Hepatitis C - Chronic Worksheet from FAA

Instructions to AMEs Examining Pilots with Hepatits C

Mar 2014

Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide page 91, 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).

Hepatitis C - Chronic Worksheet

The Examiner 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 Examiner 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.

FAA Hepatitis - C Chronic Worksheet



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

[ ] Yes

Complications or symptoms from

Chronic Hepatitis C

[ ] None

Medications for condition

[ ] None

Current Labs

[ ] Within last 90 days

[ ] AST (SGOT), ALT (SGPT), Albumin, and PT all within 10% of normal lab scale.

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

[ ] Airman meets certification criteria for Hepatitis C - Chronic.

[ ] Airman had a previous Special Issuance for this condition and now meets the regular issuance certification criteria for Hepatitis C - Chronic.

[ ] Airman does NOT meet certification criteria for Hepatitis C - Chronic. I have deferred this exam. (Mail the supporting documents to FAA identifying which criteria were not met.)

Last revision date: 06/12/2013

This page discussed Hepatitis C - Chronic Worksheet from FAA

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