1. First of all, what is a 'SPECIAL ISSUANCE' ?

A special issuance is permission from the FAA to fly despite not meeting certain recommended medical standards (for example, blood pressure, vision, etc.). When the FAA reviews the medical information and determines that you may fly SAFELY, they can issue (or allow the AME to issue) a medical certificate with certain stipulations for length of valid time, requirements for submitting follow up medical information, etc.

Once the FAA has favorably reviewed your application, you will receive a letter confirming your approved status. Included with this letter will be instructions or specifications on what to do to continue your medical certification. Usually a special issuance is for a specified period of time. The instruction sheet will explain WHAT to get done, and WHEN to get it done before your next certification. Follow this exactly and you will have no problems. 

The FAA medical services have become a kinder, gentler endeavor with more emphasis on customer service, I am delighted to say.  The FAA has defined a number (about 20) of conditions that an AME can approve and issue on the spot, so to speak.  The are called "CACI" or "conditions AME can issue".


Click Here to print a full sheet of instructions on 'special issuances'


2. I am taking HIGH BLOOD PRESSURE medicine. Can I fly?

If the BP is under good control, chances are almost 100% that you can. All commonly used medications to treat hypertension today are approvable. There is a short form that you can download and have your doctor fill out that will provide all the necessary information to allow us to issue your medical certificate 'on the spot', The data must be less than ninety days old and the doctor's name, address, and phone number must be legible. (No joke, I have gotten some reports not even a pharmacist could read) If necessary, ALL of the testing can be done at our office if you prefer. Be sure and get a copy of your EKG to bring with you or we can do one here. Your AME can approve without sending to FAA OKC.

3. I have HEART PROBLEMS. Can I fly?

Usually you can. Most common heart issues (bypasses, stents, some mild heart "attacks") can be certified after submitting the required information. The initial information is rather extensive but you can obtain it fairly easily if you ask for the right thing. Once certified, RE-certification does not require nearly so many reports. You need to know what to ask for. Here is an outline of the necessary information.

In addition, SIX MONTHS must have elapsed since the last heart "event" (stent, attack, bypass) before you submit a request for re-instatement. A little before six months have gone by, begin to collect your reports and schedule testing with your heart doctor. You will need a fresh FAA exam to submit with the report, leave that to last.

To obtain records from a hospital, contact the Medical Records Department. They may ask for a written note from you granting them permission to release. Also, they may charge for copying and postage (HINT: they usually do not charge if the reports are being sent to a doctor's office).

4. I have DIABETES. Can I fly?

Diabetes that is uncomplicated and well controlled is usually certifiable. The most common form, "Type 2" or adult onset type, is approvable as long as it is well controlled, uncomplicated, and the airman provides the required information from his treating doctor. Here is the required information documentation.

Diabetic "tendencies" (such as mild blood sugar elevation but not to diabetic levels) that have NOT been diagnosed as diabetes do not require these reports. Insulin dependant diabetes CAN be approved however it does require considerably more work. There are over 300 insulin dependant diabetics flying at this time.

5. I had SURGERY a few weeks ago, can I fly?

With a few exceptions (for example, heart or lung surgery, cancer surgery, brain surgery) you may resume flying when your surgeon releases you to your "usual activity" as before the operation. Just report it at the time of your next FAA medical exam. If any questions, call.

6. I have had EYE SURGERY (cataracts, "Lasik", etc). May I fly?

Generally, as long as your vision is stable and meets the requirements for your class of medical certificate, you may be certified. Retinal surgery or any operation that might affect your side vision is a bit more complex and requires a report from your surgeon before approval. Contact the office for more information. The eye doctor report form is FAA 8500-7

There is some new cataract surgery where the implanted lens will actually focus a lot like when you were under 40! I have an pilot older than me (!) who passed the vision test for a commercial license WITHOUT glasses. This is the "Crystalens™". It requires a 90 day period following surgery before approval but it looks like it will be fantastic !! A report from the surgeon is required at present for this lens.

For glaucoma (increased eye "pressure") down load this form: FAA 8500-14 and ask your eye care professional to fill it out.

7. I had some DEPRESSION and was on medications in the past. What do I do?

If the depression was a single episode with an obvious related cause (death in the family, divorce, etc.) and not likely to recur, you need to have been off medication for at least 90 days. A letter from the doctor who prescribed the medication is needed explaining when, why, that you are off the prescriptions (this includes over the counter drugs like St. John's wort, etc), and not likely to have a recurrence. Recurring depression requires more information, call the office for questions.

8. I have had CANCER. Can I fly?

Usually. If your treating doctor will write a letter stating that you appear to be presently free of cancer and that you are not likely to have a recurrence in the next 12 months, the FAA will usually approve your request.. Depending on the type of cancer, they may ask for a report of a liver scan or chest x-ray. Certification is usually limited to12 months intervals initially.


For surgery the FAA will ask for three things: A current (less than 90 days old) PSA test, a statement from your surgeon that you appear free of cancer, and a statement that you are free of any metastatic (spread) cancer. A copy of the pathology report and operative report. On the first time request for approval, a letter from your doc that outlines the whole treatment would be very important. It is a sort of.... what (symptoms) made you go to the doctor, what was found, how it was treated, how you responded to treatment, and what follow up is recommended. A concluding statement that you are doing well and are expected to do well would be good. This more extensive letter is only needed on the first application. The FAA will usually approve in 12 month intervals. You only need your FAA exam in the usual schedule for the class. The subsequent doctor reports are the 'three things' mentioned in the first sentence.

For radiation treatment: a thirty day stabilizing period after last treatment. On the first time request for approval, a letter from your doc that outlines the whole treatment would be very important. It is a sort of.... what (symptoms) made you go to the doctor, what was found, how it was treated, how you responded to treatment, and what follow up is recommended. A concluding statement that you are doing well and are expected to do well would be good. A PSA test this close after treatment would not be necessary but would be for your follow up letter in a year. A copy of the pathology report and the oncologist's report is needed. You will need a statement from your treating doc that you appear free of cancer, and that you are free of any metastatic (spread) cancer. In 12 months you would need a follow up report on how you are doing, a fresh PSA test, and a comment that you  remain free of any metastasis.

10. I have had a KIDNEY STONE. Can I fly?

Usually it is no problem. First occurrence: You do need a statement from your treating doc that you have no "retained stones" (or none greater than 2mm) and a written report of a current CT scan, IVP (intravenous pyelogram) or "KUB" xray (kidneys, ureters, bladder) supporting the fact that there are no stones. You can be issued a certificate without more tests. Do not let your doc order a CAT scan, it is $$$ and LOTS of radiation. A simple “KUB” satisfies the FAA requirements and is comparable to a chest xray.

Second occurrence or retained stones: Contact the office for more information as there are certain issues that need to be answered before resuming flying. You will probably need a "special issuance" with annual reports.

11. I have LOW THYROID. 

Absolutely you can fly, but there have been some changes in the past year. This used to be absolutely no difficulty at all. You will need a brief note from your treating doc stating that the problem is well controlled and a copy of a recent (within 90 days) "TSH" test. You will need this annually and will fall into the "special issuance” class however it is one that your AME is authorized to approve.