Written request for reconsideration to Federal Air Surgeon

[PTtoPilot]

Hi all, wondering if anyone has been down this path and if you had any tips or recommendations.


I met with an AME in August 2021 to talk about the possibility of applying for a first class medical with a history of depression, and was told it would be deferred and that the FAA would need additional information. Both instances involved stressful times in my life, with one in 2006 resulting in a 2-3 day hospitalization along with therapy and medication, and the other 5 months of medication in early 2021. All in all, I was off medication with no issues or treatment from 2008 – 2021. I had a neuropsychological evaluation completed in October 2021, and officially submitted my medical exam in March 2022. Of course, the FAA followed up requesting additional info and I sent it in.


I received the denial letter today, citing my history of recurrent moderate major depressive disorder with psychotic features, suicidal ideation, and general anxiety disorder. The letter says I can submit in writing a request for reconsideration to the Federal Air Surgeon. I’ve been trying to look around online to see what this written request might look like and include, but I’m coming up empty. Unfortunately, I only have 30 days to do this.


Has anyone written in for reconsideration? Any recommendations on whether I need to go back to my AME for additional testing? Any advice would be appreciated.

 

[lbfjrmd]

recurrence - suicide - psychosis = tough case. I do not think there is anything more you could provide in your appeal. But if you decide to pursue such, a simple letter requesting such would be in order.

 

[bbchien]

PTtopilot: there is an unspoken rule that after an suicidality, the only way back is:

10 yrs. No meds, no “events” and a 10 yr “successful life test”. That is why they did not send the “for further consideration” letter. FAA denies 100% of “recurrent disease, untreated and unmonitored”. It takes the 10 years to “suggest” that it will not happen again…..

if you appeal without that you get a higher level denial, which is a future logistical nightmare…..

 

[midlifeflyer]

if you appeal without that you get a higher level denial, which is a future logistical nightmare…..

Higher level denial equals "we will never issue this person a medical certificate." (Statement read in a CAMI document)

 

[guest user]

Sorry to hear about the response. It is certainly not what was hoped for.

I want to first of all say that you absolutely did the right thing in getting help for these situations. There are too many people who don't.

However, from an objective point of view, I can understand. The big concern, as you know, is will you be a threat to others while at the controls of an aircraft. Unfortunately, there have been cases of people with depression and suicidal ideations that indeed did decide to act on that and harmed other people in the process.

I can also see why 6mo (Oct 2021 - Mar 2022) is not considered a long enough period to determine if there will be a repeat. After all, the time frame between reported incidents was 15yrs (2006 - 2021).

The Class I is only needed for ATP operations, so it seems to me that that is your goal. It is a laudable goal, but it is now going to be delayed a little bit.

My suggestion, for what it is worth, is to be VERY patient. As suggested by bbchien who is an AME, if you push this further it will likely delay your chances ever further. With your medical denial you are not going to be eligible for any certificate, including Sport at this time.
However, my non-conformist mind points out that there are no reasons you can't do almost all the course work with an instructor to work on your PPL / IR / Commercial and once the 10yrs are up, you will just need to work on your solo work, which by this time would be almost a non-issue for you. I've seen people take their PPL / IR checkrides on the same day before.

In closing, I want to again commend your reason for being in this position, which is that you got the help you needed when you needed it. I hope you never second guess that decision.

 

[PTtoPilot]

PTtopilot: there is an unspoken rule that after an suicidality, the only way back is:

10 yrs. No meds, no “events” and a 10 yr “successful life test”. That is why they did not send the “for further consideration” letter. FAA denies 100% of “recurrent disease, untreated and unmonitored”. It takes the 10 years to “suggest” that it will not happen again…..

if you appeal without that you get a higher level denial, which is a future logistical nightmare…..

Higher level denial equals "we will never issue this person a medical certificate." (Statement read in a CAMI document)

Thanks for the replies. Just so I'm clear, if I attempt to have it reconsidered, it will be denied again and will decrease the chances of being approved 10yrs in the future. If I do not respond, the process ends and if 10yrs down the road I would like to re-apply, it will still be denied and I will have to fight to overturn this denial?


I think the thing that is most frustrating is that the incident that diagnosed “major depression with psychotic features” happened 16 yrs ago at this point, and does not seem to have sufficient documentation to justify the diagnosis in the medical record. When I first went to the hospital at the urging of my parents, I had been drinking at a crawfish boil with friends all day and I had gotten into a huge fight with my friends after I found them going through personal things in my bedroom (no, I don’t have an alcohol problem. Like most college kids I drank on the weekends and for the last 13yrs or so drink maybe 1-2 beers a month, if that). I can see how someone that has been drinking and found her friends going through private things after she told them not to would think her friends are out to get her (which the hospital classified as hallucinations/paranoia). My initial psychiatric assessment at the hospital reports no dellusions, no hallucinations, and a diagnosis of “major depression” with no mention of psychotic features. So with that being documented on the assessment, I don’t understand how they can still claim “with psychotic features.”


In the second instance of being treated, most of the notes from the psychiatrist use the diagnosis code for generalized anxiety disorder, and again, have no mention of psychoses or suicidal ideation.


Given all that, do you still think this is a lost cause and will continue to be denied?

 

[bbchien]

So with that being documented on the assessment, I don’t understand how they can still claim “with psychotic features.”


In the second instance of being treated, most of the notes from the psychiatrist use the diagnosis code for generalized anxiety disorder, and again, have no mention of psychoses or suicidal ideation.


Given all that, do you still think this is a lost cause and will continue to be denied?

After an suicidality, the only way back is:

10 yrs. No meds, no “events” and a 10 yr “successful life test”. That is why they did not send the “for further consideration” letter. FAA denies 100% of “recurrent disease, untreated and unmonitored”. It takes the 10 years to “suggest” that it will not happen again…..

From what you wrote, you DO NOT CURRENTLY HAVE THAT. The 2001 episode "ruined" that. It's suggests to the FAS that 2021 was not a "one-off".

 

[guest user]

Just so I'm clear, if I attempt to have it reconsidered, it will be denied again and will decrease the chances of being approved 10yrs in the future. If I do not respond, the process ends and if 10yrs down the road I would like to re-apply, it will still be denied and I will have to fight to overturn this denial?

If you fight it, you will like lose. Loss = MUCH less likely to win later at ANY point.
If you drop it, you still have a chance in about 10yrs to receive proper consideration. Not a guarantee, but much better than if you fight and lose now.

 

[midlifeflyer]

Thanks for the replies. Just so I'm clear, if I attempt to have it reconsidered, it will be denied again and will decrease the chances of being approved 10yrs in the future. If I do not respond, the process ends and if 10yrs down the road I would like to re-apply, it will still be denied and I will have to fight to overturn this denial?

Partially. Let's try this version of what you wrote:

if I attempt to have it reconsidered without having the required 10 year clean history @bbchien wrote about, it will be denied again and will decrease the chances of being approved 10yrs in the future.
If I do not respond, the process ends and if 10yrs down the road I would like to re-apply, my 10 year history at that point will be considered.​

And, no. perhaps It's not fair that the FAA would treat a request for reconsideration that way. But I think it is human nature to do so.

 

[Half Fast]

Please refer to https://en.m.wikipedia.org/wiki/Suicide_by_pilot#List_of_declared_or_suspected_pilot_suicides and you will better understand the concern

 

[kath]

...stressful times in my life, with one in 2006 resulting in a 2-3 day hospitalization along with therapy and medication...

I had been drinking at a crawfish boil with friends all day and I had gotten into a huge fight with my friends after I found them going through personal things in my bedroom ... which the hospital classified as hallucinations/paranoia...

I'm not a doctor or mental health professional. But if you were hospitalized for 2-3 days, something happened more than just "a fight with your friends". It'll be impossible to give you advice without knowing the whole story. The honest story. Keeping you for several days is serious. You don't admit to suicidal ideation as part of your story, but apparently the FAA thinks it was there, and this is also serious. So what (really) happened?

I'm not saying you have to divulge all the personal details here, with a bunch of strangers on the internet. This is for you and your AME. But trying to minimize it by calling it "a stressful time" might not be the best start, if we (or the FAA) are to be convinced that the hospital's diagnosis was wrong.