Medical Class I confusion (ssri)

[Clay Weinand]

Hey everyone,

New member here. While I have been doing my in-depth research about the medical class 3/1, I have stumbled across some good information here. However, i have tried to use the search bar to find some more in depth questions and can’t find any. They are all ‘kind of’ but not really the same situation. I’ll list out what I already know, but if I could have help filling in the blanks I would greatly appreciate it.

a little over two years ago I was diagnosed with general anxiety. Nothing overwhelming or Wild, just life worries (oh no, I’m 32…how much money will I need at 65 to retire?!). The doctor put me on sertraline and it’s helped me not create my own worries when there’s nothing to be worries about.

anyway, I have decided to make a career jump and go from auto sales to airlines. I have some awesome clients who are regional and they’ve really helped me create a plan and give me insight. However, before I start my private training, I want to get my medicals out of the way. So here are some questions:

- I have found that due to the medicine, I will be have to go through HIMS for an SI as sertraline is one of the 4 accepted on case basis. Do I have to first go to a physician to be told to go to an HIMS AME, or can I just directly go to an AME. Should I go to a physician first to ensure nothing else may hold me back? I thought I read about some time frame issues.

- I have the choice to chose my AME correct?

- due to the reason I’m on sertraline, what is require of me by HIMS test wise? While I was searching, a lot of the info I found was drug or alcohol related.

- if I get the ok, am I able to get the class 1 right off the bat, or do I have to get a 3 and a 1 at commercial?

I know this will be a long and expensive road. I don’t expect to snap my figures and breeze through it. Any clarification would be greatly appreciated!

clay

 

[rhkennerly]

Yes, you can choose your own AME.
Never, fill out the online form listing meds, etc. until…

you have completed an “advisory” physical with an AME. (Think of it as a practice test).

if there are questions, try to resolve them with regional first. At all cost, avoid sending anything to OKC for approval (other than a completed “pass” from your AME.)

shoot for a 1st class right out of the box, if you have your eye on the airlines. Never be lulled into starting with a 3rd class with thoughts that you can get all the ratings & wait until you start your ATP to get a 1st class medical.

 

[Clay Weinand]

Yes, you can choose your own AME.
Never, fill out the online form listing meds, etc. until…

you have completed an “advisory” physical with an AME. (Think of it as a practice test).

if there are questions, try to resolve them with regional first. At all cost, avoid sending anything to OKC for approval (other than a completed “pass” from your AME.)

shoot for a 1st class right out of the box, if you have your eye on the airlines. Never be lulled into starting with a 3rd class with thoughts that you can get all the ratings & wait until you start your ATP to get a 1st class medical.

thanks for the fast reply! So this is where some confusion comes in. Is there a difference between an AME and a HIMS AME? Or does an AME just put people through the HIMS process if need be?

Sounds good, I’m in Michigan and have a list of some in my area. I’ll try to look up some reviews.

Clay

 

[rhkennerly]

thanks for the fast reply! So this is where some confusion comes in. Is there a difference between an AME and a HIMS AME? Or does an AME just put people through the HIMS process if need be?

Sounds good, I’m in Michigan and have a list of some in my area. I’ll try to look up some reviews.

Clay

I’m not super familiar with the HIMS AME program, but I understand it’s more drug & alcohol related with a little SSRIs monitoring added on. I think it is mostly referral only through the FAA OKC. More AA/NA to save pilots medical than a process to GET an SI. A lot of HIMS program pilots turn themselves in after a DUI in a bid to keep flying, but under HIMS supervision. Most often HIMS is run by the pilot’s company (airline). So a lot of HIMS AMEs are in-house, not publicly accessible.

https://centerforfamilymed.org/wp-content/uploads/hims.pdf

your goal is to avoid red flags in OKC. Contact with HIMS is probably more of a red flag.

Find out who the regional AME is & have your AME contact region rather than going directly to OKC.

One reason you don’t fill out the online medical form until you are ready to undergo the actual medial exam (vs the advisory exam) is to ensure you do not have an FAA medical case number assigned to your name in the system. That way an uncooperative or under informed AME can’t dick you behind your back. [do, however, print off the form and take it with you to the advisory medical]

Not every medical condition is open to negotiation, but wording usually is. Often regional AMEs, with more experience, have a better understanding of what works with OKC.

Remember that an AME Is frequently not a pilot (doing flight physical, employment physicals, pre-hire drug testing, & worker’s comp Is just part of their revenue stream). So, not being pilots, every call they have to make during a physical carries equal weight because they don’t know what is important and what is not.

I remember a story about a pilot stampeded into the FAA paper mill because the AME wrote: amputated digits, left hand. OKC flagged it. Which digit? thumb or finger? How much? How recent? Cause? (The guy had lost two fingers above the middle knuckle in a table saw accident—as we all do, decades ago. It took months to sort out).

 

[Clay Weinand]

That makes so much more sense. Every time I would look up ssri it would go to suicide/depression or refer to HIMS drug and alcohol. Nothing for mild generic anxiety.

I’ll get set up with my normal AME physical and keep everyone update. Maybe it will help someone else out.
If anyone else has any info or insight, any and all would be appreciated!

Clay

 

[flyingron]

You can go to an HIMS AME out of the box. They generally have a bit more knolwedge on such issues because they are the ones who deal with it. What you need a referral for (and it comes from the HIMS AME not Joklahoma City) is the HIMS Neuropsych evaluation if it comes to that. The list of those physicians is a guarded secret for some reason.

Nothing "red flagging" about going to a HIMS AME. HIMS AMEs are AMEs and do uncomplicated medicals as well.

The red flag is that he has a condition that required and has had prescribed psychoactive drugs.

 

[Clay Weinand]

You can go to an HIMS AME out of the box. They generally have a bit more knolwedge on such issues because they are the ones who deal with it. What you need a referral for (and it comes from the HIMS AME not Joklahoma City) is the HIMS Neuropsych evaluation if it comes to that. The list of those physicians is a guarded secret for some reason.

Nothing "red flagging" about going to a HIMS AME. HIMS AMEs are AMEs and do uncomplicated medicals as well.

The red flag is that he has a condition that required and has had prescribed psychoactive drugs.

Ok, so it would make sense to just start with a HIMS AME vs a normal AME? My assumption is since I am on the ssri, it would end up there anyway.
My take away is that I would do an exam with them, and they would make the call to have me see a neurologist or not, correct?

Also, I have come across a lot of comments mentioning poor AME as well as great ones. However, once you choose one you cannot switch. Are there any good processes to choosing a ‘good’ one or is it a shot in the dark? I’ve read a lot about a few we’ll informed ones on here.

-Clay

 

[flyingron]

Yes, and it likely will save you some time. There are two good AMEs in this forum. Where are you located?

 

[flyingron]

Yes, and it likely will save you some time. There are two good AMEs in this forum. Where are you located?

 

[Clay Weinand]

Yes, and it likely will save you some time. There are two good AMEs in this forum. Where are you located?

I’m in metro Detroit michigan, but I’m willing to drive to meet with someone competent vs grabbing someone close and running into issues

 

[JoeSelch]

I’m in metro Detroit michigan, but I’m willing to drive to meet with someone competent vs grabbing someone close and running into issues

Not too far to drive to Dr Chien in Chicago, if need be.

Might start with a consult with Dr Gordon in Plymouth.

 

[Clay Weinand]

Not too far to drive to Dr Chien in Chicago, if need be.

Might start with a consult with Dr Gordon in Plymouth.

I’ve seen se Chien get mentioned a few times on here. Seems to be the most reputable name I’ve come across. Is dr Gordon here as well? I’ll have to look into them both.

- Clay

 

[JoeSelch]

I’ve seen se Chien get mentioned a few times on here. Seems to be the most reputable name I’ve come across. Is dr Gordon here as well? I’ll have to look into them both.

- Clay

I do not *think* Dr Gordon participate on PoA. You can google him as an AME.

 

[Clay Weinand]

Hey everyone,

I was told not to complete my 8500 online, but to print it out and bring it to my exam. However, Dr. Gordon’s office in Plymouth mi is requiring me to complete it online first.

Any insight?

- Clay

 

[TCABM]

Hey everyone,

I was told not to complete my 8500 online, but to print it out and bring it to my exam. However, Dr. Gordon’s office in Plymouth mi is requiring me to complete it online first.

Any insight?

- Clay

Stop. You should be engaging your preferred AME for a consult, not an exam at this point. Make that crystal clear to the AME’s office staff. Tell them “I have a complex case and need a consult to understand what I will need to do before I come in for the exam.”

If they continue to insist your appointment will be for an exam, you need to find an AME that will provide you with a consult.

You can fill out the MedExpress and even take the confirmation # to the consult. But under no circumstances do you give that number/piece of paper to the office staff or doctor until you are 100% certain you will be issued in the office, that day.

 

[Clay Weinand]

All of you are awesome. Quick responses with clear info. I really appreciate it everyone.

Sounds good, I registered on Medexpress but haven’t submitted any info other than an email and password. I’ll reach out to them again. Maybe they mid understood and thought o was coming in for the exam Vs consultation.

I’ll keep everyone posted.

- Clay

 

[Clay Weinand]

We’re good, consultation on Tuesday. Fingers crossed.

- Clay

 

[Lindberg]

You can complete and submit your medxpress application online and it doesn't become "live" until the AME enters the confirmation number in his computer. If that doesn't happen, it will be deleted after the requisite period of time.

 

[Joe LoRusso]

Hey everyone,

New member here. While I have been doing my in-depth research about the medical class 3/1, I have stumbled across some good information here. However, i have tried to use the search bar to find some more in depth questions and can’t find any. They are all ‘kind of’ but not really the same situation. I’ll list out what I already know, but if I could have help filling in the blanks I would greatly appreciate it.

a little over two years ago I was diagnosed with general anxiety. Nothing overwhelming or Wild, just life worries (oh no, I’m 32…how much money will I need at 65 to retire?!). The doctor put me on sertraline and it’s helped me not create my own worries when there’s nothing to be worries about.

anyway, I have decided to make a career jump and go from auto sales to airlines. I have some awesome clients who are regional and they’ve really helped me create a plan and give me insight. However, before I start my private training, I want to get my medicals out of the way. So here are some questions:

- I have found that due to the medicine, I will be have to go through HIMS for an SI as sertraline is one of the 4 accepted on case basis. Do I have to first go to a physician to be told to go to an HIMS AME, or can I just directly go to an AME. Should I go to a physician first to ensure nothing else may hold me back? I thought I read about some time frame issues.

- I have the choice to chose my AME correct?

- due to the reason I’m on sertraline, what is require of me by HIMS test wise? While I was searching, a lot of the info I found was drug or alcohol related.

- if I get the ok, am I able to get the class 1 right off the bat, or do I have to get a 3 and a 1 at commercial?

I know this will be a long and expensive road. I don’t expect to snap my figures and breeze through it. Any clarification would be greatly appreciated!

clay

1) you can go right to a HIMS AME - no referral necessary; HOWEVER, you should talk to an aviation attorney first. Not all HIMS AME are cut from the same cloth, sorry but true. Most aviation attorneys will have a good view of the landscape - for example, I have different HIMS AMEs that I recommend for different underlying conditions.

2) yes. See above on the Aviation Attorney part.

3) That is a subjective question, with an answer that finds roots is § 67.401. The scope of the testing is based off your psychiatrics history and current symptomology. At most, you will have to complete a psychiatric exam performed by a HIMS psychiatrist and a neurocognitive exam performed by a HIMS psychologist. See FAA SSRI Decision Path II

4) Yes you can get a First-Class immediately, but it is easier to progress from a third class. See 14 CFR §67.401(e).

Moral of the story, it is doable. I can't stress this enough, talk to an aviation attorney - get an advocate. By definition, a HIMS AME cannot be an advocate.

 

[Clay Weinand]

Hey everyone,

so i just finished my consultation with Dr. Gordon. Needless to say, it brought me much relief. It’s going to be a long road, that’s for sure. But we have laid out a very clear and concise plan. Based off of everything I told Dr. Gordon, he believes it should be a fairly straightforward issuance.

For anyone looking for information on the steps that will be taken:
- I must write a statement acknowledging the medication I am on, the reasons I am on them, and any start and stop dates. Also, any side effects or symptoms.
- I didn’t get with my physician and have them create a statement with their credentials, my medications, and etc.
- The third step will be to schedule an appointment with a psychiatrist. It can be any licensed psychiatrist. During our meeting, they will essentially evaluate me and go through a checklist to see if I have any underlying conditions.
- Once all that information is collected, I will meet with Dr. Gordon again to make sure all the information is listed correctly and favorably for the FAA.
- Here comes the fun. And then have to complete the dreaded cognitive bettery. He gave me some ideas of what the test were and things I should do to prepare.
- once I get the thumbs up and pass the test, I will have my official medical exam and everything will be sent to the FAA. At that point, he has given me a timeline of 6 to 12 months. He said it could be sooner, but better safe than sorry.

As I go through each step, I’ll keep everyone updated just in case we have people looking through the process for their own hiccups.

Clay

 

[Clay Weinand]

Hey everyone,

I just wanted to give a quick update. As I work on gathering my info, I reached out to the suggested dr for my cog exam. I was told for my situation it should only take about 2 1/2 hours and cost about $1500. This is less than half for both time and payment that I was expecting, so big win! I should be scheduling it within a week and they are booked about a month out.
See you all soon,

clay

 

[Clay Weinand]

Hey everyone,

Just wanted to update the status of the process.

About a week ago I went and saw my PPC and received my statement stating reasons for the medication, stability, and etc.

The next step was to find a psychiatrist, which wasn’t as easy as I thought. Everyone I spoke with asked for a reason for the visit, and refused to schedule a one off appointment. They would only see me if I was in need of help for continual treatment. However, I finally came across a psychiatrist that would meet with me for a reason STEPHEN. We set up an appointment for June 7, and that will be my Second of the three steps.

After that, I will schedule by cog exam. Even though I have no worries on my cognitive ability, it still makes me nervous as I don’t want to pay 3000 or $4500 for a $1500 exam due to multiple tries. I have been doing Lumosity To help prep myself. I don’t think that it will boost any cognitive ability, but hopefully just keep my mind used to seeing and reacting to those types of problems.

After those two are done, I take everything back to Dr. Gordon and he will submit to the FAA. Then it’s just a waiting game!

Finally, I have enrolled back in school to receive my bachelors degree. I have decided to get my BS an aeronautical’s. I have previous school experience, so a lot of my pre-rex transferred over. Also, I am strictly taking prerequisites right now in case the medical doesn’t come through. That way, I could switch majors without wasting any time or money. I do know a lot of people say not to get a degree in aviation due to the ability of being grounded down the road, But this allow me to get my RATP and start everything sooner. Also, I’m sure there will be job possibilities in someway shape or form even if I’m grounded and I’m not the pilot.

I’ll give an update after my appointment on the seventh it’ll keep chugging along.

- Clay