Real Answers from Real Pilots

HIMS Psychiatric Evaluation

(Nate Schwab) #1

Hi all,

I’m working through the first class medical certification process, which was deferred due to some medication I was taking for depression and anxiety back when I was teenager. I kept taking the medication into adulthood not necessarily because I was in rough shape, but primarily because my doctor and I agreed that the medication wasn’t causing any negative side effects and I was pretty stable and in good shape. Why mess with a good thing?

In consultation with my doctor, I stopped taking the medication once I found out the FAA doesn’t allow certain antidepressants. Once I had been off the medication for 90 days with no side effects, my doctor sent a glowing note to the FAA. They just got back to me stating they need a “current psychiatric evaluation performed by a HIMS trained psychiatrist.”

I looked at the FAA-recommended HIMS doctors and setup an appointment with one of the doctors, but his office stated that he cannot perform the evaluation himself. and he would see me simply in order to refer me to a psychiatrist his office works with. I asked for the number of his psychiatrist so I could reach out myself, and Dr. Gratzer returned my call shortly. He said that he could get me in next week, he would perform all of the necessary evaluations, and I would need to bring him a check for $1500 because insurance doesn’t cover these evaluations. I asked if he needs my FAA records and he said no, just bring my general medical records. He said he could send the report directly to the FAA and bypass the afore-mentioned HIMS referral because “I’m setup with the FAA.”

Does this sound like it’s up-and-up? I feel like I may be getting scammed here but I can’t find info online for how much these evaluations are supposed to cost. Also, what should I expect at this evaluation?

Appreciate any info anyone can provide - this whole HIMS thing is confusing to me and I just want to get the approval process finished. I’ve been at this since August and I don’t see any end in sight. :weary: I understand these things take time and government agencies are slow, but my employment situation changed recently and time is running out for me.



Honestly I have no clue but I’d call the FAA directly in Oke City or contact your local FSDO and ask them directly. They’re generally very helpful.




I have heard that the HIMS process can be very long, complex and expensive, so it does sound right from that perspective. I agree with Adam, call the FAA and ask them about this doctor.


(Nate Schwab) #4

@Chris and @Adam,

Thanks for the replies - will end up being expensive but I’m committed to seeing this through. Hopefully the shutdown ends soon.


(Sam Johnson) #6


The cost of medical testing can be negotiable like anything else but cheaper may not be best.
The HIMS program was created for alcoholics. Later the FAA adapted it to use for pilots on psychiatric meds. I have heard stories of HIMS doctors who were not professional or helpful. If you don’t have a medical diagnosis and you are not taking medicine, it seems to me that you should not need the HIMS program. When there is momentum the FAA can get wrapped around the axle with requirements. I would talk with Pilot Medical Solutions in Oklahoma ( They have helped several pilots with this stuff and can probably tell you if you need HIMS. I also agree with the post which said, don’t talk with the FAA directly. What you say to the FAA is extremely important.

(Nate Schwab) #7

@With-Prist-Please, thanks for the response. It sounds like there is a path forward. I’m confused, though, why would they need to grant me a special issuance if I have been off the medication for 120+ days with no symptoms? I also presented a note from my treating physician stating I am exhibiting no symptoms. Seems like this would be cause for a standard issuance.

Or is the idea that they need to follow up over a period of time to make sure that the symptoms don’t return?

(Nate Schwab) #8

@heavyr, thanks for the reply. After hearing from Adam and Chris a few weeks ago, I went ahead with commissioning a psychological eval report from a HIMS-referred doctor ($1,500 out of pocket - ouch). I spoke with Left Seat today and they were incredibly helpful. One of the doctors offered to take a look at the psych eval when it is completed and see if he recommends continuing with HIMS. He mentioned that he thinks – given I am 120+ days off meds, don’t have a current diagnosis and am not exhibiting symptoms – that the HIMS program may not be the best route but will need to see the report first to confirm.

If this is true, you may have just saved me a ton of money. Thanks for the advice. These guys at Left Seat seem awesome.

(Thomas Cook) #9

Hello Nate. Did you ever get your medical approved? I was wondering if the government shutdown is affecting these SI medical. How was the psychologist evaluation? I hope you didn’t have to do that cogscreen. I hear it’s nerve racking.

(Nate Schwab) #10

Hi Thomas,

Still waiting on the medical. I met with a HIMS doctor in Minneapolis last week. He reviewed the psych eval - the evaluator wrote that he sees no reason why I shouldn’t be granted a first class cert, so that’s really good news. No cog screen required as of yet unless the FAA needs more from me (doctor thought it was doubtful). He is going to send in everything this week to OKC and continue to follow up, but I understand there’s going to be a massive backlog from the shutdown, so I’m prepared to play the waiting game for several months.

I’m set to move down to AZ at the end of the month, so it’s just a waiting game for getting approved, and then I’ll enroll at the Mesa, AZ location. Thinking I’ll probably take this time to study up for the writtens, although I can’t be reimbursed for taking them until after I have the first class cert and have officially enrolled, unless I’m mistaken…




Yes, you will need to be signed up before being reimbursed for the written exams. Once you are enrolled, you can take the writtens for free at any ATP center and avoid the whole reimbursement process.