ITEM 47. Psychiatric

(Updated 10/14/2021)

CHECK EACH ITEM IN APPROPRIATE COLUMN Normal Abnormal

I. Code of Federal Regulations

All Classes: 14 CFR 67.107(a)(b)(c), 67.207(a)(b)(c), and 67.307(a)(b)(c)

(ii) The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.

(ii) "Substance dependence" means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by-

(A) Increased tolerance

(B) Manifestation of withdrawal symptoms;

(C) Impaired control of use; or (D) Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.

(ii) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

(Also see Items 18.m.,18.n., and 18.p.)

II. Examination Techniques

The FAA does not expect the AME to perform a formal psychiatric examination. However, the AME should form a general impression of the emotional stability and mental state of the applicant. There is a need for discretion in the AME/applicant relationship consonant with the FAA's aviation safety mission and the concerns of all applicants regarding disclosure to a public agency of sensitive information that may not be pertinent to aviation safety. AMEs must be sensitive to this need while, at the same time, collect what is necessary for a certification decision. When a question arises, the Federal Air Surgeon encourages AMES first to check this Guide for Aviation Medical Examiners and other FAA informational documents. If the question remains unresolved, the AMEs should seek advice from a RFS or the Manager of the AMCD.

Review of the applicant's history as provided on the application form may alert the AME to gather further important factual information. Information about the applicant may be found in items related to age, pilot time, and class of certificate for which applied. Information about the present occupation and employer also may be helpful. If any psychotropic drugs are or have been used, follow-up questions are appropriate. Previous medical denials or aircraft accidents may be related to psychiatric problems.

Psychiatric information can be derived from the individual items in medical history (Item 18). Any affirmative answers to Item 18.m., “Mental disorders of any sort; depression, anxiety, etc.," or Item 18.p., "Suicide attempt," are significant. Any disclosure of current or previous drug or alcohol problems requires further clarification. A record of traffic violations may reflect certain personality problems or indicate an alcohol problem. Affirmative answers related to rejection by military service or a military medical discharge require elaboration. Reporting symptoms such as headaches or dizziness, or even heart or stomach trouble, may reflect a history of anxiety rather than a primary medical problem in these areas. Sometimes, the information applicants give about their previous diagnoses is incorrect, either because the applicant is unsure of the correct information or because the applicant chooses to minimize past difficulties. If there was a hospital admission for any emotionally related problem, it will be necessary to obtain the entire record.

Valuable information can be derived from the casual conversation that occurs during the physical examination. Some of this conversation will reveal information about the family, the job, and special interests. Even some personal troubles may be revealed at this time. The AME’s questions should not be stilted or follow a regular pattern; instead, they should be a natural extension of the AME's curiosity about the person being examined. Information about the motivation for medical certification and interest in flying may be revealing. A formal Mental Status Examination is unnecessary. For example, it is not necessary to ask about time, place, or person to discover whether the applicant is oriented. Information about the flow of associations, mood, and memory, is generally available from the usual interactions during the examination. Indication of cognitive problems may become apparent during the examination. Such problems with concentration, attention, or confusion during the examination or slower, vague responses should be noted and may be cause for deferral.

The AME should make observations about the following specific elements and should note on the form any gross or notable deviations from normal:

Significant observations during this part of the medical examination should be recorded in Item 60, of the application form. The AME, upon identifying any significant problems, should defer issuance of the medical certificate and report findings to the FAA. This could be accomplished by contacting a RFS or the Manager of the AMCD.

III. Aerospace Medical Disposition

Drug and alcohol conditions are found in Substances of Dependence/Abuse.

A. General Considerations. It must be pointed out that considerations for safety, which in the "mental" area are related to a compromise of judgment and emotional control or to diminished mental capacity with loss of behavioral control, are not the same as concerns for emotional health in everyday life. Some problems may have only a slight impact on an individual's overall capacities and the quality of life but may nevertheless have a great impact on safety. Conversely, many emotional problems that are of therapeutic and clinical concern have no impact on safety.

B. Denials. The FAA has concluded that certain psychiatric conditions are such that their presence or a past history of their presence is sufficient to suggest a significant potential threat to aviation safety. It is, therefore, incumbent upon the AME to be aware of any indications of these conditions currently or in the past, and to deny or defer issuance of the medical certificate to an applicant who has a history of these conditions. An applicant who has a current diagnosis or history of these conditions may request the FAA to grant an Authorization under the special issuance section of part 67 (14 CFR 67.401) and, based upon individual considerations, the FAA may grant such an issuance.

All applicants with any of the following conditions must be denied or deferred:

Attention deficit/hyperactivity, bipolar disorder, personality disorder, psychosis, substance abuse, substance dependence, suicide attempt.

In some instances, the following conditions may also warrant denial or deferral:

Adjustment disorder; bereavement; dysthymic; or minor depression; use of psychotropic medications for smoking cessation

NOTE: The use of a psychotropic drug is disqualifying for aeromedical certification purposes. This includes all sedatives, tranquilizers, antipsychotic drugs, antidepressant drugs (including SSRI’s - see exceptions below), analeptics, anxiolytics, and hallucinogens. The AME should defer issuance and forward the medical records to the AMCD.

C. Use of Antidepressant Medications. (Updated 05/31/2023) The FAA has determined that applicants requesting first, second, or third-class medical certificates while being treated with one of several specific antidepressant medications may be considered. The Authorization decision is made on a case-by-case basis. The AME may not issue.

If the applicant opts to discontinue use of the SSRI, the AME must notate in Block 60, Comments on History and Findings, on FAA Form 8500-8 and defer issuance. To reapply for regular issuance, the applicant must be off the SSRI for a minimum of 60 days with a favorable report from the treating physician indicating stable mood and no aeromedically significant side effects.

See SSRI Decision Path I

Therapy, Psychotherapy and Counseling Information: Pilots / ATCS

(Updated 5/27/2026) Mental Health Counseling: A Guide for Pilots and Air Traffic Control Specialists (ATCS) Maintaining mental health is crucial for ensuring both safety and operational performance. Counseling or therapy is encouraged when medically appropriate.

If you are undergoing or contemplating counseling, see the following resources:

Therapy, Psychotherapy, and Counseling FAQs for Pilots and ATCS

(Updated 05/27/2026)

Can pilots and ATCS seek therapy?

Yes. Many aviators benefit from therapy at different points in their careers. All are encouraged to seek help early before conditions get severe. Therapy may help with:

Where do I start?

Pilot Peer Support Programs, your AME, or your primary care provider may recommend someone. When seeking a therapist/counselor, make sure they are licensed with at least a Master’s degree. On your first visit, you should provide a copy of “Information for Psychotherapists Treating Pilots and ATCS” to the provider.

Does it matter if my therapist uses the word "psychotherapy," or "counseling"?

No. For FAA purposes, the terms therapy, psychotherapy, and counseling are equivalent.

Must I report to the FAA immediately?

Pilots: No. You are not obliged to report until your next application for medical certificate. ATCS: Air Traffic controllers must abide by FAA Order 3930.3C 9.e.1-5 and should consult with the appropriate flight surgeon prior to performing any safety-related duties.

Must I ground myself immediately?

It depends. Pilots must abide by 14 CFR § 61.53, which states in part, “no person may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation.” If the severity of the symptoms is enough to impair concentration, memory, emotional stability, judgment, decision-making, alertness, etc., then yes. Otherwise, no.

What are some examples of the need to immediately self-ground?

Some examples include:

Can pilots and ATCS continue therapy while maintaining FAA medical certification or clearance? Yes. Psychotherapy is compatible with both an unrestricted medical certificate and special issuance/special consideration. Many pilots and ATCS continue therapy or have the option of resuming therapy while on special issuance or special consideration.

Does speaking with a therapist automatically create a diagnosis?

No. The therapist should make an assessment, which may or may not be a diagnosis. Again, you should provide a copy of ‘Information for Psychotherapists Treating Pilots and ATCS’ to the provider to assist in this determination.

What if the therapist does make a diagnosis?

Depending on the diagnosis, the current severity of symptoms, and associated risk factors, the AME may issue the medical certificate without further FAA review or defer to the FAA. The FAA will then review the case and issue or consider special issuance or special consideration.

Can I use medication as well as therapy?

Yes. For many conditions, medication with therapy is more effective than either alone. Aviators taking medication will have additional requirements. See “Use of Antidepressant Medications.”

What must be reported to the FAA regarding therapy or counseling?

All visits to licensed healthcare providers, including psychotherapists and counselors, must be reported on the MedXPress application. Educational counseling and religious counseling, unless the clergy member is also a licensed counselor, need not be reported. Couples counseling need not be reported unless the aviator has been referred for individual therapy. Consultations with EAP may be excluded UNLESS the consultation resulted in a referral for psychiatric evaluation or treatment.

Will the FAA see my therapy records?

Usually not. If documentation is requested, it is usually a brief summary from the therapist.

How does the FAA use information from therapy?

When therapy-related information is reviewed, the FAA focuses on diagnosis, insight, stability, current functioning, and risk factors.

The FAA also looks for insight and transparency from the aviator. These factors help establish that the aviator can responsibly manage their own safety. The aviator should be able to demonstrate the ability to:

Information for Psychotherapists Treating Pilots and ATCS

(Updated 6/24/2026) Your client is a pilot or air traffic control specialist (ATCS), both of which are public safety-sensitive positions. They are required to undergo periodic FAA medical evaluations and must meet prescribed medical standards. They are also required to disclose specific medical information related to diagnoses, treatment, and functional status. You may be asked to provide clinical progress notes, summaries, or other specific information not required for your usual clients.

Counseling and/or psychotherapy are encouraged when clinically appropriate. Here are some important considerations and recommendations for working with these clients:

Sample Treatment Summary or Quarterly Report for FAA Purposes:

“Therapy is twice monthly on average and is integrative in nature, informed by Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) to address mood and family of origin issues. Client remains engaged, appears stable, and insight is appropriate. Client continues to function adequately across occupational and social realms. Current diagnosis is Major Depressive Disorder (recurrent), in remission.”

Disclosure Statement for Ongoing Monitoring:

If ongoing monitoring is formally requested, this disclosure statement must be added to each treatment summary:

“I will notify the FAA Aeromedical Certification Division (405-954-4821) or the Aviation Medical Examiner (AME) if there is a significant clinical deterioration in my client's cognition, judgment, emotional stability, or insight.”

Therapists who are not willing or able to meet these requirements should carefully consider whether to accept a client who must adhere to FAA criteria.

• Licensed mental health providers with questions should contact
• 9-AVS-Psychiatry-Branch@FAA.gov

USE OF ANTIDEPRESSANT MEDICATIONS

(Updated 12/03/2025) Antidepressants Protocol Expansion - Effective April 24, 2024:

Additional medications have been added as allowed for special issuance consideration, representing an additional class of antidepressant medications beyond SSRIs. This change, along with the addition of Wellbutrin (a Dopamine/Norepinephrine-Reuptake Inhibitor) on 05/31/2023, has resulted in the FAA’s SSRI Protocol being renamed the Antidepressant Protocol.

PLEASE NOTE: All references to SSRIs, SSRI Protocol, or SSRI program in existing checklists, worksheets, charts, or protocol pages in the AME Guide are considered encompassed in the Antidepressant Protocol and include all conditionally approved medications.

If you are an AIRMAN taking an SSRI – see Airman Information - SSRI INITIAL Certification

If you are an ATCS taking an SSRI – see FAA ATCS How to Guide

The FAA has determined that pilots or FAA Air Traffic Control Specialists (FAA ATCS) requesting medical certificates while being treated with one of several specific antidepressant medications may be considered. The Authorization decision is made on a case-by-case basis. The AME may not issue.

If the airman/FAA ATCS opts to discontinue use of the medication, the AME must notate in Block 60, Comments on History and Findings, on FAA Form 8500-8 and defer issuance. To reapply for regular issuance, the applicant must be off the SSRI for a minimum of 60 days with a favorable report from the treating physician indicating stable mood and no aeromedically significant side effects. See SSRI Decision Path I

An individual may be considered for an FAA Authorization of a Special Issuance (SI) or Special Consideration (SC) of a Medical Certificate (Authorization) if:

1.) The applicant has one of the following diagnoses:

2.) For a minimum of 3 continuous months prior, the applicant has been clinically stable as well as on a stable dose of medication without any aeromedically significant side effects and/or an increase in symptoms. If the applicant has been on the medication under 3 months, the AME must advise that 3 months of continuous use is required before SI/SC consideration.

3.) The medication used is one of the conditionally acceptable Antidepressant Medications. (single use only; not combined).

If the applicant is on a medication that is not listed in Antidepressant Medications, the Examiner must advise that the medication is not acceptable for SI/SC."

4.) The applicant DOES NOT have symptoms or history of:

If applicant meets all of the above criteria and wishes to continue use of the medication, advise the applicant that he/she must be further evaluated by a Human Intervention Motivation Study (HIMS) AME.

Off Medication for 60 Days:

SSRI Decision Path I

Initial Certification/Clearance:

Medications

Recertification/ Follow Up Clearance:

Medications (Updated 08/27/2025)

See:

List of current Antidepressant Medications Airman Information - SSRI INITIAL Certification FAA ATCS How to Guide – SSRI FAA Certification Aid - SSRI Initial Certification/Clearance

List of current Antidepressant Medications

AIRMAN INFORMATION - SSRI INITIAL CERTIFICATION

(Updated 08/26/2026) Note: SSRI term updated to “Antidepressant”

If you are an FAA ATCS: See the FAA ATCS HOW TO GUIDE – SSRI below and contact your RFS

If you are an AIRMAN:

***Remember to bring all documents to this evaluation, including information on any other condition you may have that requires a CACI or Special Issuance. ***

• AIRMAN - Initial Certification
• FAA, Civil Aerospace Medical Institute, Building 13
• Aerospace Medical Certification Division, Room 308 - AAM-300
• PO Box 25082
• Oklahoma City, OK 73125-9867

IMPORTANT NOTE: While your exam is under review, continue to submit your Air Traffic Manager (ATCS) reports EVERY 3 months AND your HIMS AME evaluations and treating psychiatrist reports EVERY 6 months. This will ensure the FAA has the most current information and will decrease wait time. If we do not have current information when we review your case, we will have to request it, which will slow down your certification review.

For RECERTIFICATION, see the HIMS AME Checklist – SSRI Recertification/ Follow up Clearance.

FAA ATCS HOW-TO GUIDE – SSRI

(Updated 12/03/2025) 1. Notify Regional Flight Surgeon (RFS) of your diagnosis and treatment with a Selective Serotonin Reuptake Inhibitor (SSRI).

For follow up Clearance, you must provide all items listed on the FAA Certification Aid – SSRI Recertification/ Follow Up Clearance.

HIMS AME Checklist - SSRI INITIAL Certification/Clearance

(Antidepressant)

(Updated 08/26/2026) Name: ____________________________________________ Airman MID or PI#: __________________________

Submit this checklist ALL supporting information for INITIAL SSRI consideration within 14 days of deferred exam to:

• AIRMAN
• FAA, Civil Aerospace Medical Institute, Building 13
• Aerospace Medical Certification Division, Room 308
• PO BOX 25082
• Oklahoma City, OK 73125-9867
• FAA ATCS
• Regional Flight Surgeon (RFS) office

All numbered (#) items below refer to the corresponding section of the FAA CERTIFICATION AID - SSRI INITIAL Certification/Clearance.

not include CACI qualified condition(s)……….................................................................................... o List conditions:

HIMS AME Signature___________________________ Date of Evaluation_______________ IF ANY ITEMS ARE MISSING OR ARE INCOMPLETE, CERTIFICATION WILL BE DELAYED.

IMPORTANT NOTE: While your exam is under review, continue to submit your Air Traffic Manager reports (ATCS) EVERY 3 months AND your HIMS AME evaluations and treating psychiatrist reports EVERY 6 months. This will ensure the FAA has the most current information and will decrease wait time. If we do not have current information when we review your case, we will have to request it, which will slow down your certification review.

• Yes No
• Yes No
• N/A Yes No
• Yes No
• Yes No
• N/A Yes No

FAA CERTIFICATION AID – SSRI INITIAL Certification (Page 1 of 5)

(Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification/clearance requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider, there may be a delay in the processing of your medical certification or clearance until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

FAA CERTIFICATION AID – SSRI INITIAL Certification (Page 2 of 5)

(Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification/clearance requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider, there may be a delay in the processing of your medical certification or clearance until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

FAA CERTIFICATION AID – SSRI INITIAL Certification (Page 3 of 5)

REPORT FROM

MUST SPECIFICALLY ADDRESS OR STATE THE FOLLOWING (SSRI INITIAL Certification/Clearance Evaluation)

PSYCHIATRISTMust be a board certified psychiatrist(If your treating physician IS a board- certified psychiatrist, you should submit this section.)

A Current detailed evaluation report that summarizes clinical findings and status of how the airman/FAA ATCS is doing. At a minimum, it must include the following: 1. Qualifications: State your board certifications, specialty, and any other pertinent qualifications. 2. Records review: What documents were reviewed? a. Specify if using your own clinic notes and/or notes from other providers or hospitals. b. Verify if you were provided with and reviewed a complete copy of the airman/FAA ATCS’s FAA medical file. 3. History: a. Review the overall symptom and treatment history, with a timeline of evaluations and treatments (including start and stop dates). b. Discuss the severity of the condition and any relapse/recurrence. c. Each of the FAA SSRI “Rule-Outs” below MUST be individually addressed. The report must specifically detail if there have been any symptoms or any history of the following:4. Medication a. Current name and dose of medication. b. How long has the airman/FAA ATCS been on this medication at this dosage? c. Any side effects from the current medications? (If none, that should be stated.) d. When was the most recent change in medication? (Dose, medication type, or discontinuation of medication.) e. Previous medications that have been tried. List name, dosage, dates of use, and presence or absence of any side effects and outcomes. f. Are additional changes in dose or medication recommended or anticipated? 5. Diagnosis: a. Specify the current diagnosis (es). b. Discuss any prior diagnostic questions or issues and explain why/how these are no longer under consideration or have been ruled-out. c. Discuss the severity of the condition, both current and historically. 6. Summary, Treatment and follow-up recommendations: d. Discuss the airman/FAA ATCS’s overall psychiatric and behavioral status and risk of recurrence. e. How will this airman/FAA ATCS be followed? At what interval? f. Do you have any clinical concerns or recommend a change in treatment plan? 7. Agreement to immediately notify the FAA if there is any changes in the airman/FAA ATCS’s condition, dosage, change in medication or if the medication is stopped. (For airmen: 405-954-4821; for FAA ATCS: contact the RFS office) 8. Submit copies of all treatment records such as clinic or hospital notes for any period of time which the airman/FAA ATCS has sought treatment or taken medication. (You do not need to submit any records received from the FAA.)

FAA CERTIFICATION AID – SSRI INITIAL Certification (Page 4 of 5)

(Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification/medical clearance requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or medical clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider, there may be a delay in the processing of your medical certification or clearance until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

FAA CERTIFICATION AID – SSRI INITIAL Certification (Page 5 of 5)

(Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification/medical clearance requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or medical clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider, there may be a delay in the processing of your medical certification or clearance until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

SSRI RECERTIFICATION/FOLLOW-UP CLEARANCE

(Updated 12/28/2022) Policy Change in SSRI Program Cognitive Testing Requirements for Renewal of Special Issuance:

After careful study of data from 425 pilots in the SSRI Program, the FAA has determined that the neuropsychologist evaluation and routine CogScreen-AE administration are no longer necessary for RENEWAL of an SSRI special issuance, except when clinically indicated or specified on the Authorization/Special Consideration Letter. This policy change does NOT affect initial evaluations and the current AME checklists and Specifications for Neuropsychological Evaluations should still be used. This policy is effective immediately (12/15/2022).

Frequently Asked Questions (FAQs)

Yes.

No. This policy change eliminates both the neuropsychologist evaluation and CogScreen for follow up evaluations (unless the pilot/ATCS receives a specific request for follow-up).

Yes. If all other items of the HIMS AME Checklist – SSRI Recertification/Follow-Up Clearance are in the clear column and they are otherwise qualified, issue with a 6-month time limitation. Submit all information to the FAA for review.

In most cases, the requirement for a follow-up CogScreen will be removed.

Yes, if otherwise qualified. There will be some overlap in letters that were sent out prior to 12/15/2022 which asked for a follow-up CogScreen. If the pilot/ATCS has already completed the CogScreen from the previous letter, the AME should review and send it to the FAA.

If the pilot/ATCS has provided all items to the HIMS AME except the CogScreen and Neuropsychology evaluation (for follow-up SSRI Authorization), the AME can issue if all items are in the clear column of the HIMS AME Checklist – SSRI Recertification/ Follow-Up Clearance.

If the results were severe and were thought to identify significant cognitive deficits, the Special Issuance would be temporarily withdrawn while further evaluation is completed.

Not at this time. There is no change to the current INITIAL Authorization requirements.

________________________________________________________________________

Note: See important update in black boxes above. Neuropsychologist report and routine CogScreen-AE administration are no longer necessary for RENEWAL of an SSRI special issuance, except when clinically indicated or specified on the Authorization/Special Consideration Letter. This policy change does NOT affect initial evaluations and the current AME checklists and neuropsychological protocol should still be used. (Policy change 12/15/2022)

HIMS AME Checklist - SSRI Recertification /Follow Up Clearance (Updated 08/26/2026) [Note: SSRI now called Antidepressant]

Name ____________________________ Airman PI#____________________________

Instructions to the HIMS AME:

• AIRMAN
• FAA, Civil Aerospace Medical Institute, Bldg. 13
• Aerospace Medical Certification Division, Room 308 -
• AAM-300
• PO Box 25082
• Oklahoma City, OK 73125-9867
• FAA ATCS: Regional Flight Surgeon (RFS) office

I reviewed the airman’s SSRI Authorization or the FAA ATCS’s Special Consideration Letter dated: ________________ (Date of Letter) 1. HIMS AME FACE-TO-FACE, IN OFFICE EVALUATION: Required EVERY 6 months for ALL CLASSES

CACI qualified condition.) ……………………………………………………………………………………….

OR

HIMS PSYCHIATRIST REPORT plus PRESCRIBING PHYSICIAN REPORT

or Special Consideration Letter.………...........................................................................................

If indicated/specified, answer the following items:

(Mark N/A for pilots) Reports are favorable? .........................…………………………………………...

If any report is unfavorable immediately FAA RFS office.

Issuance/Consideration……………………………………………………………………………………….................

______________________________ __________________________________

HIMS AME Signature Date of Evaluation

For Airman: If ALL items fall into the clear column, the AME may issue with the time limitation specified in the Authorization Letter or Special Consideration Letter. If Any Single Item falls into the shaded column, the AME MUST DEFER or contact the FAA and Explain in the HIMS report. For FAA ATCS: When Checklist is complete, immediately contact RFS with results and submit all documents within 14 days.

No Yes

FAA CERTIFICATION AID – SSRI Recertification

Page 1 of 2 (Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or medical clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider there may be a delay in the processing of your medical certification until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

FAA CERTIFICATION AID – SSRI Recertification

Page 1 of 2 Updated 08/26/2026) The following information is to assist your treating physician/ provider who may be unfamiliar with FAA medical certification requirements. It lists the ABSOLUTE MINIMUM information required by the FAA to make a determination on a medical certificate for airmen or medical clearance for FAA ATCS. You should strongly consider taking a copy to each evaluator so they understand what specific information is needed in their report to the FAA. If each item is not addressed by the corresponding provider there may be a delay in the processing of your medical certification until that information is submitted. Additional information such as clinic notes or explanations should also be submitted as needed. All reports must be CURRENT (within the last 90 days) for FAA purposes.

• REPORT FROM REQUIRED
• INTERVAL
• MUST SPECIFICALLY ADDRESS OR STATE THE FOLLOWING
• (SSRI Recertification/ Follow Up Clearance)
• CLINICAL PSYCHOLOGIST
• OR
• NEUROPSYCHOLOGIST*

*Neuropsychologist report and routine CogScreen-AE administration are no longer necessary for RENEWAL of an SSRI special issuance, except when clinically indicated or specified on the Authorization/Special

Consideration Letter.

• (Policy change 12/15/2022)
• 1st and 2nd class: Every
• 12 months or per Authorization Letter
• FAA ATCS: Every 12 months or per the Special Consideration
• Letter
• 3rd class: Every 24 months or per Authorization Letter

CogScreen information results that must be addressed in the narrative:

Session 1 for initial test only; retests should be Session 2 or incrementally higher.

Clinical report MUST specifically comment on the following CogScreen items. If they have changed or are not normal, the narrative must discuss these findings and if they are of any clinical or aeromedical concern:

The psychologist or neuropsychologist report should also specifically mention:

ATCS: contact the RFS office) if there is any change or deterioration in the psychological status or stability in the airman/FAA ATCS’s condition.

• AIR TRAFFIC MANAGER (ATM)
• FAA ATCS employee
• ATCS Applicant for hire – Not applicable

FAA ATCS: Every 3 months (bring cumulative reports to AME evaluation every 6 months.)

Report must address:

For FAA ATCS:

For Pilots: Chief pilot reports no longer required.

ADDITIONAL PROVIDERS

Additional reports for SSRI or any other condition noted in Authorization or FAA ATCS Special Consideration

• Letter
• Every 6 months or per Authorization or FAA
• ATCS Special

Consideration Letter Varies. See the Authorization Letter or Special Consideration Letter. Include any drug testing results, therapist follow up reports, social worker reports, etc.

If the prescribing physician is NOT a psychiatrist, reports from the prescribing physician and their clinic office notes must be submitted in addition to the required psychiatric evaluations (see above).

If the airman/FAA ATCS has other non-SSRI conditions that require a special issuance/consideration, those reports should also be submitted according to the Authorization or FAA ATCS Special Consideration Letter.

HIMS AME CHANGE REQUEST

(Updated 09/25/2024) The Authorization for Special Issuance requires that individuals DO NOT change his/her HIMS AME without prior FAA approval.

In rare cases in which the HIMS AME listed on the Authorization Letter is no longer available to the individual (ex: HIMS AME retires, is no longer a HIMS AME, is deceased, or the individual or HIMS AME relocates to a new state, etc.), a change request is required.

The FAA requires the following to consider any request:

In addition, the individual must give FAA Office of Aerospace Medicine authorization to release a complete copy of their FAA Medical File to the new requested/prospective HIMS AME in advance of the new requested/prospective HIMS AME’s agreement to monitor the individual. For information on how to accomplish this, see Requesting Medical Records.

The closeout report must note if there are any concerns regarding the individual’s compliance.

If the (current) HIMS AME is deceased, his/her office staff should contact AAM-200 Manager, Medical Specialties in Washington, DC at (202) 267-8035.

The FAA will review the submitted information, and IF the change is approved*, will send an updated Authorization Letter with the new HIMS AME information to the individual.

Submit requests to:

• Federal Aviation Administration
• Civil Aerospace Medical Institute, Bldg. 13
• Aerospace Medical Certification Division, AAM-313
• PO Box 25082, Oklahoma City, OK 73125-9867

*NOTE: Submission of a HIMS AME Change Request does not automatically guarantee approval of the request.

• ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)*
• AND/OR USE OF ADHD MEDICATIONS
• All Classes
• (Updated 10/30/2024)

DISEASE/CONDITION	EVALUATION DATA	DISPOSITION
A. NO treatment or use of ADHD medication (for any reason) in past four (4) yearsANDNO symptoms in past four (4) yearsANDNO instability in academic, occupational, or social functioning within the last four (4) yearsANDNO other psychiatric condition(s) or diagnosis (current or historical).Exception: Anxiety, Depression, and Related Conditions can use this row if the individual qualifies for the Anxiety, Depression, and Related Conditions Fast Track Pathway.	The individual will need to see a psychologist or neuropsychologist for records review and evaluation*. This section may be performed in person or virtually (in compliance with State and Federal regulations).*Note: Records review and evaluation can be done virtually; however, the evaluation component must be face-to-face on screen, not audio only.• See Fast Track - FAA ADHD Evaluation General Information for Pilots and ATCS• The AME should review the FAA ADHD Summary completed by a psychologist or neuropsychologist who has training and experience in the evaluation of ADHD.If the FAA ADHD Summary is provided, all items are in the “NO” category, and the AME has NO concerns regarding this individual:Note: If FAA ADHD Summary is not provided, any “YES” answers, any AME concerns, or unable to verify history, go to Row B.	ISSUE Summarize this history, annotate Block 60 “Meets ADHD Fast Track requirements.”Submit ALL the following to the FAA:1. Completed and signed FAA ADHD Summary;2. Actual clinical visit report (not patient portal notes) from the psychologist or neuropsychologist ; and3. Copies of ALL supporting documents reviewed.
B. Symptoms, treatment or use of ADHD Medication (for any reason), or instability in past four (4) yearsORHistory of any psychiatric condition(s) or diagnosis (current or historical) including Anxiety, Depression, and Related Conditions which do not qualify for the Anxiety, Depression, and Related Conditions Fast Track Pathway.ORAME and/or HIMS Neuropsychologist have any concerns	This row requires HIMS neuropsychology evaluation and testing to identify the presence of aeromedically significant ADHD.• Evaluation and testing must be completed in person by a HIMS neuropsychologist;• ADHD testing is required after record review; and• The HIMS Neuropsychologist should reference the Standard Track - FAA ADHD Evaluation General Information for Pilots and ATCS.Medication: If the individual stopped taking ADHD medication(s), they must be off the medication(s) for 90 days before testing and evaluation.	DEFER Submit the information to the FAA.
C. Currently taking ADHD medication (for any reason), including PRN useORMedication discontinued within the past 90 daysORCurrent symptoms	Taking ADHD medication or symptoms of ADHD are incompatible with aviation safety.Submit the following for FAA review: The most recent detailed, clinical progress note from the prescribing physician which identifies the diagnosis and treatment plan.If the treating physician determines the medication can be safely discontinued, the individual should be off the medication a minimum of 90 days before obtaining the Standard Track - FAA ADHD Evaluation See Row B.	DEFER Submit the information to the FAA

*ADHD has replaced the former name Attention-Deficit Disorder (ADD).

• ANXIETY, DEPRESSION, AND RELATED CONDITIONS
• All Classes

(Updated 06/26/2024) Row A on the following Anxiety, Depression, and Related Conditions Disposition Table allows only TWO of the following:

Anxiety

Depression

Other

Note^: V code (DSM)/Z code (ICD-10) table includes but is not limited to:

Review ALL Row A criteria including psychotherapy (past and current) and medication history.

For conditions not listed above, see Row B.

• ANXIETY, DEPRESSION, AND RELATED CONDITIONS
• All Classes
• (Updated 06/26/2024)

DISEASE/CONDITION	EVALUATION DATA	DISPOSITION
A. Up to TWO listed conditions treated with any combination of:• Psychotherapy (current or historical)• Medication: A single mental health medication last taken, prescribed, or recommended two (2) or more years ago. o This includes when the treating physician changed medications for better treatment response, provided only ONE medication was taken at a time and last use was two or more years ago.ACCEPTABLE DIAGNOSES:Uncomplicated:1. Anxiety:• Generalized Anxiety Disorder• Situational anxiety (aka adjustment disorder with anxiety)• Social Anxiety Disorder• Unspecified anxiety2. Depression:• Postpartum depression• Situational depression* (aka adjustment disorder with depressed mood)• Situational• Anxiety and Depression (adjustment disorder with mixed anxiety and depressed mood)• Unspecified depression	The AME should gather information regarding the diagnosis, severity, treatment, symptoms, and address ALL of the questions on the Anxiety, Depression, and Related conditions Decision Tool for the AME.Note: For individuals who were deferred, but now may possibly meet all Row A criteria, use the FAST TRACK PATHWAY Decision Tool for Currently Deferred Cases.If all items on the decision tool are in the clear, “NO column, the AME may:DO NOT USE THIS ROW IF (go to Row B):⊗ Previously on an SI/SC for SSRI use;⊗ Recurrent episodes or symptoms. If the individual had multiple failed attempts to discontinue or stay off medication(s) over any period;⊗ If the individual has any history of requiring more than ONE mental health medication at a time (e.g., dual or triple therapy); and/or⊗ Diagnosed with Major Depressive Disorder (MDD) or Persistent Depressive Disorder (dysthymia).NOTE^: V code (DSM)/Z code (ICD-10) table includes:• Uncomplicated Bereavement;• Relationship distress with spouse or intimate partner;• Parent-Child relational problem; and/or• Phase of Life Problem (problems adjusting to major life transitions such as newly retired, getting married, empty-nest, new career, becoming a parent, etc.	ISSUESummarize this history, diagnosis, and annotate Block 60:“Discussed the history of [insert diagnosis here], no positives to screening questions, and no concerns.”If any “YES” answersORAny AME concerns:DEFER
3. Other:• Obsessive Compulsive disorder (OCD)• Post-Traumatic Stress Disorder (PTSD)• V code^ (DSM)/Z code (ICD-10) table itemsNote*: For Situational Depression - AME can use this table or the Situational Depression Disposition Table.
B. All Others• Previously on an SI/SC for SSRI use;OR• Recurrent episodes or symptoms. If the individual had multiple failed attempts to discontinue or stay off medication(s) over any period;OR• If the individual has any history of requiring more than ONE mental health medication at a time (e.g., dual or triple therapy);OR• Diagnosed with Major Depressive Disorder (MDD) or Persistent Depressive Disorder (dysthymia);AND/OR• Seasonal Affective Disorder	Submit a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days before the AME exam.	DEFERAnnotate (elements or findings) in Block 60.

• ANXIETY, DEPRESSION, AND RELATED CONDITIONS
• FAST TRACK PATHWAY Decision Tool for Current Deferred Cases
• ALL CLASSES (Updated 09/25/2024) – (Page 1 of 2)

AME instructions: If a pilot was previously deferred for anxiety, depression, or related conditions, they MAY now qualify for consideration per Row A of the Anxiety, Depression, and Related Conditions Disposition Table (published 05/29/2024). Complete the following and upload into AMCS:

APPLICANT NAME:_________________________________________________ BIRTHDATE:__________________________ APPLICANT ID#:___________________________________________________ PI#:__________________________________ A. Diagnosis: Does the individual have 3 or more of the following conditions/ diagnosis as the reason for deferral?

Circle all conditions diagnosed:

Anxiety

Depression

Other

(PTSD)

o Relationship distress with spouse or intimate partner;

o Parent-Child relational problem;

and/or o Phase of Life Problem (problems adjusting to major life transitions such as newly retired, getting married, empty-nest, new career, becoming a parent, etc.

B. Treatment: Has the individual been on an antidepressant medication in the past two (2) years?

C. Multiple medications use: Has the individual used multiple medications concurrently? This includes augmentation therapy. Circle all medications used:

Selective serotonin reuptake inhibitors (SSRI):

citalopram (Celexa) escitalopram (Lexapro) fluoxetine (Prozac; Sarafem) sertraline (Zoloft)

Serotonin and norepinephrine reuptake inhibitors (SNRI):

desvenlafaxine (Pristiq) duloxetine (Cymbalta) venlafaxine (Effexor)

Dopamine/norepinephrine-reuptake inhibitor (NDRI):

buproprion (Wellbutrin) SR/ER formulations

Other _________________________________________________________________ Note: Historic use of an antidepressant not on the above list does not exclude this pathway.

D. Do Not Issue/Do Not Fly Medications: Has the individual ever been treated with:

E. History: Does the individual have any history of:

⊗ SI/SC for SSRI use (current or previous);

⊗ Recurrent episodes or symptoms. If the individual had multiple failed attempts to discontinue or stay off medication(s) over any period;

⊗ If the individual has any history of requiring more than ONE mental health medication at a time (e.g., dual or triple therapy); and/or ⊗ Diagnosed with Major Depressive Disorder (MDD) or Persistent Depressive Disorder (dysthymia) or Seasonal Affective Disorder.

• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*

F. Answer all of the following:

(Page 2 of 2)

that does not meet ADHD Fast Track Requirements is NOT acceptable.) ...................

as cutting) ever in their life?...........................................................................................

involuntary transport) and/or court-ordered treatment?.................................................

therapy?.........................................................................................................................

episodes spaced out over an extended period of time.)................................................

OR use of any medication has continued during the last two years..……................

concerns?.....................................................................................................................

The AME who submitted the exam must verify that ALL items fall into the “NO”/CLEAR COLUMN to use this FAST TRACK pathway. If any items fall into the “YES” column, STOP. The individual does not qualify for the FAST TRACK pathway.

The AME should warn the individual if any changes in condition, symptoms or medications started, they should not fly in accordance with CFR 61.53.

• AME name _________________________________ AME number ____________
• Signature __________________________________ Date of exam ___________
• NOTES:

This FAST TRACK Pathway Decision Tool:

In some cases, additional information will be required.

• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*

• ANXIETY, DEPRESSION, AND RELATED CONDITIONS
• DECISION TOOL FOR THE AME
• All Classes

(Updated 09/25/2024) AME Instructions: Address each of the following items in your in-office exam and history review. Only uncomplicated anxiety, depression, and related will qualify for this pathway. (See disposition table for conditions.) The AME must list all diagnoses in Block 60.

……………………………………………………………………………….

involuntary transport) and/or court-ordered treatment? ...........................................

therapy?....................................................................................................................

episodes spaced out over an extended period of time.)………………………………

concerns? ......................................................................................................

If ALL items fall into the “NO”/CLEAR COLUMN, the AME may issue with notes in Block 60 which show the AME discussed the history of Uncomplicated Anxiety, Depression, and Related Conditions, found no positives to the screening questions, AND had no concerns.

*If ANY SINGLE ITEM falls into the “YES”/SHADED COLUMN, the AME MUST DEFER. The AME report should note what aspect caused the deferral and explain any YES answers.

NOTES:

• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*
• NO YES*

PATH Status Summary Anxiety, Depression, and Related Conditions

(Updated 07/29/2026)

Name: _______________________________ Birthdate: ______________________ Applicant ID: __________________________ PI#: ___________________________

Pilots/ATCS (Air Traffic Control Specialists). If you do not have a Special Issuance (SI) /Special Consideration (SC), STOP. Do not use this page.

If your SI/SC letter places you in the PATH program, have your treating clinician complete Section 1, then bring this signed page and all interim detailed clinical progress notes (DCPN) to your AME for review and upload them into your FAA file.

Section 1. Treating clinician. Please answer questions 1 and 2, sign, and return this form to the patient or their Aviation Medical Examiner (AME). See the DCPN criteria, as a letter to the FAA may not contain all the needed information.

In the past 12 months, did the individual have:

Your patient should self-report and abstain from safety-related duties (pilot/ATCS) when they have a medical deficiency (e.g., worsening of condition, symptoms, etc). However, if your patient experiences a significant clinical deterioration in cognition, judgment, emotional stability, or insight and lacks the awareness to ground themselves, please notify the FAA Aeromedical Certification Division (405-954-4821) or their AME.

______________________________________________________________________________________ Treating Clinician Printed Name Office Phone Number Date of Evaluation

______________________________________________________________ _________________ Signature MD, DO, PA-C, NP

Section 2. AME Actions. Review Section 1 and all detailed clinical progress notes. Complete #3 and #4, and sign. Upload this page (as “Beh Hlth - PATH Status Summary”) and all interim detailed clinical progress notes.

Explain any “Yes*” answers or other concerns (attach any supporting documents).

I will notify the FAA Aeromedical Certification Division (405-954-4821) if there is a significant clinical deterioration in this individual’s cognition, judgment, emotional stability, or insight.

________________________________________ _______________

AME signature Date of Evaluation *IF ANY ANSWER FALLS IN THE YES* COLUMN, OR THERE HAS BEEN SIGNIFICANT INTERVAL HISTORY WORSENING OR ANY CONCERNS, THE AME MUST DEFER.

• No Yes*
• No Yes*
• No Yes*
• No Yes*

POST-TRAUMATIC STRESS DISORDER (PTSD)

All Classes

(Updated 06/26/2024)

DISEASE/CONDITION	EVALUATION DATA	DISPOSITION
A. NO Treatment with SSRI or other psychiatric medications in the past 2 years.ANDNO symptoms in past 2 yearsNote: Previous or on-going psychotherapy is permitted.	The AME should gather information regarding the diagnosis, severity, treatment, symptoms, and address ALL of the questions on the Anxiety, Depression, and Related Conditions Decision Tool for the AME.	If all items on the decision tool are in the clear “No column”, the AME may:ISSUE Summarize this history, and annotate Block 60 with “discussed the history of PTSD, no positives to screening questions, and no concerns.”If any “YES” answers, any AME concerns, or unable to verify history, go to Row B.
B. All others including:• Continued symptoms; and/or• Treatment with SSRI or other psychiatric medication in the previous two years.	Submit the following to the FAA for review:1. Airman personal statement (typed) that describes in their own words: a. The incident(s) leading up to PTSD-related symptoms and the eventual diagnosis of PTSD. b. Triggers for PTSD symptoms - characterize the frequency and severity of the symptoms (flashbacks, nightmares, anxiety, avoidance, and cognitive changes). c. Impact - include any recent or ongoing performance change, loss of job/school, or relationship problems due to PTSD. d. Modifications - include any recent or current changes to work, academic, or living situation to accommodate or lessen the PTSD symptoms. e. Medication - list names and dates (if used); f. Counseling - include any form of individual or group counseling or psychotherapy. List dates and provider(s) name(s).	DEFER Submit the information to the FAA for a possible Special Issuance.Follow up Issuance Will be per the airman’s authorization letter.
	2. Current evaluation by your treating psychiatrist or psychologist with clinical summary to include severity, frequency of episodes, and response to treatment (medications or psychotherapy). The report should identify if there is any history of suicidal ideation(s), homicidal ideation(s), substance use disorder(s) or other co-morbid psychiatric or psychological conditions, and identify diagnosis (DSM-V), treatment plan, and prognosis.3. Medication list. List all current medications (including non-PTSD related medications), reason for use, start dates, and side effects, if any. If recently discontinued, list date and reason. Note: if currently on an SSRI, must also submit items in the Initial SSRI Protocol.4. Copies of any PTSD screening tools or other assessment instruments (already performed).5. Copies of psychological testing (already performed) including raw data.6. Veterans Administration (VA) records (if applicable) a. VA Compensation and Pension disability evaluations (C&P exam); b. VA Disability Compensation Award letters; and c. VA clinic and/or hospital records 7. Previous medical/hospital records including previous clinical progress notes for any psychiatric evaluations and clinical progress notes for any psychiatric condition or PTSD that describe the dates, severity, and any treatment used.

SITUATIONAL DEPRESSION

• Adjustment Disorder with Depressed Mood or MINOR Depression
• All Classes
• (Updated 07/27/2022)

DISEASE/CONDITION	EVALUATION DATA	DISPOSITION
A. Single episode Completely resolvedCAUTION:Depression(s) requiring treatment longer than 6 monthsORNOT resolved within 6 months AFTER the resolution of the event/stressorARE NOT adjustment disorders. While they may have a situational component, they are likely a Major Depressive Disorder (MDD) or other significant depressive diagnosis.	The AME should gather information regarding the diagnosis, severity, treatment, symptoms, and address ALL of the questions on the Situational Depression Decision Tool for the AME.If 5 or more years ago; treatment was not more than 6 months from the resolution of the stressor; there is no history of self-harm, psychiatric hospitalization, or persisting symptoms - the FAA will accept the AME history and notes in Block 60.If the single episode was LESS than 5 years ago, the AME must review a current, detailed Clinical Progress Note and actual clinical record(s) from the treating provider to verify the diagnosis.	If ALL items on the Decision Tool have been marked “YES,” the AME may:ISSUE Summarize this history including dates of symptoms and resolution. Annotate Block 60 with “discussed the history of Situational Depression, no positives to screening questions, and no concerns.”If any “NO” answers, any AME concerns, or unable to verify history - go to Row B.
B. All othersNo specific triggering event/stressorTreatment or symptoms lasted longer than 6 months from resolution of the stressorContinuing/persistent symptoms2 or more episodes in a lifetimeAny additional psychiatric conditions, symptoms, or history (e.g., intensive psychiatric treatment, suicide attempt(s), significant legal events, violence).	If currently taking an SSRI - see the SSRI protocolIf no longer on medication, the individual should submit the following for FAA review:1. Current, detailed Clinical Progress Note (actual clinical record) from a board-certified psychiatrist. It must include a summary of the history of the condition; current medications, dosage, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis;	DEFER Submit the information to the FAA for a possible Special Issuance.Follow up Issuance will be per the pilots’ authorization letter.
Medication is currently used for this condition, even if “as needed” (prn).Any treating provider concernsAny AME concerns	assessment; plan (prognosis), and follow-up.Note: A good template for the psychiatrist to follow is Page 3 of the FAA Specifications for Psychiatric Evaluation. The AME should also discuss any history of the rule out criteria listed (even if not on an SSRI).2. The Clinical Progress Note must specifically include, if applicable,• Description of the triggering event/stressor;• How long after the triggering event/stressor the condition started;• Characterize/specify the nature of the impairment(s), such as clinical symptom burden, list all behavioral symptoms, and describe social or other area(s) of impairment;• Describe treatment (medication and/or psychotherapy) with start and end dates;• Date of full resolution of symptoms or condition;• Risk of recurrence; and• Copies of all treatment records such as emergency room, urgent care, hospital, and primary care physician or psychiatry notes describing event(s)/stressor(s), diagnosis, and treatment.

Note: If Major Depression, Major Depressive Disorder (MDD), recurrent depression, or depression requiring treatment - see that section in Psychiatric Conditions. If any of the supporting documents contain a diagnosis other than Situational Depression, Adjustment Disorder With Depressed Mood, or Minor Depression - see the corresponding disposition table. See the Situational Depression Decision Tool for the AME on the following page.

SITUATIONAL DEPRESSION DECISION TOOL FOR THE AME

(Adjustment Disorder with Depressed Mood or Minor Depression) All Classes

(Updated 07/27/2022) AME Instructions: Address each of the following items in your in-office exam and history review.

not persistent (with or without treatment) .......................................................

including substance abuse in the individual’s lifetime.......................................

If ALL items fall into the CLEAR /YES COLUMN, the AME may issue with notes in Block 60 which show the AME discussed the history of Situational Depression, found no positives to the screening questions, AND had no concerns.

If ANY SINGLE ITEM falls into the SHADED/NO COLUMN, the AME MUST DEFER. The AME report should note what aspect caused the deferral and explain any NO* answers (shaded column).

NOTES:

• Yes No*
• Yes No*
• Yes No*
• Yes No*
• Yes No*
• Yes No*
• Yes No*

PSYCHIATRIC CONDITIONS

All Classes

(Updated 05/29/2024) The Psychiatric Conditions Disposition Table lists other common conditions of aeromedical significance and the corresponding AME course of action. Do not issue a medical certificate to an applicant with medical conditions that require deferral or for any condition not listed that may result in sudden or subtle incapacitation without consulting the AMCD or the RFS. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.

NOTE – See Disease Protocols for specifications for Neurocognitive, Psychiatric, and/or Psychiatric and Psychological Evaluations.

Certain personality disorders and other mental disorders that include conditions of limited duration and/or widely varying severity may be disqualifying. Under this category, the FAA is especially concerned with significant depressive episodes requiring treatment, even outpatient therapy. If these episodes have been severe enough to cause some disruption of vocational or educational activity, or if they have required medication or involved suicidal ideation, the application should be deferred or denied issuance.

Some personality disorders and situational dysphorias may be considered disqualifying for a limited time. These include such conditions as gross immaturity and some personality disorders not involving or manifested by overt acts.

(See Item 18.m.).