What is an FAA Psychiatric Exam for? Does a childhood ADHD meds history require it?

[BigJimSlade]

Good morning.

I did post this question before, but it was buried in another post. I'm asking again with a better title.

I graduated high school last May and was going to attend a 4 year public university for flight school for eventual ATP. I was deferred due to ADHD meds as a kid, took the Cogscreen and did poorly on a few sections, did some additional cog training, then passed the exam with flying colors.

My AME is a Senior HIMS AME. He said he wants me to get a psychiatric exam, as the FAA may ask for it. The FAA ADHD info as well as the deferment letter say nothing about this requirement - just the neurocognitive screen, which I have passed. I think he works mostly with adult cases that have different histories and not ADHD. Could he be asking for this exam because most of his cases ask for the same? I've been told it's $2,000, and it it's not needed by the FAA, I'd rather use that money to actually pay for college.

Can I push back? Should I push back?

 

[SkyDog58]

Wow, your profile says you are 50 and you say you just finished high school last year and are ready to start college. Kudos to you for having the courage to do this. Most folks give up by now especially if facing the mental challenges that you are obviously facing. As a recent high school grad with many years of the school of hard knocks behind you, you apparently have gained the wisdom to question or ignore the advice of a Senior HIMS AME and instead to seek out the advice of SGOTI. It takes most people much longer to realize what makes for a real expert and to seek them out. But you have come to the right location to find SGOTI advice. We have it in spades here along with tons of sarcasm and snark, in case you hadn’t yet noticed.

 

[BigJimSlade]

Ha, sorry, wrong age in my profile.

Born 2003

My dad and I signed me up for this forum together and he mistakenly used his birthday.

 

[BladeSlap]

I’d also contact your congressman, this ADD nonsense needs to come to a end with the FAA.

Good luck, and sorry to hear this has to be your first experience in aviation

 

[BladeSlap]

Wow, your profile says you are 50 and you say you just finished high school last year and are ready to start college. Kudos to you for having the courage to do this. Most folks give up by now especially if facing the mental challenges that you are obviously facing. As a recent high school grad with many years of the school of hard knocks behind you, you apparently have gained the wisdom to question or ignore the advice of a Senior HIMS AME and instead to seek out the advice of SGOTI. It takes most people much longer to realize what makes for a real expert and to seek them out. But you have come to the right location to find SGOTI advice. We have it in spades here along with tons of sarcasm and snark, in case you hadn’t yet noticed.

More opinions are more better.

Medical blunders are the 3rd leading cause of death after all.

 

[BigJimSlade]

More opinions are more better.

Medical blunders are the 3rd leading cause of death after all.

What's the endgame, then? If more opinions are better, perhaps all pilots should be required to go through the Cogscreen AE process and the neuropsychological exam. I guess I don't want another opinion if the FAA doesn't ask for it - especially considering I'm a college student who'd rather spend $2,000 on tuition vs a psychiatric exam that the FAA doesn't care about.

 

[Rushie]

That’s a lot of money if the FAA isn’t going to require it. Not being a AME myself I can’t guess what your AME is thinking. If I were in your shoes, yes, I would question him again before I dropped that amount.

 

[BladeSlap]

What's the endgame, then? If more opinions are better, perhaps all pilots should be required to go through the Cogscreen AE process and the neuropsychological exam. I guess I don't want another opinion if the FAA doesn't ask for it - especially considering I'm a college student who'd rather spend $2,000 on tuition vs a psychiatric exam that the FAA doesn't care about.

I mean not taking the first doctors opinion, not jumping through more silly FAA hoops.

 

[bbchien]

You AME maybe mistakes the Neuropsychological eval with the HIMS Psychiatrist. You use the HIMS psychiatrist when in addtion to ADD there's a history of anxiety or depression.If there's no "Of record" of the other problems, just the straight Neuropscyhological eval.

 

[BigJimSlade]

Thanks, Dr. Chien - that’s what we thought, too.

I managed to get a hold of the FAA in OKC to ask them, considering the situation, can I push back on the AME? Yes, absolutely, and the FAA said to NOT send something that’s not requested by them.

I also talked to an aviation medical organization and whoever picked up the phone was super helpful. I asked them the same question. They said we should be providing the FAA exactly what they ask for and no more.

So that’s what the AME should provide - only what’s asked, and certainly NOT an unneeded expensive exam.

 

[Jeff Oslick]

I'm trying to figure out the utility/validity of a mental health examination that you can successfully "train" to do better on. How many who "failed" the first time gave up and didn't try to prepare for a second run, but would have passed if they did? What, exactly, does this really prove?

Just like going to a tutor to prepare for the SATs, another GiGo examination.

 

[BladeSlap]

I'm trying to figure out the utility/validity of a mental health examination that you can successfully "train" to do better on. How many who "failed" the first time gave up and didn't try to prepare for a second run, but would have passed if they did? What, exactly, does this really prove?

Just like going to a tutor to prepare for the SATs, another GiGo examination.

It’s like ink blots or chiropractors, it’s a parlor trick industry.

 

[bbchien]

Far from that. It’s very well vetted. We have, by decile airman norms (thousands), and you only need to beat out the bottom 15th percentile, so FAA can say “well whatever he’s really got, it can’t be all that bad”.

FAA knows about practice effects. So you only get to test once a year. Tough to “trick it out”.

Cogscreen AE has 100+ versions so you will never see the same one (they are serialized).

You are very very dismissive of things you don’t understand....

 

[ProjectInfinity1]

Far from that. It’s very well vetted. We have, by decile airman norms (thousands), and you only need to beat out the bottom 15th percentile, so FAA can say “well whatever he’s really got, it can’t be all that bad”.

FAA knows about practice effects. So you only get to test once a year. Tough to “trick it out”.

Cogscreen AE has 100+ versions so you will never see the same one (they are serialized).

You are very very dismissive of things you don’t understand....

Annoying, but tolerable, alas if it only didn't cost so much. But at least it's not a blanket no.

 

[Lindberg]

I was deferred due to ADHD meds as a kid....

It may sound like a nit to pick, but you were not deferred due to meds you took as a kid. You were deferred because of an ADHD diagnosis. At least I hope that's the case since the form you filled out doesn't even ask about meds you took as a kid. That may seem like a small point, but we do see people on here asking about whether they have to disclose meds they took long ago, even though the form clearly does not ask for that.

 

[MyDimeIsUp]

For just an ADHD diagnosis and nothing more it should just be a neuropsychological evaluation. As Dr. Chien said there is no need for a psychiatric evaluation except if it OCD, depression, autism, etc.

You can refer to a post I made awhile ago here. Outlines process from start to finish and some of the tests I had from the neuropsychological evaluation. https://www.pilotsofamerica.com/com...ent-pilot-where-to-start.126375/#post-2927391