Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - AASI for Chronic Obstructive Pulmonary Disease (COPD)

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 (all performed no more than 90 days before the AME exam:

• An Authorization granted by the FAA;
• A completed COPD Status Summary verifying all items are “YES” or a current, detailed Clinical Progress Note which addresses each item;
• A pulmonary Function Test (PFT); and
• A 6-Minute Walk Test (6MWT).

The AME must defer to the AMCD or Region if:

• Resting oxygen saturation is 95% or lower;
• Pulmonary Function Tests show FEV1 is LESS than 60%;
• 6-Minute Walk Test (6MWT) shows 4% drop in SpO2 from baseline OR walked less than 400 meters; and
• The individual is taking 4 or more medications for COPD OR is on daily oral steroid use.

Submit the COPD Status Summary or a current, detailed Clinical Progress Note; PFTs; and 6MWT results to the FAA for retention in the file.