SSRIs and deferral timeline?

jstone said:
yes, because the Europeans were behind the times when they decided that it was ok for one Person to be in the cockpit. Most countries including the us require 2 crew members in the cockpit at all times.
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Is that correct with the timing? I thought the US also implemented the 2 person rule after the GermanWings disaster.
 
mryan75 said:
You mean aside from the fact that we have the safest aviation system in the world?
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Yes, there are a whole variety of factors other than aeromedical certification which might account for that. A bit of post-hoc ergo propter gov fallacy there.
 
DFH65 said:
Agree, the system is set up to put people in a bad position. Disclose lose your livelihood or ignore and keep flying until you can't.
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Isn't this what started the HIMS program, to give incentive for alcoholic airline pilots to get out of the cockpit while they recover without fear of losing their jobs? I don't see what is wrong with the FAA requiring pilots with known issues to clear the same medical scrutiny before issuing a medical instead of waiting until after they are in the cockpit. For me, the debate is more about the decision of what medical issue should be considered hazardous to flight. I have to accept what the FAA decides since I agreed to abide when I signed up for my license.
 
Short little update: I called OKC yesterday (using the non-consecutive day calling method) and my deferral paperwork is finally in the mail. 5 weeks from AME appt to mailed out. Not too terrible with a holiday mixed in. I will update again when I see the requirements from them.
 
Jonathan Stein said:
OP, any updates on your case?
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Just happened to be sitting at my computer when you posted this. Here is where I am at. The FAA deferral paperwork arrived one week after they mailed it (January 23rd). It said I need to send all doctor information as to when the medication was prescribed and any other additional info. I sent to Dr. Bruce and he immediately told me I would need a psych evaluation. They didnt ask for one yet but he said they definitely will. He gave me some options between trying to find a local cheap one all the way up to a HIMS psych. I opted for a HIMS evaluation (most expensive) because I dont want to mess around with possibilities, and the HIMS guys know EXACTLY what the FAA is looking for. Dr. Bruce has been extremely good with the " you could try this but" info. I had my evaluation done yesterday (2-5) which consisted of normal personal history questions about drugs, alcohol, when meds were administered and why, and current symptoms. Then some basic Cog tests like..what is this, what is the difference of this and this, what are the similarities, count backwards in 7s from this, name presidents....things like that. It took about an hour and then he sent me directly for blood work. I dont know what they are testing for, but I assume liver function (drugs) and an alcohol screening. So, at this point....I just wait for the report from the psychiatrist. I will keep everyone updated as soon as I hear something.
 
Hey Russ any updates since Feb? I went into my AME exam yesterday with zero research, and now I’m in the same boat as you.
 
I’ll update you tonight...it’s a long one!
 
Jesse Lester said:
Hey Russ any updates since Feb? I went into my AME exam yesterday with zero research, and now I’m in the same boat as you.
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if you are currently on meds, it depends what path you go down..I went down path 1 which is to discontinue use, so I will tell you my story on that path.

First thing....contact Dr Bruce or Dr Lou to help you through...both frequent this forum. You will need informed help to get through “quickly”, and the FAA will NOT help you get through quickly.

I discontinued my meds in December and had to wait 90 days and have my PCP write a letter saying my condition was improved and stable off of meds. My anxiety diagnosis was a one time diagnosis and not reoccurring...that is important.

With the help of Dr Bruce, I found a HIMS psychiatrist and got a psychiatric evaluation done. In my area that was about $1500. The FAA federal letter did NOT state I needed one, but I’ve learned that they definitely will. That’s part of the “get informed help” advice. The FAA will nickel and dime you, so to speak, with information requests and it will drag on and on. I had that done in February. If you drink alcohol, STOP NOW. I have zero substance issues, arrests, job issues, doctor recommendations, family issues or ANYTHING suggesting I have a problem with alcohol. I did over indulge over the holidays with party’s and such...responsibly of course, as I have always done. Something they WONT tell you is they will take blood and test for drugs (of course), AND alcohol biomarkers. Biomarkers show alcohol use over a period of time. Mine was high....like I said, over indulged responsibly.....what does that say to the psychiatrist ( who doesn’t know you from a hole in the ground)?.....it says “you have an alcohol abuse issue”. So that’s what I got stuck with.

Mind you, all of this is before the FAA has even requested any more information than a note from my doctor. Everything I am doing with Dr Bruce is preemptive. He knows the system and what they will ultimately ask for, so we gathered all of the info prior to them asking for it and sent it in with my initial response to their deferral letter. My packet got sent to the FAA end of last month.

Back to my story. Since the FAA is going to label me with abuse, they are going to require a special issuance. I will be required to have 14 random pee tests over 12 months and show no alcohol use....at all. We started this immediately following my visit to Dr Bruce’s office in March....again, preemptive. If they are going to require it, better to start it right away to keep the time line at a minimum. The “hope” is that after 4 months of proven abstinence, they will issue me, and then require monitoring for 2 years. The 4 months will put me into June. I have to hope my packet makes it’s way through the FAA maze by then.

so my absolute earliest chance of getting issued is June/July. 6-7 months after my deferral....and that is doing everything preemptively. Had I known what I know now:
if you drink, even responsibly, stop at least a month before your psych evaluation. I have stopped, because I have to. Did I want to? No, not really...but I could and it was easy...for me. I don’t like feeling like my liberties on a perfectly legal activity are taken away. That being said, I don’t have an alcohol problem ( I know that’s what alcoholics say) and if I want to fly this is what I have to do. As Dr Bruce told me...it’s their ball....and if you don’t play the game the way they want you to, they’ll take their ball and go home.

if I missed something and you have more questions...let me know.
 
Wow, that is absolutely insane that they check this for alcohol traces. I do have some beers or wine here and there, so I guess I need to stop. Imagine if they did this with cars? No one would be driving ever.

6-7 months isn’t as bad as I was worrying about I guess, but the continued monitoring ect is just.... wow. It’s interesting even though you stopped the meds they still required all of these evals. It doesn’t sound much different than option 2 and just staying of SSRIs. You know the real issue with this insane policy? No one will ever get treated again... people will avoid it because it takes so much away. If they start doing it for other freedoms we enjoy I mean like they want to.
 
So my issue is interesting. Diagnosed w general anxiety yrs ago and have been stable ever since on the same meds. Similar to everyone else, Dr said I might as well just keep taking it since I’m fine w no issues. My normal Dr relocated about 6 months ago, so I had to go to a new place for refills. After going in and talking to him about the issue I had 7 yrs ago, I noticed he wrote down recurrent depression on my notes... I could care less what he called it at that point in time, but now I’m really worried this Dr just messed me up big time. I have my apt with a HIMS AME this week and I’m really struggling at what I should do next. I’m at 12 hrs training and my CFII says I can solo soon cuz I’m a natural. I guess it’ll be more like 8 months to a yr if ever now.
 
Beers and wine here and there won’t really affect the test. If you have a stretch of beers and wine on a regular basis, it will show....so just keep that in mind.

I’m far from an expert here but have done a TON of research since mine started. With what you described and being listed as recurrent depression, I think you are path 2 for sure. So you will have to prove stability on the meds...as long as they are on the approved list of SSRIs. The biggest difference between your path and mine, you will have to go through the “full battery” of tests. Psychiatric evaluation, and psychological evaluation with cog screen testing. Dr Bruce is a master in this topic so he would know WAY more than me.

my 7 months to issuance is my BEST case and is me being optimistic. All I can do is do exactly as I’m told by my HIMS AME and hope for the best. It’s frustrating for sure...but I’ve made peace with the process.
 
I feel the same way with flight coming very natural to me. I know I will be a damn good pilot and it’s something I was born to do. Don’t give up. It’s gonna be a rough ride, and it will test your patience....but it can be done and if you really want it, go get it.
 
Agreed, afraid I might be on path two also.

Yea, I’m going to stick it out. I know I’ll be a great safe pilot. 20 years of driving, no wrecks, no tickets.... why don’t they check that, smh. But hopefully both of us will be faster than expected if we submit everything perfectly.
 
I thought of another question. How much of this cost can be covered by health insurance? Have you ran into anything that’s not covered?
 
Medical insurance is for fixing a medical condition. Insurance does not pay for you to prove to the FAA that you don't have a medical condition.
 
Depends on the insurance policy, they vary.

Like the exam itself, it's covered more often than people think, but many of the FAA providers are out-of-network or non-participating and can't/won't file. You have to do it directly with your insurance company.

Your insurance company probably has a pre-authorization phone number. A worthwhile call.
 
Agreed. All of mine was out of pocket
 
Even if the provider is "in network" most policies won't cover "occupational" physicals, so unless you can tie the tests requested to some actual medical treatment, they won't pay.

I guess that's one nice thing about Basic Med. I get an included "well check" every year and that can double as the basic med visit.
 
Anyone have trouble obtaining records? Every provider I've called has said they can't release them to me because of some HIPPA issue. I asked the HIMS AME and he said he didn't need them...
 
Gatorj31 said:
Anyone have trouble obtaining records? Every provider I've called has said they can't release them to me because of some HIPPA issue. I asked the HIMS AME and he said he didn't need them...
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if you have your AME request the records, he/she shouldn’t have a problem. Doctors have a much easier time getting then from other doctors. Does he not need them because he got them already?? As far as I know, he will definitely need them if he is submitting your packet to the FAA.
 
I guess it's because this is our first appointment to talk about everything and we haven't talked about what will be needed. I'm hopeful after we meet he'll be having them sent to him.
 
Gatorj31 said:
Anyone have trouble obtaining records? Every provider I've called has said they can't release them to me because of some HIPPA issue. I asked the HIMS AME and he said he didn't need them...
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Interesting. I have never had a problem obtaining records from my providers, and I always ask for them. Sometimes I have to fill out a HIPPA release, but still never had a problem.
 
The records need to go directly to the HIMS AME for an SI in any case - they cannot go through you to them.

Figure $5-10k for a pathway 2 special issuance for a full psychological and psychiatric exam and test set. Yes, it will be 6-12 months if you work with one of the specialists and everything is done right the first time.

In the meantime, how about learning to fly in gliders? They don’t require an FAA issued medical (but do require the ability to self certify). This pathway can get you to a private glider in a few months and then the power training can be a shorter add-on.

Learning to fly gliders really teaches you how a set of wings and controls handles in the air. You might even learn to enjoy soaring for its own sake. Generally people feel it makes them a better powered pilot.

Fastest is a commercial glider operation. Many may be closed now due to Covid-19, but hopefully that resolves within a month or so. In many locations, May and June will still have excellent soaring weather.
 
Gatorj31 said:
You know the real issue with this insane policy? No one will ever get treated again... people will avoid it because it takes so much away. If they start doing it for other freedoms we enjoy I mean like they want to.
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Yes, we have had many long discussions here about whether the FAA requirement for a 3rd class medical improves the safety of flight on average in any way. One of the main concerns is people avoiding treatment and testing because they don’t want it to come up on their medical. That may offset any possible gains from occasionally preventing someone with a medical issue from flying.

Likely a different situation for commercial pilots since the airlines and employers and insurers will want fairly strict requirements, whether the FAA does or not.
 
PeterNSteinmetz said:
The records need to go directly to the HIMS AME for an SI in any case - they cannot go through you to them.

Figure $5-10k for a pathway 2 special issuance for a full psychological and psychiatric exam and test set. Yes, it will be 6-12 months if you work with one of the specialists and everything is done right the first time.

In the meantime, how about learning to fly in gliders? They don’t require an FAA issued medical (but do require the ability to self certify). This pathway can get you to a private glider in a few months and then the power training can be a shorter add-on.

Learning to fly gliders really teaches you how a set of wings and controls handles in the air. You might even learn to enjoy soaring for its own sake. Generally people feel it makes them a better powered pilot.

Fastest is a commercial glider operation. Many may be closed now due to Covid-19, but hopefully that resolves within a month or so. In many locations, May and June will still have excellent soaring weather.
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Gliding is a great idea actually, I’ll look into it.

I’m crossing my fingers on a pathway 1, but I understand that might not be possible. Hopefully when my HIMS AME reviews on Friday he’ll be able to give me a better guide of what they’ll require.

What’s the ongoing cost of maintaining a SI? On the phone he estimated $2,400 yearly for bi annual screenings.
 
Gatorj31 said:
What’s the ongoing cost of maintaining a SI? On the phone he estimated $2,400 yearly for bi annual screenings.
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Sounds about right. Depending on your goals in flying, once you have the SI, you may be able to drop back to BasicMed, but that won’t work for a professional pilot.
 
Ok, I have a question on the HIMS AME selection. I have a few choices, most of which are a couple thousand bucks for their services. However, the first HIMS AME I called was 94% cheaper than the first two (literally). I cant find many reviews on the cheaper HIMS, but from what I've gathered, the HIMS AME really only processes the reports and records given by the psychiatrist / psychologist. Any opinions?

PS. the cheaper doctor was able to see me right away... the others couldn't get me in for over a month.
 
If you want one of the best...if not THE best when it comes to this stuff. Contact Dr Bruce. He is super busy, but if he is available to take your case, it would benefit you greatly. VERY reasonable, and well known. You can contact him through his website. http://www.aeromedicaldoc.com/

He is the man when it comes to SI's, and literally wrote the book on approved SSRIs and the FAA. I retained his services in December....and Im glad I did.
 
Be very careful with which HIMS AME you select. Remember that they are the ones who have the last say of when your paperwork gets submitted to the faa. I wouldn’t worry about the price so much as asking them how many special issaunces they have gotten for airman and what type of timeframe they think it will take for you to get an SI. That’s odd that his rates were extremely cheap compared to the other 2 doctors. Try to find an AME that is also an active pilot because they are more understanding and sometimes helpful of getting someone into the air as quickly and easily as possible.
 
I’m a student pilot in training, and new to POA but grateful to have found this forum.
My story is similar to gatorj31 and russS .
I have been on SSRI’s for approx the last 8 years, fluoxetine then was switched to Zoloft along with buspar in 2018 for a Generalized anxiety disorder.
I naïvely went to get my medical class 2 from the AME at my flight school, I was told to fill out the form online prior to my appointment ‍♂️
My medication was flagged by the FAA of course and currently as of yesterday got a letter stating I need to get a current psychiatric evaluation.
Do either of you have any updates to headway that you’ve made with your medical ?
From what I understand, my next step would be to get an appointment with An HIMS AME prior to seeing a aeromedical Psychiatrist?
I came off the buspar about a month ago now, I’ve also requested To my physician to no longer continue my prescription as needed for lorazepam. [ my AME I seen told me she contacted the FAA after my appointment and was informed that Occasional use
Was ok, this sounds unlikely!!]
I contacted AOPA, they also suggested I wait 60days from being prescribed those medications before going to a Psychiatric evaluation.
Any thoughts/ experiences on this would be much appreciated
Cheers
 
Cameron2020 said:
I’m a student pilot in training, and new to POA but grateful to have found this forum.
My story is similar to gatorj31 and russS .
I have been on SSRI’s for approx the last 8 years, fluoxetine then was switched to Zoloft along with buspar in 2018 for a Generalized anxiety disorder.
I naïvely went to get my medical class 2 from the AME at my flight school, I was told to fill out the form online prior to my appointment ‍
My medication was flagged by the FAA of course and currently as of yesterday got a letter stating I need to get a current psychiatric evaluation.
Do either of you have any updates to headway that you’ve made with your medical ?
From what I understand, my next step would be to get an appointment with An HIMS AME prior to seeing a aeromedical Psychiatrist?
I came off the buspar about a month ago now, I’ve also requested To my physician to no longer continue my prescription as needed for lorazepam. [ my AME I seen told me she contacted the FAA after my appointment and was informed that Occasional use
Was ok, this sounds unlikely!!]
I contacted AOPA, they also suggested I wait 60days from being prescribed those medications before going to a Psychiatric evaluation.
Any thoughts/ experiences on this would be much appreciated
Cheers
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Same advice as usual for these cases. There are only two approved pathways involving the SSRIs.

Yours sounds like it may be a difficult case but may be possible. The use of multiple agents is usually going to prevent issuance but it depends on the details. I would advise consulting with one of the two senior HIMS AMEs that frequent this board to really know. Suggest contacting one of them pronto. They are quite responsive normally.
 
It will be 90 days off of meds and stable before they will consider. I know it says 60, but buspar will make it 90. This is assuming you weren’t on again off again with the meds pointing to a reoccurring depression. The psych will do a drug panel and alcohol biomarkers which will show alcohol you may have had OVER TIME...so keep that in mind if you are a drinker. Mine stands at 7 months since deferred...probably 5 more to go. FAA sucks.
 
Cameron2020 said:
I’m a student pilot in training, and new to POA but grateful to have found this forum.
My story is similar to gatorj31 and russS .
I have been on SSRI’s for approx the last 8 years, fluoxetine then was switched to Zoloft along with buspar in 2018 for a Generalized anxiety disorder.
I naïvely went to get my medical class 2 from the AME at my flight school, I was told to fill out the form online prior to my appointment ‍♂️
My medication was flagged by the FAA of course and currently as of yesterday got a letter stating I need to get a current psychiatric evaluation.
Do either of you have any updates to headway that you’ve made with your medical ?
From what I understand, my next step would be to get an appointment with An HIMS AME prior to seeing a aeromedical Psychiatrist?
I came off the buspar about a month ago now, I’ve also requested To my physician to no longer continue my prescription as needed for lorazepam. [ my AME I seen told me she contacted the FAA after my appointment and was informed that Occasional use
Was ok, this sounds unlikely!!]
I contacted AOPA, they also suggested I wait 60days from being prescribed those medications before going to a Psychiatric evaluation.
Any thoughts/ experiences on this would be much appreciated
Cheers
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I would start by going back to the beginning of this thread and read every post, especially of RussS, do what he did, take note of the time and commitment involved, and especially take note of his compliance with what the FAA and more importantly what his doc said to do. There are other threads on these situations too, look them up. You have a long road ahead of you, accept that and give the FAA what they need to approve you.
 
Tanking two drugs (zoloft and buspar) at the same time is going to make it difficult. AOPAs medical advice is generally useless (don't get me started). You need to talk to an AME with a clue.
 
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