PTSD (Post Traumatic Stress Syndrome)

[Guest Jarhead]

Gentlemen,

I've spent 3 1/2 years in the military; 3 years in Europe, including a one-year stint on active duty as an infantry officer, and six months in the USMCR after I immigrated. Just before shipping off to Parris Island, I had some hemorrhoids removed, and this triggered childhood memories I'd been unaware of. I made it through boot camp, but when I spoke to a chaplain on Lejeune about increasing nightmares, he referred to me to the wizard, who told me I had PTSD. Long story short, I was discharged honorable/RE-3P. No suicidal tendencies, no disciplinary problems, no PD or similar, excellent write-ups from my chain of command recommending that I re-enlist once healthy. Total time on meds was about 5 weeks and I went off them the day I was discharged and haven't looked back since.

I've since responded so well to treatment that my nightmares are almost gone. I say almost because I'm back to normal but it's too early to tell. If I'm still symptom-free a year from now though, I'll start looking at re-enlisting. My goal will be a commission in the reserves and with my background I won't even think of calling a recruiter unless I'm 100% sure I'm not going to pose even the slightest risk to those in my CoC.

What I'd like to know from you is, do you think you'd ever trust someone with my medical history? This applies to both officers in general and pilots specifically. I joined the USMCR with the long-term goal of going active and getting a pilot slot in one of the services, but at this point I know my options are a big question mark.

Edited January 21, 2008 by Jarhead

[Guest hawg030]

Interesting story, hard to tell how other people would respond to your question. I guess if you wore it on your sleeve, and everyone knew about it, then people would probably think twice about you sitting in control of thier aircraft. The pilot gets the air crew there and back and unlike the movie top gun, they ground real pilots for mental illness. But if the military deemed you 100% better, and decided you were a no risk investment as an officer and more importantly an aviator, then as long as you keep it on the DL that it happened, seems to me that it shouldnt be much of an issue.

How you would get this one past flight medicine is beyond me, and Im doubting PTSD resulting in discharge is a waiverable condition at brooks. Just my extremely uneducated guesswork though. Good luck with it, the guys on here are pretty knowledgeable but I felt like giving my 10 cents first

[Guest P27:17]

Interesting story, hard to tell how other people would respond to your question. I guess if you wore it on your sleeve, and everyone knew about it, then people would probably think twice about you sitting in control of thier aircraft. The pilot gets the air crew there and back and unlike the movie top gun, they ground real pilots for mental illness. But if the military deemed you 100% better, and decided you were a no risk investment as an officer and more importantly an aviator, then as long as you keep it on the DL that it happened, seems to me that it shouldnt be much of an issue.

How you would get this one past flight medicine is beyond me, and Im doubting PTSD resulting in discharge is a waiverable condition at brooks. Just my extremely uneducated guesswork though. Good luck with it, the guys on here are pretty knowledgeable but I felt like giving my 10 cents first

Too many unsaid pieces of this pie to give a real assessment...talk with a local flight surgeon with your medical records in hand...or contact HQ AETC 210-652-3900 and speak to someone there about your commissionability.

[Guest Stephen]

Ok ive done a search and cant find much of anything on this subject. I have been in the army 8 years. I got ptsd about 3 years ago..but now its controlled. W/O Medication for the past 6 months at least. They tried a bunch of medicine, but it just wasnt right for me. I just needed time. I am getting disability from the VA for ptsd, but like i said its controlled. I dont need any medication or anything. Will i be able to get my class 1 or 2 medical certificates? I really want to fly, and I will literally do anything to become one. It sucks that ptsd might dq me from it. But i just need someone with experience to tell me if this will stop me or not.. Thanks in advance!

Another quick question for my friend who is also trying to become a pilot. He was diagnosed with MTBI (Mild traumatic brain injury) they said his brain is pushed down like 1/4 of an inch (something called benign tonsillar ectopia) he doesnt have any recurring issues from this, he was just diagnosed with a ct scan. No recuring headache or anything. Will this dq him from flying?

[Guest Stephen]

Whoever put this with the other question doesnt really get it i guess.. I havent been discharged for ptsd. just diagnosed. i have been doing my job at full capacity since i was diagnosed with it.. So it doesnt get in the way of me doing anything or i would have been discharged.

[Guest goducks]

Whoever put this with the other question doesnt really get it i guess.. I havent been discharged for ptsd. just diagnosed. i have been doing my job at full capacity since i was diagnosed with it.. So it doesnt get in the way of me doing anything or i would have been discharged.

Stephen, I'm guessing your question was moved as there was an existing PTSD thread. Doesn't mean your situation is the same, just related.

I don't have a complete answer, but I can give you some feedback. First, you're not concerned with a Flying Class II at this time (trained pilot). You need to get a Flying Class I waiver (UPT applicant). I can tell you that in my experience, I've never recalled someone with PTSD applying for UPT. I would assume that this is mostly due to the fact that the vast majority of UPT applicants don't have prior military experience. It's my gut feeling (and it's purely speculation) that you may not be DQ'd outright, but you'd likely be heavily scrutinized.

Addendum: After perusing the waiver guide, here's what I found.

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III. Waiver Consideration.

PTSD is disqualifying for all aviation duties in the USAF. It is not mentioned specifically in AFI 48-123 for FC I/IA, II or III, but would be covered under the general category of anxiety. It is mentioned specifically in the UAS section as disqualifying. It would be wise to limit waivers to those with six months of sustained remission and off all pharmacotherapy.

Table 1: Waiver potential for PTSD

Flying Class (FC) Waiver Potential Waiver Authority ACS Evaluation or Review#

I/IA Maybe *AETC Yes

II Yes MAJCOM Yes

IIU Yes AFMSA Yes

III Yes MAJCOM Yes

*Must clearly demonstrate complete resolution of all PTSD symptoms before acceptance into initial flying training and have complete documentation from mental health providers.

#Must be reviewed by the ACS prior to consideration for a waiver.

AIMWTS review in December 2009 revealed a total of 36 aviator cases submitted with a diagnosis of PTSD. There were no FC I/IA or FC IIU cases, 10 FC II cases and 26 FC III cases. Of that total, there were 30 cases resulting in a disposition of disqualified; 8 were FC II and 22 were FC III. The major factors resulting in a disqualification were persistent symptoms, chronic disease, other mental health diagnoses, and the need to treat with medications not approved for use in USAF aircrew.

IV. Information Required for Waiver Submission.

Aeromedical disposition and waiver request should only be submitted after clinical disposition has been completed and all appropriate treatments have been initiated using best current clinical guidelines/recommendations.

The aeromedical summary for initial waiver for PTSD should include the following:

A. History – symptoms to include the inciting event(s), good time-line of events; how symptoms affect job, home life, finances, and relationships. Discuss all other psychiatric conditions. Include drinking and drug use history, if applicable.

B. List and fully discuss all clinical diagnoses requiring a waiver.

C. Treatment – medications and therapy used for PTSD and any other psychiatric conditions.

D. Psychiatry/psychology consultation: Need all treatment notes from treating mental health professional as well as an MEB-type narrative summary of the mental health record.

E. Report of all psychological testing, if performed.

F. Basic labs – CBC, Chem 7, LFTs, TSH.

G. Letter of support from immediate commander.

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Sounds to me like you have a chance.

GD

Edited July 22, 2010 by goducks

[fox two]

How does a PTSD diagnosis affect an air force pilot's career these days? (very mild PTSD that would not be affecting job performance at all)

[deaddebate]

This is a pretty big question with many regulations that usually devolves to a lengthy administrative headache. Note that UCMJ charges can trump an MEB or normal administrative separation. JAG rulings will dictate what happens to the member and the MDG will not be much of a shield.

First understand that PTSD is a potentially "unsuiting" condition rather than "unfitting," meaning the Commander first has the option to administratively separate the member. For Enlisted, the standard is AFI 36-3208, para. 5.11.10., which has very specific procedures for any ENLISTED member with PTSD that is negatively impacting or precluding their ability to serve in the Air Force. OFFICERS with PTSD instead fall under AFI 36-3206, para. 2.2.6. and 2.3.7. Essentially, OFFICERS COULD be discharged much faster than ENLISTED, however they SHOULD receive the same level of care and treatment while still within the Military Healthcare System (MHS). In my experience, OFFICER and ENLISTED PTSD cases both undergo substantial scrutiny and personnel are given significant access to treatment and other resoources--noone to my knowledge has been rushed out of the service for PTSD. However it could conceivably happen to an OFFICER if an especially callous Commander and the local Chief of the Medical Staff (MDG/SGH) made it so. Once separated/retired, all Airmen certainly do receive the same level of care through the VA (presuming you consider the VA capable of actually providing any semblance of care amid their intense incompetence).

Note that administrative separation does not prohibit a servicemembers benefits within the Disability Evaluation System (DES), but that it only circumvents the normal Medical Evaluation Board processing. An administrative separation does not cheat the member of further medical care or disability claims, assuming the separation is not for UCMJ charges or some other form of dishonorable discharge. See DoDI 1332.38 for more info--Enclosure 4 is most applicable, but observe that Enclosure 5 does NOT list PTSD.

If a Commander chooses not to pursue administrative separation because in their opinion the member's PTSD is not substantially "unsuiting" for duty, the MDG can still pursue an MEB for an "unfitting" condition at the discretion of the Flight Doc/PCM, Chief of Aerospace Medicine (MDG/SGP), and the MDG/SGH per AFI 48-123 and the Medical Standards Directory (MSD). Applicable standards include MSD, para. Q7, which states: "Mental Health conditions associated with recurrent duty impairment." There are other applicable standards within Section Q of the MSD, but you get the gist.

If the MEB doesn't medically retire the member (usually by retention on ALC) or the MDG doesn't pursue MEB because the condition isn't significant enough to prevent ground duties, the Flight Doc and MDG/SGP would still likely begin medical disqualification for Flight Duty through MSD Q17 & Q18, which state: "PTSD/ASD/Adjustment Disorder/other Specified Trauma and Stressor-Related Disorder that interferes with safety of flight/controlling/alert or if member is unable to return to full duty within 60 days of diagnosis (minor residual symptoms are acceptable)." & "PTSD/Adjustment Disorder/other Specified Trauma and Stressor-Related Disorder if greater than 60 days, or if member experiences a recurrence of debilitating symptoms upon return to the operational environment." The first step is applying for a flight waiver.

For flight waiver approval, ALL personnel MUST be evaluated by the Aeromedical Consultation Service (ACS), which usually requires a TDY at WPAFB in addition to any previous treatment/consultation. A review of AIMWTS shows that only about a third of all cases are granted a waiver. If a member is retained but permanently DQ'd from flight duty (waiver denied), they would undergo personnel force shaping programs for possible AFSC re-assignment, becoming an AFPC function. For PTSD waiver consideration, the member must stable and symptom for AT LEAST 6 months, but it is frequently 12 months. The most common reason for flight waiver denial are persistent symptoms, required medications not approved for aircrew, or other conditions that also require a waiver. Even if the individual conditions are considered waiverable, but the member has multiple conditions requiring waiver, the chances of waiver approval drop greatly. All conditions are weighed together, and not independently assessed. Finally, no waivers are granted without documented Command support in the waiver package.