HIMS Psychiatric Evaluation

Hi all,

I’m working through the first class medical certification process, which was deferred due to some medication I was taking for depression and anxiety back when I was teenager. I kept taking the medication into adulthood not necessarily because I was in rough shape, but primarily because my doctor and I agreed that the medication wasn’t causing any negative side effects and I was pretty stable and in good shape. Why mess with a good thing?

In consultation with my doctor, I stopped taking the medication once I found out the FAA doesn’t allow certain antidepressants. Once I had been off the medication for 90 days with no side effects, my doctor sent a glowing note to the FAA. They just got back to me stating they need a “current psychiatric evaluation performed by a HIMS trained psychiatrist.”

I looked at the FAA-recommended HIMS doctors and setup an appointment with one of the doctors, but his office stated that he cannot perform the evaluation himself. and he would see me simply in order to refer me to a psychiatrist his office works with. I asked for the number of his psychiatrist so I could reach out myself, and Dr. Gratzer returned my call shortly. He said that he could get me in next week, he would perform all of the necessary evaluations, and I would need to bring him a check for $1500 because insurance doesn’t cover these evaluations. I asked if he needs my FAA records and he said no, just bring my general medical records. He said he could send the report directly to the FAA and bypass the afore-mentioned HIMS referral because “I’m setup with the FAA.”

Does this sound like it’s up-and-up? I feel like I may be getting scammed here but I can’t find info online for how much these evaluations are supposed to cost. Also, what should I expect at this evaluation?

Appreciate any info anyone can provide - this whole HIMS thing is confusing to me and I just want to get the approval process finished. I’ve been at this since August and I don’t see any end in sight. :weary: I understand these things take time and government agencies are slow, but my employment situation changed recently and time is running out for me.


Honestly I have no clue but I’d call the FAA directly in Oke City or contact your local FSDO and ask them directly. They’re generally very helpful.



I have heard that the HIMS process can be very long, complex and expensive, so it does sound right from that perspective. I agree with Adam, call the FAA and ask them about this doctor.


@Chris and @Adam,

Thanks for the replies - will end up being expensive but I’m committed to seeing this through. Hopefully the shutdown ends soon.



The cost of medical testing can be negotiable like anything else but cheaper may not be best.
The HIMS program was created for alcoholics. Later the FAA adapted it to use for pilots on psychiatric meds. I have heard stories of HIMS doctors who were not professional or helpful. If you don’t have a medical diagnosis and you are not taking medicine, it seems to me that you should not need the HIMS program. When there is momentum the FAA can get wrapped around the axle with requirements. I would talk with Pilot Medical Solutions in Oklahoma (www.leftseat.com). They have helped several pilots with this stuff and can probably tell you if you need HIMS. I also agree with the post which said, don’t talk with the FAA directly. What you say to the FAA is extremely important.

@With-Prist-Please, thanks for the response. It sounds like there is a path forward. I’m confused, though, why would they need to grant me a special issuance if I have been off the medication for 120+ days with no symptoms? I also presented a note from my treating physician stating I am exhibiting no symptoms. Seems like this would be cause for a standard issuance.

Or is the idea that they need to follow up over a period of time to make sure that the symptoms don’t return?

@heavyr, thanks for the reply. After hearing from Adam and Chris a few weeks ago, I went ahead with commissioning a psychological eval report from a HIMS-referred doctor ($1,500 out of pocket - ouch). I spoke with Left Seat today and they were incredibly helpful. One of the doctors offered to take a look at the psych eval when it is completed and see if he recommends continuing with HIMS. He mentioned that he thinks – given I am 120+ days off meds, don’t have a current diagnosis and am not exhibiting symptoms – that the HIMS program may not be the best route but will need to see the report first to confirm.

If this is true, you may have just saved me a ton of money. Thanks for the advice. These guys at Left Seat seem awesome.

Hello Nate. Did you ever get your medical approved? I was wondering if the government shutdown is affecting these SI medical. How was the psychologist evaluation? I hope you didn’t have to do that cogscreen. I hear it’s nerve racking.

Hi Thomas,

Still waiting on the medical. I met with a HIMS doctor in Minneapolis last week. He reviewed the psych eval - the evaluator wrote that he sees no reason why I shouldn’t be granted a first class cert, so that’s really good news. No cog screen required as of yet unless the FAA needs more from me (doctor thought it was doubtful). He is going to send in everything this week to OKC and continue to follow up, but I understand there’s going to be a massive backlog from the shutdown, so I’m prepared to play the waiting game for several months.

I’m set to move down to AZ at the end of the month, so it’s just a waiting game for getting approved, and then I’ll enroll at the Mesa, AZ location. Thinking I’ll probably take this time to study up for the writtens, although I can’t be reimbursed for taking them until after I have the first class cert and have officially enrolled, unless I’m mistaken…



Yes, you will need to be signed up before being reimbursed for the written exams. Once you are enrolled, you can take the writtens for free at any ATP center and avoid the whole reimbursement process.


Hi everyone, I moved down to Arizona at the beginning of March in anticipation of starting the ATP program as soon as I received my first class medical. The FAA lost my paperwork and my doctor had to send it in again…waited two months just to find out it needs to be forwarded to the Federal Air Surgeon’s office (in DC, right?)

I have very low expectations now when it comes to the FAA handling this medical cert in a timely manner. Very frustrating. I signed up for AOPA’s Pilot Protection Services and they told me if it’s in DC, it could be 6-12 months before I get a response. They said I could try initiating a Congressional Inquiry with my Congressman, but they said usually the FAA just ignores those.

I completed my PAR in April and will take my IRA/FII in the next week. I plan on completing all six written in the next month or two. Couple of questions:

  1. Does anyone have experience with the Federal Air Surgeon and does the 6-12 month wait before receiving a response seem reasonable? I understand the Gov’t shutdown massively slowed the pipeline down, but I’m praying for a shorter timeline than that. Seems unreasonable to make someone potentially wait a year for a response.

  2. I see the ATP price from zero time is $80,995 and the price starting with Private Pilot is $63,995. That’s a $17,000 difference. Considering I’d like to get my Private license regardless of what happens with my First Class, do you think it makes sense to take this indeterminate waiting period and pursue my Private with a third party (do I need a third class cert to do this)? I’ve seen schools in the Phoenix area that will offer Private for ~$7,000. I do understand that any program outside of ATP will be less comprehensive than ATP and will likely take longer, and I’d have to do my due diligence before pulling the trigger - but in general, does anyone know how long, on average, these third party options take to complete and if they’re any good? I feel like I need to make SOME progress while I wait for the FAA, which could take years if they request a Cog Screen.

I would suggest speaking with AOPA PPS or your AME because you need atleast a 3rd Class in hand to solo and I’m not sure if you would be able to get a 3rd class while a 1st is held up.
Hopefully the Mentors have a little more insight but I have a feeling they might defer to your AME as well.

As far as the estimated costs most flight schools estimate their costs at the FAA Minimums which most students do not go for a Checkride at (national average is 60-75hrs)


Not defending the FAA but there most definitely is a huge backlog. I just renewed my CFI and didn’t get the new cert till a day before the temp expires. That’s the first time that’s ever happened to me in many years. The AOPA really is pretty up on the process so I’d believe what they tell you as far as the timeline. That said there’s nothing prohibiting you from being a pain and calling them regularly.

As for the PPL Tom is correct. If they’re holding up your First Class I don’t believe they’ll just issue you a Third and you’ll need that to solo and get your PPL. More so while you could possibly earn your PPL cheaper, don’t forget to start ATP with credit for it you also need 78+hrs of flight time. Doing really simple math if the local school is quoting $7000 they mean the FAA min of 40hrs. That equates to $175hr. To build the 78 required that’s practically double getting you closer to $14k. Personally I don’t think it’s worth the difference.



I know how frustrating this is. I jumped through hoops to get my medical. The 6-12 month wait period is no joke.

Had I known that I could have been taking my written exams while I was waiting for the FAA to review my application, I would have taken them all. You’re doing the right thing by getting the written tests out of the way.

Without a medical in hand, I’m afraid you can only get so far. As the others have mentioned, you won’t be able to solo. With the indeterminate amount of time that it will take for you to get an answer from the FAA, I wouldn’t do any sort of flight training since it could potentially all be for nothing.



I am by no means an expert on this, but I would be surprised if you were able to obtain any class of medical certificate while the first class is being reviewed. I suggest working with AOPA on this. I would not recommend spending any money at all on flight training until you obtain some class of medical certificate.


Thanks for the replies. I guess nothing to do except take the writtens and wait…

@Adam, when you mention being a pain and calling them regularly, are you talking about AOPA or OKC (or both)?


OKC. It’s in their hands.


@nschwab – did you ever get this resolved?

Hey @Adam.Horn, short answer no.

I received a denial letter from the FAA in September citing my history of depression and dysthymia as the reason for denial. I reached out to Dr. Bruce Chien, who told me that anyone with recurring depression (more than a single isolated incident) left untreated (i.e. no meds) will always be denied by the FAA. Wish someone would have told me that in August 2018, but here we are.

So, it looks like my only option is to get back on one of the four accepted SSRI medications (started Prozac today), wait six months, and then reach out to the FAA to start the Special Issuance process. I can almost guarantee they’ll have me take one of those $1,500 psych evals again, at the very least, if not a cog screen. So I’m not holding my breath that I’ll have any sort of cert in hand within a year or two. But…the door hasn’t closed permanently, so I’m going to keep saving money for school and hoping for the best!

Everyone out there who was able to easily obtain a medical cert, be grateful. :slight_smile:

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I have never once heard of a pilot being allowed to fly while on anti depressants. I would caution you to ask the doctor point blank if you have any chance of getting a first class medical issued before proceeding any further.