Special Issuance and Medical Deferrals
When an AME cannot issue a medical on the spot, the application is deferred to the FAA — how that review works, and what an Authorization for Special Issuance means.
Not every medical is issued in the examiner's office. When your history includes a condition the FAA must review, the AME defers the application rather than issuing or denying it. Understanding the path avoids panic and speeds the outcome.
What "deferred" means
If your MedXPress application discloses a condition the examiner is not authorised to clear, the AME defers it: the file is forwarded to the FAA's Aerospace Medical Certification Division in Oklahoma City. You do not have a valid medical during the review unless you already held one that is still in date. The FAA reviews the file and often requests additional information — specialist reports, test results, a current status letter.
The Authorization for Special Issuance
For many otherwise-disqualifying conditions, the FAA can grant an Authorization for Special Issuance (SI) under 14 CFR 67.401. An SI is a time-limited medical granted despite a condition that does not meet the standard, on the basis that you are safe to fly with monitoring. It comes with follow-up requirements — periodic reports, tests or evaluations you must supply to keep it.
AASI — re-issue without going back to OKC
Once you hold an SI for certain stable conditions, the FAA may allow AME-Assisted Special Issuance (AASI): at each renewal your AME can re-issue the certificate in the office, provided you bring the required current records and still meet the criteria — no fresh trip through Oklahoma City each time.
Practical advice
- Gather your records first. The single biggest cause of delay is a slow, incomplete file — assemble specialist letters and test results before you apply.
- Consider consulting an AME (or an aeromedical advisory service) before submitting a complex history, so the file arrives complete.
- Never conceal a condition to avoid a deferral — falsification is independent grounds for denial or revocation, and many deferred conditions are ultimately approvable. See disqualifying conditions and special issuance.
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*Reference and training only — not for navigation or as legal advice. Always consult the current 14 CFR, the AIM, your aircraft’s POH/AFM and a certificated flight instructor.*