Should I leave this out of my 3rd Class FAA Medical Form?

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I've got about 9 hours of flight lessons in, working towards my private certificate, and it's time to get my 3rd class medical. In retrospect, I should have gotten it done in the beginning, but you know what they say about hindsight.

I have read horror stories from would-be pilots who acknowledged certain medical conditions, only to have their medical denied or have to fight a long, drawn-out battle to get their certificate.

I do not have any debilitating medical conditions. I'm 30 years old, in relatively good health, with seasonal allergies and allergy-induced intermittent asthma, for which I take an albuterol inhaler as needed.

My concern is this: Last year, I was going through a divorce. My wife had cheated on me (with multiple men) and it was a very dark and messy time in my life. I was legitimately depressed by the whole situation. It got to the point where I could barely motivate myself to get out of bed, was very fatigued, and getting sick a lot. Just feeling lousy overall. I finally went to the doctor.

I explained the situation and he "diagnosed" me with depression. He also prescribed sertraline (Zoloft) and said I could use it short-term. (Upon doing more research I found this advice to be less than satisfactory)

I never even went to the pharmacy to fill the prescription. Instead, I started seeing a counselor to talk about this junk, and began to feel better about my outlook.

Here's the problem. That visit with the "depression" diagnosis and the script for sertraline is in my medical records, but I'm afraid if I list it under my "health visit history" my medical is going to be kicked back.

I'm new to the bureaucracy of the FAA and I'm hoping someone here can guide me as to what to do. I'm leaning towards just leaving it off but I don't want to get myself in trouble. Considering I never even went to fill the prescription I don't think it would come back to bite me, would it?

Or should I just describe the "reason" for seeing the doctor as "fatigue" (which was the initial reason I went in)?

Please help! Flying has been a dream of mine since I was a kid. I would hate to have it postponed by some bureaucratic nonsense.

thank you.
 
1. Do not lie either by omission nor comission.
2. Contact Dr Bruce offline (PM for starters) before you go any further.
3. Don't believe any medical advice here (#1 is not medical advice) except from Dr Bruce.
 
Contact Dr Bruce, I don't think you have a problem though, just make sure you tell them the situation was over marital issues as there is special exemption wording for counseling on marital based medical issues. Since you never filled the script, leave it out of the report.
 
Enlist the help of Dr. Bruce. This shouldn't be something insurmountable.
 
Contact Dr. Bruce off forum. Contact info can be found at www.aeromedicaldoc.com.

Likely he will come on this forum around 9:30pm to 10:30pm and provide some comment. But to get it done right, contact him directly.
 
The problem is your diagnosis code. Not the marriage counseling, which you don't have to report, but you WANT to report because there is an Rx on the doc's record.

You need to go back to your doctor, and be seen. Yes, that means, make an appointment. Go with the meds in hand. Have the nurse count and enter into the record that you have returned them for destruction. She will count them and note it in your record.

He will note that you did well with a counselor.

He needs to write, "transient reactive depression related to divorce, resolving/resolved without the use of medication." If you bring that to an AME, it's magic.

Your diagnosis code is likely 308.0. If you lie remember that your codes are NOT a part of the medical record and the agency will discover it easily, the FIRST time you bend metal, had an ATC "deal" or call attention to yourself. They will find the code, subponae the record and then the s_it starts happening. Welcome to the computerized medical record. You can lose your PILOT certificate due to that, not just the medical.

Uncle Sam can make you wish you had not been born. Don't be doing that. For such a simple fix, it's not worth it.

Yes, you need to go see the doc (or maybe just the nurse if he has an advanced practice nurse in the practice). But then it will be cleared and gone. It will be a normal, office issuance like any other. It is clearly worth a return visit to the doc.

There is a cheapie work around if you have a "got to bat for you HIMS AME". You can get phamacy records for several years at both CVS and Wlagreen that show no such Rx being picked up (it can't exclude a third carrier, like WalMart or Safeway- the list of reports to rpove a negative go on and on). The Psych trained AME will do a history and can then write "totally recovered". But there are only about 100 of us, and you need to make the doc's life easier and prevent deferral. So go to your doc and bring the note.

The AME will write, has letter from doc- never took medication, has recovered with counseling and it'll be a nonissue.
 
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To Dr. Bruce, and everyone else who replied, thank you for the advice.

Dr. Bruce,
I never filled the prescription. Are you suggesting that I should go to the pharmacy, fill the prescription, and then bring the unused medication in to verify it has not been used?
Or is there a good way for my doc to see that the prescription was unfilled? Do you suppose if I bring in the pharmacy record to my primary care physician (who wrote the Rx)showing that it was unfilled, that would be enough to procure the letter from him?

For the 8500-8 form I need to fill out, do I check YES under "mental disorders of any sort: depression, anxiety, etc."? Or do I leave that checked NO and then let my AME know about the transient depression?

I will make an appointment with my PCP first thing in the morning.

How do I report the counseling? Just include it under "Health Professionals visited in the last 3 years"?

Thank you so much for helping me navigate through this.
 
Unregistered said:
To Dr. Bruce, and everyone else who replied, thank you for the advice.

Dr. Bruce,
I never filled the prescription. Are you suggesting that I should go to the pharmacy, fill the prescription, and then bring the unused medication in to verify it has not been used?
Or is there a good way for my doc to see that the prescription was unfilled? Do you suppose if I bring in the pharmacy record to my primary care physician (who wrote the Rx)showing that it was unfilled, that would be enough to procure the letter from him?

For the 8500-8 form I need to fill out, do I check YES under "mental disorders of any sort: depression, anxiety, etc."? Or do I leave that checked NO and then let my AME know about the transient depression?

I will make an appointment with my PCP first thing in the morning.

How do I report the counseling? Just include it under "Health Professionals visited in the last 3 years"?

Thank you so much for helping me navigate through this.
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I missed that you never filled it.
18m is the problem. Someone thought you were depressed. A doc, in fact. Witha diagnosis code in the databases. So you need to develop counter-testimony to that.

See about getting that note from the doc. Make the AME's life EASY and remove "sweat" from your own :)
 
bbchien said:
I missed that you never filled it.
18m is the problem. Someone thought you were depressed. A doc, in fact. Witha diagnosis code in the databases. So you need to develop counter-testimony to that.

See about getting that note from the doc. Make the AME's life EASY and remove "sweat" from your own :)
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Just curious...I do auditing in the outside world, so whenever someone tells me they didn't do something I want evidence...how would you provide evidence that you never filled the prescription?

Would the prescription (on the doc's prescription paper) still in your possession be sufficient evidence?
 
JeffDG said:
Just curious...I do auditing in the outside world, so whenever someone tells me they didn't do something I want evidence...how would you provide evidence that you never filled the prescription?

Would the prescription (on the doc's prescription paper) still in your possession be sufficient evidence?
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Wouldn't it be the other way around? They (FAA) would have to prove it wasn't filled?
 
Henning said:
Wouldn't it be the other way around? They (FAA) would have to prove it wasn't filled?
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With the Dx on file, then the burden shifts to the airman to show the Dx was not correct, and showing the Rx wasn't filled would be a big part of that.
 
JeffDG said:
With the Dx on file, then the burden shifts to the airman to show the Dx was not correct, and showing the Rx wasn't filled would be a big part of that.
Click to expand...

So where is the DEA and the pharmaceutical paper trail on this? Are there any filing requirements and database for anything except the schedule drugs?
 
JeffDG said:
Just curious...I do auditing in the outside world, so whenever someone tells me they didn't do something I want evidence...how would you provide evidence that you never filled the prescription?

Would the prescription (on the doc's prescription paper) still in your possession be sufficient evidence?
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If the guy is in an HMO it's easy. If he's in a preferred pharmacy plan in a PPO, is harder (see post #7). If he pays cash, there are about 4,800 different pharmacy vendors in the US.

That is why it's important to return to the doc's office for the letter.
 
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I am in an HMO. So, are you saying they should be able to see that I never got the Rx filled?

My flight physical is Thursday morning. I booked an appointment with my primary care doc for tomorrow. I am hoping I can leave the doc's office with letter in hand.

I think I'll call my health insurer and ask them if they can provide proof that the prescription was never filled.

And just to confirm: I should or should not check "YES" for the "Have you ever been diagnosed with mental illness" question?
 
Unregistered said:
I am in an HMO. So, are you saying they should be able to see that I never got the Rx filled?

My flight physical is Thursday morning. I booked an appointment with my primary care doc for tomorrow. I am hoping I can leave the doc's office with letter in hand.

I think I'll call my health insurer and ask them if they can provide proof that the prescription was never filled.

And just to confirm: I should or should not check "YES" for the "Have you ever been diagnosed with mental illness" question?
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They can and will do no such thing. All they can state is that they did not pay for that script to be filled. You could have walked in and bought the pills with cash.

You are supposed to check yes on that I believe and the letter Bruce told you bring from the doc is supposed to cover that right there in the office. From then on you will always check yes and fill in "Previously Reported, No Change" in the box provided.
 
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by they way you'll probably need to get a note from your doctor about your albuterol inhaler too.
 
OK, that makes sense. I'll have my doc write a note about the inhaler only used as needed for allergy-induced asthma as well.


thanks.
 
i think you need the note to say something about no hospitalizations in the last 2 years. check with your AME, or bruce, or search the archives here, it has probably come up before. It was a surprise to me as I never got any feedback until about my 5th medical because they changed the requirements.
 
Henning said:
They can and will do no such thing. All they can state is that they did not pay for that script to be filled. You could have walked in and bought the pills with cash.

You are supposed to check yes on that I believe and the letter Bruce told you bring from the doc is supposed to cover that right there in the office. From then on you will always check yes and fill in "Previously Reported, No Change" in the box provided.
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But I could at least prove that my insurance did not pay for the prescription, and I could print off my Walgreen's pharmacy record, correct? I realize it's not absolute proof--certainly someone who was trying to stay under the radar could pay cash--but I'm hoping that would be enough to give my doc peace of mind about writing a letter that states I did not use the medication.

And regarding saying "YES" to having been diagnosed with depression. Even though it was situational/transient and not a chronic medical condition, and it was not diagnosed by a mental health specialist, it sounds like I still have to check "YES." I am nervous about this, but it sounds like, from what Dr. Bruce is saying, the AME won't have a problem as long as I can get the letter from my doctor.
 
tonycondon said:
i think you need the note to say something about no hospitalizations in the last 2 years. check with your AME, or bruce, or search the archives here, it has probably come up before. It was a surprise to me as I never got any feedback until about my 5th medical because they changed the requirements.
Click to expand...

Thanks for the heads up Tony. Yeah, I've never been admitted to the hospital for asthma (or anything else for that matter). I'll ask the doc to write something up to that effect, and I'll search through the forum to see what else is there.
 
Unregistered said:
My flight physical is Thursday morning. I booked an appointment with my primary care doc for tomorrow. I am hoping I can leave the doc's office with letter in hand.
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You might consider pushing back the flight physical. If your primary care physician (PCP) is like many doctors in the land, they are not very aware of the FAA requirements and often get a bit twitchy when a patient asks for documentation that is outside of the normal chart requirements.

I'm not saying he won't write the letter, but he might not be that quick to do it.

One way to ease this is to go to his office with a "boiler pate template" provided by Bruce that he can just photocopy onto his letterhead and sign.


Another reason for considering postponing is to review ALL of the questions on the MedXpress form and make sure if any other boxes in 18 are checked yes, you are fully informed what to obtain to explain the situation and make the AME's job a yawn. DO NOT GO IN UNPREPARED.


Finally, a very important tip. After completing the MedXpress form online, you will be presented with the "Confirmation Code" that the AME uses to find your form in the database. You will also be given the chance to print out (and save) the PDF file.
  1. Print out this PDF File
  2. Cut off the confirmation code that appears at the bottom of both pages
  3. Carry this code in your pocket or wallet.
  4. When you go to the AME's office, hand him (or staff) the PDF printout only. Do not hand over the code.
  5. Allow the doctor to conduct the exam based on the information on the PDF printout.
  6. If the doctor says he is able and willing to issue your certificate right then and there, that's when you hand over the code.
  7. If the doctor says there is something that prevents him from issuing you certificate, do not hand over the code.

The point is that while you have the code in your possession, the examination is considered a consultation and not an "all or nothing" event. If the AME finds a show stopper, you have the chance to deal with it without the FAA officially knowing of the problem. You cannot be deferred or worse, denied.

Only until you surrender code is the exam official. And only do that once the AME has said he will issue you the certificate.

If he refuses to conduct the exam without the code first. Find another AME.
 
Another reason for considering postponing is to review ALL of the questions on the MedXpress form and make sure if any other boxes in 18 are checked yes said:
Finally, a very important tip[/B]. After completing the MedXpress form online, you will be presented with the "Confirmation Code" that the AME uses to find your form in the database. You will also be given the chance to print out (and save) the PDF file.
  1. Print out this PDF File
  2. Cut off the confirmation code that appears at the bottom of both pages
  3. Carry this code in your pocket or wallet.
  4. When you go to the AME's office, hand him (or staff) the PDF printout only. Do not hand over the code.
  5. Allow the doctor to conduct the exam based on the information on the PDF printout.
  6. If the doctor says he is able and willing to issue your certificate right then and there, that's when you hand over the code.
  7. If the doctor says there is something that prevents him from issuing you certificate, do not hand over the code.

The point is that while you have the code in your possession, the examination is considered a consultation and not an "all or nothing" event. If the AME finds a show stopper, you have the chance to deal with it without the FAA officially knowing of the problem. You cannot be deferred or worse, denied.

Only until you surrender code is the exam official. And only do that once the AME has said he will issue you the certificate.

If he refuses to conduct the exam without the code first. Find another AME.
Click to expand...


I am not concerned about anything other than the "mental illness" tag. My doc has seen me several times for respiratory infections (including regular ol' colds and sinus problems) and is aware that my asthma, while it contributes to making it tougher to get over a cold for instance, is not life-threatening and I have never had to go to the hospital for it. I think that will be a breeze. I'm more concerned about the letter indicating I got through my transient depression without medication.
If my doctor balks at all, or gets 'twitchy' I will call the AME's office and postpone.

The advice you've just given me about the code is indispensable. I guess I thought the form was automatically uploaded to the FAA database and the AME would just look it up. This gives me some peace of mind, although it still irks me that I have to report the tough time I had as "mental illness."

Thank you. You all have been very helpful.
 
Listen to Dr Bruce.

With that said, I did not lie or hide anything on my medical. I have insulin dependent diabetes, I had been on depression medication in the recent past (similar situation to yours), had been to see a psychologist (pretty regularly since I was in my early 20's; shoot, I think that should be considered routine maintenance, like 50-hour inspections, I still go ever so often when I feel the need to talk), and a few other things that could be flags.

I tagged them all, attached a nice letter explaining each one in detail and why it is no longer an issue, and received my medical.

EDIT: in a strange way, I have come to think of this process as a gut check of sorts. It almost feels like in a perverse way, being very upfront about stuff helps rather than hinders the ability to be viewed positively for special issuance (like in my case).
 
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Thank you, this is all making a lot more sense. As long as I'm thorough and have explanations for each "YES" in item 18, I shouldn't have a lot to worry about.
 
bbchien said:
If the guy is in an HMO it's easy. If he's in a preferred pharmacy plan in a PPO, is harder (see post #7). If he pays cash, there are about 4,800 different pharmacy vendors in the US.

That is why it's important to return to the doc's office for the letter.
Click to expand...

I called my insurer and they emailed me my prescription history for the year, which at least shows that my HMO did not pay out on a sertraline Rx. I think this will be sufficient for my doc to write the letter. I can't imagine anyone, including my doctor, needing more evidence than that. It's not like I'm trying to show proof of not having purchased a prescription pain med... I can see how unscrupulous individuals might try and hide that by paying with cash.
But there's just no good reason a person (me especially) would pay for a Zoloft Rx out of pocket.

I think this will be OK.

thanks again for all the advice, Dr. Bruce.
 
Unregistered said:
But I could at least prove that my insurance did not pay for the prescription, and I could print off my Walgreen's pharmacy record, correct? I realize it's not absolute proof--certainly someone who was trying to stay under the radar could pay cash--but I'm hoping that would be enough to give my doc peace of mind about writing a letter that states I did not use the medication.

And regarding saying "YES" to having been diagnosed with depression. Even though it was situational/transient and not a chronic medical condition, and it was not diagnosed by a mental health specialist, it sounds like I still have to check "YES." I am nervous about this, but it sounds like, from what Dr. Bruce is saying, the AME won't have a problem as long as I can get the letter from my doctor.
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If you don't have absolute proof, you have no proof, you merely have evidence. The problem with evidence is conjecture. Your doctor/FAA is either going to take you on your word or not. The only thing that adding obviously deficient evidence can do is lead to is suspicion.

With regards to "yes" you've changed your story here if you are the OP where you stated there was a diagnosis made.

I explained the situation and he "diagnosed" me with depression. He also prescribed sertraline (Zoloft) and said I could use it short-term. (Upon doing more research I found this advice to be less than satisfactory)

I never even went to the pharmacy to fill the prescription. Instead, I started seeing a counselor to talk about this junk, and began to feel better about my outlook.

Here's the problem. That visit with the "depression" diagnosis and the script for sertraline is in my medical records, but I'm afraid if I list it under my "health visit history" my medical is going to be kicked back.
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Cancel your appointment until you have all your ducks in a row...and I mean everything Dr. B has mentioned.

Here's why...

If you have everything laid out properly, it's likely the AME will be able to issue on the spot, or perhaps after a call to the RFS (Regional Flight Surgeon).

If not, then he will be required to defer your application and send it to Civil Aviation Medical Institute (CAMI) in Oklahoma City...there it will sit for at least 6-8 weeks.

Putting your medical off a week or two is much preferred to showing up and being deferred, then having to send the docs to OKC. Not that a different decision will be reached (they work to the same standard), just that it will take significantly longer if deferred.
 
Henning said:
If you don't have absolute proof, you have no proof, you merely have evidence. The problem with evidence is conjecture. Your doctor/FAA is either going to take you on your word or not. The only thing that adding obviously deficient evidence can do is lead to is suspicion.

With regards to "yes" you've changed your story here if you are the OP where you stated there was a diagnosis made for billing purposes.
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What do you mean I've changed my story?

I don't think I ever said that there was a diagnosis made for billing purposes. I said I was depressed because my wife was cheating on me, and I was fatigued and getting sick a lot. My doc diagnosed me with depression and fatigue, and prescribed the sertraline. Rather than take the prescription, I went to counseling instead and was able to talk through it.

I'm confused.

PS - I am the OP.

"Obviously deficient evidence?" There's not
 
re-reading my post, it probably comes off as combative or defensive. I'm just confused.
 
Unregistered said:
What do you mean I've changed my story?

I don't think I ever said that there was a diagnosis made for billing purposes. I said I was depressed because my wife was cheating on me, and I was fatigued and getting sick a lot. My doc diagnosed me with depression and fatigue, and prescribed the sertraline. Rather than take the prescription, I went to counseling instead and was able to talk through it.

I'm confused.

PS - I am the OP.

"Obviously deficient evidence?" There's not
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Correct, when I went back to quote I edited that detail, however the story has changed in that you just claimed NO diagnoses had been made when in the OP you state it is in your medical record. Typically the reason a diagnosis gets made though is because insurance companies require it for reimbursement.

If you do not have the prescription the Dr handed you to present, your evidence is obviously deficient. It is the only way to prove the negative, to fill the void.
 
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Henning said:
Correct, when I went back to quote I edited that detail, however the story has changed in that you just claimed NO diagnoses had been made when in the OP you state it is in your medical record. Typically the reason a diagnosis gets made though is because insurance companies require it for reimbursement.

If you do not have the prescription the Dr handed you to present, your evidence is obviously deficient. It is the only way to prove the negative, to fill the void.[/QUOTE

When did I claim no diagnosis was made?

The doc did not give me a paper prescription. It was electronically transmitted to Walgreens.
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Unregistered said:
Henning said:
Correct, when I went back to quote I edited that detail, however the story has changed in that you just claimed NO diagnoses had been made when in the OP you state it is in your medical record. Typically the reason a diagnosis gets made though is because insurance companies require it for reimbursement.

If you do not have the prescription the Dr handed you to present, your evidence is obviously deficient. It is the only way to prove the negative, to fill the void.[/QUOTE

When did I claim no diagnosis was made?

The doc did not give me a paper prescription. It was electronically transmitted to Walgreens.
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Post 20:
And regarding saying "YES" to having been diagnosed with depression. Even though it was situational/transient and not a chronic medical condition, and it was not diagnosed by a mental health specialist, it sounds like I still have to check "YES." I am nervous about this, but it sounds like, from what Dr. Bruce is saying, the AME won't have a problem as long as I can get the letter from my doctor.
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Ok, I see my misread. If it was a computerized prescription called into Walgreens, they should be able to provide the proof you require.
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right. the diagnosis was not by a mental health specialist. the diagnosis was made by my primary care physician. That is all I was saying.
 
Unregistered said:
right. the diagnosis was not by a mental health specialist. the diagnosis was made by my primary care physician. That is all I was saying.
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A thought about the letter you are asking this doc to write.

Once you get it, ask Dr. Bruce to review it ensure it has all the right elements and no hidden tripwires and landmines.
 
Thank you Mike, I will. And, as suggested by others, I will postpone my medical until I have all of these ducks in a row.
 
I am the OP.

And I now have my medical in hand!

The AME said to me (after returning from a call with his supervisor) "Wow, you really owe your doc. That letter was just... unbelievably helpful! I wonder if he's a pilot? That letter was EXACTLY what we needed."

Dr. Bruce, thank you!
And thank you to everyone else who offered advice and help.

I'll go fly now.
 
Unregistered said:
I am the OP.

And I now have my medical in hand!

The AME said to me (after returning from a call with his supervisor) "Wow, you really owe your doc. That letter was just... unbelievably helpful! I wonder if he's a pilot? That letter was EXACTLY what we needed."

Dr. Bruce, thank you!
And thank you to everyone else who offered advice and help.

I'll go fly now.
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:) :) :)
 
I want to thank Dr. Bruce for this one, on behalf of POA and GA ... another success story.

And to the OP, thanks for posting the successful outcome as well! Congrats!
 
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