Meniere's disease
What the FAA's documents say about meniere's disease, in plain words, with the FAA's own words one press away.
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row APreviously reviewed and warned by the FAA | Examiner issues | Examiner can issue |
| Row BThe first time the condition is reported to the FAA | Defers to the FAA | Special Issuance |
| Row CWith associated hearing loss | Defers to the FAA | FAA review |
Show the FAA's words: the FAA's table for Meniere's disease
- Row A · Examiner can issue
Previously reviewed and warned by the FAA. The row's note says the medical certificate should not be issued for any class until the condition is fully resolved and reviewed by the FAA, and that pilot duties must be discontinued while symptomatic or on medication for vertigo. If the examiner can determine there have been no further symptoms or episodes of vertigo, the table says ISSUE. If the pilot continues asymptomatic, the examiner annotates this information in Block 60. If symptoms return, the table says DEFER and submit the most recent ENT evaluation.
A. Previously reviewed and warned by the FAA. If the AME can determine there have been no further symptoms or episodes of vertigo: Note: The medical certificate should not be issued for any class until condition is fully resolved and reviewed by the FAA. Pilot duties must be discontinued while symptomatic or on medication for vertigo. … ISSUE If continued asymptomatic, annotate this information in Block 60. If return of symptoms, DEFER and submit the most recent ENT evaluation.
- Row B · Special Issuance
The first time the condition is reported to the FAA. The row says that after a recovery period of six (6) months showing control of vertigo, no further vertiginous attacks, and hearing that remains within standards, the following is submitted for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and the table says follow-up issuance will be per the Authorization letter.
B. The FIRST time the condition is reported to the FAA. After a recovery period of six (6) months showing: • Control of vertigo; • No further vertiginous attacks: AND • Hearing remains within standards. Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the Authorization Letter
- Row C · FAA review
With associated hearing loss. The table says that if there is associated hearing loss, the individual should be evaluated to determine if they meet hearing standards, and points to the Guide's Item 49, Hearing. The examiner defers and submits the information to the FAA.
C. With associated hearing loss. If there is associated hearing loss, the individual should be evaluated to determine if they meet hearing standards. See Item 49. Hearing. … DEFER Submit the information to the FAA
- A note on the table, 1
The table's note in Row B says pilot and safety related duties (SRD) must be discontinued while on medication for vertigo, and that 14 CFR 61.53 applies.
Note: Pilot and safety related duties (SRD) duties must be discontinued while on medication for vertigo. 14 CFR 61.53 applies.
- A note on the table, 2
Row B's evaluation data says betahistine (Serc, Beta-Serc) is NOT allowed.
Medication: Betahistine (Serc, Beta-Serc) is NOT allowed.
The FAA pathways for meniere's disease
- How this pathway works: Examiner can issueNo special pathwayRow A
- How this pathway works: Special IssuanceAuthorization for Special Issuance of a Medical CertificateRow B
- FAA reviewYour AME defers. The FAA decides.Row C
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: Row A: what the examiner determines
Previously reviewed and warned by the FAA.For Row A, your AME determines whether there have been no further symptoms or episodes of vertigo. If so, the table says ISSUE.
If the AME can determine
- There have been no further symptoms or episodes of vertigo
At the exam
- If you continue asymptomatic, your AME annotates this information in Block 60
Show the FAA's words: Row A: what the examiner determines
If the AME can determine there have been no further symptoms or episodes of vertigo: Note: The medical certificate should not be issued for any class until condition is fully resolved and reviewed by the FAA. Pilot duties must be discontinued while symptomatic or on medication for vertigo.
ISSUE
FAA source: Meniere's Disease. FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
ISSUE If continued asymptomatic, annotate this information in Block 60.
FAA source: Meniere's Disease. FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
Step 2: Row A: if symptoms return
What the table says goes to the FAA.If symptoms return.
If symptoms return.
If symptoms return, the table says DEFER and submit the most recent ENT evaluation.
Show the FAA's words: Row A: if symptoms return
If return of symptoms, DEFER and submit the most recent ENT evaluation.
FAA source: Meniere's Disease. FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
Step 3: See your AME
If the examiner can determine there have been no further symptoms or episodes of vertigo, the table says ISSUE. If the pilot continues asymptomatic, the examiner annotates this information in Block 60. If symptoms return, the table says DEFER and submit the most recent ENT evaluation.Exam day- If the examiner can determine there have been no further symptoms or episodes of vertigo, the table says ISSUE. If the pilot continues asymptomatic, the examiner annotates this information in Block 60. If symptoms return, the table says DEFER and submit the most recent ENT evaluation.
Show the FAA's words: See your AME
A. Previously reviewed and warned by the FAA. If the AME can determine there have been no further symptoms or episodes of vertigo: Note: The medical certificate should not be issued for any class until condition is fully resolved and reviewed by the FAA. Pilot duties must be discontinued while symptomatic or on medication for vertigo.
ISSUE If continued asymptomatic, annotate this information in Block 60. If return of symptoms, DEFER and submit the most recent ENT evaluation.
FAA source: Meniere's 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 AExaminer issuesExaminer can issue
If the examiner can determine there have been no further symptoms or episodes of vertigo, the table says ISSUE. If the pilot continues asymptomatic, the examiner annotates this information in Block 60. If symptoms return, the table says DEFER and submit the most recent ENT evaluation.
Row BDefers to the FAASpecial Issuance
The row says that after a recovery period of six (6) months showing control of vertigo, no further vertiginous attacks, and hearing that remains within standards, the following is submitted for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and the table says follow-up issuance will be per the Authorization letter.
If the examiner defersRow CDefers to the FAAFAA review
The table says that if there is associated hearing loss, the individual should be evaluated to determine if they meet hearing standards, and points to the Guide's Item 49, Hearing. The examiner defers and submits the information to the FAA.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Previously reviewed and warned by the FAA. The row's note says the medical certificate should not be issued for any class until the condition is fully resolved and reviewed by the FAA, and that pilot duties must be discontinued while symptomatic or on medication for vertigo. If the examiner can determine there have been no further symptoms or episodes of vertigo, the table says ISSUE. If the pilot continues asymptomatic, the examiner annotates this information in Block 60. If symptoms return, the table says DEFER and submit the most recent ENT evaluation.
A. Previously reviewed and warned by the FAA. If the AME can determine there have been no further symptoms or episodes of vertigo: Note: The medical certificate should not be issued for any class until condition is fully resolved and reviewed by the FAA. Pilot duties must be discontinued while symptomatic or on medication for vertigo. … ISSUE If continued asymptomatic, annotate this information in Block 60. If return of symptoms, DEFER and submit the most recent ENT evaluation.
- Row B · Special Issuance
The first time the condition is reported to the FAA. The row says that after a recovery period of six (6) months showing control of vertigo, no further vertiginous attacks, and hearing that remains within standards, the following is submitted for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and the table says follow-up issuance will be per the Authorization letter.
B. The FIRST time the condition is reported to the FAA. After a recovery period of six (6) months showing: • Control of vertigo; • No further vertiginous attacks: AND • Hearing remains within standards. Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the Authorization Letter
- Row C · FAA review
With associated hearing loss. The table says that if there is associated hearing loss, the individual should be evaluated to determine if they meet hearing standards, and points to the Guide's Item 49, Hearing. The examiner defers and submits the information to the FAA.
C. With associated hearing loss. If there is associated hearing loss, the individual should be evaluated to determine if they meet hearing standards. See Item 49. Hearing. … DEFER Submit the information to the FAA
If the examiner defersSpecial Issuance
In Row A, if symptoms return, the table says DEFER and submit the most recent ENT evaluation.
The table marks Row B, the first time the condition is reported to the FAA, DEFER.
The table marks Row C, with associated hearing loss, DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
In Row A, if symptoms return, the table says DEFER and submit the most recent ENT evaluation.
If return of symptoms, DEFER and submit the most recent ENT evaluation.
- Reason 2
The table marks Row B, the first time the condition is reported to the FAA, DEFER.
B. The FIRST time the condition is reported to the FAA. … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 3
The table marks Row C, with associated hearing loss, DEFER.
C. With associated hearing loss. … DEFER Submit the information to the FAA
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.
Not issued until resolved and reviewed by the FAA
Row A's note says the medical certificate should not be issued for any class until the condition is fully resolved and reviewed by the FAA. The table prints it in Row A, beside that row's ISSUE, and does not say whether it covers more than that row.
Show the FAA's words: good to know, 1
Note: The medical certificate should not be issued for any class until condition is fully resolved and reviewed by the FAA. … ISSUE If continued asymptomatic, annotate this information in Block 60.
Duties stop while on medication for vertigo
Row A's note says pilot duties must be discontinued while symptomatic or on medication for vertigo. Row B's note says pilot and safety related duties (SRD) must be discontinued while on medication for vertigo, and that 14 CFR 61.53 applies.
Show the FAA's words: good to know, 2
Pilot duties must be discontinued while symptomatic or on medication for vertigo. … Note: Pilot and safety related duties (SRD) duties must be discontinued while on medication for vertigo. 14 CFR 61.53 applies.
Betahistine is not allowed
Row B's evaluation data says betahistine (Serc, Beta-Serc) is NOT allowed.
Show the FAA's words: good to know, 3
Medication: Betahistine (Serc, Beta-Serc) is NOT allowed.
Row B names a six-month recovery period
Row B says that after a recovery period of six (6) months showing control of vertigo, no further vertiginous attacks, and hearing that remains within standards, the list that follows is submitted for FAA review.
Show the FAA's words: good to know, 4
After a recovery period of six (6) months showing: • Control of vertigo; • No further vertiginous attacks: AND • Hearing remains within standards. Submit the following for FAA review:
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, 5
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 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.