My SSRI Special Issuance

Yes, Terry. As you basically continued to function and work during the whole period, there's no question as to "psychosis" in the original legislation. Your PCP can sign you off.
:)
...the above is to your question.
So, to summarize: "path 2", i.e. BasicMed while on an SSRI is out since the meds are disqualifying; but BasicMed is possible ("path 1") as long as the person is fully functional off meds. Is that about right?
 
I just have to take a moment here to say a big thank you to Dr. Chien for helping me navigate the SI process. After a long haul I am really excited that I was granted my SI this week. If anyone has any doubts about how to proceed then Dr. Chien is who you need to speak to to get the process organized. Thanks agin Dr. Chien.


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So, to summarize: "path 2", i.e. BasicMed while on an SSRI is out since the meds are disqualifying; but BasicMed is possible ("path 1") as long as the person is fully functional off meds. Is that about right?
Not for recurrent disease, you can't do that. Recurrent disease has already recurred, and so will again.
 
Not for recurrent disease, you can't do that. Recurrent disease has already recurred, and so will again.
So for everyone's benefit, let's be perfectly clear on this. The FAA considers ANY history of recurrent depression to be disqualifying for BasicMed, even if the airman is off medication? And then the ONLY path open is the Path 2 SI, which has to be maintained? Is there ANY path to BasicMed while on the meds and under the care of a psychiatrist? What if the psychiatrist deems the patient to be restored to functionality through some form of talk therapy, and off of medication?

If that is true then where is all this spelled out? The statute talks about bipolar disorder, personality disorder manifested in overt acts, and psychosis, but I don't think most people (and probably most non-AME physicians) would think that someone who has had a couple of depressive episodes in their life would fall into any of those categories.
 
It would have been cheaper to fly to Costa Rica and pick up a license...Like so many others have.

Happy to oblige! Yes, the process took about 2.5 years in total (and I was unable to fly for right around 17 months, given time from denial to SI issuance), but that's including the 'false start' of trying to certify off-medication. If someone was already on an approved SSRI (stably for 6+ months) and wished to certify on-medication, and was already being seen/prescribed by a "board certified psychiatrist", they could receive a special issuance in just under a year based on the timeline I experienced. Of course, that's as a "non-revenue airman", as Dr. Bruce says - were I requiring a second or first class medical as part of being a commercial pilot, I'm assuming that timeline can be compressed slightly, but only Dr. Bruce could advise further.

It was bad enough for me as an applicant what with the Germanwings 9525 crash freshly on the FAA's mind, but honestly, with the stolen Q400 crash last weekend, I wonder if fresh applicants will have an even tougher time. Given the attitudes towards mental health, it makes me feel like a bit of a pariah - when others were surprised by my having to slog through a difficult SI and exclaimed "How come? You look like a perfectly healthy guy!" I simply said that it was because of a medication I take, and I didn't elaborate further. Honestly, it seems like the DUI/possession applicants have easier runs at obtaining a medical (I could very well be wrong), and my experience has certainly colored my opinion of dealing with the FAA. I know Dr. Bruce insists on full disclosure and truthfulness (which I certainly provided, and was perfectly honest when dealing with him and all other doctors), but if someone in a similar situation to mine asked me if they should slog through the SSRI application path with an unknown outcome, or if they should simply "lie via omission", I'd have a difficult time telling them that the former is truly the best route. It felt like an incredibly burdensome barrier for someone who just wanted to follow their dreams. In fairness to the FAA, however, it wasn't until 2010 that a medical was even possible to get for someone on an SSRI, so progress is at least being made (and we have Dr. Bruce in particular to thank for that). Thus endeth my rant...

How much did this cost me? What, are you trying to provoke anxiety/depression?!? ;) I can't find all my old check copies, but this breakdown is probably pretty close:
$180 - Dr. Bruce starts my file late 2015
$151.31 - general practitioner late 2015
$600 - HIMS psychiatrist april 2016
$180 - Dr. Bruce visit may 2016
....and then I got the denial. So, just under one AMU for certifying off-medication, had that been successful. But, it wasn't, so I proceeded onward with:

$158.58 - general practitioner late 2016
$130 - Board certified psychiatrist late 2016
$90 - Board certified psychiatrist late 2016
$90 - Board certified psychiatrist early 2017
$90 - Board certified psychiatrist may 2017
$280 - HIMS psychiatrist june 2017
$750 - Cogscreen-AE test (as noted in the first post, I did well enough on Cogscreen that the additional gauntlet of cognitive testing wasn't needed - the day would have cost me $1375 if my Cogscreen scores weren't sufficient on their own, and I thusly required the additional test results to prove acceptable cognitive function)
$144 - HIMS psychiatrist july 2017 (this was the optional 'cherry on top' visit)
$90 - Board certified psychiatrist aug 2017
$300 - Dr. Bruce visit aug 2017 (Dr. Bruce was running a special deal that week - "buck a pound" for paperwork submitted to the FAA. I'm kidding of course - it would have been closer to $500 if he had such an offer ;))
$90 - Board certified psychiatrist nov 2017
$90 - Board certified psychiatrist jan 2018
$90 - Board certified psychiatrist apr 2018
...and then I got the SI. So... [types numbers into calculator, shields eyes from result...] Around 2.4 AMU. Which honestly is not bad - Dr. Bruce had cautioned me that this would not be cheap, and said to expect around 4 AMU for the process, and that's the number I would give to anyone asking how much they should expect to spend. I managed to do it cheaper, but the costs can vary quite a bit based on where in the US you are, as well as other factors (I noted that the FAA only requires a 6 month visitation cycle with the board certified psychiatrist, but mine insists on 3 months).

The big question is, was it worth it? This took years (while being grounded), thousands of dollars, lots of stress, loads of aggravation, all simply to prove to a government agency that I am "fit to fly". But when I line up my little airplane on the end of 4000 feet of arrow straight asphalt under a clear blue sky, firewall the throttle, hit Vr and pull back to see the entire earth fall away from me... Yeah, it was worth it. Every. Single. Penny.
 
Hello everyone,

If I pursue the SI path and plan on staying on SSRI, is there any chance the FAA can cite me for violation of FAR 61.53? (eg, if they see when I started SSRIs and find out I've flown since then) (
a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required flight crewmember while that person:
  • Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation;)
Thanks for the advice!
 
Azure, to Clarify: It 's not disqualifying, if you have won a single SI, for the condition. Only then you can do Basic med.
 
Hello everyone,

If I pursue the SI path and plan on staying on SSRI, is there any chance the FAA can cite me for violation of FAR 61.53? (eg, if they see when I started SSRIs and find out I've flown since then) (
a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required flight crewmember while that person:
  • Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation;)
Thanks for the advice!
Pinging Doctor's Lou and Bruce for their input to this question. @lbfjrmd @bbchien

Early on in the adoption of of the SSRI issuance protocol, there was an amnesty period. But I haven't seen any discussion about it since said period came to a close.
 
Hello everyone,

If I pursue the SI path and plan on staying on SSRI, is there any chance the FAA can cite me for violation of FAR 61.53? (eg, if they see when I started SSRIs and find out I've flown since then) (
a person who holds a current medical certificate issued under part 67 of this chapter shall not act as pilot in command, or in any other capacity as a required flight crewmember while that person:
  • Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation;)
Thanks for the advice!
The reg doesn't say that. The reg in paragraph (a) which you are quoting specifically exempts operations under paragraphs (b) (things like sport pilot, gliders, flight instruction) and (c) (basic med) from being subject to that rule.
 
Azure, to Clarify: It 's not disqualifying, if you have won a single SI, for the condition. Only then you can do Basic med.
Bruce, are we both talking about ordinary, run of the mill (i.e. non-psychotic) depression? If so, this is really NOT clear from the statute, which only talks about psychosis, bipolar, personality disorder severe enough to have manifested in overt acts, and substance dependence. If it's true, I'll bet there are a number of pilots flying on Basic Med who have such a diagnosis (some may not even know it), who shouldn't be. Most PCPs would certainly not read that into the list of disqualifying conditions, and I even wonder how may AMEs would.
 
By putting their user name in the post with the @ symbol, it does cause an alert... just like saying @Palmpilot brought you to this post.
 
By putting their user name in the post with the @ symbol, it does cause an alert... just like saying @Palmpilot brought you to this post.
I received no alert. What brought me to this post was clicking on "Watched Threads" at the top of the page. The list which that produced included this thread because it had a new post since the last time I opened the thread. That happens whether someone types "@Palmpilot" or not.
 
I received no alert. What brought me to this post was clicking on "Watched Threads" at the top of the page. The list which that produced included this thread because it had a new post since the last time I opened the thread. That happens whether someone types "@Palmpilot" or not.
This must have something to do with settings. Whenever someone uses the @azure form in a post, I get an alert the next time I log in saying that someone "mentioned" me in a post.
 
This must have something to do with settings. Whenever someone uses the @azure form in a post, I get an alert the next time I log in saying that someone "mentioned" me in a post.
You're right. I just checked my Alert Preferences page, and "Mentions you in a message" is not checked. I'm pretty sure that I have never changed those settings from their defaults, so it looks like this is not a reliable way to get someone's attention.
 
You're right. I just checked my Alert Preferences page, and "Mentions you in a message" is not checked. I'm pretty sure that I have never changed those settings from their defaults, so it looks like this is not a reliable way to get someone's attention.
Interesting... since I'm pretty sure I've never changed my Alert Preferences settings either. ;)

You made me curious, so I just checked mine, and it looks like all of the boxes are checked. I wonder what the default is. :dunno:
 
Bruce, are we both talking about ordinary, run of the mill (i.e. non-psychotic) depression? If so, this is really NOT clear from the statute, which only talks about psychosis, bipolar, personality disorder severe enough to have manifested in overt acts, and substance dependence. If it's true, I'll bet there are a number of pilots flying on Basic Med who have such a diagnosis (some may not even know it), who shouldn't be. Most PCPs would certainly not read that into the list of disqualifying conditions, and I even wonder how may AMEs would.
Psychotic depression is not issuable, any class, so assumedly if one had that in his /her history, the third would never have been issued, therefore no Eligibility for BasicMed. Of course, then there are liars, sociopaths, etc.....
 
Interesting... since I'm pretty sure I've never changed my Alert Preferences settings either. ;)

You made me curious, so I just checked mine, and it looks like all of the boxes are checked. I wonder what the default is. :dunno:
It's a mystery!
 
Psychotic depression is not issuable, any class, so assumedly if one had that in his /her history, the third would never have been issued, therefore no Eligibility for BasicMed. Of course, then there are liars, sociopaths, etc.....
Of course someone might get the dx after holding a 3rd class for some years...

But ok, so I have to ask... since we are talking about recurrent but non-psychotic depression, what is your source for that requiring a one-time SI? And how widely known is that fact? Hopefully we can agree that it is not spelled out the way you are saying in the statute.
 
Benflyguy: I'm working on instrument rating so I fly every week. May as well get dual time in working on approaches, etc. since CFII is my brother it helps. He also does Angel Flights so it's another opportunity to learn the IFR ropes. I am missing getting up on my own though.


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So your post made me wonder. So if I understand correctly I can be on a SSRI and still be able to take flight lessons?

In other words I can be on a SSRI for 6 months and be working towards my CFI while on the SSRI? Is it all I need to do is surrender my medical until I stop taking the SSRI for at least 60 days, get my medical back and at that time be able fly by myself or start flight instructing?

Is this correct? What I don’t know is once I’m ready to take my CFI checkride can I still be on the SSRI?
OR
do I need to wait 60 days to be clear from the SSRI and THEN take the checkride?

Thoughts?
 
So your post made me wonder. So if I understand correctly I can be on a SSRI and still be able to take flight lessons?

In other words I can be on a SSRI for 6 months and be working towards my CFI while on the SSRI? Is it all I need to do is surrender my medical until I stop taking the SSRI for at least 60 days, get my medical back and at that time be able fly by myself or start flight instructing?

Is this correct? What I don’t know is once I’m ready to take my CFI checkride can I still be on the SSRI?
OR
do I need to wait 60 days to be clear from the SSRI and THEN take the checkride?

Thoughts?

Well you don’t need a medical to take lessons. You just can’t solo. So why I was waiting for my SI to issue I kept taking lessons. As far as the 6 months and then get your medical back I can’t give an opinion on that. It ptook me about a year to get my SI. Dr. Bruce Chien is the man to give you an opinion about that process. Since I first posted this I have since passed my IFR check ride.


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So if I understand you correctly it took you 1 year to get your SI? Granted you took advantage of the time and continue working on your instrument and all was DUAL since you could not solo due to the SSRI and instrument training doe not require solo anyways.
When you did the instrument "check ride", were you still under the SSRI or did you have your SI?
 
So if I understand you correctly it took you 1 year to get your SI? Granted you took advantage of the time and continue working on your instrument and all was DUAL since you could not solo due to the SSRI and instrument training doe not require solo anyways.
When you did the instrument "check ride", were you still under the SSRI or did you have your SI?

I had my SI issued for my 3rd class and then went to Basic Med.


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I just wanted to say I really appreciate you for taking the time to tell your story. I so admire you for sticking with it! I started toward my private pilot and am 7 hours in. I Just had my medical and didn't realize my 15 plus years on stable meds was a deal breaker. We have very similar histories! I'm prior military on 25mg Zoloft... currently a veterinarian.
I LOVE flying, and thought about going through the process like u did just to stick it to the FDA. But your story helped me decide not to go forward. It's insane how difficult and expensive they make those "hoops.". It's really hard to find out the process, so again thank you so much for explaining how it works. Happy flying! I wish I was up there with you. No wonder there's a pilot shortage! And probably a bunch of people lying on their medicals or not seeking treatment when they should.
 
I LOVE flying, and thought about going through the process like u did just to stick it to the FDA. But your story helped me decide not to go forward. It's insane how difficult and expensive they make those "hoops.". It's really hard to find out the process, so again thank you so much for explaining how it works. Happy flying! I wish I was up there with you. No wonder there's a pilot shortage! And probably a bunch of people lying on their medicals or not seeking treatment when they should.

I'm a little sad that you decided not to go forward, but everyone's case is a little different (and in my case, I was _extremely_ determined to fly no matter what I needed to do - sticking it to the FAA was most certainly a motivator). The whole purpose of me posting was to give others an idea of what the whole process entailed, as it seems SSRIs are a common sticking point. So I'm glad it provided enough insight to help you make a decision!

Looks like it's been a year since I last posted - early this year I switched to BasicMed, and it's quite a relief having done so. I still have to regularly visit the Board Certified Psychiatrist, but I don't have to worry about biannual CogScreen-AE evaluations, etc. to remain on the SI. Plus, there's loads of people who need Dr. Bruce's help much more than I do at this point - not having to make annual visits to him hopefully means that there's one more person in my shoes that he's able to assist as a result. In other words, I can just enjoy flying.
 
I'm curious if anyone has experienced the other side of this, going off an SSRI and trying to maintain a 3rd class medical? I had a special issuance 3rd class, and decided to go off the medication. I did it under the supervision of my AME over a year ago, and I'm very happy to be off the medication. The FAA first issued another special issuance, then for the next round withdrew my medical and said I need to be evaluated by an HIMS AME. My last special issuance expired 6 months ago, and the process is still ongoing. The short story is that I've not flown for 6 months, and I don't know how long it will be until I fly again. If I'd just switched to Basic Med I would have continued to fly and not spent thousands on an HIMS AME. Right now my advice is, unless a Basic Med just doesn't work for you, if you have a special issuance stick with it or go to Basic Med. The form is very clear that you can go from a special issuance to Basic Med.
 
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I'm at the tail end of my Special Issuance journey but I'm currently stuck because the HIMS psychiatrist my HIMS AME referred me to wants to charge $1,000-$3,000 to evaluate my paperwork. I've already done the cog screen and all of that. Are these charges normal?!?
 
My HIMS psychiatrist charged 800-1500 depending on situation. I don’t know what determines the exact cost.

I paid $1k for psychiatrist eval. Ssri path 1
 
Living, as I do, in one of the most expensive places in the nation, I suspect that costs for medical consultations, as with everything else, varies with location.
 
Cogscreamer: I am so happy that we got you there..... :), and it finally dawned on me who you are. Hey don’t be a stranger, the rest at 1C5 is a great lunch meet up...and it 200 yards from the office door ....:) :)
 
Cogscreamer: I am so happy that we got you there..... :), and it finally dawned on me who you are. Hey don’t be a stranger, the rest at 1C5 is a great lunch meet up...and it 200 yards from the office door ....:) :)

Thanks, Bruce! Will certainly have to drop in sometime!
 
My Hims Pschologist 2500.00
My cog screen 2500.00
Hims doctor. 500.00
2nd Hims doctor. 500.00
I’ve been in this process for just over 1 year. My file was finally sent to Washington 2weeks ago. 2nd Hims doctor you ask? The 1st one was let go from the hospital shortly after my initial visit!
 
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