Adjustment Disorder

[future pilot]

Hello,

I’m in the process of renewing my 1st class medical so I can continue my flight training. Recently, while paying a medical bill I was scrolling through and few things and noticed a line that says “Adjustment Disorder with Anxious Mood”. This is something that had been completely unknown to me.

For a little background, a few years ago I started having strange digestive symptoms. I started looking a few things up and came across a few scary possibilities. At my next doctors appointment, my doctor told me he thinks some of my symptoms may be being caused by some anxiety and worrying. Hence, the Adjustment disorder with anxious mood. I have never seen a mental health professional, nor have I been medicated or treated in any way.

I have passed two 1st class medicals since this was put on my record however I never checked the previous mental health issue box because I genuinely did not think I had any. Is this adjustment disorder with anxious mood considered a mental health issue diagnosis? If so, how should I proceed? Is the FAA understanding of honest mistakes such as this?

Thank you,

 

[DE727UPS]

I would ask your AME about this.

This is not the question you are asking but I'd never check any of the "bad" boxes without talking with your AME about it first. I think you will probably be fine since they haven't questioned you up to this point. You're probably better off not worrying about unless you hear from the FAA. But see what your AME says.

This is one good reason that if you have a good AME that you like and have a relationship with, stick with them forever. Even if you have to commute half was across the country once or twice a year.

 

[FlightSurgeon]

I don't think it will be a serious problem for you. It sounds like the physician used an ICD code when billing for insurance purposes. I would have a talk with the doctor in question, remind them that putting such a diagnosis on paper could be potentially damaging, and possibly obtain their treatment note to look into it further. I agree with the above, rather than checking the box consider having a conversation with your AME who can record it in their notes on the application.

Best Regards,

Aaron Florkowski, MD
FAA designated AME
www.kansascityame.com

 

[future pilot]

I would ask your AME about this.

This is not the question you are asking but I'd never check any of the "bad" boxes without talking with your AME about it first. I think you will probably be fine since they haven't questioned you up to this point. You're probably better off not worrying about unless you hear from the FAA. But see what your AME says.

This is one good reason that if you have a good AME that you like and have a relationship with, stick with them forever. Even if you have to commute half was across the country once or twice a year.

I don't think it will be a serious problem for you. It sounds like the physician used an ICD code when billing for insurance purposes. I would have a talk with the doctor in question, remind them that putting such a diagnosis on paper could be potentially damaging, and possibly obtain their treatment note to look into it further. I agree with the above, rather than checking the box consider having a conversation with your AME who can record it in their notes on the application.

Best Regards,

Aaron Florkowski, MD
FAA designated AME
www.kansascityame.com

Thank you both for your input! Just to confirm, should i bring this up at my next physical? Or should i reach out prior to that to discuss?

 

[FlightSurgeon]

I would talk to your treating physician first to get some clarity on the situation. Explain to them that you are required to undergo regular FAA physicals and that the FAA requires you to self-declare psychiatric issues. The reason for obtaining your previous treatment note is to see what your physician's assessment of your condition is, more than just a billing code. If your physician feels that there is no problem asking them to put a note to that effect in the chart could be helpful. You don't need to mention it until your medical comes up if it is not a condition that affects your fitness to fly.

 

[Richman]

I think this serves as a good example. If you have a PCP, you really need to have a frank exchange of views to ensure random tidbits don’t wind up in your record. There should be a clear diagnosis with no “supposals”.

There are a stark minority of PCPs who understand how the FAA works and the rather stringent reporting requirements we live under. The chance decreases significantly if it’s a “group” setting where you may see one doctor or another.

Diagnosis codes are the bane. Watch them closely.

I’ve found that specialists tend to be a little bit better in this regard, but you need to have the conversation with them as well.

The most common response after discussing the reporting requirements and the Rx restrictions is “you’re kidding, right?”

 

[future pilot]

So i finally got an answer to all of this last month when i applied to renew my 1st class medical. My doctor DID diagnose me with an adjustment disorder due to my worry over health symptoms i was having at the time (I disagree but that doesn't matter now). My AME deferred my application at the beginning of June and i finally received a letter of support from my PCP to send off to the FAA. Once that is sent off, any idea on the time frame i am looking at? I am sure with COVID that has slowed things down even more. This whole process has been frustrating since i had to wait 3 weeks for my PCP to write up the letter of support and i am just itching to get my training going. Am i looking at a few more weeks or few more months?

 

[juxtapilot]

So i finally got an answer to all of this last month when i applied to renew my 1st class medical. My doctor DID diagnose me with an adjustment disorder due to my worry over health symptoms i was having at the time (I disagree but that doesn't matter now). My AME deferred my application at the beginning of June and i finally received a letter of support from my PCP to send off to the FAA. Once that is sent off, any idea on the time frame i am looking at? I am sure with COVID that has slowed things down even more. This whole process has been frustrating since i had to wait 3 weeks for my PCP to write up the letter of support and i am just itching to get my training going. Am i looking at a few more weeks or few more months?

Did your AME say if your file had to go to Washington?

Deferred for an Adjustment Disorder... Good grief... the FAA needs to get their crap together and realize that making such a big deal out of a little mental health issue discourages people from getting treatment for them...

 

[future pilot]

Did your AME say if your file had to go to Washington?

Deferred for an Adjustment Disorder... Good grief... the FAA needs to get their crap together and realize that making such a big deal out of a little mental health issue discourages people from getting treatment for them...

Yea unfortunately he said it needed to be deferred because the diagnosis was “adjustment disorder with anxious mood” specifically because of the anxious part. He said it shouldn’t be a big deal and that I should get my medical, it just sucks that I’m going to have to sit around for a while while it is reviewed.

 

[juxtapilot]

Yea unfortunately he said it needed to be deferred because the diagnosis was “adjustment disorder with anxious mood” specifically because of the anxious part. He said it shouldn’t be a big deal and that I should get my medical, it just sucks that I’m going to have to sit around for a while while it is reviewed.

Most people probably go through that at some point in their lives... the good news is that it’s probably not a big deal to them (since at no point were you on an antidepressant) but the bad news is that you’ll probably have to wait 4 to 6 weeks to hear from them, possibly longer due to COVID.... I’d expect maybe a month or two unless OKC defers to DC in which case they’re running about 8 months. I highly doubt that will happen though.

You can call the FAA for updates at 405-954-4821. They won’t tell you of a decision but they should be able to let you know where it’s at in the process. If you haven’t heard anything by August it might be worth a call.

Please keep us updated!

 

[future pilot]

Most people probably go through that at some point in their lives... the good news is that it’s probably not a big deal to them (since at no point were you on an antidepressant) but the bad news is that you’ll probably have to wait 4 to 6 weeks to hear from them, possibly longer due to COVID.... I’d expect maybe a month or two unless OKC defers to DC in which case they’re running about 8 months. I highly doubt that will happen though.

You can call the FAA for updates at 405-954-4821. They won’t tell you of a decision but they should be able to let you know where it’s at in the process. If you haven’t heard anything by August it might be worth a call.

Please keep us updated!

Thanks for the number! From what i hear, calling every other day can get your file added to "Interested Airman" status, which can cut down on the wait time. Have you ever heard of this? With it only being a month, i'm going to sit-tight for a little bit and let them do their job. But may start calling if i haven't heard anything toward the middle to end of the month.

 

[juxtapilot]

Thanks for the number! From what i hear, calling every other day can get your file added to "Interested Airman" status, which can cut down on the wait time. Have you ever heard of this? With it only being a month, i'm going to sit-tight for a little bit and let them do their job. But may start calling if i haven't heard anything toward the middle to end of the month.

I don't think calling will help or hurt. It just is a way for you to get an update on the status. Nobody knows how or what the FAA does--not even the FAA....

 

[future pilot]

Welp, i got the letter from the FAA describing what is needed on my part. One has already been provided and i am working on the other two. One of these is a personal statement, would you all recommend i meet with my AME after writing the statement to be sure it is what they are looking for? I want to be sure we have our ducks in a row before submitting it.

 

[FlightSurgeon]

If your AME is willing to look at your letter and offer advice I certainly would review it before submitting.

 

[juxtapilot]

Welp, i got the letter from the FAA describing what is needed on my part. One has already been provided and i am working on the other two. One of these is a personal statement, would you all recommend i meet with my AME after writing the statement to be sure it is what they are looking for? I want to be sure we have our ducks in a row before submitting it.

My gawd the faa must be bored. Shoot me a PM with your email address. Let’s chat.

I’m sure this will all work out. It’s also a good sign they got back to you so quickly.

 

[Boris Badenov]

Dear God. As if pilots needed any more encouragement not to report anything up to and including a stubbed toe, lest they lose their entire livelihood. "No sir, Doc, feel great, right as rain, I'm invincible!"

Hope it all pans out well for you.

 

[jynxyjoe]

Dear God. As if pilots needed any more encouragement not to report anything up to and including a stubbed toe, lest they lose their entire livelihood. "No sir, Doc, feel great, right as rain, I'm invincible!"

Hope it all pans out well for you.

Well, honestly, I've never felt better! I'm being honest.

Stories like the OP is why I never read the fine print or anything with the docs. "What I'm hearing is I'm good to go?- Great!"

 

[BEEF SUPREME]

No doubt. If it happened before you held a medical certificate and it no longer affects you in any way, why report it?

 

[future pilot]

No doubt. If it happened before you held a medical certificate and it no longer affects you in any way, why report it?

The way i understand it, the FAA wants to know if you currently are, or have ever been diagnosed with any kind of mental health condition of any kind (I fully disagree with the diagnosis and think what happened was a very normal response that many people would have, but that is neither here nor there at this point). I spoke with my AME before disclosing it and he confirmed that we would need to disclose and defer my application. it sucks but Id rather be honest and get it out of the way now than have the FAA come knocking on my door $30K into training.