AASI: AME Assisted Special Issuance
The first time, the FAA decides. At later exams, the examiner may reissue under the Authorization.
- From 12 FAA documents
- Checked by Crosscheck 14 October 2026
- Not affiliated with the FAA
What AASI is
The examiner may reissue under an Authorization for Special Issuance the FAA has already granted.
An FAA physician makes the first decision and grants the Authorization. The examiner reissues at later exams.
The FAA's definition in full
AASI stands for AME Assisted Special Issuance. The Guide describes it as a process that lets the examiner reissue a certificate under the provisions of an Authorization for Special Issuance, to an applicant who has a medical condition that is disqualifying under 14 CFR part 67.
FAA source: what AASI means
AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations (14 CFR) part 67.
How AASI works
Two different processes: the first time, and at later exams.
Initial Authorization · the FAA decides
First-time certification
Examiners may not issue an initial Authorization. The FAA decides and grants it.
Prepare the medical information
The first-time process the Guide describes is for a pilot who has all the medical information needed for a determination.
The AME defers
Then, at the exam, the examiner must defer and send all of the documentation to the AMCD or an RFS.
The FAA decides
Examiners may not issue an initial Authorization. An FAA physician makes the initial certification decision.
When the FAA grants the Authorization, its letter comes with attachments that say what the treating physicians must provide for later reissues.
View FAA sources for these steps: First-time certification
- Step 1. Prepare the medical information
The first-time process the Guide describes is for a pilot who has all the medical information needed for a determination.
If this is a first-time application for an AASI for a disqualifying disease/condition, and the applicant has all the requisite 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.
- Step 2. The AME defers
Then, at the exam, the examiner must defer and send all of the documentation to the AMCD or an RFS.
If this is a first-time application for an AASI for a disqualifying disease/condition, and the applicant has all the requisite 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.
- Step 3. The FAA decides
Examiners may not issue an initial Authorization. An FAA physician makes the initial certification decision.
Examiners may not issue initial Authorizations.
- Step 3. The FAA decides
Examiners may not issue an initial Authorization. An FAA physician makes the initial certification decision.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401.
- How it ends
When the FAA grants the Authorization, its letter comes with attachments that say what the treating physicians must provide for later reissues.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401.
- How it ends
When the FAA grants the Authorization, its letter comes with attachments that say what the treating physicians must provide for later reissues.
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
Reissuance · the examiner may reissue
Renewal and reissuance
Only after the FAA has granted an Authorization, for a condition with an AASI. Then the examiner may reissue.
Read your Authorization letter
Its attachments specify what the treating physicians must provide for the reissue.
Gather the follow-up information
The examiner may reissue only if the pilot provides the medical information required for the determination.
Visit your AME
The examiner checks the AASI's specialized criteria for the condition.
Criteria met, and the pilot otherwise qualified. The examiner may reissue, and the FAA continues to review AASI documents afterwards.
Not met. The condition's AASI sheet says when the examiner must defer to the FAA.
View FAA sources for these steps: Renewal and reissuance
- Step 1. Read your Authorization letter
Its attachments specify what the treating physicians must provide for the reissue.
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
- Step 2. Gather the follow-up information
The examiner may reissue only if the pilot provides the medical information required for the determination.
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the requisite medical information required for determination.
- Step 3. Visit your AME
The examiner checks the AASI's specialized criteria for the condition.
Following the granting of an Authorization for Special Issuance of a Medical Certificate (Authorization) by the AMCD or RFS, an Examiner may reissue a medical certificate to an applicant with a medical history of an initially disqualifying condition once the AASI's specialized criteria is met and the applicant is otherwise qualified.
- How it ends
Criteria met, and the pilot otherwise qualified. The examiner may reissue, and the FAA continues to review AASI documents afterwards.
Following the granting of an Authorization for Special Issuance of a Medical Certificate (Authorization) by the AMCD or RFS, an Examiner may reissue a medical certificate to an applicant with a medical history of an initially disqualifying condition once the AASI's specialized criteria is met and the applicant is otherwise qualified.
- How it ends
Criteria met, and the pilot otherwise qualified. The examiner may reissue, and the FAA continues to review AASI documents afterwards.
AAM will continue to review AASI documents after an AME issues.
- Or
Not met. The condition's AASI sheet says when the examiner must defer to the FAA.
The Examiner must defer to the AMCD or Region if: … The condition is not stable or has become uncontrolled (per the treating physician note);
Good to know
Only some conditions
DetailsThe Guide's AASI pages concern a number of selected medical conditions that are initially disqualifying, and each AASI has its own specialized clinical criteria.
FAA source: AASI, Only some conditions
The following pages of the Guide for Aviation Medical Examiners introduce the AME Assisted Special Issuance (AASI) process. … The Guide refers to a number of selected medical conditions that are initially disqualifying … Each AASI has their own specialized clinical criteria, by which an Examiner may reissue a medical certificate
Some are for third class only
DetailsThe Guide keeps a second list of AASIs that are presently restricted to a third-class certificate.
FAA source: AASI, Some are for third class only
The AASI's listed below are presently restricted to the issue of a third-class airman medical certificate.
The FAA can review it
DetailsThe Guide says the examiner's decision is subject to review by the FAA.
FAA source: AASI, The FAA can review it
An Examiner's decision or determination is subject to review by the FAA.
Requirements for your condition
Look up a condition to see which pathways the FAA's documents put it on, with the FAA's own documents.
Conditions whose FAA guidance includes AASI: conditions whose FAA guidance includes AASI
Many conditions have more than one pathway. Open a condition to see when its FAA guidance uses this one.
- Aortic insufficiency
- Arthritis
- Asthma
- Atrial fibrillation
- Bladder cancer
- Blood clots (DVT and PE)
- Blood disorders
- Breast cancer
- Chronic kidney disease
- Chronic lymphocytic leukemia (CLL/SLL)
- Colitis, Crohn's disease or IBS
- Colon cancer
- COPD
- Coronary heart disease
- Depression or anxiety treated with an antidepressant
- Diabetes treated with medication
- Glaucoma
- Heart valve replacement
- Hepatitis C
- High blood pressure
- Hyperthyroidism
- Hypothyroidism
- Immune thrombocytopenia (ITP)
- Kidney cancer
- Kidney stones
- Lymphoma and Hodgkin's disease
- Melanoma
- Migraine and chronic headache
- Mitral valve disease
- Neurofibromatosis
- Paroxysmal atrial tachycardia
- Prediabetes
- Prostate cancer
- Psoriasis
- Sleep apnea
- Stroke or TIA
- Testicular cancer
- Weight loss management
FAA sources for this page
If Crosscheck's wording and the FAA's differ, the FAA's document is the one that counts.
- AASI for Third-ClassFAA date 31 December 2024
- Special IssuancesFAA date 28 August 2024
- Authorization for Special Issuance and AME Assisted Special Issuance (AASI)FAA date 28 August 2024
- AASI for HypertensionFAA date 27 October 2015
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.
Where Crosscheck's FAA information comes fromOfficial FAA references