Hello everyone,
I’m 25 years old and currently attending a university for Professional Pilot. My ultimate goal is to become an airline pilot, but I have some concerns about my medical history and whether obtaining a 1st class medical is still possible.
On September 2024, I was hospitalized for alcohol-induced pancreatitis. My hospital records document alcohol abuse/alcohol-related diagnoses.
I’ve been completely alcohol-free ever since, just over two years now.
I never attended a formal rehabilitation program, as I stopped drinking following my hospitalization. I also have no history of DUIs, arrests, or alcohol-related legal issues.
Here’s where I currently stand with the FAA medical process:
Earlier this year, I scheduled a consultation with a Senior AME to discuss my history before formally applying for my first-class medical.
After discussing my hospitalization and medical history, he gave me a list of documents and steps to complete, including:
A complete 10-year driving record.
A personal statement explaining my alcohol history, hospitalization, sobriety, and lifestyle changes.
Hospital records, including my discharge summaries, admission records, and official diagnoses.
A substance-abuse evaluation from a qualified medical professional.
I’ve gathered essentially all of the requested documentation, with the substance-abuse evaluation being the remaining step.
My main concern is whether I’m approaching this process correctly.
The Senior AME I consulted told me he would work with me through the process. He also mentioned that an FAA deferral could take approximately a year.
However, he isn’t a HIMS AME. When I previously asked him about needing a HIMS evaluation, he indicated that I could obtain a substance-abuse evaluation through a regular physician rather than going directly through HIMS.
After doing more research, I’m beginning to wonder whether I should consult a HIMS AME before moving forward.
A few questions for anyone who has been through something similar:
With my history of alcohol abuse and alcohol-induced pancreatitis, is obtaining a first-class medical realistically possible?
Would you recommend continuing with my current Senior AME, who is already familiar with my case and willing to help, or seeking a HIMS AME instead?
Is an evaluation from a regular physician generally sufficient for this type of history, or is the FAA likely to require a more specialized evaluation?
For those who’ve gone through a deferral, how did it go for you time-wise?
I understand that this process may take time, money, testing, and monitoring. I’m willing to do whatever is legitimately required to demonstrate my fitness to fly.
I haven’t submitted my first-class medical application yet because I want to make sure I’m taking the right steps before potentially getting deferred.
Aviation is genuinely what I want to do with my life, and I’d hate to give up on that dream without knowing whether there’s a way forward.
Thank you all!

Hey all,

I recently posted in here both before & after my neuropsych appt back in August, and I mentioned I had my psychiatric evaluation in January. Well, just this past week the office called and asked if I'd like to move it up to early November. Of course, other than the added financial strain for the next couple paychecks, this was ideal so I jumped on it.

Now that this is coming up much quicker than initially expected, I'm curious about what really comes next usually. The main diagnoses for me are substance abuse and MDD with past SSRI use (been off a good 5 years and sober 4), but one hospitalization for each issue in the past. Hospitalization for substance use was 5 years ago and the MDD one was well over 10 years ago. In my denial letter, the only two things requested of me were the psych/neuropsych, and I believe I understand the process up to this point. I understand it'll go to DC if the decision is to be overturned for SI as well.

My question is basically what comes next granted the psych eval goes well? The neuro report was favorable & recommended continuation with HIMS monitoring, but did not deem retesting necessary or anything of the sort. I just don't really know how it goes from here on out. Additionally, I'm confused about the typical process with recovery meetings & drug testing. I know the drug testing is pretty much a given, but I've heard conflicting accounts about meetings. Some say that meetings are usually only required if you're actively in a career or have legal complications (which I have none), though some say meetings are always a given. Curious if anyone can weigh in on this with their experience.

Anyways, any input from you great people would be obliged!

Hey all,

I recently started the FAA HIMS process following a DUI in 2020 with a BAC over .15. I completed everything required by the court, haven't had any further incidents, and have since given up alcohol and other substances entirely.

I'm working with a HIMS AME who seems cautiously optimistic about my chances of eventually getting a medical. I understand this is going to be a long and expensive process, but I'm committed to seeing it through.

My goal is purely recreational flying. I'd like to get my PPL and eventually an instrument rating. I started this process in early September, so I know there's still a long road ahead. I haven't submitted anything through my AME to the FAA yet, and I'm currently waiting on records from the FAA.

I have two questions:

1. HIMS process for a single DUI

Has anyone gone through HIMS for a single DUI with a BAC over .15? What was your experience, and did you eventually get your medical?

2. Childhood migraines

I used to get migraines in middle school, roughly 25 years ago. I vaguely remember my pediatrician recommending something with B12, possibly OTC, but I can't recall exactly what it was. I haven't had a migraine since, and I'm no longer in contact with that doctor.

Has anyone reported childhood migraines from decades ago? Did the FAA require additional documentation, and did it complicate your medical certification?

I know everyone's situation is different, and ultimately my AME and the FAA will make the determination. Just hoping to hear some firsthand experiences.

Thanks!

Thoughts if I would need more evidence

I just met with my HIM AME and my Doctor said I have a very good chance if getting my class 1 medical certificate. When I go out of the Army, I filled out my disability benefits questionnaire (DBQ). We were told put our worst injuries or moments, even if better now. Without going into to much personal information, I told my VA Theropist about when I first joined, how I lost my grandmother. She was my maternal figure since I didnt have a mother growing up. I had a bad moment about barley over 3 months. I struggled since had a controlling parent I was trying to leave, new to adult life. I was alone since my unit was deployed and I got to my duty station late October during holiday season, and couldn't drive since I wasn't allowed to learn growing up. Because I was new to the unit I was denied ordinary leave during holiday , and because my grandmother was not my immediate family , I was denied emergency leave. I was stuck and in a bad place mentally. Eventually everything did get better.

Anyway, I told the VA therapist about my situation, and I was automatically referred to a VA psychologist. Eventually after I told her about that moment, even though it was a singular incident, I was still diagnosed with major depressive disorder. And yes before comments say something, I did try and currently trying to remove that rating because I did not think it was a fair diagnosis and dont want to fight this later on if I become a pilot. Because I was diagnosed with major depressive disorder it's been a uphill battle trying to get a cleared Medical because the VA takes forever with paperwork. Eventually I did go to a VA psychiatrist, that went over all my records and agreed it was situational bereavement depression and not major depressive disorder. My HIMS AME also agreed and said with my psychiatric consult notes, I will be good to get my medical certificate. The only issue I have is is there anything else other than the airman's personal statement with my psychiatric notes confirming I do not have major depressive disorder? I already got a deferred and denied letter because I couldn't get my evidence soon enough. Now I'm trying to dot my Ts and cross my Is to make sure I have all my records straight to submit. Do you all have any recommendations? Thank you

I heard there was a neurocog subreddit where whoever runs it just posts about what kinds of things to expect. I know it’s like memory and special orientation and i think a personality test but i guess i wonder what that entails how can i prepare other than just getting a good nights sleep? anyone have this info or can just shed light on what they really have you do?

I am looking for recommendations for a HIMS Neuropsychologist and a HIMS Psychiatrist located in the SoCal and/or Vegas area. I have a history of ADD that exceeds 4 years, but I will be unable to use the fast-track option since I have also have taken anti-depressants years ago(I think I am reading the rules into all this correctly, please correct me if I'm wrong).
Any experiences with doctors in these areas would be super helpful, especially if there are ones to avoid. Based on some light researching it sounds like getting a bad one could either mean a flat out negative recommendation or extended time to sraw out more cost? Anything would be a giant help for me, this whole process seems so daunting.

OK Pilots!

I have been followed by a local mental health clinic for nearly four years (I live outside of Baltimore). My medication management comes from a psychiatric nurse practitioner. The medical director is a physician but not a board certified psychiatrist.

How insistent will the FAA be on the board certified psychiatrist requirement prior to scheduling a HIMS evaluation?

Hi everyone. My neuropsychological report came back pretty good, although the neuropsych recommended I do monthly psychotherapy to continue to monitor my disposition given recency of recovery. To best improve my chances, I plan to start psychotherapy, and wanted to ask if anyone here knows any HIMS informed therapists? I live in the San Antonio area, but am very open to telehealth.

Has anyone been in a similar boat? Do you see a therapist per FAA guidelines?

If I submit a pack with my FAA HIMS, I know that most of the medical history comes from me; as in I request it from my doctors, I give it to the HIMS, and we send it off as a packet. Does the FAA themselves ever reach out to the doctors directly to ask for medical history papers, or is that mostly all from me?

Please let me know from experience or anything.

I’m currently going through the FAA ATC hiring process and was recently medically disqualified. I’m trying to figure out how realistic it is to get the DQ overturned through reconsideration, and I’d really appreciate hearing from anyone who has gone through something similar.

Here’s my situation:

I’m 25 and applied for an FAA ATC off-the-street position. I passed the ATSA with a Best Qualified score and received a TOL. I made it through the security portion of the process, but I was ultimately medically disqualified.

The DQ letter says I don’t meet the medical standards because of:
-History of substance abuse involving THC/marijuana
-A marijuana possession citation from 6 years ago

Regarding marijuana specifically, I had an Illinois medical marijuana card in the past. My last actual marijuana use was in March 2024, and I have not used it since. My use was relatively infrequent. My medical marijuana card eventually expired in March 2025, and I have not had a card since.
I also had a marijuana-related citation in Illinois in 2020 that resulted in court supervision, which I completed. My understanding is that the FAA is treating this history as part of the substance-abuse issue. I have never had any other substance-related issues and have never been diagnosed with any substance dependence.

The reconsideration instructions I received say that I need to complete an FAA-approved substance abuse treatment program, aftercare/random follow-up testing, and demonstrate at least two years of abstinence from THC/marijuana and other mind/mood-altering substances. After that, the FAA says I would need evaluation by a HIMS aerospace psychiatrist and formal neurocognitive testing under the FAA substance-dependence protocol.
I’m currently trying to figure out exactly what that process will look like and whether successfully completing all of those requirements could realistically result in the DQ being overturned.

A few questions for anyone with FAA/HIMS experience:
Has anyone here been medically disqualified for a similar marijuana/substance-abuse history and successfully gotten the DQ overturned?
If so, what did your reconsideration process look like?
How strict is the FAA about the two-year abstinence requirement?
Does having a medical marijuana card and relatively infrequent use make a significant difference, or is the FAA primarily concerned with the overall history?
Has anyone gone through the HIMS psychiatrist + neuropsychological testing process for a substance-abuse DQ?
How difficult was the neurocognitive testing?
Were there specific things that caused problems during reconsideration?
For anyone who has actually been through this, how long did the process take from DQ to final FAA decision?

I’m not looking for someone to tell me what I want to hear. I’d honestly appreciate hearing both success stories and cases where people were unable to get their DQ overturned.
If anyone has experience with this specific type of FAA medical DQ, I’d really appreciate hearing what happened in your case and anything you wish you had known beforehand.

I’m 19 and pursuing an airline pilot career. For context, I had diagnoses of Major Depressive Disorder and Generalized Anxiety Disorder in 2022. At the time, I also disclosed to my doctor that I had experimented with marijuana and alcohol. I have remained abstinent since then and have not required SSRIs or ongoing psychiatric treatment.

I began working with a HIMS AME in September 2025 and completed the required evaluations/monitoring, including AA, aftercare, monthly therapy, and 14 alcohol/drug tests over 12 months. I received my First-Class Special Issuance in March 2026.

My current requirements are monthly psychotherapy, 14 drug/alcohol tests in 12 months, and HIMS AME visits every three months.

I just had my 6 month renewal with my HIMS AME, and we discussed the possibility of reducing my monitoring. We also discussed the FAA HIMS Step Down Plan, but I understand that the published Phase 2 to Phase 3 transition criteria primarily address substance-dependence cases, whereas my history was classified as abuse rather than dependence.

My HIMS AME indicated that he would address the possibility of reducing monitoring in his report, and my therapist’s recent report also states that a reduction in monitoring may be appropriate.

Has anyone with a similar abuse history had their HIMS monitoring reduced, particularly relatively early in their Special Issuance? If so, what did the process look like?

Also, if an AME recommends a reduction but the FAA doesn’t make a change, has anyone successfully pursued the issue further through an aviation medical attorney?

Hey y’all. I have been waiting for my medical for an entire year now. I was initially deferred because I have a recurrent diagnosis of Major Depressive Disorder and Generalized Anxiety Disorder that I got in 8th grade (I’m 22 now) and because of the “recurrent” part, I was officially denied in July. I have spent thousands of dollars to go see different doctors and mental health professionals to prove that I am healthy and my mental health is stable. I have not been on medication for over two and a half years and my mental health has been very stable. I have been in therapy since I came off medication and I have learned coping skills that have genuinely changed my life. I wholeheartedly believe my recurrent diagnosis was just growing pains. However, I had an appointment with my AME a week ago and he said I have two options. Option one: wait 3-5 years and start the process over. Option 2: go back on an approved medication and in 3 months, I can continue the process by going to see a neuropsychologist for cognitive testing. I will also have to have checkups with my AME every 3 months and checkups with my neuropsychiatrist every 6 months. I am frustrated because I don’t want to mess with the stability of my mental health by taking meds again, but it is ultimately the option I chose. I’m a week into my meds and so far, I haven’t noticed a difference. My AME says if everything goes well with the cognitive testing, he believes I can get my medical by June. Would you have picked the same option? Thanks for reading.

Looking to see if anyone have worked with Dr Cole Weatherby or Dr. Pat "Blue" Spruce?

It’s a pretty complicated situation and both are senior HIMS AMEs.

Just received an FAA letter requesting some items including a 10 panel and PEth test, both within the next 48 hours, to be sent using the enclosed envelopes. The only thing is no envelopes were enclosed. Weirdly, the letter stated it was via "Certified Mail" but arrived via regular mail. I haven't received any certified mail deliveries or notices and the post office confirmed there is nothing being held for me.

Until I can get in touch with my AME, should I call the FAA for details?

Just got my neuropsych report back for a Second-Class app (Standard Track ADHD + Substance Abuse eval). Substance use, depression, and past suicidal ideation history all came back clean full remission, no concerns.

Also passed the aviation-specific CogScreen with no red flags.

But general testing flagged low working memory (5th percentile) and some "judgment/impulsivity" concerns based on one example from my personal life.

Evaluator didn't recommend for or against just says these findings are "relevant for FAA decision making" and floated a possible 12-month reassessment if the FAA thinks it's warranted.

Anyone dealt with something similar? What actually happened next approved with a letter, asked for more info, deferred etc?

Hello,
I'm working on my packet to send to FAA with my HIMS and i accidently discover something.

I use Kaiser so I use the patient portal to talk to my doctor. Basically in my history it only MEDICALLY like IN MY HISTORY I was only provided with 75 mg of zoloft but at one point doctor told me to take 75 mg with another half of the 75 so i'm taking like 100 mg.

Never written in my medical history except the 75, so in the patient portal while we were talking i very professional stated that in the statement she writes we can just write the 75 MG provided even though at one point I took two pills.

So, I was stupid and I didn't know it ended up in my medical history as patient doctor email conversation.

But FAA only asks for all mental health or psychiatric information right? I don't have to hand this right?

Also before anyone get mad at me I was told by many people only give FAA information they need if not in my medical history don't give which is why I wrote 75MG. I don't have to submit my messages in my medical history with doctor right...?

EDIT; Only took for six months a year ago, all pharmacy, all records say I only took 75 Mg. Doctor orally told me on call if it doesn't work take two or a half, never mentioned in my medical history, except the email i sent her saying let's just put 75 because that's just medically record what i took. But my question is, I don't have to submit messages with my doctor to FAA even if it's in my record right? Just the stuff they need like mental health history?

Long story short I was diagnosed with ADHD as a child and tried a few medications in high school, but eventually stopped taking them. Years later, while in college, I went back to a doctor because I was struggling with ADHD. I told him about my history and also mentioned that I occasionally used marijuana and alcohol. I was 21 and living in California at the time, so both were legal but at the time i had no idea how bad of an idea it was to share this information with a medical professional. I was prescribed Adderall and an anxiety/depression medication. Because in California if you are prescribed a medication like Adderall you can only be prescribed your first dose from a regular doctor and then all following doses need to be prescribed by a psychiatrist. So I later saw a psychiatrist, switched to Wellbutrin, and eventually stopped taking the Adderall. I’ve been on Wellbutrin for about four years and it has worked extremely well for me.

Im a BMW technician at a dealership and have always been interested in aviation and have considered going to school again and switching careers to aviation maintenance, as well as getting my pilot’s license. I looked through my medical records and found some things that really concerned me.
The original doctor documented “substance abuse in remission” under my diagnoses, despite me never having a substance abuse diagnosis or believing I ever had a substance abuse problem. The notes for that visit also say I took Xanax in high school, which is completely false. I have never taken Xanax in my life. It also lists severe depression with one episode, even though I only reported some mild/intermittent anxiety and never considered myself severely depressed.

I have an appointment with the doctor to discuss these records and hopefully get the inaccuracies corrected.
My main question is how would something like this affect getting an FAA medical, and does having the original doctor correct the inaccurate diagnoses/documentation make a difference? I feel like i would still have to answer yes to the question that asks about if i have ever been diagnosed with a substance abuse issue.

Should I talk to an AME before doing anything else? One of my concerns is i can’t be entirely truthful with the AME and my one off situation or else it’ll bite me in the ass..

I guess my only other option is to get my sports license and avoid the situation all together but idk.

Made a post about this a few months ago and wanted to check in to see if anyone has any updated information. Submitted all paperwork for initial SSRI approval on August 24. Was told by the FAA phone number today that my file is now in DC and that I should be expecting a letter from the FAA that was sent out two days ago saying they are in receipt of my psych package. Is this meaning I’m close? Have the timelines been getting faster still?

I recently switched HIMS AME's and will have my first visit with him in October which is the 6 month renewal of my 1 year class 2 medical. Historically, I would go to my AME at the 6 month midpoint and he would print out the new medical and MedExpress was only an annual event. Do you think I need to do MedExpress for the 6 months visit or will the AME's names have been switched automatically?

It doesn't seem like the new AME's office knows what to expect and I don't want to be unprepared but I also don't want to generate a new MedExpress number unnecessarily.

Thank you for your time.

I'm hoping somebody here has dealt with something similar, preferably an AME, HIMS AME, or pilot who has actually been through the process.

I had a DWI arrest in January 2003. I was 19, legitimately drunk, and wrecked my Jeep. The charge was ultimately reduced to obstructing a highway, but I'm not trying to hide behind that reduction. I was drunk and made a very bad decision.

A year or two later, I was working on my PPL and made another mistake with the FAA. On my medical application, I answered the alcohol question incorrectly because I focused on the fact that I had not been convicted of DWI and failed to understand that the arrest itself needed to be disclosed. The FAA caught it; I received notice from Oklahoma City, and they denied my medical before I ever got to solo. I was grounded until further notice.

After that huge hit to what I thought my future looked like, alcohol continued to be a problem for me for years. In December 2016, I voluntarily entered residential treatment and quit drinking. I have not had an issue with alcohol since, and I continue to abstain. Life is very different now. I'm 42, married, established in my career, and have no interest in minimizing what happened when I was younger.

The flying bug never went away, though, and I'm starting to wonder whether finishing my PPL might actually be possible. I have no aspirations toward flying commercially, and my understanding is that the previous medical denial takes the driver's-license Sport Pilot route off the table unless I eventually resolve the medical. Please correct me if I'm wrong about that.

I'm in the Fort Worth area and would especially love to hear from someone local who knows the FAA medical system. My instinct is that I should start with a consultation with a HIMS AME before submitting another MedXPress application, get a copy of my old FAA medical file, and figure out exactly what documentation they'll want regarding the arrest, treatment, and sobriety.

I'm not looking for a shortcut or trying to conceal anything. I'm perfectly willing to do the work. I just don't want to walk blindly into the FAA medical process and make another procedural mistake because I don't know what I'm doing.

Has anyone here gone through something comparable after a long period of documented sobriety? And if you're in DFW, is there a particular AME or HIMS AME you would trust for the initial consultation?

FWIW, I grew up flying GA with my family (C172/C310/Piper Lance), and it was a big part of who I thought I would become in those younger moments. I'm not delusional. I know this will be uphill, but the bug is back in a way I can't put it back in the closet.

Finished up my neurocog last weekend, went well. Once that report is in my HIMS psychiatrist can finish her own report, then my HIMS AME and I will probably submit later next month. Originally tested neuropsych in May, HIMS neuropsych looked at day 1 testing and said to try again with 6 months of sobriety. Picked up a 6 month coin last week. My formal alcohol use disorder diagnosis landing me in the program was 2.5 years ago, sobriety date in March this year after HIMS AME took a look at my history and said I’d be categorized as alcohol dependence. Started BOAF meetings in March, went to in-person AA in May, got a sponsor and started running 90/90 then. Finished that in August, still go to 3-4 meetings/week mostly split between birds and AA. Very, very glad I did that. My history with alcohol is pretty harrowing, culminated in an inpatient psych stay (where I was diagnosed). I spent a long time afterwards with a lot of anger and denial about my situation. Very grateful for the acceptance and understanding I’ve found within the recovery community, should have walked into an AA meeting a lot sooner. Have been on monitoring since March, 7 negative tests. Decided to self-enroll in a weekly aviation aftercare program in June which I’ve attended diligently.

In addition to the alcohol, also had providers/a past psych evaluation suggest ADHD and an unspecified personality disorder. Thankfully, based on neurocog and my history the consensus among my HIMS providers seems to be that the behaviors causing that were almost certainly due to my drinking, its impact on my brain chemistry, and my lack of acceptance of circumstance at the time. The FAA could always decide differently and put up more hoops—if so, that’s okay. I’ve learned to really appreciate “one day at a time” over the last few months. Most importantly, my AME is very optimistic about my prospects for a first class SI.

The one thing I’ve not done is attend rehab or IOP. Given my history, it would be hard to blame OKC for raising an eyebrow. Insurance would likely not cover it and I work full time, so if I get asked to do it then I would need to plan appropriately. Ultimately have to wait to see what the FAA says and deal with it then but was curious to know what the buzz around the water is around that requirement for people with 6+ months of sobriety. I know other pilots in similar situations have been told to go back and do at least an IOP, although some of those were a few years ago before the FAA started reforms in its aeromedical division.

Very nervous. Shittin' pants. Not looking forward to it.

I'm trying to do my best to get good sleep but it's keeping me up at night.

So, I went into this with eyes wide open. I did my homework, collected all available clinical documentation for the past 8 years (The extent of my engagement with mental health services). ADHD/Depression/ASD. I proactively sought out A) A HIMS AME to coordinate this process, B) Both a neurocog eval and a psych interview (passed easily). All required random personal records.

...I still got a "more information required" letter requesting more clinical information. What exactly am I supposed to provide? It says they need" All treatment records". Guys that's literally what I sent you.

I’ve done everything the FAA has asked of me for a year now. Neuropsychologist and Psychiatrist. (For GAD/ADHD)

Usually the FAA sends me a letter in a timely manner after I submit materials but I most recently submitted my Psychiatrist interview to the FAA. That happened on Aug.1st and I know it hasn’t been super long but I’ve really been wanting to make sure I can get a 1st class before I start putting money into flight training.

I call the FAA every week and they just tell me it’s in review with no ability to give me a timeline. I’ve seen people had some success or at least some communication after involving state senators. I’m just curious when’s an appropriate time to contact them.

Thanks!

I was medically DQ from the ATC OTS bid, but I'm going to appeal it and I have a few questions, mostly about the cost.

1. Do any HIMS Psych allow payment plans or is it all lump sum?

2. Can I shop around for a cheaper price or are they fixed price points across the board?

As a side note, what exactly are these exams? I was medically DQ for 5G/Mental/Maladaptive personality traits. So no definitive diagnosis. I don't want to throw away a few thousand dollars on a maybe