What do CACIs have to do with FAA Flight Physicals?

If you’re a pilot, chances are you have heard a horror story or two about FAA flight physicals. Even if you fly under the provisions of Basic Med, most experts agree that you are still obligated to ground yourself under 14 CFR part 61.53 if you have a health problem that the FAA considers unsafe. There is no way around it. Most pilots have some degree of apprehension when it comes to their FAA physical. A lot of that apprehension results from the fact that FAA medical standards are mysterious to many pilots. CACIs are one FAA attempt to change that, but confusion still reigns among many pilots. 

So what is a CACI anyway?

CACI (pronounced “khaki”) is an acronym that stands for Conditions AMEs Can Issue. The term could be more descriptive. To begin with, Aviation Medical Examiners (AMEs) do not issue conditions. They issue medical certificates – at least they do if you are healthy or qualify for a CACI. The FAA developed the CACI program in 2013 to allow AMEs more freedom to issue medical certificates for pilots with certain well-controlled medical conditions [1]. The list has grown from 12 at the program’s inception to the FAA’s current list of 20. CACIs are essentially a way to speed up the medical certification process for pilots with certain medical conditions. 

How a condition becomes a CACI

A condition has to meet several criteria before the FAA will add it to the CACI list. It has to be common. Moreover, it has to pose a low risk to aviation safety. Furthermore, it must have a quantifiable way to classify the disease status. And, finally, it must not have any known association with an aircraft accident or mishap. If a medical condition passes each of those tests, there’s a good chance the FAA is already considering its addition to the CACI list. The process is not fast, but the list has grown steadily over the years. 

What conditions qualify? 

The current list of CACIs includes the following medical diagnoses:

  • Arthritis
  • Asthma
  • Bladder Cancer
  • Breast Cancer
  • Chronic Hepatitis C
  • Chronic Immune Thrombocytopenia
  • Chronic Kidney Disease
  • Colitis
  • Colorectal Cancer
  • Glaucoma
  • Hypertension
  • Hypothyroidism
  • Migraine and Chronic Headache
  • Mitral Valve Repair
  • Pre-Diabetes
  • Primary Hemochromatosis
  • Prostate Cancer 
  • Renal Cancer
  • Retained Kidney Stone(s)
  • Testicular Cancer

If you have one of these conditions and it is currently well controlled, your AME can most likely issue your certificate on the day of your exam [2]. 

Any AME can help with a CACI, but not all do

Unfortunately, while any AME can help you through the process of qualifying for a medical certificate with a CACI condition, not all of them do. That sad but true reality is one factor that sets good AMEs apart from the rest. Some AMEs have high volume practices that get healthy pilots in and out of their offices quickly. For them, CACIs and other pilot health problems erode the efficiency of their process and decrease revenue. Others have been doing FAA flight physical exams for so long, that they still consider the FAA’s 2013 initiative still seems new age. The easiest way for an AME to deal with a complex medical certification is to defer the decision to the FAA. They always have that option. Make sure to do your homework. With our AME directory, you can read PIREPS and AME reviews from other pilots to find out which examiners know the process and are willing to take the time.

Qualifying for a CACI  

The FAA publishes worksheets for each CACI condition that guide AMEs through the process of issuing certificates to pilots with those diagnoses. The worksheets are essentially checklists that spell out each piece of information your AME will need to gather in order to issue your certificate. They all require that you have certain test results and/or documentation from your treating physicians so you’ll need to plan carefully for your AME exam. If you have any doubts about the information you should bring to your exam, it is a good idea to coordinate with your AME ahead of time or hire a consultant. The information is also available for free on the FAAs website, but you will need to have a good understanding of medical jargon to use it effectively.   

Approaching your FAA flight physical 

If you are healthy except for a well-controlled CACI condition, or even more than one well-controlled CACI condition, your AME can issue your certificate on the day of your exam. Make sure you show up to your appointment prepared. Read AMEs reviews and talk to other pilots to help you choose an AME that is up to the task. Know the requirements ahead of time and make sure you have all the necessary documentation before your exam. If you have any questions about the process, ask an expert.

CACIs should be easy

The whole point of the CACI program is to reduce bureaucracy and keep pilots with common well-controlled medical conditions flying. Preparing for your flight physical will be harder than simply filling out a MedXPress application and scheduling your AME exam, but it is worth it. Taking the time to understand the CACI program and preparing the right way for your AME exam can help you avoid lengthy reviews by the FAA. CACIs is a big step in the right direction for FAA medical certification for those who know what they are and how to use them.   


[1] “FAA TV: AME Minute: Why was the CACI program developed?” https://www.faa.gov/tv/?mediaId=2143 (accessed Sep. 03, 2022).

[2] “Guide for Aviation Medical Examiners.” https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/ (accessed May 08, 2022).

Also, see CACI for Renal Cancer.