Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - AASI for Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)

AME Assisted Special Issuance (AASI) is a process that provides AMEs 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 requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

AMEs 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 CLL/SLL Status Summary and a current, detailed Clinical Progress Note from the treating physician that includes all of the required information; and
• The results of a complete blood count (CBC) performed no more than 90 days before the AME exam.

The AME must defer to the AMCD or Region if:

• The condition worsens, individual becomes symptomatic, or new treatment is initiated;
• The condition currently requires treatment with a chemotherapeutic agent;
• Rai stage is 3 or higher or Binet stage is C;
• Evidence of active disease;
• The hemoglobin is less than 10, the platelet count is less than 100,000/microL, or the total or absolute lymphocytic count doubling time is less than 6 months.