Pursue HIMS or wait it out?
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Answered By AOPA
Hello. 

I am just re-starting my private pilot venture after a 10-year hiatus and I’ve hit a snag. I am currently taking an FAA-approved SSRI and have been for almost 6 months. It’s low dosage (20 mg), my only history with SSRIs and I am stable on it.  

I also happen to be an Air Force air traffic controller (currently DNIC due to the medication). At the 6 month mark I will be able to get a waiver to continue controlling while on the medication, though I also intend to come off the meds at some point in the near future. I’d love to now, but my AF flight doctor prefers to leave his patients on the medication for at least a year before tapering them off. 

My question is: Should I pursue an SI through the HIMS process or just wait until I come off the meds (+90 days) and just go the normal route of seeing an AME and reporting that I have taken the medication in the past?  Which process is easier/faster?

I was really hoping to start flying in September, but given these circumstances, I’m doubting that will be the case. 


Any information would be helpful!! Thank you! 
18 Replies
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AOPA Staff Answer
Hi Kristen,

For an individual such as yourself, who wants to fly for pleasure, I agree with Ronald and Bruce, if you qualify for Basic Med, that would be a great route for you to pursue. Under Basic Med there are no HIMS evaluations or FAA pre-approvals. It would not only save you time but the cost of the evaluation as well. This would also allow you to continue to work with your physician and make the decision to either stay on the SSRI or come off it, based on your personal needs, not because of the FAA approval process. 

The process is easy, have a physical by a state licensed physician (it does not need to be an AME), complete the online assessment course and print a certificate of completion. The online assessment is renewed every two years and the physical exam every four years. Here is a link to the Basic Med website  https://www.aopa.org/advocacy/pilots/medical/basicmed

If you need any further assistance please contact us at 1-800-872-2672 #3
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The FAA isn't going to issue a medical certificate with a history of SSRI use without knowing why you were taking in the first place it even if you've stopped for more than 90 days.  What such issuance will require depends on that underlying diagnosis and your current situation vis a vis that condition.  You need to talk this over with an expert on FAA medical certification issues like Dr. Bruce Chien, who will probably be along later tonight.

You should also realize that if you previously held an FAA medical certificate which was valid on or after July 14, 2006, and that certificate was not suspended or revoked, and you haven't had a subsequent medical certificate application denied, then you have the option to go Basic Med as long as the condition which required the SSRI wasn't:

(i) A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;

(ii) A psychosis, defined as a case in which an individual—

(A) Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or

(B) May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;

(iii) A bipolar disorder; or

(iv) A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of this chapter.

This would allow you to do most Private Pilot flying without going through the medical certificate application/approval process.  For more on the Basic Med option, see:

https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/
https://www.aopa.org/advocacy/pilots/medical/basicmed
 
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Thanks for the reply Ronald. 

I was not aware that I could go the Basic Med route. I did previously hold a class-III in 2009-2010 when I flew, so that is helpful! 

 
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I would not apply.  The ON SSRI path is for disease that is expected to recur.  Once you are on it you have a hard time convincing anyone that you don't have recurrent disease.

Your USAF doc is correct. If he/she withdraws you off the SSRI too early, and it comes back then you by definition have recurrent disease and then can ONLY ever be certified ON SSRI.

Dr Bruce
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So would the Basic Med route be the way to go?  I’m only looking to get my PPL and fly for pleasure (maybe get a few endorsements like tailwheel..) So looking into that option, it does seem ideal. 
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Basic Med would do for what you plan.  See if the Flight Surgeon is willing to do that.  If they're not familiar with Basic Med, point them here;

https://www.aopa.org/-/media/files/aopa/home/advocacy/pilots/medical/basicmed-physicians-guide_final.pdf?la=en

Otherwise you may need to go outside the service.

https://www.aopa.org/advocacy/pilots/medical/doctor-finder
 
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Here's the paperwork.8700-2_BasicMed.pdf
Attached files
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Hello everyone,

This information helps me out as well.  Almost three years ago I applied for a class 3 medical, and had been sober for three years prior to that.  I am under a physician health program similar to the HIMS program as I am a doctor.  I just want to fly for pleasure and continue to learning and eventually get my CFI for fun.  I do not plan to fly as a career.  I was talking to my brother who is a professional pilot and because I recently started an FAA approved SSRI, he put me into contact with his HIMS AME and I am going to start the process for special issuance.  

If I understand correctly, I can renew my medical under BasicMed, and not have to pursue a special issuance for the SSRI?  I have been sober for 5 years and love my sobriety and all the gifts that being sober has brought to me.  I plan on renewing my contract with my HIMS equivalent physician program because its worked for 5 years why change.  But if I don't have to go through all the hoops of a special issuance that would be great.  If i do need to do that to continue to fly I will.  

Any help would be great.

Thank you,

Lee
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Couple of things up front...

I'm assuming that your application three years ago was approved and has not been suspended or revoked.  Next, if you started taking an SSRI since that application was approved,, per 61.53(a)(2), you are now grounded until you either get the SSRI SI or get a Basic Med approval.

That said...

Yes, you can go Basic Med.  And yes, you can get all the certificates and ratings needed to be a CFI and work as a CFI as long as you don't do anything requiring Commercial Privileges, like fly someone's airplane for them or do any 91.147 sightseeing rides (things many CFI's working for FBO's/flight schools often do).
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Yes, I currently only fly with an instructor while I am pursuing a SI.  The SSRI is for anxiety  and I was sober for 3 years prior to obtaining a class three medical certificate. At the time I did not think I needed to disclose to the FAA my history.  So, I felt I made a mistake and I now want to correct that mistake by getting a SI.  So, then, I can obtain a BasicMed and not have to go through the process of a SI?