Your Guide to the Airman Medical Certification Process

To become or remain a certificated pilot under Federal Aviation Administration (FAA) rules, you must obtain a valid medical certificate or complete a Basic Med evaluation. The process begins when you complete FAA Form 8500‑8 (via the online FAA MedXPress system), which captures your personal, medical, and flight-history information.

After submission, you meet with a designated Aviation Medical Examiner (AME), who reviews your application, verifies your identity, and performs a physical exam. If the AME finds no disqualifying issues, they may issue a medical certificate — typically valid for a fixed period depending on the class of certificate and your age.

A stethoscope resting on a medical examination table, symbolizing the airman medical certification process.

Disqualifying Medical Conditions

Certain medical conditions are considered “disqualifying” under the FAA’s standards because they pose a risk of sudden incapacitation, impaired judgment, or other safety-critical failures. Examples include:

• Cardiovascular issues: e.g., angina pectoris, coronary heart disease, heart-attack history or heart surgery (e.g., valve replacement), having a pacemaker or heart transplant.

• Neurological problems: e.g., epilepsy or seizure disorders, unexplained loss of consciousness, other neurologic conditions that could impair coordination or awareness.

• Mental health or psychiatric disorders: e.g., psychosis, bipolar disorder, certain severe personality disorders; also substance abuse or dependence (including alcohol) and any history of substance-related impairment.

• Metabolic/endocrine disorders: e.g., diabetes mellitus requiring insulin or other hypoglycemic medication (though some cases may qualify for special issuance).

Use of certain disqualifying medications (especially those affecting cognition, alertness, or cardiovascular/neurologic function) may also prevent issuance of a standard certificate.

Because of the safety risks involved, the FAA treats these conditions seriously to protect both the airman and the public.

Special Issuance - A Path Forward For Many

Having a disqualifying condition does not always mean you’re permanently grounded. Under 14 CFR § 67.401 the FAA may grant a Special Issuance Authorization (often called “Special Issuance” or “SI”) — a discretionary waiver that allows certification despite a disqualifying medical history.

To obtain a Special Issuance, you typically need to provide extensive medical documentation (e.g., testing results, specialist reports) showing your condition is stable, managed, and does not pose an unacceptable risk of incapacitation.

If granted, the medical certificate may come with conditions: such as a limited time before re-evaluation (often annually), requirements for follow-up reports or periodic testing, and sometimes operational restrictions depending on the condition

PreFlight Consulation Helps To Avoid Delays

Because the rules are detailed and the list of disqualifying conditions broad, many prospective airmen are uncertain whether a medical condition or medication will disqualify them. That’s where my Pre-Flight Consultation service comes in.

• Early screening: Before you complete and submit your FAA Form 8500-8, we meet to review your full medical history, current medications, and any prior diagnoses — especially those related to cardiovascular, neurological, metabolic, or mental health concerns.

• Risk evaluation: I assess whether your condition or medications are likely to trigger a disqualification or require Special Issuance. I advise on steps to document your condition, stabilize treatment, and organize any supporting information (e.g., lab results, specialist summaries).

• FAA-ready guidance: If your condition could qualify under a Special Issuance, I guide you on what documentation or monitoring will likely be needed, helping to avoid common delays or denials.

• Peace of mind: This consultation gives you clarity upfront — you don’t proceed to FF 8500-8 submission until we are confident about your eligibility or next steps.

For many airmen, a pre-flight consultation can significantly smooth the path to certification, avoid surprise denials, and reduce the risk of unexpected delays or documentation requests.