BPPV (positional vertigo)
What the FAA's documents say about BPPV (positional vertigo), in plain words, with the FAA's own words one press away.
FAA term: Benign Paroxysmal Positional Vertigo (BPPV)
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AResolved, with symptoms that lasted 1 year or less in total | Examiner issues | Examiner can issue |
| Row BEpisodes whose combined time lasted 1 year or more | Defers to the FAA | Special Issuance |
| Row CSevere/persistent recurrent/refractory to treatment, or surgery | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for BPPV (positional vertigo)
- Row A · Examiner can issue
Resolved, and the symptoms lasted 1 year or less in total. The table says this may have been a single episode or multiple episodes. The table says ISSUE if the examiner can determine the condition has fully resolved without sequelae (with favorable notes from the PCP, ER or ENT), there are no symptoms or current problems that would interfere with flight duties, medications, if any, are discontinued, and there is no hearing loss. Its note says symptoms should be brief, mild, not disabling, and respond to repositioning. The examiner annotates this information in Block 60.
A. RESOLVED AND symptoms lasted 1 year or less in total. (This may have been single or multiple episode[s]). … If the AME can determine: • The condition has fully resolved without sequelae (with favorable notes from PCP, ER, or ENT); • No symptoms or current problems that would interfere with flight duties; • Medications, if any, are discontinued; and • No hearing loss: Note: Symptoms should be brief, mild, not disabling, and respond to repositioning. … ISSUE Annotate this information in Block 60.
- Row B · Special Issuance
Multiple or intermittent episodes for which the combined time of symptoms or sickness lasted 1 year or more. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates elements or findings in Block 60.
B. Multiple/intermittent episodes for which the combined time of symptoms/sickness lasted 1 year or more. … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Annotate elements or findings in Block 60.
- Row C · Special Issuance
Severe/persistent recurrent/refractory to treatment (the table's slashes, as printed), or requiring surgery at any time. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
C. Severe/persistent recurrent/refractory to treatment OR Requiring surgery at any time … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
The FAA pathways for BPPV (positional vertigo)
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: what the examiner determines
Resolved, with symptoms that lasted 1 year or less in total.For Row A, your AME determines the findings the table lists. If your AME can determine them, the table says ISSUE.
If the AME can determine
- The condition has fully resolved without sequelae (with favorable notes from the PCP, ER, or ENT)
- No symptoms or current problems that would interfere with flight duties
- Medications, if any, are discontinued
- No hearing loss
At the exam
- Your AME annotates this information in Block 60
Show the FAA's words: Row A: what the examiner determines
If the AME can determine: • The condition has fully resolved without sequelae (with favorable notes from PCP, ER, or ENT); • No symptoms or current problems that would interfere with flight duties; • Medications, if any, are discontinued; and • No hearing loss: Note: Symptoms should be brief, mild, not disabling, and respond to repositioning.
ISSUE
FAA source: Benign Paroxysmal Positional Vertigo (BPPV). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
ISSUE Annotate this information in Block 60.
FAA source: Benign Paroxysmal Positional Vertigo (BPPV). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The table says ISSUE if the examiner can determine the condition has fully resolved without sequelae (with favorable notes from the PCP, ER or ENT), there are no symptoms or current problems that would interfere with flight duties, medications, if any, are discontinued, and there is no hearing loss. Its note says symptoms should be brief, mild, not disabling, and respond to repositioning. The examiner annotates this information in Block 60.Exam day- The table says ISSUE if the examiner can determine the condition has fully resolved without sequelae (with favorable notes from the PCP, ER or ENT), there are no symptoms or current problems that would interfere with flight duties, medications, if any, are discontinued, and there is no hearing loss. Its note says symptoms should be brief, mild, not disabling, and respond to repositioning. The examiner annotates this information in Block 60.
Show the FAA's words: See your AME
A. RESOLVED AND symptoms lasted 1 year or less in total. (This may have been single or multiple episode[s]).
If the AME can determine: • The condition has fully resolved without sequelae (with favorable notes from PCP, ER, or ENT); • No symptoms or current problems that would interfere with flight duties; • Medications, if any, are discontinued; and • No hearing loss: Note: Symptoms should be brief, mild, not disabling, and respond to repositioning.
ISSUE Annotate this information in Block 60.
FAA source: Benign Paroxysmal Positional Vertigo (BPPV). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
The table says ISSUE if the examiner can determine the condition has fully resolved without sequelae (with favorable notes from the PCP, ER or ENT), there are no symptoms or current problems that would interfere with flight duties, medications, if any, are discontinued, and there is no hearing loss. Its note says symptoms should be brief, mild, not disabling, and respond to repositioning. The examiner annotates this information in Block 60.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates elements or findings in Block 60.
If the examiner defersRow CDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Resolved, and the symptoms lasted 1 year or less in total. The table says this may have been a single episode or multiple episodes. The table says ISSUE if the examiner can determine the condition has fully resolved without sequelae (with favorable notes from the PCP, ER or ENT), there are no symptoms or current problems that would interfere with flight duties, medications, if any, are discontinued, and there is no hearing loss. Its note says symptoms should be brief, mild, not disabling, and respond to repositioning. The examiner annotates this information in Block 60.
A. RESOLVED AND symptoms lasted 1 year or less in total. (This may have been single or multiple episode[s]). … If the AME can determine: • The condition has fully resolved without sequelae (with favorable notes from PCP, ER, or ENT); • No symptoms or current problems that would interfere with flight duties; • Medications, if any, are discontinued; and • No hearing loss: Note: Symptoms should be brief, mild, not disabling, and respond to repositioning. … ISSUE Annotate this information in Block 60.
- Row B · Special Issuance
Multiple or intermittent episodes for which the combined time of symptoms or sickness lasted 1 year or more. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates elements or findings in Block 60.
B. Multiple/intermittent episodes for which the combined time of symptoms/sickness lasted 1 year or more. … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Annotate elements or findings in Block 60.
- Row C · Special Issuance
Severe/persistent recurrent/refractory to treatment (the table's slashes, as printed), or requiring surgery at any time. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
C. Severe/persistent recurrent/refractory to treatment OR Requiring surgery at any time … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
If the examiner defersSpecial Issuance
The table marks Row B, multiple or intermittent episodes whose combined time of symptoms or sickness lasted 1 year or more, DEFER.
The table marks Row C, severe/persistent recurrent/refractory to treatment, or requiring surgery at any time, DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, multiple or intermittent episodes whose combined time of symptoms or sickness lasted 1 year or more, DEFER.
B. Multiple/intermittent episodes for which the combined time of symptoms/sickness lasted 1 year or more. … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks Row C, severe/persistent recurrent/refractory to treatment, or requiring surgery at any time, DEFER.
C. Severe/persistent recurrent/refractory to treatment OR Requiring surgery at any time … DEFER Submit the information to the FAA for a possible Special Issuance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
What Row A's symptoms should be like
Row A's note says symptoms should be brief, mild, not disabling, and respond to repositioning. The row also lists no hearing loss among what the examiner determines.
Show the FAA's words: good to know, 2
• No hearing loss: Note: Symptoms should be brief, mild, not disabling, and respond to repositioning.
Row A and Row B both name one year
Row A is symptoms that lasted 1 year or less in total. Row B is a combined time of 1 year or more. The table's words put exactly one year in both rows, and this page shows them as printed.
Show the FAA's words: good to know, 3
A. RESOLVED AND symptoms lasted 1 year or less in total. … B. Multiple/intermittent episodes for which the combined time of symptoms/sickness lasted 1 year or more.
Surgery at any time is Row C
Row C includes BPPV requiring surgery at any time, and the table marks it DEFER. Where surgery was performed, the row asks for copies of all clinic records.
Show the FAA's words: good to know, 4
OR Requiring surgery at any time … DEFER Submit the information to the FAA for a possible Special Issuance. … 2. If surgery was performed, copies of all clinic records including:
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.