Search for AME specializing in difficult cases (past Hx of ADHD)

langgp

Filing Flight Plan
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langgp
Hello, I'm in search of senior AME to help me navigate the process of obtaining a third class medical certificate after being denied for a past history of ADHD.

I'll give you a brief summary of my situation. I was diagnosed with ADHD back in 2011 and prescribed adderall during my undergraduate studies. I took the medication sporadically, mainly in preparation for tests. At that time I truthfully wanted to be diagnosed, because I felt, with medication it would help enhance my scores and ultimately lead to a better chance of being accepted into dental school. Following undergrad, I did one year of lab based research with FDA on the NIH campus at Bethesda, MD and the subsequent year was accepted into dental school at VCU. Once in dental school I stopped taking the medication and did well throughout the four years plus a one year advanced education in general dentistry residency. My last filled prescription for Adderall was in 2012 and I've not been on any meds since. I'm currently 35 and my medical history is otherwise unremarkable. I initially applied for, and was denied, my class III medical in 2012 and then subsequently in 2018. In 2012, I admitted on the questionnaire to previously having been prescribed adderall. In 2018, through the guidance of an AME specializing in difficult cases completed the battery of cog tests with a psychologist. The final conclusion was an "absence of current evidence of ADHD" with " no evidence of a pattern of cognitive or psychological concerns that would preclude him from engaging in the activities of a third class airman". Despite this, the FAA ruled against me quoting a few areas of the test that were below average. It's now been five years since my last attempt so I'm ready to try again. My thought is to subscribe to a program such as optimal aviation to help brain train and then retake another COG test. Obviously, the only possible pathway to success here is a better score on the COG test.

Suggestions? Advice? Referrals?

Thanks for your help.
 
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why dont you start with the three on this board ? All are experienced in difficult cases.
 

Do you have access to your Cogscreen report? If not, you should acquire it. In the report, you should have a LRPV value, a statistical coefficient that describes the likelihood of you having cognitive defects. What was your LRPV? In addition, you should be above the lowest 15th percentile in each test subcategory, we're you below that threshold in any area? A few average or slightly below average scores shouldn't be an issue unless they are serious outliers.

Did you complete a Test of Variable Attention (TOVA) like the CPT? If so, what were your results on the TOVA?

More info is needed. The big thing is that you need an an experienced HIMS Neuropsychologist conducting your assessment. The list is publicly available. I would recommend Dr. DaSilva in Morristown NJ, he is the FAA external neuropsych consultant and if he says you are good to go, the federal air surgeon will take his word.
 
Thanks for the feedback.

I do have my Cogscreen report.
The LRPV value was .9865.
I was in the normal/high average range for most everything with exception to about 6 categories that came back as mildy deficit.
CPT tests: 18 of the categories were "normal"
CPT-2 Hit RT ISI Changes was mildily atypical
PASAT, 2.4 pacing was mild deficit
Trail making test, Part B was mild deficit

I'll reach out to Dr. DaSilva.

Thanks
 
Thanks for the feedback.

I do have my Cogscreen report.
The LRPV value was .9865.
I was in the normal/high average range for most everything with exception to about 6 categories that came back as mildy deficit.
CPT tests: 18 of the categories were "normal"
CPT-2 Hit RT ISI Changes was mildily atypical
PASAT, 2.4 pacing was mild deficit
Trail making test, Part B was mild deficit

I'll reach out to Dr. DaSilva.

Thanks

That is an elevated LRPV, and if I was a betting man I'd say that is what is causing your issues. That indicated a high probability of dysfunction, at least from the point of view of the test. If you weren't provided the supplemental battery, you will probably require that as well. For reference, I had an LRPV of 0.001, and was issued a 1st Class medical after a lengthy review despite a long childhood history of ADHD and depression treatment.

Do you have the T scores and percentile values for your subcategories on the Cogscreen? If any were below 15th percentile, that is likely a no-go as well.

I paid for a luminosity subscription before taking the Neuropsych eval, and also did various brain games/multitasking apps for daily practice. I also play video games fairly avidly, including fast paced competitive online games, and I think that helped with some of the raw processing and memory tests as well. Good luck, let me know what other info might be helpful.
 
The bad news about a legitimate diagnosis of ADHD is that you have to go through the cognitive testing to prove it isn't actually a disorder. The good news is that if you pass the testing, you'll get your medical (assuming no other issues of consequence). The FAA doesn't really hold past failures against you so if you do better and pass, you have a good chance.
 
And we’re hoping at the end of this month for some AME “limited authority” in some of these cases…if we can verify 4 years off meds and good function…but we be yet to see this vaporware….
 
And we’re hoping at the end of this month for some AME “limited authority” in some of these cases…if we can verify 4 years off meds and good function…but we be yet to see this vaporware….
Could you elaborate on that? Or point to some available information? That could be spectacularly good news for a lot of people.
 
Thanks for the feedback.

I do have my Cogscreen report.
The LRPV value was .9865.

That is an elevated LRPV, and if I was a betting man I'd say that is what is causing your issues. That indicated a high probability of dysfunction, at least from the point of view of the test. If you weren't provided the supplemental battery, you will probably require that as well. For reference, I had an LRPV of 0.001, and was issued a 1st Class medical after a lengthy review despite a long childhood history of ADHD and depression treatment.

To OP: Good luck! The medical process can be challenging to navigate. Find a good HIMS AME and let them guide you.

@redbaron is right though: 0.9865 seems very high, especially considering that the LRPV is an "estimated probability of brain dysfunction." For comparison, I was required to do the full battery HIMS neurocog (for a completely different reason than you, however) and came away with an LRPV of 0.0011, which my HIMS neuropsychologist described as a "good LRPV summary score."

Your goal isn't impossible but will likely require more time, money, and testing. The users here were very helpful when I was going through my 3rd-class medical HIMS process (which was frustrating at times) and I suspect that if you are patient and compliant, you may have success.
 
Yes! I agree this thread has been very valuable. The first time going into the COG test I had no idea what I was getting into. I was caught off guard. Big time. Through the links provided I’ve learned a ton. I fly frequently with my dad and it’s something I’m not going to give up on. Delayed gratification is my specialty. You learn to be patient after 9 years of education to become a D.D.S.
Thanks again for the helpful information.
 
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