Hey all,
TL;DR: I’ve been in twice-monthly talk therapy since 11/2024 for general life improvement, stress management, and anxiety related to several life events. My therapist diagnosed me with Adjustment Disorder – Unspecified (F43.20). I was issued a 3rd-class medical in July and have started PPL training, but I’m concerned the FAA could overturn the issuance and send me through the HIMS psych/CogScreen process.
Sorry for the wall of text below...
I received my 3rd-class medical in July and have since started working on my PPL. The AME issued it on the spot despite my active F43.20 diagnosis and ongoing twice-monthly therapy, which began in November 2024.
I have never been prescribed psychiatric medication or any medication on the FAA's disqualifying/required-reporting lists.
I initially sought therapy because I was dealing with a a ton of stress: grad school (M.S. Engineering) with a demanding full-time engineering lead position, while also dealing with serious health issues affecting all three of my pets that popped up simultaneously. The pet-health situation is technically still ongoing.
After the first few months, I was feeling substantially better with regard to stress and anxiety. At that point, therapy shifted toward general self-improvement: building stronger relationships, developing healthier habits, becoming more of a self-advocate, and working through various life events as they came up (lost friendships/relationships, work issues, etc.).
My therapist is a licensed counselor, not a psychologist, and needed to assign a diagnosis for treatment. They chose Adjustment Disorder – Unspecified (F43.20) because nothing else fit. I also specifically requested that I not be given a more significant psychiatric diagnosis because I was seeking therapy primarily for stress management and general personal improvement.
My therapist provided a letter for the AME summarizing the diagnosis, the original reason for treatment (worry/anxiety/stress were specifically stated in the letter), and my overall status. It stated that I am stable, functioning well across all areas of my life, have never been medicated, etc.
I’m planning to end therapy in the next few weeks because I genuinely feel that I’m in a very good place and have accomplished the goals I originally set. Total treatment duration will be approximately 21 months.
During my AME exam, the AME seemed unsure which section of the AME Guide applied because there is a table for adjustment disorder with anxiety and adjustment disorder with depression. He ultimately used the anxiety table because there was no indication of depression anywhere in my therapist’s documentation, and I have never considered myself depressed.
He issued the 3rd-class medical immediately, and I’ve been proceeding with PPL training since.
My concern is whether the FAA could later review this and send me a certified letter requiring additional evaluation or disagree completely with the AME's decision. Specifically:
Thanks in advance!
TL;DR: I’ve been in twice-monthly talk therapy since 11/2024 for general life improvement, stress management, and anxiety related to several life events. My therapist diagnosed me with Adjustment Disorder – Unspecified (F43.20). I was issued a 3rd-class medical in July and have started PPL training, but I’m concerned the FAA could overturn the issuance and send me through the HIMS psych/CogScreen process.
Sorry for the wall of text below...
I received my 3rd-class medical in July and have since started working on my PPL. The AME issued it on the spot despite my active F43.20 diagnosis and ongoing twice-monthly therapy, which began in November 2024.
I have never been prescribed psychiatric medication or any medication on the FAA's disqualifying/required-reporting lists.
I initially sought therapy because I was dealing with a a ton of stress: grad school (M.S. Engineering) with a demanding full-time engineering lead position, while also dealing with serious health issues affecting all three of my pets that popped up simultaneously. The pet-health situation is technically still ongoing.
After the first few months, I was feeling substantially better with regard to stress and anxiety. At that point, therapy shifted toward general self-improvement: building stronger relationships, developing healthier habits, becoming more of a self-advocate, and working through various life events as they came up (lost friendships/relationships, work issues, etc.).
My therapist is a licensed counselor, not a psychologist, and needed to assign a diagnosis for treatment. They chose Adjustment Disorder – Unspecified (F43.20) because nothing else fit. I also specifically requested that I not be given a more significant psychiatric diagnosis because I was seeking therapy primarily for stress management and general personal improvement.
My therapist provided a letter for the AME summarizing the diagnosis, the original reason for treatment (worry/anxiety/stress were specifically stated in the letter), and my overall status. It stated that I am stable, functioning well across all areas of my life, have never been medicated, etc.
I’m planning to end therapy in the next few weeks because I genuinely feel that I’m in a very good place and have accomplished the goals I originally set. Total treatment duration will be approximately 21 months.
During my AME exam, the AME seemed unsure which section of the AME Guide applied because there is a table for adjustment disorder with anxiety and adjustment disorder with depression. He ultimately used the anxiety table because there was no indication of depression anywhere in my therapist’s documentation, and I have never considered myself depressed.
He issued the 3rd-class medical immediately, and I’ve been proceeding with PPL training since.
My concern is whether the FAA could later review this and send me a certified letter requiring additional evaluation or disagree completely with the AME's decision. Specifically:
- Diagnosis: My diagnosis is F43.20 (Adjustment Disorder – Unspecified), not F43.22 (Adjustment Disorder with Anxiety). The AME Guide provides specific guidance for F43.22 but doesn’t address F43.20 directly. Could the FAA interpret F43.20 as potentially involving depression and require further evaluation?
- Duration of treatment: By the time I finish therapy, I’ll have had ~21 months of twice-monthly talk therapy. The AME Guide references “6 months from the resolution of the stressor,” which is hilariously broad. I would argue that some of the original stressors (work and my pets’ health) are still ongoing.
Thanks in advance!
