Guide for Aviation Medical Examiners

Special Issuances
AME Assisted - All Classes - Thrombocytopenia

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; and
  • An update of the status of the disease from the last FAA medical examination and any testing deemed necessary by the treating physician; and
  • CBC within the past 90 days.

The Examiner must defer to the AMCD or Region if:

  • There has been any recurrence or disease progression; or
  • There has been any bleeding that required treatment; or
  • Any new treatment is initiated such as IVIG, high dose steroids, platelet transfusion, splenectomy (as treatment, not traumatic), or others; or
  • Platelet count falls below 50,000/microL


Last updated: Monday, October 25, 2021