Hello I'm about to go for my medical clearance again; I got one in 2014,first class,when I first came to the US for pilot training. I had stopped and started back up with my training due to some issues with finances and communications. Since I've been in the US I've been diagnosed with social anxiety; I'm on one of the SSRIs listed for anti-depressants. I see that I could be given an SI but that is not something I think is good for my career. I've been a lot better since receiving this diagnosis and could go off my meds with no problem. If I did that and was cleared after 60 days would I get a regular First class or would I still have the SI with it? I'm very concerned about having a special issuance attached to my medical as I've read a lot of airlines won't hire someone with it.....
Yikes. Pretty soon bbchien will be along. He is the AME who was involved in the SSRI protocol, and is maybe the best AME in the country for getting people through difficult medical certification issues. If I were in your position I would follow his advice to the letter.
After you are off the SSRI for 60 days you can be considered for issuance. Your doctor, based on just what the underlying diagnosis may still defer you and the FAA may come back and demand psychological testing before issuance. You may still end up with a special issuance for a few years until they see how things shake out. Alas, mental illness for first class medicals is a bit of a touchy subject of late.
I've done so much reading and gone through many forum posts and have found so many different answers that I thought the best way to find out was to post the question myself. I'm just very concerned about having that SI because I've read a lot of people have issues with it....
[snotty, snarky mode on] Why do you expect to find expert medical advice on the web? The best advice has been offered, to contact a knowledgeable AME on the subject, and that's Dr Bruce Chien. Anything else is about as useful as the directions for the Do It Yourself Appendix Removal! Sorry folks, I just get so tired of people believing the web is the answer to all things. [snotty mode off]
Again, the official FAA policy is that if you are off meds for 60 days and normally functioning, you can be issued. Again, the issue is what does normally functioning mean? In many cases, a letter from the doctor who, perhaps recklessly, prescribed the SSRIs initially with a lame "I see no reason that would preclude his operation of an aircraft" means absolutely SQUAT. The FAA is going to look at the words of the original diagnosis. Based on their interpretation (or misintrepretation) fo that diagnosis they may issue, they may demand further (expensive and time-consuming) tests, or they may deny you. I don't know what you expect us to tell you. A good HIMS AME can probably give you a better read in your situation, but such is not going to be done via forum posts.
Agree with Ron and Rushie. Look in this forum for Dr. Bruce Chien's other posts and make contact through the email in his signature. Be 100% honest and humble and you will get the correct answer. I been if it's a no, it will be the correct answer.
Wonder if the doc in question knew the ramifications for his "diagnosis" if he still would have made it. My rx would have been shots, couple friends and a club or two.
Yeah but he found out about Dr. Bruce Chien by going to.... the web! If you're talking about general googling, nothing wrong with learning all you can about a subject in general as long as you recognize that you need a doctor to look at your individual case, which OP has already said he does. What more do you want from the guy?
I agree with Rushie on this. Also, I wonder how many of the snarky replies folks asking similar questions here get are because we all feel powerless to change anything about the FAA's rather draconian standards on mental health issues, that would disqualify 30% or more of the population from holding any class of medical. Being disqualified (or needing an SI) for a dx of social anxiety is so over the top by any reasonable standards of safety that it's understandable that physicians are generally unaware of it. For most pilots in a similar situation who've held a medical certificate in the past 10 years, BasicMed is going to be a godsend since social anxiety isn't one of the mental health conditions requiring an SI - and the ones that do require one are fairly major issues that have devastating impacts on quality of life. If I had a dx of social anxiety I wouldn't bother with OKC, I would just go off the meds, wait 3 months and go BasicMed. But the OP can't do that because he needs a 1st class. OP, best of luck to you and I hope it works out.
What makes you think social anxiety isn't disqualifying and requiring an SI. It depends on how it manifests.
I'm sure you can think up an extreme case where social anxiety was accompanied by a personality disorder that manifested in "overt acts", or resulted in substance dependence. But it's not a psychosis, doesn't involve delusions or hallucinations, and it's not bipolar disorder. For simple social anxiety, I think it's a real stretch to read the BasicMed mental health special case as requiring an SI. (Actually, social anxiety and substance dependence probably go together fairly often so maybe that's not such a stretch. But it's the substance dependence that makes it disqualifying, not the social anxiety.)
That's what I was thinking until I looked it up. http://www.mayoclinic.org/diseases-...-disorder/basics/tests-diagnosis/con-20032524 Does this describe your problem OP? If you are uncomfortable with having your actions scrutinized you might have problems working as a pilot; or was this a bogus diagnosis? Just saying... As others have pointed out, the advice on what to do about your medical is better left to the AMEs such as bbchien.
I wasn't stretching it that far. I was stretching to the point where the FAA would believe it was sufficient on a normal medical to require the PPP test protocol and put you on a SI. Believe me, I've seen this happen. The fact he was prescribed an SSRI is already putting the FAA on alert. As I stated, it isn't necessarily the case that his prescribing doc, who probably wasn't a psychiatrist to begin with, will be able to sway them with just a "Oh, never mind, he's OK to fly." In fact, in the two cases I'm familiar with, there wasn't even any drug intervention involved.
I think we were talking about two different things entirely. You're talking about a normal medical, such as one gets from an AME. I have no doubt that in any case where a pilot was prescribed an SSRI for any kind of anxiety disorder, the FAA is going to want some testing at the very least, and may deny or require some kind of SI. I can easily believe that even without the SSRI, the dx might be enough to trigger the testing requirement. I was talking about BasicMed though - where the only mental health conditions requiring the one-time SI are (paraphrasing from memory) (1) a personality disorder severe enough to have manifested in overt acts (2) psychosis such as would manifest in hallucinations or delusions (3) bipolar disorder (4) substance abuse I don't think anxiety disorder, by itself, falls under any of those headings.
