Basic Med - anxiety?

[Terry M - 3CK (Chicago)]

Strictly hypothetically, let's say you're a PPL who has a recently expired 3rd class where you would otherwise be eligible for Basic Med.

An MD recently said you had ADD and prescribed Adderall. (No class III or basic Med - I get that).

Professionals then run some tests and do a bunch of other stuff and say, it's not ADD, it's really anxiety.

Is anxiety DQ for the Class III (and meaning no basic Med)? Only if medicated or the diagnosis is DQ? (ADD is the meds or diagnosis are both DQ).

Any anxiety situation with meds that you can fly with?

 

[flyingron]

First off, in my opinion, a general practitioner who would make such a diagnosis and prescribe psychoactive drugs is a dangerous and unethical fool.
Hopefully, this fool didn't put his bullpoop guesswork into your medical records and you didn't attempt to fill that prescription.

Note however that you are WRONG about Basic Med. The GENERAL disqualification is for: (i) Personality disorder severe enough to have repeatedly manifested itself by overt acts (ii) Psychosis (iii) Bipolar disorder (iv) Substance dependence within the previous 2 years. With either ADHD or Anxiety Disorder, you only need to convince your doctor that you are safe to fly an aircraft with your disorder and the effects of whatever medication you are using.

If you are even going to think about a medical certificate, you better have a frank talk with a good AME (there are two here on the boards) prior to submitting an application. Your quack PCP has really screwed the pooch on this.

Being psychoactive, almost all of the commonly prescribed drugs for anxiety disorder are expressly forbidden. Some transient use of Valium or Restoril are allowed with waiting periods after the last dose.

Frankly, I'd suspect your best bet is with basic med. However, I'd be looking towards a psychiatrist for a proper diagnosis and treatment plan rather than the poking at it with a stick (or drug of the month ). Then you can worry about whether you can be certified under basic med given a qualified doctor to work on your checklist.

 

[Terry M - 3CK (Chicago)]

Thanks. At a high level, discussed with Dr Bruce before Basic Med was official. Considered going through the FAA docs to reverse diagnosis in the paperwork or just going Sport Pilot.

Sought out a psychologist who recently ran through these tests and multiple office visits and he's reviewing but really doesn't see ADD, but anxiety.

I thought, based on a post here or the red board, the doc checklist points them to FAA guidance on disqualifying meds (no fly meds) and diagnosis.

Isn't that accurate?

I thought it would be dishonest/sloppy to get a signoff with ADD in my chart without getting the FAA docs to reverse that (it would indicate the basic Med doc didn't read the materials). I'd be much less sad if that isn't the case. After the recap from my psychologist, I was suddenly hopeful I could get the FAA docs to reverse the ADD diagnosis. But then it sounds like the anxiety diagnosis is a shot in the foot as well.

 

[dans2992]

The FAA would apparently prefer you not see a doctor, and just continue flying.

The sad part is that everyone reading this will now reconsider seeking medical assistance... :/

 

[azure]

Thanks. At a high level, discussed with Dr Bruce before Basic Med was official. Considered going through the FAA docs to reverse diagnosis in the paperwork or just going Sport Pilot.

Sought out a psychologist who recently ran through these tests and multiple office visits and he's reviewing but really doesn't see ADD, but anxiety.

I thought, based on a post here or the red board, the doc checklist points them to FAA guidance on disqualifying meds (no fly meds) and diagnosis.

Isn't that accurate?

I thought it would be dishonest/sloppy to get a signoff with ADD in my chart without getting the FAA docs to reverse that (it would indicate the basic Med doc didn't read the materials). I'd be much less sad if that isn't the case. After the recap from my psychologist, I was suddenly hopeful I could get the FAA docs to reverse the ADD diagnosis. But then it sounds like the anxiety diagnosis is a shot in the foot as well.

Pretty sure that F'Ron is right on this. Neither anxiety nor ADHD is disqualifying for Basic Med, as long as you didn't try to get an FAA med certificate and were denied. (In that case the disqualifier would be the denial, not the dx.) If you can convince a state licensed physician that you are safe to fly despite these dx's, and your last valid medical was within the last 11 years (since July 2006), and you have none of the "Big Three" disqualifying conditions, then you're eligible for Basic Med according to the rule.

 

[Palmpilot]

...I thought, based on a post here or the red board, the doc checklist points them to FAA guidance on disqualifying meds (no fly meds) and diagnosis.

Isn't that accurate?

I thought it would be dishonest/sloppy to get a signoff with ADD in my chart without getting the FAA docs to reverse that (it would indicate the basic Med doc didn't read the materials). I'd be much less sad if that isn't the case....

Reading the FAA guidance pointed to in the checklist is a recommendation to the examining physician, not a requirement. The law that Congress passed and the president signed contains no such requirement. I believe it would be a violation of that law for the FAA to put such a requirement in place.

Note carefully the wording above the list of FAA guidance:

"You should consider consulting available aeromedical resources on the flight hazards associated with medical conditions/medications, to include..." [emphasis added]​

"Should consider" is the wording of a recommendation, not a requirement.

The only thing that would be dishonest would be lying about your medical history, or withholding information about your medical history.

 

[lbfjrmd]

https://www.faa.gov/about/office_or...de/app_process/exam_tech/item47/amd/table/ap/

anxiety is reportable ... on basic med (18x - you saw a doctor that attached the diagnosis and 19-last 3 years) and/or a faa medical application. How a basic med non AME doc would handle this is unknown.

Most AME's are trained to report and defer to the FAA.

 

[Terry M - 3CK (Chicago)]

So the diagnosis, regardless of meds, requires SI under class 3. Bummer. I was hopeful.

I don't think an MD would sign when it is a DQ condition in the referenced FAA docs (unless they don't read it - and I see that leading to problems for me down the road).

 

[lbfjrmd]

speaking as a AME to a potential applicant for say 3rd class: a SI may not be needed. but a psychiatric exam by a designated FAA shrink is likely unavoidable.

 

[Terry M - 3CK (Chicago)]

Thank you.

 

[Terry M - 3CK (Chicago)]

It has been suggested by a highly trusted source that Sport Pilot or gliders is the best course forward.

 

[flyingron]

The FAA would apparently prefer you not see a doctor, and just continue flying.

The sad part is that everyone reading this will now reconsider seeking medical assistance... :/

Eh? The whole point of Basic Med is that it's better that you DO see a doctor, rather than eschewing treatment for a condition just because you fear the CAMI bureaucracy and grounding possibilities.

 

[bbchien]

Terry, call me up. Anxiety disorder in the personality level is not the same as an anxiety neurosis. IF not dealt with by FAA, that does not rise to the level of (ii) psychosis, and that remains in the purview of the signing doc. You should have come by the office today

 

[Terry M - 3CK (Chicago)]

Dr Bruce - it was my wife and MIL. I was at work!

 

[Palmpilot]

So the diagnosis, regardless of meds, requires SI under class 3. Bummer. I was hopeful.

I don't think an MD would sign when it is a DQ condition in the referenced FAA docs (unless they don't read it - and I see that leading to problems for me down the road).

How would an MD's decision not to read the FAA's reference material cause problems for you?

 

[Terry M - 3CK (Chicago)]

@Palmpilot I can't really answer. Just my gut.

 

[Unregistered]

Terry, call me up. Anxiety disorder in the personality level is not the same as an anxiety neurosis. IF not dealt with by FAA, that does not rise to the level of (ii) psychosis, and that remains in the purview of the signing doc. You should have come by the office today

Which diagnosis is disqualifying? Guess i'm not clear on the difference between the two types.

What about short term medications for one of them to deal with situational anxiety? <6 months?

 

[llamaboy1988]

So, I am still confused...lets say you
1) Get off your meds and wait the 60 days
2) Apply for and get a standard class 3 cert
3) And then want to start taking those originally disqualifying meds again....
Is that allowed under basic med if you get evaluated by a regular MD and they say you are ok?

 

[flyingron]

No llamaboy, as you stated it, you are going to be flying illegal. Your 3rd class will be issued contigent on you NOT going back on the drugs.
If you do, your medical is invalid.

What you could do in between steps 2 and 3 and go through the basic med process. Then it's a matter between you and your basic med physician as to what you're going to take.

Note that EVEN UNDER BASIC MED, flying with disqualifying drugs is not a good idea.

 

[James331]

Strictly hypothetically, let's say you're a PPL who has a recently expired 3rd class where you would otherwise be eligible for Basic Med.

An MD recently said you had ADD and prescribed Adderall. (No class III or basic Med - I get that).

Professionals then run some tests and do a bunch of other stuff and say, it's not ADD, it's really anxiety.

Is anxiety DQ for the Class III (and meaning no basic Med)? Only if medicated or the diagnosis is DQ? (ADD is the meds or diagnosis are both DQ).

Any anxiety situation with meds that you can fly with?

Sounds like you need better doctors, or maybe just a nutritionist and personal trainer.

Also taking charge of your medical dealings, letting them put down that you had ADD or writing a script for adderall, no bueno.

This all sounds unnecessary and like it’s going to get expensive.

 

[Terry M - 3CK (Chicago)]

Sounds like you need better doctors, or maybe just a nutritionist and personal trainer.

Also taking charge of your medical dealings, letting them put down that you had ADD or writing a script for adderall, no bueno.

This all sounds unnecessary and like it’s going to get expensive.

Agreed. I was desperate at the time for an improvement at work and made a costly mistake.

I'm working on fixing it. Diet and exercise are absolutely key. I've got a long uphill road ahead. About 80-100lbs to lose.

 

[llamaboy]

Thanks for the input. So you are allowed to fly with meds that would otherwise be disqualifying if you go through the basic med process? I.e. totally cool to fly with Adderall or venlafaxine or w/e as long as your regular MD approves it and you meet all the other basic med requirements? Trying to see if this is a valid option or if I just have to suck it up and go SLA and then never be able to find a plane to rent...

No llamaboy, as you stated it, you are going to be flying illegal. Your 3rd class will be issued contigent on you NOT going back on the drugs.
If you do, your medical is invalid.

What you could do in between steps 2 and 3 and go through the basic med process. Then it's a matter between you and your basic med physician as to what you're going to take.

Note that EVEN UNDER BASIC MED, flying with disqualifying drugs is not a good idea.

 

[llamaboy]

Also, by "not a good idea" does that mean you can't? I kind of get the impression that the FAA restrictions might be a little bit...over restrictive...there are plenty of people who could fly perfectly well on some of the meds....maybe even better than without them...(i.e. add)

No llamaboy, as you stated it, you are going to be flying illegal. Your 3rd class will be issued contigent on you NOT going back on the drugs.
If you do, your medical is invalid.

What you could do in between steps 2 and 3 and go through the basic med process. Then it's a matter between you and your basic med physician as to what you're going to take.

Note that EVEN UNDER BASIC MED, flying with disqualifying drugs is not a good idea.

 

[Terry M - 3CK (Chicago)]

@llamaboy1988 my situation is slightly different. I had a 3rd class medical, I got a new job that was very challenging for me, and I foolishly went on a search for why I wasn't feeling like a rockstar at the new job.

So I have a 3rd class. I got a diagnosis and was prescribed a Med, either of which on its own is disqualifying with the FAA. The diagnosis would require a difficult special issuance and the meds are on the FAA do not fly list provided to doctors.

For Basic Med, there is a chance the PCP would sign me off. The Med, however, wouldn't work. The PCP is directed through the checklist to a list of no fly drugs.

I'm hopeful that, after this miscalculation on my end, that I can remain off the drugs, improve my diet and make a few other changes to get a Basic Med signoff.

If, however, I didn't previously have a 3rd class, I'd need a special issuance. Discontinuing the meds for 60 days doesn't work. Once you disclose to the FAA that you ever had that diagnosis or were prescribed those meds (depression, anxiety, ADD or anytu My similar) at any point in your life (even as a child where you haven't taken the drugs for years) you have to go the special issuance route.

That is a much more involved route.

 

[Palmpilot]

The standard for BasicMed is whether the examining physician is willing to sign you off, plus 14 CFR 61.53(b) and (c)(2):

§61.53 Prohibition on operations during medical deficiency.

...(b) Operations that do not require a medical certificate. For operations provided for in §61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

(c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in §61.23(c), a person must meet the provisions of—

...(2) Paragraph (b) of this section if that person holds a U.S. driver's license.​

As I pointed out earlier in the thread, the advice for the examining physician to read the FAA's guidance materials is worded as a recommendation, not a requirement. The existence of a medication list on an FAA Web site could conceivably be construed as "reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner," but I think that could be argued either way, since those URLs appear in the instructions to the examining physician, not the instructions to the applicant. I don't think anyone knows how it would be decided if it came up in an enforcement action or appeal.

 

[Rushie]

@llamaboy1988 my situation is slightly different. I had a 3rd class medical, I got a new job that was very challenging for me, and I foolishly went on a search for why I wasn't feeling like a rockstar at the new job.

I think this is a danger of our times. We are constantly bombarded with information about disorders that I think there's a phenomenon of "medical student's disease" in the general population now. Especially psychological disorders because there's no visible physical signs or blood tests to confirm or deny a yes/no diagnosis. We end up convinced we have something because we see repeated ads on TV or on the internet about it and we start imagining we have the symptoms.

I did a little test on myself. I read several books on the subject of ADHD. Then I took an internet quiz "Do you have ADHD?" The result was yes. Months later after I had spent a long time not thinking at all about the subject, I took the quiz again. This time, the result was NO.

I realize neither of the times I took that quiz was valid, it was not a formal psychological workup, but it did illustrate how my answers were very different from where I had recently spent a long time studying the disorder, to where I had not thought about it in months. Yes I realize all the flaws in my study, it was not scientifically objective at all. But still interesting nevertheless, I tried to answer the questions honestly both times.

I feel sure somebody could duplicate this result in a real study, demonstrating the effects of being exposed to constant messages about psychological illnesses, being associated with differences in how subjects answer questions, and maybe even rates of diagnoses.

 

[dans2992]

All this crap does is keep people who want to fly from seeking treatment.

Brilliant, FAA, brilliant.

 

[Terry M - 3CK (Chicago)]

@Rushie it started with trying to address adult ADD and low testosterone.

I eventually found a specialist in adult ADD who eventually smiled and said he was certain I did NOT have ADD. I took a quotient test?

Hoping to figure it out in the next year.

 

[Kenny Phillips]

All this crap does is keep people who want to fly from seeking treatment.

Brilliant, FAA, brilliant.

It is not the FAA that is diagnosing millions with some sort of illness.