Kidney stones are temporarily disqualifying due to incapacitation risk — but most pilots can return to flying once the acute episode resolves. Understanding the CACI pathway and what documentation your AME needs makes recertification straightforward.
Informational Use Only. The information on this page reflects our understanding of current FAA medical certification requirements and is provided for general educational purposes only. FAA policies and the AME Guide are updated frequently. The FAA AME Guide is the authoritative source in all cases. Always verify with your AME and at faa.gov/ame_guide.
Why Kidney Stones Are Temporarily Disqualifying
Kidney stone pain (renal colic) can be completely incapacitating and sudden in onset — one of the most severe pain events in medicine. The FAA's concern is that a stone migrating down the ureter could cause sudden total incapacitation in the cockpit without any warning. A pilot with an active stone is not certifiable. A pilot with a passed or stable retained stone can pursue certification through the appropriate pathway.
Certification pathway depends on stone timing, current status, and complications.
Most recent stone event at least 5 years ago: no symptoms, normal renal function, no ongoing treatment or surveillance
Qualifying single stone within 5 years: passed or in the bladder, no complications or further problems, imaging verifies no retained stones
Retained or multiple asymptomatic stones without complications — every worksheet criterion met
Complications, including three or more stone procedures in five years, obstruction, renal failure, chronic hydronephrosis or stone-related sepsis/recurrent infection
Active stone passage symptoms currently — pain, hematuria, obstruction
Retained stone with evidence of growth, new symptoms, or renal function compromise
Bilateral or multiple stones: not automatic SI; evaluate symptoms, complications, underlying cause and CACI criteria
The FAA distinguishes between a single passed stone and retained/multiple stones — these have different dispositions. Your clinical picture determines which applies.
Per FAA Scenario B, the AME can issue directly — no CACI worksheet needed. The AME summarizes in Block 60 after confirming:
The AME can issue using the CACI Retained Kidney Stones Worksheet. The physician's note must confirm:
Flying after a stone episode before clearance — even if the pain has resolved, a retained or migrating stone may still be present
No imaging to confirm stone passage — 'I think it passed' is not sufficient. CT or imaging confirmation of clearance is required
Not disclosing a stone episode on Form 8500-8 — required disclosure includes current and historical episodes
Assuming a universal repeat-imaging schedule — the treating physician determines clinically indicated testing to document stability
Using narcotics for stone pain and then flying — narcotics are categorically unacceptable for flight duties
Dehydration risk not addressed — the dry cabin environment predisposes pilots to recurrence; treating physician should address prevention strategy
Official FAA sources used in developing this guide.