Class 3 Medical Deferral for General Anxiety

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LookingtoFly

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Looking for input from any medical certification experts, aviation lawyers, or HIMS psychiatrists/psychologists on this one.

I’m generally healthy - but have had mild anxiety I have been seeing a psychologist for at weekly therapy sessions. Nothing serious - I’m a practicing trial lawyer and scuba diver so I’m not a stranger to the stresses of life and can clearly function. At one point in time 9+ months ago, work was especially unforgiving with 14 hour days, my relationship was on some serious rocks, and my elderly cat had nighttime dementia which prevented me from sleeping more than 2-3 hours a night on top of all I was going through, so I sought and was prescribed klonopin and trazodone to “assist” as needed. I ended up not needing it much of either - the trazodone was too powerful, and I was able to manage my anxiety mostly without use of the medication (1 pill weekly at the most at it’s peak, then becoming maybe one a month). Through regular therapy and couples therapy, and the cat’s eventual passing, my situation drastically improved, such that I discontinued the medication voluntarily. Because the last time I ever took a was barely within 90 days before my AME, I disclosed it on MedXpress. The AME said the FAA would defer, which of course they did, asking for a current clinical progress note from the prescribing physician and the psychologist. My GP, who prescribed the klonopin, sent a stellar letter stating I was doing great without medication, stating I hadn’t refilled the script at all, and said he had no objections to me pursuing and obtaining a airman’s medical certificate, as did my psychologist, who wrote a glowing recommendation. The FAA has now asked for the entire file from both providers along with prescription records for 4 years. Their tone was a bit harsh, and the request seems broad and excessive. I’ll of course provide them what they want - but what are the chances they will flat out deny me? Or send me to a super expensive HIMS psychiatrist for what was essentially a relatively minor case, all things considered. Has anyone seen a case like this get a medical granted? What are the chances they send me to a HIMS psychiatrist?
 
You need to see a reply from one of the senior AMEs here. One was involved with the FAA in developing the procedures for such an issuance.

You can search the forum here for anxiety or that med and see some of their historical posts.
 
The experts will chime it but if this started 9 months ago and ended three months ago, you may be fine once the FAA gets the documentation they've requested. I don't know if it applies in this situation, but one option in the meantime is to return the remaining pills to the pharmacy that filled the prescription and get a written statement to that effect.

Don't be too alarmed by what seems to be "broad and excessive" on the part of the FAA. I think they just generally assume that if an applicant had a little problem it's really been a big problem until proven otherwise.
 
Depends upon what the “entire file” shows. General anxiety is a pretty broad diagnosis.
 
Yes it depends on what the entire file shows. PCP, and Ph.D. Psychiatrist.

And on what a ten year Pharmacy Report looks like
And since you will need a well written psychiatry history for which I have never seen done properly by a Family Doc (heck I used to train them and they only get 3 weeks of psychiatry), you need a visit for a board certified Psychiatrist’s take on the whole situation. NOT Psychologist (Ph.D.).

“Broad and excessive” is because the letter was written by one of your professional colleagues….sigh.

The burden is to provide all those little details that allow the AMCD to determine the probability of an unmonitored relapse during the year ahead…and those clues are subtle.



B
 
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Thanks for all the replies - much appreciated!

Dr. Chien, would it be better to find a FAA-certified HIMS psychiatrist to do the eval and history on the front end? Or is any board-certified psychiatrist with a knowledge of aviation medicine enough? Also, should I wait for the FAA to reply to the records submission or just go ahead and get it done?

Many thanks!

P.S. - Your point about my professional brethren writing the letter is well-taken. We as a "species" don't often consider what a normal human being might feel like reading a lawyer's letter. :)
 
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