HIMS lawsuits

AreWeThereYet

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AreWeThereYet
Is anyone aware of any lawsuits, ongoing or past, against the HIMS program?

I am aware of one by a United pilot for forcing people to attend AA on the basis that it is a religious program that violates his religious beliefs. I am referring more to people being wrongly being denied a medical and forced into a Special Issuance to keep flying rather than challenging a specific aspect of of the HIMS program like AA.
 
Trying to argue the FAA standards shouldn't apply to you or are too hard has been tried and it never succeeds. The FAA is allowed to make the process as difficult as they see fit. The cases that win are the ones like you mention where the FAA treats someone differently because of a protected attribute.

AA is a cult treatment of religion and rightfully not crammed down people's throats. It's also entirely ineffective as substance abuse treatment.
 
You can challenge all you want. But if you don't have what they want, they will do nothing. That is essentially, dismissal with, "Have a nice life".
HIMS essentially self validates- no in air events in its entire history. Nobody is going to "vary" the formula.

You Can do Smart and you can do various other programs, but if you don't "get it" according to the 12 steps" in the AA big book, no flight deck for you. Ever.
And I can tell you that for an airman who is not "at peace", e.g. Railing about HIMS, IMO the dominant chance is that he is NOT in recovery (though he still may be sober).
 
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HIMS on a federal level is gonna be challenged for cramming religion eventually on a large scale. it’s a tough battle.

On a company level it’s practically doomed. Always run by overzealous amateurs... Their wrongdoing is gonna bring a heap of troubles on themselves.

Another issue rapidly going critical mass is abstinence monitoring with bio markers that are simply not well vetted, less understood, and zero requirement for even common sense medical review. If i had a nickel for every time i’ve heard an AME say “well, i’m not an expert in toxicology...”. become one if you’re gonna rely on it! That wave of lawsuits is getting ready to go viral.

Another aspect about to rear it’s head is fraud and malpractice. If the FAA wants to define mental illnesses outside of APA guidelines and definitions, that’s fine. But doctors diagnosing APA disorders in order to get insurance to pay for treatment to satiate the FAA is gonna get problematic.

Calling the program successful because of a zero incident rate doesn’t make sense for several reasons:

1. HIMS literature says only 10% of substance dependent pilots are identified. So there’s a zero incidence rate with 90% of the drug addict and alcoholic running around unchecked, yet causing no problems.

2. What was the incidence rate before HIMS?

Calling it successful because of an amazing relapse rate of only 10% while the rest of the world has a 90% relapse rate merely shows how many people are forced into this program who are not alcoholics or addicts. HIMS claims this is because of their ability to leverage licensure. One thing we know about TRUE addicts and alcoholics, you can’t scare them. Think about that. Pilots are patient, it takes years. HIMS for years for the hell of it is tolerated. HIMS for life is not. HIMS needs to consider being legit.

HIMS lists denial as a primary diagnostic criteria of addiction. W O W. Think Salem witch trials.

HIMS needs major reform. which is fine, it’s time. it’s not complicated. This is most likely going to come about slowly because of lawsuits and NTSB appeals.


All “HIMS says...” assertions come directly from HIMSPROGRAM.COM.
 
He got a second chance that he didn’t deserve, but the Union and the employers went to bat for guys like him with the FAA. Now he wants to sue the FAA because they made him something he disliked. Nice.
 
HIMS on a federal level is gonna be challenged ..
I don’t have a dog in this hunt, and I can’t read tea leaves better than anyone else, but challenged and successfully challenged are two different things.

Methodology may be susceptible to change, but FAA authority to regulate is not, and medical certification is regulatory.
 
AA is a cult treatment of religion and rightfully not crammed down people's throats. It's also entirely ineffective as substance abuse treatment.

Unfortunately AA is crammed down throats almost daily. Most all first time offenders for DUI are forced to attend AA and get a signature at each meeting for verification as part of their education and diversion program. Thank MADD for this. The worst part of it is that the people who choose to attend AA and are perceiving benefit from it are saddled with the "court appointed friends" who generally get nothing but stale coffee and an earful of stories they'd happily live the rest of their lives without.

Mind you, I'm not knocking AA. For those who decide they need it, decide to follow it, and realize benefit from it, it beats the alternative. But putting it on a punitive checklist isn't helpful for anyone.
 
I don't think we're disagreeing. The studies shows that on a whole those who participate in AA fare in the long run no better than those who attempt NO treatment for their alcoholism. That isn't to say that many people who do enter (and stay with) AA don't receive benefits from it. It's just junk science as to trying to induce an outcome.

The FAA isn't actually looking for efficacy here. They want a pound of flesh: they want to HIM participants to show that they are exerting some effort. It's unfortunate that they don't provide secular and possibly even EFFECTIVE options (and such DO exist). This is clearly a violation of the first amendment because there is just no way around claiming that twelve-step is little more than a religious ritual that scapegoats God as being both he cause and cure. It's reprehensible to the atheist and the devout alike in my opinion. It's as bad as the fact that the government abdicated to the NRA in many state laws.
 
I don't think we're disagreeing. The studies shows that on a whole those who participate in AA fare in the long run no better than those who attempt NO treatment for their alcoholism. That isn't to say that many people who do enter (and stay with) AA don't receive benefits from it. It's just junk science as to trying to induce an outcome.

Can you provide a link or two? I've always heard that AA was among the most, if not the most, effective program for alcoholics. But I confess, I've not previously looked for actual data, and would be happy to educate myself. Searching a few minutes ago turned up a lot of links, but the first two I opened (a Stanford study last year, and a decade old NIH paper) both supported AA as quite effective.
 
actually, “alcoholism” has a natural recitivism rate of 25-30 percent. AA success rate is like 5-10 percent.

numbers show you’re better off without. but figures lie, and liars figure...

this could be justified by “harsher” cases turning to AA. in the end, it does seem clear a one size fits all is really flawed. FAA gives a tailored approach lip service, bits that’s all.
 
Seems to me that the problem with the whole substance abuse treatment industry is that you are often thrown in it based on an incident which is not well correlated with the abuse of substance. Not everyone that gets pinched for DUI is an alcoholic. If that were true, the majority of college graduates from the 70's are alcoholics. Probably the same for later groups but my data points are from that era. There are a few times in my misspent youth where I could have been cited for DUI. I got lucky. My subsequent life makes clear that I am not an alcoholic.

But for the unlucky, you are thrown into a program where you are required to admit that you are an alcoholic, even when you are not. There is something fundamentally wrong when you have to lie to be "saved". And if you insist that you are not an alcohol, then you are in denial which then defines you as an alcoholic. Nice Catch-22!
 
"Alcoholic" is not defined. Substance abuse problem is. As far as psychology goes, if you drink and get busted for DUI, then you do have a substance abuse problem. The criteria is "one or more" event in a 12-month period.

"Substance dependence" is defined as tolerance, withdrawal symptoms, or taking in large quantities, and/or unsuccessful efforts to control your use.

Both of these (at the DSM-IV level) fits what the FAA interprets abuse and dependence to be. My issue is that I believe their procedures for resolving these issues is not well-founded in science.

And no, I've never been had substance abuse issues with the FAA or anybody else.
 
actually, “alcoholism” has a natural recitivism rate of 25-30 percent. AA success rate is like 5-10 percent.

numbers show you’re better off without. but figures lie, and liars figure...

this could be justified by “harsher” cases turning to AA. in the end, it does seem clear a one size fits all is really flawed. FAA gives a tailored approach lip service, bits that’s all.

As you state, all substance abusers are alike. AA gets the bottom of the barrel and some go to Betty Ford.
 
Unfortunately, I know several AA's.

First, self identified as an alcoholic and went to AA to save his marriage. Never drank again, after 20 years of heavy drinking. He became an excellent pilot, partner in our plane, neighbor, and friend.

Second, met him at Sun n Fun, he did not self identify until his marriage was ended, joined, never drank again, excellent pilot, very good host under the wing of his C 182, shared a variety of non alcoholic drinks, iced. One of the best friends met at that fly in.

Third, high school classmate, self identified early in his marital problems, doing fine at 50 years old, still married to his first wife.

So, self identified, in my experience, AA works

Not self identified, I agree that it has a spotty record.

I know several people who were required by the courts to attend, the did, but continued to drink heavily.

Two died in drunk driving events.

One continued to get DUI tickets, lost the right to own a car. He was then caught driving a friends car, received jail time, and the car was impounded until the owner went through court proceedings to reclaim it.

My assistant at work received 3 DUI's, figured out that driving slowly attracted the attention of the Police, so next time he drank, he dutifully drove at the speed limit, until he met a 4 foot wide oak tree. He refused to go to AA "because he was not an alcoholic" That last DUI had the death penalty.

Self identified seems to work, but court identified has its problems. The easy alternative is to take their license to drive, and if they continue, take their car.

My family has had several members who were the victims of drunk drivers, including fatalities. There is a reason that MAD exists. The problem is how to deal with the citizens who cannot or will not limit their use of drugs and alcohol.

The people here criticizing AA are not proposing a workable solution to keep persistent abusers of drugs and alcohol from operating potentially dangerous machinery.

I have not been drunk since I was 23, but have not joined AA. It only took 2 times to convince me that I should limit myself, and have done so since.
 
Unfortunately, I know several AA's.

First, self identified as an alcoholic and went to AA to save his marriage. Never drank again, after 20 years of heavy drinking. He became an excellent pilot, partner in our plane, neighbor, and friend.

Second, met him at Sun n Fun, he did not self identify until his marriage was ended, joined, never drank again, excellent pilot, very good host under the wing of his C 182, shared a variety of non alcoholic drinks, iced. One of the best friends met at that fly in.

Third, high school classmate, self identified early in his marital problems, doing fine at 50 years old, still married to his first wife.

So, self identified, in my experience, AA works

Not self identified, I agree that it has a spotty record.

I know several people who were required by the courts to attend, the did, but continued to drink heavily.

Two died in drunk driving events.

One continued to get DUI tickets, lost the right to own a car. He was then caught driving a friends car, received jail time, and the car was impounded until the owner went through court proceedings to reclaim it.

My assistant at work received 3 DUI's, figured out that driving slowly attracted the attention of the Police, so next time he drank, he dutifully drove at the speed limit, until he met a 4 foot wide oak tree. He refused to go to AA "because he was not an alcoholic" That last DUI had the death penalty.

Self identified seems to work, but court identified has its problems. The easy alternative is to take their license to drive, and if they continue, take their car.

My family has had several members who were the victims of drunk drivers, including fatalities. There is a reason that MAD exists. The problem is how to deal with the citizens who cannot or will not limit their use of drugs and alcohol.

The people here criticizing AA are not proposing a workable solution to keep persistent abusers of drugs and alcohol from operating potentially dangerous machinery.

I have not been drunk since I was 23, but have not joined AA. It only took 2 times to convince me that I should limit myself, and have done so since.

The people criticizing AA have another agenda. I know several AA participants who have been sober for decades.
 
But for the unlucky, you are thrown into a program where you are required to admit that you are an alcoholic, even when you are not. There is something fundamentally wrong when you have to lie to be "saved". And if you insist that you are not an alcohol, then you are in denial which then defines you as an alcoholic. Nice Catch-22!

Oh you've said a mouthful. Ironic thing is, I was pretty innocent and open vested when nobody cared about me because I had no money. It's when I decided to tie my livelihood to flying that I had to become a tactical liar and feign contrition for a living... #gameischess
 
Anecdotes of how well people you know have done on AA isn't scientific proof upon which the FAA should be holding up as an exclusive path to certification. While it indeed helps people in the short term who are participants, when you take a look at the general population, you're just as likely to spontaneously sober up on your own (i.e., without any program) as you are to have success embarking on AA. Even if AA had a decent track record, the fact that it is effectively a religious cult should bar forced participation from a government agency.

Believe me I know the perils of drunk driving all too well. I spent several years picking up trauma victims (and far too often fatalities) from alcohol-induced MVAs. The FAA needs to get off their high horse and approve the competing science-based programs.
 
Anecdotes of how well people you know have done on AA isn't scientific proof upon which the FAA should be holding up as an exclusive path to certification. While it indeed helps people in the short term who are participants, when you take a look at the general population, you're just as likely to spontaneously sober up on your own (i.e., without any program) as you are to have success embarking on AA.

I still haven't see a link to any study supporting your statement, so at this point I also consider it anecdotal. Here is a link to the Stanford School of Medicine study last year, mentioned in my post above. It is not the only study supporting the effectiveness of AA.

https://med.stanford.edu/news/all-n...ost-effective-path-to-alcohol-abstinence.html.

They did a meta analysis of 35 studies tracking outcomes of 10,080 participants, and concluded: "Most of the studies that measured abstinence found AA was significantly better than other interventions or no intervention. In one study, it was found to be 60% more effective. None of the studies found AA to be less effective."
 
If you read that actual paper (rather than the press hype you linked to) you'll see that is yet another short term (12 month) analysis. The same journal, Cochrane, produced studies a decade earlier finding no such proof of efficacy. The bulk of the surveys find that given a long term (decade let's say) analysis, AA is an overall wash compared to other therapies, and in some cases, no therapy at all. Again, there's definitely gains in TSF mostly due to the peer support aspects. Frankly, they could probably be just as effective if they deleted a bunch of the steps.
 
If you read that actual paper (rather than the press hype you linked to) you'll see that is yet another short term (12 month) analysis. The same journal, Cochrane, produced studies a decade earlier finding no such proof of efficacy. The bulk of the surveys find that given a long term (decade let's say) analysis, AA is an overall wash compared to other therapies, and in some cases, no therapy at all. Again, there's definitely gains in TSF mostly due to the peer support aspects. Frankly, they could probably be just as effective if they deleted a bunch of the steps.

I read the extended abstract on the Cochrane site; my organization doesn't have a subscription that will unlock the raw data behind the paywall. The study I cited included the two previous Cochrane studies, which were small and inconclusive. But that's why one does a meta analysis. Here, the Stanford team cast a very wide net:

"We searched the Cochrane Drugs and Alcohol Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, CINAHL and PsycINFO from inception to 2 August 2019. We searched for ongoing and unpublished studies via ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 15 November 2018. All searches included non‐English language literature. We handsearched references of topic‐related systematic reviews and bibliographies of included studies."

I've said twice I'm happy to read links to studies supporting your position, but it appears I just have to accept that you really don't like AA, and we'll leave it at that.
 
I read the extended abstract on the Cochrane site; my organization doesn't have a subscription that will unlock the raw data behind the paywall.

It is available at sci-hub. Good site to know about.

https://sci-hub.se/10.1002/14651858.CD012880.pub2

Also, there is an email link you can click at the publishers site for the corresponding author. If you politely request an article from an academic, they will almost always send you a pdf copy.
 
It is available at sci-hub. Good site to know about.

https://sci-hub.se/10.1002/14651858.CD012880.pub2

Also, there is an email link you can click at the publishers site for the corresponding author. If you politely request an article from an academic, they will almost always send you a pdf copy.

I didn't check Sci-Hub. It's pirated content. I do think the for-profit journals have priced themselves out of any reasonable market, but I don't think ignoring the copyrights and putting it all on a server in Kazakstan is the right solution.

The reminder to email the corresponding author and ask for a copy is a good one! I think I still have, in the attic, boxes of reprints from olden times when you wrote to the author and asked to be sent a paper reprint. Apparently I never got as many requests as I thought I would.
 
The reminder to email the corresponding author and ask for a copy is a good one! I think I still have, in the attic, boxes of reprints from olden times when you wrote to the author and asked to be sent a paper reprint. Apparently I never got as many requests as I thought I would.

Another solution that often works, but does not in this case, is to type the full title into Google scholar. That will often produce a link to the article itself on the author’s website or elsewhere.

I also had those boxes, but I think I got rid of my boxes of those when last moving the office.

I didn't check Sci-Hub. It's pirated content. I do think the for-profit journals have priced themselves out of any reasonable market, but I don't think ignoring the copyrights and putting it all on a server in Kazakstan is the right solution.

The question of the best market model and how to respect property rights in the case of research funded primarily by tax dollars is an interesting one. “Spin Zone” material though I think.
 
Hmmmn. Tools is grinding his tools here it appears.
Not at peace. Not grateful for a second chance....that tells us some things......
 
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Stolen from another thread:

AA Meeting.jpg
 
FlyingRon, you said "The criteria is "one or more" event in a 12-month period...."Substance dependence" is defined as tolerance, withdrawal symptoms, or taking in large quantities, and/or unsuccessful efforts to control your use."

Can you source this please? I'm not arguing with you. I'm just looking at a different FAA definition and wondering who has the right one. What I'm looking at says "The FAA defines 'Substance Dependance' as follows: a) increased tolerance b) manifestation of withdrawal symptoms c) impaired control of use or d) continued use despite damage to physical health or impairement of social, personal or occupational functions." It doesn't mention quantity as a defining factor or a 12-month period. Where did you get your FAA definition from please?
 
Pretty sure the 12 month thing is a DSM 5 criteria, as in two or more of 11 things in a 12 month period.

The FAA uses (a subset of?) the older DSM-4 definition, which didn’t specify the 12 month thing.

That’s kind of a weird thing, in order to be diagnosed “medically”, the DSM 5 applies. The FAA simply uses their own rules, which they label as more cautious (which is their right). Most insurance won’t pay for things not defined in the latest DSM.
 
hmmm, so my question about lawsuits regarding HIMS has evolved into a discussion about whether AA is or isn't effective. The example of the pilot who sued about being forced to go to AA despite his religious beliefs was only example. The original question, however, was not about AA in particular.

AA aside, is there any closed or ongoing litigation against HIMS NOT regarding AA. For example, I am surprised that no one has yet challenged the concept of lifetime monitoring only for pilots who were in the program in the last 12 months and future admissions while pilots who were released to a regular medical only months ago are not being recalled into monitoring. Or maybe that challenge is out there and I just haven't seen it.

Anyway, my question still remains has anyone ever successfully sued to the program. If someone could address that in the midst of the argument about whether AA is effective, that would be awesome.
 
Interesting thing about the FAA using it's own definition instead of the DSM, I spoke with a substance abuse counselor who said he would never do an assessment of alcohol abuse/dependence for the FAA because it would be a breach of ethics to his profession and grounds for license revocation. His explanation made perfect sense.

The FAA uses its own standard of alcoholism. They absolutely have the right to do that. No dispute there.

As he pointed out, IF the FAA trained their own evaluators to do substance abuse evaluations based on their own criteria, that would also be perfectly fine. No dispute there.

The problem comes in when the FAA uses a licensed Psychiatrist but asks them to perform an evaluation by a criteria other than the DSM definition. As this counselor pointed out, he is not allowed by medical standards to have his own definition of alcoholism (or bipolar or anti-social or any other mental disorder). For him to diagnose someone as alcoholic (or any mental disorder as this is not limited to alcoholism), the subject MUST meet the CURRENT DSM criteria. Random example, alcoholics often get beligerent and get into fights. Someone could have a well established pattern of getting into physical altercations while intoxicated but a psychiatrist cannot cite this as a reason for his diagnosis because it's not a DSM criteria (the doctor's words not mine). Bottom line, it's malpractice for a psychiatrist to make a diagnosis for any reasons other than those in the DSM.

The counselor's point is when the FAA hires a Psychiatrist to perform an evaluation but "handcuffs" them to using an alternative definition other than the DSM definition, the FAA is giving the false impression that the pilot has a psychiatric diagnosis of substance abuse/substance dependance when, in fact, he/she does not because a diagnosis that doesn't follow the DSM is not a valid diagnosis.

It would be like a company that wants to fire its CEO but can't get around his air-tight employment contract so they accuse him of being bipolar to leverage a section of his contract that allows him to be dismissed for mental illness. Knowing he doesn't meet the DSM bipolar criteria, the Board of Directors creates a policy of "this is the criteria of bipolar for employees of XYZ company". They send him and this policy to a Psychiatrist for evaluation. Any ethical Psychiatrist should say, "I can't evaluate him by your standards. I can only evaluate him by the standards of my profession."

Now obviously the FAA has its own Psychiatrists on staff who clearly take a different perspective but, on the off chance there's any licensed psychiatrist reading, I would be curious to hear his/her take.
 
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I believe so. I only have anecdotal evidence, so can’t reference it. It was a lawsuit against the FAA and HIMS related supposedly.

I do know substance abuse related FAA denials have been appealed to the NTSB successfully, namely a Delta captain about 2000.

I am in the midst of a quasi HIMS “lawsuit”. Mine involves a false positive resulting in termination. Ergo, since “labor” related it’s an arbitration. And for lack of just cause. So not specifically HIMS, but as you could imagine, if I get a ruling stating specifically that this particular test doesn’t prove drinking (which is what the FAA thought), this will have far reaching consequences for HIMS programs. If I get a ruling that simply doesn’t address the test, which is possible as they didn’t “investigate” (necessary for just cause), then not so much.

If my arbitration is successful, I do plan to ask for pre duty period testing vs random testing. I assume the FAA will deny, and I will appeal to the NTSB. I just think it’s a more effective methodology. Not only does it bring 49cfr40 rules into play which protects pilots’ careers, it TOTALLY protects the public.

If a qualified doctor wants to use bio markers clinically, fine. But companies using them forensically is not.

I do know one lawyer who wants to challenge the lifetime issue. As it stands, it is problematic. The FAA wants to rule via internal policy rather than the regulations they have on the books. But nothing official there yet.

I know another lawyer actively seeking to start a class action suit for the forced religion issue. The whole AA issue SHOULD be a personal choice. If it’s a disease, let the patient decide, like any other disease. HIMSPROGRAM.COM even acknowledges the FAA can’t force AA, and then says HIMS requires it.. ironic as HIMS is a voice of the FAA. The contradiction is clear, it simply hasn’t been challenged. The aspect of AA being forced being unconstitutional will very likely prevail, it has in MANY other venues.

I agree the original question got skirted. But it kinda is “not that simple”!! Everything evolves, HIMS will too. Think Buddhism and impermanence.
 
Interesting thing about the FAA using it's own definition instead of the DSM, I spoke with a substance abuse counselor who said he would never do an assessment of alcohol abuse/dependence for the FAA because it would be a breach of ethics to his profession and grounds for license revocation. His explanation made perfect sense.

The FAA uses its own standard of alcoholism. They absolutely have the right to do that. No dispute there.

As he pointed out, IF the FAA trained their own evaluators to do substance abuse evaluations based on their own criteria, that would also be perfectly fine. No dispute there.

The problem comes in when the FAA uses a licensed Psychiatrist but asks them to perform an evaluation by a criteria other than the DSM definition. As this counselor pointed out, he is not allowed by medical standards to have his own definition of alcoholism (or bipolar or anti-social or any other mental disorder). For him to diagnose someone as alcoholic (or any mental disorder as this is not limited to alcoholism), the subject MUST meet the CURRENT DSM criteria. Random example, alcoholics often get beligerent and get into fights. Someone could have a well established pattern of getting into physical altercations while intoxicated but a psychiatrist cannot cite this as a reason for his diagnosis because it's not a DSM criteria (the doctor's words not mine). Bottom line, it's malpractice for a psychiatrist to make a diagnosis for any reasons other than those in the DSM.

The counselor's point is when the FAA hires a Psychiatrist to perform an evaluation but "handcuffs" them to using an alternative definition other than the DSM definition, the FAA is giving the false impression that the pilot has a psychiatric diagnosis of substance abuse/substance dependance when, in fact, he/she does not because a diagnosis that doesn't follow the DSM is not a valid diagnosis.

I agree with your concerns in principle. I don't want to see any government agency getting in the business of defining medical conditions and I think the regs around substance abuse/dependence could use a refresh. I also think HIMS is being diluted/harmed with the latest lifetime monitoring stuff for dependence, but it's the best we have right now.

Here's the rub. The FAA is the government expert on safety of flight, and that includes medical certification. That's not going to change. Even with BasicMed they're still the authority. The key is the difference between a clinical evaluation and a forensic evaluation.

Clinical evaluations are performed as part of the treatment of the patient at the behest of the patient. The patient is the "customer". They are performed to help treat a patient for a condition at the request of the patient.

Forensic evaluations are performed to evaluate an individual at the behest of the requestor. The requestor (FAA) is the customer even though the patient is paying for it in this case. The FAA isn't treating the airman. They're asking for an unbiased determination of whether the airman meets the criteria for substance abuse/dependence as define by the FARs. These regulations were produced after extensive rule making processes, and they're pretty clear in their criteria. The problem is AMCD wants to keep changing their interpretation of the regs, or enacting rules by closed door policy rather than public rule making.

Because the evaluation isn't clinical in nature, isn't being used by a clinician for treatment purposes, and the patient isn't the "customer" the requestor (FAA) is well within their rights to define how they want the evaluation performed. That said, the clinician is also well within their rights to refuse to perform the evaluation for ethical reasons or simply because they have better things to do that day. The airman can also refuse to be subject to the forensic evaluation (although there will most likely be medical certificate and possibly airman certificate repercussions)

If you want to see this in action, consider an airman requesting their "full" medical file under PBOR. If that file contains psychiatric evaluations they will not receive copies of those evaluations. They're not the customer and they have limited rights to that information. They have to request a "blue ribbon" certified copy of their record (used for legal purposes) to get the true full record.

It's similar to pre-employment drug testing or pre-employment psychological testing (think security clearance).

When these evaluations are performed they have to be done by professionals that have background in aviation, otherwise they'll be of little use in the process. When these professional produce their evaluation they will always be clear about which criteria is being used for the result. If they're not clear, they're worthless to the FAA. You'll see language like:

(Meets/does not meet) DSM-V criteria for alcohol use disorder (mild/moderate/severe) (in/not in) (early/sustained) remission.
(Meets/does not meet) CFR part 67 criteria for alcohol (dependence/abuse) (with/without) evidence of recovery.

My opinion is there is a justifiable reason to get upset up about how HIMS airmen have to select mental health professionals. Someone who gets involved with HIMS HAS to use the FAA's short list of psychiatrists and neuropsychologists. These people make A LOT of money performing these evaluations (+$3k for nueropsych eval, +$2.5k substance abuse eval, +$800/year follow up), and the FAA is providing them a steady stream of airmen. The supply of services is artificially limited and the airmen are a coerced captive audience. The pricing is simple economics. Airmen determined to be dependent/abusive are also a source of recurring revenue for at least a few years, and sometimes for as long as they hold a medical. It raises the question as to whether there is a conflict of interest, and if these professionals are truly independent evaluators and not influenced by a strongly coupled relationship to the requesting agency.

I won't say cash is running the show. I will say that I have first hand knowledge of a HIMS mental health professional getting involved in the program at the urging of another HIMS medical professional partially due to the revenue generating potential. It's also no unheard of that paying for these services must be in cash. No credit cards, no insurance claims.

The FAA's position is these professionals have to go through the agency's training otherwise they're not smart enough to extrapolate how the patient's substance use could impact aviation. That's why they're short listed. I have to believe that anyone smart enough to make it through medical school/psychology graduate school is capable of reaching reasonable conclusions without obtaining the agency's royal seal of approval after a few days at a government seminar.
 
FlyingRon, you said "The criteria is "one or more" event in a 12-month period...."Substance dependence" is defined as tolerance, withdrawal symptoms, or taking in large quantities, and/or unsuccessful efforts to control your use."

Can you source this please? I'm not arguing with you. I'm just looking at a different FAA definition and wondering who has the right one. What I'm looking at says "The FAA defines 'Substance Dependance' as follows: a) increased tolerance b) manifestation of withdrawal symptoms c) impaired control of use or d) continued use despite damage to physical health or impairement of social, personal or occupational functions." It doesn't mention quantity as a defining factor or a 12-month period. Where did you get your FAA definition from please?
Comes straight from DSM-IV.
 
It's also no unheard of that paying for these services must be in cash. No credit cards, no insurance claims.

Totally off topic, but when I had my HIMS neuropsych visit back in October, my Delta AmEx was offering triple points * USD. The conversation with the office went like this:

Me: Do you take AmEx?
Them: We prefer Visa/Mastercard.
Me: But you take AmEx?
Them: We prefer Visa/Mastercard. It's lower percentage off the top for us.
Me: Perfect. Thanks.

Paid for my $3,600 visit with my Delta AmEx and got my triple points!
 
I do know one lawyer who wants to challenge the lifetime issue.

Who is the attorney who is challenging lifetime commitment to HIMS?

That seems like a very valid challenge IMHO. If the FAA pulled every pilot who has been in HIMS back into the program, that would certainly be their perogative. But to say that lifetime monitoring is only required for pilots as of a certain date (while others were released from monitoring months, weeks, even days before don't need to be monitored) is arbitrary it's beyond justification. Of course, the real reason is probably lack of resources to monitor all pilots but imagine a mechanic signing off an engine repair as "good enough" because he lacked resources to fix it right.
 
I'm curious about this post. I'm not so sure about a lawsuit, but I am an aspiring pilot with a DUI, and I was just told by a HIMS psychiatrist that it's going to be $5000 for an evaluation and I'm going to have to be entered into the HIMS program. I've been sober in AA for 5 years....

I don't mind the idea of being monitored, but it's a pricetag I can't afford if I want to actually start paying for a PPL. Anyone have any insight? Is it possible to appeal the FAA to skip some steps of the HIMS stepdown?
 
Without details of the case the FAA will investigate the DUI and make its decision. There is not any wiggle room to appeal.
 
The best defense is a good offense... I recommend an attorney. A consult with a good one will let you know what your up against and can expect. You want a medically minded attorney.

About as good is a legal minded doc.

The bestest is a consult with both...
 
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