Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - Hypertension (HTN)

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 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.

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 current status report from the treating physician detailing:
  • If the is condition stable and, if so, for how long;
  • Any secondary cause for the HTN;
  • Any co-morbid condition (such as diabetes, obstructive sleep apnea); and
  • Any history of end organ damage (such as heart failure, myocardial infarction, cerebrovascular accident, kidney disease, eye disease); and
  • The name and dosage of medication(s) and presence or absence of any side effects.

   

  The Examiner must defer to the AMCD or Region if:

  • The condition is not stable or has become uncontrolled (per the treating physician note);
  • The airman is taking a medication that is not acceptable (See Pharmaceuticals - Antihypertensive);
  • The airman has aeromedically significant side effects from the medication;
  • There is a new co-morbid condition, complication, or end organ damage; or
  • The end organ damage condition(s) do not meet FAA requirements. (See the applicable section for the specific condition(s) in the AME guide)