Chiari malformation
What the FAA's documents say about chiari malformation, in plain words, with the FAA's own words one press away.
Covers: All classes
Show the FAA's words: which classes the FAA's table covers
CHIARI MALFORMATION All Classes
- Row A says that if an underlying condition is identified, for example headaches, see that page, and does not name it. Crosscheck has a page on migraine and chronic headache, written from the FAA's headache and migraine documents.
Short version
The disposition table has three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AType I: incidental, or decompression 2+ years ago; asymptomatic | Examiner issues | Examiner can issue |
| Row BType 1 surgically corrected/decompressed within the past 2 years | Defers to the FAA | Special Issuance |
| Row CCurrently symptomatic, or any Chiari type (II, III, IV) | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Chiari malformation
- Row A · Examiner can issue
Type I (aka low-lying tonsils), an incidental finding on imaging, or Chiari 1 decompression surgery 2+ years ago, and asymptomatic. The examiner should review a current, detailed clinical progress note and the table's second item. If review of the documentation verifies the Chiari malformation is an incidental finding on imaging or was surgically corrected 2 or more years ago, is asymptomatic, has no additional treatment recommended, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner annotates Block 60 and submits the evaluation to the FAA for retention in the file.
A. Type I (aka low-lying tonsils) Incidental finding on imaging OR Chiari 1 decompression surgery 2+ years ago AND Asymptomatic … The AME should review: … If review of documentation verifies the Chiari malformation is: • An incidental finding on imaging OR • Was surgically corrected 2 or more years ago; • Is asymptomatic; • No additional treatment recommended; and • No symptoms that would interfere with flight or safety related duties: … ISSUE Annotate Block 60 and submit the evaluation to the FAA for retention in the file.
- Row B · Special Issuance
Type 1, surgically corrected or decompressed within the past 2 years. The row says there is no mandatory recovery period after decompression surgery. 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. Type 1 surgically corrected/decompressed within the past 2 years … No mandatory recovery period after decompression surgery. … 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
Currently symptomatic, or any Chiari type (II, III, IV). 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.
C. Currently symptomatic OR ANY Chiari type (II, III, IV) 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.
- A note on the table, 1
Row A says that if an underlying condition is identified, for example headaches, see that page. It does not name the page.
(If an underlying condition is identified, e.g., headaches, see that page.)
The FAA pathways for chiari malformation
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 reviews
Type I, an incidental finding or surgery 2+ years ago, and asymptomatic.Progress note from your treating physician
Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician, no more than 90 days before the exam.
The table's second item
Row A's second item: it must specifically include the reason the imaging was performed.
Show the FAA's words: Row A: what the examiner reviews
The AME should review: 1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating physician no more than 90 days prior to the AME exam.
FAA source: Chiari Malformation. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
2. It must specifically include the reason the imaging was performed.
FAA source: Chiari Malformation. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
If review of documentation verifies the Chiari malformation is: • An incidental finding on imaging OR • Was surgically corrected 2 or more years ago; • Is asymptomatic; • No additional treatment recommended; and • No symptoms that would interfere with flight or safety related duties:
ISSUE
FAA source: Chiari Malformation. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
ISSUE Annotate Block 60 and submit the evaluation to the FAA for retention in the file.
FAA source: Chiari Malformation. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
(If an underlying condition is identified, e.g., headaches, see that page.)
FAA source: Chiari Malformation. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The examiner should review a current, detailed clinical progress note and the table's second item. If review of the documentation verifies the Chiari malformation is an incidental finding on imaging or was surgically corrected 2 or more years ago, is asymptomatic, has no additional treatment recommended, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner annotates Block 60 and submits the evaluation to the FAA for retention in the file.Exam day- The examiner should review a current, detailed clinical progress note and the table's second item. If review of the documentation verifies the Chiari malformation is an incidental finding on imaging or was surgically corrected 2 or more years ago, is asymptomatic, has no additional treatment recommended, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner annotates Block 60 and submits the evaluation to the FAA for retention in the file.
Show the FAA's words: See your AME
A. Type I (aka low-lying tonsils) Incidental finding on imaging OR Chiari 1 decompression surgery 2+ years ago AND Asymptomatic
The AME should review:
If review of documentation verifies the Chiari malformation is: • An incidental finding on imaging OR • Was surgically corrected 2 or more years ago; • Is asymptomatic; • No additional treatment recommended; and • No symptoms that would interfere with flight or safety related duties:
ISSUE Annotate Block 60 and submit the evaluation to the FAA for retention in the file.
FAA source: Chiari Malformation. FAA date 27 March 2024; 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 examiner should review a current, detailed clinical progress note and the table's second item. If review of the documentation verifies the Chiari malformation is an incidental finding on imaging or was surgically corrected 2 or more years ago, is asymptomatic, has no additional treatment recommended, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner annotates Block 60 and submits the evaluation to the FAA for retention in the file.
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, submits the information to the FAA for a possible Special Issuance, and annotates elements or findings in Block 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Type I (aka low-lying tonsils), an incidental finding on imaging, or Chiari 1 decompression surgery 2+ years ago, and asymptomatic. The examiner should review a current, detailed clinical progress note and the table's second item. If review of the documentation verifies the Chiari malformation is an incidental finding on imaging or was surgically corrected 2 or more years ago, is asymptomatic, has no additional treatment recommended, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner annotates Block 60 and submits the evaluation to the FAA for retention in the file.
A. Type I (aka low-lying tonsils) Incidental finding on imaging OR Chiari 1 decompression surgery 2+ years ago AND Asymptomatic … The AME should review: … If review of documentation verifies the Chiari malformation is: • An incidental finding on imaging OR • Was surgically corrected 2 or more years ago; • Is asymptomatic; • No additional treatment recommended; and • No symptoms that would interfere with flight or safety related duties: … ISSUE Annotate Block 60 and submit the evaluation to the FAA for retention in the file.
- Row B · Special Issuance
Type 1, surgically corrected or decompressed within the past 2 years. The row says there is no mandatory recovery period after decompression surgery. 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. Type 1 surgically corrected/decompressed within the past 2 years … No mandatory recovery period after decompression surgery. … 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
Currently symptomatic, or any Chiari type (II, III, IV). 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.
C. Currently symptomatic OR ANY Chiari type (II, III, IV) 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.
If the examiner defersSpecial Issuance
The table marks Row B, Type 1 surgically corrected or decompressed within the past 2 years, DEFER.
The table marks Row C, currently symptomatic or any Chiari type (II, III, IV), DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, Type 1 surgically corrected or decompressed within the past 2 years, DEFER.
B. Type 1 surgically corrected/decompressed within the past 2 years … DEFER Submit the information to the FAA for a possible Special Issuance
- Reason 2
The table marks Row C, currently symptomatic or any Chiari type (II, III, IV), DEFER.
C. Currently symptomatic OR ANY Chiari type (II, III, IV) … 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.
Rows A and B both name two years
Row A includes Chiari 1 decompression surgery 2+ years ago, and its list says surgically corrected 2 or more years ago. Row B is surgically corrected/decompressed within the past 2 years. The table does not say which row a surgery exactly two years ago falls in, and this page shows both as printed.
Show the FAA's words: good to know, 2
Chiari 1 decompression surgery 2+ years ago … • Was surgically corrected 2 or more years ago; … B. Type 1 surgically corrected/decompressed within the past 2 years
Symptoms after a recent decompression
Row B is a Type 1 decompressed within the past 2 years. It says that if no complications, "can consider" once the treating neurosurgeon has determined recovered, no symptoms and is stable, and its progress note must specifically include if symptoms have resolved. Row C is currently symptomatic, or any Chiari type (II, III, IV). The table does not say where a case that fits both rows falls.
Show the FAA's words: good to know, 3
B. Type 1 surgically corrected/decompressed within the past 2 years … If no complications, can consider once the treating neurosurgeon has determined recovered, no symptoms and is stable. … It must specifically include: • If symptoms have resolved; … C. Currently symptomatic OR ANY Chiari type (II, III, IV)
An underlying condition, such as headaches, is on another page
Row A says that if an underlying condition is identified, for example headaches, see that page. It does not name the page.
Show the FAA's words: good to know, 4
(If an underlying condition is identified, e.g., headaches, see that page.)
Chiari Type II and spinal cord imaging
For Row C the neurological evaluation must specifically include a consideration of syringomyelia, with spinal cord imaging supplied if deemed clinically necessary, and if Chiari Type II, the table asks for copies of the most recent spinal cord imaging for syringomyelia.
Show the FAA's words: good to know, 5
• Consider syringomyelia and supply spinal cord imaging if deemed clinically necessary; … 5. If Chiari Type II, submit copies of most recent spinal cord imaging for syringomyelia.
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.