Blood clots (DVT and PE)
What the FAA's documents say about blood clots (DVT and PE), in plain words, with the FAA's own words one press away.
FAA term: Venous Thromboembolism (VTE) - Deep Venous Thrombosis (DVT), Pulmonary Embolism (PE), and/or Hypercoagulopathies
Short version
The FAA's table sorts it into two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| First applicationA first-time application for the AASI for this condition. | Defers to the FAA | Special Issuance |
| Under an AuthorizationA later exam, where the pilot holds an Authorization for Special Issuance. | Examiner issues | AASI |
Show the FAA's words: the FAA's table for Blood clots (DVT and PE)
- First application · Special Issuance
A first-time application for the AASI for this condition. Where the pilot has all the required medical information for a determination, the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination, and an FAA physician provides the initial certification decision and grants the Authorization.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401 . … If this is a first-time application for an AASI for the above disease/condition and the applicant has all the required 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.
An applicant with a history of thromboembolic disease must submit the following if consideration for medical certification is desired:
- Under an Authorization · AASI
A later exam, where the pilot holds an Authorization for Special Issuance. Examiners may reissue under the provisions of the Authorization for Special Issuance if the pilot provides what the AASI sheet lists.
Aviation Medical Examiners may re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance, if the applicant provides the following:
The FAA pathways for blood clots (DVT and PE)
Which exam
Your step-by-step plan
Step 1: What to submit for consideration
The hospital summary and a current status report, from the protocol.One question insideHospital admission and discharge summary
The hospital admission and discharge summary.
Current status report
A current status report.
It includes
- A detailed family history of thromboembolic disease
- A neoplastic workup, if clinically indicated
- Any blood clotting disorder, such as PT/PTT, Protein S and C, or Factor V Leiden
INRs since hospital discharge
If you are still on warfarin (Jantoven): all your INRs, no less than monthly, from hospital discharge to the present.
Show the FAA's words: What to submit for consideration
An applicant with a history of thromboembolic disease must submit the following if consideration for medical certification is desired:
Hospital admission and discharge summary
FAA source: Disease Protocols – Thromboembolic Disease. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
Current status report including:
Detailed family history of thromboembolic disease
Neoplastic workup, if clinically indicated
Any blood clotting disorder (e.g. PT/PTT, Protein S and C, Factor V Leiden); AND
FAA source: Disease Protocols – Thromboembolic Disease. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
If still anticoagulated with warfarin (Jantoven), submit all (no less than monthly) INRs from time of hospital discharge to present
FAA source: Disease Protocols – Thromboembolic Disease. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
Step 2: After starting treatment
The protocol's minimum observation times for warfarin and NOAC/DOACs.For applicants just beginning treatment, the protocol sets a minimum observation time.
Warfarin (Jantoven)
- At least 6 weeks after starting warfarin therapy
- 6 INRs, no more frequently than 1 per week
- Any required observation time for the underlying condition, too
NOAC/DOACs
- At least 2 weeks after starting therapy
- Any required observation time for the underlying condition, too
Show the FAA's words: After starting treatment
Warfarin (Jantoven): For applicants who are just beginning warfarin (Jantoven) treatment the following is required:
Minimum observation time of 6 weeks after initiation of warfarin therapy;
Must also meet any required observation time for the underlying condition; AND
6 INRs, no more frequently than 1 per week
FAA source: Disease Protocols – Thromboembolic Disease. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
NOAC/DOACs: For applicants who are just beginning treatment with NOAC/DOACs, the following is required:
Minimum observation time of 2 weeks after initiation of therapy; AND
Must also meet any required observation time for the underlying condition
FAA source: Disease Protocols – Thromboembolic Disease. FAA date 27 March 2024; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
First applicationDefers to the FAASpecial Issuance
Where the pilot has all the required medical information for a determination, the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination, and an FAA physician provides the initial certification decision and grants the Authorization.
If the examiner defersUnder an AuthorizationExaminer issuesAASI
Examiners may reissue under the provisions of the Authorization for Special Issuance if the pilot provides what the AASI sheet lists.
Show the FAA's words: what the examiner does on each row
- First application · Special Issuance
A first-time application for the AASI for this condition. Where the pilot has all the required medical information for a determination, the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination, and an FAA physician provides the initial certification decision and grants the Authorization.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401 . … If this is a first-time application for an AASI for the above disease/condition and the applicant has all the required 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.
An applicant with a history of thromboembolic disease must submit the following if consideration for medical certification is desired:
- Under an Authorization · AASI
A later exam, where the pilot holds an Authorization for Special Issuance. Examiners may reissue under the provisions of the Authorization for Special Issuance if the pilot provides what the AASI sheet lists.
Aviation Medical Examiners may re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance, if the applicant provides the following:
If the examiner defersSpecial Issuance
For a first-time application for this AASI, the AASI sheet says the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
What the FAA lists to send
- Item 1. The hospital admission and discharge summary.
- Item 2. A current status report including a detailed family history of thromboembolic disease, a neoplastic workup if clinically indicated, and any blood clotting disorder.
- Item 3. If still anticoagulated with warfarin (Jantoven), all INRs, no less than monthly, from the time of hospital discharge to the present.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
For a first-time application for this AASI, the AASI sheet says the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
If this is a first-time application for an AASI for the above disease/condition and the applicant has all the required 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.
What the FAA lists to send
- Item 1
The hospital admission and discharge summary.
Hospital admission and discharge summary
- Item 2
A current status report including a detailed family history of thromboembolic disease, a neoplastic workup if clinically indicated, and any blood clotting disorder.
Current status report including: … Detailed family history of thromboembolic disease … Neoplastic workup, if clinically indicated … Any blood clotting disorder (e.g. PT/PTT, Protein S and C, Factor V Leiden); AND
- Item 3
If still anticoagulated with warfarin (Jantoven), all INRs, no less than monthly, from the time of hospital discharge to the present.
If still anticoagulated with warfarin (Jantoven), submit all (no less than monthly) INRs from time of hospital discharge to present
After the FAA decides
AASIThe AASI sheet says an FAA physician provides the initial certification decision and grants the Authorization, and that examiners may then reissue under the Authorization for Special Issuance when the pilot provides what it lists.
Show the FAA's words: after the FAA decides
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401 . … Aviation Medical Examiners may re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance, if the applicant provides the following:
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.
Observation time after starting treatment
For applicants just beginning treatment, the protocol requires a minimum observation time of 6 weeks for warfarin (Jantoven), with 6 INRs no more frequently than 1 per week, or 2 weeks for a NOAC/DOAC, plus any required observation time for the underlying condition.
Show the FAA's words: good to know, 2
Minimum observation time of 6 weeks after initiation of warfarin therapy; … Must also meet any required observation time for the underlying condition; AND … 6 INRs, no more frequently than 1 per week … Minimum observation time of 2 weeks after initiation of therapy; AND
INR values out of range mean deferral
Under the AASI, the examiner must defer to the AMCD or Region if, using Jantoven (warfarin), more than 20% of INR values are below 2.0 or above 3.0.
Show the FAA's words: good to know, 3
* The Examiner must defer to the AMCD or Region if: … If using Jantoven (warfarin) and more than 20% of INR values are <2.0 or >3.0; or
The first AASI is deferred to the FAA
For a first-time application for this AASI, with all the required medical information for a determination, the AASI sheet says 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, 4
If this is a first-time application for an AASI for the above disease/condition and the applicant has all the required 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.
- Disease Protocols – Thromboembolic DiseaseOpen to print: Disease Protocols – Thromboembolic Disease, a page at the FAA, in a new tab
Special Issuance
- AASI – Venous Thromboembolism (VTE)Open to print: AASI – Venous Thromboembolism (VTE), a page at the FAA, in a new tab
The sheet the examiner follows to reissue under an FAA Authorization.
AASI
- 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.