Asthma Checklist: Derived from FAA AME Guide Asthma Worksheet

Instructions to AMEs Examining Pilots with Asthma

Mar 2014

Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide page 69, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

The AME must review a current status report by the treating physician and any supporting documents to determine the applicant’s eligibility for certification. If the applicant meets ALL the acceptable certification criteria listed below, the AME can issue the Medical Certificate. Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam (interval depends on age).


AME MUST NOTE in Item 60: AME Comments on History and Findings one of the following:

[ ] Airman meets certification criteria for asthma.
  • Treating Physician Declares Stability
  • Symptoms Well Controlled
  • Medications are Acceptable
  • Current and PFTs > 80% Predicted

(Full Details Below)

[ ] Airman had a previous Special Issuance for this condition and now meets the regular issuance certification criteria for asthma.
[ ] Airman does NOT meet certification criteria for asthma. I (your AME) have deferred the exam.
  • (AME will then mail the supporting documents to FAA identifying which criteria were not met.)

Asthma Checklist

These are relevant clinical instructions for your AME derived from the FAA Asthma Worksheet, 2014 AME Guide, page 69

AME MUST REVIEW

ACCEPTABLE CERTIFICATION CRITERIA

Treating physician finds the condition stable on current regimen and no changes recommended

[ ] Yes

Symptoms: Stable and well-controlled (either on or off medication)




 

[ ] Yes for all of the following:

  • Acceptable frequency of symptoms
    • not more than 2 days per week
  • Acceptable use of inhaled short-acting beta agonist (rescue inhaler)
    • not more than 2 days per week
  • Acceptable use of oral corticosteroids for exacerbations
    • not more than 2 times per year
  • In the last year:
    • No in-patient hospitalizations
    • No more than 2 outpatient clinic/urgent care visits for exacerbations (with symptoms fully resolved)

Acceptable Medications

[ ] One or more of the following

  • Inhaled long- acting beta agonist
  • Inhaled short-acting beta agonist (e.g., albuterol)
  • Inhaled corticosteroid
  • leukotriene receptor antagonist, (e.g. montelukast [Singulair])


FAA Note: A short course of oral or IM (injectable) steroids during an exacerbation is acceptable. Your AME will caution you not to fly until course of oral steroids is completed and you are symptom free.
 

Pulmonary Function Tests *


 



*PFT is not required if the only treatment is PRN use on one or two days a week of a short-acting beta agonist (e.g. albuterol).

[ ] Current within last 90 days



[ ] Results are satisfactory. Satisfactory is defined as each of the following is equal to or greater than 80% predicted before bronchodilators.

  • FEV1
  • FVC
  • FEV1/FVC

 


Commentary:

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Note from FlightPhysical.com: FAA double negatives can be tricky, so read this form carefully. AMEs must attest through applicant's history or independent medical records verification that the asthma is stable and well-controlled as defined by criteria in the right column. In the symptoms row the top "yes" means that the objective threshholds for unstable are excluded (double negative logic). If all sub-criteria are met, and none of the 4 list items are present (eg, NOT MORE than 2 days of symptoms per week, etc) then "yes" can be checked. In the medication row, there is no an approved list by specific medication, but the approved categories are described. If all of the applicant's medications are within the allowed categories listed in green, then this criteria is met. If you don't satisfy all of these criteria, do not immediately give up. The AME can still request a waiver (special issuance) depending on your unique circumstances.


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This page discussed Asthma Checklist: Derived from FAA AME Guide Asthma Worksheet


Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now