Neuralgia
What the FAA's documents say about neuralgia, in plain words, with the FAA's own words one press away.
FAA term: Neuralgia (Trigeminal Neuralgia, Post Herpetic Neuralgia)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
NEURALGIA (Trigeminal Neuralgia, Post Herpetic Neuralgia) All Classes
- Row B's note says that if due to Multiple Sclerosis or other condition, see that section. Crosscheck has a page on multiple sclerosis, written from the FAA's Multiple Sclerosis (MS) disposition table.
Short version
The disposition table has four rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| A1Post herpetic or occipital neuralgia, resolved and off medications | Examiner issues | Examiner can issue |
| A2Trigeminal: symptom free, treatment ended 5+ years ago, no procedure | Examiner issues | Examiner can issue |
| Row BTrigeminal: symptomatic, unresolved, or treatment in the past 5 years | Defers to the FAA | Special Issuance |
| Row CTrigeminal: treated with surgery or gamma knife (ever) | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Neuralgia
- A1 · Examiner can issue
Post herpetic neuralgia or occipital neuralgia, fully resolved and off medications. If the examiner can determine that the post herpetic or occipital neuralgia has fully resolved, medications have been discontinued, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If there is no AME explanation, the individual may be asked to provide documentation.
A1. Post Herpetic Neuralgia, Occipital Neuralgia Fully resolved AND off medications If the AME can determine that the Post herpetic or occipital neuralgia • Has fully resolved; • Medications have been discontinued; and • Individual has no symptoms that would interfere with flight or safety related duties: ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
- A2 · Examiner can issue
Trigeminal neuralgia, symptom free and treatment completed 5 or more years ago, and did not require surgery, gamma knife, or other procedure. If the examiner can determine that the trigeminal neuralgia fully resolved 5 or more years ago, does not require any medication, was never treated with surgery, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If the examiner is unable to determine this, the table says to request a current, detailed clinical progress note from the treating physician, and if medications are currently used, the examiner should check with the Do Not Issue - Do Not Fly list. If there is no AME explanation, the individual may be asked to provide documentation.
A2. Trigeminal Neuralgia Symptom free and treatment completed 5 or more years ago AND did NOT require surgery, gamma knife, or other procedure If the AME can determine that the Trigeminal Neuralgia • Fully resolved 5 or more years ago; • Does not require any medication; • Was never treated with surgery; and • Individual has no symptoms that would interfere with flight or safety related duties: If the AME is unable to determine the above, request a current, detailed Clinical Progress Note from the treating physician. If medications are currently used, the AME should check with the Do Not Issue - Do Not Fly list. ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
- Row B · Special Issuance
Trigeminal neuralgia that is symptomatic, unresolved, or requiring treatment within the past 5 years. The row's note says that if due to Multiple Sclerosis or other condition, see that section. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Trigeminal Neuralgia Symptomatic, unresolved OR requiring treatment within the past 5 years Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. … Note: If due to Multiple Sclerosis or other condition - see that section.
- Row C · Special Issuance
Trigeminal neuralgia treated with surgery or gamma knife (ever). The table lists what to submit for FAA review, starting with Row B evaluation data. The examiner defers and submits the information to the FAA for a possible Special Issuance.
C. Trigeminal Neuralgia Treated with surgery or gamma knife (ever) Submit the following for FAA review: 1. Row B evaluation data … DEFER Submit the information to the FAA for a possible Special Issuance.
- A note on the table, 1
Row B's note says that if due to Multiple Sclerosis or other condition, see that section.
Note: If due to Multiple Sclerosis or other condition - see that section.
The FAA pathways for neuralgia
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 A1: what the examiner determines
Post herpetic or occipital neuralgia, fully resolved and off medications.For Row A1, your AME determines the findings the table lists. If your AME can determine them, the table says ISSUE.
If the AME can determine that the post herpetic or occipital neuralgia
- Has fully resolved
- Medications have been discontinued
- Individual has no symptoms that would interfere with flight or safety related duties
At the exam
- Your AME annotates this information in Block 60
- If there is no AME explanation, the table says the individual may be asked to provide documentation
Show the FAA's words: Row A1: what the examiner determines
A1. Post Herpetic Neuralgia, Occipital Neuralgia Fully resolved AND off medications If the AME can determine that the Post herpetic or occipital neuralgia • Has fully resolved; • Medications have been discontinued; and • Individual has no symptoms that would interfere with flight or safety related duties: ISSUE
FAA source: Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
FAA source: Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 2: See your AME
If the examiner can determine that the post herpetic or occipital neuralgia has fully resolved, medications have been discontinued, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If there is no AME explanation, the individual may be asked to provide documentation.Exam day- If the examiner can determine that the post herpetic or occipital neuralgia has fully resolved, medications have been discontinued, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If there is no AME explanation, the individual may be asked to provide documentation.
Show the FAA's words: See your AME
A1. Post Herpetic Neuralgia, Occipital Neuralgia Fully resolved AND off medications If the AME can determine that the Post herpetic or occipital neuralgia • Has fully resolved; • Medications have been discontinued; and • Individual has no symptoms that would interfere with flight or safety related duties: ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
FAA source: Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
A1Examiner issuesExaminer can issue
If the examiner can determine that the post herpetic or occipital neuralgia has fully resolved, medications have been discontinued, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If there is no AME explanation, the individual may be asked to provide documentation.
A2Examiner issuesExaminer can issue
If the examiner can determine that the trigeminal neuralgia fully resolved 5 or more years ago, does not require any medication, was never treated with surgery, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If the examiner is unable to determine this, the table says to request a current, detailed clinical progress note from the treating physician, and if medications are currently used, the examiner should check with the Do Not Issue - Do Not Fly list. If there is no AME explanation, the individual may be asked to provide documentation.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
If the examiner defersRow CDefers to the FAASpecial Issuance
The table lists what to submit for FAA review, starting with Row B evaluation data. The examiner defers and submits the 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
- A1 · Examiner can issue
Post herpetic neuralgia or occipital neuralgia, fully resolved and off medications. If the examiner can determine that the post herpetic or occipital neuralgia has fully resolved, medications have been discontinued, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If there is no AME explanation, the individual may be asked to provide documentation.
A1. Post Herpetic Neuralgia, Occipital Neuralgia Fully resolved AND off medications If the AME can determine that the Post herpetic or occipital neuralgia • Has fully resolved; • Medications have been discontinued; and • Individual has no symptoms that would interfere with flight or safety related duties: ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
- A2 · Examiner can issue
Trigeminal neuralgia, symptom free and treatment completed 5 or more years ago, and did not require surgery, gamma knife, or other procedure. If the examiner can determine that the trigeminal neuralgia fully resolved 5 or more years ago, does not require any medication, was never treated with surgery, and the individual has no symptoms that would interfere with flight or safety related duties, the table says ISSUE, and the examiner annotates this information in Block 60. If the examiner is unable to determine this, the table says to request a current, detailed clinical progress note from the treating physician, and if medications are currently used, the examiner should check with the Do Not Issue - Do Not Fly list. If there is no AME explanation, the individual may be asked to provide documentation.
A2. Trigeminal Neuralgia Symptom free and treatment completed 5 or more years ago AND did NOT require surgery, gamma knife, or other procedure If the AME can determine that the Trigeminal Neuralgia • Fully resolved 5 or more years ago; • Does not require any medication; • Was never treated with surgery; and • Individual has no symptoms that would interfere with flight or safety related duties: If the AME is unable to determine the above, request a current, detailed Clinical Progress Note from the treating physician. If medications are currently used, the AME should check with the Do Not Issue - Do Not Fly list. ISSUE Annotate this information in Block 60. If no AME explanation the individual may be asked to provide documentation.
- Row B · Special Issuance
Trigeminal neuralgia that is symptomatic, unresolved, or requiring treatment within the past 5 years. The row's note says that if due to Multiple Sclerosis or other condition, see that section. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Trigeminal Neuralgia Symptomatic, unresolved OR requiring treatment within the past 5 years Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. … Note: If due to Multiple Sclerosis or other condition - see that section.
- Row C · Special Issuance
Trigeminal neuralgia treated with surgery or gamma knife (ever). The table lists what to submit for FAA review, starting with Row B evaluation data. The examiner defers and submits the information to the FAA for a possible Special Issuance.
C. Trigeminal Neuralgia Treated with surgery or gamma knife (ever) Submit the following for FAA review: 1. Row B evaluation data … DEFER Submit the information to the FAA for a possible Special Issuance.
If the examiner defersSpecial Issuance
The table marks Row B, trigeminal neuralgia that is symptomatic, unresolved, or requiring treatment within the past 5 years, DEFER.
The table marks Row C, trigeminal neuralgia treated with surgery or gamma knife (ever), DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, trigeminal neuralgia that is symptomatic, unresolved, or requiring treatment within the past 5 years, DEFER.
B. Trigeminal Neuralgia Symptomatic, unresolved OR requiring treatment within the past 5 years … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks Row C, trigeminal neuralgia treated with surgery or gamma knife (ever), DEFER.
C. Trigeminal Neuralgia Treated with surgery or gamma knife (ever) … 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.
Post herpetic or occipital neuralgia has one row
The table's only row for post herpetic or occipital neuralgia is Row A1, fully resolved and off medications. Rows A2, B and C are all trigeminal neuralgia. The table gives no row for post herpetic or occipital neuralgia that has not fully resolved or is still on medications, and this page adds none.
Show the FAA's words: good to know, 2
A1. Post Herpetic Neuralgia, Occipital Neuralgia Fully resolved AND off medications … A2. Trigeminal Neuralgia … B. Trigeminal Neuralgia … C. Trigeminal Neuralgia
Row A2 and Row B both name 5 years
Row A2 is treatment completed 5 or more years ago. Row B is requiring treatment within the past 5 years. The table does not say which row treatment completed exactly 5 years ago falls in, and this page shows both as printed.
Show the FAA's words: good to know, 3
Symptom free and treatment completed 5 or more years ago … B. Trigeminal Neuralgia Symptomatic, unresolved OR requiring treatment within the past 5 years
Surgery, gamma knife, or other procedure
Row A2's first column says the trigeminal neuralgia did not require surgery, gamma knife, or other procedure, and its list of what the examiner determines says it was never treated with surgery. Row C is trigeminal neuralgia treated with surgery or gamma knife (ever). The table does not say which row trigeminal neuralgia treated with another procedure falls in.
Show the FAA's words: good to know, 4
AND did NOT require surgery, gamma knife, or other procedure … • Was never treated with surgery; and … C. Trigeminal Neuralgia Treated with surgery or gamma knife (ever)
Medications in Row A2
Row A2's list of what the examiner determines says the trigeminal neuralgia does not require any medication. The same row says that if medications are currently used, the examiner should check with the Do Not Issue - Do Not Fly list. Both are shown as printed.
Show the FAA's words: good to know, 5
• Does not require any medication; … If medications are currently used, the AME should check with the Do Not Issue - Do Not Fly list.
Row C includes Row B's evaluation data
Row C's list starts with Row B evaluation data, then brain imaging performed after the procedure and hospital records for any hospitalization, surgery, or procedures related to this condition.
Show the FAA's words: good to know, 6
1. Row B evaluation data 2. Brain imaging performed AFTER the procedure. 3. Hospital records. Include these specific hospital records for any hospitalization, surgery, or procedures related to this condition.
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.
- Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia)Open to print: Neuralgia - (Trigeminal Neuralgia, Post Herpetic Neuralgia), a PDF at the FAA, in a new tab
Examiner can issue, Special Issuance
- 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.