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FAA CACI Chronic Hepatitis C Worksheet

Pilots with chronic hepatitis C can be certified at the AME's office under the FAA's CACI program when the condition is stable and needs no medication. This worksheet, updated 11/24/2021, requires a treating physician's current status report finding no complications or symptoms, no medication for the condition and labs within 90 days showing AST, ALT, albumin and PT all within 10% of normal.

Who completes it

The AME completes the worksheet after reviewing a current status report from the treating physician and any supporting documents; the FAA treats a status report as a current, detailed clinical progress note.

Submitting and payment

How to submit it
If all criteria are met, the AME issues, notes 'CACI qualified Hepatitis C - Chronic' in Block 60 and keeps the documents on file without sending them to the FAA; otherwise the AME defers and submits them.
Who pays
The FAA does not set AME examination fees; the pilot pays the examiner, and the FAA recommends the usual and customary local fee for similar services.

Good to know

  • Medications for the condition must be none, so a pilot currently taking treatment for hepatitis C does not meet this worksheet.
  • Labs within the last 90 days must show AST (SGOT), ALT (SGPT), albumin and PT all within 10% of the normal lab scale.
  • The treating physician must find the condition stable with no changes recommended and no complications or symptoms from chronic hepatitis C.
  • First- and second-class applicants provide this information annually; third-class applicants provide it with each required exam.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI - Hepatitis C - Chronic Worksheet

Official pagePDF

Fill it with Vero

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A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What labs does the FAA hepatitis C CACI require?

AST, ALT, albumin and prothrombin time drawn within the last 90 days, each within 10% of the lab's normal scale. The treating physician's status report should include these results with a finding that the condition is stable and causing no complications or symptoms.

Can a pilot on hepatitis C treatment use the CACI?

No. The worksheet requires no medications for the condition. A pilot who is taking treatment, or who has complications or abnormal labs, does not meet the CACI, so the AME defers and submits the supporting documents to the FAA for review.