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Conditions AMEs Can Issue (CACI) are a series of conditions which allow AMEs to regular issue the pilot medical certificate if the applicant meets the parameters of the CACI Condition Worksheet. The worksheets provide detailed instructions to the examiner and outline condition-specific requirements for the applicant.

  • AME must review the disposition table BEFORE the CACI worksheet to verify a CACI is required.
  • If all the CACI criteria are met and the applicant is otherwise qualified, the AME may issue on the first exam or the first time the condition is reported to the AME without contacting AMCD/RFS. Document the appropriate notes in Block 60 and keep the supporting documents in your files; they do not need to be submitted to the FAA at this time.
  • If the requirements are not met, the AME must defer the exam and send the supporting documents to the FAA.

To determine the applicant’s eligibility for certification, the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam. If the applicant meets ALL the acceptable certification criteria listed below, the AME can issue. Applicants for first- or second-class must provide this information annually; applicants for third-class must provide the information with each required exam.

AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA
The treating physician's current, detailed Clinical Progress Note verifies:
  • Condition is stable;
  • If recurrence, there has been NO spread outside the bladder;
  • There is no current or historic evidence of any metastatic disease or muscle invasion;
  • Active treatment is completed (chemotherapy/radiation, etc.) and no new treatment is recommended at this time; and/or
  • If surgery has been performed, the airman is off pain medication(s), has made a full recovery, and has been released by the surgeon.
[ ] Yes
Symptoms [ ] None
Current treatment

Notes: If it has been 5 or more years since the airman has had any treatment for this condition, with no history of metastatic disease, and no recurrence, CACI is required. Note this in Block 60. (See disposition table.)

If the airman is currently on chemotherapy or radiation treatment, defer the exam. (See disposition table.
[ ] None or maintenance intravesical BCG or mitomycin.

(If these medications are used, the airman should not fly until 24 hours post treatment and asymptomatic.)

AME MUST NOTE in Block 60 one of the following:

[ ] CACI qualified bladder cancer. (Documents do not need to be submitted to the FAA.)

[ ] Has current OR previous SI/AASI but now CACI qualified bladder cancer.

[ ] NOT CACI qualified bladder cancer. I have deferred. (Submit supporting documents.)

FAA AME Guide Dec 2025 version
Apr 27, 2022
Dec 29, 2025
Dec 29, 2025