FAA and PTSD

[Wheeler86]

So a few months ago I was set to start flight school. Went to do my flight physical and since I checked the yea box for behavioral health (PTSD diagnosis from the VA) I was informed by the physician and then by the FAA that since I have PTSD associated with the military I had to write a statement in regards to the circumstances surrounding the diagnosis and why I don’t take medication or what have you. I was annoyed and discouraged by that. Then with how busy work got I never followed up and stopped trying to fly.

 

 

Fast forward to now. I’m wanting to go through flight school and get my commercial and IFR ratings. Since more then 60 days have lapsed I have to go through the whole flight physical process again. My question is has anyone else have to write the letter to the FAA in regards to a PTSD diagnosis? If so what all did you include? I tried figuring out what to write the last time but wasn’t 100% sure on what include and never could get ahold of anyone at the FAA for clarification.

 

feel free for to message me privately if it makes things more comfortable to discuss. 
 

thank you for any feed back 

[helonorth]

The FAA has no sense of humor regarding medical issues that involve substance abuse or psychological problems. They are career killers. Don't do anything until you confer with one or both of these organizations. This is NOT something you should try handling yourself. 

https://www.leftseat.com/professional-pilots/

https://www.aopa.org/go-fly/medical-resources

[Wheeler86]

Thank you

[iChris]

On 3/2/2022 at 2:24 PM, Wheeler86 said:

Fast forward to now. I’m wanting to go through flight school and get my commercial and IFR ratings. Since more then 60 days have lapsed I have to go through the whole flight physical process again. My question is has anyone else have to write the letter to the FAA in regards to a PTSD diagnosis? If so what all did you include? I tried figuring out what to write the last time but wasn’t 100% sure on what include and never could get ahold of anyone at the FAA for clarification.

feel free for to message me privately if it makes things more comfortable to discuss. 
thank you for any feed back 

Oh no! God help you. You’ve fallen into the hands of the FAA’s medical system. Once they get a hold of you, it’s very hard for them to let go. So you were forced to answer YES to a medical history question in section #18. You’re likely to need professional help suggested in Helonorth’s post above. Let’s see what’s next. The letter you mentioned is one of the first of seven other items or tasks they will require from you. 

 The practical test standards (PTS) outline standards each pilot must adhere to. Likewise, the FAA Guide for Aviation Medical Examiners outlines standards they must follow. The Aviation Medical Examiner’s Handbook guidance shows the algorithm (decision tool) they use to issue or defer a medical certificate. The link to their handbook is listed below. The handbook also outlines what the letter you mentioned should include.

 Some medical examiners take the time to contact your family doctor and get the required information or documents to satisfy their examination and pass you at the examiner level; saving time as a deferral may take several months to complete. You can also ask your family doctor to call the examiner and answer some of the medical history questions the examiner may have. 

 It appears the examiner could not answer “No” to all the critical questions or was unable to determine or verify your medical history sufficiently. So download that handbook and check out pdf pages 190-192 to get an idea of what you’re about to experience.

Decision tool -

AME Instructions: 

Address each the following items in your in-office exam and history review: 

 1. Is there any additional mental health diagnosis other than PTSD? (Including but not limited to depression, anxiety, ADHD, substance disorder

 2. Is there any history of suicidal (or homicidal) ideation or attempt(s) ever in their life

 3. Have there been any symptoms of PTSD (such as: re-living, avoidance, or increased arousal) within the past two (2) years? 

 4. Has the individual taken medication or undergone psychotherapy for the PTSD in the past two (2) years

5. Is there any history of the individual being limited by the PTSD in performing the functions of any job (aviation related or not)? 

6. Are there any elements of the history (such as: nature of the triggers, social dysfunction) which cause you to question whether the PTSD is in full remission or is of aeromedical concern? 

7. Do you have ANY concerns regarding this airman or are unable to obtain a complete history? 

If all items on the decision tool are in the clear “No column”, the AME may:  ISSUE

Summarize this history, and annotate Block 60 with “discussed the history of PTSD, no positives to screening questions, and no concerns.” If any “YES” answers, any AME concerns, or unable to verify history - go to Row B.  DEFER

The most current version of this guide may be found and downloaded at the following FAA site https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/

 

 

Edited July 31, 2022 by iChris

[Wheeler86]

14 hours ago, iChris said:

Oh no! God help you. You’ve fallen into the hands of the FAA’s medical system. Once they get a hold of you, it’s very hard for them to let go. So you were forced to answer YES to a medical history question in section #18. You’re likely to need professional help suggested in Helonorth’s post above. Let’s see what’s next. The letter you mentioned is one of the first of seven other items or tasks they will require from you. 

 The practical test standards (PTS) outline standards each pilot must adhere to. Likewise, the FAA Guide for Aviation Medical Examiners outlines standards they must follow. The Aviation Medical Examiner’s Handbook guidance shows the algorithm (decision tool) they use to issue or defer a medical certificate. The link to their handbook is listed below. The handbook also outlines what the letter you mentioned should include.

 Some medical examiners take the time to contact your family doctor and get the required information or documents to satisfy their examination and pass you at the examiner level; saving time as a deferral may take several months to complete. You can also ask your family doctor to call the examiner and answer some of the medical history questions the examiner may have. 

 It appears the examiner could not answer “No” to all the critical questions or was unable to determine or verify your medical history sufficiently. So download that handbook and check out pdf pages 190-192 to get an idea of what you’re about to experience.

Decision tool -

AME Instructions: 

Address each the following items in your in-office exam and history review: 

 1. Is there any additional mental health diagnosis other than PTSD? (Including but not limited to depression, anxiety, ADHD, substance disorder

 2. Is there any history of suicidal (or homicidal) ideation or attempt(s) ever in their life

 3. Have there been any symptoms of PTSD (such as: re-living, avoidance, or increased arousal) within the past two (2) years? 

 4. Has the individual taken medication or undergone psychotherapy for the PTSD in the past two (2) years

5. Is there any history of the individual being limited by the PTSD in performing the functions of any job (aviation related or not)? 

6. Are there any elements of the history (such as: nature of the triggers, social dysfunction) which cause you to question whether the PTSD is in full remission or is of aeromedical concern? 

7. Do you have ANY concerns regarding this airman or are unable to obtain a complete history? 

If all items on the decision tool are in the clear “No column”, the AME may:  ISSUE

Summarize this history, and annotate Block 60 with “discussed the history of PTSD, no positives to screening questions, and no concerns.” If any “YES” answers, any AME concerns, or unable to verify history - go to Row B.  DEFER

The most current version of this guide may be found and downloaded at the following FAA site:https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AME_GUIDE_02-23-2022.pdf

 

 

I wish I would have had this info before going into my physical. I went in with the thought that I check the box and am honest. The doc would ask clarifying questions and that would be it.  Instead she asked why I checked the box told her that I have a diagnosis of PTSD from the military but it doesn’t affect me. I don’t take meds or go to counseling.  She stopped there and was like well since it is military related I can approve the medical and based off FAA regulations but the FAA will contact me for further info. 
 

I reached out to the resources that helonorth mentioned, which leftseat has contacted me back so far.  It’s been almost a year since the first flight physical would it make since to do new one with a different doc and go armed with info from the AME?

 

The people from Leftseat sent my paperwork to fill out along with a check for $1000 to review and then I send another $1000 after they make a plan and they will help me write the statement and gather the documents.

[iChris]

15 hours ago, Wheeler86 said:

I wish I would have had this info before going into my physical. I went in with the thought that I check the box and am honest. The doc would ask clarifying questions and that would be it.  Instead she asked why I checked the box told her that I have a diagnosis of PTSD from the military but it doesn’t affect me. I don’t take meds or go to counseling.  She stopped there and was like well since it is military related I can approve the medical and based off FAA regulations but the FAA will contact me for further info. 

I reached out to the resources that helonorth mentioned, which leftseat has contacted me back so far.  It’s been almost a year since the first flight physical would it make since to do new one with a different doc and go armed with info from the AME?

The people from Leftseat sent my paperwork to fill out along with a check for $1000 to review and then I send another $1000 after they make a plan and they will help me write the statement and gather the documents.

Given the documentation the FAA wants, you'll need some help. Your best option is a Pilot Protection Services Plus membership with the AOPA for only $189 per year. That's much better than that $2000 option that you mentioned. 

No need going to another examiner; it'll just kickback (See page 250). Once you walk into that office and start that examination, you're in the loop. The systems gotcha; the examiners are required to report their findings whether you complete the examination or not within 14 days back to FAA Oklahoma. You need to go back to that first examiner and try to work something out and obtain your case status. 

Still, with AOPA's help, I think you'll be able to get it done. The Services Plus membership includes the following:

1 Review your medical records before you submit them to the FAA.

2 Provide an experienced opinion about the likelihood of medical certificate issuance.

3 Ask for an "FAA Status Check" that allows them to monitor the status of your case review and advocate on your behalf if needed -https://www.aopa.org/membership

Quote

Submit the following to the FAA for review:

1. Airman personal statement (typed) that describes in their own words: 

a. The incident(s) leading up to PTSD-related symptoms and the eventual diagnosis of PTSD. 

b. Triggers for PTSD symptoms - characterize the frequency and severity of the symptoms (flashbacks, nightmares, anxiety, avoidance, and cognitive changes). 

c. Impact - include any recent or ongoing performance change, loss of job/school, or relationship problems due to PTSD. 

d. Modifications - include any recent or current changes to work, academic, or living situation to accommodate or lessen the PTSD symptoms.

e. Medication - list names and dates (if used); 

f. Counseling - include any form of individual or group counseling or psychotherapy. List dates and provider(s) name(s). 

2. Current evaluation by your treating psychiatrist or psychologist 

with clinical summary to include severity, frequency of episodes, and response to treatment (medications or psychotherapy). The report should identify if there is any history of suicidal ideation(s), homicidal ideation(s), substance use disorder(s) or other co-morbid psychiatric or psychological conditions, and identify diagnosis (DSM-V), treatment plan, and prognosis. 

3. Medication list. List all current medications (including non-PTSD related medications), reason for use, start dates, and side effects, if any. If recently discontinued, list date and reason. Note: if currently on an SSRI, must also submit items in the Initial SSRI Protocol.

4. Copies of any PTSD screening tools or other assessment instruments (already performed). 

5. Copies of psychological testing (already performed) including raw data. 

6. Veterans Administration (VA) records (if applicable) 

a. VA Compensation and Pension disability evaluations (C&P exam); 

b. VA Disability Compensation Award letters; and 

c. VA clinic and/or hospital records 

7. Previous medical/hospital records including previous clinical progress notes for any psychiatric evaluations and clinical progress notes for any psychiatric condition or PTSD that describe the dates, severity, and any treatment used. 

 

 

Edited March 16, 2022 by iChris