background image

643 

Federal Aviation Administration, DOT 

§ 68.9 

individual’s answers regarding medical 
history, are true and complete; 

(ii) The individual understands that 

he or she is prohibited under FAA regu-
lations from acting as pilot in com-
mand, or any other capacity as a re-
quired flight crew member, if he or she 
knows or has reason to know of any 
medical deficiency or medically dis-
qualifying condition that would make 
the individual unable to operate the 
aircraft in a safe manner; and 

(iii) The individual is aware of the 

regulations pertaining to the prohibi-
tion on operations during medical defi-
ciency and has no medically disquali-
fying conditions in accordance with ap-
plicable law; 

(b) A section with instructions for 

the individual to provide the completed 
checklist to the State-licensed physi-
cian performing the comprehensive 
medical examination required under 
§ 68.5; and 

(c) A section, for the physician to 

complete, that instructs the physi-
cian— 

(1) To perform a clinical examination 

of— 

(i) Head, face, neck, and scalp; 
(ii) Nose, sinuses, mouth, and throat; 
(iii) Ears, general (internal and ex-

ternal canals), and eardrums (perfora-
tion); 

(iv) Eyes (general), ophthalmoscopic, 

pupils (equality and reaction), and ocu-
lar motility (associated parallel move-
ment, nystagmus); 

(v) Lungs and chest (not including 

breast examination); 

(vi) Heart (precordial activity, 

rhythm, sounds, and murmurs); 

(vii) Vascular system (pulse, ampli-

tude, and character, and arms, legs, 
and others); 

(viii) Abdomen and viscera (including 

hernia); 

(ix) Anus (not including digital ex-

amination); 

(x) Skin; 
(xi) G–U system (not including pelvic 

examination); 

(xii) Upper and lower extremities 

(strength and range of motion); 

(xiii) Spine and other musculo-

skeletal; 

(xiv) Identifying body marks, scars, 

and tattoos (size and location); 

(xv) Lymphatics; 

(xvi) Neurologic (tendon reflexes, 

equilibrium, senses, cranial nerves, and 
coordination, etc.); 

(xvii) Psychiatric (appearance, be-

havior, mood, communication, and 
memory); 

(xviii) General systemic; 
(xix) Hearing; 
(xx) Vision (distant, near, and inter-

mediate vision, field of vision, color vi-
sion, and ocular alignment); 

(xxi) Blood pressure and pulse; and 
(xxii) Anything else the physician, in 

his or her medical judgment, considers 
necessary; 

(2) To exercise medical discretion to 

address, as medically appropriate, any 
medical conditions identified, and to 
exercise medical discretion in deter-
mining whether any medical tests are 
warranted as part of the comprehensive 
medical examination; 

(3) To discuss all drugs the individual 

reports taking (prescription and non-
prescription) and their potential to 
interfere with the safe operation of an 
aircraft or motor vehicle; 

(4) To sign the checklist, stating: ‘‘I 

certify that I discussed all items on 
this checklist with the individual dur-
ing my examination, discussed any 
medications the individual is taking 
that could interfere with his or her 
ability to safely operate an aircraft or 
motor vehicle, and performed an exam-
ination that included all of the items 
on this checklist. I certify that I am 
not aware of any medical condition 
that, as presently treated, could inter-
fere with the individual’s ability to 
safely operate an aircraft.’’; and 

(5) To provide the date the com-

prehensive medical examination was 
completed, and the physician’s full 
name, address, telephone number, and 
State medical license number. 

§ 68.9

Special Issuance process. 

(a) 

General.  An individual who has 

met the qualifications to operate an 
aircraft under § 61.113(i) of this chapter 
and is seeking to act as a pilot in com-
mand or serve as a required flightcrew 
member under that section must have 
completed the process for obtaining an 
Authorization for Special Issuance of a 
Medical Certificate for each of the fol-
lowing: 

VerDate Sep<11>2014 

14:00 Mar 14, 2024

Jkt 262047

PO 00000

Frm 00653

Fmt 8010

Sfmt 8010

Q:\14\14V2.TXT

PC31

aworley on LAPBH6H6L3 with DISTILLER

background image

644 

14 CFR Ch. I (1–1–24 Edition) 

§ 68.9 

(1) A mental health disorder, limited 

to an established medical history or 
clinical diagnosis of— 

(i) A personality disorder that is se-

vere enough to have repeatedly mani-
fested itself by overt acts; 

(ii) A psychosis, defined as a case in 

which an individual— 

(A) Has manifested delusions, hallu-

cinations, grossly bizarre or disorga-
nized behavior, or other commonly ac-
cepted symptoms of psychosis; or 

(B) May reasonably be expected to 

manifest delusions, hallucinations, 
grossly bizarre or disorganized behav-
ior, or other commonly accepted symp-
toms of psychosis; 

(iii) A bipolar disorder; or 
(iv) A substance dependence within 

the previous 2 years, as defined in 
§ 67.307(a)(4) of this chapter. 

(2) A neurological disorder, limited 

to an established medical history or 
clinical diagnosis of any of the fol-
lowing: 

(i) Epilepsy; 
(ii) Disturbance of consciousness 

without satisfactory medical expla-
nation of the cause; or 

(iii) A transient loss of control of 

nervous system functions without sat-
isfactory medical explanation of the 
cause. 

(3) A cardiovascular condition, lim-

ited to a one-time special issuance for 
each diagnosis of the following: 

(i) Myocardial infarction; 
(ii) Coronary heart disease that has 

required treatment; 

(iii) Cardiac valve replacement; or 
(iv) Heart replacement. 
(b) 

Special rule for cardiovascular con-

ditions.  In the case of an individual 
with a cardiovascular condition, the 
process for obtaining an Authorization 
for Special Issuance of a Medical Cer-
tificate shall be satisfied with the suc-
cessful completion of an appropriate 
clinical evaluation without a manda-
tory wait period. 

(c) 

Special rule for mental health condi-

tions.  (1) In the case of an individual 
with a clinically diagnosed mental 
health condition, the ability to operate 
an aircraft under § 61.113(i) of this chap-
ter shall not apply if— 

(i) In the judgment of the individual’s 

State-licensed medical specialist, the 
condition— 

(A) Renders the individual unable to 

safely perform the duties or exercise 
the airman privileges required to oper-
ate an aircraft under § 61.113(i) of this 
chapter; or 

(B) May reasonably be expected to 

make the individual unable to perform 
the duties or exercise the privileges re-
quired to operate an aircraft under 
§ 61.113(i) of this chapter; or 

(ii) The individual’s driver’s license 

is revoked by the issuing agency as a 
result of a clinically diagnosed mental 
health condition. 

(2) Subject to paragraph (c)(1) of this 

section, an individual clinically diag-
nosed with a mental health condition 
shall certify every 2 years, in conjunc-
tion with the certification under 
§ 68.3(b)(3), that the individual is under 
the care of a State-licensed medical 
specialist for that mental health condi-
tion. 

(d) 

Special rule for neurological condi-

tions.  (1) In the case of an individual 
with a clinically diagnosed neuro-
logical condition, the ability to oper-
ate an aircraft under § 61.113(i) of this 
chapter shall not apply if— 

(i) In the judgment of the individual’s 

State-licensed medical specialist, the 
condition— 

(A) Renders the individual unable to 

safely perform the duties or exercise 
the airman privileges required to oper-
ate an aircraft under § 61.113(i) of this 
chapter; or 

(B) May reasonably be expected to 

make the individual unable to perform 
the duties or exercise the privileges re-
quired to operate an aircraft under 
§ 61.113(i) of this chapter; or 

(ii) The individual’s driver’s license 

is revoked by the issuing agency as a 
result of a clinically diagnosed neuro-
logical condition. 

(2) Subject to paragraph (d)(1) of this 

section, an individual clinically diag-
nosed with a neurological condition 
shall certify every 2 years, in conjunc-
tion with the certification under 
§ 68.3(b)(3), that the individual is under 
the care of a State-licensed medical 
specialist for that neurological condi-
tion. 

[Docket FAA–2016–9157, Amdt. 68–1, 82 FR 
3165, Jan. 11, 2017, as amended by Docket No. 
FAA–2021–1040, Amdt. Nos. 61–152, 87 FR 
71238, Nov. 22, 2022] 

VerDate Sep<11>2014 

14:00 Mar 14, 2024

Jkt 262047

PO 00000

Frm 00654

Fmt 8010

Sfmt 8010

Q:\14\14V2.TXT

PC31

aworley on LAPBH6H6L3 with DISTILLER