PTSD and licensing

Discussion in 'Medical Topics' started by Unregistered, Feb 19, 2011.

  1. Unregistered

    Unregistered Guest

    Hi all!

    I have service-connected PTSD and am hoping to go school for my pilot's license. Will there ever be a time when I will need to disclose this? I was hoping that since it's my medical records that no one would ever know, but am not sure as I do receive VA disability compensation for it. I just think it would really be a shame to go through all of the education and training only to be denied because I received treatment from trauma from combat.

    Thank you so much for your help.
     
  2. poadeleted20

    poadeleted20 Deleted

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    Yes, you will have to disclose this on your aviation medical application. You'll also have to disclose that you're receiving disability benefits. Beyond that, wait until Bruce comes along to give you the full story on how to deal with the situation.
     
  3. Unregistered

    Unregistered Guest

    Thanks CapN Ron. I really appreciate your answer. My other compensation is for scarring, so at least I'm not too worried about having to disclose that :)
     
  4. AdamZ

    AdamZ Administrator Management Council Member

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    Well first off thanks for your service to our country. As for the disclosure issue if you are receiving Psych therapy or treatment you will need to disclose it. Whether PTSD is disqualifying I don't know and you should as Ron said wait for Bruce Chien to respond. The disability will probably have to be reported as well but is something like scaring isn't goinig to affect your ability then even though you have to disclose it perhaps its not disqualifying but again Bruce will know.

    Your making a wise decision getting these answers first before spending time and money on training. Here's hoping you get a good answer!
     
  5. bbchien

    bbchien Touchdown! Greaser!

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    Yes, on question #18M (EVER had any "Mental disorders, anxiety, etc") you hwill have to check yes. PTSD is a category of disorder that shows up abnormally frequently in the accident reports and you will be deferred.

    To certify you will need the full boat: A current psychological review by a state licensed Psychologist (this even if you are not medicated). If you are medicated you cannot be certified for this diagnosis.

    You will have also to check 18y "disability compensation" and state it there.

    These evalualtions are pretty pricey and the psychs only get paid by insurance if they GIVE you a diagnosis, which is NOT what you want. If they clear you fo the diangosis, there goes your compensation.

    It's a catch-22 and I think you should consider becoming a light sport pilot. If you never apply for an FAA medical and you are functional, you can use a driver's license in lieu of medical qualfication if your doctor agrees.

    But once you get denied by FAA medical, you can no longer do even that.
     
  6. Unregistered

    Unregistered Guest

    My medical certificate is currently pending for the exact same thing: PTSD rated at 30%, full recovery.

    I am recommending you wait until I can report back on what happened. They have currently asked for:

    1. Discharge/Refrad Medical
    2. Psychiatric Report from Psychiatrist

    Its been 5 months and that's it so far.

    Again, recommend you stand by until I get resolution on my case.
     
  7. Art VanDelay

    Art VanDelay Pattern Altitude

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    Thank you for your service to our country and I agree with Doc Bruce about the Sport Pilot idea. Going the LSA route may not seem that glamourous but it will get you up in the air which in my book can be the best cure for any and all kinds of stress.
     
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  8. Gary F

    Gary F Final Approach

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    I believe that anybody with a history of PTSD should get the advice of a psychiatrist before flying LSA. Just because it is legal does not mean that it is safe.
     
  9. Matthew

    Matthew Touchdown! Greaser!

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    Thanks to both unregistered posters. It's a helluva price you've had to pay.

    A bit off topic, but this got me wondering. With the number of service members we have that are in any number of combat areas now - are we creating a new generation who may not be certified because of PTSD complications?
     
  10. RJM62

    RJM62 Touchdown! Greaser!

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    First, to the OP, thank you for your service and sacrifice. I wish you all the best. You deserve it.

    I have a little story that's apropos to this thread. This is going back a few years, but I once knew a man (he was one of my clients at the time) who had been a career Air Force pilot, and who had been involved in a particularly sad mistargeting incident during Desert Storm.

    As best as I can recall from what he told me, after a few months had passed since the incident, he started having nightmares, flashbacks, etc., and sought help from his base mental health department.

    He was removed from flight duty and sent to some sort of treatment program for service members with PTSD, successfully underwent treatment, and eventually was returned to full duty. He served as an Air Force pilot for another nine years before retiring.

    After retiring, he decided to get a civilian pilot certificate. He passed some special written examination for former military pilots and was issued a CP-Airplane certificate with ME and IR -- along with a letter informing him that he had to obtain a medical before exercising the privileges of his certificate. No problem, he thought. If he could pass the Air Force's flight physical, an FAA Second Class should be no problem.

    But as you've probably guessed by now, he was wrong. The PTSD diagnosis disqualified him, even though he had continued to fly military jets for almost a decade after the Air Force pronounced him recovered. He was given a photocopied letter detailing the medical and psychological hoops he'd have to jump through if he ever hoped to fly as a civilian.

    This was back in mid-2001, and he was debating whether to go through with the evaluations FAA wanted. Then on on a particular morning, while playing golf in Port Washington, New York, he heard the familiar sound of fighter jets overhead. He also realized that he hadn't heard any civilian aircraft for a while.

    The Air Force officer in him sensed that something was wrong, and he returned to the clubhouse to learn that America was under attack. Not very long thereafter, he was back on active duty, flying for his country again. He may still be, for all I know: He sold his house shortly thereafter, and I haven't heard from him since.

    On the one hand, I can understand why the FAA would want evidence of a person's recovery from something like PTSD prior to issuing that person a medical. But there's something broken when a bureaucracy doesn't consider a clean bill of health from the Air Force and a decade of military flying after a diagnosis to be sufficient evidence of recovery.

    -Rich
     
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  11. spiderweb

    spiderweb Final Approach

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    That's an amazing story.

     
  12. airbornejohnny

    airbornejohnny Line Up and Wait

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    Hello all! I too am a combat vet, also with PTSD (service connected) disability compensation. Does anybody know what factors are considered when the ME deferrs? I have no other issues other than ptsd, and most of my symptoms arise during sleep, and even then I havent had any of those in over a year.
    To define "considerations," it is not aviation related, but I have also been a volunteer firefighter since before and after my military service (since 1996). In this capacity, the stereotypical PTSD effected person may be thought to have particular sensitivity (i.e. gruesome car accidents/deaths/fires etc) although, again, this is NOT the kind of trigger which caused episodes in the past. I realize that what I may feel is relevant (such as that the safety of others has always been my number one priorty, only reinforced by my NCO days as a team leader) may or may not be relevant to FAA, and like my brethren above, I am seeking to educate myself more before running hurdles. Any help is much appreciated!
    -John
     
  13. Unregistered

    Unregistered Guest

    Okay, I am posting the answer to all of your questions (I think).

    I have my response from the FAA:

    Authorization for Special Issuance good for 6 Months! I was certainly anxiously awaiting the answer. No other limitations noted. Obviously I have a duty to report any changes in my medical status of this condition, or if I take any medicines. I will have to provide an update from the Psychiatrist/Psychologist prior to renewal.

    So before you run off and apply for a Medical, remember these caveats to my situation:

    This is for a 3rd Class Medical Only, so if you are seeking a 1st or 2nd Class, the situation may be different.

    With that said, you have some room to stand on, since the FAA granted a 1st Class Medical to a PTSD case who actually developed Flying Phobia and had panic attacks in the air a few years ago. The FAA even wrote about it:

    www.faa.gov/library/reports/medical/fasmb/.../200901_color.pdf
    Look at Page 1 and it continues to Pages 4, 5 and 6 I think.

    The symptoms in the article are far worse than anything I experienced in my case and were for a 1st Class Medical, but he was also a pilot with 12000 hours and I am not.

    My symptoms were minor: insomnia, depression, guilt, irritability, hypervigilence. I had no panic attacks or severe anxiety symptoms, I definitely had no hallucinations, psychoses or anything where I didn't understand reality. Never woke up and thought I was deployed, etc.

    Under different circumstances my circumstances could have been considered more of a depression, rather than PTSD. I took no psychiatric medications but did occasionally take Ambien to aid in sleeping for a while. I also have had remission with no symptoms at all for well over 1 year and have no real risk of remission.

    Presumably, the FAA is not blind to the fact that the VA is now handing out PTSD ratings like its Christmas. It should also be noted, the US Military occasionally allows their pilots who have recovered from PTSD to continue flying.

    I'm not a doctor, but have researched what little I can find on the FAA's past decisions on Mental Health issues and for the most part, with the exception of mental health, they will generally work with you to overcome any issue. If you had hallucinations, psychosis, bipolar or took potent Psychiatric medications, even once, you will be permanently denied, even if it was many years in the past. Minor and resolved is okay, Severe is not.

    On a personal level:

    1.
    Don't screw everyone else over and try to game the system. If you have made a recovery, and have been symptom free for 12 months, and you get an authorization to fly, when the VA reevaluates your disability (which who knows how long that will actually take for them to do it), you better not try to say you are still having issues to keep your rating high. You need to take appropriate steps to prepare for Uncle Sam to cut off your disability payments. Fortunately for you, the VA is so backlogged on reevaluations that may be a very long time. But I'll tell you what, if you make statements to the VA AFTER you get a special issuance that you are still having mental health issues, you will probably lose both the FAA Medical / and the VA will probably start becoming more strict.

    Worse than that, you will:
    A. Screw Veterans who still do need benefits for ongoing, unresolved mental health issues from the VA who will be scrutinized more carefully.

    B. You will screw Veteran Pilots (like me and others like me) who have overcome minor post-deployment issues.

    And 2.
    If you do something stupid or illegal, don't try to get out of it by saying you had PTSD or some other weak ass, ****ty excuse like that. If you do that, FAA will start denying veterans their medicals, even if they have recovered. If you are having a minor relapse, self-ground, overcome it, then get back to flying... without incident.

    Bottom line, don't be a Buddy ****er.

    So my Advice:

    1. Get your medical decision out of the way before you spend a dime on training. Review your medical information, if your discharge Physical says you experienced significant psychiatric issues, then don't bother with an FAA Medical. If you told the VA you have severe psychiatric issues, to get a high rating, or the VA told you that you have significant problems, then don't bother with an FAA Medical because it will never happen. Go Light Sport Aircraft (assuming you comply with the Self-Certification Requirements).

    2. Contact AOPA or the FAA (or look online) for the FAA Psychiatric Specification, it will say what they need. Don't bother with the Psychological Testing unless the FAA specifically asks for it, I did not require it, so I wasted my money on it and its several hours of tests. Your Psychiatrist may tell you to complete the testing, if he does, do it.

    3. If you have decided to apply for the Medical, get a letter from a Psychiatrist prior to applying. It will save you some time. If the Psychiatrist agrees that you are good to go, and writes a letter saying so, then you can feel a lot better about your chances. Remember this, and insure your Psychiatrist does too, you need to be stable, resolved, no recurrences, and be able to provide a CLEAR explanation of the cause of your PTSD (Combat on such and such date, or whatever) and an obvious improvement with time and symptoms that have been gone for over a year. You also need to have an Excellent Prognosis. If the Psychiatrist doesn't agree that you are good to go, I would stop here and go LSA (assuming you can self-certify).

    4. Reassess your decision, remember, you still haven't applied at this point. If you have doubts, or your psychiatrist says to give it some more time, then don't apply right now. Isn't it better to be able to apply in 5 years and say, "oh yeah, I had issues years ago"? A lot easier to say it with a long time behind you. Also, the FAA is slowly getting more in tune with the rest of the world on Mental Health. They aren't there yet, but the old-school, deny-everything flight surgeon doctors are going away - even if its slowly. I hope one day, the FAA will offer a 'path to certification' for every applicant and that there would be no such thing as a permanent denial. Again, we aren't there yet, but its still a real possibility in the future.

    Plus, Light Sport Aircraft training can be used towards a private pilot. And maybe several years of LSA experience will help with your medical issuance. Or perhaps they will remove the LSA Catch-22. You never know.

    5. Okay, if you have decided to proceed, bring your discharge/REFRAD Physical Exam, and letter from the Psychiatrist along with any treatment history to the AME. I recommend you apply for a 3rd Class medical. The FAA has a lot more leeway for Waivers on 3rd Class than on 2nd Class and 1st Class Medicals. Even if you wish to go Commercial in the future, apply for 3rd Class for your early training. You can always upgrade the medical later.

    I would also suggest a personal letter to the FAA describing how you overcame your issues and how you will demonstrate that you will be a safe pilot.

    No matter what documentation you bring and no matter how minor your symptoms are, 100:1 odds that once the AME reads "PTSD", they will deny or defer you. Mine called the Regional Flight Surgeon, who told him to defer it. The current 2011 AME Guidebook doesn't actually address PTSD, nor does it cover Anxiety disorders (which PTSD is considered). Not sure why, given the number of Veterans affected in some way shape or form by it, but there is ZERO official guidance to AMEs on the subject.

    Remember that most AMEs are Family Practice types, not Psychiatrists and they probably don't want to dig into the issues. Sadly, my AME was pretty unhelpful once he deferred and showed little interest in assisting me secure certification nor review documents, I had to contact another AME in the area for information. Make sure your AME is a pilot and find out if he tries to assist his patients overcome issues. You might even speak to him/her prior to the application and see what they think about your case.

    If the AME defers you, the FAA will contact you (eventually) to request more information (see Step 4) unless the information you have provided answers their questions.

    If the AME denies you, appeal the decision to the the Manager of the Civil Aviation Medicine (Dr Warren Silberman). The AME Denial letter should say how to do it or to contact the FAA for details.

    You should not consider either of these results, at this point, to mean much. The AME guidebook (2011 version) doesn't actually prevent them from issuing the certificate but again, if they see 'PTSD', they will probably call the FAA for information, and the FAA will tell them to defer you. Fortunately, the FAA does not seem to tell them to automatically deny. Which could be an improvement. Most likely, they will defer since its less paperwork than a denial and a denial by an AME is guaranteed to be appealed, so in a way, its not really a denial anyway just a deferment with a different name.

    If the AME actually gives you the medical certificate (and I'll probably choke on my food if they do), go to Step 8. Be prepared for the FAA to contact you within 60 days requesting more information, potentially even suspending the Medical until they determine your case. In some cases, this may be a worse outcome because you would likely start your training and then potentially have to stop training while the FAA decides the fate of your flying career.

    6. Be patient and persistent, call the FAA medical every couple of weeks to check the status. And be polite to the contractors that answer the phone. They take notes, and if you fly off the handle at them in some uncontrolled rage, it may not harm your case, but I doubt it will help either. They cannot provide time estimates. Some will give you an idea, most will not provide any estimate. If the FAA requests information, give it to them quickly. Send it FEDEX, it gets there faster and doesn't have to go through Security Screening. A week after it arrives, call and confirm receipt. Stay on it, but stay cool and polite. The process is slow. I repeat, the process is slow.

    7. Start your training, with Medical Certificate in hand. Don't be like me who waited until after and was ready to solo when I got the medical deferred and then a 5 month gap.

    8. Regardless of how it turns out, SHARE THE RESULT(S). Forums like this, with the IAVA (Iraq and Afghanistan Veteran's of America), etc. Other Veterans need to know that they can come forward with minor post-deployment issues and not be stigmatized later in life by the FAA. A lot of people are asking the same questions about FAA Medicals (including myself just a few weeks ago) - help shine a light in the black box.

    If Veterans who have overcome Post-Deployment mental health issues are mostly facing discrimination at the hands of the FAA, then we need to do something about it and the way that happens is by raising awareness! Full court press on the FAA, Congress, VFW, IAVA, the Media. Contact the DOD and VA and everyone else who will listen and even those who won't.

    Remember that minor PTSD after combat is 100% normal. The only abnormal people are the ones who had no issues during/after the war.

    If you are denied, appeal it - all the way to the NTSB, make the FAA / Dept of Transportation tell you that Veterans who are honest, upfront and responsible for their mental health are a danger. Make them say it publicly and on the record.

    If the FAA starts creating a pattern of medical denials for Veterans, then the only result will be Veterans will start their own patterns of denial on their medical applications or even worse: they won't see anyone so that they don't have to risk a diagnosis/history, and it will be bad for everyone.

    Hopefully, my case is more the norm and we can commend the FAA for their understanding of Veteran's Health Issues. They might even view it as a matter of Patriotism.

    My hope is for the FAA to allow resolved PTSD to be issued by AME's, without Special Issuance to avoid delays. Its a stretch, but that will only happen if enough people come forward and demonstrate that Veterans can overcome ANY obstacle, including temporary post-deployment issues.


    Good Luck!
     
  14. Unregistered

    Unregistered Guest

    Hey OP-
    Can you define "potent" meds? SSRI's that arent FAA approved? or Antipsychotics or tranquilizers or something to that effect?
    Also did you get your psycheval from VA or a private shrink? If VA, did you have to go to a regional hospital or does it matter? I don't recall getting a REFRAD when I left, it was optional.
    Thanks for the advise!!!
     
  15. bbchien

    bbchien Touchdown! Greaser!

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    the 5:09AM poster:

    Also, don't just go to an AME. Go to a HIMS AME. We're the psych credentialled FAA guys. We actually know what to do.
     
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  16. DaytonaLynn

    DaytonaLynn Line Up and Wait

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    Hi Bruce:
    What about epilepsy
    Can this be overcome? Can the pilot get a waiver?
    Thank you.
     
  17. DaytonaLynn

    DaytonaLynn Line Up and Wait

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    One who misses Daytona!
    Good luck, sounds like you have some good news!
    Thanks for your service to our country!
     
  18. bbchien

    bbchien Touchdown! Greaser!

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    Four years off meds with no episode gets you an medical.
     
  19. DaytonaLynn

    DaytonaLynn Line Up and Wait

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    Thank you,
     
  20. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser! PoA Supporter

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  21. bbchien

    bbchien Touchdown! Greaser!

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    ...and this unreg is at risk for denial if it does not work out. So I stongly suggest to the first unreg that he needs to obtain the highly qualified (and recognized-by-FAA) opinion FIRST, and determine whether or not it will be adequate, before putting all his aviation at risk. It's pricey to get the right guys.

    And I can tell you unequivocally, the VAH psych guys are NOT the right guys (and the examiners in OKC generally agree, I think).

    What the FAA is afraid of goes like this one: SEA05FA125 (this one is OCD, and I'm looking for my PTSD example, but read the report and you'll "get it".). A prominent event and the whole speicial issuance system goes "bye bye".
     

    Attached Files:

    Last edited: Oct 19, 2012
  22. Mason

    Mason Pattern Altitude

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    Amen to that.
     
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  23. bbchien

    bbchien Touchdown! Greaser!

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    Nah. It's broken because Congress, in its "wisdom" has chosen to stand up before the cameras and say, "we will never let this happen again.......!! (Sen. Richard Durbin, D-IL).

    He has, and a few others- Rangel, Schumer, etc, gotten appropriate nicknames we cannot share here....
     
  24. Kyle123

    Kyle123 Guest

    So, I'm in the process of signing up for the commercial aviation program at big bend college. I have a 70% rating for PTSD. Do I even have chance is what I'm wondering? After reading the prior comments I'm feeling pretty doubtful.
     
  25. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    Pinging @bbchien back to this necro
    thread so he can respond. This is Dr. Bruce Chien, one of our esteemed senior and top level AME's in the country. Dr. Lou Fowler is another.

    To get the answer faster and in private, as well as to discuss your potential course of action, you can reach Dr. Chien directly by leaving him a message on this web page: http://www.aeromedicaldoc.com/how-to-start.html

    Oh, and I would hold up on your application and giving Big Bend College any monies until you know for beyond 100% certain that you can obtain a first class medical and what is needed to maintain it after the initial issuance.

    If you chose to go on your own without the professional guidance of a senior top level AME like Doctors Bruce or Lou, then god speed and good luck as the odds will be severely stacked against you.
     
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  26. cmjj90

    cmjj90 Guest

    Hello all, I'm currently deffered and the FAA has requested information on my TBI, PTSD/Depression/Anxiety. I still have some symptoms such as hyper-vigilance, guilt, and seclusion but they are non-episodic, I am Not medicated. The VA has me rated at 100% permanent/indefinite. Flying is my life's dream; what are my odds of getting cleared? Should I put this off? What is my most hopeful course of action?
     
  27. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    Do not go anywhere near an FAA form or "live" medical certification exam until you speak and consult with a Senior HIMS Aviation Medical Examiner who knows how to handle situations like yours and has sponsored a few applications through the system to a successful end.

    The main starting focus is to initiate a dialog with that AME and start your education on what the FAA standards are, what is needed documentation wise to demonstrate you meet these standards, and how do you go about obtaining this documentation, including the appropriate neurocognative and neuropsychological examinations.

    Again, do not officially approach the FAA until you "know what you need to know". Why? Because if you decide to do it your own way, you run a high risk of having your application denied. A denied application effectively kills your "Flying is my life's dream".

    What is a HIMS AME?

    HIMS (Human Intervention Motivation Study) AMEs are trained in evaluating airmen for substance- or alcohol-related conditions or other mental conditions. HIMS AMEs can provide sponsorship and monitoring for such conditions when required by the FAA for medical certification purposes.

    https://www.faa.gov/pilots/amelocator/media/HIMS%20INDEPENDENT%20MEDICAL%20SPONSORS.pdf

    Of the HIMS AME's who can deal with PTSD applicants and how to deal with the medical providers at the VA, Pilots of America is very fortunate to have two of them as active members:

    Dr. Bruce Chien, @bbchien
    Bolingbrook, IL
    Http://www.aeromedicaldoc.com/how-to-start.html

    Dr. Lou Fowler, @lbfjrmd
    Pensacola, Florida
    https://g.co/kgs/SahwT2

    Something to keep in mind that the process of building a successful application will take a significant amount of dedication and resources such as both time and money.

    Some of the testing has to be done to exact standards by one of a very small number of "known-to-the-FAA" neuropsychologists, and insurance does not cover their fees. Plus there may be significant travel involved. And the AME sponsoring you and your journey needs to be properly paid for his time, efforts, and expertise. Finally, once the submission is submitted to the FAA, it will take significant time for it to make its way to the proper reviewing doctor and then the top of his work stack. This is many, many months for this step. If your case requires the approval of the Federal Air Surgeons office, then add additional months to the review process.


    I wish you the best of luck and ask that if you do embark on this journey, keep us updated on your progress as we all enjoy learning more details on what is involved and how airmen overcome their obstacles.
     
  28. bbchien

    bbchien Touchdown! Greaser!

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    Kyle123, any ptsd award is totally grounding. And reversing it will take the better part of a year. Remember all those PHQ-9s you filled out on Active? Well the VAH award, to aviation is like checking “YES” on the last one....
     
    Last edited: Jul 11, 2019 at 8:35 PM
  29. George A. Taylor

    George A. Taylor Filing Flight Plan

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    Wings Of Osmium
    Hello my friend, Flying is my life's dream! We share the same name, so for now my name will be Wings Of Osmium! I hope you get a laugh out of it.

    I am scheduled to test today on my PTSD/TBI with Dr. Kate Glywsky here in Texas who tests specifically for Aviators being challenged by the FAA. I am 100% totally and permanently disabled from over 30 years of beating my body up in the young mans game called the Army. I applied for 3rd class to start my training when I received my deferred letter from the FAA. I do fear of losing my disability with a positive out come as it would/could affect my family and I am not sure it would be worth it to fulfill this old Soldiers dream of flying. God bless I am no longer medicated and I feel great. I still carry some issues Depression/Anxiety/symptoms such as hyper-vigilance, guilt, and seclusion but they are non-episodic as well. They don't help my sleep and a few other small issues, but doing well. I don't feel I am a danger to myself or others, but again, that is my opinion. Like all within this post advising you, seek professional advise before you do anything with the FAA or commit money to a school. I will return and let you know if I will be sharing the blue skies with you any time soon.

    I thank you all who have served and those that love someone who has served or is serving!!

    11Bravos Combat Medics rule!!

    V/r

    WOO (Wings Of Osmium)