Deployment related stress; no diagnosis, no medication, short duration CBT
Joined 03/10/2020 - 5 Posts
I'm a private pilot certificate holder, check ride in 2013, just turned 40.  I'm military so I've moved twice since then, and haven't flown.  Medical expired.  I'm approaching retirement in about a year and a half, and I'm looking to get back into aviation, possibly as a second career.  I have concerns about the medical.  

Summary:  Deployed twice 2003-4 and 2006-7, totaling 15 months in Iraq.  In 2012 I visited a Vet Center for counseling, but it was out-patient, no diagnosis, more or less 'reintegration' related.  In 2018 I visited a VA Vet Center for a bit more counseling, I would again call it 'reintegration' related.  My marriage was suffering, I wasn't being social, etc.  In 2018, I also visited the Behavioral Health center on a military post for a more official assessment.  

Outcome: No formal diagnosis was provided. No medication was ever prescribed-nor did I ever seek any.  I was given a few 'assessments.'  One for PTSD, one for Depression, and one for Generalized Anxiety Disorder.  The record says no diagnosis was made on that visit, and none were entered into the record in the next three visits.  The test results were entered suggesting I met the assessment criteria, but the record also suggested those were not going to be used to diagnose.  I was released without limitation and without a requirement for additional counseling.  The only 'intervention' was Cognitive Behavioral Therapy (CBT) and information.  The military has never questioned my mental health, I've been highly successful in my continued military service, and my performance remains high.

So, my question is:  how does this translate into the medical process?  In the MedXPress process, I'm being asked to select Yes/No for mental health.  I feel I 'should' say Yes, but I also feel quite strongly that my self-referral was the healthy thing to do, and kept me healthy.  It also asks me to list all visits to medical professionals.  Again, I feel I should say yes.  I'm not attempting to circumvent the system.  I'm simply looking for someone who is familiar to describe to me what I should expect.  I'm also seeking some guidance on how to best report this.  Further, my medical records will soon be reviewed for VA disability rating, and I'm not sure what the appropriate approach should be there.  I'm not looking for any particular rating, but I am wondering how ANY VA rating my impact a future medical. 

Anybody have some suggestions on who to call?  Websites to review?  Any recommendations?  Thanks.  I've been away from aviation for a bit, but I'd really like to get back to it.  I'd also like to know if this is going to be a substantial hurdle, so I know if I need to attack it now, or if, with no other issues, this seems pretty cut-and-dried.
8 Replies
Joined 06/11/2017 - 700 Posts
Dr. Bruce Chien (who comes around here occasionally) is an AME who specializes in difficult medical certifications, and is one of the nation's top experts in that area.  You should contact him via his website for advice.

Whatever you do, if you apply for medical certifications, be advised the FAA will get access to all your records, including the VA file, so make sure what you tell the FAA is the truth, the whole truth, and nothing but the truth -- you can actually go to jail for lying to the FAA on something like this, not to mention being permanently denied.  Same goes for talking to Bruce, although all he can do is drop you like a hot rock if you aren't straight with him.
Joined 03/10/2020 - 5 Posts
Thanks.  Not trying to hide anything.  Just trying to get some idea of what happens under the circumstances.  I’ll reach out to Dr Chien as recommended.
Joined 12/22/2019 - 22 Posts
Hey Jeff,

Welcome HOME and thanks for all you did over there...we are grateful. 

I am also a vet and went through something similar, but like you, no meds prescribed and no diagnosis. In my case, the doc wanted to diagnose me with PTS but I fortunately had no self-reported symptoms, so nothing happened and no record of it. (My retirement physical)

I don't think you will have any issues getting BasicMed with that record. Like the others said, be your usual honest self and everything will be ok. I have seen other vets back flying who had major issues with PTS and mild TBI, so you can do it.

Flying is the best mental therapy anyway!

Lots of non-military docs seem to WANT to prescribe PTS thinking they are doing us a favor. It takes a lot more than one office call to determine something so complex.  BTW, PTS is not abnormal, it is actually very normal for people who have lived through mentally intense and physically violent times to have some distress afterwards, which seems to fade over time for most.  That is why we are dropping the D in is not a disorder, it is a normal human reaction. 

If you ever get to fly over to N94, Carlisle, PA, look me up and I will buy first round. Looking forward to it.

Mike N714AJ (Persian Gulf War, Bosnia, Somalia, Haiti, Enduring Freedom in Central Asia, Iraqi Freedom up in Kurd country, Iraq)

Joined 03/10/2020 - 5 Posts
Thanks for the note, Mike, and the encouragement.  Got my ASEL at N14 in New Jersey, so not too far from where you are now.  I’m down in South Texas these days, which I’m still undecided on.   Great photo!  I only got to see Iraq-twice...🤷‍♂️.

Joined 09/19/2019 - 39 Posts
Jeff, in addition to the private email(which I wrote B4 seeing this), the problem is whether any diagnosis was used to get you into CBT.  You know how the VAH is: "state the reason why Veteran needs CBT" (pull down reason and "no reason" isn't among the choices.

So although you don't think you have a diagnosis, I would be careful. The whole file needs review.  But the real kerfuffle comes if/when you get a PTSD award. I would advise withdrawing any application for that one, as you will have then to document why you don't have PTSD, which is an expensive long process, and then you lose the award anyway if you succeed in getting it. Net/Net: down for a year, Out $3,000+, + aggravation.

But there is usually a reason stated for giving an exiting soldier CBT.  I'd be very careful of that one because they don't give it for NO DIAGNOSIS..
Joined 01/27/2020 - 10 Posts
First, thank you for all you have sacrificed.

You deserve the best possible shot and it seems to me that involves getting the best possible expert counsel and support.  I would definitely contact the AME mentioned above and would explore other available forms of counsel/representation.  Your cause is honorable and worthwhile and my hunch is that you will succeed.
Joined 03/10/2020 - 5 Posts
@Dr Chien-Thanks.  Saw the email.  The CBT is just written in the file.  I think it’s how he captured the discussion over the 3-4 visits.  

I don’t think I’m following the “award” term.  I’m not seeking a VA award for PTSD in a disability rating process.  Is that what you mean?  Sorry if I’m exposing my ignorance.  If that never occurs, you’re saying there is no requirement to report?  

And thanks...your suggesting I’m right to be concerned about it, which is good to know.  

Should I find someone to do a “whole file review” before I submit?  Is that also what you’re saying?
Joined 03/10/2020 - 5 Posts
@Barry Isaacson.  Thanks, I appreciate the support.