Medical Standards and Certification

Subpart -A General

67.1

Applicability.

67.3

Issue.

Subpart -B

First-Class Airman Medical Certificate

67.101 Eligibility.

67.103

Eye.

67.105

Ear, nose, throat, and equilibrium.

67.107

Mental.

67.109

Neurologic.

67.111

Cardiovascular.

67.113

General medical condition.

67.115

Discretionary issuance.

Subpart -C

Second-Class Airman Medical Certificate

67.201

Eligibility.

67.203

Eye.

67.205

Ear, nose, throat, and equilibrium.

67.207

Mental.

67.209

Neurologic.

67.211

Cardiovascular.

67.213

General medical condition.

67.215

Discretionary issuance.

Subpart -D

 Third-Class Airman Medical Certificate

67.301

Eligibility.

67.303

Eye.

67.305

Ear, nose, throat, and equilibrium.

67.307

Mental.

67.309

Neurologic.

67.311

Cardiovascular.

67.313

General medical condition.

67.315

Discretionary issuance.

Subpart -E

 Certification Procedures

67.401

Special issuance of medical certificates.

67.403

Applications, certificates, logbooks, reports, and records: Falsification, reproduction, or alteration; incorrect statements.

67.405

Medical examinations: Who may give.

67.407

Delegation of authority.

67.409

Denial of medical certificate.          

67.411

Medical certificates by flight surgeons of Armed Force

67.413

Medical records.

67.415

Return of medical certificate after suspension or revocation.

Appendix A

Equipment Required

 

SUBPART- A

General

67.1 Applicability

This part prescribes the medical standards and certification procedures for issuing medical certificates for airmen and for remaining eligible for a medical certificate.

67.3 Issue

A person who meets the medical standards prescribed in this part, based on medical examination and evaluation of the person´s history and condition, is entitled to an appropriate medical certificate.

SUBPART -B

First-Class Airman Medical Certificate

67.101  Eligibility

To be eligible for a first-class airman medical certificate, and to remain eligible for a first-class airman medical certificate, a person must meet the requirements of this subpart.

67.103  Eye

Eye standards for a first-class airman medical certificate are:

  1. Distant visual acuity of 20/20 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/20 vision, the person may be eligible only on condition that corrective lenses are worn while exercising the privileges of an airman certificate.
  2. Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses. If age 50 or older, near vision of 20/40 or better, Snellen equivalent, at both 16 inches and 32 inches in each eye separately, with or without corrective lenses.
  3. Ability to perceive those colors necessary for the safe performance of airman duties.
  4. Normal fields of vision.
  5. No acute or chronic pathological condition of either eye or adnexa that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.
  6. Bifoveal fixation and vergence-phoria relationship sufficient to prevent a break in fusion under conditions that may reasonably be expected to occur in performing airman duties. Tests for the factors named in this paragraph are not required except for persons found to have more than 1 prism diopter of hyperphoria, 6 prism diopters of esophoria, or 6 prism diopters of exophoria. If any of these values are exceeded, the Medical Examinar may require the person to be examined by a qualified eye specialist to determine if there is bifoveal fixation and an adequate vergence-phoria relationship. However, if otherwise eligible, the person is issued a medical certificate pending the results of the examination.
  7. Prism diopter equivalents of ortho-rater phoria scores:

Vertical Phoria

(Prism Diopters)

Lateral Phoria

(Prism Diopters)

Score

             Far                               Noar

Far                                  Noar

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

2.0  LH                             1.5   LH

1.0   LH

0.5   LH

0.17 LH

0.17 RH                          0.5   RH

1.0   RH

1.5   RH

1.5   LH

1.0   LH

0.5   LH

0.17 LH

0.17 LH

0.5  RH                           1.0   RH

1.5  RH                            2.0   RH

 

 

 

+7.33                                +6.0

+6.33                                +4.5

+5.33                                +3.0

+4.33                                +1.5

+3.33                                     0

+2.33                                - 1.5

+1.33                                - 3.0

+0.33                                - 4.5

- 0.66                                - 6.0

- 1.66                                -7.5

- 2.66                                - 9.0

- 3.66                               -10.5

- 4.66                               -12.0

- 5.66                              - 13.5

- 6.66                              - 15.0

 

67.105    Ear, nose, throat, and equilibrium

Ear, nose, throat, and equilibrium standards for a first-class airman medical certificate are:

  1. The person shall demonstrate acceptable hearing by at least one of the following tests:
    1. Demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the examiner, with the back turned to the examiner.
    2. Demonstrate an acceptable understanding of speech as determined by audiometric speech discrimination testing to a score of at least 70 percent obtained in one ear or in a sound field environment.
    3. Provide acceptable results of pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards:

      Frequency (Hz)

      500

      Hz

      1000

      Hz

      2000

      Hz

      3000

      Hz

      Better ear (dB)

      35

      30

      30

      40

      Poorer ear (dB)

      35

      50

      50

      60

  2. No disease or condition of the middle or internal ear, nose, oral cavity, pharynx, or larynx that :
    1. Interferes with, or is aggravated by, flying or may reasonably be expected to do so; or
    2. Interferes with, or may reasonably be expected to interfere with, clear and effective speech communication.
  3. No disease or condition manifested by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium.

67.107  Mental

Mental standards for a first-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts.
    2. A psychosis. As used in this section, "psychosis" refers to a mental disorder in which:
      1. The individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition; or
      2. The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.
    3. A bipolar disorder
    4. Substance dependence, except where there is established clinical evidence, satisfactory to the Medical Examiner of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section :
      1. "Substance" includes: Alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
      2. "Substance dependence" means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by :
        1. Increased tolerance;
        2. Manifestation of withdrawal symptoms;
        3. Impaired control of use; or
        4. Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
  2. No substance abuse within the preceding 2 years defined as:
    1. Use of a substance in a situation in which that use was physically hazardous, if there has been at any other time an instance of the use of a substance also in a situation in which that use was physically hazardous;
    2. A verified positive drug test result acquired under any recognized anti-drug program; or
    3. Misuse of a substance that the Medical Examiner, based on case history and appropriate, qualified medical judgment relating to the substance involved, finds :
      1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
      2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No other personality disorder, neurosis, or other mental condition that the Medical Examiner, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.109  Neurologic

Neurologic standards for a first-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. Epilepsy;
    2. A disturbance of consciousness without satisfactory medical explanation of the cause; or
    3. A transient loss of control of nervous system function(s) without satisfactory medical explanation of the cause.
  2. No other seizure disorder, disturbance of consciousness, or neurologic condition that the Medical Examiner, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds:
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.111  Cardiovascular

Cardiovascular standards for a first-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. Myocardial infarction;
    2. Angina pectoris;
    3. Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;
    4. Cardiac valve replacement;
    5. Permanent cardiac pacemaker implantation; or
    6. Heart replacement;
  2. A person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination:
    1. At the first application after reaching the 35th birthday; and
    2. On an annual basis after reaching the 40th birthday.
  3. An electrocardiogram will satisfy a requirement of paragraph (b) of this section if it is dated no earlier than 60 days before the date of the application it is to accompany and was performed and transmitted according to acceptable standards and techniques.
  4. Blood pressure:

    Adjusted maximum readings

    (reclining blood pressure in mm) 1

    Maximum readings

    (reclining blood pressure in mm)

    Age Group

    Diastolic

    Systolic

    Diastolic

    òSystolic

     

    -----

     

    98

     

    100

     

    100

    -----

     

    155

     

    165

     

    170

     

    88

     

    92

     

    96

     

    98

    140

     

    145

     

    155

     

    160

    20-29

     

    30-39

     

    40-49

     

    50 and over

     



    1  For an applicant at least 30 years of age whose reclining blood pressure is more than the maximum reading for his age group and whose cardiac and kidney conditions, after complete cardiovascular examination, are found to be normal.

67.113  General medical condition

The general medical standards for a first-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.
  2. No other organic, functional, or structural disease, defect, or limitation that the Medical Examiner, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No medication or other treatment that the Medical Examiner, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.115  Discretionary issuance

A person who does not meet the provisions of 67.103 through 67.113 may apply for the discretionary issuance of a certificate under 67.401.


SUBPART- C

Second-Class Airman Medical Certificate

67.201  Eligibility

To be eligible for a second-class airman medical certificate, and to remain eligible for a second-class airman medical certificate, a person must meet the requirements of this subpart.

67.203  Eye

Eye standards for a second-class airman medical certificate are:

  1. Distant visual acuity of 20/20 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/20 vision, the person may be eligible only on condition that corrective lenses are worn while exercising the privileges of an airman certificate.
  2. Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses. If age 50 or older, near vision of 20/40 or better, Snellen equivalent, at both 16 inches and 32 inches in each eye separately, with or without corrective lenses.
  3. Ability to perceive those colors necessary for the safe performance of airman duties.
  4. Normal fields of vision.
  5. No acute or chronic pathological condition of either eye or adnexa that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.
  6. Bifoveal fixation and vergence-phoria relationship sufficient to prevent a break in fusion under conditions that may reasonably be expected to occur in performing airman duties. Tests for the factors named in this paragraph are not required except for persons found to have more than 1 prism diopter of hyperphoria, 6 prism diopters of esophoria, or 6 prism diopters of exophoria. If any of these values are exceeded, the Medical Examinar may require the person to be examined by a qualified eye specialist to determine if there is bifoveal fixation and an adequate vergence-phoria relationship. However, if otherwise eligible, the person is issued a medical certificate pending the results of the examination.

67.205  Ear, nose, throat, and equilibrium

Ear, nose, throat, and equilibrium standards for a second-class airman medical certificate are:

  1. The person shall demonstrate acceptable hearing by at least one of the following tests:
    1. Demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the examiner, with the back turned to the examiner.
    2. Demonstrate an acceptable understanding of speech as determined by audiometric speech discrimination testing to a score of at least 70 percent obtained in one ear or in a sound field environment.
    3. Provide acceptable results of pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards:

      Frequency (Hz)

      500 Hz

      1000 Hz

      2000 Hz

      3000Hz

      Better ear (dB)

      35

      30

      30

      40

      Poorer ear (dB)

      35

      50

      50

      60

  2. No disease or condition of the middle or internal ear, nose, oral cavity, pharynx, or larynx that :
    1. Interferes with, or is aggravated by, flying or may reasonably be expected to do so; or
    2. Interferes with, or may reasonably be expected to interfere with, clear and effective speech communication.
  3. No disease or condition manifested by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium.

67.207  Mental

Mental standards for a second-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts.
    2. A psychosis. As used in this section, "psychosis" refers to a mental disorder in which:
      1. The individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition; or
      2. The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.
    3. A bipolar disorder.
    4. Substance dependence, except where there is established clinical evidence, satisfactory to the Medical Examiner of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section :
      1. "Substance" includes: Alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
      2. "Substance dependence" means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by:
        1. Increased tolerance;
        2. Manifestation of withdrawal symptoms;
        3. Impaired control of use; or
        4. Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
  2. No substance abuse within the preceding 2 years defined as:
    1. Use of a substance in a situation in which that use was physically hazardous, if there has been at any other time an instance of the use of a substance also in a situation in which that use was physically hazardous;
    2. A verified positive drug test result acquired under any recognized anti-drug program; or
    3. Misuse of a substance that the Medical Examiner based on case history and appropriate, qualified medical judgment relating to the substance involved, finds :
      1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
      2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No other personality disorder, neurosis, or other mental condition that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.209  Neurologic

Neurologic standards for a second-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. Epilepsy;
    2. A disturbance of consciousness without satisfactory medical explanation of the cause; or
    3. A transient loss of control of nervous system function(s) without satisfactory medical explanation of the cause;
  1. No other seizure disorder, disturbance of consciousness, or neurologic condition that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.211  Cardiovascular

Cardiovascular standards for a second-class medical certificate are no established medical history or clinical diagnosis of any of the following:

  1. Myocardial infarction;
  2. Angina pectoris;
  3. Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;
  4. Cardiac valve replacement;
  5. Permanent cardiac pacemaker implantation; or
  6. Heart replacement.

67.213  General medical condition

The general medical standards for a second-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.
  2. No other organic, functional, or structural disease, defect, or limitation that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No medication or other treatment that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.215  Discretionary issuance

A person who does not meet the provisions of 67.203 through 67.213 may apply for the discretionary issuance of a certificate under  67.401.


SUBPART- D

Third-Class Airman Medical Certificate

67.301  Eligibility

To be eligible for a third-class airman medical certificate, or to remain eligible for a third-class airman medical certificate, a person must meet the requirements of this subpart.

67.303  Eye

Eye standards for a third-class airman medical certificate are:

  1. Distant visual acuity of 20/40 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/40 vision, the person may be eligible only on condition that corrective lenses are worn while exercising the privileges of an airman certificate.
  2. Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses.
  3. Ability to perceive those colors necessary for the safe performance of airman duties.
  4. No acute or chronic pathological condition of either eye or adnexa that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.

67.305  Ear, nose, throat, and equilibrium

Ear, nose, throat, and equilibrium standards for a third-class airman medical certificate are:

  1. The person shall demonstrate acceptable hearing by at least one of the following tests:
    1. Demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the examiner, with the back turned to the examiner.
    2. Demonstrate an acceptable understanding of speech as determined by audiometric speech discrimination testing to a score of at least 70 percent obtained in one ear or in a sound field environment.
    3. Provide acceptable results of pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards:

      Frequency (Hz)

      500 Hz

      1000 Hz

      2000 Hz

      3000 Hz

      Better ear (dB)

      35

      30

      30

      40

      Poorer ear (dB)

      35

      50

      50

      60

  2. No disease or condition of the middle or internal ear, nose, oral cavity, pharynx, or larynx that :
    1. Interferes with, or is aggravated by, flying or may reasonably be expected to do so; or
    2. Interferes with clear and effective speech communication.
  3. No disease or condition manifested by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium.

67.307  Mental

Mental standards for a third-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts.
    2. A psychosis. As used in this section, "psychosis" refers to a mental disorder in which:
      1. The individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition; or
      2. The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.
    3. A bipolar disorder.
    4. Substance dependence, except where there is established clinical evidence, satisfactory to the Medical Examiner, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section :
      1. "Substance" includes: alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
      2. "Substance dependence" means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by:
        1. Increased tolerance;
        2. Manifestation of withdrawal symptoms;
        3. Impaired control of use; or
        4. Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
  2. No substance abuse within the preceding 2 years defined as:
    1. Use of a substance in a situation in which that use was physically hazardous, if there has been at any other time an instance of the use of a substance also in a situation in which that use was physically hazardous;
    2. A verified positive drug test result conducted under any approved anti-drug rule or internal program; or
    3. Misuse of a substance that the Medical Examiner based on case history and appropriate, qualified medical judgment relating to the substance involved, finds:
      1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
      2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No other personality disorder, neurosis, or other mental condition that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds:
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.309  Neurologic

Neurologic standards for a third-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. Epilepsy;
    2. A disturbance of consciousness without satisfactory medical explanation of the cause; or
    3. A transient loss of control of nervous system function(s) without satisfactory medical explanation of the cause.
  2. No other seizure disorder, disturbance of consciousness, or neurologic condition that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.311  Cardiovascular

Cardiovascular standards for a third-class airman medical certificate are no established medical history or clinical diagnosis of any of the following:

  1. Myocardial infarction;
  2. Angina pectoris;
  3. Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;
  4. Cardiac valve replacement;
  5. Permanent cardiac pacemaker implantation; or
  6. Heart replacement.

67.313  General medical condition

The general medical standards for a third-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.
  2. No other organic, functional, or structural disease, defect, or limitation that the Medical Examiner based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  3. No medication or other treatment that the Medical Examiner, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds :
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

67.315  Discretionary issuance

A person who does not meet the provisions of  67.303 through 67.313 may apply for the discretionary issuance of a certificate under  67.401.

SUBPART –E

Certification Procedures

 

67.401  Special issuance of medical certificates

  1. At the discretion of the Medical Examiner, an Authorization for Special Issuance of a Medical Certificate (Authorization), valid for a specified period, may be granted to a person who does not meet the provisions of subparts B, C, or D of this part if the person shows to the satisfaction of the Medical Examiner that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force. The Medical Examiner may authorize a special medical flight test, practical test, or medical evaluation for this purpose. A medical certificate of the appropriate class may be issued to a person who does not meet the provisions of subparts B, C, or D of this part if that person possesses a valid Authorization and is otherwise eligible. An airman medical certificate issued in accordance with this section shall expire no later than the end of the validity period or upon the withdrawal of the Authorization upon which it is based. At the end of its specified validity period, for grant of a new Authorization, the person must again show to the satisfaction of the Medical Examiner that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety during the period in which the Authorization would be in force.
  2. At the discretion of the Medical Examiner, a Statement of Demonstrated Ability (SODA) may be granted, instead of an Authorization, to a person whose disqualifying condition is static or nonprogressive and who has been found capable of performing airman duties without endangering public safety. A SODA does not expire and authorizes a designated aviation medical examiner to issue a medical certificate of a specified class if the examiner finds that the condition described on its face has not adversely changed.
  3. In granting an Authorization or SODA, the Medical Examiner may consider the person´s operational experience and any medical facts that may affect the ability of the person to perform airman duties including:
    1. The combined effect on the person of failure to meet more than one requirement of this part; and
    2. The prognosis derived from professional consideration of all available information regarding the person.
  4. In granting an Authorization or SODA under this section, the Medical Examiner specifies the class of medical certificate authorized to be issued and may do any or all of the following:
    1. Limit the duration of an Authorization;
    2. Condition the granting of a new Authorization on the results of subsequent medical tests, examinations, or evaluations;
    3. State on the Authorization or SODA, and any medical certificate based upon it, any operational limitation needed for safety; or
    4. Condition the continued effect of an Authorization or SODA, and any second- or third-class medical certificate based upon it, on compliance with a statement of functional limitations issued to the person in coordination with the Director of Flight Safety or the Director General´s designee.
  5. In determining whether an Authorization or SODA should be granted to an applicant for a third-class medical certificate, the Medical Examiner considers the freedom of an airman, exercising the privileges of a private pilot certificate, to accept reasonable risks to his or her person and property that are not acceptable in the exercise of commercial or airline transport pilot privileges, and, at the same time, considers the need to protect the safety of persons and property in other aircraft and on the ground.
  6. An Authorization or SODA granted under the provisions of this section to a person who does not meet the applicable provisions of subparts B, C, or D of this part may be withdrawn, at the discretion of the Medical Examiner, at any time if:
    1. There is adverse change in the holder´s medical condition;
    2. The holder fails to comply with a statement of functional limitations or operational limitations issued as a condition of certification under this section;
    3. Public safety would be endangered by the holder´s exercise of airman privileges;
    4. The holder fails to provide medical information reasonably needed by the Medical Examiner for certification under this section; or
    5. The holder makes or causes to be made a statement or entry that is the basis for withdrawal of an Authorization or SODA under  67.403.
  7. A person who has been granted an Authorization or SODA under this section based on a special medical flight or practical test need not take the test again during later physical examinations unless the Medical Examiner determines or has reason to believe that the physical deficiency has or may have degraded to a degree to require another special medical flight test or practical test.
  8. Extent of authority. The authority of Medical Examiner and Aviation Medical Examiner is as follows:
    1. Medical Examiner : the Chairman of  civil aviation aeromedical board inwho is  designated by DGCAA to issue all the medical certificates .
    2. Aviation Medical Examiner : is a private governmental or military physician trained  in civil aviation medicine and  designated by DGCAA to perform airmen medical examinations and to issue medical certificate.
  9. If an Authorization or SODA is withdrawn under paragraph (f) of this section the following procedures apply:
    1. The holder of the Authorization or SODA will be served a letter of withdrawal, stating the reason for the action;
    2. By not later than 60 days after the service of the letter of withdrawal, the holder of the Authorization or SODA may request, in writing, that the Medical Examiner provide for review of the decision to withdraw. The request for review may be accompanied by supporting medical evidence;
    3. Within 60 days of receipt of a request for review, a written final decision either affirming or reversing the decision to withdraw will be issued; and
    4. A medical certificate rendered invalid pursuant to a withdrawal, in accordance with paragraph (a) of this section, shall be surrendered to the DGCAA upon request.

67.403 Applications, certificates, logbooks, reports, and records: Falsification, reproduction, or alteration; incorrect statements

  1. No person may make or cause to be made :
    1. A fraudulent or intentionally false statement on any application for a medical certificate or on a request for any Authorization for Special Issuance of a Medical Certificate (Authorization) or Statement of Demonstrated Ability (SODA) under this part;
    2. A fraudulent or intentionally false entry in any logbook, record, or report that is kept, made, or used, to show compliance with any requirement for any medical certificate or for any Authorization or SODA under this part;
    3. A reproduction, for fraudulent purposes, of any medical certificate under this part; or
    4. An alteration of any medical certificate under this part.
  2. The commission by any person of an act prohibited under paragraph (a) of this section is a basis for:
    1. Suspending or revoking all airman, ground instructor, and medical certificates and ratings held by that person;
    2. Withdrawing all Authorizations or SODA´s held by that person; and
    3. Denying all applications for medical certification and requests for Authorizations or SODA´s.
  3. The following may serve as a basis for suspending or revoking a medical certificate; withdrawing an Authorization or SODA; or denying an application for a medical certificate or request for an authorization or SODA:
    1. An incorrect statement, upon which the CAA relied, made in support of an application for a medical certificate or request for an Authorization or SODA.
    2. An incorrect entry, upon which the CAA relied, made in any logbook, record, or report that is kept, made, or used to show compliance with any requirement for a medical certificate or an Authorization or SODA.

67.405  Medical examinations: Who may give

  1. First-class. Any aviation medical examiner who is specifically designated for the purpose may give the examination for the first-class medical certificate. Any interested person may obtain a list of these aviation medical examiners,  from the CAA Flight Safety Directorate.
  2. Second- and third-class. Any aviation medical examiner may give the examination for the second or third-class medical certificate. Any interested person may obtain a list of aviation medical examiners, in any area, from the CAA Flight Safety Directorate.

67.407  Delegation of authority

  1. The authority of the DGCAA to issue or deny medical  certificate is delegated to the medical examiner to the extend necessary to :
    1. Examine applicants for and holders of medical certificates to determine whether they meet applicable medical standards; and
    2. Issue, renew, and deny medical certificates, and issue, renew, deny, and withdraw Authorizations for Special Issuance of a Medical Certificate and Statements of Demonstrated Ability to a person based upon meeting or failing to meet applicable medical standards.
  2. Subject to limitations in applicable parts of JCAR , the delegated functions of the Medical Examiner to examine applicants for and holders of medical certificates for compliance with applicable medical standards and to issue, renew, and deny medical certificates are also delegated to aviation medical examiners and to authorized representatives of the Medical Examiner within the CAA.
  3. The authority of the DGCAA, to reconsider the action of an aviation medical examiner is delegated to the Medical Examiner. Where the person does not meet the standards of  67.107(b)(3) and (c), 67.109(b), 67.113(b) and (c), 67.207(b)(3) and (c), 67.209(b), 67.213(b) and (c), 67.307(b)(3) and (c), 67.309(b), or 67.313(b) and (c), any action taken under this paragraph other than by the Medical Examiner is subject to reconsideration by the Medical Examiner. A certificate issued by an aviation medical examiner is considered to be affirmed as issued unless CAA official named in this paragraph (authorized official) reverses that issuance within 60 days after the date of issuance. However, if within 60 days after the date of issuance an authorized official requests the certificate holder to submit additional medical information, an authorized official may reverse the issuance within 60 days after receipt of the requested information.
  4. The authority of the DGCAA to re-examine any civil airman to the extent necessary to determine an airman´s qualification to continue to hold an airman medical certificate, is delegated to the Medical Examiner and his or her authorized representatives within the CAA.

67.409  Denial of medical certificate

  1. Any person who is denied a medical certificate by an aviation medical examiner may, within 30 days after the date of the denial, apply in writing and in duplicate to the Medical Examiner, for reconsideration of that denial. If the person does not ask for reconsideration during the 30-day period after the date of the denial, he or she is considered to have withdrawn the application for a medical certificate.
  2. The denial of a medical certificate :
    1. By an aviation medical examiner is not a denial by the DGCAA.
    2. By the Medical Examiner is considered to be a denial by the DGCAA.
  3. Any action taken under Sec 67.407(c) that wholly or partly reverses the issue of a medical certificate by an aviation medical examiner is the denial of a medical certificate under paragraph (b) of this section.
  4. If the issue of a medical certificate is wholly or partly reversed by the Medical Examiner, the person holding that certificate shall surrender it, upon request of the CAA.

67.411  Medical certificates by flight surgeons of Armed Forces

  1. The DGCAA has designated flight surgeons of the Armed Forces on specified military posts, stations, and facilities, as aviation medical examiners.
  2. An aviation medical examiner described in paragraph (a) of this section may give physical examinations for the CAA medical certificates to persons who are on active duty or who are, under Armed Forces medical programs, eligible for CAA medical certification as civil airmen. In addition, such an examiner may issue or deny an appropriate CAA medical certificate in accordance with the regulations of  applicable parts of JCAR and the policies of the CAA.

67.413  Medical records

  1. Whenever the DGCAA finds that additional medical information or history is necessary to determine whether an applicant for or the holder of a medical certificate meets the medical standards for it, the DGCAA requests that person to furnish that information or to authorize any clinic, hospital, physician, or other person to release to the DGCAA all available information or records concerning that history. If the applicant or holder fails to provide the requested medical information or history or to authorize the release so requested, the DGCAA may suspend, modify, or revoke all medical certificates the airman holds or may, in the case of an applicant, deny the application for an airman medical certificate.
  2. If an airman medical certificate is suspended or modified under paragraph (a) of this section, that suspension or modification remains in effect until the requested information, history, or authorization is provided to the CAA and until the Medical Examiner determines whether the person meets the medical standards under this part.

67.415  Return of medical certificate after suspension or revocation

The holder of any medical certificate issued under this part that is suspended or revoked shall, upon the DGCAA request, return it to the DGCAA.

Appendix-A

Equipment Required

A  - WEIGHT AND HEIGHT SCALE

B - ENT

A-OTOSCOPE

B-NASAL SPECULUM

C-TONGU BLADES

D-LARYNGEAL MIRROR

C - EYE

A-QUALITY OPHTHALMOSCOPE

B-TITMUS VISION TESTER

C-ISBIRARAH COLOURED VISION BOOK

D-FAA NEAR VISION ACUITY TEST CARD

E-SNELLEN 20 FOOT CHART

D -

A-ECG

NINE WAY

B-TUNING FORK

C-PLASTIC CONTAINER FOR URINE ANALYSIS

Guide for Aviation Medical Examiner

CERTIFICATION SUMMARY

Class of Medical Certificate Type Pilot

First-Class

Airline Transport Pilot

Second –Class

Commercial Pilot

Third –Class

Private Pilot

DISTANT VISION

20/20 in each eye separately without correction at least 20/100 in each eye separately corrected  to 20/20  or better with corrective lenses (glasses or contact lenses).

At least 20/50, without correction; or if vision is poorer than 20/50, must correct to 20/30 or better with corrective lenses (glasses or contact lenses).

NEAR VISION

 At least 20/40 in each eye separately with or without correcting glasses.

At least 20/60 in each eye separately with or without correcting glasses.

HYPERPHORIA

Maximum of 1 diopter

No standard

ESOPHORIA &

EXOPHORIA

Maximum of 6 diopters of esophoria exophoria

No standard

COLOR VISION

Normal color vision

Ability to distinguish aviation signal red, aviation signal green  and white.

AUDIOMETRY

Maximum of 40 dB loss at 500 Hz; 35 dB in frequencies of 1.000 and 2.000 Hz, ANSI

No requirement . Audiometry  may be performed as a service to applicant with his/her permission.

HEARING

 Able to hear whispered voice in each ear separately at 20 feet.

 Able to hear whispered voice in each ear separately at 8 feet.

 Able to hear whispered voice at 3 feet.

 

ENT

No acute or chronic disease of  ears, mastoid , or problem with equilibrium; no unhealed performation of eardrum

No acute or chronic disease of ears, no acute of ear no acute of chronic ENT problems. Including no problem with equilibrium.

PULSE

At rest maximum of 100 beats per minute.

 

BLOOD PRESSURE

Maximum of 160/98 at age 50 and over.

Maximum of 170/100.

EKG

Required at age 35, and annually after age 40

Not requires if cardiovascular examination is normal.

OTHER   CONDITIONS

Examiner must disqualify if the applicant has an established medical history or clinical diagnosis of;

*(1) Diabetes Mellitus requiting insulin or hypoglycemic;

*(2) Angina pectoris ;

*(3)Coronary heart disease that has required treatments or, if untreated, that has

  been symptomatic or clinically significant ;

*(4) Myocardial infraction;

*(5) Epilepsy;

*(6) Alcoholism;

*(7) Drug dependence;

*(8) Disturbance of consciousness with out satisfactory medical explanation ;

*(9) Personality disorder manifested by repeated over acts; and

*(10) psychosis.

Safety

Legislations & Regulations