Cogscreen Reported Results Issues & SI Denial

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Feeling Frustrated

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Hi! I am working through an SI and I’ve had to do 2 cogscreens and FAA is now requesting a 3rd. After a recent denial I noticed that the 1st cogscreen report compared my results to GA and commercial pilots normative group. The second then compared them to major airline pilots…I’m just seeking a class 3.

After the denial I questioned the report and the neuropsychological Dr acknowledged they (the Dr) made a mistake and that the results painted a much worse picture to the FAA. They provided an addendum to the prior report stating such, so rather than 5 test being below average (15th percentile) when compared to major airline pilot normative groups (wrong group), the corrected results show me above average (15th percentile) for those 5 test and for all other tests . Brain impairment probability (LRPV) is in-line with all categories, including major airline pilots…i.e. very low probability. The revised report even went on to say, in so many words, that my cogscreen results were not concerning when even compared to the more stringent major airline normative data group.

However, the FAA’s decline letter specifically stated “aeromedically significant cognitive deficits” as a reason for the decline and is asking for more testing…which isn’t cheap. So I waited 8 months to get a decline which may actually be based upon incorrect data.

Any suggestions on what I should do? Any way to make the FAA aware of this without having to get at the back of the line and wait another 8-10 months??

Thanks!
 
If you don't mind sharing what was the LRPV score? I just took the test about a month ago as well and also had a few categories that were below the 15%-ile, namely the processing speed and something relating to improved memory over repeated trials
 
mbfg12 said:
If you don't mind sharing what was the LRPV score? I just took the test about a month ago as well and also had a few categories that were below the 15%-ile, namely the processing speed and something relating to improved memory over repeated trials
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~.177
 
Feeling Frustrated said:
Hi! I am working through an SI and I’ve had to do 2 cogscreens and FAA is now requesting a 3rd. After a recent denial I noticed that the 1st cogscreen report compared my results to GA and commercial pilots normative group. The second then compared them to major airline pilots…I’m just seeking a class 3.

After the denial I questioned the report and the neuropsychological Dr acknowledged they (the Dr) made a mistake and that the results painted a much worse picture to the FAA. They provided an addendum to the prior report stating such, so rather than 5 test being below average (15th percentile) when compared to major airline pilot normative groups (wrong group), the corrected results show me above average (15th percentile) for those 5 test and for all other tests . Brain impairment probability (LRPV) is in-line with all categories, including major airline pilots…i.e. very low probability. The revised report even went on to say, in so many words, that my cogscreen results were not concerning when even compared to the more stringent major airline normative data group.

However, the FAA’s decline letter specifically stated “aeromedically significant cognitive deficits” as a reason for the decline and is asking for more testing…which isn’t cheap. So I waited 8 months to get a decline which may actually be based upon incorrect data.

Any suggestions on what I should do? Any way to make the FAA aware of this without having to get at the back of the line and wait another 8-10 months??

Thanks!
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That sucks, sorry to hear that.

Good luck!
 
Wrong consultant. Who did you go to....pretty sure it wasn't to one of the "go to" shops....that's sloppy work.
Now if you go to another and it's favorable, you'll be subject to the "resolution of conflicting experts" process. It takes AGES.
 
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bbchien said:
Wrong consultant. Who did you go to....
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Rather not say. Just looking for a pathway to fix this and hopefully not add another year to the process needlessly. Whether that be just sending in info to OKC PO Box, legal help, AOPA or otherwise.

My HIMS AME said to mail to OKC. I guess I was just hoping for some more direct means since the FAA approved neuropsych Dr goofed.
 
Prolly cheaper to fly to DC personally and go knock on Susan’s door…. Even if you go first class and stay at the ritz… take in a show at the Kennedy Center.

Geesh, wish this weren’t NORMAL, but it is.
 
Sheesh. Plus ca change…

I quit flying - hopefully temporarily - in 2018 and my third expired shortly after. They sure make Basic Med (which would cover any flying I’m likely to do) or MOSAIC appealing.
 
0.17 seems pretty low, sorry to hear your getting sucked into the process for longer
 
PostTenebrasLux said:
Sheesh. Plus ca change…

I quit flying - hopefully temporarily - in 2018 and my third expired shortly after. They sure make Basic Med (which would cover any flying I’m likely to do) or MOSAIC appealing.
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Sorry for the thread drift... but if your valid 3rd Class expired in 2018 - why can you not do Basic Med? Do you still need a one-time SI?
 
172andyou said:
Since you're anonymous anyway, are you willing to share how you ended up needing an SI?
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Alcohol “dependence.”

They also wanted soberlink twice daily in the new denial letter. Is that normal for class 3 medical or do they think I’m an airline pilot??
 
Feeling Frustrated said:
Alcohol “dependence.”

They also wanted soberlink twice daily in the new denial letter. Is that normal for class 3 medical or do they think I’m an airline pilot??
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Got it. Thanks. Yeah, there are as many different stories in the PoA archives on that as there are people who have gone through it.
 
It looks like my HIMS AME may have never sent my IOP treatment intake and discharge forms to the FAA. I think my head is going to explode…called OKC and they can’t see them.
 
mbfg12 said:
0.17 seems pretty low, sorry to hear your getting sucked into the process for longer
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Actually, that's 4.25 x legal for a pilot. Someone Naieve to alcohol would be face downon the curb....but you were attempting to operate a motor vehicle. Cogscreens in that situation can really reflect permanent brain changes form getting that tolerant (drinking over time). Never mind the Psychologist's apparent error. So 0.17 isn't really low at all....
 
bbchien said:
Actually, that's 4.25 x legal for a pilot. Someone Naieve to alcohol would be face downon the curb....but you were attempting to operate a motor vehicle. Cogscreens in that situation can really reflect permanent brain changes form getting that tolerant (drinking over time). Never mind the Psychologist's apparent error. So 0.17 isn't really low at all....
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I think the .177 was referencing LRPV score.
 
bbchien said:
Actually, that's 4.25 x legal for a pilot. Someone Naieve to alcohol would be face downon the curb....but you were attempting to operate a motor vehicle. Cogscreens in that situation can really reflect permanent brain changes form getting that tolerant (drinking over time). Never mind the Psychologist's apparent error. So 0.17 isn't really low at all....
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LRPV was .177. Very low probability of brain impairment per the neuropsych. So I don't understand how the FAS determined "significant cognitive deficits."

That's not a BAC.
 
Half Fast said:
Well, they use it as for screening purposes. If you choose Class 3 over Basic Med, you're required to get a cogscreen and enter HIMS.
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Uh. No, I’m not. I’m not the OP with the issue. Absolutely no reason I’d have a problem getting a class III. I just figure I won’t really need it and all these stories about mistakes scream to not bother “just in case” they screw up their end. Never had an SI, never had an issue though I do have a letter of eligibility for a medical thing decades ago.
 
PostTenebrasLux said:
Uh. No, I’m not. I’m not the OP with the issue. Absolutely no reason I’d have a problem getting a class III. I just figure I won’t really need it and all these stories about mistakes scream to not bother “just in case” they screw up their end. Never had an SI, never had an issue though I do have a letter of eligibility for a medical thing decades ago.
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(Heads up - your sarcasm detector might be underperforming.)
 
Feeling Frustrated said:
LRPV was .177. Very low probability of brain impairment per the neuropsych. So I don't understand how the FAS determined "significant cognitive deficits."

That's not a BAC.
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Oh, my bad....an LRPV of 0.177 is actually pretty good. Anything below 0.4 is acceptable.
You say he didn't send your rehab records- wrong consultant AND a HIMS AME who got buried in your paperwork..
sigh.

Hang in there. The race goes to the prepared and to the persistent.
 
bbchien said:
Oh, my bad....an LRPV of 0.177 is actually pretty good. Anything below 0.4 is acceptable.
You say he didn't send your rehab records- wrong consultant AND a HIMS AME who got buried in your paperwork..
sigh.

Hang in there. The race goes to the prepared and to the persistent.
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Thanks, Dr Chien!
 
Jon Wilder said:
If this were me, I’d be switching all of my HIMS personnel out for competent ones. Perhaps consider switching to Dr Chien. He’s definitely one of the more competent HIMS AMEs (I think he had a hand in writing some of the HIMS protocols even).
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I wish, you have to have the FAA’s approval for that, or at least to change HIMS AME, and it apparently sends up red flags for the FAA. Sounds like I’m stuck.

This is a terribly administered process.
 
Feeling Frustrated said:
I wish, you have to have the FAA’s approval for that, or at least to change HIMS AME, and it apparently sends up red flags for the FAA. Sounds like I’m stuck.

This is a terribly administered process.
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Another HIMS AME could certainly handle that approval process. It shouldn't send up red flags for the FAA, especially if your new HIMS AME has sufficient information to prove that the previous HIMS AME wasn't doing his job (such as the apparent paperwork errors you're experiencing, failing to send in paperwork, etc). It only sends up red flags if it appears to them that you're "shopping around" for one.
 
Jon Wilder said:
Another HIMS AME could certainly handle that approval process. It shouldn't send up red flags for the FAA, especially if your new HIMS AME has sufficient information to prove that the previous HIMS AME wasn't doing his job (such as the apparent paperwork errors you're experiencing, failing to send in paperwork, etc). It only sends up red flags if it appears to them that you're "shopping around" for one.
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Paging Dr Chien - how does one go about changing HIMS AMEs and is it possible in this situation?
 
No one cares if you switch docs… except maybe the doc FROM WHICH you are switching. If he quits, it’s a no brainer…

Quit paying him, pretty sure he’s gonna quit spending time on you.

Just a thought…
 
Feeling Frustrated said:
I wish, you have to have the FAA’s approval for that, or at least to change HIMS AME, and it apparently sends up red flags for the FAA. Sounds like I’m stuck.

This is a terribly administered process.
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You don’t need the faa’s approval to change HIMS Ames before your SI is issued. I changed mine more than once. If I were you I would drop the one you have since he seems awful.
 
Bit of an update, and seeking additional clarity. I met with my HIMS AME this week - I got some correspondence from the FAS stating that they will accept an IOP so long as it is satisfactory to the evaluating HIMS AME and provides thorough and good reports. This would be a second IOP as I self admitted prior to starting HIMS monitoring/prior to a medical issuance (it was a 12 week in person program) but had a slip/relapse in early 2024. I started HIMS monitoring a couple of weeks after starting abstinence again (which has now been over 14 months) and have 14 months of negative randoms, AA logs, etc under HIMS monitoring.

I met the HIMS AME and asked them if we can get clarity on what "satisfactory" means as there are 4-6 week IOPs, 8-10 weeks, 12 weeks, in person, virtual, etc and before I shell out another $5K-$10K on treatment to meet this requirement. The HIMS AME refuses to call the FAA for clarity. He just gave me the number for 2 IOP programs to call. I asked how we would know that these would even work/satisfy the FAA...he said we wouldn't, we'd just find out after done and after waiting to hear back.

Is that accurate? It's like any question or desire to understand and be clear on things is seen as arguing and "not actively in recovery."

I'm in a bit of a weird spot as I'm a class 3 applicant, I've been told insurance won't cover me for this IOP as I'm not clinically indicated as needing such. These things cost from $200 - $500 per session! Are my expectations too high that the person the FAA makes you work with and are paying be able to help navigate this and be my liaison to the FAA ask for this type of clarification?

I've now talked to other HIMS AMEs that say this Dr. has no idea what he is doing, never heard of him or seen him at the HIMS conferences, even though he is on the FAA list of approved HIMS AMEs, that it's absolutely the HIMS AME's job to seek clarity and converse with the FAA for such clarifications and that he can absolutely suggest a recommended IOP solution based upon my situation.

I am getting totally conflicting answers on changing HIMS AME's too. Some say you absolutely cannot, others you can but only in certain special situations, and that you can but plan on tacking on another 6 months as it looks bad to the FAA.

I am totally lost. I'm trying to do what the FAA is asking of me, I've already come this far and spent a ton of $. Am I incorrect or asking too much for the HIMS AME to help develop a plan that both meets the FAA's requirement and makes sense for the applicant or seek clarity on what exactly "satisfactory" means??? Or is it too much for the HIMS AME to even say "I'm going to recommend and I support that applicant John Doe do a virtual IOP for 6 weeks with ongoing screening."

I'd appreciate some help.
 
Feeling Frustrated said:
I am getting totally conflicting answers on changing HIMS AME's too. Some say you absolutely cannot, others you can but only in certain special situations, and that you can but plan on tacking on another 6 months as it looks bad to the FAA.
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See posts #32 and #33. If you can't trust Dr. Bruce's opinion, you can't trust anybody. Change AMEs and get on with it.
 
Half Fast said:
See posts #32 and #33. If you can't trust Dr. Bruce's opinion, you can't trust anybody. Change AMEs and get on with it.
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Thank you. Before I do that, however, am I adding on additional scrutiny by the FAA/FAS? More time? Am I going to end up just as frustrated with another AME, meaning are my expectations out of line/too high and this is just normal?
 
Feeling Frustrated said:
Thank you. Before I do that, however, am I adding on additional scrutiny by the FAA/FAS? More time? Am I going to end up just as frustrated with another AME, meaning are my expectations out of line/too high and this is just normal?
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Quit over-thinking and over-worrying. Read post #32, take Bruce's concurrence with #32 as gospel, change AMEs and get on with it.
 
Half Fast said:
Quit over-thinking and over-worrying. Read post #32, take Bruce's concurrence with #32 as gospel, change AMEs and get on with it.
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Well, in fairness, it sounds like underthinking and not doing due diligence on the AME is what got OP into this position, or at least a contributing factor.
 
Feeling Frustrated said:
Thank you. Before I do that, however, am I adding on additional scrutiny by the FAA/FAS? More time? Am I going to end up just as frustrated with another AME, meaning are my expectations out of line/too high and this is just normal?
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Depends how well you interview the new HIMS guy. The questions here should be asked of the ones you interview. Along with how many ‘complex’ cases like yours they have handled.

Run your candidate names against a google search to see reviews/experiences.
 
As a participant in this convoluted process who has changed AME's: this is a long-term relationship once you are issued. There is a wide spectrum of AME opinion on just what constitutes recovery (as there are no published standards); there are equally divergent approaches to dealing with the FAA ranging from "throw it at the wall and we'll see what they want" to "overdeliver to ensure success." Both of these extremes will cost you time, frustration and money.

I also was told my insurance wouldn't pay. Don't be too sure. Get it straight from the insurance company. You have a lifetime condition, and seeking treatment or help even without relapse may indeed qualify. Mine delivered and I have a hell of a lot longer period of sobriety than 14 months.

I fell victim to the "be silent and accept whatever they do because the FAA will be mad" approach. It cost me time and money. If your relationship with your AME won't work, if there are inaccuracies or misunderstandings, stand up and get them resolved in a calm, professional manner.

Recommend: in-person interviewing HIMS AMEs of interest, if possible. Find one you get along with and is reasonable. Do this and make your selection before changing anything. Also, if you're not involved already, there are pilot-specific recovery groups and aftercare. There is a wealth of knowledge in that community and the shared experience will help immensely in your ability to stay the course prior to and after your eventual issuance.
 
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