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Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - Warfarin (Coumadin) Therapy for Deep Venous Thrombosis (DVT), Pulmonary Embolism (PE), and/ or Hypercoagulopathies

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.

An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance 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.

Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:

  • An Authorization granted by the FAA;
  • A summary of the applicant´┐Żs medical condition since the last FAA medical examination, including a statement regarding any further episodes of DVT, PE or other complication of hypercoagulopathy (see below*);
  • The name and dosage of medication(s) used for treatment and/or prevention with comment regarding side effects; and
  • A minimum of monthly International Normalized Ratio (INR) results for the immediate prior 6 months for those being treated with warfarin (Coumadin).

* The Examiner must defer to the AMCD or Region if:

  • More than 20 percent of INR values are < 2.0 or > 3.0 for those being treated with warfarin (Coumadin); or
  • The applicant develops emboli, thrombosis, bleeding that required medical intervention, or any other cardiac or neurologic condition previously not diagnosed or reported.

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