Paraplegia
What the FAA's documents say about paraplegia, in plain words, with the FAA's own words one press away.
Covers: All classes
Show the FAA's words: which classes the FAA's table covers
PARAPLEGIA All Classes
Short version
The disposition table has one row, paraplegia.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AParaplegia | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Paraplegia
- Row A · Special Issuance
Paraplegia. The table lists what to submit for FAA review, and says that in most cases a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. The examiner defers and submits the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
A. Paraplegia Submit the following for FAA review: … In most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. DEFER Submit the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
The FAA pathways for paraplegia
Your step-by-step plan
Step 1: The neurological evaluation
From your treating neurologist, and the table's second item.Neurological evaluation from your treating neurologist
Within 90 days before the examA current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, from a clinic visit with your treating neurologist no more than 90 days before the exam.
Items your physician specifically addresses
Items your physician specifically addresses, as the table's second item lists them.
It must specifically address
- Cause of paraplegia
- Medication use and side effects, if any
- Autonomic functions such as bowel, bladder, and blood pressure control
- Orthostatic episodes
- Hypotensive episodes on the ground (the table says this could be exacerbated with G-forces in flight)
- Description of movement, strength, and tone (ability to get into and out of an airplane)
Show the FAA's words: The neurological evaluation
Submit the following for FAA review: 1. A current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
2. It must specifically address: • Cause of paraplegia; • Medication use and side effects, if any; • Autonomic functions such as bowel, bladder, and blood pressure control; • Orthostatic episodes; • Hypotensive episodes on the ground. (This could be exacerbated with G-forces in flight.); and • Description of movement, strength, and tone (ability to get into and out of an airplane).
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024; checked by Crosscheck 14 October 2026.
Step 2: Movement, strength, and functional ability
If the neurology evaluation does not adequately describe them.If not addressed, in the table's words.
If not addressed, in the table's words.
If not addressed, the table says a PT/OT/PMR Functional Capacity Evaluation (FCE) may be required.
Show the FAA's words: Movement, strength, and functional ability
If not addressed, a PT/OT/PMR Functional Capacity Evaluation (FCE) may be required.
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
If the neurology evaluation does not adequately describe movement, strength, and functional ability, the AME should describe any functional limitations that could affect the ability to operate aircraft controls.
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 3: What the table notes
Medications, and the Medical Flight Test.The table's note on medications, and its line on the Medical Flight Test.
Medications
- Most anticholinergic medications are not acceptable
The Medical Flight Test
- In most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes
- The examiner defers and submits the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA
Show the FAA's words: What the table notes
Note: Most anticholinergic medications are not acceptable.
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
In most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. DEFER Submit the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
FAA source: Paraplegia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
Row ADefers to the FAASpecial Issuance
The table lists what to submit for FAA review, and says that in most cases a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. The examiner defers and submits the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
Paraplegia. The table lists what to submit for FAA review, and says that in most cases a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. The examiner defers and submits the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
A. Paraplegia Submit the following for FAA review: … In most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. DEFER Submit the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
If the examiner defersSpecial Issuance
The table marks its one row, paraplegia, DEFER, for a possible Special Issuance or Medical Flight Test and SODA.
What the FAA lists to send
- Item 1. A current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with the treating neurologist no more than 90 days before the exam.
- Item 2. Items the physician specifically addresses, as the table's second item lists them. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address. This item's words are "It must specifically address".
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks its one row, paraplegia, DEFER, for a possible Special Issuance or Medical Flight Test and SODA.
A. Paraplegia … DEFER Submit the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
What the FAA lists to send
- Item 1
A current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with the treating neurologist no more than 90 days before the exam.
1. A current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.
- Item 2
Items the physician specifically addresses, as the table's second item lists them. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address. This item's words are "It must specifically address".
2. It must specifically address: • Cause of paraplegia; • Medication use and side effects, if any; • Autonomic functions such as bowel, bladder, and blood pressure control; • Orthostatic episodes; • Hypotensive episodes on the ground. (This could be exacerbated with G-forces in flight.); and • Description of movement, strength, and tone (ability to get into and out of an airplane).
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
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.
A Medical Flight Test in most cases
The table says that in most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes, and its disposition reads for a possible Special Issuance or Medical Flight Test and SODA.
Show the FAA's words: good to know, 1
In most cases, a Medical Flight Test (MFT) is required prior to medical certification and/or Special Issuance for all classes. DEFER Submit the information to the FAA for a possible Special Issuance or Medical Flight Test and SODA.
Hypotensive episodes on the ground
The second item's list includes hypotensive episodes on the ground, and the table says this could be exacerbated with G-forces in flight. The list also includes orthostatic episodes, and autonomic functions such as bowel, bladder, and blood pressure control.
Show the FAA's words: good to know, 2
• Autonomic functions such as bowel, bladder, and blood pressure control; • Orthostatic episodes; • Hypotensive episodes on the ground. (This could be exacerbated with G-forces in flight.)
Getting into and out of an airplane
The second item's list ends with a description of movement, strength, and tone (ability to get into and out of an airplane). If the neurology evaluation does not adequately describe movement, strength, and functional ability, the table says the examiner should describe any functional limitations that could affect the ability to operate aircraft controls.
Show the FAA's words: good to know, 3
• Description of movement, strength, and tone (ability to get into and out of an airplane). … If the neurology evaluation does not adequately describe movement, strength, and functional ability, the AME should describe any functional limitations that could affect the ability to operate aircraft controls.
"If not addressed"
The table says that if not addressed, a PT/OT/PMR Functional Capacity Evaluation (FCE) may be required. It does not say what "not addressed" refers to, and this page shows it as printed.
Show the FAA's words: good to know, 4
If not addressed, a PT/OT/PMR Functional Capacity Evaluation (FCE) may be required.
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.