The FAA medical
Your FAA Medical Was Deferred. What Happens Now?
✓ Reviewed against current FAA sources on October 28, 2026
In this guide
In short
A deferral is not a denial. It means the examiner could not issue at the appointment and sent your file to the FAA, usually because the condition needs review or the supporting documentation was missing. In the FAA's own words the AME must defer when documentation is missing, while denial at the appointment happens only in very rare cases. From there the routes are a regular issuance once the paperwork is in, a condition on the FAA's 29 item CACI list that an examiner can issue directly, or an Authorization for Special Issuance or a Statement of Demonstrated Ability under 14 CFR 67.401 (opens in a new tab).
The letter arrives and it says deferred. Most people read that as a polite no. It is not. A deferral means your examiner could not issue the certificate at the appointment and sent the file to the FAA instead. That is a wait and a request for paperwork. It is a different outcome from a denial, and the FAA says so plainly.
What the FAA actually says about the two outcomes
In the FAA's own words, for some conditions, or if missing required documentation, the AME must defer the examination to the FAA. Denial at the appointment is the rare case: in very rare cases, an AME can deny for a specifically disqualifying condition.
Read the proportions in that. Deferral is the ordinary route whenever something needs looking at. Denial at the chair requires a condition that is specifically disqualifying, and the FAA describes it as very rare. If you were deferred, nobody has decided anything about you yet.
Why it happened
Two reasons cover most deferrals. Either the condition is one the examiner has no authority to issue on, or the authority existed and the paperwork to support it was not in the room. The second is the frustrating one, because it is the one that was avoidable on the day.
That matters because of what the examiner is allowed to do, which is more than most applicants realize.
The 29 conditions an examiner can issue on the spot
The FAA runs a program called CACI, for Conditions AMEs Can Issue. For a named list of ordinary conditions it publishes a worksheet, and where you meet that worksheet and are otherwise qualified your examiner may issue the certificate at that examination, the first time you report the condition, without contacting the FAA at all. The supporting documents stay in the examiner's file instead of going in.
There are 29, and they are worth reading as a list of things you can pass with rather than a list of things that stop you. They include arthritis, asthma, colitis, psoriasis, hypertension, prediabetes, hypothyroidism, polycystic ovarian syndrome, migraine and chronic headache, essential tremor, glaucoma, chronic kidney disease, retained kidney stones, chronic hepatitis C, carotid or vertebral artery stenosis, mitral valve repair and the bladder, breast, colon, prostate, renal and testicular cancers.
The worksheet is the whole difference. Meet it and bring what it asks for and you can be issued at the appointment. Turn up without the paperwork and the same condition becomes a deferral. That is the argument for reading the worksheet for your condition before the appointment rather than after it, and the worksheets are revised, so read the current one.
If the condition does not meet the standard
A condition that does not meet the standard is still not the end of it. Section 67.401 (opens in a new tab) sets out two routes.
- Authorization for Special Issuance. The Federal Air Surgeon may grant one to a person who does not meet the standards, where the applicant shows that the duties of the certificate can be performed without endangering public safety. It is granted for a specified period, so it is renewed by making that showing again, and it can be withdrawn if the condition changes or required information is not provided.
- Statement of Demonstrated Ability. A SODA is for a condition that is static or nonprogressive. Unlike an Authorization it does not expire, and it lets an examiner issue the certificate directly for as long as the condition has not changed for the worse.
Which is why documentation is the whole game. Current specialist letters, test results and a clear account of your own history give the FAA something to work from. The disclosure with nothing behind it is what turns a routine appointment into a long wait.
What to do while you wait
Answer what the FAA asks for, completely, the first time. Each incomplete response is another round trip, and the rounds are measured in weeks. If a specialist report is requested, make sure it addresses the question the FAA asked rather than summarizing your general health, because a report that does not answer the question produces another letter.
Before you apply again
Two practical points about the mechanics, both from the FAA's own guidance.
Your MedXPress application will remain active for 60 days and disappears from the system if your examiner has not uploaded it within that time.
And the one worth knowing before you walk into any appointment with an unresolved question: the FAA's Medical Examination Bill of Rights lets you terminate an examination, with the understanding that if the application has been imported by the Aviation Medical Examiner or the exam has begun, the AME must submit the incomplete application. Once it has been imported or the exam has started, changing your mind does not undo it. The incomplete application goes to the FAA anyway.
So the questions are cheap to resolve before the application is imported and expensive afterward. If you have been deferred once, that is the single most useful thing to carry into the next one.