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Immune thrombocytopenia (ITP)

What the FAA's documents say about immune thrombocytopenia (ITP), in plain words, with the FAA's own words one press away.

FAA term: Chronic Immune Thrombocytopenia (cITP); Thrombocytopenia (Platelet count < 150,000)

FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

Short version

The disposition table is for thrombocytopenia, a platelet count below 150,000.

How the FAA's table sorts Immune thrombocytopenia (ITP)
SituationWhat the examiner doesPathway
Row AThe most recent event or diagnosis was 5 or more years ago, with no symptoms or current problems, and no ongoing treatment or surveillance needed.
Examiner issues
Examiner can issue
Row BLess than 5 years ago, and due to drugs (including heparin induced thrombocytopenia, HIT), infection (now resolved), pregnancy, etc. The table's evaluation data is a treating physician report verifying the condition has resolved or, if due to a medication, that it has been stopped with no plan to re-start; no symptoms or current problems; and no ongoing treatment or surveillance needed. Its note says that if an underlying condition is identified, see that section, and gives as an example thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use.
Examiner issues
Examiner can issue
Row CImmune thrombocytopenia (ITP), less than 5 years ago. The table's note says the CACI is for chronic ITP only, and sends all other causes of thrombocytopenia to row D, All others.
Worksheet
CACI
Row DAll others.
Defers to the FAA
Special Issuance
Show the FAA's words: the FAA's table for Immune thrombocytopenia (ITP)
  1. Row A · Examiner can issue

    The most recent event or diagnosis was 5 or more years ago, with no symptoms or current problems, and no ongoing treatment or surveillance needed. The table says ISSUE, and has the examiner summarize this history in Block 60.

    5 or more years ago Most recent event/diagnosis No symptoms or current problems. No ongoing treatment OR surveillance needed. ISSUE Summarize this history in Block 60.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  2. Row B · Examiner can issue

    Less than 5 years ago, and due to drugs (including heparin induced thrombocytopenia, HIT), infection (now resolved), pregnancy, etc. The table's evaluation data is a treating physician report verifying the condition has resolved or, if due to a medication, that it has been stopped with no plan to re-start; no symptoms or current problems; and no ongoing treatment or surveillance needed. Its note says that if an underlying condition is identified, see that section, and gives as an example thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use. The table says ISSUE, and has the examiner summarize this history in Block 60.

    Less than 5 years ago Due to: Drugs (including HIT*), Infection (now resolved), Pregnancy, etc. *Heparin induced thrombocytopenia … Treating physician report verifies condition has resolved or, if due to a medication, it has been stopped with no plan to re-start. … No symptoms or current problems. … No ongoing treatment OR surveillance needed. … Note: If an underlying condition is identified, see that section. Example: Thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use. … ISSUE Summarize this history in Block 60

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  3. Row C · CACI

    Immune thrombocytopenia (ITP), less than 5 years ago. The table's note says the CACI is for chronic ITP only, and sends all other causes of thrombocytopenia to row D, All others. The table sends the examiner to the CACI worksheet for chronic immune thrombocytopenia (cITP), and has the examiner annotate Block 60.

    Less than 5 years ago Immune thrombocytopenia (ITP) See CACI worksheet Note: CACI is for Chronic ITP only. All other causes of thrombocytopenia, See item “D. All Others” below. … Follow the CACI – Chronic Immune Thrombocytopenia (cITP) Worksheet Annotate Block 60.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  4. Row D · Special Issuance

    All others. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.

    All others … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

What the pathway names mean

The FAA pathways for immune thrombocytopenia (ITP)

Which exam

Your step-by-step plan

  1. Step 1: The progress note from the treating doctor or specialist

    The note the examiner reviews, and what it verifies.Within 90 days before the exam

    A current, detailed progress note from a clinic visit with your treating physician or specialist, no more than 90 days before the exam. Your AME reviews it.

    It verifies

    • Chronic ITP, with platelet counts stable above 50,000/microL
    • More than 12 months from diagnosis
    • No splenectomy required for treatment
    • No increased risk of bleeding, such as an ulcer or a high fall risk
    • No treatment changes recommended

    No history, ever, of

    • Not: Bleeding episodes that required medical attention (medication, IVIG, etc.)

    No current use of

    • Not: Antiplatelet agents (NSAIDS, ASA, gingko biloba)
    • Not: Anticoagulants
    Show the FAA's words: The progress note from the treating doctor or specialist

    the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    The condition is CHRONIC ITP* and platelet counts are stable above 50,000/microL;

    *Notes: Chronic ITP defined as more than 12 months from diagnosis.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    It has been more than 12 months from diagnosis;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    No history of bleeding episodes that required medical attention ever (medication, IVIG, etc.);

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    No splenectomy required for treatment;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    No current use of antiplatelet agents (NSAIDS, ASA, gingko biloba) or anticoagulants;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    No increased risk of bleeding (ulcer, high fall risk); and

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    The treating physician’s current, detailed Clinical Progress Note verifies:

    No treatment changes recommended. [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

  2. Step 2: A blood count (CBC)

    A CBC from the last 90 days, and what it shows.

    A CBC within the last 90 days.

    It shows

    • A platelet count of 50,000/microL or higher
    • No anemia or leukopenia
    Show the FAA's words: A blood count (CBC)

    CBC within the last 90 days shows a platelet count of 50,000/microL or higher AND no anemia or leukopenia [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

  3. Step 3: The worksheet's other criteria

    Activities, current treatment, and when the worksheet says not to fly.

    The worksheet's box for current treatment is None.

    The worksheet's other criteria

    • Back to full, unrestricted activities

    When the worksheet says not to fly

    With any recurrence, bleeding that requires treatment, or a platelet count that drops below 50,000/microL, or if any surgery or invasive procedures are performed, the worksheet says the pilot should not fly, in accordance with 61.53.

    Show the FAA's words: The worksheet's other criteria

    Current treatment: [ ] None

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    Back to full, unrestricted activities. [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.

    Any recurrence, bleeding that requires treatment, or platelet count drops below 50,000/microL OR if any surgery or invasive procedures are performed, the airman should not fly in accordance with 61.53.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022; 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, and has the examiner summarize this history in Block 60.

  • Row BExaminer issuesExaminer can issue

    The table says ISSUE, and has the examiner summarize this history in Block 60.

  • Row CWorksheetCACI

    The table sends the examiner to the CACI worksheet for chronic immune thrombocytopenia (cITP), and has the examiner annotate Block 60.

  • Row DDefers to the FAASpecial Issuance

    The examiner defers and submits the listed 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
  1. Row A · Examiner can issue

    The most recent event or diagnosis was 5 or more years ago, with no symptoms or current problems, and no ongoing treatment or surveillance needed. The table says ISSUE, and has the examiner summarize this history in Block 60.

    5 or more years ago Most recent event/diagnosis No symptoms or current problems. No ongoing treatment OR surveillance needed. ISSUE Summarize this history in Block 60.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  2. Row B · Examiner can issue

    Less than 5 years ago, and due to drugs (including heparin induced thrombocytopenia, HIT), infection (now resolved), pregnancy, etc. The table's evaluation data is a treating physician report verifying the condition has resolved or, if due to a medication, that it has been stopped with no plan to re-start; no symptoms or current problems; and no ongoing treatment or surveillance needed. Its note says that if an underlying condition is identified, see that section, and gives as an example thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use. The table says ISSUE, and has the examiner summarize this history in Block 60.

    Less than 5 years ago Due to: Drugs (including HIT*), Infection (now resolved), Pregnancy, etc. *Heparin induced thrombocytopenia … Treating physician report verifies condition has resolved or, if due to a medication, it has been stopped with no plan to re-start. … No symptoms or current problems. … No ongoing treatment OR surveillance needed. … Note: If an underlying condition is identified, see that section. Example: Thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use. … ISSUE Summarize this history in Block 60

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  3. Row C · CACI

    Immune thrombocytopenia (ITP), less than 5 years ago. The table's note says the CACI is for chronic ITP only, and sends all other causes of thrombocytopenia to row D, All others. The table sends the examiner to the CACI worksheet for chronic immune thrombocytopenia (cITP), and has the examiner annotate Block 60.

    Less than 5 years ago Immune thrombocytopenia (ITP) See CACI worksheet Note: CACI is for Chronic ITP only. All other causes of thrombocytopenia, See item “D. All Others” below. … Follow the CACI – Chronic Immune Thrombocytopenia (cITP) Worksheet Annotate Block 60.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  4. Row D · Special Issuance

    All others. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.

    All others … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

The CACI worksheet's criteria

Row C: immune thrombocytopenia (ITP), less than 5 years ago

Progress note

It verifies

  • Chronic ITP, with platelet counts stable above 50,000/microL
  • More than 12 months from diagnosis
  • No splenectomy required for treatment
  • No increased risk of bleeding, such as an ulcer or a high fall risk
  • No treatment changes recommended

No history, ever, of

  • Not: Bleeding episodes that required medical attention (medication, IVIG, etc.)

No current use of

  • Not: Antiplatelet agents (NSAIDS, ASA, gingko biloba)
  • Not: Anticoagulants

CBC

  • A platelet count of 50,000/microL or higher
  • No anemia or leukopenia

Your current treatment for ITP

The worksheet's other criteria

  • Back to full, unrestricted activities

When the worksheet says not to fly

With any recurrence, bleeding that requires treatment, or a platelet count that drops below 50,000/microL, or if any surgery or invasive procedures are performed, the worksheet says the pilot should not fly, in accordance with 61.53.

Show the FAA's words: the CACI worksheet's criteria for Immune thrombocytopenia (ITP)
  1. Chronic ITP, with platelet counts stable above 50,000/microL

    FAA criterion: the progress note verifies the condition is chronic ITP and platelet counts are stable above 50,000/microL. The worksheet's notes define chronic ITP as more than 12 months from diagnosis.

    The treating physician’s current, detailed Clinical Progress Note verifies: … The condition is CHRONIC ITP* and platelet counts are stable above 50,000/microL; … *Notes: Chronic ITP defined as more than 12 months from diagnosis.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  2. More than 12 months from diagnosis

    FAA criterion: the progress note verifies it has been more than 12 months from diagnosis.

    The treating physician’s current, detailed Clinical Progress Note verifies: … It has been more than 12 months from diagnosis;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  3. No history of bleeding episodes that required medical attention, ever

    FAA criterion: the progress note verifies no history, ever, of bleeding episodes that required medical attention (medication, IVIG, etc.).

    The treating physician’s current, detailed Clinical Progress Note verifies: … No history of bleeding episodes that required medical attention ever (medication, IVIG, etc.);

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  4. No splenectomy required for treatment

    FAA criterion: the progress note verifies no splenectomy was required for treatment.

    The treating physician’s current, detailed Clinical Progress Note verifies: … No splenectomy required for treatment;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  5. No current use of antiplatelet agents or anticoagulants

    FAA criterion: the progress note verifies no current use of antiplatelet agents or anticoagulants. The worksheet names NSAIDS, ASA and gingko biloba as antiplatelet agents.

    The treating physician’s current, detailed Clinical Progress Note verifies: … No current use of antiplatelet agents (NSAIDS, ASA, gingko biloba) or anticoagulants;

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  6. No increased risk of bleeding

    FAA criterion: the progress note verifies no increased risk of bleeding; the worksheet's examples are an ulcer and a high fall risk.

    The treating physician’s current, detailed Clinical Progress Note verifies: … No increased risk of bleeding (ulcer, high fall risk); and

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  7. No treatment changes recommended

    FAA criterion: the progress note verifies no treatment changes are recommended.

    The treating physician’s current, detailed Clinical Progress Note verifies: … No treatment changes recommended. [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  8. Back to full, unrestricted activities

    FAA criterion: back to full, unrestricted activities.

    Back to full, unrestricted activities. [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  9. A CBC within the last 90 days

    FAA criterion: a CBC within the last 90 days shows a platelet count of 50,000/microL or higher and no anemia or leukopenia.

    CBC within the last 90 days shows a platelet count of 50,000/microL or higher AND no anemia or leukopenia [ ] Yes

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  10. When the worksheet says the pilot should not fly

    The worksheet's notes say that with any recurrence, bleeding that requires treatment, or a platelet count that drops below 50,000/microL, or if any surgery or invasive procedures are performed, the pilot should not fly in accordance with 61.53.

    Any recurrence, bleeding that requires treatment, or platelet count drops below 50,000/microL OR if any surgery or invasive procedures are performed, the airman should not fly in accordance with 61.53.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

If the examiner defersSpecial Issuance

The table's last row is All others, and the table marks it DEFER. Its note on row C says the CACI is for chronic ITP only, and sends all other causes of thrombocytopenia to this row.

What the FAA lists to send

  1. Item 1. A current status report from the treating hematologist with the diagnosis, the treatment plan and the prognosis.
  2. Item 2. Where an underlying cause is identified, the status report should include the diagnosis, the treatment plan, the prognosis, and adherence to treatment for this condition.
  3. Item 3. A list of medications and side effects, if any.
  4. Item 4. Operative notes and the discharge summary, if applicable.
  5. Item 5. Copies of imaging reports or other lab, if the treating hematologist has already performed them.
  6. Item 6. A CBC within the past 90 days.
Show the FAA's words: if the examiner defers

When the examiner defers

  1. Reason 1

    The table's last row is All others, and the table marks it DEFER. Its note on row C says the CACI is for chronic ITP only, and sends all other causes of thrombocytopenia to this row.

    All others … DEFER Submit the information to the FAA for a possible Special Issuance.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

    Note: CACI is for Chronic ITP only. All other causes of thrombocytopenia, See item “D. All Others” below.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

What the FAA lists to send

  1. Item 1

    A current status report from the treating hematologist with the diagnosis, the treatment plan and the prognosis.

    Current status report from the treating Hematologist with diagnosis, treatment plan and prognosis;

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  2. Item 2

    Where an underlying cause is identified, the status report should include the diagnosis, the treatment plan, the prognosis, and adherence to treatment for this condition.

    If an underlying cause is identified, the status report should include diagnosis, treatment plan, prognosis, and adherence to treatment for this condition;

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  3. Item 3

    A list of medications and side effects, if any.

    List of medications and side effects, if any;

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  4. Item 4

    Operative notes and the discharge summary, if applicable.

    Operative notes and discharge summary (if applicable);

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  5. Item 5

    Copies of imaging reports or other lab, if the treating hematologist has already performed them.

    Copies of imaging reports or other lab (if already performed by treating hematologist); and

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  6. Item 6

    A CBC within the past 90 days.

    CBC within the past 90 days.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

After the FAA decides

AASI

After a Special Issuance, the table says follow-up issuance will be per the pilot's own authorization letter. The FAA's AASI sheet, headed Thrombocytopenia, says an FAA physician provides the initial certification decision and grants the Authorization, and that for a first-time AASI application, with all the medical information needed for a determination, the examiner must defer and submit all of it to the AMCD or RFS for the initial determination.

Show the FAA's words: after the FAA decides
Follow up Issuance will be per the airman’s authorization letter.

FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

AME Assisted - All Classes - Thrombocytopenia … An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401 . … 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 Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

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 work

At later examsAASI

First and second class
Every year
Third class
At each required exam

The worksheet says first- and second-class applicants must provide this information every year, and third-class applicants must provide it with each required exam.

Show the FAA's words: how often the FAA asks again
Applicants for first- or second-class must provide this information annually; applicants for third-class must provide the information with each required exam.

FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

Under an FAA Authorization, the FAA's AASI sheet lists what the pilot provides for the examiner to reissue. The sheet is headed Thrombocytopenia and does not narrow itself to chronic ITP, as the CACI worksheet does. It lists the Authorization granted by the FAA; an update of the status of the disease from the last FAA medical examination and any testing deemed necessary by the treating physician; and a CBC within the past 90 days. The sheet says the Authorization letter comes with attachments that specify the information the treating doctors must provide for the reissue determination.

Show the FAA's words: at later exams
AME Assisted - All Classes - Thrombocytopenia … The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. … Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA; and … An update of the status of the disease from the last FAA medical examination and any testing deemed necessary by the treating physician; and … CBC within the past 90 days.

FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

What AASI is

AASI stands for AME Assisted Special Issuance. The Guide describes it as a process that lets the examiner reissue a certificate under the provisions of an Authorization for Special Issuance, to an applicant who has a medical condition that is disqualifying under 14 CFR part 67.

How the FAA pathways work
  • The Authorization granted by the FAA

    The AASI sheet's list for a reissue begins with an Authorization granted by the FAA.

    Show the FAA's words: The Authorization granted by the FAA
    Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA; and

    FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

  • An update of the status of the disease since the last FAA exam, and any testing

    The AASI sheet asks for an update of the status of the disease from the last FAA medical examination, and any testing deemed necessary by the treating physician.

    Show the FAA's words: An update of the status of the disease since the last FAA exam, and any testing
    An update of the status of the disease from the last FAA medical examination and any testing deemed necessary by the treating physician; and

    FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

  • A CBC within the past 90 days

    The AASI sheet asks for a CBC within the past 90 days.

    Show the FAA's words: A CBC within the past 90 days
    CBC within the past 90 days.

    FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

  • What the Authorization letter comes with

    The AASI sheet says the Authorization letter comes with attachments that specify the information the treating physicians must provide for the reissue determination.

    Show the FAA's words: What the Authorization letter comes with
    The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.

    FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

  • When the examiner defers a reissue

    The AASI sheet says the examiner must defer to the AMCD or Region if there has been any recurrence or disease progression; any bleeding that required treatment; any new treatment initiated, such as IVIG, high dose steroids, platelet transfusion, splenectomy (as treatment, not traumatic), or others; or a platelet count that falls below 50,000/microL.

    Show the FAA's words: When the examiner defers a reissue
    The Examiner must defer to the AMCD or Region if: … There has been any recurrence or disease progression; or … There has been any bleeding that required treatment; or … Any new treatment is initiated such as IVIG, high dose steroids, platelet transfusion, splenectomy (as treatment, not traumatic), or others; or … Platelet count falls below 50,000/microL

    FAA source: AASI – Thrombocytopenia. FAA date 25 October 2021. Checked by Crosscheck 14 October 2026

Good 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.

    FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024. Checked by Crosscheck 14 October 2026

  • The CACI is for chronic ITP only

    The table says the CACI is for chronic ITP only. The worksheet defines chronic ITP as more than 12 months from diagnosis.

    Show the FAA's words: good to know, 2
    Note: CACI is for Chronic ITP only.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

    *Notes: Chronic ITP defined as more than 12 months from diagnosis.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  • An underlying cause has its own section

    On row B, the table says that if an underlying condition is identified, see that section -- for example, thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders or alcohol use.

    Show the FAA's words: good to know, 3
    Note: If an underlying condition is identified, see that section. Example: Thrombocytopenia due to chemotherapy, malignancy, autoimmune disorders, or alcohol use.

    FAA source: C-ITP (Chronic Immune Thrombocytopenia) Disposition Table. FAA date 25 September 2019. Checked by Crosscheck 14 October 2026

  • Bleeding history has no time limit

    The worksheet's criterion on bleeding episodes that required medical attention has no time limit; its word is ever.

    Show the FAA's words: good to know, 4
    No history of bleeding episodes that required medical attention ever (medication, IVIG, etc.);

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

  • When the pilot should not fly

    The worksheet says that with any recurrence, bleeding that requires treatment, a platelet count that drops below 50,000/microL, or any surgery or invasive procedure, the pilot should not fly in accordance with 61.53.

    Show the FAA's words: good to know, 5
    Any recurrence, bleeding that requires treatment, or platelet count drops below 50,000/microL OR if any surgery or invasive procedures are performed, the airman should not fly in accordance with 61.53.

    FAA source: CACI – Chronic Immune Thrombocytopenia Worksheet. FAA date 27 April 2022. Checked by Crosscheck 14 October 2026

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.