Pilots and aspiring pilots who readily meet FAA medical standards typically find obtaining a Medical Certificate to be a straightforward process. One has to consult an AME, provide a medical history, undergo a physical exam and in the absence of disqualifying findings can be issued a certificate. Others find the process to be far more complex due to potentially disqualifying conditions and may require additional specialist consultation before the application can be considered. It is also wise to use a Senior AME (designated by the FAA) who has added qualifications to assist in such complex matters. Neuropsychological examination represents such a specialized consultation that may assist the pilot in overcoming a denial by the FAA. The FAA does not certify neuropsychologists or psychologists but lists certain clinicians, known as HIMS-trained, who have added qualifications specific to aeromedical issues. Pilots requiring such evaluation are well- served by using someone with this designation who use proper measures and address the particular concerns of the FAA. In some matters, the pilot also needs to consult a HIMS-trained psychiatrist who also has such added qualifications. We can help refer you a psychiatrist if you need that service. Decisions regarding issuance of a medical certificate are made by the FAA and the neuropsychologist's report exists to help the FAA make that decision. 

Some Conditions that will Likely Require Neuropsychological Examination

1. Substance abuse

2. Depression or anxiety (including use of certain psychoactive medications)

3. Post traumatic stress disorder

4. ADHD

5. Vascular illness ( stroke, TIA, cardiac arrest)

6. Neurological disorders (tumor, seizure, MS, PD, unexplianed LOC)

7. Traumatic brain injury (TBI, Concussion)

8. Viral infections (long term COVID, seropositive HIV)

Services are provided by David Prewett, Psy.D. and Allison Waterworth, Psy.D. ABPP, both HIMS-trained neuropsychologists in College Park, GA. The office is convenient to KATL via MARTA. Accomodations and dining are convenient to the office for those staying overnight. Dr. Waterworth also maintains a practice in San Francisco, CA. which may be a more convenient location for some applicants.

For all evaluations, the FAA requires a thorough document review pertaining to your issue. Once you have scheduled an appointment a list of documents needed will be forwarded. Your FAA medical file is required for all exams (except in cases where no medical file exists) and can be requested via the FAA website. Have the file sent electronically to Dr.Prewett or Dr Waterworth and allow six weeks for the file to arrive. Below is a link to the FAA website.

https://www.faa.gov/pilots/medical_certification/requesting_medical_records

Office Address: 1882 Princeton Avenue

Suite Three

College Park, GA 30337

About the Providers

Drs. Prewett and Waterworth both graduated from the Florida Institute of Technology and are licensed in their respective states of practice. Both have exceptional experience in complex psychological and neuropsychological evaluations. Beyond a basic recitation of the "data" both clinicians excel in narrating the personal story the pilot brings to the office which adds considerable depth to their reports. They approach the assessment in a comprehensive, thoughtful and compassionate fashion which expands the basic "numbers" reported to a genuine description of the individual's current functioning. In doing so, they help the FAA reviewers get a full, nuanced appreciation of the applicant which greatly assists them in coming to an informed, appropriate decision in the case. Both clinicians are in independent practice and are not employed by any carrier, legal firm, treatment center, the FAA or other firm or agency. However, their work product is often viewed, in part or wholly, by a variety of such parties based upon the applicant's informed consent to release such information.

Dr. Prewett, a HIMS-trained neuropsychologist, has a 40 year background in evaluating professionals, such as health care providers as well as aviators who have a history of chemical abuse and dependency and other neuropsychologically concerning issues. He has seen more than three thousand pilots from all major United States based airlines, regional carriers, charter operations and general aviation who have had a variety of conditions concerning FAA medical certification. His practice in Atlanta is exclusively dedicated to aerospace neuropsychology. With a Master's degree in anthropology from the University of Kentucky and worked as an archeologist for 5 years before returning to school to obtain his doctorate in clinical psychology with subsequent specialty training in neuropsychology. More recently he obtained his USCG (OUPV) Captains License with an eye toward working as a fishing guide once he retires from practice.

Dr. Waterworth, a HIMS-trained neuropsychologist, has a thirty year background in learning disability and ADHD evaluations as well as aerospace neuropsychology. She has seen several thousand persons for such assessment referred by various educational institutions and other sources along with her work with pilots. Dr. Waterwoth, in recognition of her experience and expertise, was recently selected by the FAA as a neuropsychology reviewing consultant on more difficult cases. She is past president of the American Board of Couple and Family Psychology (ABPP) and was selected by the American Psychological Association for the Leadership Institute for Women in Psychology. She practices in San Francisco and Atlanta.

"Cleared for takeoff. Fly runway heading..."

Preparing for your exam

PREPARING FOR YOUR FAA EXAM

There is no specific way to study for this exam and you are advised to be cautious about relying too strongly on the information (gouge) you may have seen on the internet. There are many tests at our disposal and it is unwise to assume you will be given the exact tests that may have been described. In general, the exam will cover background problem-solving ability, complex reasoning and your ability to learn new information, speed of mental operation, concentration and sustained attention and verbal and visual memory. This is not a test of flying skills, instead focusing on cognitive abilities shown to relate to safe and competent aviation. You may wish to consult such sites as Lumosity.com to see examples of these types of tasks. It is very important to be well-rested for your exam. This is particularly important if you are traveling across time zones. Take whatever steps needed to be functioning on Eastern time. Have some good nutrition before coming to the office and you will be given ample time for lunch. We have plenty of coffee but bring whatever else you may wish to drink. We endeavor to elicit your very best performance during the exam and breaks during testing occur as needed. Sometimes, we ask that you stay on a bit longer, or return to the office at a later date if there are additional tests that need to be conducted. Do not schedule other appointments around the time of your exam without contacting the office beforehand. It takes about a week to score and evaluate results. If we are waiting for records report preparation will be delayed. The report is sent to your AME who has the responsibility of transmitting it to the FAA. The cost of your exam was discussed before the appointment and payment is required at the time of the exam. It is your responsibility to seek any third-party reimbursement. You are obligated to pay for any additional documentation that may be requested by parties other than by the FAA.

 David Prewett, Psy.D. 

Allison Waterworth, Psy.D. ABPP

 1882 Princeton Ave Suite Three College Park, GA 30337

HIMS Personal Statement for Substance Abuse

HIMS Personal Statement

Use the format below to create your HIMS Personal Statement

Your application for Special Issuance of an FAA Medical Certificate requires you to provide a personal statement regarding your addiction/substance abuse, treatment experience, and current recovery program. Much of the information will come from a summarized version of your 1st Step detailing significant consequences, legal troubles, and the events that caused you seek treatment. Be sure to include comments on the use pattern (e.g., daily, binge, layovers), the type of substances used, and the peak amounts you could use in a 24hour period. Also, discuss medical complications, hospitalizations, and enduring medical issues. Be sure to comment on the impact using had on others and any comments others may have had concerning your use. Describe the date(s) and location of treatment you may have received. Discuss your current recovery program stating the name of your home group, meeting times and schedule of face-to-face contact with your sponsor as well as the step work you have completed. Pilot-specific aspects of recovery details such as peer monitoring, BOAF, individual/couples counseling, and aftercare group should be provided. Discuss the impact recovery has had on your home life, overall wellness, relationship with others and any benefits you can attribute to recovery. During the evaluation be prepared to demonstrate internalization of recovery principles in all your affairs.

FAA reviewers prefer considerable detail in this statement and your effort influences a decision as to whether certification is warranted. You are encouraged, therefore, to take the time to do a thorough job. Please bring you statement with you to the neuropsychological evaluation. If you prefer, it can be emailed to dprewett55@gmail.com. or Allison@drwaterworth.com

SSRI Medication:

Neuropsychological Evaluation for FAA Medical Certificate

The FAA has approved five medications for treatment of anxiety and depression in airmen with the requirement that the airman be on an unchanged dose for the six months prior to your exam and that the airman is generally asymptomatic. These medications are fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), buproprion (Wellbutrin) and escitalopram (Lexapro) one of which must be taken for a six-month period at an unchanged dose. The FAA does not permit taking more than one medication at any given time. The airman must be generally free of symptoms as a result of treatment and records from the prescribing physician are needed to verify your response to care. These medications have well-known (minimal) side effects that represent an acceptable risk to air safety in the FAA’s estimation.

Aside from a review of medical records, the FAA requires the airman to undergo evaluation by a properly trained aerospace neuropsychologist who, at a minimum, will administer the CogScreen-AE, but may also require additional examination. The CogScreen-AE is not a measure of flying skills. It is a measure of cognitive ability that is associated with cognitive tasks one encounters in flight operations. Generally, these are memory, concentration, multi-tasking and executive functioning and you can find analogs of these cognitive domains on the internet. You also can find a general description of the CogScreen-AE via the internet. As of December 2022, the FAA no longer requires follow-up screening (annual or biannual) except in a few cases.

Plan to spend about four hours in the office to complete the basic exam. Be sure to be well rested when you come for the exam. We look forward to seeing you.

The HIMS program has helped thousands of pilots recover physical, emotional and spritual health as well as their occupation. Read more about HIMS by clicking the link below.

https://himsprogram.com/about-hims/

Below are links to two Senior AMEs in the Atlanta area who have vast experience managing complex cases.

Charles R. Haper, II, MD

https://www.aeromedicalinc.com/

_____________________________________________

Alan Kozarsky, MD

https://flightphysical.com/dr-kozarsky-atlanta

AMAS provides pilots a variety of helpful resources.

Aviation Medical Advisory Services

https://aviationmedicine.com/

_____________________________________________

We can refer you to an aviation attorney if your case merits such counsel.

Aviation and ADHD

Those with a history of diagnoisis and treatment for ADHD who apply for a medical certificate will have the decison to issue deferred pending further evaluation of their circumstances. The FAA is concerned that distracted pilots pose an unacceptable safety risk. Those concens can be mitigated based on comprehensive evaluation that examines the applicant's current functioning in the context of the aviation environment. The symptoms and expression of of ADHD vary across the lifespan and the identified difficulties in earlier years may no longer be present or greatly diminished in later years. Also, there may have been issues at the time of initial diagnosis that caused the individual to exhibit chareteristics of ADHD that are better attributed to other causes. Finally, the thoroughness of the intial diagnostic evaluation varies greatly leaving some affixed diagnoses suspect. The FAA recognizes these factors and rather than making a blanket decison to deny all who had a prior diagnosis, offer the applicant a chance to demonstrate medical standards are met. To meet this burden of proof the applicant must submit considerable information (described below) and undergo a comprehensive, aeromedically informed, evaluation by a qualified clinician. This is a serious undertaking that requires effort and time. Such evaluations are costly not just in time, but also money. Therefore, it is very important that the decision to proceed is carefully considered by all involved and that there is a thorough commitment to aviation.

Use this format for your ADHD personal statement required for all ADHD evaluations

ADHD Personal Statement: The FAA requires that you offer a personal statement concerning ADHD. Read the guidelines below and answer thoroughly. This statement is a valuable part of the overall evaluation and will have an impact on the decision to issue a Medical Certificate. Feel free to email the Statement to the office ahead of your appointment. Dprewett55@gmail.com Allison@drwateworth.com

Write a statement which describes your diagnosis and stimulant medication history to include the following information: 1. Why did you seek treatment or an evaluation for ADHD? 2. What symptoms and behaviors did you have? 3. Why were you prescribed an ADHD medication and or other treatment? 4. What medications were prescribed? List all medications prescribed or otherwise used and reason for changes in medications, if any. List approximate dates. 5. If you were prescribed or otherwise took ADHD medication, did it help? If so, under what circumstance and for how long were they effective? 6. Did the treatment improve your academic, occupational, or social life? Explain your answer. 7. Did you experience any adverse effects/side effects from the medication? a. If yes, describe the effects; and b. What did you do to reduce these side effects? 8. Who was involved in diagnosing and treating your ADHD? List all professionals involved (e.g., teacher, school counselor, therapist, psychologist, primary care physician, psychiatrist, or education specialist, if applicable). 9. Were you diagnosed with any other condition such as Depression/Anxiety/Obsessive Compulsive Disorder (OCD)/Autism Spectrum Disorder (ASD)/Oppositional Defiant Disorder (ODD)? 10. Were diagnosed with a learning disorder (dyslexia/reading difficulties/math difficulties)? 11. Which of the following were performed by the person who diagnosed you with ADHD? Include all that apply: a. Interview with a psychologist/psychiatrist/neuropsychologist/Primary Care Physician (PCP) or provider/pediatrician b. Interviews with others such as parents, teachers, friends, etc. c. Completion of forms/questionnaires (specify completed by self and/or others) d. Computer testing e. Psychological testing conducted by psychologist or neuropsychologist f. Other (specify) g. If no testing was performed, that should be stated 12. How did the symptoms of ADHD change over time? Are the symptoms gone and if so, as of when? 13. Describe coping strategies you learned to deal with ADHD or any other diagnosis. Are they still used? 14. Describe your current ADHD symptoms and behaviors. If you have no symptoms, that should be stated (and the date resolved).

Urine Drug Screen for ADHD

As you are aware, the FAA requires a urine drug screen within 24 hours of your

exam completion. If you prefer, the office can arrange that screen for you. If this

is your preference please email your Date of Birth and ZIP code where you will be

the day following the testing to dprewett55@gmail.com or

Allison@drwaterworth.com. You will be contacted by

Choice Lab with the necessary documents via email. Failure to obtain a drug screen

within the 24-hour timeframe invalidates your testing.

Safety of the Federal Airspace is the Goal

Test Results and Limits of Confidentialty

All evaluations are structured to help determine the applicant's capacity to meet FAA medical standards irrespective of the class of medical certificate sought. The testing environment is designed to elicit the applicant's best performance in a supportive and respectful fashion while assuring the integrity and reliability of the test findings. Ultimately, safety of the Federal Airspace is the goal and there is no doctor/patient relationship formed between the applicant and the clinician and the typical rules governing such doctor/patient confidentiality do not apply. By requesting, agreeing to and participating in any assessment you are permitting the test findings to be sent to the FAA. If you are referred by an attorney whom you have contractually retained, you are permitting the findings to be sent to that attorney who has the obligation to determine to whom the findings are sent. We will discuss and answer any questions you have concerning these issues to assure that you fully understand and consent to assessment prior to beginning any data collection or test procedures. The final decision regarding issuance of a medical certificate is made by the FAA.

Contact the office to schedule via phone or email. We will discuss your issues in detail to determine the type of evaluation needed and ask to see any correspondance you may have received from the FAA. Allow sixty days from time of contact to the appointment time to allow collection of necessary documents prior to your visit.

Payment Information: Payment via cash, check or credit card is accepted and is required at the time of your appointment. The cost of the evaluation was discussed when the appointment was made, but any follow up testing may result in additional costs. Because this evaluation is in response to a regulatory matter rather than a medical neccesity third party (insurance) reimbursement is unlikely. However, you will be given an invoice that can be submitted by you in an attempt to secure reimbursement, but our office does not file insurance or seek payment from any third party.

Lodging, Ground Transportation, Dining

The Hotel Indigo, College Park is about a five minute walk from the office and many who come for evaluation choose to stay there the evening before the appointment. Other lodgings are nearby, but slightly less convenient. For dining the Corner Grille is a favorite of many applicants and is also near the office. There is ample free parking next to the office for those driving to the appointment. The office is one stop (College Park) from ATL on MARTA and trains run every 10 or 20 minutes depending on the day. There are always plenty of Lyft and Uber rides available in the area. Links are below.

Hotel Indigo

The Corner Grille

MARTA

The joy of flying