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1Fix the driver behind crashes, sound loss and screen glitches2Repair Windows errors before they cause bigger problems3Scan for outdated or missing drivers - takes under a minuteA mental health diagnosis or treatment does not automatically end a pilot’s chance of certification. The FAA evaluates the specific condition, symptoms, treatment and records; an Aviation Medical Examiner (AME) may issue a certificate when the applicable standards are met or defer the application for FAA review. Some applicants may qualify for a condition-specific special issuance or special consideration, but eligibility is individual.
How the application and AME examination work
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Complete the application in MedXPress. Answer the medical-history questions accurately, including relevant diagnoses, treatment and medications. The FAA advises applicants with current or past conditions or medication use to review the applicable AME Guide material before the appointment.
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Arrange an examination with an AME. The FAA’s applicant guidance describes a 60-day period after submitting the application to complete the examination. Because application instructions can change, check the current FAA guidance for the deadline that applies to you.
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Bring relevant records. Keep a copy of the application and bring medical documents that may help the AME assess the disclosed history. The AME can submit relevant material to the FAA. If the FAA requests records and does not receive a complete response, the review may be delayed or the application may be denied.
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The AME examines the applicant and reviews the history and documentation. The FAA’s “How do I get a Medical Certificate and what to expect during the AME examination” guidance explains the basic application and examination process.
Who decides: the AME, the FAA or both?
The route depends on whether the applicant meets the ordinary medical standards and whether the condition’s guidance calls for FAA review. Deferral is not the same as denial: it sends the application to FAA medical staff for a decision. The FAA says it provides written notice of the outcome, and missing information can hold up that review.
| Path | Who makes the decision | When it may apply | What follows |
|---|---|---|---|
| Ordinary issuance | The AME | The applicant meets the applicable standards and the required documentation supports issuance. | The AME may issue the certificate. |
| Deferral for FAA review | FAA medical staff | The condition’s guidance requires FAA action, or the AME cannot issue based on the available information. | The FAA reviews the case and sends written notice. Additional requested records may be needed. |
| Special issuance or special consideration | The FAA | A condition-specific protocol allows case-by-case consideration even though ordinary standards are not met. | An authorization may have a specified validity period and conditions for follow-up. |
| AME-assisted special issuance (AASI) reissuance | An AME, after the FAA’s initial authorization | The FAA has already granted a special issuance and the applicant meets the applicable follow-up criteria. | An eligible AME may reissue under the authorization’s terms; this is not the initial FAA decision. |
The FAA’s AME Guide says an examiner should not issue when a case requires deferral and that medical documentation must support issuance. The applicable psychiatric disposition depends on the particular diagnosis and circumstances, not on a single rule for all mental health histories.
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How the FAA evaluates mental health history and medication
The FAA’s general psychiatric guidance treats psychotropic medication as disqualifying for aeromedical certification purposes, while also setting out condition-specific protocols and exceptions. That general rule does not mean every diagnosis or treatment history results in permanent disqualification. The FAA’s Psychiatric Conditions Table of Medical Dispositions, listed as updated May 29, 2024, separates conditions and required actions.
For example, the table says depression requiring antidepressant medication requires an FAA decision. It also describes circumstances in which some resolved adjustment disorders may follow an issue route, but only when specified conditions involving stability, thought, recurrence and medication are met. These examples illustrate why a diagnosis label alone cannot establish eligibility.
The FAA encourages pilots to seek help for mental health conditions, stating that “most, if treated, do not disqualify a pilot from flying.” The FAA also says about 0.1% of medical certificate applicants who disclose health issues are denied; the agency’s page does not state the year for that figure. It is not a mental-health-specific denial rate and does not describe all applicants.
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When antidepressant treatment may be considered
The FAA renamed its former SSRI protocol the Antidepressant Protocol after adding additional medications. Under the FAA’s current protocol summary, an applicant may be considered case by case for a special issuance or special consideration authorization if the applicable diagnostic, stability, medication and history criteria are met.
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The person must have been clinically stable on a stable dose for at least three continuous months.
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The medication must be among those the FAA conditionally accepts for the protocol and must be used alone.
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The protocol lists history factors that disqualify an applicant from this pathway. The FAA directs the applicant to further evaluation by a HIMS AME.
The AME cannot grant the authorization. The medication list, condition-specific decision tools and evaluation requirements should be checked in the live FAA materials; this summary cannot determine whether a particular person or medication qualifies.
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The FAA’s protocol describes a separate route for applicants who discontinue an antidepressant: the examiner defers issuance, and an applicant seeking regular issuance must be off the medication for at least 60 days and provide a favorable report from the treating physician indicating stable mood and no aeromedically significant side effects. This is a certification criterion, not advice to stop medication. Treatment decisions belong with the applicant and treating clinician.
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What special issuance means after approval
Under the FAA’s summary of 14 CFR § 67.401, the Federal Air Surgeon may authorize certification for a person who does not meet ordinary standards if the person demonstrates that they can perform the duties of the relevant airman certificate without endangering public safety. It is an individualized authorization, not a blanket exemption. The authorization has a specified validity period; the medical certificate expires no later than the authorization or its withdrawal, and a further authorization requires demonstrating eligibility again.
After an initial FAA authorization, some applicants may qualify for AME-assisted special issuance. The FAA’s AASI guidance allows an AME to reissue in eligible cases when the applicant meets the specialized follow-up criteria attached to the authorization. The initial authorization remains an FAA decision.
Where to check the requirements for an individual case
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Review the current FAA AME Guide entry for the relevant psychiatric condition and the related disposition table.
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For antidepressant treatment, check the live FAA Antidepressant Protocol and its linked medication and evaluation materials.
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Discuss the application and required records with an AME, including whether the case should be referred to a HIMS AME.
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Consult the treating clinician about diagnosis, symptoms, records and any treatment decision. FAA certification criteria do not replace individualized medical advice.
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