Melanoma : 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).
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 melanoma, 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; and
- A current status report performed within 90 days that must include all the required followup items and studies as listed in the Authorization letter and that confirms absence of recurrent disease.
The AME must defer to the AMCD or Region if:
- There has been any recurrence of the cancer, or
- Any new treatment is initiated.
- A Special Issuance or AASI is required for any metastatic melanoma regardless of Breslow level
- A Special Issuance or AASI is required for any melanoma which exhibits Breslow Level > .75 mm with or without metastasis
- A melanoma that exhibits a Breslow Level < .75 mm which has no evidence of metastasis may be regular issued.
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