Medical Deferred for past use of SSRI

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I used an SSRI for about two years for a temporary adjustment disorder. I stopped in July, and got a letter from my family (prescribing) doctor stating stable for 90 days.

I also hired a psychiatrist to look at me and she wrote a letter stating I have no conditions (other than a resolved case of adjustment disorder with depressed mood). All stable.

Showed up to an AME this morning with my letters to submit for my third class medical, and he deferred it (and my paperwork) to OKC.

Everything else seemed fine, but he said all psych issues, no matter how minor, are deferred.

Any idea what's next?
 
I hope your AME is willing to pursue this certification. Othewise, make SURE the FAA has the psychiatrist letter by calling into 405-954-4821. After you have confirmed they DO have it (I'd just fax a copy with a cover letter to 405-954-4300), call about a week later, on three nonconsequitive days.

They are taking a long time to get to cases in which there is no "pinging" going on. Be courteous, nonabusive, they can't tell you much, but each call registers.

The AME COULD short circuit all this by calling himself, but as he didn't call today, I don't think he's going to call next week....sigh.
 
My CFI recommended this guy, but it was clear to me the AME was just punting and wanted to be done with it.

He said my supporting letters looked good, and gave me the # to call starting in about a week. I'm suspecting this will take 3-4 months.
 
My CFI recommended this guy, but it was clear to me the AME was just punting and wanted to be done with it.

Not that (s)he probably cares, but you must fire this AME and find another AME for the next go-around, if this is his/her attitude.
 
I very much agree, DenverPilot. Once this ordeal is over, despite the outcome, I'm moving on.
 
Stories like this make me appreciat Dr. Bruce and what he does for me and others more and more.
 
Sigh. I should read more carefully. If, 90 days after no meds, you have a board certified psychiatrist saying Axis 1 is negative, and the AME can get one particular examiner (the psych HIMS guy) on the phone, you could have had a cert. (3rd class only) that day. Sigh again.
 
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Dr - slightly off topic, but might be useful: You keep up with what's going on at FAA. How often does the average AME really get updated on the inner workings? Is there some kind of recurrent training? Or is it really up to the AME to take the initiative?
 
To clarify - the letter from the psych was written a week or so before I discontinued. I saw her to make sure I wasn't bananas and that it was ok to quite.

She wrote a letter saying I had a resolved case of adjustment disorder.

Then I stopped the meds.

Then, 90 days later, my prescribing doc wrote a letter saying I was stable and without symptoms, and without history of drug or alcohol abuse. I didn't see a shrink after I quit the meds.

Then, I saw my AME. He said all psych cases are automatically deferred to OKC, no matter how minor or resolved.
 
You need the psych eval to occur when off the meds. If you were within 90 days or still on the meds, you may well be denied.

The examiner in OKC MIGHT approve you, but it is not a slam dunk.

The only way to know it would be a slam dunk is if the psychiatrist's eval reflected that you had been off 90 days at time of psychiatric evaluation. The meds can hide a lot of things......which it doesn't sound like are there to begin with. Sigh.

Here's how the conversation goes:

FAS: Dr. Eaminer, I understand you certified an airman who had been on an SSRI for two years, and didn't have a PSYCHIATRIST evaluation at >90 days off the meds, is that right?
DR. Examiner: Yes. But he had credible testimony that the underlying diagnosis was an adjustment disorder.....
FAS: AND you did NOT use the federal consultant psychiatrist?
Dr. Examiner: But the diagnosis.....
FAS: Nor the federal psychiatrist himself?

...do you see where this is going? The eval at 90 days off (by someone with psychiatric BOARDS, not the family doc) is a REQUIREMENT.

...I wish you the best of luck. But if you really wanted this to get through, I'd get the psych to see you again and to write again, and fax that into the agency at 405-954-4300.

********
Matthew said:
Dr - slightly off topic, but might be useful: You keep up with what's going on at FAA. How often does the average AME really get updated on the inner workings? Is there some kind of recurrent training? Or is it really up to the AME to take the initiative?
Matt: it's the paradox of "you have to be busy to keep up". Every time you do something complex, you get the opportunity to interact with the examiners. That's how you learn.

I did get invited to do (and did) "Advanced AME" which is a course for 4 guys, (you have to get invited) in which you essentially become an examiner and they grade you. This is the remains of the old "super AME" course which by reg couldn't create a field examiner empowered to issue SIs on their own (which was the original intent).

So then you have to learn and pump every bit of information from the full time examiners who each have a niche. But the guys who get invited to this- are the already busy guys.

It is really quite sweet to know the examiners personally and it goes two ways. When one of us is authorized to give an initial SI in the office, both the Federal guy and the AME are walking out on the same plank- there is a link of trust that neither will betray. It allows the agency to get stuff done. Amazingly, there are some cases in which the Federal guy says, "are you willing to fly with this guy?" and he is asking for an assessment of intangibles. If you can say, "YES", or better, "I just did his Flight Review and he was good", it can make a difference. The examiners, after all, ARE PILOTS.

I will name one guy by name: Arnold Angelisi, who is now the deputy RFS in Atlanta (went to be nearer his spouse). OKC lost a good one, Atlanta got a good one. We miss you, Arnie.
 
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Matt: it's the paradox of "you have to be busy to keep up". Every time you do something complex, you get the opportunity to interact with the examiners. That's how you learn.

I did get invited to do (and did) "Advanced AME" which is a course for 4 guys, (you have to get invited) in which you essentially become an examiner and they grade you. This is the remains of the old "super AME" course which by reg couldn't create a field examiner empowered to issue SIs on their own (which was the original intent).

So then you have to learn and pump every bit of information from the full time examiners who each have a niche. But the guys who get invited to this- are the already busy guys.

This makes it sound a lot like there's a culture of not placing any value on slowing down enough to document.

(A common problem in computer systems engineering also.)

Then someone gets run over by the proverbial bus and all their knowledge is lost.

(Or they move to Atlanta. ;) )

Docs aren't exactly the personality types usually to say "my job is to document this so well I work myself out of this job", I suppose.

Engineers rarely want to do it either.

Each time one of these "complex" cases comes up, is it put in a system somewhere where a non-busy AME can find it and reference it? What's the value in keeping it secret?

I ask that question, but I already know that "knowledge bases" don't work in systems engineering either.

The non-busy engineer looks up something and starts building, and becomes busy. They never read from not update the KB ever again unless threatened with job-loss because they don't write a certain number of articles.

The quality of the articles tanks, and that's the typical end of the KB experiment...

They're also expensive and require full-time staff to organize and pare down the system. KBs without that are an utter mess.

That invitation-only course smells of a good old boy's club a little bit. Not appropriate at all, from a Federal agency, but alas... I'm glad you got to go... Plenty of worse examples of that in other professional disciplines.
 
HIPAA kills both us and the agency. No free information exchange.

The agency is limited in resources for the "advanced AME" course and can only produce so many a year. So they tend to choose the onew whose names show up on a lot of charts....

Sigh. No fix for this Nate, it's fifteen pay grades above me.
 
Just a quick update for anyone following my case:

My AME sent my documents in on Nov. 1. I called the FAA yesterday, and they had no record of receiving the paperwork.

I called this afternoon, and my paperwork is "with an examiner."

This sounds ridiculously fast, not that I'm complaining.
 
HIPAA kills both us and the agency. No free information exchange.

The agency is limited in resources for the "advanced AME" course and can only produce so many a year. So they tend to choose the onew whose names show up on a lot of charts....

Sigh. No fix for this Nate, it's fifteen pay grades above me.

I hear ya... not a problem for me, just an observation.

HIPAA will probably cost us a boat-load to implement various things at our company this coming year too, and will provide little in terms of actual safety of the information...
 
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