AME-Assisted Special Issuance: What Airmen Candidates Need to Know

Airmen with disqualifying medical conditions may be eligible for FAA medical certification waivers through the AME-assisted Special Issuance medical certification process. The medical certificate typically provides the same authorization but can carry certain limitations such as the date of expiration.

The special issuance process requires considerable documentation and decisions are made on a case by case basis.  As a result, the special issuance process timeframe is often measured in months rather than days or weeks.

The FAA also requires Special Issuance for many medical conditions not specifically listed as disqualifying.  Some conditions require immediate grounding while others do not.

The conditions listed below are specifically listed as disqualifying, yet most of these conditions still permit Special Issuance medical certification.

  - Coronary heart disease
  - Angina
  - Myocardial infarction
  - Heart replacement
  - Cardiac valve replacement
  - Permanent cardiac pacemakers
  - Diabetes
  - Psychosis
  - Bipolar disorder
  - Severe personality disorder
  - Substance dependence or abuse
  - Epilepsy
  - Disturbance of consciousness
  - Transient loss of nervous system function

Please contact Steel City Direct Care for a free consultation if you believe that you may have a medical condition that will require an AME-assisted special issuance.

Aviation Medical Examiners (AME’s) generally are NOT authorized to grant the initial authorization for Special Issuance certification. AME-assisted special issuance waivers must be issued by an FAA government employee (Federal Air Surgeon or designee) versus an AME who is not employed by the federal government.
 
While Aviation Medical Examiners are permitted to renew certain Special Issuance waivers, in most cases the initial waiver authorization must be granted from the Federal Air Surgeon first. This is typically authorized by a letter to the pilot from the Aeromedical Certification Division (AMCD) of the FAA in Oklahoma City.

Those who are authorized will received a letter permitting them to see their AME for Special Issuance renewal.

Currently, Special Issuance may be renewed by AME’s (when authorized in writing by the  FAA) for the following medical conditions:

  - Asthma
  - Arthritis
  - Brachytherapy
  - Cancer: Breast, Bladder, Colon, Hodgkin’s Lymphoma, Lymphoma, Melanoma, Prostate, Renal
  - Chronic Lymphocytic Leukemia
  - Chronic Obstructive Pulmonary Disease (COPD)
  - Crohn’s Disease
  - Diabetes Type II (Diet controlled or Oral Medication Only)
  - Glaucoma or Ocular Hypertension
  - Hepatitis C
  - Hyperthyroidism
  - Hypothyroidism
  - Kidney Stones ( Urolithiasis)
  - Migraine Syndrome
  - Sleep Apnea
  - Ulcerative Colitis
  - Cardiovascular / Heart: Angina Pectoris (chest pain), Atrial Fibrillation, Coronary Artery Disease, Coronary Bypass Grafting (CABG), Mitral & Aortic Insufficiency, Murmur, Myocardial Infarction, Paroxysmal Atrial Tachycardia, Percutaneous Transluminal Coronary Angioplasty (PTCA), Stent Implantation, Valve Replacement

Steel City Direct Care places the airman at the center of all that we do.  We are here to work with the other members of your clinical care team to may sure that the FAA has all of the documentation required to render a definitive medical certification decision in the shortest timeframe possible.

We look forward to connecting with you!

Christopher T. Conti, MD is a Senior Aviation Medical Examiner, based in Wexford, PA, just 30-minutes outside of the Pittsburgh city limits.