologist told me I don't have ADHD and I know I don't have anxiety disorders (although I was prescribed Xanax so that may be a cause) but I do have cognitive deficits in working memory and processing speed.

When I was really young I was diagnosed with a speech disorder but was mostly able to overcome it completely thanks to intensive therapy that lasted a while. I don't know what to do for the deficits I have now. I believe these deficits are leftovers from the speech disorder I had when I was young.

I have tried looking into Brain Balance but they mostly cater to children, I am looking at Interactive Metronome too to see what services they offer. I need suggestions please as to what I can do to improve my cognition so it at least falls into the average level and does not ring bells with the FAA.

Having to leave COA and this for a while is hard............. but I don't care how long it takes as long as I can fly again as a career.

My dean told me "Marc your 22 years old, you just got out of your diapers and you have a long time to become a pilot so relax", he is very supportive of me and hopes I will be able to get my medical back.

The FAA is also concerned about my socio-hebhavioral functionign regarding social boundaries, I am working with a licensed CBT specialist with that and she is very helpful. I enjoy working with her and she is helping me with my behavioral issues. She suggested that I do cognitive training AND seek support groups at the same time.

Does anybody know of a place that offers cognitive training and group settings in the Michigan, Oakland County area?

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Please help me, and your opinion counts! :)
 
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Mike Smith said:
Marc, yours seems a complicated case with a lot of moving parts. There are two very good AME’s that frequent these boards. @bbchien and @lbfjrmd
Want until one of them chimes in. None of the rest of the crew here would be much help I don’t think.
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Ditto. Do not go this alone. Get professional advice to navigate these waters.
 
lbfjrmd said:
I suspect you denial letter outlined some steps to take to remedy this situation. Seek out a HIMS-AME to take action!
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Hey, sadly no they just said my application is denied and I can't fly for now. I will have to get cog therapy because with the deficits I have now I won't be able to pass them again unless I fix them.

The question is where can I find cog therapy? which type did you recommend to your pilot lbfjrmd?
 
I've no advice- you are in contact with one of the people best able to help. But I wish you the best and hope all turns out well for you.
 
You should not be prepping for the testing. The major cognitive test that the FAA relies on will detect such prep and you'll still fail. You need a proper evaluation from a HIMS Neuropsych who will come up with an evaluation the FAA will accept. You can't go to those directly, you start with a HIMS AME.
 
Marc Stanford said:
Hey, sadly no they just said my application is denied and I can't fly for now. I will have to get cog therapy because with the deficits I have now I won't be able to pass them again unless I fix them.

The question is where can I find cog therapy? which type did you recommend to your pilot lbfjrmd?
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I would like to see the FAA denial. If indeed they specifically state you have to have cognitive therapy, a HIMS-AME can arrange such.
 
lbfjrmd said:
I would like to see the FAA denial. If indeed they specifically state you have to have cognitive therapy, a HIMS-AME can arrange such.
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The guy I use is in Indianapolis, and is the originator.

The letter I'm sure DOES NOT SAY that they require this. If may suggest that it is possible but you do need a HIMS AME to know what the letter means. FAA cannot tell you what care to get. But that can suggest routes.

A person to ask would be the HIMS trained neuropsychologist who did your testing. She/he would have been sitting at the neuropscyhologist's breakout session at the 2018, (or 2017) National HIMS meetings where this was discussed. If your neuropsych evaluation was done by a NON-HIMS Psychologist, then there are many many other issues complicating your problem.
 
bbchien said:
The guy I use is in Indianapolis, and is the originator.

The letter I'm sure DOES NOT SAY that they require this. If may suggest that it is possible but you do need a HIMS AME to know what the letter means. FAA cannot tell you what care to get. But that can suggest routes.

A person to ask would be the HIMS trained neuropsychologist who did your testing. She/he would have been sitting at the neuropscyhologist's breakout session at the 2018, (or 2017) National HIMS meetings where this was discussed. If your neuropsych evaluation was done by a NON-HIMS Psychologist, then there are many many other issues complicating your problem.
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I just contacted my Neuropsychologist Dr.Milanovich, who is HIMS trained in the Michigan area. Hope to hear back from him as to what therapy I might need. I'm also getting the cog therapy not to "prepare" for the 2nd round of tests but to fix my brain so I won't get into this situation again.

As for the denial letter I will try and upload it if I can.
 
Marc Stanford said:
Here is the letter
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The only way to attach is from google drive but it seems not to be working, how do you upload pics on this site?
open
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Marc

In the interest of your privacy, don't upload the letter but email directly to lbfjrmd , since he's the one who requested it. This is public website, meaning anyone and everyone in the world can view everything, regardless if they are registered members or not. And it will also come up in a google search.
 
murphey said:
Marc

In the interest of your privacy, don't upload the letter but email directly to lbfjrmd , since he's the one who requested it. This is public website, meaning anyone and everyone in the world can view everything, regardless if they are registered members or not. And it will also come up in a google search.
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Ok thanks, just contacted him via PM.
 
"A careful review of your application and physical examination performed on
July 31, 2016 and subsequent medical information received, discloses that you
do not meet the medical standards prescribed in Title 14 of the Code of
Federal Regulations (CFR), Part 67. By virtue of your Attention Deficit
Hyperactivity Disorder (ADHD) , Anxiety disorders, and Neurocognitive
deficiencies, it has been determined that you are not qualified for any class
of medical certificate at this time."

No mention is made suggesting or commanding you to obtain cognitive rehabilitation.


Got it. It does not bode well for you. There is neurocognitive rehabilitation available and I have referred airmen for it successfully. But you also have two other mental health diagnoses: Attention Deficit Hyperactivity Disorder (ADHD) and Anxiety disorders. It is possible that in the future you can demonstrate ( ie education, obtaining and holding a job etc.) you could apply again. If rehab corrected your neurocognitive deficiencies, and if a FAA Psychiatrist deemed the 2 above mentioned diagnoses to be remote and not presenting an aeronautical obstacle at that time, you could possibly prevail.

By this post we, as u suggested are asking Dr B to chime in.


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So, we have corresponded privately also

The presence of a medicated "now not medicated" anxiety disorder is grouped as a anxiety/depressive disoreder by FAA and by DSM 5.
Any cognition deficit is a dual diagnosis situation is regarded by FAA as a signa to investigate carefully that the underlying anxiety disorder is not totally in remission. Then there is the issue of sporadic treatment - meaning, is this a recurrent disorder which keeps recurring? If so you can't be certified "unomonitored and untreated".

Now would be the time to disucss the other elements missing in your Original post. If you have recurrent disease the only way to certify is on the SSRI protocol. Very finicky and quite expensive. i have several whose cognition actually improved on one of the 4 SSRIs, and they lost the xanax. But you can only certify if your RECORD is without:
(1) Severe Anxiety Depression that challenged reality testing
(2) Hospitalization for same
(3) suicidality
(4) Dual drug treatment (a severity index).

If you have had more than one episode (which it appears you have) and any of the above 4, then you cannot apply on the "ON SSRI" pathway.

What I think you missed is that cognitive disorders may be linked to incomplete resolution of the underlying anxiety/depressive disorder, and that may still be active. OR, you might just have an baseline cognitive dysfunction. We Can't tell from here.

In any case, cognitive retaining is useless until the true nature of the underlying anxiety disorder is dealt with. And oddly enough, the 4 SSRI were chosen by us in the original petition for the lest DELETERIOUS effects on cognition. there is no telling if you can do better on one of the listed 4, or will do worse.

Mostly you need the care of a sharp local psychiatrist (in addition to the psychologist), not a PCP. Someone who really "gets what's going on". Most of the cases in which I am asked to comment (I'm not saying this is you) lack an authoritative well trained board certified psychiatrist, local provider.....
 
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So: add years to your life and along the way finish your education, seek employment, start a family (or not) all while under the care of a psychiatrist. If you want to be a pilot, and if put on SSRI's, choose one of the 4 approved. You may have to try one or all of them. At some point your psychiatrist may consider cog testing, before or after cog rehab. You have to be making long term plans to possibly not be able to obtain a FAA Medical License of any class.

Addendum: appears airman has now moved on to other advice
 
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Not to sound like a dick, but this is why the first thing I tell anyone looking to be a pilot is to get your medical before you spend any money on flying lessons. If you want to have a career as a pilot, get your first class right away, just to make sure you can get it.
 
Groundpounder said:
Not to sound like a dick, but this is why the first thing I tell anyone looking to be a pilot is to get your medical before you spend any money on flying lessons. If you want to have a career as a pilot, get your first class right away, just to make sure you can get it.
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So very very true my friend!! Like an old friend of mine used to say that we are all one flight physical away from a career change..
 
Just like everybody else in your situation: "I was diagnosed, but I don't have the condition", followed closely by "I was given the medication but there was no diagnosis".

How on God's green earth did you get this far into a professional aviation university curriculum before this all came up? That would be my first question.

I'd get into flight simming if I were you.
 
One would think that the admissions department of an aviation college would make sure that candidates can get a medical before enrolling them and taking their money, especially considering how many kids are saddled with questionable "diagnoses" by persons not qualified to make them while they were in school. But alas, one would be wrong.

Best of luck to the OP, however it eventually turns out.

Rich
 
These schools have very bad records of being realistic with applicants before signing them up for a course of study that even if they successfully complete won't allow them to get a job. I've seen more felons in criminal justice programs and my wife had to let down a classmate very gently in that if you have a learning disability which pretty much bars you from reading, despite all the accomodations you were given throughout your schooling, you're going to have a difficult time functioning in a primary education role.
 
RJM62 said:
One would think that the admissions department of an aviation college would make sure that candidates can get a medical before enrolling them and taking their money, especially considering how many kids are saddled with questionable "diagnoses" by persons not qualified to make them while they were in school. But alas, one would be wrong.

Best of luck to the OP, however it eventually turns out.

Rich
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It's not so much whether the diagnosis is questionable or not. Everyone who finds themselves in a situation that they'd rather not be in questionable ("I got a DWI, but I was two blocks from my house," "I was prescribed the medication, but there was no diagnosis", etc.). The issue is the diagnosis, period. In other words, whether the diagnosis is questionable or not is debatable, the fact that there was one is not. So while I agree with you in general, the school not even finding out about the diagnosis is the core issue, rather than who made it, their qualifications, etc.
 
mryan75 said:
It's not so much whether the diagnosis is questionable or not. Everyone who finds themselves in a situation that they'd rather not be in questionable ("I got a DWI, but I was two blocks from my house," "I was prescribed the medication, but there was no diagnosis", etc.). The issue is the diagnosis, period. In other words, whether the diagnosis is questionable or not is debatable, the fact that there was one is not. So while I agree with you in general, the school not even finding out about the diagnosis is the core issue, rather than who made it, their qualifications, etc.
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Yes, I understand that it's the diagnosis itself, not whether it was valid, that's the problem.

I have a family member who inquired about joining the Navy. She'd been "diagnosed" with ADHD by a shrink contracted by the school system, who interviewed her for all of five minutes when she was 6 years old. It was all nonsense. She stopped taking the medication when she was about 8 and transferred to a charter school. She did just fine, eventually graduating from a charter high school with honors, with no medications and no learning or testing accommodations.

The recruiter told her that although ADHD is disqualifying, if the diagnosis was made prior to age 14, the candidate hadn't taken any medications for it in the past two years before applying for enlistment (doctor's note and urine test required), had completed high school without any accommodations, and scored well-enough on the ASVAB without any meds, they would be accepted. Apparently, the Navy is well aware that many, if not most, ADHD and related diagnoses in childhood are ********; but just to be sure, they have standards in place to weed out those that are genuine before the candidate enlists.

The FAA, however, is much more cautious. Disabusing a bad diagnosis to FAA's satisfaction can cost many thousands of dollars that are not covered by insurance. And mind you, ADHD and other psych diagnoses are only a few of the bazillion things that can disqualify an aspiring airman from ever getting a medical.

That's why the fact that an aviation college doesn't go out of their way to insure that prospective students are medically qualified before enrolling them angers me. It also affirms my deeply-held belief that higher education in general in the United States is a racket worthy of a RICO indictment.

Just follow the money. The Navy would incur costs if a candidate were accepted who turned out to be medically unfit, so they screen first. A college, on the other hand, will take in revenue for a year or two regardless of whether the candidate can get certified, so they don't screen. Am I to believe that the direction the money is flowing has nothing to do with the difference in the college's approach compared to the Navy's?

This is the Web site for a well-known commercial driving school:

https://ntts.edu/cdl-training/admissions/

Scroll down to CDL School Admission Requirements and look at the fourth and fifth bullet items. Students aren't even allowed to enroll in a CDL training program until they have a DOT medical card and a clean urine screen. Why doesn't a much-more-expensive aviation college require the same before taking a student's money?

It's a racket, pure and simple.

Rich
 
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Which is why it is incumbent of parents to notch the system and fight to protect their children from paperwork death sentences before they even have the legal ability to consent to anything in this blasted Country. I just chucked my kid out of public school after one grade (kindergarten... FFS). What an administrative bloat, overcrowded, all-testing-no-teaching hell that was. 8 weeks in and the teacher was already spring loaded to get him "evaluated". Kid's just another 5 year old male, and these administrators are licking their chops for "metrics". Meat packing plant.

So now I pay even more hard earned money for the mere "privilege" of an environment where at least the mf'ers looking me in the eye telling me the kid needs to be branded for life don't actually have an economic incentive for wanting him on a pharmaceutical's "honor roll" from the age of 5 so they get to keep their jerb. I had no idea how existential a threat childhood can be for American children from a vocational standpoint. To be sure, I had 99 problems growing up in a colony *cough*-- territory, but this effetry just wasn't one of them. Absolutely unimpressed with the Country and our profiteering culture in this regard.
 
UPDATE

Just went through the cognitive training program here and I managed to mostly overcome my cognitive deficits, my neuropsychologists the same one who performed the battery tests for the FAA coached me through my training and told me I got significant gains in both working memory and processing speed.

So right now we are waiting a bit before we repetition for the medical.
 
hindsight2020 said:
Which is why it is incumbent of parents to notch the system and fight to protect their children from paperwork death sentences before they even have the legal ability to consent to anything in this blasted Country. I just chucked my kid out of public school after one grade (kindergarten... FFS). What an administrative bloat, overcrowded, all-testing-no-teaching hell that was. 8 weeks in and the teacher was already spring loaded to get him "evaluated". Kid's just another 5 year old male, and these administrators are licking their chops for "metrics". Meat packing plant.

So now I pay even more hard earned money for the mere "privilege" of an environment where at least the mf'ers looking me in the eye telling me the kid needs to be branded for life don't actually have an economic incentive for wanting him on a pharmaceutical's "honor roll" from the age of 5 so they get to keep their jerb. I had no idea how existential a threat childhood can be for American children from a vocational standpoint. To be sure, I had 99 problems growing up in a colony *cough*-- territory, but this effetry just wasn't one of them. Absolutely unimpressed with the Country and our profiteering culture in this regard.
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Thus the reason I’m looking long and hard for a way to not pay school taxes, it’s not just the money, I simply don’t support what the schools (at least by my property) are doing and don’t want to contribute to that dumpster fire.

But it’s not just kids, seems everything government related is all about getting anyone and everyone in as many databases as posssible, like the digital version of the scarlet letter, nonfly lists, red flag laws, diagnosing small children with anything and everything except education and play, “zero tolerance” laws for all the things, every DMV pushing for “real id”... databases for everything and everyone, one might say it’s the puritanical age meets the digital age.
 
Marc, you are on an excellent path! Bruce is the medical professional to have in your corner. Be strong and keep following his advice.

The FAA aeromed folks can be extremely frustrating and occasional irrational and or ignorant of their own rules. Accept this and just be prepared. Allow me to share from personal experience. I too had always wanted to fly professionally. After surviving a rare form of cancer (between my now 3 oncologists, 2 are retired) they have seen 6 prior cases I decided to go for it! Received my initial 1st class medical then a letter from OK City saying it was good only for 6 months! Not a year 6 months and it could not be used as for 2nd or 3rd class purposes. Fortunately, the oncologist who was treating me then had dealt with the FAA before. Over the course of a year he submitted numerous detailed reports explaining my disease and debunking the aeromed folks one size fits all approach.

Later down the road after leaving the 121 environment I continued to hold a 1st class medical. At one point the eallet said quit spending so much so I decided to let medical lapse to a 2nd class. Some genius looks at my file for whatever reason and decides I need an EKG...no not required for a 2nd class. They send a lettletterer demanding I submit an EKG. My response was a letter explaining I was letting the medical lapse to a 2nd class so an EKG was not required. 2nd letter arrives acknowledging my response but still demanding an EKG and ups the ante by threatening me with an emergency revocation of my medical! I wrote the head (then DR Silverman) a letter detailing all that had occurred. He responded that everything was ok and apologizing for his staff's unsatisfactory handling of my case. Great doc (he reformed the FAA's treatment of many conditions especially diabetes)!

To close with a bit of humor, remember the FAA is still skeptical of this new fangled penicillin stuff!

May you enjoy much success!!
 
jonvcaples said:
James331, "notch the system" do you mean watch the system?
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I think 'notch' can be an appropriate use. Remember, Notch, as in defensive maneuver. Used in air combat to defeat missile radar system tracking by exploiting doppler effect at 9-Aspect, plus extends the distance the missile has to fly by constantly having to homing-turn to the target at the highest heading crossing angle possible (higher energy expenditure).

In the context of government intrusion by the educational/medical/industrial complex, notching would be akin to stonewalling, deferring, defending against, "Heismanning" attempts by the authorities to make you compliant. Basically a defensive counter meant to get the offender to lose interest because you're not low hanging fruit compared to your more compliant peers (which exists in greater numbers, higher profitability per amount of effort incurred). This as opposed to going full up Waco and trying to confront the system in the offensive counter, which simply doesn't work in the aggregate. Basically, making yourself a marginally less convenient target than your neighbor, and letting the numbers game of herd attrition insulate you by proxy.

We all 'notch' both corporations and government intrusion to varying degrees in our lives. We all violate laws by default every day by virtue of living our lives in a nominal way. Some socioeconomic classes have more privilege than others in legally rationalizing this behavior, but the behavior end game is the same. There's a reason the trope about pro pilots having two doctors is a thing in the first place. I'm not excusing law breaking as a principle, I'm just saying we live in a grey world and we all have to define what hills we're willing to die on, for ourselves and for our children for those of us who have them, until they can attain enough age to exercise agency and consent in their own lives. The hall monitor/pharisee types who take exception to approaching the greyness of life in such pragmatic and 'grey' ways, can straight up John 8:7 kiss my @ss. :D To each their own.
 
Wow impressive! Hadn't thought of notch applying here but it does (also kind of surprised to see it used here).
 
This is great to hear! I'm going through the same thing. Was diagnosed with ADHD and Aspergers and now have to get cleared before I start going to college. $2,000+ is a lot but it will be well worth it if I pass with good scores and the FAA approves me!
 
MyDimeIsUp said:
This is great to hear! I'm going through the same thing. Was diagnosed with ADHD and Aspergers and now have to get cleared before I start going to college. $2,000+ is a lot but it will be well worth it if I pass with good scores and the FAA approves me!
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I very much hope you pass :D, I too have Aspergers,ADHD, but also depression and OCD.
 
James331 said:
Thus the reason I’m looking long and hard for a way to not pay school taxes, it’s not just the money, I simply don’t support what the schools (at least by my property) are doing and don’t want to contribute to that dumpster fire.
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Then can I stop paying ALL my taxes and get everything back from the feds for the last 2+ years, speaking of dumpster fires? Didn't think so.

You don't get out of paying taxes because of philosophical differences. Sorry. I don't even have children, but I understand why I pay school taxes.
 
mryan75 said:
Then can I stop paying ALL my taxes and get everything back from the feds for the last 2+ years, speaking of dumpster fires? Didn't think so.

You don't get out of paying taxes because of philosophical differences. Sorry. I don't even have children, but I understand why I pay school taxes.
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So even though I wasn’t the one who knocked the woman up, it’s my job to raise the kid for you?

We really should be on a usage type tax structure. Can’t afford a kid, don’t have one.

Plus letting big government raise your kid from 5 years old to 18, if you think that’s a good idea well that’s just another example of the failed education system, or maybe that’s not a flaw but a feature lol
 
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So when I repetition I know I will need to take these tests again to demonstrate I've overcome my initial concerns.

Has anyone had luck with retaking the neuropsych tests? what advice would you give me?
 
Marc Stanford said:
So when I repetition I know I will need to take these tests again to demonstrate I've overcome my initial concerns.

Has anyone had luck with retaking the neuropsych tests? what advice would you give me?
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Get a good night's sleep the night before.
 
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