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AME Guidance for Processing a Colitis Worksheet CACI (Condition AME Can Issue)

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
A current, detailed Clinical Progress Note from the treating physician [ ] Condition is stable with no effects that would interfere with flight duties. AND
[ ] No surgery for the condition in the last 6 (six) weeks.
Symptoms [ ] None or mild diarrhea with or without mild abdominal pain/cramping

Fatigue which limits activity or severe abdominal symptoms are not acceptable for certification.
Cause of Colitis [ ] Crohn's disease, ulcerative colitis, or irritable bowel syndrome
Any other causes require FAA decision.
Medications for condition

KEY:

Interleukin Inhibitors (IL)

Phosphodiesterase-4 Enzyme Inhibitor (PDE4)

Tumor necrosis factor inhibitors (TNF)

Selective Adhesion-Molecule Inhibitor (SAM)
[ ] One or more of the following:
  • Guanylate Cyclase-C (GC-C) Agonist
    • linaclotide(Linzess), plecanatide (Trulance), tenapanor (Ibsrela)
  • Steroids
    • Oral formulations prednisone 20 mg/day equivalent or less (see steroid conversion calculator)
    • Oral budesonide 9mg or less
    • Steroid foams or enemas/ budesonide enema
  • azathioprine (Imuran)
  • hyoscyamine - use 1-2 times a week with no side effects and no-fly 48 hours after use
  • loperamide less than or equal to 16 mg a day and no side effects
  • mercaptopurine (6-MP)
  • mesalamine (Asacol, Pentasa, Lialda)
  • methotrexate (Trexall)
  • sulfasalazine (Azulfidine)
  • Any single medication listed below after a 2-week ground trial and:
    • No post-dose observation time:
      • JAK: tofacitinib (Xeljanz) and upadacitinib (Rinvoq)
    • 4-hour post-dose observation time:
      • TNF: adalimumab (Humira and all biosimilars), certolizumab (Cimzia), golimumab (Simponi)
      • IL: guselkumab (Tremfya), mirikizumab (Omvoh), risankizumab (Skyrizi), ustekinumab (Stelara)
      • SAM: vedolizumab (Entyvio)
    • 24-hour post-dose observation time:
      • TNF: infliximab (Inflectra, Remicade, Renflexis)

AME MUST NOTE in Block 60 one of the following:

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

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

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

FAA AME Guide Dec 2025 version
Aug 27, 2025
Dec 29, 2025
Dec 29, 2025