Diagnosed With Something New? What It Means for Your Medical Certificate
July 10, 2026 · By Dr. Sam Fereidouni, MD, MHSA · Aviation Medicine
The most common phone call I get from pilots starts with a worried pause: "Doc, I was just diagnosed with ___. Am I grounded?" The honest answer, most of the time: no - but the path back to your medical depends on doing things in the right order.
Three paths, not one
Regular issuance. Many conditions, once controlled, fall under the FAA's CACI program and can be certified by your AME at the exam itself - no Oklahoma City involvement. Well-managed high blood pressure and hypothyroidism are classic examples.
Special issuance. Conditions like diabetes requiring medication, certain cardiac history, or sleep apnea need FAA review and periodic reporting. It takes longer the first time, but thousands of pilots fly on special issuance every day. The system rewards good documentation and consistent treatment.
Deferral. This is what happens when an exam surfaces something unresolved. It is the outcome we work hardest to avoid - not by hiding anything, but by resolving and documenting the condition before you sit down for the exam.
Why you should call your AME before your exam
Once an exam starts, I am required to act on what I find. Before the exam, I'm free to be your advocate: to tell you which tests the FAA will want, which letters your cardiologist should write, and when the timing is right to apply. That pre-exam consultation is the single highest-value call a pilot with a new diagnosis can make.
A note on diabetes and flying
As a practice that specializes in diabetes care, we see the aviation and medical sides of this together. Diet-controlled diabetes is CACI-eligible; insulin-treated diabetes now has a protocol-driven path even to first- and second-class certification. If you manage both a cockpit and an A1c, we speak both languages under one roof.
Have a new diagnosis and a medical coming up? Call 480-300-GOMD and ask for a pre-exam consultation with Dr. Fereidouni.