Prozac use/OCD FAA medical denial

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Dboy2002

Filing Flight Plan
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Dboy2002
Hi,
My son is a minor, 17 yrs.. He is interested in becoming a commercial pilot and recently received a letter of denial for his 1rst class medical from the FAA. The reason for the denial was "history of trichotillomania" which was diagnosed when he was 15 as he was pulling hair from the front of his head (about the size of a quarter)-being the good mom that I am-I took him to a Psych/ARNP who put him on Prozac (40 mg) for about 1 year which immediately stopped the pulling behavior. He has been off this medication for at least 9 months with no return of the behavior. Is there any chance if we get a Psychiatric eval and all his treatment notes sent to the FAA that he will ever get a first class medical? We are very discouraged and not sure if he should pursue this career now-we were going to tour Embry-Riddle next week... Thanks for your advice. Dana
 
Dboy2002 said:
we were going to tour Embry-Riddle next week...
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You guys can take the tour, but if having a first class medical is a absolute requirement for entrance into ERU, then you might need to make plans to push the pause button on him going there for at least the fall semester and likely not attending the spring either.

Getting the medical certificate issuance done when psychological issues are in play is a very slow process. The requirements are very specific and take time to comply with to build up the "case file" that is then sent to the FAA for review. Then once in the hands of the FAA, it will take many, many weeks, if not months, before the file makes it to the top of the stack on the desk of the correct reviewer or doctor.

But even then it isn't a guarantee, as the file could be found missing something, so they send you a letter with the request for what they want. Then you must take the time to get it. Then the time to send it to the FAA, then the time for the new documents to be scanned into the system, then to the bottom of the reviewers stack, then the time to reach the top of the stack, then hope all items are there and the reviewer can make a decision.

In the big picture, there is an very large ocean full of submissions to be reviewed, yet only a very tiny boat's worth of qualified reviewer minions and an even smaller group of MD's.


The best folks on PoA to provide comment and hopefully guidance are Dr. Bruce Chien, @bbchien, and Dr. Lou Fowler, @lbfjrmd.
 
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Something worth mentioning that the young lad can be doing while you are sorting the medical certification issues is studying for and eventually taking the written knowledge exam. Some free books are available on the FAA.gov website that can get him started:

Pilots Handbook of Aeronautical Knowledge
Airplane Flying Handbook
​
There are several others texts that will eventually be added to the mix, but these are a good start.
 
It would appear to me this young airman's case could be favorably resolved. FAA ltrs would need to be evaluated. I suspect avenues to pursue such were in the FAA denial.
 
Hi, Dboy. Sorry to hear of your son's problems. Assuming a good ultimate result, I also recommend getting him started with ground school study. He might as well do something positive to move along the journey. Have him join www.GroundSchool.com. If you PM me I will give you instructions and we will provide him full access with our compliments (i.e., no charge). Best of luck to him.
 
Wow!! Thank you all for this great information! I have started working on the things the FAA needs to pass him medically: “all medical records from the prescribing doctor” and a current psychiatric eval by a doctor with “aerospace psychiatry”-any thoughts on where to find such a specific doctor? Thanks again!
 
AggieMike88 said:
Something worth mentioning that the young lad can be doing while you are sorting the medical certification issues is studying for and eventually taking the written knowledge exam. Some free books are available on the FAA.gov website that can get him started:

Pilots Handbook of Aeronautical Knowledge
Airplane Flying Handbook
​
There are several others texts that will eventually be added to the mix, but these are a good start.
Click to expand...

Great idea!! Thank you :)
 
write-stuff said:
Hi, Dboy. Sorry to hear of your son's problems. Assuming a good ultimate result, I also recommend getting him started with ground school study. He might as well do something positive to move along the journey. Have him join www.GroundSchool.com. If you PM me I will give you instructions and we will provide him full access with our compliments (i.e., no charge). Best of luck to him.
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Thank you! He is excited-he still has a year left of high school-so plenty of time to work toward these goals. We are trying to be positive as we had already provided documentation to show how long he had been off the meds and that he had been discharged from the psychologist as we had been advised to do so. This will keep him headed in the right direction-Thank you! Dana
 
Dboy’s mom said:
Wow!! Thank you all for this great information! I have started working on the things the FAA needs to pass him medically: “all medical records from the prescribing doctor” and a current psychiatric eval by a doctor with “aerospace psychiatry”-any thoughts on where to find such a specific doctor? Thanks again!
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One source has already commented above lbfrjrmd is a senior ame that handles hims cases dr Bruce is the other expert that will probably chime in here soon. Either one is a great source, well worth their fees. Get in contact with them.
 
lbfjrmd said:
It would appear to me this young airman's case could be favorably resolved. FAA ltrs would need to be evaluated. I suspect avenues to pursue such were in the FAA denial.
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Yes, they want a Psychiatric eval and the prescribing doctors notes .
 
bbchien said:
Trichotillomania is a symptom. Really key is the diagnosis and IIRC he doesn’t have a board certified psychiatrist. See your private email, we need to “get going”.....
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Got it-sent you an email :)
 
I was denied for a third class medical back in March of this year because I was taking a disqualifying medicine, which was Detrol LA. I also was taking Prozac. I was able to discontinue both medications and have no reoccurring problems. I have been off of both medicines for the at least 60 days, which is what was required. The FAA has asked for all the medical records from the physician that prescribed the Prozac. I am in the process of getting those sent in.

Do you think I will be required to have a psychiatric evaluation?
 
fortner102 said:
I was denied for a third class medical back in March of this year because I was taking a disqualifying medicine, which was Detrol LA. I also was taking Prozac. I was able to discontinue both medications and have no reoccurring problems. I have been off of both medicines for the at least 60 days, which is what was required. The FAA has asked for all the medical records from the physician that prescribed the Prozac. I am in the process of getting those sent in.

Do you think I will be required to have a psychiatric evaluation?
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yes
 
I am not a doctor or an expert of any sort. But, it seems to me like professional pilot might be a bad choice of careers for your son. Having to jump through such serious hoops before even beginning, imagine how difficult this career will be long term. I’ve often wondered how anyone outside military could choose a profession that could end at the blink of an eye with any number or common maladies that wouldn’t even be noticed in other careers, but with such a high hurdle right out of the gate....

I would have your son look at his career from both sides, it’s not as glamorous as it may appear. Have him talk to actual career pilots.

After that, then do whatever Bruce says and help him live the dream!
 
Also, perhaps consider starting to learn to fly in gliders. They really do teach how a set of wings and controls handles in the air. A private certificate for gliders can then later be upgraded to powered flight.
 
As mentioned, flying as a career can be chancey and one medical problem, or even a regulation change, can ground him. Make sure he has a good alternate. A STEM or business degree can still pay the bills if he has to stop, or wants to stop, flying. Always have a plan B.

The number one thing a pilot needs is good judgment. He can start learning that right now.
 
Salty said:
I’ve often wondered how anyone outside military could choose a profession that could end at the blink of an eye with any number or common maladies that wouldn’t even be noticed in other careers,
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Well... what else could a fellow do??

Seriously though just have to accept there is risk and go for it...
 
Half Fast said:
As mentioned, flying as a career can be chancey and one medical problem, or even a regulation change, can ground him. Make sure he has a good alternate. A STEM or business degree can still pay the bills if he has to stop, or wants to stop, flying. Always have a plan B.

The number one thing a pilot needs is good judgment. He can start learning that right now.
Click to expand...

Thanks for your interest-after talking with Dr. Chien- my son has decided to pursue the no meds route for 10 years with yearly psychological checkups and if he is still interested in flying after that, he could apply to the FAA again. This will give him time to finish college and work a bit, as well as grow up some :) Unfortunately, unbeknownst to me, on one page of his medical record the doctor checked the “anxiety disorder” diagnosis and that changed everything. But your advice was very uplifting to me as I have been sad that this didn’t work out-so maybe it is for the best :)
 
Salty said:
I am not a doctor or an expert of any sort. But, it seems to me like professional pilot might be a bad choice of careers for your son. Having to jump through such serious hoops before even beginning, imagine how difficult this career will be long term. I’ve often wondered how anyone outside military could choose a profession that could end at the blink of an eye with any number or common maladies that wouldn’t even be noticed in other careers, but with such a high hurdle right out of the gate....

I would have your son look at his career from both sides, it’s not as glamorous as it may appear. Have him talk to actual career pilots.

After that, then do whatever Bruce says and help him live the dream!
Click to expand...

Thanks for your interest-after talking with Dr. Chien- my son has decided to pursue the no meds route for 10 years with yearly psychological checkups and if he is still interested in flying after that, he could apply to the FAA again. This will give him time to finish college and work a bit, as well as grow up some :) Unfortunately, unbeknownst to me, on one page of his medical record the doctor checked the “anxiety disorder” diagnosis and that changed everything. But your advice was very uplifting to me as I have been sad that this didn’t work out-so maybe it is for the best :)
 
write-stuff said:
Hi, Dboy. Sorry to hear of your son's problems. Assuming a good ultimate result, I also recommend getting him started with ground school study. He might as well do something positive to move along the journey. Have him join www.GroundSchool.com. If you PM me I will give you instructions and we will provide him full access with our compliments (i.e., no charge). Best of luck to him.
Click to expand...

Hi Write-Stuff-Thanks for your interest in my son again-after talking with Dr. Chien- my son has decided to pursue the no meds route for 10 years with yearly psychological checkups and if he is still interested in flying after that, he could apply to the FAA again. This will give him time to finish college and work a bit, as well as grow up some :) Unfortunately, unbeknownst to me, on one page of his medical record the doctor checked the “anxiety disorder” diagnosis and that changed everything. But your support and advice was very uplifting to me as I have been sad that this didn’t work out-but maybe it is for the best :) Thanks again, Dana
 
Dboy’s mom said:
Thanks for your interest-after talking with Dr. Chien- my son has decided to pursue the no meds route for 10 years with yearly psychological checkups and if he is still interested in flying after that, he could apply to the FAA again. This will give him time to finish college and work a bit, as well as grow up some :) Unfortunately, unbeknownst to me, on one page of his medical record the doctor checked the “anxiety disorder” diagnosis and that changed everything. But your advice was very uplifting to me as I have been sad that this didn’t work out-so maybe it is for the best :)
Click to expand...


Dr Chien is one of the best. He’s the AME I used for my own medical. You can take what he tells you as gospel.

Best of luck to your son and to you.
 
Again (see August 2): Trichotillomania is a symtom. The real question is what is the underlying diagnosis.
Is the underlying condition recurrent?
etc.
etc.
etc.
 
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