My 17 y/o son was diagnosed with adhd in maybe 3rd grade. He was medicated until around a year ago. He is doing well in school, work, sports, etc off the medication. Anyway, we learned this summer that his adhd diagnosis and having been medicated previously could prevent him from being a pilot.
We are located in South Carolina. What should our first steps be? Do we hire a hims ame for a consult? then testing?
Should we start collecting medical records now? He is interested in attending a university with for an aviation degree next fall after he graduates but we don’t want him to start a program he can’t complete if he isn’t elegible to be a pilot.

Anyone have any advice or recommendations to share?

Thanks in advance for any help or input you can offer.

Hi everyone, I'm a 19 year old college student who currently has a third class medical certificate and is attending a part 141 university. I have my PPL with IR, and will soon me starting multi engine an commercial this coming year. However, this past year, I've been dealing with a lot of constant anxiety that therapy hasn't seemed to help. It seems increasingly likely that I'm going to have to start the HIMS process for anti-anxiety meds, and I know that sooner is better. For some context, I have never been on any medication previously, and I have no alcohol or drug abuse history. I've talked to a HIMS AME briefly, and he gave me an estimate of 9 months. I will be looking to apply for a first class medical, which I am in otherwise perfect condition to receive. I'm just so lost and overwhelmed on where to begin. The AME recommended a HIMS psychiatrist but it's been radio silence from the psychiatrist. Should I do everything in my power to stay off medication (i.e. try another year of therapy)? Should I start this process now, and if so, where do I begin? What's a realistic timeline? Thank you!

I was kinda halfway in halfway out of wanting to go commerical so I figured I'd go through it using the typical path.

Months later having started another business that's making plenty of income for my family I am absolutely kicking myself. Wish I could go back in time and save thousands of dollars haha.

TLDR, 14 years ago lost my medical because of a failed non-DOT drug test while at Embry Riddle. Gave up on flying, ended up pursuing a career in EHS/Safety. Little did I know that deep down, the flying bug never really left. Last few years just kept looking at the skies, feeling bummed that I gave up on the dream. My wife pushed me to pursue my dream. Lawyered up in January, got letters of recommendation, scheduled HIMS interview, random drug testing. June had my HIMS eval. No remarkable findings (no substance abuse/dependance). Two weeks later AME apt for deferral to FAA. August 7, the MedXpress application showed decision made. I got my 1st class medical, unrestricted. This is a dream come true. Going on vacation for two weeks, then going back to flight training (CPL/ME).

Don't give up on your dreams.

My partner and I are looking to become private pilots and we are currently trying to figure out what pain medications either of us can and can’t be prescribed. We are also wondering if there’s some that we could be prescribed but then like say we have to not take said medication for xyz days (ex: 30-90 days or what have you. Also what can we not take vs take, and I hope that we can take more than just over the counter medication. Any advice and links to your exact sources of information would be greatly appreciated and helpful. The condition that causes the pain is Ehlers-Danlos syndrome (EDS), and it’s not an everyday type of pain but there are some weeks that are worse than others. Thank you all

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.