Disclosing Therapy Question

[Wheresmychute]

Good morning. I just had a quick question about receiving and disclosing therapy. I am in the process of receiving an SI for a GAD diagnosis. I am currently on medication. As it stands I am in the "get tested and collect paperwork" phase. I have a cogscreen and psych eval coming up soon.

As for my situation, I received therapy a few years back and it helped a lot. Recently my anxiety has been getting pretty rough and I would like to start going again but don't want to screw up this process I've been in for over a year now. The therapy would be for an addiction that is unrelated to anything disqualifying for flying but still contributes significantly to my anxiety.

I cannot afford out of pocket cost and will need insurance to cover the therapy, which will mean it will have to be done as treatment for my GAD. This means I will have to disclose it to the FAA.

My question is, what is disclosure? Is it just letting the FAA know I am receiving therapy? Giving them the medical records or a note from the therapist? Or is it full on therapy notes (which my past therapist had declined to provide to the FAA, and I agreed).

Also, will this put a wrench in my current efforts? Delay them or such? Or is it just, "yea send us this record just so we know."

Any help is appreciated, if there are other way to get around this let me know too.

 

[bbchien]

They want to see all the session notes. At very least, it will appear in your psychiatry eval. commentary and the HIMS pscyhiatrist needs to have them, too. Period. Disclosure = "bare to the wind", man.

Hard to say about the "wrench" without reading the notes.
What really will throw a wrench is having less-than full disclosure discovered. That just Shuts the whole process down....

 

[Wheresmychute]

They want to see all the session notes. At very least, it will appear in your psychiatry eval. commentary and the HIMS pscyhiatrist needs to have them, too. Period. Disclosure = "bare to the wind", man.

Hard to say about the "wrench" without reading the notes.
What really will throw a wrench is having less-than full disclosure discovered. That just Shuts the whole process down....

My HIMS AME seemed to think full notes was optional, they mentioned it to me, both me and my therapist balked and they said a letter would suffice. Honestly the notes themselves likely cannot be found anyways, at least according to my old therapist.

So I would have to receive the therapy for a condition other than the GAD and one that is not disqualifying I guess.

 

[Lindberg]

This is a conversation you should have with your HIMS AME. It's understandable you didn't want to share details here, but they're important. A recurrence of the condition you're selling an SI for, while under treatment, may very well have an impact on the process, but details matter. Hopefully you had an open and frank discussion with your AME before beginning this process, and you should continue.

 

[bbchien]

Well if they aren't avaiable a letter disclosing what was at stake, will HAVE TO DO. The key here is "willful" withholding, or not. then of at course, @ FAA's option, they might demand a current status update. Must about everything except marriage relationships, is thought by FAA to be under the purview of FAA.

 

[mryan75]

The therapy would be for an addiction that is unrelated to anything disqualifying for flying but still contributes significantly to my anxiet

Get the help you need, my friend…

 

[Wheresmychute]

A little update, I went to do a psych eval with a HIMS psychiatrist. I expressed the same concern and he assured me that the FAA should not need full session notes. Saying a treatment summary is all they will need from the treating psychiatrist even for continuous therapy. This is with a diagnosed condition.

As is seen in this thread this contradicts other experts. So once again another policy that is far too vague and far too impactful for pilots. Personally I agree with the idea that the FAA does not need full notes, they just don't. Especially for something as personal as talk therapy.

 

[Lindberg]

A little update, I went to do a psych eval with a HIMS psychiatrist. I expressed the same concern and he assured me that the FAA should not need full session notes. Saying a treatment summary is all they will need from the treating psychiatrist even for continuous therapy. This is with a diagnosed condition.

As is seen in this thread this contradicts other experts. So once again another policy that is far too vague and far too impactful for pilots. Personally I agree with the idea that the FAA does not need full notes, they just don't. Especially for something as personal as talk therapy.

In fairness to the FAA, you haven't asked them what they want. You've asked your treatment team, which it seems has given a consistent answer, and the Internet.

 

[Wheresmychute]

In fairness to the FAA, you haven't asked them what they want. You've asked your treatment team, which it seems has given a consistent answer, and the Internet.

No one I consulted was in my treatment team. Either way, this is like saying "okay, you've asked your doctor, but did you ask the CDC?" Both people I asked should be a perfectly legitimate source of information on this.

 

[TCABM]

No one I consulted was in my treatment team. Either way, this is like saying "okay, you've asked your doctor, but did you ask the CDC?" Both people I asked should be a perfectly legitimate source of information on this.

Your example would be more accurate if you had to apply to the CDC for a certificate of good health according the CDC standards, using CDC processes so that you can apply for a driver’s license.

The question you should be asking your treatment team is whether any of them a familiar with the FAAs medical standards and processes as found in 14 CFR Part 67 and the AME guide.

Having said all that, Doc Bruce’s method is provide everything up front in order to ensure all the squares are filled and the documentation supports an issuance in a timely manner.

The other school of thought is to apply and wait for the demand letter, then answer that and only that. Wait and see what the result is. Then rinse, lather, and repeat until such time as a decision is made.

The choice, ultimately, is yours to make.

 

[Lindberg]

Or is it full on therapy notes (which my past therapist had declined to provide to the FAA, and I agreed).

My HIMS AME seemed to think full notes was optional, they mentioned it to me, both me and my therapist balked and they said a letter would suffice.

I went to do a psych eval with a HIMS psychiatrist. I expressed the same concern and he assured me that the FAA should not need full session notes.

No one I consulted was in my treatment team.

Is it the word "treatment" that you take issue with?
I didn't suggest you ask the FAA. But you said the FAA's policy was vague. And I just don't know how you can make this statement when 1) you haven't asked the FAA what its policy is, and b) everyone you've personally consulted has given you consistent answers.

 

[Wheresmychute]

Is it the word "treatment" that you take issue with?
I didn't suggest you ask the FAA. But you said the FAA's policy was vague. And I just don't know how you can make this statement when 1) you haven't asked the FAA what its policy is, and b) everyone you've personally consulted has given you consistent answers.

Gotta read the rest of the thread man.

They want to see all the session notes. At very least, it will appear in your psychiatry eval. commentary and the HIMS pscyhiatrist needs to have them, too. Period. Disclosure = "bare to the wind", man.

This is the other expert I mentioned. Unless Dr. Chien is no longer involved in HIMS.

This is what Im confused about.

 

[Lindberg]

Gotta read the rest of the thread man.

I don't gotta do anything man.

This is the other expert I mentioned. Unless Dr. Chien is no longer involved in HIMS.

This is what Im confused about.

If you're confused because the people actually familiar with your case, who you're paying to advise you, have consistently told you one thing, and SGOTI told you something different, then you should probably dump the professionals you're working with and hire Bruce.

 

[Wheresmychute]

I don't gotta do anything man.

Where have I heard this before.... "I dont gotta check the weather, look its fine, clear and sunny outside."

The point isn't "who is right" but why the point is in confusion in the first place. I'm looking for certainty. Both sources just told me straight up one way or the other. So its like you said, I'm looking to the FAA itself. I was hoping someone here could help with that, but not in a "the FAA will tell you this," but like, "Yes, the FAA has excepted progress summaries for my client with no problem."

 

[bbchien]

Bottom line; if it's availabe they want it. If it's not available what you got (which isn't as good) is what you got.

 

[TCABM]

…The point isn't "who is right" but why the point is in confusion in the first place. I'm looking for certainty. …

You will not find that anywhere.

There isn’t certainty because each case in unique. No one here knows (and you should not be disclosing here) the entirety of your relevant diagnoses, medications (if any of any type from OTC to controlled substances), treatment plans, or the answers to the 24 or so different things on question 18.

 

[Lindberg]

Where have I heard this before.... "I dont gotta check the weather, look its fine, clear and sunny outside."

Huh?

The point isn't "who is right" but why the point is in confusion in the first place. I'm looking for certainty.

Huh?

Both sources just told me straight up one way or the other. So its like you said, I'm looking to the FAA itself.

"[The FAA's] not here."

I was hoping someone here could help with that, but not in a "the FAA will tell you this," but like, "Yes, the FAA has excepted progress summaries for my client with no problem."

If your HIMS AME and HIMS Psych have so little experience with this that you don't trust their answers, you might want to hire someone else.

 

[UTLonghorn_1979]

Might be wise to not even allow FAA to designate someone a HIMS AME if they can’t readily navigate the administrative processes set out by the FAA.

Administration should leave no room for subjectivity. Since, according to the frequents here, AMEs aren’t practicing medicine, which is often opinion and subjective based upon observations, every situation should be handled objectively the same.

This is clearly not the case and hence why people come to these forums. It’s pathetic that in many instances SGFTI knows more than the HIMS AME.