Lead time for SSRI Path 1

J

Justin Leach

Guest
Hi everyone,

For context: About 10 hours into my flight training I learned that being on an SSRI would delay my medical certification. After looking at the two paths, I chose SSRI path 1 which is to discontinue my SSRI (Lexapro) on record which I did.

I am 30 days I and just a follow up with my prescribing doctor and she said that I am doing great and that she will have my take two tests to provide concrete evidence in addition to a detailed report that my anxiety is in remission.

My question, looking at the SSRI path sheet it suggests I should be applicable for normal issuance once I show my favorable report to my AME.

I am now told by AOPA that my AME will likely still have to defer my application. Has anyone gone through this process and can shed insight on how long this process took said and done?
 
Just to set expectations I suspect it will be a long time, hopefully a doc will check in.
 
The AME can issue this ONLY if this is your only episode, and
You treatment was < 180 days
You were only on one med
You have been of 60 days
There was no severity
And you are fully recovered
And the AME can document all that. The audit rate is 100%. So most will not issue that in the office.
 
First and foremost, thank you so much for your help and for your advocacy with the aviation community!

Second, my AME recommended I get my medical done ASAP before my sixty days on record is complete to get ahead of the process. He said he could note on my deferred application that I will have a formal evaluation to share on x date and it may expedite the process.

Does it make sense to submit all paperwork at once and hope I am sent an approved letter or should I listen to my AME’s advice? I have read that you should NOT do this and submit all at once.

Again thank you for your help. It is greatly appreciated!


bbchien said:
The AME can issue this ONLY if this is your only episode, and
You treatment was < 180 days
You were only on one med
You have been of 60 days
There was no severity
And you are fully recovered
And the AME can document all that. The audit rate is 100%. So most will not issue that in the office.
Click to expand...
 
There is no withdrawing an application. I would get the documentation FIRST B4 doing any Medxpress. When the agency give you 60 days, it's a struggle to meet that and even worse, until you have the documentation in hand, you don't know if it covers it.

The community doc writes that 'he's fine", and that's a FAIL. If he leave out that "this is to my knowledge his only episode in his life" it's a FAIL, etc, etc... Then 60 days go by and you get denied. That's a FAIL. Get the documentation FIRST.

Doing the exam first is like pulling the pin out of the hand gernade.....
 
bbchien said:
There is no withdrawing an application. I would get the documentation FIRST B4 doing any Medxpress. When the agency give you 60 days, it's a struggle to meet that and even worse, until you have the documentation in hand, you don't know if it covers it.

The community doc writes that 'he's fine", and that's a FAIL. If he leave out that "this is to my knowledge his only episode in his life" it's a FAIL, etc, etc... Then 60 days go by and you get denied. That's a FAIL. Get the documentation FIRST.

Doing the exam first is like pulling the pin out of the hand gernade.....
Click to expand...

OP said the doctor said his anxiety was in remission. If the SSRI was being prescribed for anxiety as opposed to depression, does that change anything?
 
I'm not an AME so take my $.02 for what it's worth. But if your AME is encouraging you to submit an application that you don't KNOW is going to result in issuance, I'd find a different AME. Take what Dr. Bruce said about pulling the pin to heart. And consider how much you want to rely on an AME who's advising you to do that. I'd want an AME who's going to make sure I get a medical or maintain my ability to fly without one, not one who's eager to take a shot and see what happens.
 
Justin Leach said:
Hi everyone,

For context: About 10 hours into my flight training I learned that being on an SSRI would delay my medical certification. After looking at the two paths, I chose SSRI path 1 which is to discontinue my SSRI (Lexapro) on record which I did.

I am 30 days I and just a follow up with my prescribing doctor and she said that I am doing great and that she will have my take two tests to provide concrete evidence in addition to a detailed report that my anxiety is in remission.

My question, looking at the SSRI path sheet it suggests I should be applicable for normal issuance once I show my favorable report to my AME.

I am now told by AOPA that my AME will likely still have to defer my application. Has anyone gone through this process and can shed insight on how long this process took said and done?
Click to expand...

Wait, you haven’t even taken the exam yet? You’ve been off for 30 days? What’s all the fuss? The question on the form asks what medications are you currently taking. If you were prescribed something that had a 30 day supply and you are now on your 31st day and don’t have a new prescription, in my opinion you are not currently taking anything . You might get dinged for “have you ever in your life” been diagnosed with a mental health disorder.

but sure get your prescribing doc on your side and documentation ready to submit.

I went down ssri decision path 1, deferred, the first letter from the faa came a month after deferral, submitted my docs letter postmarked and dated exactly 60 days after discontinuance, and had my third class in the database 1.5 weeks after that. I’ve been told the turnaround in my case was extraordinary.
 
Francis Reyes said:
Wait, you haven’t even taken the exam yet? You’ve been off for 30 days? What’s all the fuss? The question on the form asks what medications are you currently taking. If you were prescribed something that had a 30 day supply and you are now on your 31st day and don’t have a new prescription, in my opinion you are not currently taking anything . You might get dinged for “have you ever in your life” been diagnosed with a mental health disorder.

but sure get your prescribing doc on your side and documentation ready to submit.

I went down ssri decision path 1, deferred, the first letter from the faa came a month after deferral, submitted my docs letter postmarked and dated exactly 60 days after discontinuance, and had my third class in the database 1.5 weeks after that. I’ve been told the turnaround in my case was extraordinary.
Click to expand...

Interesting, so the FAA was not concerned with whatever mental condition you specified for 18.m, and was satisfied with just your doc's letter saying you were off the meds for 60 days and stable?
 
Wow, thats remarkable! Yeah, my plan is pretty much similiar to yours with the exception that I plan to have my outlined evaluation (proving 60 days of discontinuation and stable) in hand to have my AME submit that when he submits my application so I can (hopefully) avoid even waiting a month for them to ask me for a favorable report. Thank you for your answer, definitely reassuring!

Francis Reyes said:
Wait, you haven’t even taken the exam yet? You’ve been off for 30 days? What’s all the fuss? The question on the form asks what medications are you currently taking. If you were prescribed something that had a 30 day supply and you are now on your 31st day and don’t have a new prescription, in my opinion you are not currently taking anything . You might get dinged for “have you ever in your life” been diagnosed with a mental health disorder.

but sure get your prescribing doc on your side and documentation ready to submit.

I went down ssri decision path 1, deferred, the first letter from the faa came a month after deferral, submitted my docs letter postmarked and dated exactly 60 days after discontinuance, and had my third class in the database 1.5 weeks after that. I’ve been told the turnaround in my case was extraordinary.
Click to expand...
 
Justin Leach said:
First and foremost, thank you so much for your help and for your advocacy with the aviation community!

Second, my AME recommended I get my medical done ASAP before my sixty days on record is complete to get ahead of the process. He said he could note on my deferred application that I will have a formal evaluation to share on x date and it may expedite the process.

Does it make sense to submit all paperwork at once and hope I am sent an approved letter or should I listen to my AME’s advice? I have read that you should NOT do this and submit all at once.

Again thank you for your help. It is greatly appreciated!
Click to expand...

Hire Dr. Chien (@bbchien) or Dr. Fowler (@lbfjrmd) and have them walk you through this. Too many landmines and pitfalls along the way that could delay your ticket, or prevent it altogether. Let one of the experts make sure that every T is crossed and I dotted. It's your best avenue in terms of a successful outcome in the least amount of time possible.
 
Francis Reyes said:
Wait, you haven’t even taken the exam yet? You’ve been off for 30 days? What’s all the fuss? The question on the form asks what medications are you currently taking. If you were prescribed something that had a 30 day supply and you are now on your 31st day and don’t have a new prescription, in my opinion you are not currently taking anything . You might get dinged for “have you ever in your life” been diagnosed with a mental health disorder.

but sure get your prescribing doc on your side and documentation ready to submit.

I went down ssri decision path 1, deferred, the first letter from the faa came a month after deferral, submitted my docs letter postmarked and dated exactly 60 days after discontinuance, and had my third class in the database 1.5 weeks after that. I’ve been told the turnaround in my case was extraordinary.
Click to expand...
Francis: This happens when the exposure was <179 days and there has been no other episode. Don’t know you circumstances! But in that case the AME had the option to issue and defend his issuance.......
 
Hi everyone, I wanted to follow up on the outcome of my medical application and share the news that my third-class medical was issued this week and just arrived in the mail today. Below is a timeline of the process and what it may look like at this given moment. Though this process was long, I can't reiterate enough how helpful and polite everyone was at FAA that I talked to over the past few weeks. They are just overwhelmed / outnumbered but aren't bad people.

Timeline...
  • 6/6/21: Take my first flight lesson with the plan to fly two days a week to breeze through my PPL. At this point, I was unaware of the implications of taking an SSRI would have on getting my third-class medical certificate.
  • 6/16/21: With eight flying hours under my belt, I went to go apply through MedXpress and soon learned before applying that the SSRI would require either a special issuance or discontinuation of the SSRI. I choose to discontinue usage and worked with the treating physician on how to safely ween off.
  • 7/6/21: I fully discontinued my SSRI on record (Keyword ON RECORD) with my treating physician.
  • 9/17/21: After 73 days of being off the medication, my treating physician did a full evaluation which was favorable and issued a report detailing, date started on medication, date stopped, medication, what it was used to treat, single episode (IMPORTANT), favorable prognosis (free of symptoms and stable), etc.
  • 9/28/21: Medical exam with senior HIMS AME. He was very friendly and supportive of my aviation journey. He submitted application with the favorable report from my treating physician and a report about 1x asymptomatic kidney stone (certifiable via CACI worksheet).
  • 11/26/21: Initial letter is sent to me requesting a copy of an imaging report for a past kidney stone.
  • 11/29/21: I submitted the requested documentation of the report via email
  • 12/1/21: My third-class medical showed up within the Airmen Registry.
  • 12/2/21: My third-class medical arrived via mail at my residence.
What I've learned through this process, have patience and make sure you have your ducks in a row BEFORE you fill out MedXpress and see an AME. Have all supporting paperwork ready and this will make the process go by much quicker in the grand scheme of everything. Also, be persistent. I called the FAA numerous times and eventually figured out that calling at 10 random times during the day typically lead to getting through to an actual person. Each time you call your case gets flagged as an "interested airmen"

Also, listen to people like Dr. Bruce. He outlined exactly what the favorable report needed to contain which helped my certification. The process for SSRI Pathway 1 is ambiguous do research on what documentation you need prior. There are MANY disqualifying factors which make SSRI Pathway 1 not possible.
 
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