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:
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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]
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