Mental Health & Class 3

Discussion in 'Medical Topics' started by JN863, Aug 8, 2021.

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Do I have a chance at getting a Class 3 Medical Certificate?

  1. Yes

    0 vote(s)
    0.0%
  2. Maybe, with strong documentation

    55.6%
  3. Not a snowball's chance in hell

    44.4%
  1. JN863

    JN863 Guest

    Hi there!

    Like a dummy I started flying lessons and got hooked on it, but now I have some concerns when it comes to seeking a Class 3 medical. I have a concern and I would like an opinion to decide if it is worth chasing a 3rd class medical at all. I have a few medical issues that I feel okay with as they are being managed with my primary doctor, but the item that sticks out as a major concern is depression and the use of SSRI. I was diagnosed with PTSD and depression in 2017 while in the military. For clarity, I HAVE NOT submitted anything on MedXpress yet, so LSA is always an option but I really do have my heart set on becoming a private pilot and working towards and instrument rating.

    For context, I was outed during the "Don't ask don't tell" era and was nearly kicked out of the Army during a deployment to Iraq, lived with the regret of someone getting hurt because they took my place because of the whole snafu, and upon my return from Iraq, I was sexually assaulted in the barracks. I ended up not getting kicked out of the military, and I have borne the weight of that trauma for about a decade before finally getting the treatment I needed well after "Don't ask don't tell" was repealed.

    So that leaves me to the present day... am I screwed? After reviewing the initial SSRI certification/clearance, I see that I would need my psychiatrist to produce a report that specifically addresses "rule-outs". How strict are the rule-outs?

    When I first started seeing a psychiatrist in 2017, there was the initial phase where we were finding out what medication would work best. We tried hydroxyzine, sertraline, and eventually gave Wellbutrin a try. At one time hydroxyzine and sertraline were used at the same time. Ultimately, we settled on sertraline, and I have been on a steady dose for quite some time. Does this qualify as having a "history of treatment with multiple antidepressants concurrently"? I'm wondering if the rule-out is intended to be black and white in regards to exclusionary criteria or if the FAA just wants to know if there is a history, and if so, explain that history.

    I have a similar concern with a "history of suicidal ideation or attempts". In 2018 I started Cognitive Processing Therapy (CPT) to address my PTSD, and we were revisiting a lot of subjects that unfortunately put me back in a dark place. While there is no direct observation or notation of suicidal ideation, during the CPT program, there are several remarks in my chart along the lines of:

    "No HI [homicidal ideation] was reported or observed. The Veteran acknowledged some passive, transient SI [suicidal ideation] in the form of thoughts that he would be better off dead, but he denied any plans/intent to commit suicide & was future-focused."

    "He expressed that he feels "depressed" most of the time and that this has contributed to some transitory, passive suicidal ideation (e.g., thinking about what his funeral would be like.) However, he denies any current plans or intent to commit suicide. No HI was reported or observed."

    Will the FAA even consider my application with these kinds of remarks on my record with the understanding that this was years ago and I have gotten therapy for, or is it a hard no at this point? I'm hoping it's something they just want clarification on and not the latter where it's an automatic denial.

    I actually have an appointment with my psychiatrist next month, and we will start the conversation about tapering off and eventually weaning of the sertraline. I know there is an observation period that must follow before I could even consider attempting SSRI Path I, but with the history I have, is Path I even an option if my doc thinks I'm ready to work the SSRI out of my care plan? I am seriously hoping that the rule-outs are not black and white and that the folks that review my packet understand that I have been working hard on tackling these issues since 2017.

    I appreciate any insight you can provide me.
     
  2. idahoflier

    idahoflier Cleared for Takeoff

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    Sure, there's a chance. As you noted Light Sport is an option, but once you start the medical process if it doesn't work out then there are no options other than gliders or ultralights. I don't have any experience with the process you're considering, but based on numerous posts on boards like this I do know it's time consuming, frustrating and expensive. As an instrument rated commercial pilot I can say that probably 90% of my flying would be covered by Sport Pilot. I really wouldn't miss the other 10% and if I was in your position I would go Sport Pilot and not look back. What ever you decide, good luck and Blue Skies!

    Edit: Whatever you do, consult a qualified AME that has successfully seen someone in your position to medical certification to discuss your situation!
     
  3. Albany Tom

    Albany Tom Line Up and Wait PoA Supporter

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    I can't speak to the medical part at all, except to say that in my opinion the FAA likes to live in the dark ages. But I did get my sport pilot before a private. The training hours may or may not transfer, depending on how you do it, so you may want to watch that if you take that route. But even if the training doesn't count directly, the experience and skill you'll learn for light sport directly translates to private pilot. It's all daytime, and all VFR, so you should learn to get your head out of the plane and fly by sight and feel...and that's a valuable skill. I don't regret doing my sport first at all.
     
  4. AggieMike88

    AggieMike88 Touchdown! Greaser!

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  5. bflynn

    bflynn Final Approach

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    My take is that it’s possible, but will be very expensive ($$$$) and it will take time.

    work with a senior AME in a consult before you submit a medical. They can help you with the testing needed and can help with the evaluation of your chances much better than we can.
     
  6. lbfjrmd

    lbfjrmd Line Up and Wait

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    The only thing I would add - find a HIMS-AME to sponsor your case.
     
  7. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    And possibly see my FAA medical page for some further discussion about this. http://faamed.info .

    As noted, you will need to work with a senior HIMS AME on this case. If possible, figure 6-12 months of work and $5-10k in fees.

    You can start flying in a number of other ways in the meantime.
     
  8. JN0

    JN0 Guest

    Thank you so much for sending this link. I read it a little while ago, that's why I wanted to reach out and hopefully get a rough opinion on whether or not this is achievable. I was already expecting this journey to take around a year at least and set me back a little bit.

    For now, I'll still fly and probably track the LSA route when it is time to solo, or I can just ride shotgun with a friend and take controls for a little to keep my skills sharp and just not log the hours unless with a CFI.

    It sounds like with adequate preparation this is attainable. I was just fearful that the FAA would take the rule-out criteria at face value and just give me a straight no.

    JN

     
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  9. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    Multiple diagnoses and multiple drugs at the same time (not to mention the suicidal aspects) is going to be a tough certification, I think. Heed Dr. LBF carefully
     
  10. JN0

    JN0 Guest

    People always say there's strength in admitting that you need help, and now it's like I gotta jump through more hoops and prove myself. "There's no stigma in seeking help." I found that out to be a lie both in the military and in the civilian world. There are these "penalties" in the name of safety. I know why they are there, it just sucks for people like me.

    I wouldn't wish rape on anybody, but at the same time I just kind of wish people could experience the night and day difference before and after that weight was lifted off my shoulders. Maybe that would offer a little more perspective than just how I look in a paper packet. I get it... what I described doesn't paint a very good picture of my history.

    I know LSA will always be an option up until that point, but I also realize that the places I want to go and the people I want to take with me make that impractical. So, I do have to keep my expectations real, however, if there is even a glimmer of a chance, I'll do whatever it takes to get that class 3.

    I appreciate everyone's input. It sounds like it will be a bit of a gamble, but if the odds are 51% or more in favor of getting special issuance, then it's still "at least as likely than not" attainable. (Anyone who has ever dealt with the VA for claims will get that reference. LOL)
     
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  11. Albany Tom

    Albany Tom Line Up and Wait PoA Supporter

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    You know how miserable bureaucracies are, more than I do. To me, you sound like you have your head on right, and were dealt a couple of bad hands. I mean that. But that logic may not have any weight at all with the FAA right now. So stating outright that all the people posting here have more experience and knowledge in this area than me, here's what I would recommend you try, as just a random person on the Internet. Get with your doc, and see if it's reasonable to get off the SSRI's. Then, if that works, stay off them for a while. Then follow whatever the procedures are, as recommended by the smart docs here. Then you've got the best shot, and you can explain that the PTSD, depression and treatment, caused your service in the military during wartime, is behind you. Memories that do not affect your judgement, your outlook on life, or your ability to fly an aircraft safely. In the meantime, if you and your doc are good with it, fly light sport. Flying, in and of itself, is an amazing thing to do.

    Or in short version, yeah, the system sucks. But focus on what's best for you.
     
  12. bbchien

    bbchien Touchdown! Greaser!

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    The five exclusions for “on SSRI” conditions are pretty hard baked.
    The fifth year, 2022 is coming soon. Cases more than five years’ duration are generally regarded as chronic and likelihood of relapse are high..so you would then likely need the on ssri program, but it would not be available for ten yrs after suicidality.
     
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  13. JN0

    JN0 Guest

    @bbchien thank you for your reply. Just so I understand correctly, I have to put at least 10 years of distance between those notes and when I go for a medical? I am not likely to be considered for special issuance until at least 2027? If so, I guess I'll just stop where I'm at and just build hours as an LSA pilot for a few years.
     
  14. bbchien

    bbchien Touchdown! Greaser!

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    Yes, and yes.....
     
  15. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    @bbchien Doesn’t the OP just have passive SI here? Is that still a complete block?
     
  16. bbchien

    bbchien Touchdown! Greaser!

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    Only the HIMS psychiatrist can determine what is “passive”.....
     
  17. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    So the OP might be able to get issued depending on the outcome of the exam by the forensic psychiatrist?
     
  18. JN0

    JN0 Guest

    That doesn't sound very promising. I'd rather settle for being a halfway-pilot for a few years and giving myself the best chance possible. Since there's no telling who will be the one to review my case, I don't want to risk a denial and closing off the LSA route until 2027. Unless there is a way to build up a solid case. I understand that every case is unique but why the FAA wants a blanket policy that applies.

    So if there's a black and white waiting time of 10 years that's hanging on an subjective interpretation of whether or not "I just want to go to sleep and not wake up" constitutes suicidal ideation, then I will just have to assume it carries equal weight as having a gun in my hand while actively deciding if I should pull the trigger. I'll need more favorable odds if I am going to consider going in for a class 3.

    J


     
  19. bbchien

    bbchien Touchdown! Greaser!

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    He'd have to front the HIMS AME to do the spade work (and get the referral) and then the HIMS psychiatrist referral and it may be all for naught. That's beyond the time/energy budget for most folks....and his paragraph #7 tells us he's not recovered fully.

    He's near out to 5 years.....I'm not saying impossible but per the poll, it's pretty hot for a snowball.
     
  20. GaryM

    GaryM Cleared for Takeoff

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    Nothing halfway about it. If you earn your ticket to fly light sport, you're a pilot!
     
  21. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    Amen. After I allowed my medical to expire in 2015, I took plenty of trips while exercising sport-pilot privileges for two years, including one from the San Francisco area to near the Canadian border. One just has to stick to day VFR, etc., and learn to pack light!
     
  22. JN0

    JN0 Guest

    Sorry, not to knock the light sport route, but I say half-way pilot from my perspective that I can still fly, but not where I really want to go or with the people I want to carry.

    I thought about purchasing a light sport aircraft, but after looking at some of the POH's I wouldn't be able to take off from some of the airports I want to go to with the load I plan on taking.

    I truly appreciate everyone's input, I guess I'll revisit the issue in a few years. In the meantime I'll find an LSA to continue my training in.
     
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  23. PeterNSteinmetz

    PeterNSteinmetz En-Route PoA Supporter

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    Also don't forget to consider gliders and soaring. There is nothing halfway about being a good soaring pilot!

    There really is an elegance to the sport and it teaches people how wings and controls act in the air very well.

    https://www.ssa.org/where-to-fly-map/
     
    Last edited: Aug 13, 2021
  24. Dana

    Dana Pattern Altitude

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    Flying a LSA will make you a better pilot than learning in a C-172 or PA-28 that's so solid and stable that it hides your mistakes.

    And by 2027, the definition of LSA may well have expanded to include the kinds of aircraft you want to fly.
     
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  25. kell490

    kell490 Pre-Flight

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  26. Half Fast

    Half Fast Final Approach

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    Maybe. But don’t bet on it. LSA manufacturers don’t really want SPs to be able to fly 172s, Cherokees, etc.
     
  27. JN0

    JN0 Guest

    Okay, last question for @bbchien and all:

    In a few weeks I will have another appointment with my psychiatrist, and she will start the discussion of possibly weaning off the sertraline. I know it was mentioned that since I'm coming up on the 5 year mark since starting sertraline it is "generally regarded as chronic and likelihood of relapse are high", would that be a good thing or a bad thing come 2027 if I decided to still pursue a Class 3 then? Assuming that I stick with the psychiatrist and have continuous documentation for the next few years, would that be a better indicator? Even if I couldn't pursue pathway 1, 6 years is a considerable amount of observation time as opposed to 60 days.

    If I'm not doing myself any favors by removing the sertraline now, I could ask to stay on sertraline indefinitely. I have at least 6 years before I go for a Class 3. My weight is coming down, my blood pressure is back in the normal range for about a year now, my A1c has come back down to the pre-diabetic range, my cholesterol levels are back in normal range... I'm making all these changes to live healthier and increase the quality of life that I have, and I want to make this time count to give me the best odds possible.

    Thanks all!
    JN
     
  28. Rushie

    Rushie En-Route

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    Just if it were me:

    I would wean off the antidepressant beginning right now, carefully, but be sure to be completely off well before the 5 year mark. Then see how I do. If I’m doing well, wean off the psychiatrist, IF paragraph #7 referenced by Bruce refers to 2018, not today.

    If today you are feeling fine and you think it might have something to do with better overall health, the only way to tell whether it’s the better physical health or the drug is to remove one of them. And I don’t recommend getting fat and getting your BP back up or you a1c, wait… you said it has come down TO the pre-diabetic range? Was it higher, in the diabetic range? If so that’s a whole other FAA thing.

    Losing weight, lowering blood pressure, better overall quality of life (getting exercise and sun) and you’re probably improving your diet, this all helps enormously. Also make sure your hormones are all within normal range.

    Plus you are now many years removed from the traumatizing events. You might be healthier than you think you are. Assuming you had no indications of depression prior to the outing in the military and all the subsequent consequences.

    If it were me I’d do all that and see how it goes. If off the drug you go downhill then you might be truly a case of depression and need the SI pathway, but if it were me I would not assume that yet. Beware getting off an antidepressant can have withdrawal affects, so do it slowly and give yourself time to settle out before coming to any conclusion. But depending on what month in 2017 you started you’re running out of time, because you might need several months to taper off, that’s why I said I would start now.

    If you want to strategize this, must get off the drug before 5 years however be honest with yourself. If you honestly in your soul think you’re prone to depression don’t risk it. I’m just saying what I’d do if I were in your boat. The primary goal should be your happiness and health though, not becoming a pilot.
     
  29. JN0

    JN0 Guest

    I was diagnosed with pre-diabetes, and had one A1c result that jumped up into the diabetic range, but I think diet and exercise was started early enough. My doctor said they usually make the diagnosis with two consecutive elevated levels of A1c, but since it was only 1 of 5 labs he wasn't going to switch the diagnosis from pre-diabetes to diabetes until the levels were high again. He said there are many implications to upgrading the diagnosis, (foot exams, etc.) and they often aren't reversible, so that really has me motivated to do all the right things to keep that in check. We're keeping an eye on it and the current plan is to manage it with diet, exercise, and metformin.

     
  30. Rushie

    Rushie En-Route

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    GOOD, that’s excellent and good for your doctor. Don’t get me started on getting “diabetes” into your medical record when you don’t have it. I won’t repeat my story again, but I never even had a single A1c in the diabetic range and now I think it would be easier to bring someone back from the dead than get diabetes removed from my record.

    And good for you for managing it early although I don’t know how being on metformin will affect your medical. I’m sure it doesn’t disqualify you but of course needs to be reported and they’ll want documentation. Others here will know more.