Asthma : Further FAA Medical Workup
AASI Protocol Instructions for Airman and AME
Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide page 264, 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).
FAA Note: If the applicant has mild symptoms that are infrequent, have not required hospitalization, or use of steroid medication, and no symptoms in flight, the AME may issue an airman medical certificate. See Item 35., Lungs and Chest Aerospace Medical Disposition. Otherwise, if the pilot does not meet the above criteria, the must must follow this AASI process.
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 physician 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 asthma, and the applicant has all the requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or the Regional Flight Surgeon for the initial determination.
AMEs may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
- An Authorization granted by the FAA;
- The applicant's current medical status that addresses frequency of attacks and whether the attacks have resulted in emergency room visits or hospitalizations;
- The Examiner should caution the applicant to cease flying with any exacerbation as warned in 61.53;
- The name and dosage of medication(s) used for treatment and/or prevention with comment regarding side effects; and
- Results of pulmonary function testing, if deemed necessary, performed with last 90 days
The AME must defer to the AMCD or Region if:
- The symptoms worsen;
- There has been an increase in frequency of emergency room, hospital, or outpatient visits;
- The FEV1 is less than 70% predicted value;
- The applicant requires 3 or more medications for stabilization; or
- The applicant is taking steroids doses equivalent to more than 20mg of prednisone per day.
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