FAA Medical Denial - Neurocognitive Deficits
Votes
Answered By AOPA
Hey all, would love any advice on where to go from here.

I take Lexapro to control a diagnoses of depression. I went through the "Initial SSRI Certification" workflow, with what I thought was mostly success (until the end). Both my primary care doctor, and psychiatrist in their reports indicated stable with medication, and depression in remission. HIMS AME recommended issuance based on our interview. Initial neuropsych battery indicated borderline results and recommended full panel testing. I went through the full panel testing at which point it was indicated that memory scores were below pilot norms. Other indicators were average, or above average. I was ultimately denied because of this.

I am trying to determine where to go from here, to get back to my dream of flying. I could appeal - but I don't have confidence that that will do much good. So here are my questions: 

- Is it possible an appeal could be fruitful?
- What are other avenues to getting my third class medical? I would of course like to avoid retesting due to expense, especially if it is unlikely to yield new results. Since I am stable as attested to by myself and my doctors, the only other variable I think I can control is the taking of Lexapro itself. Since I initially started taking Lexapro due to situational depression, would I have a better shot going off the medication? Up to this point it has been a not-broke-dont-fix-it type situation. Would I still have to go through testing if off medication, and proved to be stable?

Thanks for your time
3 Replies
Votes
AOPA Staff Answer
Hi Jeffrey - once a denial has been issued a pilot does have the right to ask the FAA for reconsideration of that denial. In response, the FAA will provide a list of items and/or testing that the pilot will need to provide before they will reconsider their denial. Once the pilot has received the FAA response letter, the pilot can then decide to either follow through with the request or accept the denial. A denial unfortunately does not disappear after a period of time. At any time in the future if you should want to try and pursue a medical certificate, you will still have to provide documentation that this denial should be overturned.

If the decision for a denial was due to low memory scores you can certainly work on improving these scores and ask to be re-evaluated. Your physician may be able to offer some guidance on how this can be done. The FAA will likely require a new HIMS AME evaluation performed, regardless if you are still taking a medication or not. They will need to establish what you current health status is before they will make a determination on whether to grant a medical certificate. Unfortunately there is no way to know for sure what the FAA will decide. 

 
Votes
Jeffrey Bornemann:
- Is it possible an appeal could be fruitful?

Anything's possible, but the likelihood is something only an expert like Dr. Bruce Chien can tell you. He usually checks in here late in the evening after work.
Jeffrey Bornemann:
- What are other avenues to getting my third class medical?

Besides appeal or reapplication (including new testing) after ceasing Lexapro as discussed by Vampiress, there aren't any.
Votes
Careful everyone. Realize that low scores can be due to Incompletely Resolved depression, Unresolved anxiety, or to Lexapro, Or inherent processing. And one cannot successfully appeal against a “Standard”.

To make the medication decision as an informed decision, you need a Board Certified Psychiatrist, not a PCP and "how'm I feeling"..

Also be aware of the fact that if you come off of Lexapro and relapse, then decision path 1 (Discontinuation with Dr.'s assent + 90 (not 60) days) is no longer ever available as you would the have “ recurrent disease unmonitored and untreated” which is always denied.