Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - Migraine Headaches

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 statement regarding the frequency of headaches and/or other associated symptoms since last followup report;
  • A statement regarding if the characteristics of the headaches changed; and
  • The name and dosage of medication(s) used for treatment and/or prevention with comment regarding side effects.


The Examiner should defer to the AMCD or Region if:

  • The frequency of headaches and/or other symptoms increase since the last followup report; or
  • The applicant is placed on medication(s), such as isometheptene mucate, narcotic analgesic, tramadol, tricyclic-antidepressant medication, etc.


Last updated: Thursday, March 9, 2023