CACI, AASI and Special Issuance side by side
The same five questions asked of each, with the FAA's words one press away.
- From 12 FAA documents
- Checked by Crosscheck 14 October 2026
- Not affiliated with the FAA
Five questions, three pathways
Read across a row to compare, or down a column for one pathway.
| Question | CACI | Special Issuance | AASI |
|---|---|---|---|
| Who makes the first decision | The examiner, at the exam. | The Federal Air Surgeon, the Manager of the AMCD, or an RFS. | An FAA physician. |
| Is an FAA Authorization involved | No. The Guide calls it a regular issue. | Yes. It is what the FAA grants. | Yes. The examiner reissues under it. |
| What the examiner can do | Issue, when all CACI criteria are met and the applicant is otherwise qualified. | Not issue an initial Authorization. For some conditions, or missing documents, the examiner defers the exam to the FAA. | Reissue, once the AASI's specialized criteria are met and the applicant is otherwise qualified. |
| At later exams | The worksheet says how often the information is asked for again. | The pilot must again show the Federal Air Surgeon, for a new certificate or a Re-Authorization. | The Authorization's attachments specify what the treating physician(s) must provide for the reissuance determination. |
| Why the pilot's own FAA letter matters | The examiner keeps the CACI supporting documents on file rather than submitting them to the FAA at that time. | It specifies the class, and may limit the Authorization's duration, condition a new Authorization on later medical tests, examinations, or evaluations, state operational limitations needed for safety, or condition the Authorization and any second- or third-class certificate based on it on compliance with a statement of functional limitations. | Its attachments specify what the treating doctors provide. |
View FAA sources for this comparison
Who makes the first decision
- CACI
The examiner, at the exam.
If all the CACI criteria are met and the applicant is otherwise qualified, the AME may issue on the first exam or the first time the condition is reported to the AME without contacting AMCD/RFS.
- Special Issuance
The Federal Air Surgeon, the Manager of the AMCD, or an RFS.
The authority of the Federal Air Surgeon under the special issuance section of part 67 (14 CFR 67.401) is also exercised by the Manager, AMCD, and each RFS.
- AASI
An FAA physician.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401.
Is an FAA Authorization involved
- CACI
No. The Guide calls it a regular issue.
which allow AMEs to regular issue if the applicant meets the parameters of the CACI Condition Worksheet.
- Special Issuance
Yes. It is what the FAA grants.
A medical certificate of the appropriate class may be issued to a person who fails to meet one or more of the established medical standards if that person possesses a valid agency issued Authorization and is otherwise eligible.
- AASI
Yes. The examiner reissues under it.
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.
What the examiner can do
- CACI
Issue, when all CACI criteria are met and the applicant is otherwise qualified.
If all the CACI criteria are met and the applicant is otherwise qualified, the AME may issue on the first exam or the first time the condition is reported to the AME without contacting AMCD/RFS.
- Special Issuance
Not issue an initial Authorization. For some conditions, or missing documents, the examiner defers the exam to the FAA.
Examiners may not issue initial Authorizations.
- Special Issuance
Not issue an initial Authorization. For some conditions, or missing documents, the examiner defers the exam to the FAA.
For some conditions, or if missing required documentation, the AME must defer the examination to the FAA for review and/or further investigation.
- AASI
Reissue, once the AASI's specialized criteria are met and the applicant is otherwise qualified.
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.
At later exams
- CACI
The worksheet says how often the information is asked for again.
Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam.
- Special Issuance
The pilot must again show the Federal Air Surgeon, for a new certificate or a Re-Authorization.
An airman must again show to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety in order to obtain a new medical certificate and/or a Re-Authorization.
- AASI
The Authorization's attachments specify what the treating physician(s) must provide for the reissuance determination.
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
Why the pilot's own FAA letter matters
- CACI
The examiner keeps the CACI supporting documents on file rather than submitting them to the FAA at that time.
Document the appropriate notes in Block 60 and keep the supporting documents in your files; they do not need to be submitted to the FAA at this time.
- Special Issuance
It specifies the class, and may limit the Authorization's duration, condition a new Authorization on later medical tests, examinations, or evaluations, state operational limitations needed for safety, or condition the Authorization and any second- or third-class certificate based on it on compliance with a statement of functional limitations.
In granting an Authorization, the Federal Air Surgeon specifies the class of medical certificate authorized to be issued and may do any or all of the following: Limit the duration of an Authorization; Condition the granting of a new Authorization on the results of subsequent medical tests, examinations, or evaluations; State on the Authorization, and any medical certificate based upon it, any operational limitation needed for safety; or Condition the continued effect of an Authorization, and any second- or third-class medical certificate based upon it, on compliance with a statement of functional limitations issued to the person in coordination with the Director of Flight Standards or the Director's designee
- AASI
Its attachments specify what the treating doctors provide.
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
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