Most pilots must have a valid medical certificate to exercise the privileges of their airman certificates. Glider and free balloon pilots are not required to hold a medical certificate. Sport pilots may hold either a medical certificate or a valid state driver’s license. Regardless of whether a medical certificate or drivers license is required, 14 CFR 61.53 requires every pilot not to act as a crewmember if they know, or have reason to know, of any medical condition that would make them unable to operate the aircraft in a safe manner.

Acquisition of a medical certificate requires an examination by an aviation medical examiner (AME), a physician with training in aviation medicine designated by the Civil Aerospace Medical Institute (CAMI). There are three classes of medical certificates. The class of certificate needed depends on the type of flying the pilot plans to perform.
A third-class medical certificate is required for a private or recreational pilot certificate. It is valid for 5 years for those individuals who have not reached the age of 40; otherwise it is valid for 2 years. A commercial pilot certificate requires at least a second-class medical certificate, which is valid for 1 year. First-class medical certificates are required for airline transport pilots and are valid for one year if the airman is 40 or younger; 40 and older it is valid for 6 months.
The standards are more rigorous for the higher classes of certificates. A pilot with a higher class medical certificate has met the requirements for the lower classes as well. Since the required medical class applies only when exercising the privileges of the pilot certificate for which it is required, a first-class medical certificate would be valid for 1 year if exercising the privileges of a commercial certificate and 2 or 5 years, as appropriate, for exercising the privileges of a private or recreational certificate. The same applies for a second-class medical certificate. The standards for medical certification are contained in Title 14 of the Code of Federal Regulations (14 CFR) part 67 and the requirements for obtaining medical certificates can be found in 14 CFR part 61.

Students who have physical limitations, such as impaired vision, loss of a limb, or hearing impairment may be issued a medical certificate valid for “student pilot privileges only” while learning to fly. Pilots with disabilities may require special equipment to be installed in the aircraft, such as hand controls for pilots with paraplegia. Some disabilities necessitate a limitation on the individual’s certificate; for example, impaired hearing would require the limitation “not valid for flight requiring the use of radio.” When all the knowledge, experience, and proficiency requirements have been met and a student can demonstrate the ability to operate the aircraft with the normal level of safety, a “statement of demonstrated ability” (SODA) can be issued. This waiver, or SODA, is valid as long as the physical impairment does not worsen. Contact the local Flight Standards District Office (FSDO) for more information on this subject.

The FAA medical standards, 14 CFR part 67, specify fifteen medical conditions that are considered disqualifying by “history or clinical diagnosis.” Regardless of when one of these conditions was diagnosed and treated, an airman may not be issued a medical certificate except through a process called a “Special Issuance Authorization,” as explained in 14 CFR part 67, section 67.401. A special issuance is a discretionary issuance by the FAA Federal Air Surgeon and requires satisfactory completion of special testing determined by the FAA to demonstrate that an airman is safe to fly for the duration of the medical certificate issued. The specific disqualifying conditions include:

  • Diabetes mellitus requiring oral hypoglycemic medication or insulin
  • Angina pectoris
  • Coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant
  • Myocardial infarction
  • Cardiac valve replacement
  • Permanent cardiac pacemaker
  • Heart replacement
  • Psychosis
  • Bipolar disorder
  • Personality disorder that is severe enough to have repeatedly manifested itself by overt acts
  • Substance dependence (including alcohol)
  • Substance abuse
  • Epilepsy
  • Disturbance of consciousness and without satisfactory explanation of cause
  • Transient loss of control of nervous system function(s) without satisfactory explanation of cause

However, this list includes only the mandatory disqualifying conditions. There are many other medical conditions that fall into the General Medical Condition section of the regulations that are considered by the FAA to be disqualifying even though they are not stated in the regulations. Conditions such as cancer, kidney stones, neurologic and neuromuscular conditions including Parkinson’s disease and multiple sclerosis, certain blood disorders, and other conditions that may progress over time require review by the FAA before a medical certificate may be issued.

The important thing to remember is that with very few exceptions, all disqualifying medical conditions may be considered for special issuance. If you can present satisfactory medical documentation to the FAA that your condition is stable, the chances are good that you will be able to qualify for an Authorization.