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.


#2

Nate,

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.

Adam


#3

Nate,

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.

Chris


(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.

Nate


(David Wilson Rohwer) #5

Nate,

It sounds like you’re going down the right path.

First thing to note is the Regional Flight Surgeons (RFS) that work each region are not always the best or totally up to date on what needs to be completed for psychiatric testing. Your HIMS Psychiatrist is correct in that he’ll send the information straight to DC for your case to be reviewed by the FAA Psychiatric board. My advice is to not bother talking straight to Oklahoma City nor the FSDO but talk straight with any folks in the HIMS program as they know who to talk to and submit the paperwork to. From what I understand it’s the fastest way to get approval.

HIMS is a very successful program. It was originally written for professional pilots who had substance abuse issues but the FAA has began using it for psychiatric cases. It may seem like a spider web of requirements but it’s the surest way for you to get an unrestricted medical. The vibe I get from the HIMs AMEs / Psychiatrists is they are a tight knit group who communicate freely with each other. Follow their advice to the letter.

Given it sounds like you don’t intend to continue drug treatment once you have a medical you’ll most likely be given a Special Issuance. A special issuance is a fully cleared medical that you can use for all of the privileges of that medical, whether it be a 1st, 2nd or 3rd. What they will require however will most likely be follow up psychiatric testing, which is on a case by case basis. After a certain duration you may get a special issuance.

I STRONGLY encourage you get a consultation with AMAS (https://www.aviationmedicine.com/). They are extremely helpful and will answer any questions or concerns you may have. They also can give you guidance on what may be tested.

The process will be daunting and expensive however for the cost of a tail wheel endorsement you could have a career of flying ahead of you.

Let me know if you have any questions.


(Sam Johnson) #6

Nate,

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 (www.leftseat.com). 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.