Unspecified Anxiety Diagnosis and the Cogscreen Test

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John9000

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Hello all,

I am an 18 year old in pursuit of a First Class Medical Certificate. The college I go to requires a 2nd or 1st class certificate. The FAA required a psychiatric evaluation due to a previous depression diagnosis from 6 years ago and being on SSRIs. I have not taken zoloft medication in 3 years. The psychiatrist believed that I actually never had depression and it was a result of complications with eosinophilic esophagitis, which is well managed now. However, I was nervous and tired throughout the interview and it led him to make a diagnosis of unspecified anxiety disorder after ruling out depression. I guess this is mainly because I struggled with my working memory at the time after a long day of midterm exams. This particular day was the only time the doctor was available, and I had waited for three months to get the appointment. I messed up digit spans and other mental acuity tests and got clearly nervous. I have since attempted similar tests on my own and I do well with them. Any anxiety I had was purely situational.

My concern is about the unspecified anxiety disorder that he diagnosed me with in our one hour interview. The psychiatrist in his report said that he suspected "Other specified anxiety disorder (elements of test anxiety, social anxiety, possibly GAD)". He also stated that my application could be enhanced with some additional information, even though his suspicion of an aeromedical problem was low. Because of this he sent his recommendation to the FAA for me to see a HIMS-AME and do the basic FAA cognitive screening, which I assume is the cogscreen. I'm going to guess the FAA would follow his recommendation. I do not believe I have any anxiety disorder and have had no previous issues with anxiety. All of this was caused by me getting flustered during a very stressful interview after taking three midterm exams earlier that day. I wish there was a way I could fight this because I am seriously concerned about the affordability of the cogscreen. I already spent 2,500 dollars for someone to tell me to spend thousands more. This quite honestly could kill my dream of flying. Is there anything I can do to avoid having to take the cogscreen?

Also I thought that anxiety wasn't immediately disqualifying even if I do have it. Especially since my depression diagnosis was ruled out, but I'm not sure since I was technically on SSRIs. I found some documents from the FAA saying that I wouldn't even have to be differed for uncomplicated anxiety.
https://www.faa.gov/ame_guide/media/Anxiety_Depression_Decision_Tool.pdf

Any ideas would be appreciated.
 
John9000 said:
Would getting a second opinion from another psychiatrist do any good?
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I think you need to shift your thinking. You’re on the hamster wheel, and there’s no getting off of it if you’re going to stay in aviation. Your focus should be on finding someone to guide you through the process so you don’t mess up again.
 
Who would you recommend to guide me through this? Are you thinking like my AME or someone else?
 
John9000 said:
Because of this he sent his recommendation to the FAA for me to see a HIMS-AME and do the basic FAA cognitive screening, which I assume is the cogscreen.
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I think this indicates that he has already applied.
 
John9000 said:
Yes I have already applied about 6 months ago.
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I find it sad that apparently no one (flight school, instructor, receptionist at AME, whoever) cautioned you about "applying". A simple "consult" with an AME would have highlighted the challenges in your case... pre-application.

Particularly with the MOSAIC changes, there are solid options for becoming a (non-professional) pilot without going through the FAA medical gauntlet.
 
At this point, you will need to do what the FAA asks. But as said above, you need to find a good HIMS-AME to guide you through the process.
 
Boys and girls, when the FAA issues you a certfied letter with a list of minimum demands ("the FAA may requrie further information"), imagine the effect on "order and discipline" if one Medical officer were to contradict another?

That's not happening. The TRICK is to understand what FAA really wants, and provide all of that which is in the letter and whatever lies beyond - on the first round, so that it does not go "round and round" forever. The premise of this entire string is incorrect. "Do I have to do this, I'd rather not!?" simply means, "if you don't I know I am going to take the bus".

But you need a knowledgable HIMS AME to review the entire file and figure out if according to FAA's definitions of disease (Which are NOT DSM4), that your path is going to yield or not. And if the answer to the first question is YES, the second question is, what all more might they need (or, is this going to be a brick wall?).
 
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Well, does anybody have a recommendation for a good HIMS AME around the Greater St. Louis Area? I'm calling my AME today. I believe he offers HIMS services.

Also in case you are curious, the FAA has had me in a deferral loop for a while and never tells me what information they actually need. It is quite frustrating. They ask me about one thing and then ask for something different and unrelated from information they had for months. More importantly is how long it takes for the snail mail to reach me. It's practically a month and a half to get certified mail. Too bad the FAA doesn't have a secure medical chart we could access to send things instantly. However, I assume this could have been avoidable if I was talking to my AME more about what to expect. Unfortunately I'm in for it now.
 
Software isn’t the problem… it’s the excuse. Organizationally they’re just messed up. I got this whole “we have outdated systems blah blah blah” from one of their star AMEs, and it turns out he was successfully sued for malpractice over misusing his hims AME “authority”. Think he was held accountable in any respect? Months after the decision he was in the spotlight at their national convention being all adored. It’s in the public record. However, I recommend him, he CAN get you certified, just don’t offend him… good luck.

They need a fundamental paradigm shift to “this ought to be medical, fair and transparent” for any hardware/software support stuff to help.

What you are facing is simply the norm. I say this after 8 years of CAREFUL scrutiny and talking with well over 200 airmen.

So the question becomes how do you know who is a good AME? You don’t. Northrup preached at Oshkosh “help us help you” and submit everything correctly… Wha????!!!! Isn’t that the AMEs job? And there isn’t any ranking of their performance. You flunk a checkride it becomes employer visible… but not AMEs.

You’re not looking for medical expertise, but rather administrative expertise. Ask them how many part 121 clients they have… that’s a clue. There are others.

Feel free to contact me personally, I’ll help any way I can.
 
John9000 said:
Well, does anybody have a recommendation for a good HIMS AME around the Greater St. Louis Area? I'm calling my AME today. I believe he offers HIMS services.

Also in case you are curious, the FAA has had me in a deferral loop for a while and never tells me what information they actually need. It is quite frustrating. They ask me about one thing and then ask for something different and unrelated from information they had for months. More importantly is how long it takes for the snail mail to reach me. It's practically a month and a half to get certified mail. Too bad the FAA doesn't have a secure medical chart we could access to send things instantly. However, I assume this could have been avoidable if I was talking to my AME more about what to expect. Unfortunately I'm in for it now.
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For something like this it’s best to use the best. There’s one in this thread above ya ;)
 
John9000 said:
...the FAA has had me in a deferral loop for a while and never tells me what information they actually need. It is quite frustrating. They ask me about one thing and then ask for something different and unrelated from information they had for months.
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This is exactly why you hire someone like @bbchien . You need someone who knows ahead of time everything the FAA will eventually want and who can help you give it to them in one shot. Otherwise you will spin and spin in bureaucracy hell for years.
 
I wouldn't assume the FAA would want more information, though I could be wrong. The psychiatrist's recommendation stated that if I pass the Cognitive Screening without any issue he would support a 1st Class Medical issuance. You never know with the FAA though.
 
John9000 said:
I wouldn't assume the FAA would want more information, though I could be wrong. The psychiatrist's recommendation stated that if I pass the Cognitive Screening without any issue he would support a 1st Class Medical issuance. You never know with the FAA though.
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Two things jump out at me here…”pass a cognitive screening without any issue” means what, exactly? Based on other threads here, it seems that it’s possible for you to sabotage yourself and be unprepared to pass like you did with your psychiatric evaluation. You need guidance.

He also said “he would support” issuance. Whom do you have to ultimately satisfy to get the issuance, and are there going to be conditions attached? Again, you need guidance.

Don’t think you can go this alone.
 
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