Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - Renal Calculi

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 from your treating physician regarding the location of the retained stone(s), estimation as to size of stone, and likelihood of becoming symptomatic; and
  • A current report of appropriate imaging study (IVP, KUB, Ultrasound, or Spiral CT Scan) and provide a metabolic work-up, both performed within last 90 days.

The Examiner must defer to the AMCD or Region if:

  • If the treating physician comments that the current stone has a likelihood of becoming symptomatic;
  • If the retained stone(s) has moved when compared to previous evaluations; or
  • If the stone(s) has become larger when compared to previous evaluations.


Last updated: Thursday, March 9, 2023