The Fine Print

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THE FINE PRINT

This disclosure is critical to understanding the purposes of your evaluation, the uses of the report, and the limitations of an independent assessment.

Your evaluation will be an independent psychiatric examination. An independent psychiatric evaluation is different from a clinical assessment in a few key areas.

A DOCTOR-TO-PATIENT TREATMENT RELATIONSHIP IS NOT ESTABLISHED

The purpose of an independent psychiatric evaluation is to answer a question posed by a court, a regulatory body, a government agency, an attorney, or an employer. The questions that come to this office can represent any aspect of psychiatry or substance use.

Since an independent psychiatric evaluation answers a regulatory question of some sort, the product of the evaluation produces a report that is considered evidence. It does not produce clinical recommendations even if the psychiatrist’s findings discuss clinical concepts. A doctor-to-patient relationship is not established in an independent evaluation. Unless you present with a life-threatening emergency that interrupts the examination, you will not receive a clinical recommendation that would demonstrate that I am a part of, or directing, your clinical care.

Because we are not meeting for the purposes of treatment, the usual rules of patient-client confidentiality and privilege do not apply in these evaluations. As the evaluation is often used for a legal or regulatory matter, the rules of confidentiality of the assessment, the findings, and subsequent developments are determined by the rules of the court or regulator. However, I still have a duty to safeguard your information from hacking and loss.

After the report has been offered as evidence, I am obligated to answer later questions about the report from the FAA or another regulator of jurisdiction even if you feel the discussion is not in your best interest. If the evaluation is requested for and paid for by your employer or another third-party, then I am obligated to answer questions posed by the company or other third-party.

WHO IS THE CLIENT? SOMETIMES NOT THE PILOT!

It is essential to understand the distinction between a client and a person being evaluated. The client is the party who has requested and is responsible for the payment of the evaluation. In some cases, this could mean that an employer or some other third party or agency is the client, even though you are answering the questions and giving me records.

ANSWER THE QUESTIONS ACCURATELY, EVEN IF SOME OF THIS IS HARD TO TALK ABOUT

Please answer all questions, whether oral or written, as accurately as you can. Information that is withheld, misleading, or false is potentially more damaging to you than openly discussing any problems you may have had with the courts, law enforcement, an employer, or any other entity. Even if you think negative details may hurt your case, discussing the problems openly is encouraged because then I may be able to place the problems into a broader context that may be less damaging.

I do not have a duty to correct you during the evaluation if you offer misleading or erroneous information. Any information that, in my sole opinion, is deliberately withheld, deceptive, or false will be identified as such in the report and can be used to form a negative opinion about your case.

LEGAL, MEDICAL, AND THERAPY RECORDS ARE JUST AS IMPORTANT AS THE EVALUATION

Even though normal medical privacy rules may not apply, another organization may still insist that you follow their rules for a medically protected release. You agree that you will participate in helping me gain all records that I request, including by signing HIPAA compliant forms with third parties. Not assisting to secure the record, either by refusing to complete medical records requests, limiting what can be shared with me, or adding unnecessary delay can be noted explicitly in the report and the lack of cooperation can be harmful to your case. An incomplete documentary record potentially damages your case by leading to inconclusive, speculative, or prejudicial findings by the examiner.

MY OPINIONS ARE NOT THE FINAL WORD

My opinions do not limit in any way your ability to protest the evidence in your case, including my written opinions. The method of how you protest evidence could be governed by a contract or a regulation. It is your sole responsibility to make sure that you follow the proper procedures as designated by the agency or contract for any protest or appeal. You cannot protest the findings to me. Your report cannot be changed once it is considered final except at my sole discretion, and these changes are limited to the correction of minor typographical errors that have outsized implications for the conclusions.

THE FULL REPORT IS THE ONLY OPINION

I cannot give an opinion about the case until the written report is generated. I have no opinion but for the final opinion, and the final opinion is contained only in the written report. You should never take a verbal comment, email, or any other form of communication to imply that I have formed an opinion about your case until the final report has been signed.

If you are the client, you can request a copy of the evaluation. Requesting your assessment or a summary of it will terminate the independent review, even if the evaluation is incomplete and no opinion has yet been formed. Therefore, asking for your record too soon can have negative consequences. Unless there is some other fee agreement spelled out in a contract, the report will not be released until any balance due is paid. An incomplete evaluation after a case has been terminated cannot be updated for any reason. A new evaluation can commence but only at my sole discretion. A waiting period may be required

WHO GETS THE REPORT?

Your report when complete will be released to your Aviation Medical Examiner, HIMS Aviation Medical Examiner, Independent Medical Sponsor, or your employer. If you are the client, you will also get a copy. The report is not usually sent directly to the FAA from this office. The FAA often asks for other statements or documents not held in this office, so it is probable that sending an aviation psychiatric examination directly to the FAA from here would still leave your FAA file incomplete. If the independent assessment concluded that your status poses a risk to public safety or the public airspace, then you would not be able to prevent a release of the report to your employer, AME, the FAA, or any other regulator of jurisdiction.

I AM NOT A LAWYER, SO DISCUSS THE EVALUATION AND REPORT WITH AN ATTORNEY IF YOU HAVE QUESTIONS ABOUT THE LAW AND REGULATION

I am not an attorney and cannot give you legal advice. Many clients engage an attorney to represent and protect their interests. If you are concerned about the use of this report, you should discuss any issues with an attorney before we proceed to evaluation. If you do not have an attorney, then you are solely responsible for understanding all applicable laws and regulations in your case, including how this independent examination will be used.

FEES

This agreement ends when the final balance has been paid and your report has been filed with the client. For a description of the costs and how they are determined, you can go here:

Fees and Timeslines

Nothing in this agreement establishes that I have agreed to serve as an expert witness or consultant with you or an attorney. Expert witness and consultation agreements require a separate contract and will have a different fee structure.