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“The best option is to talk to an attorney ahead of time so that we can develop a care plan, to get the best experts to help you pass your medical evaluation,” he prefaced. “Cardiac issues are common. Interestingly, the FAA does not employ a cardiologist. They have six psychiatrists on staff but not a single cardiologist. They are trying to send airmen to cardiac panels, but the panels do not convene often. So, as a result, cardiac cases are getting backlogged. Another thing that we see a lot of, which is pretty genera- tional, is ADHD. ADHD cases are immediate denials by the AME and must go through the Federal Air Surgeon’s office for further review.”
In recent years, he has seen some other conditions become increasingly concerning.
“There is an almost daily frustration that I am having with my pilots. Through COVID, we saw the highest num- ber of mental health issues in the United States that we have ever seen. Pilots are no different than anyone else and are members of the same society, so we had an influx of pilots that reported seeing a therapist on their 8500-8’s [Application for Airman Medical Certificate]. You must report if you have seen a doctor, a therapist, or a coun- selor, within the last three years. So, these pilots reported seeing those individuals for acute depression, situational depression or anxiety, treatable mental health conditions, and were denied a medical certificate,” he advised.
“What is frustrating is that the mental health world is dynamic, and the FAA regulations are not. FAA regula- tions on mental health were crafted based on DSM-3 [The Diagnostic and Statistical Manual of Mental Disorders, third generation], which expired in 1987. We’re talking about greater than three decades ago. With the DSM-5 soon to drop, the FAA will be four generations behind on clinical mental health.”
LoRusso states that there are repercussions from this highlighted mismatch.
“Because FAA regulations are so antiquated, owner- operators have a warranted and justifiable fear of report- ing mental health treatment. We have a justifiable fear that reporting will turn into a denial. As a result, there are two issues: Pilots either refuse to seek mental health assistance and are flying with conditions that need to be treated, or they are seeing mental health professionals and lying on their 8500’s.”
These purported issues, combined with others he has observed during his last ten years of medical defense work, make LoRusso firmly believe that something needs to change. He outlines what he feels would improve the current medical process.
“Without question, the FAA’s 2023 reauthorization bid should include a promise of medical reform. But what does that look like? I believe it begins with a new
18 • TWIN & TURBINE / April 2023
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