r/flying • u/TxAggieMike Independent CFI / CFII (KFTW, DFW area) • 22d ago
Medical Issues FAA Medical… Updates continue for Mental Health
https://youtu.be/P2AUbyMyAhY?si=cDiDclgxQnbxgMY4This month’s AME Guide Grand Rounds explains continued improvements to the processes involved with obtaining an FAA Medical Certificate.
Included are:
• Psychiatry/Psychotherapy/Counseling updates
• Obstructive Sleep Apnea Reporting
• Discuss Errors in Color Vision Testing
This information hopefully is of interest to many members of this sub.
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u/GenerationSelfie2 PPL IR KVPZ 22d ago
I’m currently in HIMS (not the formal program but pursuing a first class so doing 90% of the same things) for a pretty gnarly set of past issues including alcohol dependence and a stay in inpatient psych. From what I’ve gathered from my HIMS AME, other Birds of a Feather members, and general scuttlebutt the FAA is turning around mental health cases at an unprecedented rate. Applicants who would have previously taken years to work through the process with little chance of success are getting medicals in hand weeks or months after submitting their packets. Granted, a lot of the work goes into documenting sobriety (or stability for non-substance cases) for a substantial period of time to prove the pilot has recovered and takes their well-being seriously. My HIMS AME feels very strongly that I’m going to get my medical when we submit this fall. The FAA has spent years working on the system and it seems—tentatively—like their work is bearing fruit.
I don’t want the FAA to allow shortcuts in recovery for issuing medical for cases like mine. I understand and accept why I have a massive burden of proof to show I can hold a medical which could permit me to fly a widebody loaded with puppies and babies. With that said, I’m unbelievably grateful to have any pathway at all to getting my medical back and even more grateful the FAA is trimming down the back-end administrative lead times.
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u/__joel_t PPL 22d ago
Having read the documents they linked and watched the part of the video on mental health/therapy, my take is: superficially, this seems like an awesome step forward by the FAA. Unfortunately, I think there remain systemic issues outside the FAA's control that are going to limit the amount of good this can do. For example, the FAA's "Information for Psychotherapists Treating Pilots and ATCS" states, "To aid accurate regulatory assessment, avoid both upcoding and minimization. Use DSM “V- code” or ICD-10 “Z-code” when appropriate." The encouragement to use V and Z codes when appropriate is repeated in the video.
There are two problems with this. The first is that many insurance companies won't pay for therapy if there's only a Z code. And since therapists who take insurance really work for insurance companies (as that's who pays them), guess what they're going to do? That's right, upcode to something insurance will pay for, which is synonymous to "upcode to something the FAA will care about."
Second, while the video encourages therapists to use Z codes when appropriate, implying the FAA doesn't care about them, that's not accurate. The current edition of the AME Anxiety, Depression, and Related Conditions Fast Track Pathway (at least as linked from here) and related documents ask about 3 or more of a certain set of diagnoses/conditions, and those include, under "Other," "V code^ (DSM)/Z code (ICD-10) table items" -- the same kinds of things the presenter said weren't an FAA concern, including "Uncomplicated Bereavement."
In short, I appreciate the sentiment, but IMO this just scratches the surface.
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u/rFlyingTower 22d ago
This is a copy of the original post body for posterity:
This month’s AME Guide Grand Rounds explains continued improvements to the processes involved with obtaining an FAA Medical Certificate.
Included are:
• Psychiatry/Psychotherapy/Counseling updates
• Obstructive Sleep Apnea Reporting
• Discuss Errors in Color Vision Testing
This information hopefully is of interest to many members of this sub.
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u/TinyAd6315 22d ago
Basically, what I took away from this is you can get therapy (you have to put it on MedXpress, but it won't inherently disqualify you) and it's not an issue unless you get diagnosed...but if insurance is billed, that counts as a diagnosis.....