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Aeromedical Forum

Special Issuance: Its Care and Feeding

One thing that endlessly confuses airmen (and occasionally AMEs) is the processing of Special Issuances. First of all what, you might ask, is a Special Issuance (SI)? An SI is granted by the FAA to a pilot who has a medical condition that otherwise would disqualify him from obtaining a medical certificate.

The list of disqualifying conditions is a very long one. Basically anything that might suddenly or insidiously impair your ability to physically or mentally carry out the duties of pilot in command is disqualifying and requires an SI. How then do you get an SI? First of all you go to your Aviation Medical Examiner (AME) with a completed FAA Form 8500-8. That’s the medical history sheet you fill out online through MedXPress ( Be sure to print out a copy of the completed form containing your Confirmation Number. The AME has to have that to start his examination then send it to the FAA. Your AME will look over your form and ask a few questions regarding any medical problems you have that might be disqualifying. Then he’ll perform an examination. If by history or exam something turns up that is disqualifying he’ll defer your case to the FAA’s medical branch (CAMI, the Civil Aerospace Medical Institute) down in Oklahoma City. You will not get a medical certificate at the time of examination but instead will get a letter some three to six weeks later from the FAA. In it you’ll be told that you have medical condition X which is disqualifying but you may get a medical ticket if you do things A, B, C… Basically the FAA will ask you to get a statement from your treating physician as to your medical condition along with any number of tests that will allow the FAA to assess your current health status. Most of the time the tests the FAA asks for are no more than what your doc would normally do in following your condition. So bring a copy of your FAA letter to your treating physician. Make sure he or she reads it carefully. Make sure every test the FAA asks for is done. I sometimes see a treating doc say that in his opinion test “A” is not medically necessary. He may be right, but that doesn’t matter. If the FAA wants it, the FAA is going to get it if you want to fly. Once you get your attending physician’s statement addressing all the questions the FAA wants answered and you have all the tests the FAA wants done, you will pack them into a great big envelope and send them off to CAMI at the address indicated in the letter. Wait until you have everything they ask for and send it in one mailing, otherwise it may be months until all the pieces are put together down in OKC. Now here is the good news. If indeed you do everything the FAA asks and if indeed your medical condition is well-controlled, you will almost certainly get a medical certificate issued under an SI!

Whew, glad that’s taken care of! Alas, there is more. If you have a medical problem that is significant enough to warrant an SI you will have to have it periodically re-assessed. The time intervals for re-evaluation vary but most commonly it’s every twelve months. Your certificate will be accordingly time limited and say “Not valid for any class after XX/XX/20XX.” The letter the FAA sends you granting an SI will give the specifics as to what needs to be done and when. Typically it will require a statement from your treating physician indicating that everything is ok, addressing a few specific questions. So, a month or two before your next re-evaluation is due, head over to your doc with your SI letter. Again make sure she addresses each question the FAA wants answered. You might also be required to have a few follow-up tests. Make sure your doc orders each of them and that you get a copy of your results. With all that in hand, go to your AME for a flight physical. The good news is, most SI’s allow your own AME to review your re-evaluation materials and if they are up to snuff, issue you a medical certificate on the spot. Sound onerous? Not really. Most of the requirements the FAA establishes for re-certification are what you would otherwise do to make sure your condition is well controlled. So jump through the hoops and keep flying!

Fly wisely.  See you next month.

Also, we’ve moved our office to Airlake Airport’s FBO (KLVN)!  Call 952-469-4414 or email us for a flight physical appointment.


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