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FAA CACI MASH/NASH Liver Worksheet

Pilots with metabolic dysfunction-associated or non-alcoholic steatohepatitis (MASH/NASH) can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. The AME reviews the hepatologist's or treating physician's progress note from a visit within 90 days of the exam and confirms the condition is controlled, there is no cirrhosis, and a recent fibrosis score falls under the FAA cutoffs.

Who completes it

The AME completes the checklist and records the Block 60 outcome. The hepatologist or treating physician writes the current, detailed Clinical Progress Note, including the fibrosis score, that the AME reviews.

Submitting and payment

How to submit it
When the pilot qualifies, the AME notes 'CACI qualified MASH/NASH' in Block 60 of FAA Form 8500-8 and the documents do not need to be submitted. If not, the AME defers and submits the supporting documents.

Good to know

  • The fibrosis score must come from lab work or imaging no more than 90 days old: FIB-4 under 2.68, VCTE under 8 kPa, or MR elastography under 2.55 kPa.
  • If no imaging has been done, the FIB-4 index is calculated from age, platelet count, AST and ALT, so the note should include those values.
  • The note must state the condition is under control, any insulin resistance is adequately treated, and there are no symptoms such as fatigue or malaise affecting flight duties.
  • Accepted treatment is none, vitamin E, or weight loss medication (checked against its own CACI page), in any combination. Any clinical evidence or diagnosis of cirrhosis disqualifies.

Get the official form

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

CACI – MASH/NASH (Liver) Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

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 FIB-4 score does the FAA accept for MASH/NASH?

Under 2.68. The worksheet alternatively accepts vibration-controlled transient elastography under 8 kPa or magnetic resonance elastography under 2.55 kPa. The test must have been done no more than 90 days earlier, and none of the reported values may exceed the cutoffs.

Can a pilot with MASH on weight loss medication use this CACI?

Yes, if every item is met. The MASH/NASH worksheet accepts no medication, vitamin E, or weight loss medication in any combination, with the weight loss drug reviewed against its own CACI page. There must be no cirrhosis and the fibrosis score must be under the FAA thresholds.