FAA Proposes Letting AMEs Certify Pilots With Non-Insulin-Controlled Diabetes, Cites Backlog Reductions

The FAA is pursuing changes to pilot medical certification aimed at reducing application backlogs and simplifying requirements for certain medical conditions. Caitlin Locke, associate administrator for the FAA's Aviation Safety Oversight and Certification Organization, outlined the efforts on Wednesday at a regulatory panel at NBAA-BACE in Las Vegas, describing work to make regulatory decisions faster and more predictable.

Among the changes under consideration is a proposed rule, first introduced in September, that would allow pilots whose diabetes is controlled through non-insulin medications to obtain first-, second- or third-class medical certificates directly from aviation medical examiners (AMEs). Under current regulations, those applicants generally require FAA Special Issuance authorization. The FAA estimates that approximately 3,000 applicants annually could qualify for immediate certification under the revised standards.

The agency is also working to cut medical application delays following earlier concerns about review backlogs. A May report from the U.S. Office of Special Counsel states that the FAA increased its medical officer staff from 52 to 78 and changed its case management procedures. In July, the agency expanded AME authority to handle certain mental health renewals following an initial FAA authorization.

Locke also discussed broader efforts to modernize supplemental oxygen requirements and emergency medical kit regulations through more performance-based standards. The proposed diabetes rule remains pending, and the FAA has not announced an implementation date. Pilots whose diabetes requires insulin would continue to follow the existing Special Issuance process.

The common thread in these changes is delegation. Special Issuance sends an applicant's file to the FAA for an individual decision, and that queue is where delays build up. Letting examiners issue certificates directly for a defined group, and for certain mental health renewals once the FAA has authorized the first one, moves routine cases out of that queue. Added medical officer headcount and revised case management work the same problem from the other side by raising the agency's own throughput.

For the pilot population this matters most at the margins. A pilot with medication-controlled diabetes currently has to wait on a Special Issuance decision before flying; under the proposal that step would, for the roughly 3,000 applicants a year the FAA counts, collapse into the AME visit. The boundary stays sharp, though: pilots whose diabetes requires insulin remain on the existing Special Issuance path, so the benefit is confined to one defined group.

The next milestone is the rule itself. It remains a proposal, and the FAA has not announced an implementation date, so nothing changes for applicants until the agency finalizes it. Until then the Special Issuance process continues to apply to these applicants.