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roles & responsibilites
Sometimes there can be some confusion about the role of an Aviation Medical Examiner (AME). Let us clarify to help you better understand an AMEs responsibilities and how we can assist you. You can also check out a quick and helpful video clip about this: HERE.
What Does an AME Do?
An AME is designated by the FAA to perform screening medical exams and to provide the results to the FAA. Based on the findings of the exam, the AME is either authorized to issue a medical certificate or is required to defer the certification decision to the FAA for further review. The AME's role is limited to conducting the exam and making a certification decisions in accordance with what the FAA has authorized.
When a Case is Deferred and/or the FAA Requests Additional Information
If your case is deferred to the FAA and/or if the FAA needs additional information, the resolution process is strictly between you and the FAA. AMEs generally have limited involvement in deferred cases, aside from answering basic questions about the process. If you require additional assistance beyond this point, a formal engagement—such as an AME Consultation or Case Management service—will be necessary.
Your Options Moving Forward
- Manage Your Case Independently: You can choose to manage your case directly with the FAA. An AME's involvement is limited to addressing basic process-related questions. For complex issues or guidance, a formal consultation will be required.
- AME Consultation: A one-time consultation provides an opportunity to review your case in detail and receive guidance on the best path forward. This 30-minute session can be conducted in person or via phone (in-person is the default unless otherwise requested). An AME Consultation might also be useful before you schedule an exam if you have any questions or concerns. You can schedule a consultation through the link at TexasAME.com.
- Case Management: This comprehensive service includes active AME involvement throughout your case. You would provide all relevant documentation, and your AME would offer ongoing review and suggestions to optimize the process and outcome. Your AME would submit all documentation to the FAA for you. If you’re interested in Case Management, check out this section below for more details.
We are not Treating Physicians
Unlike medical practitioners, we are not treating physicians which means:
- We do not diagnose medical conditions.
- We do not provide treatment or make referrals.
- We do not retain medical records (the FAA is the legal custodian).
- We have no role with insurance, reimbursements, disability, etc.
For your health management needs and to facilitate your medical certification, it is crucial to establish care with a treating physician. If you need referrals to specialists or ongoing care, your treating physician will handle those aspects.
A note regarding receipts…
Our receipts are similar to those of any other service-based business rather than those from medical practitioners who bill insurance. We do not use ICD codes, procedures, or modifier codes because our services are not structured for reimbursement.
We acknowledge that some employers and insurance providers have specific receipt requirements for reimbursement. Our receipts are generated through Square, following standard industry formatting. Unfortunately, Square does not give us the ability to modify our receipts to meet individual requirements.
Any attempt to obtain reimbursement is entirely up to the client—our role is limited to providing our industry-standard receipt. While some clients may be able to obtain reimbursement, that decision is entirely up to their employer or insurer.
Our Shared Goal: National Airspace Safety
As an AME, our primary responsibility is ensuring the safety of the National Airspace. Information obtained during the application process is not protected by a “doctor-patient” relationship and is subject to disclosure to the FAA as needed for certification decisions. While we exercise discretion in reporting, we will include information we believe is pertinent to your case and present it in a way that supports an accurate review by the FAA. Transparency and honesty are key!
The Importance of Honesty and Openness
An AME's role is not to investigative; we rely on applicants to be honest and forthcoming with all relevant information. When clients provide complete and truthful details, we can best use our experience to help optimize their case. If critical information is withheld, it compromises the trust and effectiveness of our working relationship and can delay your certification with the FAA.
Our Advice: put everything on the table and trust us to manage your case with the FAA effectively and ethically.
AME SERVICES OFFERED
Core Aviation Medical Examiner (AME) Services include:
- 1st Class Exam (without ECG/EKG)
- 2nd Class Exam
- 3rd Class Exam
- HIMS AME Full Services
- ATCS (FAA Employees)
- ATCS (Non-FAA Employees)
- AME Consultation Services
Integrated Services include:
- HIMS Aviation Medical Examiner Case Management and/or Monitoring
- HIMS Neuropsychological Evaluation
- HIMS Psychiatric Evaluation
(See Integrated Services Package for more information)
Additional Services include:
- Audiometric & Vision Screening (Color and Acuity)
- EKG (baseline at age 35, annually at age 40 and above)
- Special Issuance & Document Processing
- AME Consultations
- Case Management Services (see below)
- SCCA Pro Racing and others non-flying Medicals
- BasicMed (see below)
(Please see our scheduling site for current prices)
document processing
Document Completion, Review, Processing, and/or Submission
Our primary function is to perform the Aviation Medical Examination. Performing an exam does not include the submission of any documentation to the FAA beyond the examination report itself (which is completed within the FAA’s system). In addition we offer a paid specialized service to assist you in managing any documentation that may be required for FAA-related matters. This service is optional and is designed to ease the administrative burden, expedite the process, and provide expert support, but we want to ensure that expectations are aligned.
- Scope: Our service encompasses a range of tasks related to medical documentation, including processing Special Issuance Authorization (SIA) and CACI items, reviewing documentation and records, uploading items to the FAA (The FAA may direct you to provide documents to your AME for upload), and filling out additional forms as necessary or requested. We are equipped to handle various aspects of the documentation process.
- SIA (Special Issuance Authorization): All SIA documentation reviewed by, processed by, and or uploaded to the FAA by our office incurs our Document Processing Fee. This can be a stand-alone service, it may be virtual, and/or may be added onto an Exam or other services. The Client retains the right to process their own documentation with the FAA should they so choose.
- EKG/ECG (Electro CardioGram): We include the processing and uploading of EKGs in the paid EKG services we provide. You can rely on our expertise in managing this aspect of the examination when necessary.
- CACI (Conditions an AME Can Issue): We reserve the right to make exceptions for CACI documentation at the discretion of each Provider (i.e. the Provider may waive the fee for processing CACI items). Please consult with your Provider to determine if your specific CACI condition falls under this exception.
- Client Responsibilities: It's essential that you understand your responsibilities in this process, which include providing us with all necessary medical records and documents and ensuring compliance with FAA requests, programs, and deadlines.
- Fee Structure: We have established a fee structure for our services, which covers the various tasks involved in processing and submitting medical documentation. Our base fee includes the processing of Special Issuance Authorization (SIA) and CACI documentation. Reviewing documentation and records, uploading other items to the FAA, filling out additional forms as necessary or requested, etc can be included at a customized rate.
- Client Consent: By utilizing our services, you grant us consent to act on your behalf when it comes to the submission and management of your medical documentation with the FAA and related authorities.
- Limit of Liability: We want to make it clear that our role is that of a service provider, and we do not guarantee specific outcomes with the FAA. This service is limited to the one-time processing of specific documents and should not be confused with Consultation nor Case Management Services. For SIA processing we will review your documents to determine whether they meet the specific conditions of your SIA. For CACI processing we will review your documents to determine whether they meet the FAA’s CACI criteria for your condition. For Case Management Services we will review your documents. If you are simply utilizing our services as a convenience to upload your documents, we will NOT review the documents nor assume any responsibility for their content nor completeness; we will simply upload what you provide.
- Case Management: Document review, processing, and uploading is included within the Case Management Services we offer in accordance with our Case Management Disclaimer. If you are interested in learning more about having us help manage your complete case for expeditious and optimized service, simply send us a request for our Introduction to Case Management message.
You may schedule stand-alone Document Processing by following the scheduling link at TexasAME.com. This will be a virtual service. You may schedule the service for any available date and then we will adjust it to coincide with the date we process your documents. We are also happy to add this service on to an existing exam appointment for processing at the time of the exam.
We are committed to providing high-quality service and ensuring that your interactions with the FAA are as smooth as possible. If you have any questions or concerns about our services or the process, please do not hesitate to contact us. We are here to assist you and provide the support you need throughout this journey.
Thank you for entrusting us and we look forward to ongoing success with your FAA medical certification needs!
authorization for special issuance
ASI / Special Issuance
Authorization TypesThere are two types of authorizations you may receive:
- Authorization for AME-Assisted Special Issuance (AASI)
- Authorization for Special Issuance (ASI)
The title of the authorization should indicate which type it is. However, please be aware that the FAA doesn’t always label these authorizations correctly, so it’s essential to read the details carefully. Here are the key differences:
- AASI (Usually titled “AUTHORIZATION FOR AVIATION MEDICAL EXAMINER (AME) ASSISTED SPECIAL ISSUANCE OF MEDICAL CERTIFICATION” by the FAA): The AME is authorized to re-issue your medical certificate directly. The typical wording might be: “If you meet all the requirements for re-certification and are otherwise qualified, your AME is authorized to special issue an airman medical certificate time-limited to…”
- ASI (Usually titled “AUTHORIZATION FOR SPECIAL ISSUANCE OF A MEDICAL CERTIFICATE” by the FAA): The FAA reviews your documentation and either sends an authorization letter for your AME to issue at your next exam or mails you an updated medical certificate if the exam has already been performed and deferred. The typical wording might be: “If there have been no significant adverse changes in your medical status, you have complied with all conditions of certification described in your Authorization, and we are satisfied that the duties permitted by the medical certificate can be performed without endangering public safety, the Medical Appeals Section may then grant you a new Authorization for an additional period.”
YOUR RESPONSIBILITY
If you are under an ASI, it is your sole responsibility to 1) bring your Authorization letter to your AME at the time of your exam, and 2) meet all of the requirements of your Authorization letter at the time of your exam. The FAA directs, "If the AME does not have this Authorization and all the required reports, they will need to defer your application to the FAA for eligibility determination.". If you do not meet the requirements of your ASI at the time of your exam, your case will be deferred to the FAA in accordance with FAA directive.
Document Submission for FAA Authorization
For any type of FAA Authorization, updated documents must be submitted to the FAA as specified within your authorization. If you choose to mail your documents directly to the FAA, it is recommended that current reports (dated within 90 days of the due date) are mailed at least 60 days before your certificate expires. This allows sufficient time for the FAA to review the documents and either send a new certificate or authorize your AME to issue a new certificate during a future exam.
Simplify the Process with Texas AME
A more convenient option is to let your AME handle the submission for you! If an exam is not required, simply schedule a stand-alone Document Processing appointment by following the scheduling link at TexasAME.com. You can choose any available date, and we will adjust it to align with the date we process your documents. This is a virtual service—there’s no need to visit our office. You can email or upload the necessary documents directly to us.
If you have an upcoming exam, we can also add this service to your existing appointment and process your documents at that time. Should you prefer to bring the documents in person, you can do so when you come in for your exam.
Other Considerations
Regarding the expiration date on your Special Issuance Authorization: this often causes confusion, but it’s important to note that it has nothing to do with how long you’ll remain under a Special Issuance. The expiration date is simply an internal deadline for the FAA. If you stop applying for re-certification, their system will close out your Special Issuance on this date to avoid indefinite authorizations. Legally, the FAA cannot have an open-ended authorization.
Typically, the FAA will send you a new Authorization with a new expiration date—usually 6-7 years in the future—sometime in the year prior to the current expiration date.
If you also have any CACI conditions, be sure to pay special attention to the CACI paragraphs. These sections can be misunderstood to imply that all documents can be submitted to your AME, whereas only the CACI-required documents are being referred to.
CDCPN: Current Detailed Clinical Progress Note
When the FAA requires updated information regarding a medical condition, they will often request a Current Detailed Clinical Progress Note (CDCPN). This is a very specific request and it is important that the FAA's specifications are correctly met. Unlike a "Current Status Report" (a brief paragraph from a physician providing an updated on the condition), a CDCPN requires an in-person office visit with your physician and the report is a clinical progress note from that visit. The report usually contains a paragraph explaining your visit, a section where your vitals and physical exam are documented, an assessment of your medical conditions, and a plan addressing each condition. It likely includes lab/test results and a list of your medications. This report is usually NOT something you can download from a Patient Portal; you likely will need to make the request directly from your physician in accordance with your Authorization for Special Issuance or the appropriate CACI resource.
You can find more information on what the FAA considers acceptable for a CDCPN here: FAA Detailed Clinical Progress Note Guide.
CACI & CDCPN
CACI: Condition an AME Can Issue
CACI (Condition an AME Can Issue) is a procedure where the FAA authorizes an Aviation Medical Examiner (AME) to issue a medical certificate to an airman with a CACI condition, provided the airman meets all the criteria outlined on the CACI worksheet. It is important to note that the CACI worksheet is strictly for use by the AME and should not be utilized by your personal physician as a checklist or certification tool. This practice is not accepted by the FAA.
Instead, your Primary Care Physician (PCP) should refer to the CACI worksheet when preparing the Current Status Report (CSR) or Current Detailed Clinical Progress Note (CDCPN). The goal is to ensure that their report addresses all required elements as stipulated by the FAA. The AME will then use the CSR/CDCPN to verify that each criterion on the CACI worksheet has been met. If the conditions are satisfied, the AME is authorized to issue a medical certificate. If not, the case must be deferred to the FAA.
You can find more information on what the FAA considers acceptable for a CDCPN here: FAA Detailed Clinical Progress Note Guide.
Please be aware that you must meet the CACI criteria at the time of your medical examination. In certain situations, the AME may allow a short extension to obtain an updated report. However, if the necessary documentation is not received in time or the CACI criteria are not fulfilled, the AME is obligated to defer your case to the FAA. After deferral, the application is handled directly between the applicant and the FAA (See Roles & Responsibilities above). The FAA will request any additional information needed, and upon satisfactory review, they will issue the medical certificate.
For specific information on your CACI-qualifying condition, please review the following resource: FAA CACI Guidelines.
CDCPN: Current Detailed Clinical Progress Note
When the FAA requires updated information regarding a medical condition, they will often request a Current Detailed Clinical Progress Note (CDCPN). This is a very specific request and it is important that the FAA's specifications are correctly met. Unlike a "Current Status Report" (a brief paragraph from a physician providing an updated on the condition), a CDCPN requires an in-person office visit with your physician and the report is a clinical progress note from that visit. The report usually contains a paragraph explaining your visit, a section where your vitals and physical exam are documented, an assessment of your medical conditions, and a plan addressing each condition. It likely includes lab/test results and a list of your medications. This report is usually NOT something you can download from a Patient Portal; you likely will need to make the request directly from your physician in accordance with your Authorization for Special Issuance or the appropriate CACI resource.
You can find more information on what the FAA considers acceptable for a CDCPN here: FAA Detailed Clinical Progress Note Guide.
Case Management
FAA Submission Options
Sometimes the FAA will require additional information in order to make a certification decision. There are two pathways to submit necessary documentation to the FAA: 1) Self-Service, or 2) Case Management /AME Consultation.
Self Service
Description:
When the FAA issues a request, you are responsible for collecting the documentation you believe they are asking for and mailing it directly to the FAA. You then wait an initial 60–72 days for a response.
If you have already completed your medical exam and submitted all the necessary documentation, the FAA’s response may include your medical certificate and/or a Special Issuance Authorization. However, more often, the FAA will reply with a letter outlining additional, specific requirements. You must then gather and submit those items, and wait again.
This cycle may repeat several times until the FAA determines that your case is complete and ready for a certification decision.
PROs:
- Least expensive option.
CONs:
- Typically the slowest process, often taking 2–3 months at minimum, and frequently 6–9 months or longer.
- High risk of submitting incomplete, incorrect, or excessive documentation, which can lead to additional FAA reviews.
- Each additional review can add 2–3 more months to the timeline.
Expert FAA Medical Case Management
Navigating the FAA medical certification process can be complex and time-consuming. With our Case Management service, you're engaging a dedicated professional to proactively guide and manage your case, leveraging their expertise to streamline your path to certification.
How Case Management Works for You:
When you choose Case Management, you're investing in our upfront professional expertise and strategic time. Here's what that means for your case:
- Proactive Strategy: Your Case Manager will anticipate what the FAA is most likely to request, helping you prepare efficiently and reducing unexpected delays.
- Clear Guidance: We'll help you understand precisely what the FAA needs, ensuring you provide accurate and complete information.
- Thorough Document Review: We meticulously receive and review your documents for completeness, identifying potential issues that could prolong your process.
- Direct FAA Submission: We handle the submission of your items directly to the FAA, aiming for quick delivery and proper correlation with your FAA account.
Our goal is to minimize your overall timeline and optimize your certification outcome by addressing potential issues correctly from the start. This proactive approach helps ensure you don't have to worry about them throughout your career.
Benefits of Case Management:
- Significant Time Savings*: Our expert management aims to make your process as efficient as possible.
- Higher Likelihood of Optimal Certification: Benefit from your AME's advice and suggestions, specifically tailored to optimize your medical circumstances and minimize certification issues.
- Issues Resolved Upfront: We strive to get items resolved correctly from the beginning, reducing future complications.
Investment:
The primary investment for Case Management is the cost of having a professional manage your case. We'll provide you with a customized quote based on the specifics and complexity of your case.
*Please Note: While our strategies are based on extensive experience, we cannot make guarantees on behalf of the FAA. This includes their response times or specific information requests. There is always a possibility of additional information being requested, which could extend the process. Our timelines are best estimates.
Ready to Optimize Your Certification?
If you're interested in Case Management or would like to learn more, simply send us an email by clicking the button below, and we'll be happy to provide you with the information you need.
basic med
The Basics of BasicMed with us:
NOTE: For our BasicMed exams we generally use the same medical criteria as an FAA 3rd Class, but can provide a bit more flexibility with some of their Special Issuance policies/requirements. The ideal physician to perform your BasicMed exam is your PCP.
You have a couple of options:
- If you have any concerns regarding our comfort signing off on your BasicMed application (i.e. you're not having any monitoring criteria nor any restrictions for 4 years of flying), you should schedule yourself first for a consultation where you can update us on your situation and we’ll provide our thoughts on how your case will play out and whether additional information would change the outcome. Then you would schedule yourself for the BasicMed exam.
- If you feel good about things, then just bring any FAA letters and associated medical documents with you to your appointment. If we don’t have any concerns we’ll be pleased to sign your BasicMed form. Otherwise, we’ll let you know whether there is something that can be cleared up with additional information or whether we are not comfortable signing a BasicMed at all in your situation. Please understand that you are charged the full appointment fee regardless of the outcome!
- Please bring your printed BasicMed application form in it's entirety with you to your appointment.
- Please also bring any FAA letters / Special Issuance you may have received.
FAA Aviation Medical Exams, AME Consultations, and HIMS Services.
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