Some Medical Relief From The FAA

The program, known as CACI or Conditions AMEs Can Issue, is the brainchild of a very hard working FAA physician Dr. Brian Johnson. CACI allows your AME to make medical decisions about your condition and issue your medical certificate without the delays of a Special Issuance! This ultimately will give the FAA staff physicians more time to focus on complex cases and problems. The new guidelines target many common medical conditions including various forms of arthritis, asthma, glaucoma, hepatitis C, hypothyroidism, migraine and chronic headaches, pre-diabetes, and kidney cancer. It also covers pilots on hypertension medication.

If you were previously given a time-limited certificate known as Special Issuance, with the help of CACI you may be able to receive a regular issue certificate from your AME without any time limitation. Note that if the condition is not covered under CACI, then your existing Special Issuance reporting requirements still apply and the time limitation remains the same.

Each CACI medical condition requires specific information from your treating physician that must be provided to your AME. The catch is, when renewing or applying for a medical certificate, this now applies to EVERYONE, even pilots not previously on Special Issuance. Over the years many pilots were "grandfathered" and not placed on Special Issuance for some of these conditions. With the implementation of CACI, all pilots are now required to present reports to obtain ANY medical.

A very common condition I see with pilots in the office every day is hypothyroidism on medication. Let's take a look at what is now needed to obtain your FAA medical under the new CACI requirements. First, your condition must be considered stable. If your doctor is in the process of changing medicines or adjusting the dose, your condition is NOT stable. Typically, if a dose adjustment is necessary, wait two weeks and repeat at least the TSH lab test. If it's normal, you can renew your medical. Next, your doctor must provide a typed letter indicating you are stable on the present medication, there are no side effects from the medicine(s), and list the medicines by name and dose. Finally, a normal value TSH lab test report within the last 90 days is required.

Your best option is to plan ahead and always bring any necessary reports, labs, etc. to your AME appointment. If I had a dollar for every time I heard, "But my doctor said they would send it to you," I could have retired by age 30. If you do not meet the requirements or have the documentation, your AME can hold the application for a few days but then must defer it to the FAA for disposition. Translation: Don't expect a quick resolution. If your application is deferred to Oklahoma City, plan on a significant wait until you are flying again.

Fly safe! I hope your next FAA medical application is problem free.

Dr. Stephan Kramer is an FAA Senior AME for pilots and Air Traffic Controllers located in Frisco, Texas (North Dallas). He specializes in obtaining Special Issuance medicals and waivers in addition to HIMS and denial cases. He has lectured at many area pilot events and provided expert testimony. When not in the office, Dr. Kramer is also an ATP-rated pilot and flies the Falcon 900, 50, and Hawkers. His office number is (972) 731-9555.