Melanoma
What the FAA's documents say about melanoma, in plain words, with the FAA's own words one press away.
FAA term: Malignant Melanoma
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Less than 0.75 mm or in situLess than 0.75 mm in depth, or melanoma in situ | Examiner issues | Examiner can issue |
| 0.75 mm or greaterEqual to 0.75 mm or greater in depth | Defers to the FAA | Special Issuance |
| Metastatic or unknown primaryMetastatic, or of unknown primary origin | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Melanoma
- Less than 0.75 mm or in situ · Examiner can issue
Melanoma less than 0.75 mm in depth, or melanoma in situ. The examiner reviews the medical records describing the diagnosis and treatment, and the pathology reports. The table says ISSUE if there was complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports, and has the examiner document it in block 60 and submit the reports to the FAA for retention in the file.
Melanoma Less than 0.75 mm in depth OR Melanoma in Situ … Review: ☐ Medical records describing the diagnosis and treatment; and … ☐ Pathology report(s); … ISSUE … If complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports. Document in block 60 AND submit reports to FAA for retention in the file.
- 0.75 mm or greater · Special Issuance
Melanoma equal to 0.75 mm or greater in depth. The examiner reviews and submits the items the table lists, and defers. The reports are submitted to the FAA for review, and follow-up certification is based on a Special Issuance Authorization.
Melanoma Equal to 0.75 mm or greater in depth … Review and submit the following: … DEFER … Submit reports to FAA for review. Follow-up certification - based on Special Issuance Authorization.
- Metastatic or unknown primary · Special Issuance
Metastatic melanoma, or melanoma of unknown primary origin. The table lists what to submit for FAA review. The examiner defers, and the supporting documents are submitted for FAA review.
Metastatic Melanoma OR Melanoma of Unknown Primary Origin … Submit the following for FAA review: … DEFER … Submit supporting documents for FAA review.
- A note on the table, 1
Where the pathology is unknown, the table says that if the examiner is unable to verify the pathology, the airman collects the medical records describing the diagnosis and treatment, and the pathology reports. Its disposition is more information needed, and once the reports are received it refers to the appropriate skin cancer diagnosis in the table.
Unknown pathology … If unable to verify pathology, have airman collect: … ☐ Medical records describing the diagnosis and treatment; and … ☐ Pathology report(s) … More information needed … Once reports are received, refer to the appropriate skin cancer diagnosis in this section.
- A note on the table, 2
The AASI's note says a Special Issuance or AASI is required for any metastatic melanoma regardless of Breslow level, and for any melanoma with a Breslow level equal to or deeper than 0.75 mm, with or without metastasis. It says a melanoma with a Breslow level of less than 0.75 mm and no evidence of metastasis may be regular issued.
A Special Issuance or AASI is required for any metastatic melanoma regardless of Breslow level. … A Special Issuance or AASI is required for any melanoma which exhibits Breslow Level equal to or deeper than 0.75 mm with or without metastasis. … A melanoma that exhibits a Breslow Level of less than 0.75 mm and no evidence of metastasis may be regular issued.
The FAA pathways for melanoma
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: Records for the examiner to review
For melanoma less than 0.75 mm in depth, or melanoma in situ.Medical records describing the diagnosis and treatment, and the pathology reports. Your AME reviews them.
The table says ISSUE if they show
- Complete resection with clear margins
- No recurrence
- No metastatic disease
- Favorable reports
Then
Your AME documents it on the exam form (block 60) and submits the reports to the FAA for its file.
Show the FAA's words: Records for the examiner to review
Melanoma Less than 0.75 mm in depth OR Melanoma in Situ
Review: ☐ Medical records describing the diagnosis and treatment; and
☐ Pathology report(s);
FAA source: Item 40 – Malignant Melanoma. FAA date 7 January 2021; checked by Crosscheck 14 October 2026.
ISSUE
If complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports.
FAA source: Item 40 – Malignant Melanoma. FAA date 7 January 2021; checked by Crosscheck 14 October 2026.
Document in block 60 AND submit reports to FAA for retention in the file.
FAA source: Item 40 – Malignant Melanoma. FAA date 7 January 2021; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The examiner reviews the medical records describing the diagnosis and treatment, and the pathology reports. The table says ISSUE if there was complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports, and has the examiner document it in block 60 and submit the reports to the FAA for retention in the file.Exam day- The examiner reviews the medical records describing the diagnosis and treatment, and the pathology reports. The table says ISSUE if there was complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports, and has the examiner document it in block 60 and submit the reports to the FAA for retention in the file.
Show the FAA's words: See your AME
Melanoma Less than 0.75 mm in depth OR Melanoma in Situ
Review: ☐ Medical records describing the diagnosis and treatment; and
☐ Pathology report(s);
ISSUE
If complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports. Document in block 60 AND submit reports to FAA for retention in the file.
FAA source: Item 40 – Malignant Melanoma. FAA date 7 January 2021; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Less than 0.75 mm or in situExaminer issuesExaminer can issue
The examiner reviews the medical records describing the diagnosis and treatment, and the pathology reports. The table says ISSUE if there was complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports, and has the examiner document it in block 60 and submit the reports to the FAA for retention in the file.
0.75 mm or greaterDefers to the FAASpecial Issuance
The examiner reviews and submits the items the table lists, and defers. The reports are submitted to the FAA for review, and follow-up certification is based on a Special Issuance Authorization.
If the examiner defersMetastatic or unknown primaryDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, and the supporting documents are submitted for FAA review.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Less than 0.75 mm or in situ · Examiner can issue
Melanoma less than 0.75 mm in depth, or melanoma in situ. The examiner reviews the medical records describing the diagnosis and treatment, and the pathology reports. The table says ISSUE if there was complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports, and has the examiner document it in block 60 and submit the reports to the FAA for retention in the file.
Melanoma Less than 0.75 mm in depth OR Melanoma in Situ … Review: ☐ Medical records describing the diagnosis and treatment; and … ☐ Pathology report(s); … ISSUE … If complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports. Document in block 60 AND submit reports to FAA for retention in the file.
- 0.75 mm or greater · Special Issuance
Melanoma equal to 0.75 mm or greater in depth. The examiner reviews and submits the items the table lists, and defers. The reports are submitted to the FAA for review, and follow-up certification is based on a Special Issuance Authorization.
Melanoma Equal to 0.75 mm or greater in depth … Review and submit the following: … DEFER … Submit reports to FAA for review. Follow-up certification - based on Special Issuance Authorization.
- Metastatic or unknown primary · Special Issuance
Metastatic melanoma, or melanoma of unknown primary origin. The table lists what to submit for FAA review. The examiner defers, and the supporting documents are submitted for FAA review.
Metastatic Melanoma OR Melanoma of Unknown Primary Origin … Submit the following for FAA review: … DEFER … Submit supporting documents for FAA review.
If the examiner defersSpecial Issuance
The table's row for melanoma equal to 0.75 mm or greater in depth is marked DEFER.
The table's row for metastatic melanoma or melanoma of unknown primary origin is marked DEFER.
What the FAA lists to send
- Item 1. Medical records describing the diagnosis and treatment.
- Item 2. Pathology reports.
- Item 3. Operative notes.
- Item 4. A current status report that includes whether there are any additional lesions, any metastatic disease, and any current or future treatment planned.
- Item 5. A current MRI of the brain.
- Item 6. For metastatic melanoma or melanoma of unknown primary origin, also a PET scan.
- Item 7. For metastatic melanoma or melanoma of unknown primary origin, also copies of any additional testing performed by the treating physician that is not listed above.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table's row for melanoma equal to 0.75 mm or greater in depth is marked DEFER.
Melanoma Equal to 0.75 mm or greater in depth … DEFER … Submit reports to FAA for review.
- Reason 2
The table's row for metastatic melanoma or melanoma of unknown primary origin is marked DEFER.
Metastatic Melanoma OR Melanoma of Unknown Primary Origin … DEFER … Submit supporting documents for FAA review.
What the FAA lists to send
- Item 1
Medical records describing the diagnosis and treatment.
Review and submit the following: … ☐ Medical records describing the diagnosis and treatment;
- Item 2
Pathology reports.
☐ Pathology report(s); … ☐ Operative notes;
- Item 3
Operative notes.
☐ Operative notes; … ☐ Current status report that includes if any additional lesions
- Item 4
A current status report that includes whether there are any additional lesions, any metastatic disease, and any current or future treatment planned.
☐ Current status report that includes if any additional lesions, any metastatic disease, any current or future treatment planned; and
- Item 5
A current MRI of the brain.
any current or future treatment planned; and … ☐ Current MRI brain
- Item 6
For metastatic melanoma or melanoma of unknown primary origin, also a PET scan.
Metastatic Melanoma OR Melanoma of Unknown Primary Origin … ☐ PET scan; and
- Item 7
For metastatic melanoma or melanoma of unknown primary origin, also copies of any additional testing performed by the treating physician that is not listed above.
Metastatic Melanoma OR Melanoma of Unknown Primary Origin … ☐ Copies of any additional testing performed by your treating physician not listed above
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.
Thin melanoma reports still go to the FAA
For melanoma less than 0.75 mm in depth or melanoma in situ, the row says ISSUE, and also has the examiner submit the reports to the FAA for retention in the file.
Show the FAA's words: good to know, 2
ISSUE … If complete resection with clear margins, no recurrence, no metastatic disease, and favorable reports. Document in block 60 AND submit reports to FAA for retention in the file.
A brain MRI from 0.75 mm
For melanoma equal to 0.75 mm or greater in depth the table asks for a current MRI of the brain. For metastatic melanoma or unknown primary origin it asks for that row's information, plus a PET scan.
Show the FAA's words: good to know, 3
Melanoma Equal to 0.75 mm or greater in depth … ☐ Current MRI brain … Metastatic Melanoma OR Melanoma of Unknown Primary Origin … ☐ Info from Melanoma greater than 0.75 mm above; … ☐ PET scan; and
Unknown pathology means more information
If the examiner is unable to verify the pathology, the table has the airman collect the medical records and pathology reports; once they are received, it refers to the appropriate skin cancer diagnosis.
Show the FAA's words: good to know, 4
Unknown pathology … If unable to verify pathology, have airman collect: … More information needed … Once reports are received, refer to the appropriate skin cancer diagnosis in this section.
The first AASI is deferred to the FAA
When this is a first-time application for this AASI and the applicant has all the requisite medical information for a determination, 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 Examiner 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.
- Item 40 – Malignant MelanomaOpen to print: Item 40 – Malignant Melanoma, a page at the FAA, in a new tab
Examiner can issue, Special Issuance
- Open to print: AASI – Melanoma, a page at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
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.