Parkinson's disease
What the FAA's documents say about parkinson's disease, in plain words, with the FAA's own words one press away.
FAA term: Parkinson's Disease and Parkinsonism (Secondary)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
PARKINSON'S DISEASE and PARKINSONISM (Secondary) All Classes
Short version
The disposition table has two rows, and both defer to the FAA for a possible Special Issuance.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AParkinson's disease or secondary parkinsonism | Defers to the FAA | Special Issuance |
| Row BParkinson's treated with a deep brain stimulator (DBS) | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Parkinson's disease
- Row A · Special Issuance
Parkinson's disease or secondary parkinsonism, a current or historical diagnosis. The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA for a possible Special Issuance.
A. Parkinson’s Disease or Secondary Parkinsonism Current or historical diagnosis Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
- Row B · Special Issuance
Parkinson's treated with a deep brain stimulator (DBS). The table asks for all of Row A's evaluation data, the operative report and the DBS Status Summary, and its note says DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Parkinson's Treated with Deep Brain Stimulator (DBS) Submit the following for FAA review: 1. All Row A evaluation data 2. Operative report 3. DBS Status Summary Note: DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. DEFER Submit the information to the FAA for a possible Special Issuance.
The FAA pathways for parkinson's disease
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: The neurological evaluation
From your treating neurologist, with what the table's second item names.Neurological evaluation
Within 90 days before the examA current, detailed neurological evaluation that meets 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 Row A's second item lists them.
It must specifically include
- The Unified Parkinson's UPDRS-III motor rating scale
- Comment on medications, side effects, and effectiveness of medication or treatment
- Findings if/when an individual misses a dose of medication
- Stability of the condition: fluctuations of motor and cognitive function; dyskinesia, in response to the medication; and the pattern of fluctuations throughout the day
- Autonomic dysfunction, such as blood pressure fluctuation or orthostasis
Acceptable medication
The only medication currently acceptable for aeromedical purposes is carbidopa + levodopa (in either long or short acting preparations).
Show the FAA's words: The neurological evaluation
1. A current, detailed neurological evaluation that meets 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: Parkinson’s Disease and Parkinsonism (Secondary). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
2. It must specifically include: • Unified Parkinson's UPDRS-III motor rating scale; • Medication*: Comment on medications, side effects, and effectiveness of medication or treatment; • Describe findings if/when an individual misses a dose of medication; • Must discuss stability of the condition: Fluctuations of motor and cognitive function; dyskinesia, in response to the medication; and what is the pattern of fluctuations throughout the day; and • Autonomic dysfunction such as blood pressure fluctuation or orthostasis;
FAA source: Parkinson’s Disease and Parkinsonism (Secondary). 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.
*Acceptable Medication(s): The only medication currently acceptable for aeromedical purposes is carbidopa + levodopa (in either long or short acting preparations).
FAA source: Parkinson’s Disease and Parkinsonism (Secondary). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 2: MRI brain and the neuropsychological evaluation
The MRI within 12 months, the evaluation within 90 days.MRI brain
An MRI brain (magnetic resonance imaging) performed within the 12 months before the exam.
How it is sent
- The interpretive report on paper
- Imaging on CD in DICOM readable format, with a file named 'DICOMDIR' in the root directory of the CD-ROM
- The CD verified to display the images before sending
- The table suggests keeping a copy of all films, as a safeguard if lost in the mail
Neuropsychological evaluation
Within 90 days before the examA current neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with your treating neuropsychologist no more than 90 days before the exam.
Show the FAA's words: MRI brain and the neuropsychological evaluation
3. MRI brain (Magnetic Resonance Imaging) performed within the 12 months before the AME exam. Submit the interpretive report on paper and imaging on CD in DICOM readable format (there must be a file named 'DICOMDIR' in the root directory of the CD-ROM). Please verify the CD will display the images before sending. You may wish to retain a copy of all films as a safeguard if lost in the mail.
FAA source: Parkinson’s Disease and Parkinsonism (Secondary). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
4. A current Neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, generated from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
FAA source: Parkinson’s Disease and Parkinsonism (Secondary). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 3: See your AME
The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA for a possible Special Issuance.Exam day- The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA for a possible Special Issuance.
Show the FAA's words: See your AME
A. Parkinson’s Disease or Secondary Parkinsonism Current or historical diagnosis Submit the following for FAA review:
DEFER Submit the information to the FAA for a possible Special Issuance.
FAA source: Parkinson’s Disease and Parkinsonism (Secondary). 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.
Row ADefers to the FAASpecial Issuance
The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA for a possible Special Issuance.
If the examiner defersRow BDefers to the FAASpecial Issuance
The table asks for all of Row A's evaluation data, the operative report and the DBS Status Summary, and its note says DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. 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
- Row A · Special Issuance
Parkinson's disease or secondary parkinsonism, a current or historical diagnosis. The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA for a possible Special Issuance.
A. Parkinson’s Disease or Secondary Parkinsonism Current or historical diagnosis Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
- Row B · Special Issuance
Parkinson's treated with a deep brain stimulator (DBS). The table asks for all of Row A's evaluation data, the operative report and the DBS Status Summary, and its note says DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Parkinson's Treated with Deep Brain Stimulator (DBS) Submit the following for FAA review: 1. All Row A evaluation data 2. Operative report 3. DBS Status Summary Note: DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. DEFER Submit the information to the FAA for a possible Special Issuance.
If the examiner defersSpecial Issuance
The table marks Row A, Parkinson's disease or secondary parkinsonism, a current or historical diagnosis, DEFER.
The table marks Row B, Parkinson's treated with a deep brain stimulator (DBS), DEFER.
What the FAA lists to send
- Item 1. A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with the treating neurologist no more than 90 days before the exam.
- Item 2. Items the physician specifically addresses, as Row A'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.
- Item 3. An MRI brain (magnetic resonance imaging) performed within the 12 months before the exam, with the interpretive report on paper and imaging on CD.
- Item 4. A current neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with the treating neuropsychologist no more than 90 days before the exam.
- Item 5. For Row B, the operative report.
- Item 6. For Row B, the DBS Status Summary.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, Parkinson's disease or secondary parkinsonism, a current or historical diagnosis, DEFER.
A. Parkinson’s Disease or Secondary Parkinsonism Current or historical diagnosis … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks Row B, Parkinson's treated with a deep brain stimulator (DBS), DEFER.
B. Parkinson's Treated with Deep Brain Stimulator (DBS) … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with the treating neurologist no more than 90 days before the exam.
1. A current, detailed neurological evaluation that meets 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 Row A'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.
2. It must specifically include: • Unified Parkinson's UPDRS-III motor rating scale;
“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.
- Item 3
An MRI brain (magnetic resonance imaging) performed within the 12 months before the exam, with the interpretive report on paper and imaging on CD.
3. MRI brain (Magnetic Resonance Imaging) performed within the 12 months before the AME exam. Submit the interpretive report on paper and imaging on CD in DICOM readable format
- Item 4
A current neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with the treating neuropsychologist no more than 90 days before the exam.
4. A current Neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, generated from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
- Item 5
For Row B, the operative report.
1. All Row A evaluation data 2. Operative report
- Item 6
For Row B, the DBS Status Summary.
2. Operative report 3. DBS Status Summary
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.
The table names one acceptable medication
The table says the only medication currently acceptable for aeromedical purposes is carbidopa + levodopa (in either long or short acting preparations). The second item asks for comment on medications, side effects, and effectiveness of medication or treatment, and for findings if/when an individual misses a dose.
Show the FAA's words: good to know, 1
• Medication*: Comment on medications, side effects, and effectiveness of medication or treatment; • Describe findings if/when an individual misses a dose of medication; … *Acceptable Medication(s): The only medication currently acceptable for aeromedical purposes is carbidopa + levodopa (in either long or short acting preparations).
The MRI's window is 12 months
The MRI brain is performed within the 12 months before the exam. The neurological and neuropsychological evaluations are from clinic visits no more than 90 days before the exam.
Show the FAA's words: good to know, 2
3. MRI brain (Magnetic Resonance Imaging) performed within the 12 months before the AME exam. … generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam. … generated from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
DBS and lesioning therapy
Row B is Parkinson's treated with a deep brain stimulator (DBS). Its note says DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis. The table's rows name DBS and do not name lesioning therapy.
Show the FAA's words: good to know, 3
B. Parkinson's Treated with Deep Brain Stimulator (DBS) … Note: DBS and lesioning therapy may carry a risk of cognitive impairment and are reviewed on a case-by-case basis.
A historical diagnosis is Row A too
Row A is Parkinson's disease or secondary parkinsonism, a current or historical diagnosis, and the table marks it DEFER.
Show the FAA's words: good to know, 4
A. Parkinson’s Disease or Secondary Parkinsonism Current or historical diagnosis … DEFER Submit the information to the FAA for a possible Special Issuance.
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.
Medication guidance
Medications Crosscheck lists as taken for parkinson's disease, each with its own page on what published FAA guidance says about it.
- The one medication the FAA's Parkinson's disease table names as acceptable
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.