FAA's Beef with ADHD

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Never ever ever disclose any mental health issue to the faa. If you think you have a problem get the proper help and then return to flying. Involving the faa creates one gigantic **** show. I’m really hoping that since the previous chief psychiatrist who was a huge piece of trash is gone that maybe the faa can make a few internal changes to how they handle some of these issues.
 
Doing everything the FAA asks for does not mean you're healthy or eligible. He was deferred because he wasn't apparently eligible. And the further testing apparently supported that conclusion. Other than his compliance, do you have evidence that the FAA made the wrong decision?
Quite the opposite. There is proof they were right. It’s just being ignored.
 
- If the FAA wants extra testing, they should pay for it. Perhaps with an administrative fee on the part of the applicant (no more than $100).

Why should I pay for some other squirrel's medical tests??! The FAA only pays for anything by using tax dollars. That "they" you refer to is you and me, friend. I don't see how it's fair for me to pay for tests to keep some diabetic insomniac with clinical depression and a history of alcohol abuse in the cockpit.


- If a career pilots loses their medical, their employer should be compelled to pay them until the situation is resolved one way or the other.

There's already insurance available, but especially for mental health issues, this can (and will) be abused. Tired of working? Mention suicidal ideation and have your retirement ticket punched.
 
Why should I pay for some other squirrel's medical tests??! The FAA only pays for anything by using tax dollars. That "they" you refer to is you and me, friend. I don't see how it's fair for me to pay for tests to keep some diabetic insomniac with clinical depression and a history of alcohol abuse in the cockpit.
The purpose of this idea is two-fold. First, if pilots don't have to foot the bill for excessive testing, it's likely that more pilots would be forthright on their medicals and seek treatment when necessary. This makes the skies safer, which is of public benefit. Therefore, this would arguably be worthy of tax dollars. Second, if the FAA has to foot the bill instead of pilots, the FAA would be incentivized to find ways to make that bill smaller, perhaps eliminating a lot of unnecessary testing and decreasing the general social cost of such testing.
There's already insurance available, but especially for mental health issues, this can (and will) be abused. Tired of working? Mention suicidal ideation and have your retirement ticket punched.
You got me here. My idea would absolutely create this problem.

But we should still be looking for ways to make it easier for pilots to be upfront on about their medicals.
 
Second, if the FAA has to foot the bill instead of pilots, the FAA would be incentivized to find ways to make that bill smaller,
The FAA doesn't "foot the bill," the taxpayers do. The FAA will have no incentive to make that bill smaller; no FAA employee has his compensation tied to the FAA's financial performance. In industry, we have forms of incentive compensation (bonuses, profit sharing, etc.) which do this, but there's no such thing in a federal bureaucracy.


But we should still be looking for ways to make it easier for pilots to be upfront on about their medicals.

Agreed. I think better response times from the FAA would be a big help. Even a pilot who knows he's likely to be approved (eventually) will balk at being grounded for two years, but he might not if the grounding were only for two months.
 
The purpose of this idea is two-fold. First, if pilots don't have to foot the bill for excessive testing, it's likely that more pilots would be forthright on their medicals and seek treatment when necessary. This makes the skies safer, which is of public benefit. Therefore, this would arguably be worthy of tax dollars. Second, if the FAA has to foot the bill instead of pilots, the FAA would be incentivized to find ways to make that bill smaller, perhaps eliminating a lot of unnecessary testing and decreasing the general social cost of such testing.
Nobody has to foot the bill for excessive testing. If you don't want to do the tests, if it isn't worth it to you, don't. The testing comes up because the FAA has said, "We don't believe you are eligible for a medical certificate." The airman said, "But I am." And the FAA said, "Prove it to us." If you don't like the FAA's standard of proof, talk to your congressman. But the FAA and taxpayers are under no moral or legal obligation to prove that you're eligible for a medical.
 
Does anyone have statistics on how many initial denials/defferrals are affirmed vs eventually resulting in issuance?
 
I don't think there's much debate on whether people with true mental illness should be allowed to pilot an aircraft. The real problem is what we define as "mental illness", and in my layman's opinion mild ADHD or OCD or autistic tendencies aren't disorders or mental illness, they're just one end of the normal spectrum. We arbitrarily draw a line across the spectrum and say, "beyond this lies madness," but even if the line is in the right place (which I doubt), psychiatry is so fuzzy that it's often impossible to identify a person is relative to that line.
 
What it demonstrated was someone who was on the edge and one more thing caused him to snap.
Everyone has a breaking point. None of us is immune.

Who gets to define what "mental illness" is? What do we do when FAA medical holds us to a standard that is so far out of line with general medicine? When all of your doctors have written countless letters attesting to your mental health state and that you are not a flight risk, but the FAA refuses to listen? When the FAA won't even listen to their own AMEs? They only listen to their own. HIMS psychiatrists are nothing more than FAA agents.

The NTSB Vice Chair even stated "It's been said that pilots don't understand the system, but I've seen that the FAA doesn't want pilots to understand the system. They don't even trust their own AMEs."

This is clearly a rigged system going by very outdated information from the 1950s. Both AAM-300 and the regs need a major overhaul.
 
Nobody has to foot the bill for excessive testing. If you don't want to do the tests, if it isn't worth it to you, don't. The testing comes up because the FAA has said, "We don't believe you are eligible for a medical certificate." The airman said, "But I am." And the FAA said, "Prove it to us." If you don't like the FAA's standard of proof, talk to your congressman. But the FAA and taxpayers are under no moral or legal obligation to prove that you're eligible for a medical.
Isn't there a certain injustice, though, in the FAA's letting the applicant's test results sit around until they are no longer valid and then demanding that they be repeated?
 
I mean isn’t part of the issue here our asinine insurance system that demands a diagnosis for every mental health visit to have any form of therapy covered? Therapy can be very helpful for people who aren’t at the level of an actual diagnosable condition but would like some support, possibly to prevent the situation evolving to a full blown condition. But in this country we have to slap a diagnosis code to get that at an even moderately reasonable price and suddenly you now have to check 18M.

The fact that they have a carve out for marriage counseling shows how arbitrary this is. Last I checked, marital issues is one of the many stressors that can contribute to mental health problems.

 
I mean isn’t part of the issue here our asinine insurance system that demands a diagnosis for every mental health visit to have any form of therapy covered?
Maybe the problem with our health insurance system is that people expect it to pay for whatever they want regardless of whether it's necessary. There are plenty of free or very low-cost mental-health treatment options that are available and don't even require reporting to the FAA.
 
Maybe the problem with our health insurance system is that people expect it to pay for whatever they want regardless of whether it's necessary. There are plenty of free or very low-cost mental-health treatment options that are available and don't even require reporting to the FAA.
I pay for my insurance and it pays for preventative care in the form of physicals. Do I leave every physical with a diagnosis? No. Does every visit for a symptom or two leave with a diagnosis? No, of course not, but we still sometimes seek care to make sure it isn’t more serious or get some basic treatment for a relatively minor problem. Therapy at hard times can be the same exact thing.
 
My apologies, I didn't mean to derail your thread.

To bring it back on topic, former bomber pilot here. Was issued go -pills, chose to forego them in long range operation. Wicked euphoria at the end of a 17 hour sortie (well in excess of 24 hour awake when accounting for the entire duty period plus time getting to the squadron). Shooting that ILS back at Barksdale at 3am was interesting. I couldn't stop joking/laughing during debrief (apparently that's my individual physiological response to sleep depravation, or lethal-proximate stress respectively). Driving home that morning was probably the stupiddest ish I've ever done in hindsight (username checks!).

At any rate, many more stories I could tell you about my peers and their actual eventual use of the issued drugs. I won't go into it on here. BL, from where I sit, the discussion on .mil issuance on uppers and downers as supportive of general aviation ADHD medication is just a non-sequitur. Not trying to be elitist, just a completely different use-case and demographic, to say nothing of DOD taking operational ownership of us subjects' behavior in question, and the degree of medical coercion we are bounded by under UCMJ penalty, compared to recreational civilian participants good bad or indifferent. We also crash an #ss ton of airplanes compared to professional civilians. @TCABM comment's pretty much "covered the fly bys" on this topic already, and I second his commentary.

Sorry in advance for the thread hijack, but did you know or work with Gen Robert Elder? Asking because maybe 20 years ago, post Katrina, he did a presentation on cyber security here in Albany that was one of the best I've heard. At the time, he was apparently in charge of USAF global strike, and the USAF cyber force. Which seemed like an odd combination to me, but somehow he tied them together. He had a major flipping slides for him, which also seemed weird to me.

Back on topic, to me military use of performance enhancing drugs is different than civilian use for a number of reasons. For one, the risk profiles are completely different. The military is absolutely willing to put pilots at risk in combat operations, and from everything I can tell the cold war fit that description. For another, again from my perspective, it was never a thing that the military was every good with for a pilot coming in. It was specifically done after a pilot had demonstrated their ability and was put into a pilot position. So they knew they could fly without it.

As to OP? I read it as someone that's claiming they're perfectly fine w/o any drugs, yet take the because they perform better with them. Maybe I'm off base. I'm not a fan of FAA processes around anything, but I'm not sure we're ready for OK'ing what sounds pretty close to recreational or minor drug use that doesn't affect performance much. How do you measure that, in terms of what is reasonable? But maybe meth isn't all that much different than caffeine...no sarcasm, I'm no doctor.
 
And here we have it.

"Get your mental health squared away."

"But I cannot afford it."

"Heh...that's your problem. Sorry about your luck."

What a way to kick people when they're down.
 
And here we have it.

"Get your mental health squared away."

"But I cannot afford it."

"Heh...that's your problem. Sorry about your luck."

What a way to kick people when they're down.
So in your reckoning, the FAA should pay for all the testing a diagnosed mentally ill person needs in order to prove he isn't mentally ill, or is only minimally mentally ill, is that right? And then if he actually is mentally ill, the FAA should pay for treatment? Should the FAA pay for my BP meds because it has a BP standard, or the exam to get my PCP to fill out the hypertension CACI worksheet? Should it pay for sleep studies and buy CPAPs for pilots with OSA? Buy older pilots reading glasses? Where do you draw the line?

I think you have the FAA confused with some other federal agency.
 
The FAA doesn't "foot the bill," the taxpayers do. The FAA will have no incentive to make that bill smaller; no FAA employee has his compensation tied to the FAA's financial performance. In industry, we have forms of incentive compensation (bonuses, profit sharing, etc.) which do this, but there's no such thing in a federal bureaucracy.
You're right. The FAA is not subject to market forces that would normally incentivize an organization to cut costs. However, the FAA is subject to Congress. Under such a program (which would have to be authorized by Congress in the first place) the FAA would have to justify its funding level. So if the FAA orders excessive tests, which the government would be paying for, they have to justify the X number of billions going into the medical office. If their numbers are looking a bit high, which they would under the current system, Congress would start asking uncomfortable questions about whether the current system is a bit excessive.

As a side note, I suspect that if the current system was widely understood by the public and Congress, it would be deemed unacceptable and replaced with something else. Indeed, we're already seeing this slowly happen.
There are plenty of free or very low-cost mental-health treatment options that are available and don't even require reporting to the FAA.
I was under the impression that any and all mental health treatment, with or without meds, must be reported. Am I mistaken?
 
… military use of performance enhancing drugs…
That’s the first time I’ve heard amphetamines and barbiturates referred to as performance enhancing drugs.
 
You're right. The FAA is not subject to market forces that would normally incentivize an organization to cut costs. However, the FAA is subject to Congress. Under such a program (which would have to be authorized by Congress in the first place) the FAA would have to justify its funding level. So if the FAA orders excessive tests, which the government would be paying for, they have to justify the X number of billions going into the medical office. If their numbers are looking a bit high, which they would under the current system, Congress would start asking uncomfortable questions about whether the current system is a bit excessive.

As a side note, I suspect that if the current system was widely understood by the public and Congress, it would be deemed unacceptable and replaced with something else. Indeed, we're already seeing this slowly happen.

I was under the impression that any and all mental health treatment, with or without meds, must be reported. Am I mistaken?

Depends if you consider certain types of counseling as mental health treatment.
 
I was under the impression that any and all mental health treatment, with or without meds, must be reported. Am I mistaken?
From the medxpress instructions:

"List visits for counseling only if related to a personal substance abuse or psychiatric condition."
 
And here we have it.

"Get your mental health squared away."

"But I cannot afford it."

"Heh...that's your problem. Sorry about your luck."

What a way to kick people when they're down.


I will (and do) happily donate substantial sums of money to help people in need. That’s different from having my money taken at government gun point to give to others. One is charity; the other is theft.
 
From the medxpress instructions:

"List visits for counseling only if related to a personal substance abuse or psychiatric condition."

And therein lies the rub…psychiatric condition. That’s covers a lot of territory.
 
And here we have it.

"Get your mental health squared away."

"But I cannot afford it."

"Heh...that's your problem. Sorry about your luck."

What a way to kick people when they're down.
I think it's more like: "Get your mental health squared away," followed by "Now turn in your medical and go be a barista, you mental nut case." The cost of professional flight training flushed down the crapper far exceeds the cost of a typical doctor's visit.
 
The fixable problem comes when the real doctors says you are fine, but the FAA OKC "doctors", without even an exam, say you are not. There are many real doctors working as AME and the FAA should trust them over the "doctors" in OKC. CAMI helps and should be expanded to everything not on the BasicMed big 3. ...to start

The FAA bureaucrats then require expensive tests that the real doctors and insurance companies conclude are not medically necessary. Worse, many of the tests are not valid in the professional medical world. For example real doctors have used DSM 5 for a decade. The FAA just won't keep up. As a minimum, they should state formally that the US Government has determined these tests to be medically necessary, would make it easier to get insurance support. Society and the real medical community just see things differently than the dinosaurs at the FAA.

The best thing about BasicMed is that a real doctor using real medicine will actually exam you, treat you, and make a medically appropriate call about your health for the pilot to use in his flight suitability decisions. It is proven to work safely and the FAA should take note.

A pilot who took an ADD med in 7th grade 30 years ago to keep his/her grades up through puberty should obviously not be delayed with expensive tests. Well, not IMHO, but the FAA thinks it should be. Heck the FAA made me jump through hoops because they said prostate cancer made me an unacceptable risk for sudden incapacitation or something. My real doctor thought it was a total clown show, i agree.

Every time the FAA says they need more money, i raise my hand and offer areas where they could save, they don't care.
 
A pilot who took an ADD med in 7th grade 30 years ago to keep his/her grades up through puberty should obviously not be delayed with expensive tests.
And he isn't delayed under the ADHD fast track protocol, as long as a psychologist agrees. No expensive tests required.
 
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It’s way past time to get rid of most or all of the old doctors running FAA medical and bring in the new generation. I’d say hire doctors who have around 10 years in practice. Just old enough to have solid experience, and still young enough to not care how it’s always been done and be energetic to be up,to the minute. Oh wait, those folks won’t take the pay cut. The sharp ones will stay in private practice amd leave the bureaucratic jobs to doctors who will take the easy route and not make waves.
 
And therein lies the rub…psychiatric condition. That’s covers a lot of territory.
Yeah... that truly is the issue.

I don't want to go off on a personal issue, but this is important to me. I asked the question because I have a previous diagnosis that I disclosed to the FAA. Thing is I probably need to go back to counseling again, but don't think it's related to the original diagnosis. I don't want to jeopardize my medical chances. My medical got deferred and I sort of decided to just wait for them to issue and then go on BasicMed. But it might be a while.

The other side of this is that, technically, as I understand the rules, I would only need to report it the next time I fill out a medical application, which if I got issued a Third Class and stuck with BasicMed would be... never. So I'm stuck here trying to decide whether going to a counselor would jeopardize my deferment.

To be clear, I'm just somewhat sad. But in the FAA's mind, sad = suicidal
 
Yeah... that truly is the issue.…

To be clear, I'm just somewhat sad. But in the FAA's mind, sad = suicidal
Feeling sad is not depression or suicidal ideation. Sadness is something where counseling on finding effective positive coping skills would not a be psychiatric issue.

But that ignores your personal history, and that’s where I’d be paying @bbchien his small fee for a consult on what the entirety of your documented history means to the FAA.
 
Feeling sad is not depression or suicidal ideation. Sadness is something where counseling on finding effective positive coping skills would not a be psychiatric issue.

But that ignores your personal history, and that’s where I’d be paying @bbchien his small fee for a consult on what the entirety of your documented history means to the FAA.
Sorry, that was a little hyperbole on my part. I’m working with a HIMS AME (a different one). I suppose I should probably ask him.
 
I will (and do) happily donate substantial sums of money to help people in need. That’s different from having my money taken at government gun point to give to others. One is charity; the other is theft.
Too bad, so sad. If I have to fund your department of defense at the point of a gun, you should have to fund universal health care. It's absurd that in the richest country in the world we have people unable to access health care, largely because of a wage freeze during WWII.
 
The real problem is what we define as "mental illness", and in my layman's opinion mild ADHD or OCD or autistic tendencies aren't disorders or mental illness, they're just one end of the normal spectrum.
In what little I learned/retained from psychology is the fact that all of us, in some small way, are a little bit "whacked" ... :eek2:
 
Too bad, so sad. If I have to fund your department of defense at the point of a gun, you should have to fund universal health care. It's absurd that in the richest country in the world we have people unable to access health care, largely because of a wage freeze during WWII.
Nah. Don't conflate these issues. The only reason I want the FAA to pay for their excessive medical testing is because this is a problem created by them, so it should be fixed by them.

Overall healthcare is a separate issue outside the scope of this thread.
 
Nah. Don't conflate these issues. The only reason I want the FAA to pay for their excessive medical testing is because this is a problem created by them, so it should be fixed by them.

Overall healthcare is a separate issue outside the scope of this thread.
Nope. When he brings taxes and "point of the gun" nonsense into things, it's perfectly on topic to point out that the gun points in a lot of directions. If he's going to point a gun at me to fund the military then he should be equally accountable for peoples health care. Neither should be optional in the richest nation on earth. If I have to pay thousands of dollars a year against my will to blow people up, he can save money (versus the current system) every year by having a universal health care system that's tax funded (at the point of a gun!)
 
Nope. When he brings taxes and "point of the gun" nonsense into things, it's perfectly on topic to point out that the gun points in a lot of directions. If he's going to point a gun at me to fund the military then he should be equally accountable for peoples health care. Neither should be optional in the richest nation on earth. If I have to pay thousands of dollars a year against my will to blow people up, he can save money (versus the current system) every year by having a universal health care system that's tax funded (at the point of a gun!)
Well, maybe this isn't the place for a discussion of public versus private goods.
 
The fixable problem comes when the real doctors says you are fine, but the FAA OKC "doctors", without even an exam, say you are not. There are many real doctors working as AME and the FAA should trust them over the "doctors" in OKC. CAMI helps and should be expanded to everything not on the BasicMed big 3. ...to start
CAMI = Civil Aerospace Medical Institute.
CACI = Conditions AMEs can issue.

Did you perhaps mean the latter?
 
I will (and do) happily donate substantial sums of money to help people in need. That’s different from having my money taken at government gun point to give to others. One is charity; the other is theft.
When the American colonies threw off British rule, one of the slogans was "No taxation without representation." The "taxation is theft" claim sounds like an argument for "No taxation WITH representation."

So, is the idea that government should funded solely through donations?

When the question of "Which activities are worthy of taxpayer funding" is being considered, equating taxation with theft sheds no light whatsoever, because it applies equally to ALL government spending, not just to spending that the writer disfavors.
 
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