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Attention-Deficit/Hyperactivity Disorder (ADHD), formerly called Attention Deficit Disorder (ADD), and medications used for treatment may result in cognitive deficits that would make an airman unsafe to perform pilot duties.
Airmen who have a regulatory diagnosis of alcohol dependence or abuse may require evaluation and monitoring before they can obtain a medical certificate. If an airman requires monitoring they should establish with a HIMS (Human Intervention Motivation Study) trained AME (HIMS AME) to help them work through the FAA process.
Decision Considerations – Aerospace Medical Dispositions for Arthritis
Decision Considerations – Aerospace Medical Dispositions for Asthma
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Per FAA Advisory Circular (AC) 70-2A, Reporting of laser illumination of aircraft, all pilots and crewmembers are requested to immediately report incidents of unauthorized laser illumination by radio to the appropriate ATC controlling facility.
Upon arrival at destination, all pilots and crewmembers affected by an unauthorized laser illumination are requested to complete the FAA Laser Beam Exposure Questionnaire
Notes regarding Bladder Cancer: If the airman is currently on radiation or chemotherapy, the treatment course must be completed before medical certification can be considered.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
For the purpose of airman certification coronary heart disease (CHD) is divided into 4 broad categories, with or without myocardial infarction (MI):
- Open revascularization of any coronary artery(s) and left main coronary artery stenting (with or without MI). Open revascularization includes coronary artery bypass grafting (CABG; on- or off-pump), minimally invasive procedures by incision, and robot operations. Left main coronary artery stenting carries the same risk of future cardiac events as CABG, thus it is treated the same for certification or qualification purposes
- Percutaneous intervention (with or without MI). This includes angioplasty (PTCA) and bare metal or drug-eluting stents
- MI without any open or percutaneous intervention
- MI from non-coronary artery disease causes. Examples include epinephrine injection, cardiac trauma, complications of catheterization, Factor V Leiden, etc.
Note: If cardiac catheterization and/or coronary angiography have been performed, all reports and actual films (if films are requested) must be submitted for review. Copies should be made of all films to safeguard against loss. Films should be labeled with the applicant’s name and return address.
* Limited second-class medical certificate refers to a second-class certificate with a functional limitation such as “Not Valid for Carrying Passengers for Compensation or Hire,” “Not Valid for Pilot in Command, Valid Only When Serving as a Pilot Member of a Fully Qualified Two-Pilot Crew,” etc.
Decision Considerations – Aerospace Medical Dispositions for Item 41. G-U System – General Disorders
CACI Worksheet Pre-Diabetes (PDF)
Diabetes Mellitus Type II – Medication Controlled Page (FAA)
Diabetes Hyperglycemia Medication Report (PDF)
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Third-Class Insulin Treated Diabetes Mellitus (Type I / Type II) (FAA)
Initial Certification
- The applicant must have had no recurrent (two or more) episodes of hypoglycemia in the past 5 years and none in the preceding 1 year which resulted in loss of consciousness, seizure, impaired cognitive function or requiring intervention by another party, or occurring without warning (hypoglycemia unawareness).
- The applicant will be required to provide copies of all medical records as well as accident and incident records pertinent to their history of diabetes.
- A report of a complete medical examination preferably by a physician who specializes in the treatment of diabetes will be required.
Visual Acuity Standards:
- As listed below or better;
- Each eye separately;
- Snellen equivalent; and
- With or without correction. If correction is used, it should be noted and the correct
limitation applied.
First / Second Class:
Distant Vision: 20/20
Near (16 inch) / Internmediate (32 inches): 20/40
Third Class:
Distant / Near (16 inches): 20/40
Intermediate: N/A
FAA Gender Dysphoria Mental Health Status Report (PDF)
The AME may ISSUE (no further information is needed), if the airman:
- Was evaluated for or diagnosed with Gender Dysphoria and has never undergone treatment (counseling or support group for GD does not require information);
- Has no history of other mental health diagnoses or treatment; and
- Is otherwise qualified
* Side effects from hormone therapy can be aeromedically significant. The airman should be warned not to fly per Title 14 CFR 61.53 if they experience medication side effects.
The Examiner should deny or defer issuance of a medical certificate to an applicant if there is a loss of visual fields or a significant change in visual acuity.
The FAA may grant an Authorization under the special issuance section of Part 67 (14 CFR 67.401) on an individual basis. The Examiner must obtain a report of Ophthalmological Evaluation for Glaucoma (FAA Form 8500-14) from an ophthalmologist. See Glaucoma Worksheet (PDF). Because secondary glaucoma is caused by known pathology such as; uveitis or trauma, eligibility must largely depend upon that pathology. Secondary glaucoma is often unilateral, and if the cause or disease process is no longer active and the other eye remains normal certification is likely.
Decision Considerations – Aerospace Medical Dispositions for Heart – Valvular Disease
Coronary Heart Disease (CHD) Procedures
[Third-Class] AME Assisted SI – Valve Replacement
Mitral Valve Repair Disposition (PDF)
CACI Worksheet (Mitral Valve Repair) (PDF)
[All Classes] AME Assisted SI – Mitral and Aortic Insufficiency
CACI Worksheet For Hepatitis C (PDF)
Decision Considerations – Aerospace Medical Dispositions for Abdomen and Viscera and Anus Conditions
Human Immunodeficiency Virus (HIV) Specifications (FAA) (PDF)
Persons on antiretroviral medication will be considered only if the medication is approved by the U.S. Food and Drug Administration and is used in accordance with an acceptable drug therapy protocol. Acceptable protocols are cited in Guidelines for the Use of Antiretroviral Agents in HIV Infected Adults and Adolescents developed by the Department of Health and Human Services Panel on Clinical Practices for Treatment of HIV Infection.
For persons taking HIV medication for long-term prevention or Pre-Exposure Prophylaxis (PrEP), see Item 48. General Systemic – Human Immunodeficiency Virus (HIV).
Application for special issuance must include reports of examination by a physician knowledgeable in the treatment of HIV infected persons and a medical history emphasizing symptoms and treatment referable to the immune and neurologic system. In addition, these reports must include a “viral load” determination by polymerase chain reaction (PCR), CD4+ lymphocyte count, a complete blood count, and the results of liver function tests. An assessment of cognitive function (preferably by Cogscreen or other test battery acceptable to the Federal Air Surgeon) must be submitted. Additional cognitive function tests may be required as indicated by results of the cognitive tests. At the time of initial application, viral load must not exceed 1,000 copies per milliliter of plasma, and cognitive testing must show no significant deficit(s) that would preclude the safe performance of airman duties.
If the airman’s blood pressure is elevated in clinic, you have any of the following options:
- Recheck the blood pressure. If the airman meets FAA specified limits on the second attempt, note this in Block 60 along with both readings.
- Have the airman return to clinic 3 separate days over a 7-day period. If the airman meets FAA specified limits during these re-checks, note this and the readings in Block 60. Also note if there was a reason for the blood pressure elevation.
- Send the airman back to his/her treating physician for re-evaluation. If medication adjustment is needed, a 7-day no-fly period applies to verify no problems with the medication. If this can be done within the 14 day exam transmission period, you could then follow the Hypertension Disposition Table.
Implanted Pacemaker
A 2-month recovery period must elapse after the pacemaker implantation to allow for recovery and stabilization.
No consideration can be given for special issuance until all the required data has been received.
The use of the airman’s full name and date of birth on all correspondence and reports will aid the agency in locating the proper file.
[All Classes] Special Issuance – Melanoma
Determination based on type of medical diagnosis of Skin condition.
Medical History: Use of sleep aids is a potential risk to aviation safety due to effects of the sleep aid itself or the underlying reason/condition for using the sleep aid.
All the currently available sleep aids, both prescription and over the counter, can cause impairment of mental processes and reaction times, even when the individual feels fully awake. (As examples, see the Food and Drug Administration drug safety communications on zolpidem and eszopiclone.
FAA Mandates minimum wait times for flight after taking certain medications:
- Ambien (zolpidem)- 24 hour
- Ambien CR (zolpidem) – 24 hours
- Edlur (zolpidem) – 36 hours
- Intermezzo (zolpidem) – 36 hours
- Lunesta (eszopiclone) – 30 hours
- Restoril (temazepam) – 72 hours
- Rozerem (ramelteon) – 24 hours
- Sonata (zaleplon) – 6 hours
- Zolpimist (zolpidem) – 48 hours
For specific medication requirements, call us at 773-755-2600
Our office will be glad to perform your medical examination for consideration of your Student Pilot’s Certificate.
Your Pilot Certificate will be issued to you by the FAA. We will give you your Medical Certificate.
Notes regarding Testicular Cancer: If the airman is currently on radiation or chemotherapy, the treatment course must be completed before medical certification can be considered. Watchful waiting is allowed. See CACI Testicular Cancer Worksheet (PDF).
