Advice on HIMS Program

JustSomeGuy73 said:
Two events in a lifetime is dependence. You'll need two years of proven sobriety at least and anything else AAM-300 decides to make up for you. The FAA doesn’t care what anyone besides the FAA says. Also, going through all of that without FAA approval could be seen as an admission of substance dependence…

Its like Vegas Vacation,

Give them half of your money and they’ll take you out back and kick you in the nuts

The only thing you can do is come back tomorrow and try again.
Click to expand...
No. Two in a lifetime is ABUSE. It's any use of alcohol AFTER Abuse- that'd be dependency.
 
bbchien said:
No. Two in a lifetime is ABUSE. It's any use of alcohol AFTER Abuse- that'd be dependency.
Click to expand...
This is very odd.
When I asked the FAA to send me my medical records with notes in it, there was a speeding ticket that I reported in 2002.
For some reason, a doctor said "Oh, that's three events". It was a speeding ticket. Not a DUI or arrest. She also went on to say it's abuse. This was back in 2012 when they knew about all the events. I never applied for another medical since and now in 2023, I am faced with this.
One Doctor at the FAA clearly stated in my notes that a COG Test is not needed. They also said they can clearly evaluate at a late time "Holistically".
My HIMS AME talked to one of the doctors at OSHKOSH and now he saying they want me to do the COG Test and another HIMS AME psychiatrist report. My first one is not even 8 months old yet.
Regardless, I went an set up the COG screening.
I have done and IOP and Aftercare. I have 6+ months of proven abstinence with a 10 panel drug screening.
This just seems frustrating. What do you think I am in for next?
Any chance this could be abuse vs. dependency?
 
I’d have to read the entire FAS medical record to tell. But if the HIMS psychiatrist called out part 67 dependency , that’s what they’re dealing…..
 
bbchien said:
I’d have to read the entire FAS medical record to tell. But if the HIMS psychiatrist called out part 67 dependency , that’s what they’re dealing…..
Click to expand...
Thank you Dr. Chien. The HIMS psychiatrist reports exactly this:

For the reasons noted above, it does not appear that Mr. XXX has Alcohol Use
Disorder as defined by DSM-5-TR. However, from an FAA standpoint, XXX
“continued use despite…impairment of social, personal, or occupational functioning”
fulfills the criteria of alcohol dependence and is evidenced by two DUI arrests and
their implications for his aviation aspirations/interests.

According to him two incidents are dependence.
Would you open to a paid consultation? Finance are not of major concern. I have done so much in 6-7 months and I am just stuck. Any help would be much appreciated.

Thanks,

Would you be
 
You CAN have dependence after two. You can even have it after ONE if your attitude is "I can handle it" and you are blithe to what the ETOH is doing to your judgement. If there is escalation of dose at any time in your history, you have tolerance and dependence.

It can be AFTER JUST ONE DUI.
Hey no kidding.
 
bbchien said:
You CAN have dependence after two. You can even have it after ONE if your attitude is "I can handle it" and you are blithe to what the ETOH is doing to your judgement. If there is escalation of dose at any time in your history, you have tolerance and dependence.

It can be AFTER JUST ONE DUI.
Hey no kidding.
Click to expand...
Thank you for the response Dr. Chien.
I believe I have done everything that I could think of, advised on, and researched on.
Quick history, I accomplished the following in 6 months with zero direction from the FAA:

HIMS Psychiatrist EVAL.
(5) HIMS AME meetings and favorable reports to the FAA.
6 months of proven abstinence using SOBERLINK.
110 AA and Smart Recovery Meetings.
AA Sponsor established.
IOP.
Aftercare.
SMART Recovery facilitator training and graduation certificate.
10 Panel negative drug screening.

The frustration comes that one doc at the FAA says something and another one contradicts the first one.
There should be some structure.
I have had zero correspondences from them in over 7 months.

Thanks again.
Is there anything else I could be doing?
I have a COG Screening set up for next month after one doc said it was not necessary. Now another one says it is.
 
You didn't go to rehab(at least you didn't list it)?....which is a requirement for any class 2 or Class 1. For 3rd class only you cna go 2 years proven sober and then to the HIMS psychiatirst (and the Neurocog) for hopefully "Alcohol dependence in sustained remission". And get a 3rd class only.

There is structure. Only the office of the Federal Air surgeon makes the determination for 2nd and 1st class. Everyone else is acting on partial information.

You never did say whether or not the application was a 1st/2nd or a 3rd. 3rd is determined in OKC.
 
bbchien said:
You didn't go to rehab(at least you didn't list it)?....which is a requirement for any class 2 or Class 1. For 3rd class only you cna go 2 years proven sober and then to the HIMS psychiatirst (and the Neurocog) for hopefully "Alcohol dependence in sustained remission". And get a 3rd class only.

There is structure. Only the office of the Federal Air surgeon makes the determination for 2nd and 1st class. Everyone else is acting on partial information.

You never did say whether or not the application was a 1st/2nd or a 3rd. 3rd is determined in OKC.
Click to expand...
Thank you.
I did not go to an inpatient. I am applying for a third class.
My medical notes state: A minimum of IOP is required for and SI consideration. I did the IOP 3 months ago and did another month of aftercare.
I have now enrolled in continued aftercare.
 
bbchien said:
You didn't go to rehab(at least you didn't list it)?....which is a requirement for any class 2 or Class 1. For 3rd class only you cna go 2 years proven sober and then to the HIMS psychiatirst (and the Neurocog) for hopefully "Alcohol dependence in sustained remission". And get a 3rd class only.

There is structure. Only the office of the Federal Air surgeon makes the determination for 2nd and 1st class. Everyone else is acting on partial information.

You never did say whether or not the application was a 1st/2nd or a 3rd. 3rd is determined in OKC.
Click to expand...
Hello Dr. Chien,

In your experience, have you a had a similar case like mine be required to do an inpatient rehab treatment?
I am applying for a 3rd class.

Thanks.
 
If you want to satisfy 67.307, how’re you gonna do that w/o 2 years of proven sobriety? So it’s either that, or rehab…..
Yes, and the answer is “many, many”…...
 
bbchien said:
If you want to satisfy 67.307, how’re you gonna do that w/o 2 years of proven sobriety? So it’s either that, or rehab…..
Yes, and the answer is “many, many”…...
Click to expand...
bbchien said:
If you want to satisfy 67.307, how’re you gonna do that w/o 2 years of proven sobriety? So it’s either that, or rehab…..
Yes, and the answer is “many, many”…...
Click to expand...
I guess I am confused.
Im engaged in HIMS. I am monitoring using SOBERLINK as I choose this.
I have done IOP.
I have done aftercare and continue to do aftercare.
I am doing at least 2 AA meetings a week.
My medical notes stat at least and IOP for SI consideration.
I have over 6 months of proven sobriety. Are you saying if I stay this course and I am 100% compliant, I will still have to wait two years for an SI and do inpatient? My HIMS psychiatrist only recommended 14 UA’s in 12 months. Will they issue an SI while I continue using SOBERLINK and proven sobriety?
 
No rehab = no cert without 24 mosproven sobriety, due to 67.307. “No pilot shall within the preceding 2 years, have abused….”

How do you show that w/o 24 months of proven negative urines?
 
bbchien said:
No rehab = no cert without 24 mosproven sobriety, due to 67.307. “No pilot shall within the preceding 2 years, have abused….”

How do you show that w/o 24 months of proven negative urines?
Click to expand...
I guess I am not sure.
Doesn’t SOBERLINK monitored with my HIMS AME count? My workload is demanding and that is why I choose SOBERLINK as an approved method.
Does IOP not count towards rehab? Does it have to be a traditional 28+ resident program.
I have a large business and I don’t see myself able to do a 28 day break from this.
 
bigbird said:
By the way everyone ever involved in HIMS should read the congressionally mandated study just out by Senator Jeanne Shaheen's office in NH.
It is not out in print yet but an advanced copy is available here: https://nap.nationalacademies.org/c...-programs-in-commercial-aviation-safety-first
read the entire study carefully and you might be enlightened to just how far FAA and HIMS don't want any outside reviews of their practices.
The recommendations from the committee align current medical standards and not that of the FAA unpublished internal policies.
Check out.
Appendix C
Communications between the Committee and the FAA, HIMS,
ALPA, and Congressional Staff
as an example of the programs stonewalling techniques.
Also the incredibly low response from pilots to comment on the efficacy of HIMS was best addressed by their statement on page 5-12
"the committee never received indications that HIMS and​
its administering organization, Air Line Pilots Association–International (ALPA), ever​
distributed the link or sought pilot participation."​

I hope that this brings lots of discussion and I urge all pilots that may have insight to share with the authors, to do so.
I have yet determined how best to submit my experiences to the committee.
I'll reach out to Senator Shaheen's office and publish the results shortly.
-t
Click to expand...
This report is DAMNING to the FAA yet nothing happens!! WTF??? It’s so blatantly obvious how badly reform is needed!!
 
bigbird said:
By the way everyone ever involved in HIMS should read the congressionally mandated study just out by Senator Jeanne Shaheen's office in NH.
It is not out in print yet but an advanced copy is available here: https://nap.nationalacademies.org/c...-programs-in-commercial-aviation-safety-first
read the entire study carefully and you might be enlightened to just how far FAA and HIMS don't want any outside reviews of their practices.
The recommendations from the committee align current medical standards and not that of the FAA unpublished internal policies.
Check out.
Appendix C
Communications between the Committee and the FAA, HIMS,
ALPA, and Congressional Staff
as an example of the programs stonewalling techniques.
Also the incredibly low response from pilots to comment on the efficacy of HIMS was best addressed by their statement on page 5-12
"the committee never received indications that HIMS and​
its administering organization, Air Line Pilots Association–International (ALPA), ever​
distributed the link or sought pilot participation."​

I hope that this brings lots of discussion and I urge all pilots that may have insight to share with the authors, to do so.
I have yet determined how best to submit my experiences to the committee.
I'll reach out to Senator Shaheen's office and publish the results shortly.
-t
Click to expand...
This report is RIDICULOUS!! How much more evidence do they need?? This program is so desperately in need of reform! Contact your senators and representatives all!! The time for change was yesterday!!
 
George S said:
The reason why alpa refuses to share or change anything related to HIMS is so that all their “henchmen” aka HIMS Ames neuropsychologists, psychiatrists, social workers and other support staff is they are making a FORTUNE off of it. The amount of money someone can make from just being a HIMS ame is absolutely insane. There are HIMS Ames out there charging $500-$600 an hour and charge by the minute. It is so corrupt and needs actual oversight from someone either than the faa or alpa. Some of these people should be arrested for conspiring and succeeding in taking peoples careers and livelihood away from them. It has profound effects on pilots and their family’s. Read up on karlene petit and you’ll see the corruption and abuse of using mental health for airlines to get rid of “problem” pilots that just want to fly and have a safer airspace system. There should be a system in place for pilots to report HIMS professionals that are crooked but the faa protects them and just doesn’t care.
Click to expand...
PREACH!!!
 
Listen all. LESSONS in Life.
NB: I am not saying that eveything is corrupt, NOT AT ALL.

But If you engage in a HIMS program funded by someone other than youself why could you think that it's completely on your behalf?.
Engage everyone on your own dime. Why would you ever think, that if you're not driving the whole process, that it's on your behalf. DRIVE YOUR OWN process.

The analogy is going to an auto insurance Co Collision shop. They're taking care of their income source- the insurance company. If you want it done right, go to YOUR shop and deal with the reimbursement. I've just been through that. Lowball Ins. CO bid. Shop refused to not replace a critical part (the Fwd Radar module).
Ins. co eventaully capitulated.

Think about it!
 
bbchien said:
But If you engage in a HIMS program funded by someone other than youself why could you think that it's completely on your behalf?.
Engage everyone on your own dime. Why would you ever think, that if you're not driving the whole process, that it's on your behalf. DRIVE YOUR OWN process.
Click to expand...
It’s never completely on your behalf. I had a HIMS ame lie right to my face telling me he was going to do one thing and then I found out later on he sent a note on my “behalf” to the faa where he told them something completely different. Some of the info was also a complete lie or at best he made major mistakes that had a huge effect that I’m still feeling today. I notified the faa of this. Do you think they gave 2 ****s that one of their coveted HIMS Ames lied? Of course not, let’s just brush it under the rug because we’re the faa and can’t get in trouble for anything. The HIMS program has no oversight and this has to change.
 
These are the stories that just blow my mind! And the fact that it’s not just a rare occurrence makes the problem widespread! The genuine lack of oversight is mind blowing! I’m 6.5 years with solid abstinence… the regs themselves ask for a minimum of 2 years! So why in gods name is anyone being kept in past 3 or 4 years? The FAA doesn’t even follow its own regulations!!
 
George S said:
It’s never completely on your behalf. I had a HIMS ame lie right to my face telling me he was going to do one thing and then I found out later on he sent a note on my “behalf” to the faa where he told them something completely different. Some of the info was also a complete lie or at best he made major mistakes that had a huge effect that I’m still feeling today. I notified the faa of this. Do you think they gave 2 ****s that one of their coveted HIMS Ames lied? Of course not, let’s just brush it under the rug because we’re the faa and can’t get in trouble for anything. The HIMS program has no oversight and this has to change.
Click to expand...
WRONG. I have never had financial interference on behalf of any airman. He either "gets it" and is returned to service or he doesn't "get it" I don't ever submit a thing.
My sole source of reimbursement is the Airman.

Think about that for a while.
The airmen who come in "with an angle" get told to try another guy.
i've very happy over here in suburban CHI HIMS-land.....and have never accepted an outside $.
 
Last edited:
So how does recommending and condoning medical “treatment” (not medically necessary) to satiate an administrative requirement reconcile?

Administration trumps medical ethic?

Seems a little like taking the salary of a wide body Captain to load’em up in a bus and just drive… it hardly warrants my training.
 
The HIMS program is never going to change. It has a long term success rate of over 88% long term. Compare that to AA alone, which is at about 40%.
Seems like rehabbing a wide body captain who has abridged the public trust, is the point.

As for George, you chose the wrong AME, it would seem.
A recent airman, relapsed during the FAA's decision period. He's an Ass't chief, and he stuck it out and is currently going to Re-SIM in Dallas. And I stuck with him.

I took on one from another HMS AME who fired him. It's a total rebuild.
 
Last edited:
bbchien said:
The HIMS program is never going to change. It has a long term success rate of over 88% long term. Compare that to AA alone, which is at about 40%.
Seems like rehabbing a wide body captain who has abridged the public trust, is the point.

As for George, you chose the wrong AME, it would seem.
A recent airman, relapsed during the FAA's decision period. He's an Ass't chief, and he stuck it out and is currently going to Re-SIM in Dallas. And I stuck with him.

I took on one from another HMS AME who fired him. It's a total rebuild.
Click to expand...
Those numbers are artificially inflated and do not account for those who left the program instead of being forced into suffrage! It doesn’t account for those who retired early instead of dealing with the irrationality of this program. Change is coming. All you have to do is see the NTSB summit from last December to see it! 50 years of no change is archaic at best! Change should be welcomed and embraced by all!
 
George S said:
My thoughts exactly. I’m not with an airline and am paying completely out of pocket for my HIMS program. Seemed pretty real to me when the unscrupulous HIMS AME I had did some pretty awful things.
Click to expand...
Sorry that happened to you!! Change is brewing!! Speak up and speak out!!
 
Careful for what you ask. In the current budgetary crisis they'll just cancel it and all those boys with DUIs will be done. DONE. As in Pre 1985.
 
bbchien said:
Careful for what you ask. In the current budgetary crisis they'll just cancel it and all those boys with DUIs will be done. DONE. As in Pre 1985.
Click to expand...
Did you see the NTSB panel? That’s not going to happen! Besides there would be some serious lawsuits to be had for those with recorded long term abstinence!
 
bigbird said:
That's a pretty strong definitive statement. "2 events in a lifetime is dependence"
Please back that up with some supportive literature. back it up the hyperbole please.
Click to expand...
Not dependence in the real world. It’s in the FAA made up world where some ******* gov employee makes an arbitrary sweeping decision based on medical guidance from 40 years ago.
 
bbchien said:
WRONG. I have never had financial interference on behalf of any airman. He either "gets it" and is returned to service or he doesn't "get it" I don't ever submit a thing.
My sole source of reimbursement is the Airman.

Think about that for a while.
The airmen who come in "with an angle" get told to try another guy.
i've very happy over here in suburban CHI HIMS-land.....and have never accepted an outside $.
Click to expand...
You say wrong but then don’t address the main point of his post, a dishonest AME that misrepresented the facts in his paperwork to OKC.

Are you saying that all HIMS AMEs are honest and never lie?

If you are then you are way more naive than I would have expected. Normally people as deep in the bureaucracy as you see the dishonesty and corruption clearly. Not sure what you are defending here. It seems like you didn’t fully read the post you quoted. Or perhaps quoted the wrong one.
 
If there’s a budgetary crisis, it’s because THEY arbitrarily decided to make it a lifelong problem based on the 1930s musings of self diagnosed nit wits.

So, how many people they let out of the program from 1974 to 2018 later relapsed and bent metal?

How many bent metal from 1930-1974?

What about the 90 percent of “unidentified alcoholics” running around?

I’m failing to see the reason they’re wasting all their resources, and ignoring real concerns and problems.
 
HIMSSCREWED said:
Did you see the NTSB panel? That’s not going to happen! Besides there would be some serious lawsuits to be had for those with recorded long term abstinence!
Click to expand...

Your passion does not exceed Bruce’s experience.

As for the NTSB, the FAA rarely acts NTSB recommendations, but what Bruce is saying us that meaningful reform by the FAA takes them to DSM V, which is no longer abuse or dependence, but instead only substance use disorder as a clinical diagnosis with symptoms of

* Hazardous use.
* Social or interpersonal problems related to use.
* Neglected major roles to use.
* Withdrawal.
* Tolerance.
* Used larger amounts/longer.
* Repeated attempts to control use or quit.
* Much time spent using.
* Physical or psychological problems related to use.
* Activities given up to use.
* Cravings.

Then, the FAA will simply state a clinical diagnosis of SUD is disqualifying, just like abuse/dependence are today, except no SI will be offered, existing SIs will be revoked, and HIMS, as a program, is no more.
 
TCABM said:
Your passion does not exceed Bruce’s experience.

As for the NTSB, the FAA rarely acts NTSB recommendations, but what Bruce is saying us that meaningful reform by the FAA takes them to DSM V, which is no longer abuse or dependence, but instead only substance use disorder as a clinical diagnosis with symptoms of

* Hazardous use.
* Social or interpersonal problems related to use.
* Neglected major roles to use.
* Withdrawal.
* Tolerance.
* Used larger amounts/longer.
* Repeated attempts to control use or quit.
* Much time spent using.
* Physical or psychological problems related to use.
* Activities given up to use.
* Cravings.

Then, the FAA will simply state a clinical diagnosis of SUD is disqualifying, just like abuse/dependence are today, except no SI will be offered, existing SIs will be revoked, and HIMS, as a program, is no more.
Click to expand...
That is probably what will happen. What I don’t understand is if you ban guns only outlaws will have guns. People will fly planes if they want to anyway. The lack of respect for our government is everywhere and in every industry.
 
And just like that, 10 percent of the airlines’ pilots are gone. Think the airlines are gonna allow that?

Don’t think the airlines tell the faa what to do?
 
Tools said:
And just like that, 10 percent of the airlines’ pilots are gone. Think the airlines are gonna allow that?

Don’t think the airlines tell the faa what to do?
Click to expand...

Doesn’t matter. The majors can reach down to the regionals to close their gaps. The regionals, ACMI, cargo, corp, and frac operations will suffer the biggest hits. That also ignores the fact that airlines are turning qualified applicants away.

The FAA can also do a nuanced shut down following their current step-down guidance. Some airmen in the program can be released from HIMS with notice that any further instances will be disqualifying, others get revoked, while also not approving new (first-time) applications.
 
There is always nuance that cannot be expressed nor understood by a new poster who has about 2 doz posts all of which are "axe griding".(and therefore, not real contributions).
Like my website sez, "have a problem solving mentality"

The policy stuff is determined by folks at least 10 pay grades above me....and by persons in the US House (see leigslation in 2008 and 2009). The post of 07:40 AM today by TCABM is HEART of the matter.
 
TCABM said:
Your passion does not exceed Bruce’s experience.

As for the NTSB, the FAA rarely acts NTSB recommendations, but what Bruce is saying us that meaningful reform by the FAA takes them to DSM V, which is no longer abuse or dependence, but instead only substance use disorder as a clinical diagnosis with symptoms of

* Hazardous use.
* Social or interpersonal problems related to use.
* Neglected major roles to use.
* Withdrawal.
* Tolerance.
* Used larger amounts/longer.
* Repeated attempts to control use or quit.
* Much time spent using.
* Physical or psychological problems related to use.
* Activities given up to use.
* Cravings.

Then, the FAA will simply state a clinical diagnosis of SUD is disqualifying, just like abuse/dependence are today, except no SI will be offered, existing SIs will be revoked, and HIMS, as a program, is no more.
Click to expand...
Passion most definitely! Truth even more so and THAT is why we will win this fight! Enough is enough! Viva La Resistance!!
 
HIMSSCREWED said:
You don’t like being challenged do you? I’m guessing you got a lot of participation trophies as a child! Oh well, each their own. Be well!
Click to expand...
In the south when someone says “he’s challenged” it means the same as “he’s special” and you would have to be challenged to think you’ll win this fight.

I’m quite successful and have overcome many setbacks in my life. No participation trophies for my generation. Unfortunately it was my generation giving them out to the kids.

Good luck. I hope you come out the other side of this journey well

Just save this thread and please update us when you consider it to be a finished quest.
 
Back
Top