Therapy and medical

[mandm]

Looking to do some self improvement therapy and for insurance to pay for it they have to diagnose you. They said it would be an “adjustment disorder”. No medication.

Does this have any issues with the medical or have to be reported in any future potential pilot work or medicals?

 

[Lindberg]

Don't accept an insurance diagnosis. Pay cash.

 

[Salty]

 

[Tantalum]

"The applicant should list visits for counseling only if related to a personal substance abuse or psychiatric condition."

also check out: https://www.faa.gov/pilot-mental-fitness

...sounds like you're safe

also, "some self improvement therapy" if you have no 'real' condition would there be alternatives you can explore as opposed to an insurance paid visit to a mental health professional? There are business coaches out there, career support groups and professionals, etc.

 

[robin ardoin]

The line "However,.........and some types of personality disorder automatically disqualify a pilot from obtaining an FAA medical certificate" gives me great pause. Tread carefully.

 

[Daleandee]

Looking to do some self improvement therapy and for insurance to pay for it they have to diagnose you. They said it would be an “adjustment disorder”. No medication.

No doctor here but I must ask the obvious question.

How can they know that it would only be a "no medication, adjustment disorder" if there hasn't been a diagnosis? I'd be afraid that once they get you roped in someone would come in to say, "well ... things have come out a bit differently that we planned!"

I would take Salty's advice ...

 

[Half Fast]

Consider that paying for it yourself will probably be much less than paying to get your medical back if some diagnosis or report proves to be a problem. Be aware that a medical provider might “help” you by over-diagnosing in order to maximize an insurance payout.

 

[Salty]

Also consider that if an assistant accidentally types a diagnosis code in your record, it’s your problem. Nobody else is going to care. Especially the FAA.

 

[lbfjrmd]

you will have to disclose this to your AME.

 

[Half Fast]

you will have to disclose this to your AME.

There's a requirement to disclose self-improvement?

 

[Lindberg]

There's a requirement to disclose self-improvement?

No. But he would have to disclose a diagnosis of adjustment disorder, even if he takes it only so insurance will pay.

 

[Lindberg]

No doctor here but I must ask the obvious question.

How can they know that it would only be a "no medication, adjustment disorder" if there hasn't been a diagnosis? I'd be afraid that once they get you roped in someone would come in to say, "well ... things have come out a bit differently that we planned!"

When starting to see a new therapist, the first thing you do is have a conversation about what your issues are. That doesn't mean that something won't come up down the road, but opinions can form quickly.

 

[Half Fast]

No. But he would have to disclose a diagnosis of adjustment disorder, even if he takes it only so insurance will pay.

AGREED! That's exactly why some of us are saying to avoid using insurance, since they've told him they would enter that diagnosis to enable payment. If he can self-pay without an official recorded diagnosis it will be much safer for his medical cert.

 

[TCABM]

Sigh. For some things insurance billing practices seems as ripe for reform as FAA medical standards are.

 

[Lindberg]

AGREED! That's exactly why some of us are saying to avoid using insurance, since they've told him they would enter that diagnosis to enable payment. If he can self-pay without an official recorded diagnosis it will be much safer for his medical cert.

Yes, that's what I said in the first response. But I was answering your question.

 

[Daleandee]

When starting to see a new therapist, the first thing you do is have a conversation about what your issues are. That doesn't mean that something won't come up down the road, but opinions can form quickly.

Yep ... I'd be afraid that a slight "adjustment" might quickly grow into something that needs continuing treatment and then medications because insurance is involved.

 

[Lindberg]

Yep ... I'd be afraid that a slight "adjustment" might quickly grow into something that needs continuing treatment and then medications because insurance is involved.

The vast majority of therapy is not with anyone who can prescribe medication. And unless you're committed, no one's going to make you take medication, so you can always decline if it's offered. And no insurance means no diagnosis needed. This really isn't hard.

This stuff all begins with a conversation. And you can say, "I have some stuff going on in my life that I'd like to talk through and get impartial advice on. I'm going to pay cash, so please don't feel that you need to come up with a diagnosis. I'm also a licensed pilot, and if you do diagnose me with a disorder I'll have to disclose it. So it's important that my records are not ambiguous one that point. If at any time in our discussions you start to lean that way, let's discuss it before you come to any conclusions."

There are millions, if not thousands, of priests, ministers, licensed therapists, social workers, etc., who would be happy to never document a diagnosis and couldn't prescribe medication even if they wanted to. We tell people all the time to take ownership of their medical, but they should also take ownership of their healthcare treatment.

Talk therapy in itself is not reportable.

 

[WDD]

Linberg has a great idea. Go to someone who will never bill insurance and document a diagnosis. Not because you're trying to hide something, but because insurance and diagnosis codes might be misconstrued by the FAA as something reportable. What if this gets spun into something that's on the bad list of conditions? Just be careful.

I assume "future pilot work" means you're commercial or ATP, which rules out Basic Med. IF you're going to be a noncommercial pilot, might consider going Basic Med for additional protection from any potential future errors in evaluating your medical fitness.

 

[Daleandee]

There are millions, if not thousands, of priests, ministers, licensed therapists, social workers, etc., who would be happy to never document a diagnosis and couldn't prescribe medication even if they wanted to.

We don't disagree. All would be well as long as insurance stays out of it ...

 

[Salty]

We don't disagree. All would be well as long as insurance stays out of it ...

All would be well if the government wasn’t invading your privacy by looking at your medical insurance records.

 

[mandm]

Sounds like a mess, with intentions on improving communication. Any AME’s on here have any comments?

 

[TCABM]

…, "I have some stuff going on in my life that I'd like to talk through and get impartial advice on. I'm going to pay cash, so please don't feel that you need to come up with a diagnosis. I'm also a licensed pilot, and if you do diagnose me with a disorder I'll have to disclose it. So it's important that my records are not ambiguous one that point. If at any time in our discussions you start to lean that way, let's discuss it before you come to any conclusions."….

You seem to have some paranoia about your therapy and that won’t help you get better. Let’s find the root cause of your paranoia.

 

[drummer4468]

Sigh. For some things insurance billing practices seems as ripe for reform as FAA medical standards are.

Agreed. My girlfriend is a therapist. Not only does it really bug me that they “need” to diagnose you with something for insurance purposes, but I cringe hard whenever she talks about the local rules she’s under and that everything immediately goes on patients’ official medical record. She gets new clients constantly, poor souls that have been slapped with bipolar, OCD, crazy meds, etc left and right, but without any of the proper substantiating symptoms. Like these “professionals” have no regard how that crap can seriously derail someone’s life plans.

 

[Daleandee]

She gets new clients constantly, poor souls that have been slapped with bipolar, OCD, crazy meds, etc left and right, but without any of the proper substantiating symptoms. Like these “professionals” have no regard how that crap can seriously derail someone’s life plans.

Had a family member years ago in elementary school that got a note from the school saying this family member needed to be put on Ritalin. I couldn't help but wonder who at the local elementary school was qualified to render such a decision because, as far as I knew, there had been no testing or evaluation of any kind.

From what I understand the school folks were instructed go and play in the traffic ...