Airman Resources
A comprehensive reference for pilots navigating the FAA medical certification and HIMS program process.
FAA Medical Certificate Classes
Understanding which class of medical certificate applies to your flying privileges is the first step.
FAA Medical Exams — Start Here
New or renewing? Everything you need before scheduling your exam.
Required for Airline Transport Pilot (ATP) privileges. Necessary to serve as Pilot-in-Command (PIC) of a commercial airline operation.
- Airline Transport Pilot (ATP)
- Commercial airline PIC
- Most stringent medical standards
- Annual renewal under age 40; 6-month renewal age 40+
Required for commercial pilot privileges, such as flying for hire as a charter pilot, corporate pilot, or flight instructor for compensation.
- Commercial pilot privileges
- Corporate & charter operations
- Annual renewal required
- Degrades to 3rd Class after 12 months
Required for private pilot privileges. The least restrictive class of medical certificate, allowing non-commercial operations.
- Private pilot privileges
- Non-commercial operations
- Valid 5 years under age 40; 2 years age 40+
- Least stringent medical standards
Note: BasicMed is not a service Chester Medical provides.
Common FAA Medical Conditions
In-depth guides for the conditions pilots ask about most. Each page covers FAA evaluation criteria, what to gather, pitfalls to avoid, and direct links to FAA primary sources.
DUI & Alcohol
Updated for the September 30, 2026 FAA standards: DUI/DWI review pathways, required records and uploads, separate reporting obligations, and what to do before your next flight.
Read Full GuideDepression & Anxiety
From past history to current antidepressant use, understand the FAA Antidepressant Protocol, what makes a strong clinician letter, and what triggers deferral.
Read Full GuideADHD
The most documentation-intensive common pathway. Learn the Fast Track vs Standard Track difference, personal statement requirements, and why test format matters.
Read Full GuideDiabetes
Diet-controlled, oral medications, or insulin — each carries different FAA requirements. The acceptable medication combinations rule and what stability documentation looks like.
Read Full GuideHeart Conditions
From hypertension to stents, arrhythmias to bypass surgery — protocol-driven pathways by condition and certification class, with a focus on the right documentation.
Read Full GuideColor Vision
Testing requirements changed January 1, 2025. Understand the new computer-based screening rules, congenital vs. acquired deficiency, and what a restriction means for your flying.
Read Full GuideWeight Loss & GLP Medications
GLP-1 medications like Wegovy and Zepbound are now CACI-eligible. Understand which medications are accepted, which are prohibited, the A1C gate, and observation period requirements.
Read Full GuideTestosterone Replacement (TRT)
TRT for hypogonadism is now a CACI condition. Learn the ground trial requirements, the hematocrit limit, why enclomiphene is not acceptable, and what documentation your AME needs.
Read Full GuideOSA / Sleep Apnea
OSA follows the FAA six-group assessment process and applicable Special Issuance requirements. Understand the STOP-BANG screening tool, AHI severity levels, CPAP compliance requirements, and what treatment documentation the FAA expects.
Read Full GuideMigraine & Headache
Most migraines qualify under the CACI program. Learn the critical no-fly waiting periods for triptans and CGRP medications, which preventives are acceptable, and what a qualifying physician's note must contain.
Read Full GuideHypertension (HTN)
The FAA limit is 155/95 for all classes. Learn how medication count affects your CACI eligibility, which antihypertensives are unacceptable, and what end-organ damage means for your certification pathway.
Read Full GuideKidney Stones
An active stone is temporarily disqualifying due to incapacitation risk. Direct issuance for a qualifying passed single stone; CACI for qualifying retained or multiple asymptomatic stones. Learn what imaging and physician documentation your AME requires.
Read Full GuideVision Standards
A complete reference for FAA visual acuity, near, intermediate, color, and field requirements by certificate class — plus how common conditions like LASIK, cataracts, and monocular vision affect certification.
Read Full GuideGlaucoma
Open-angle glaucoma is a CACI condition — but medication type matters. The current FAA medication table lists pilocarpine as unacceptable. Learn how visual field loss affects eligibility and what Form 8500-14 or an equivalent report must contain.
Read Full GuideThe HIMS Step-Down Process
A structured, multi-year pathway designed to return pilots to flying status safely and in compliance with FAA requirements.
- Sobriety established
- Inpatient or IOP treatment
- 90/90 meeting requirement
- HIMS neuropsych evaluation
- HIMS psychiatric evaluation
- Random drug & alcohol testing
- Monthly check-ins
- Continued aftercare
- Ongoing random testing
- Peer pilot assessment
- Chief pilot assessment
- FAA Special Issuance review
- Reduced monitoring frequency
- Quarterly reporting
- Demonstrated stability
- Continued drug/alcohol screens
- AME evaluation every 6 months
- FAA SI renewal
- Minimal required monitoring
- AME evaluation at each exam
- Long-term sobriety verified
- PEth testing continued
- Ongoing SI authorization
- Career-long compliance
Monitoring Requirements Overview
Depending on your HIMS phase and assigned pathway, one or more of the following monitoring methods may be required.
Urine Drug Screen
The most common form of random testing. Screens for a panel of substances including alcohol metabolites, opioids, stimulants, and more. Typically conducted through a certified lab via a monitoring service.
Hair Follicle Test
Provides a longer detection window (up to 90 days) compared to urine. Useful for identifying historical substance use patterns.
PEth Blood Test
A highly sensitive biomarker for alcohol use, detectable in the blood for up to 3–4 weeks after consumption. Commonly required before medical renewals.
SoberLink (Breathalyzer)
A real-time, GPS-enabled breathalyzer device that transmits results directly to your HIMS AME. Often required in early HIMS phases for continuous alcohol abstinence verification.
Frequently Asked Questions
Common questions from pilots navigating the HIMS and FAA medical certification process.
View full FAQ pageGlossary of Key Terms
Aviation medical and HIMS terminology demystified.
AME
Aviation Medical Examiner — an FAA-designated physician authorized to perform aviation medical examinations.
HIMS AME
Human Intervention Motivation Study AME — an AME with special FAA certification to manage pilots with substance use disorders.
SI
Special Issuance — an FAA authorization allowing an airman with a disqualifying condition to hold a medical certificate under specific terms.
CACI
Conditions AMEs Can Issue — a list of medical conditions an AME can evaluate and certify without FAA regional office review.
SUD
Substance Use Disorder — the diagnosis relevant to HIMS program eligibility. Can include alcohol or drug dependence/abuse.
SAP
Substance Abuse Professional — a clinician qualified to evaluate and recommend treatment for individuals with SUD.
IOP
Intensive Outpatient Program — a structured treatment program that does not require overnight hospitalization, typically 3–5 days/week.
PEth
Phosphatidylethanol — a biomarker blood test used to detect alcohol use over the prior 3–4 weeks.
MedXPress
FAA's online system for submitting the FAA Form 8500-8, the official medical examination application.
90/90
A common HIMS requirement to attend 90 support group meetings (e.g., AA/NA) within 90 consecutive days.
ATP
Airline Transport Pilot — the highest level of pilot certificate, typically requiring a 1st Class medical.
CFI
Certified Flight Instructor — a pilot certificate allowing the holder to provide flight instruction.
Official FAA & Aviation Resources
Direct links to official government and aviation organization resources.
FAA MedXPress (8500-8 Application)
Submit your FAA medical application online.
FAA Guide for Aviation Medical Examiners
The current FAA AME Guide with certification standards, CACI conditions, and pharmaceutical guidance.
FAA Aerospace Medical Certification
Official FAA page for medical certification information.
FAA HIMS Substance Use Guidance
Official FAA AME Guide section on substance abuse and dependence, including HIMS program requirements.
HIMS Program
A trusted support resource for pilots in the HIMS substance abuse treatment program seeking to return to flight.
Pilot's Bill of Rights
Your rights as an airman subject to an FAA investigation, including access to air traffic data.
AOPA Medical Resources
Pilot advocacy and guidance on navigating medical certification and special issuances.
FAA Pilot Mental Fitness
Official FAA resource on pilot mental health, certification standards, and how to seek care without jeopardizing your certificate.
Pilots for HIMS Reform
Grassroots advocacy group providing guides, toolkits, and resources for pilots navigating FAA psychiatric monitoring and the HIMS system.
Featured Podcast
Expert aviation medicine discussions from one of the world's leading medical institutions.
Mayo Clinic Clear Approach
Mayo Clinic Section of Transportation Medicine · 97 Episodes
Tackles medical topics important to commercial aviators and recreational pilots — covering FAA, NTSB, aeromedical certification, and conditions that affect pilots. Expert discussions from "the other side of the gurney."
Peer Support & Mental Health Resources
Recovery and wellness are team efforts. These organizations provide confidential support for pilots.
Birds of a Feather (BOAF)
Worldwide AA-based peer support network created specifically for pilots and aviation professionals in recovery.
Aviation Medical Advisory Service (AMAS)
Medical consultants specializing in FAA medical certification issues.
Alcoholics Anonymous
International fellowship for individuals with alcohol use disorder.
Narcotics Anonymous
Fellowship for individuals in recovery from drug addiction.
SAMHSA National Helpline
Free, confidential, 24/7 treatment referral and information service.
Aviation Family Network
Support community for spouses, family members, and loved ones of pilots navigating the HIMS program and addiction recovery.
Ready to Start Your HIMS Journey?
Chester Medical is here to guide you through every step of the process. Contact us today or submit a consultation request to get started.