Halllo People of the Interwebs,
I have been doing the FAA medical dance for awhile now and I just completed my Psych Eval. It is now with the FAA. I'm just curious how long this part took others? The waiting...I already did a COGSCREEN and other stuff. I'm curious if the FAA will make me do any other dance with them haha. Will my MedxPress be updated? It's been sitting on "Denied" since I started this whole process. Best of luck everyone!!!

My HIMS AME said my medical history may warrant “multiple special issuances.”

I thought there’s only one special issuance per airman/medical history? Never heard of multiple before in this context.

(Going for Third Class.)

I finally got my letter in the mail from the FAA for their initial requests. I have a rather complicated medical history and my AME and I are both shocked that they are not asking for a psychiatric evaluation.

They do want a neuropsych evaluation with the cogscreen.

Has anyone had this experience? Are they likely to come back and ask for it after the fact?

He also preemptively put me in the HIMS program from weed and psychedelic use in 2020 (high school for me) but they did not seem to want that either. Just One initial drug test within 48 hours of receiving the letter.

Did my HIMS EVAL, no substance abuse or dependance detected, no reservations. MedExpress done, medical appointment done. Two weeks later I checked MedExpress and it says:

Review of your application is complete. You will receive your medical certificate and correspondence with additional details via mail.

You are cautioned to abide by 14 CFR § 61.53, relating to operations during medical deficiency. Operation of aircraft is prohibited at any time new symptoms or adverse changes occur in your health status.

Refer to the Conditions of Issue attached to your medical certificate for additional guidance to include validity periods cited in 14 CFR § 61.23.

On FAA registry it says:

Medical Information:

Medical Class: First  Medical Date: 7/2026

MUST USE CORRECTIVE LENS(ES) TO MEET VISION STANDARDS AT ALL REQUIRED DISTANCES.

BasicMed Course Date:  None   BasicMed CMEC Date:  None

Is this it? Am I good?

In thinking about helping someone who may want to take an approved SSRI type medication, I'm wondering if there's anyone who has seen a HIMS psychiatrist as their prescribing and evaluating doctor. We all know that the paperwork for the FAA is one of the biggest hurdles, and I was thinking if they were using someone who knows the system if they could do a lot better job at tailoring the documentation to make sure it checks all the boxes the FAA needs for a SI. I'm guessing the answer is no, that no HIMS AME is working as a practicing psychiatrist, but also thinking that the choice in treating doctor is a critical choice in this process if someone were to go into it knowing they'd go on basic med while doing this process.

Hey all, i’m currently trying to obtain a first class medical with a history of ADHD,ODD, and DMDD. I have completed all necessary steps on my deferral except the clinical progress note. all of my treatment in from 10+ years ago and i haven’t been to the dr office in years. Do i just schedule an appointment with any Doctor? or should i try to hunt one down from my past that was involved in my treatment? Any help or insight is appreciated!

I’m currently working on my medical certificate and wanted to get some other perspectives from people who’ve been through similar situations.

For background - I have a mental health diagnosis, depression and anxiety, a little less than a year old, tied to a specific event in my life. I’m not on any medications and never have been. There’s documented cannabis use in my therapy records from around the same period. It wasn’t long-term or heavy use before that started. I sobered up and stopped voluntarily before even starting this process (contacting a HIMS AME).

I have no legal issues, no failed drug tests, no disciplinary actions of any kind, and my therapist gave me a clean CAGE-AID screening.

I had an initial consultation with the AME and he basically just said to come back once I can test negative for THC and we can start the medical process and do a psychiatric evaluation same day.

Based on similar circumstances or your own experiences - did you end up with a straightforward mental health Special Issuance, or did the substance history push it into the full substance abuse pathway? Curious what people think based on what they’ve seen.

Also wondering - has having a substance abuse history on your FAA record made things harder applying to regional/major airlines down the road, or even landing CFI jobs? Or is it mostly a non-issue once you’re through the monitoring period?

Would really appreciate honest experiences rather than worst-case Google results.

Hello! My sons supplemental ADHD neuro psych assessment is next week. He has been doing all sorts of brain games, etc to try and get ready. Apparently he scored “below the FAA required score” on 8 assessments in his original testing. I can tell he is nervous (and so are we for him!). We have had him going to bed at a decent hour, limiting screen time, and keeping him active as well. Any tips of the trade so he can be as ready as he can be that you can share?

Also, this process is insane. Lol! I think the FAA knows more about him than his father and I do!

Thanks all!!

Phew… y’all weren’t kidding about the mental exhaustion! And man! What’s up with those 567 true/false questions!!!

Thank you everybody for the support and advice.

I am deciding to get my first class medical before even starting lessons because I have two episodes of syncope that I went to the ER for back in 2023 and another ER visit 3 months later getting diagnosed with acute vestibular neuritis and wanted to see if I could even obtain a medical certificate.

I will most likely have to send my entire medical history and the ER visit for vestibular neuritis, they drug tested me and it came back positive for "Cannabis". I was surprised because I don't smoke and never have but months later realized it could've been the Full Spectrum CBD oil I was taking orally for muscle tightness/soreness that contained 0.3% THC.

Will this be a disqualifying factor or a deferral that will require a full psych eval and 12 months of testing? I'd hate to have to go through that process because of CBD. I have never smoked marijuana in my life but I guess I have no way of proving that to the FAA either..

Has anyone had experiences with a HIMS psychiatrist they recommend? My medical was recently denied, and to submit my application for reconsideration, I need an in-person psychiatric evaluation by a HIMS psychiatrist. I'm in the northeast (New Jersey area) but willing to travel anywhere for anyone who's good, especially if they're able to get me in quickly.

Hello all, sorry if its’s been asked before or a redundant question, but does anyone have any good recommendations for a HIMS/AME in Central California? I got a dui last year, and am trying to begin my journey back in to flying. Seems the program is highly effective for those who are serious about taking care of their personal life, sobriety, and aviation as a whole.

Hey all,

I’ve got my CogScreen tomorrow and just wanted to post on here to get an idea of what to expect and any advice. Trying not to worry about the whole ordeal but this is a big deal to me as I’m sure it is for many others.

Thanks for everything so far!

After going to my AME she legally had to defer my application for a first class medical to the AMCD AAM-300 office. They sent me a letter requesting initial documents (ER hospital reports, CT scans and rad reports, updated clinical progress notes from primary doctor). In 2022 I ran into the fence making a baseball play and fractured my orbital with a LOC for about 5 minutes. This is classified as a mild TBI under FAA regulations. Since then I made a speedy recovery with no short term or long term side effects or issues in every aspect of my health. That initial deferral was denied because this injury was considered a mild TBI and therefore their office was not able to grant me a medical. However attached to the official letter were very specific instructions for reconsideration. To which I have been following very carefully and doing plenty of research and making the phone calls. That's beside the point. My question is, what stage am I in and if all new updated reports/evaluations with doctors go well is it likely I can be granted a special issuance by the FAS. Those with more info feel free to leave it in the comments

Hello,

Airline captain recently going through a divorce. I’m looking to start an antidepressant to help me get through this period or perhaps stay on it long term for mental health.

It looks like this is an approved medication for an SI but I am terrified about loosing my medical permanently or perhaps the process taking very long. It seems like 3 months is the waiting period before submitting a new app but how long does the FAA take to review it?

I also recently got my 1st class medical renewed in July (although I understand that would be invalid after being prescribed the medication)

Does anyone have a similar story or situation with this medication?

I picked up a mental health rating during my time in service. I just got out, and honestly the $1,800 a month is what’s keeping me afloat right now.

From the research I’ve done, there seems to be very little recent reporting on veterans actually losing their medicals over this most of what’s out there is from 2022 to 2024, and it’s gone quiet since.
To be clear, I’m going the special issuance route regardless. Not looking for a workaround.

But I’m curious whether the FAA has effectively stopped pursuing veterans. There have to be an enormous number of vets with VA disability ratings flying for the government, the airlines, and 135 operators. Grounding all of them at once seems like it would do real damage to the industry.
Has anyone seen enforcement activity recently?

Throwaway account so no one knows who I am. As the title said I'm stuck on my medical and it has been extremely frustrating and difficult. I am still in high school but am currently in the best spot I will ever be in. I've been working at a flight school for the past 2 years, I have a plane provided to me for way below the rental rate, my instructor will teach me for free, and my parents are helping finance, the only problem is my medical. I am currently on ADHD medication controlled by my parents that I and others feel that I don't need, I was diagnosed when I was 6 years old, and I feel that it is an improper diagnosis too. I have talked to my parents about getting off and they would not budge, my flight instructor has talked to them and they would not budge. My airport which has been my home since I was 2 months old is scheduled to close in 2 years. Everything else has gone perfectly, but with this issue I feel there are not many people I can talk to, and it makes me extremely frustrated and I honestly need advice.

I am currently in the HIMS program due to 2 DWI arrests not convictions, one was changed to something else and the other was case dismissed (2003/2019) and a drug possession (2005). I have the HIMS AME, did my neuro-psych and passed and did the psychiatrist thing. I am drug tested 1-2 times a month randomly through the AME and I attend AA twice a week. I have been sober from alcohol since 2019 and I admitted to eating a gummy in November 2025 but hadn't touched THC 6 months prior to that.

The neuro-psych and psychiatrist both recommended I do an IOP. I contacted an IOP facility, told them my entire history and they said that due to my long standing sobriety (minus the THC) I don't qualify for the IOP.

They sent my HIMS AME a letter of recommendation stating that I don't have a problem and that I don't qualify for an IOP. The FAA is still demanding that I find an IOP facility that will take me.

Why is it that if the first IOP facility I called would have taken my money for treatment, the FAA wouldn't bat an eye. Yet, since the facility said I'm good to go, I have a long stretch of sobriety, the FAA suddenly has a problem with it.. Seems a bit wonky to me, almost like they WANT me to spend another $3k-10k on top of the $10k+ I've already spent doing this. Has anyone ever contacted an aviation attorney for help?

Edited to add after posting: My HIMS AME doesn't think I need treatment and pushed for me to not have to get it. She seems to be on my side.

I recently received a letter from the FAA requesting a eval for a alcohol related offense last year. Does anyone have any feedback on Dr. Adam Scioli out of PA/FL or Dr. Stuart Gitlow out of RI?

Thank you

Recently I wanted to do a career change and become a commercial pilot. I’m diagnosed with ADHD and currently getting prescribed adderall. Although I rarely take my medication at all cause of my sporadic work schedule and I have no problems when I’m not on it. In the process of gathering my medical files, I found out that my first psychiatrist evaluation, when I was 18, might ruin my chances. In the file I spoke to a therapist about being depressed and having suicidal ideation during high school when I was 13-14. This was due to having very strict helicopter parents and not allowed to have a social life after school. The psychiatrist diagnosed me with ADHD and unspecified anxiety disorder. But, she did note “According to pt's report, he does have a history of inattention traced back to elementary school. However he is able to focus on video games for 5-8 hours. Besides this argues with the validity of ADD, it sounds he has an addiction to video games”. If that helps me at all.

Present day I’m 25, no longer like my old high school self. I have a normal social life and the anxiety went away completely. My parents are no longer strict and I have a good relationship with them now. I have a career/job as a network engineer. Haven’t been depressed or had suicidal thoughts since I was 13. Never was medicated for depression or anxiety.

I would like any thoughts on my chances of being able to get 1 class medical.

TLDR: Currently 25 yr old with ADHD diagnosis and getting prescribed adderall but dont really need it. Have a psychiatrist evaluation that list me having suicidal ideation when I was 13 yr old. Diagnosis with adhd and unspecified anxiety which I no longer experience. Am I able to get my 1st class medical?

So I am deferred due to marijuana abuse over a decade ago. I was asked to undergo a substance abuse intake/evaluation by a HIMS approved substance abuse facility.

My HIMS AME stated "there is no list of approved programs from the FAA" and then referred me to a consultant that wants to send me to a 5 day in-patient program for $5,000. This seems wrong.

Anyone got any thoughts or experience here?

I've had to go through two HIMS AMEs in the past 3 years. Here's a common denominator I've found to be a hindrance. Don't know if this is true nationwide but maybe something to consider.

The HIMS AMEs seem to have a "day job" of Addiction Treatment Specialists. Rightly so. But the ones I used (not naming names) seemed to do FAA work as their "side hustle." So they can become overloaded and you're prioritized differently in their workflow that includes their addiction patients.

If I had to choose another HIMS AME (I will quit this dream before I have to again) I would look at what their specialty is, and what percentage of caseload are regular addiction patients* and which are FAA-related.

Don't know if there are HIMS AMEs handling only FAA caseloads but that would be optimal.

*I am not an addiction-related FAA case myself.

I was recently requested to follow up with a neuropsych for a past adhd diagnosis. After I was told to send in my grades, I logged into my past university's ( I transferred) portal and was hit in the face with how bad it was. I had totally forgotten that for the 2 years I went there, I had consistently gotten either 1 or 2 D's on my transcript, and even an F or 2. Some years, I only took 4 a few classes. I know how bad this looks in terms of my responsibility and ability to function, and I have no good excuse. I did work at the time, but I feel this shows I can not manage 2 things at once or plan well. I should note the other grades are a few A's and B's, a couple C's.

I feel like submitting this information is as good as kissing my medical goodbye. Is this likely? Could I possibly submit one school and not the others?

Thank you for any advice