AME Guidance for AASI: Overview of AME Assisted Special Issuance

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Pathways for AMEs to Expedite your FAA Medical Waiver
A pathway for pilots with conditions that would normally prevent certification (like past heart attacks or stents) to get their certificate back.
The FAA AASI (AME Assisted Special Issuance) process lets an Aviation Medical Examiner (AME) re-issue a medical certificate for certain previously approved, but still disqualifying, conditions, streamlining renewals by allowing the AME to approve based on submitted physician reports, rather than requiring full FAA review, if the pilot meets strict criteria and the condition hasn't worsened. The pilot brings their existing Special Issuance Authorization letter and updated, specific medical documentation from their treating doctors; the AME reviews this, ensures no adverse changes, and issues the certificate, sending everything to the FAA for final review. If you have a manageable medical issue, the FAA tells your AME what specific tests and records they need; the AME then acts as their agent to approve your certificate once those requirements are met. An AASI (AME Assisted Special Issuance) is the term for FAA process letting an Aviation Medical Examiner (AME) (a specially trained doctor) re-issue an airman medical certificate to a pilot who has a disqualifying medical condition, but meets specific FAA criteria after initial FAA review and authorization. The AME, acting under an FAA Authorization as their Designee The AME reviews required medical documentation from the pilot's treating physicians (usually specialists or primary care team), and can then the AME now has the authority to re-issue the certificate, streamlining the process for common conditions like the ones listed on this page.

AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations (14 CFR) part 67.

An FAA staff physician (your AME's medical supervisor) 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 required 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.

Here is a checklist for pilots:
  • 1. Gathering Documentation: Before their exam, you as the pilot gather updated reports from your treating physicians (e.g., cardiologist, endocrinologist) and gathers all required tests (labs, EKGs, etc.) as specified in the FAA's Authorization letter.
  • 2. AME Exam: As the pilot or ATC controller, you should bring these required documents to your AME for your scheduled flight physical.
  • 3. During the Medical Exam the AME checks your application (often via MedXPress), and reviews your submitted medical documentation, and verifies that you meet the criteria in the FAA Authorization letter and that there's been no significant worsening of the condition or new issues.
  • 4. Issuance: If all conditions are met, your AME re-issues the medical certificate on the spot.
  • 5. FAA Submission: After the appointment your AME sends all the documentation to the FAA for their records and final review, though the pilot can continue flying with the re-issued certificate. Only rarely does the FAA revoke a certificate after the visit and the "conditional" medical certificate that you received at your AME's office.
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