FAA publishes changes to special issuance medical conditions

April 11, 2013

The FAA on April 9 posted changes to the “Guide for Aviation Medical Examiners” that will streamline the medical certification process for pilots with certain medical conditions that previously required special issuance authorizations.

A new program, known as Conditions the AME Can Issue (CACI), resulted in medical certification changes for pilots with arthritis, asthma, glaucoma, hepatitis C, hypertension, hypothyroidism, migraine and chronic headaches, pre-diabetes (metabolic syndrome, impaired fasting glucose, insulin resistance, glucose elevation/intolerance), and renal cancer. These conditions previously required an initial FAA special issuance authorization before your AME could issue a medical certificate. Under the new policy, the AME is authorized to issue a normal duration medical certificate at the time of examination if the applicant provides adequate documentation showing good control of the condition. A specification worksheet for each of the conditions will include the medical documentation required to satisfy the AME and the FAA that the condition is stable.

AOPA has for many years supported the philosophy that AMEs should be granted broader authority to issue medical certificates to their airmen. That advocacy resulted in the AME-Assisted Special Issuance (AASI) program that the FAA adopted years ago as the predecessor to the CACI program, and allowed the AME to issue subsequent medical certificates under special issuance authorizations following initial approval from the FAA.

The CACI program is the next iteration in that process of reducing the up-front oversight of airman medical certification, and should result in a positive impact on the workload and review time for more complex medical cases at the FAA Aerospace Medical Certification Division in Oklahoma City. At a time when government resources are stretched, and with sequestration still very much in the spotlight, this is a beneficial change that will reduce the cost and regulatory burden for pilots who have one or more of these conditions.

This program follows another recent change to FAA policy regarding certain cardiac conditions. Just recently, the FAA announced that the recovery and stabilization period after coronary artery stenting was reduced from six months to three months, another positive step toward getting pilots back in the air sooner after successful treatment for serious medical conditions. Those changes are already in effect, and will be published soon in the “Guide for Aviation Medical Examiners.”