COPD
What the FAA's documents say about COPD, in plain words, with the FAA's own words one press away.
FAA term: Chronic Obstructive Pulmonary Disease (COPD), Emphysema, Chronic Bronchitis
Short version
The disposition table has two rows, and both defer to the FAA for a possible Special Issuance.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AGOLD stage 1A or 2A, with every finding listed | Defers to the FAA | Special Issuance |
| Row BAny other GOLD stage, or any of the other findings listed | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for COPD
- Row A · Special Issuance
GOLD stage 1A or 2A on multi-dimensional assessment of COPD, and oxygen saturation (SpO2) of 96% or higher at rest on room air (without supplemental oxygen), post-bronchodilator FEV1 of 61% or higher, 6-minute walk test findings of a 1-3% drop in SpO2 from baseline and walking 400 meters or more, treatment with 3 or fewer medications (excluding a rescue inhaler), and NOT taking a daily oral steroid. The row says all others see Row B. The table lists what to submit. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
A. GOLD stage 1A or 2A on multi-dimensional assessment of COPD AND • Oxygen saturation (SpO2) is 96% or higher at rest, on room air (without supplemental oxygen) • Post-bronchodilator FEV1 is 61% or higher • 6-minute walk test findings: o 1-3% drop in SpO2 from baseline AND o Walked 400 meters or more • Treated with 3 or fewer medications (excluding a rescue inhaler) • NOT taking a daily oral steroid ALL OTHERS, see Row B … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Item 60.
- Row B · Special Issuance
All others, or any of the following -- any GOLD stage other than 1A or 2A on multi-dimensional assessment of COPD, oxygen saturation (SpO2) of 95% or less at rest on room air (without supplemental oxygen), post-bronchodilator FEV1 of 60% predicted or less, 6-minute walk test findings of a greater than 3% drop in SpO2 from baseline or walking less than 400 meters, treatment with 4 or more medications (excluding a rescue inhaler), or daily oral steroid use. The table asks for all the items in Row A, except that the evaluation and current, detailed clinical progress note must be from a board-certified pulmonologist, and the PFT must include DLCO, both pre- and post-bronchodilator, and include flow volume loops. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
B. All others (or any of the following) Any GOLD stage other than 1A or 2A on multi-dimensional assessment of COPD OR • Oxygen saturation (SpO2) is 95% or less at rest, on room air (without supplemental oxygen) • OR • Post-bronchodilator FEV1 is 60% predicted or less OR • 6-minute walk test findings: o Greater than 3% drop in SpO2 from baseline OR o Walked less than 400 meters OR • Treated with 4 or more medications, (excluding a rescue inhaler) OR • Daily oral steroid use … Submit the following: ALL items in Row A HOWEVER: • The evaluation and current, detailed Clinical Progress Note must be from a board-certified PULMONOLOGIST • Pulmonary Function Test (PFT) must include DLCO, both pre- and post-bronchodilator, and include flow volume loops … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Item 60.
The FAA pathways for COPD
Which exam
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: The COPD Status Summary
The FAA's form, filled in by the physician who manages your COPD.The COPD Status Summary, filled in by your pulmonologist or the physician who manages your COPD.
What it asks, YES or NO
- GOLD stage
- 1 or 2a, stable, with no hospitalizations and no moderate or severe exacerbations in the past year
- Resting oxygen saturation
- 96% or higher
- PFT, no more than 90 days ago
- Post-bronchodilator FEV1 greater than 60% predicted
- 6-minute walk test, no more than 90 days ago
- A drop in SpO2 of 3% or less from baseline, and 400 meters or more
- Medications
- Three (3) or fewer, excluding a rescue inhaler, and oral prednisone (or similar) not needed or not used daily
Any NO answer or other concern is explained, with a current, detailed progress note attached.
With it
- A current, detailed progress note addressing each item
- A copy of the pulmonary function test and the 6-minute walk test results
- Sent to your AME, or mailed to the FAA
Show the FAA's words: The COPD Status Summary
1. The COPD Status Summary (to expedite case processing);
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
Please have your Pulmonologist or the physician who manages your COPD provide the requested information in the space provided. Submit this summary and a current, detailed Clinical Progress Note addressing each item. Attach a copy of Pulmonary Function Test (#3) and the 6-minute Walk Test results (#4) and submit to your AME or mail to the FAA:
FAA source: COPD Status Summary. FAA date 28 June 2023; checked by Crosscheck 14 October 2026.
1. Is the individual classified as GOLD stage 1 or 2a and stable with no hospitalizations and no moderate or severe exacerbations in the past year?
2. Resting oxygen saturation is 96% or higher.
3. Pulmonary Function Test (PFT), performed no more than 90 days ago: Is the Post-bronchodilator FEV1 greater than 60% predicted:
4. 6-minute walk test, (6MWT) performed no more than 90 days ago, Do the results verify: a. Less than or equal to 3% drop in SpO2 from baseline AND b. Walked 400 meters or more
5. Medications. a. Treated with three (3) or fewer medications, excluding a rescue inhaler (e.g., Trelegy plus albuterol) AND b. Oral prednisone (or similar) not needed/ not used daily.
6. Explain any “NO” answers or other concerns. (Attach a current, detailed Clinical Progress Note).
FAA source: COPD Status Summary. FAA date 28 June 2023; checked by Crosscheck 14 October 2026.
Step 2: The progress note
From your treating physician or a board-certified pulmonologist.Within 90 days before the examA current, detailed progress note from your treating physician or a board-certified pulmonologist, no more than 90 days before the exam.
It must specifically include
- History of the condition: how it was diagnosed, past and current treatments
- Current disease severity, using the GOLD multi-dimensional assessment
- History of acute exacerbations or other complications
- Medication list, with side effects or none, and dates used
- Physical exam findings
- Treatment plan
- Prognosis
Show the FAA's words: The progress note
2. A current, detailed Clinical Progress Note from the treating physician or a board-certified Pulmonologist no more than 90 days before the AME exam;
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
3. The progress note must specifically include: • History of the condition (how it was diagnosed, past and current treatments); • Current disease severity utilizing GOLD multi-dimensional assessment; • History of acute exacerbations or other complications; • Medication list noting presence or absence of side effects and dates used; • Physical exam findings; • Treatment plan; and • Prognosis;
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
Step 3: Breathing test, walk test and labs
The tests the table lists, and results already on file.Pulmonary function test (PFT)
Within 90 days before the examA pulmonary function test (PFT), no more than 90 days before the exam.
The test
- Both pre- and post-bronchodilator
- Including flow volume loops
6-minute walk test
A current 6-minute walk test.
Labs, including a CBC
Labs to include a CBC within the past 90 days, and any other tests deemed indicated or already performed.
Tests or imaging already performed
If already performed.
If already performed.
Results of any tests or imaging already performed.
Show the FAA's words: Breathing test, walk test and labs
4. Pulmonary Function Test (PFT) performed no more than 90 days before the AME exam. PFT must be both pre- and post-bronchodilator and include flow volume loops;
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
5. Current 6-minute walk test;
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
6. Labs to include CBC within the past 90 days and any other tests deemed indicated or already performed; and
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
7. Results of any tests/ imaging already performed.
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
Step 4: See your AME
The table lists what to submit. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.Exam day- The table lists what to submit. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
Show the FAA's words: See your AME
A. GOLD stage 1A or 2A on multi-dimensional assessment of COPD AND • Oxygen saturation (SpO2) is 96% or higher at rest, on room air (without supplemental oxygen) • Post-bronchodilator FEV1 is 61% or higher • 6-minute walk test findings: o 1-3% drop in SpO2 from baseline AND o Walked 400 meters or more • Treated with 3 or fewer medications (excluding a rescue inhaler) • NOT taking a daily oral steroid ALL OTHERS, see Row B
DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Item 60.
FAA source: COPD Disposition Table. FAA date 26 August 2026; checked by Crosscheck 14 October 2026.
Step 5: After the FAA decides
The AASI sheet says an FAA physician provides the initial certification decision and grants the Authorization, and that examiners may then reissue under the Authorization when the pilot provides what it lists.- The AASI sheet says an FAA physician provides the initial certification decision and grants the Authorization, and that examiners may then reissue under the Authorization when the pilot provides what it lists.
Show the FAA's words: After the FAA decides
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401.
AMEs may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following
FAA source: AASI – Chronic Obstructive Pulmonary Disease. 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 ADefers to the FAASpecial Issuance
The table lists what to submit. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
If the examiner defersRow BDefers to the FAASpecial Issuance
The table asks for all the items in Row A, except that the evaluation and current, detailed clinical progress note must be from a board-certified pulmonologist, and the PFT must include DLCO, both pre- and post-bronchodilator, and include flow volume loops. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
GOLD stage 1A or 2A on multi-dimensional assessment of COPD, and oxygen saturation (SpO2) of 96% or higher at rest on room air (without supplemental oxygen), post-bronchodilator FEV1 of 61% or higher, 6-minute walk test findings of a 1-3% drop in SpO2 from baseline and walking 400 meters or more, treatment with 3 or fewer medications (excluding a rescue inhaler), and NOT taking a daily oral steroid. The row says all others see Row B. The table lists what to submit. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
A. GOLD stage 1A or 2A on multi-dimensional assessment of COPD AND • Oxygen saturation (SpO2) is 96% or higher at rest, on room air (without supplemental oxygen) • Post-bronchodilator FEV1 is 61% or higher • 6-minute walk test findings: o 1-3% drop in SpO2 from baseline AND o Walked 400 meters or more • Treated with 3 or fewer medications (excluding a rescue inhaler) • NOT taking a daily oral steroid ALL OTHERS, see Row B … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Item 60.
- Row B · Special Issuance
All others, or any of the following -- any GOLD stage other than 1A or 2A on multi-dimensional assessment of COPD, oxygen saturation (SpO2) of 95% or less at rest on room air (without supplemental oxygen), post-bronchodilator FEV1 of 60% predicted or less, 6-minute walk test findings of a greater than 3% drop in SpO2 from baseline or walking less than 400 meters, treatment with 4 or more medications (excluding a rescue inhaler), or daily oral steroid use. The table asks for all the items in Row A, except that the evaluation and current, detailed clinical progress note must be from a board-certified pulmonologist, and the PFT must include DLCO, both pre- and post-bronchodilator, and include flow volume loops. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Item 60.
B. All others (or any of the following) Any GOLD stage other than 1A or 2A on multi-dimensional assessment of COPD OR • Oxygen saturation (SpO2) is 95% or less at rest, on room air (without supplemental oxygen) • OR • Post-bronchodilator FEV1 is 60% predicted or less OR • 6-minute walk test findings: o Greater than 3% drop in SpO2 from baseline OR o Walked less than 400 meters OR • Treated with 4 or more medications, (excluding a rescue inhaler) OR • Daily oral steroid use … Submit the following: ALL items in Row A HOWEVER: • The evaluation and current, detailed Clinical Progress Note must be from a board-certified PULMONOLOGIST • Pulmonary Function Test (PFT) must include DLCO, both pre- and post-bronchodilator, and include flow volume loops … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Item 60.
If the examiner defersSpecial Issuance
The table marks Row A, GOLD stage 1A or 2A with every finding it lists, DEFER.
The table marks Row B, all others, DEFER.
What the FAA lists to send
- Item 1. The COPD Status Summary, to expedite case processing.
- Item 2. A current, detailed clinical progress note from the treating physician or a board-certified pulmonologist no more than 90 days before the exam, specifically including what the table lists.
- Item 3. A pulmonary function test (PFT) performed no more than 90 days before the exam, both pre- and post-bronchodilator and including flow volume loops.
- Item 4. A current 6-minute walk test.
- Item 5. Labs to include a CBC within the past 90 days, and any other tests deemed indicated or already performed.
- Item 6. Results of any tests or imaging already performed.
- Item 7. For Row B, the evaluation and progress note from a board-certified pulmonologist, and a PFT that includes DLCO.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, GOLD stage 1A or 2A with every finding it lists, DEFER.
A. GOLD stage 1A or 2A on multi-dimensional assessment of COPD AND … DEFER Submit the information to the FAA for a possible Special Issuance
- Reason 2
The table marks Row B, all others, DEFER.
B. All others (or any of the following) … DEFER Submit the information to the FAA for a possible Special Issuance
What the FAA lists to send
- Item 1
The COPD Status Summary, to expedite case processing.
1. The COPD Status Summary (to expedite case processing);
- Item 2
A current, detailed clinical progress note from the treating physician or a board-certified pulmonologist no more than 90 days before the exam, specifically including what the table lists.
2. A current, detailed Clinical Progress Note from the treating physician or a board-certified Pulmonologist no more than 90 days before the AME exam; … 3. The progress note must specifically include:
- Item 3
A pulmonary function test (PFT) performed no more than 90 days before the exam, both pre- and post-bronchodilator and including flow volume loops.
4. Pulmonary Function Test (PFT) performed no more than 90 days before the AME exam. PFT must be both pre- and post-bronchodilator and include flow volume loops;
- Item 4
A current 6-minute walk test.
5. Current 6-minute walk test;
- Item 5
Labs to include a CBC within the past 90 days, and any other tests deemed indicated or already performed.
6. Labs to include CBC within the past 90 days and any other tests deemed indicated or already performed; and
- Item 6
Results of any tests or imaging already performed.
7. Results of any tests/ imaging already performed.
- Item 7
For Row B, the evaluation and progress note from a board-certified pulmonologist, and a PFT that includes DLCO.
ALL items in Row A HOWEVER: • The evaluation and current, detailed Clinical Progress Note must be from a board-certified PULMONOLOGIST • Pulmonary Function Test (PFT) must include DLCO
After the FAA decides
AASIThe AASI sheet says an FAA physician provides the initial certification decision and grants the Authorization, and that examiners may then reissue under the Authorization when the pilot provides what it lists.
Show the FAA's words: after the FAA decides
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. … AMEs may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following
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.
The Status Summary comes first
The table lists the COPD Status Summary first, to expedite case processing. The summary asks the pulmonologist or the physician who manages the COPD to fill it in.
Show the FAA's words: good to know, 2
1. The COPD Status Summary (to expedite case processing);
Please have your Pulmonologist or the physician who manages your COPD provide the requested information in the space provided.
Row B asks for a board-certified pulmonologist
For Row B the table asks for all the items in Row A, but the evaluation and progress note must be from a board-certified pulmonologist, and the PFT must include DLCO.
Show the FAA's words: good to know, 3
ALL items in Row A HOWEVER: • The evaluation and current, detailed Clinical Progress Note must be from a board-certified PULMONOLOGIST • Pulmonary Function Test (PFT) must include DLCO, both pre- and post-bronchodilator, and include flow volume loops
The three documents print different figures
Row A of the table: FEV1 61% or higher, a 1-3% walk-test drop. The Status Summary: FEV1 greater than 60%, a drop of 3% or less. The AASI's reasons to defer include FEV1 LESS than 60% and a 4% drop. Each is shown as published.
Show the FAA's words: good to know, 4
Post-bronchodilator FEV1 is 61% or higher • 6-minute walk test findings: o 1-3% drop in SpO2 from baseline AND
Is the Post-bronchodilator FEV1 greater than 60% predicted: … a. Less than or equal to 3% drop in SpO2 from baseline AND
Pulmonary Function Tests show FEV1 is LESS than 60%; … 6-Minute Walk Test (6MWT) shows 4% drop in SpO2 from baseline OR walked less than 400 meters; and
The first AASI is deferred to the FAA
For a first-time application for this AASI, with all the requisite medical information for a determination, the AASI sheet says the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Show the FAA's words: good to know, 5
If this is a first-time application for an AASI for the above disease/condition, 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 RFS for the initial determination.
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.
- COPD Disposition TableOpen to print: COPD Disposition Table, a PDF at the FAA, in a new tab
Special Issuance
- COPD Status SummaryOpen to print: COPD Status Summary, a PDF at the FAA, in a new tab
Special Issuance
- AASI – Chronic Obstructive Pulmonary DiseaseOpen to print: AASI – Chronic Obstructive Pulmonary Disease, a page at the FAA, in a new tab
The sheet the examiner follows to reissue under an FAA Authorization.
AASI
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
Related conditions
Each has its own page, with what the FAA's documents say about it.
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.