Disqualifying Conditions and Special Issuance

The FAA lists certain medical conditions as specifically disqualifying, but a diagnosis is rarely the end of the story — many pilots fly with these conditions through a Special Issuance (SI).

Specifically disqualifying conditions

The regulations name a set of conditions that automatically require FAA review, including: angina/coronary disease that's been treated, heart attack or cardiac valve replacement, permanent pacemaker, diabetes requiring medication for control, epilepsy, a disturbance of consciousness without explanation, certain psychiatric conditions (psychosis, bipolar disorder, severe personality disorder), and substance dependence or abuse.

Special Issuance (SI)

If you have a disqualifying or otherwise concerning condition, the FAA can grant an Authorization for Special Issuance — a time-limited medical, often with conditions and periodic reporting, once you provide the medical evidence that you can fly safely. Many serious conditions, well-managed, are approvable.

Practical advice

• Don't fly with a condition you know is disqualifying until you're cleared.
• Work with your AME — and for complex cases, a pilot-focused aeromedical specialist — before your exam, so a deferral doesn't strand your certificate.
• The "CACI" (Conditions AMEs Can Issue) program lets AMEs clear many common, stable conditions on the spot without a formal SI.

This is general information, not medical advice — consult your AME for your situation.

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*Reference and training only — not for navigation. Always consult the current AIM, FAR/AIM, your aircraft’s POH/AFM, official weather products and a certificated flight instructor.*