Title 14—Aeronautics and Space--Volume 1
PART 68—REQUIREMENTS FOR OPERATING CERTAIN SMALL AIRCRAFT WITHOUT A MEDICAL CERTIFICATE
§ 68.1   Applicability.
This part prescribes the medical education and examination requirements for operating an aircraft under § 61.113(i) of this chapter without holding a medical certificate issued under part 67 of this chapter.
§ 68.3   Medical education course requirements.
(a) The medical education course required to act as pilot in command or serve as a required flightcrew member in an operation under § 61.113(i) of this chapter must—
(1) Educate pilots on conducting medical self-assessments;
(2) Advise pilots on identifying warning signs of potential serious medical conditions;
(3) Identify risk mitigation strategies for medical conditions;
(4) Increase awareness of the impacts of potentially impairing over-the-counter and prescription drug medications;
(5) Encourage regular medical examinations and consultations with primary care physicians;
(6) Inform pilots of the regulations pertaining to the prohibition on operations during medical deficiency and medically disqualifying conditions; and
(7) Provide the checklist developed by the FAA in accordance with § 68.7.
(b) Upon successful completion of the medical education course, the following items must be electronically provided to the individual seeking to act as pilot in command or serve as a required flightcrew member under the conditions and limitations of § 61.113(i) of this chapter and transmitted to the FAA—
(1) A certification of completion of the medical education course, which shall be retained in the individual's logbook and made available upon request, and shall contain the individual's name, address, and airman certificate number;
(2) A release authorizing single access to the National Driver Register through a designated State Department of Motor Vehicles to furnish to the FAA information pertaining to the individual's driving record;
(3) A certification by the individual that the individual is under the care and treatment of a physician if the individual has been diagnosed with any medical condition that may impact the ability of the individual to fly, as required under § 61.23(c)(3) of this chapter;
(4) A form that includes—
(i) The name, address, telephone number, and airman certificate number of the individual;
(ii) The name, address, telephone number, and State medical license number of the physician performing the comprehensive medical examination;
(iii) The date of the comprehensive medical examination; and
(iv) A certification by the individual that the checklist described in § 68.7 was followed and signed by the physician during the medical examination required by this section; and
(5) A statement, which shall be signed by the individual certifying that the individual understands the existing prohibition on operations during medical deficiency by stating: “I understand that I cannot act as pilot in command, or any other capacity as a required flight crew member, if I know or have reason to know of any medical condition that would make me unable to operate the aircraft in a safe manner.”.
§ 68.5   Comprehensive medical examination.
(a) Prior to the medical examination required by § 61.23(c)(3) of this chapter, an individual must—
(1) Complete the individual's section of the checklist described in § 68.7; and
(2) Provide the completed checklist to the State-licensed physician performing the medical examination.
(b) The physician must—
(1) Conduct the medical examination in accordance with the checklist set forth in § 68.7,
(2) Check each item specified during the examination; and
(3) Address, as medically appropriate, every medical condition listed and any medications the individual is taking.
§ 68.7   Comprehensive medical examination checklist.
The comprehensive medical examination required to conduct operations under § 61.113(i) must include a checklist containing the following:
(a) A section, for the individual to complete that contains—
(1) Boxes 3 through 13 and boxes 16 through 19 of the FAA Form 8500-8 (3-99), or any successor form; and
(2) A signature line for the individual to affirm that—
(i) The answers provided by the individual on that checklist, including the individual's answers regarding medical history, are true and complete;
(ii) The individual understands that he or she is prohibited under FAA regulations from acting as pilot in command, or any other capacity as a required flight crew member, if he or she knows or has reason to know of any medical deficiency or medically disqualifying 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 prohibition on operations during medical deficiency and has no medically disqualifying conditions in accordance with applicable law;
(b) A section with instructions for the individual to provide the completed checklist to the State-licensed physician performing the comprehensive medical examination required under § 68.5; and
(c) A section, for the physician to complete, that instructs the physician—
(1) To perform a clinical examination of—
(i) Head, face, neck, and scalp;
(ii) Nose, sinuses, mouth, and throat;
(iii) Ears, general (internal and external canals), and eardrums (perforation);
(iv) Eyes (general), ophthalmoscopic, pupils (equality and reaction), and ocular motility (associated parallel movement, nystagmus);
(v) Lungs and chest (not including breast examination);
(vi) Heart (precordial activity, rhythm, sounds, and murmurs);
(vii) Vascular system (pulse, amplitude, and character, and arms, legs, and others);
(viii) Abdomen and viscera (including hernia);
(ix) Anus (not including digital examination);
(x) Skin;
(xi) G-U system (not including pelvic examination);
(xii) Upper and lower extremities (strength and range of motion);
(xiii) Spine and other musculoskeletal;
(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, behavior, mood, communication, and memory);
(xviii) General systemic;
(xix) Hearing;
(xx) Vision (distant, near, and intermediate vision, field of vision, color vision, 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 determining whether any medical tests are warranted as part of the comprehensive medical examination;
(3) To discuss all drugs the individual reports taking (prescription and nonprescription) 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 during 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 examination 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 interfere with the individual's ability to safely operate an aircraft.”; and
(5) To provide the date the comprehensive 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 command 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 following:
(1) A mental health disorder, limited to an established medical history or clinical diagnosis of—
(i) A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
(ii) A psychosis, defined as a case in which an individual—
(A) Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
(B) May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms 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 following:
(i) Epilepsy;
(ii) Disturbance of consciousness without satisfactory medical explanation of the cause; or
(iii) A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
(3) A cardiovascular condition, limited 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 conditions. In the case of an individual with a cardiovascular condition, the process for obtaining an Authorization for Special Issuance of a Medical Certificate shall be satisfied with the successful completion of an appropriate clinical evaluation without a mandatory wait period.
(c) Special rule for mental health conditions. (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 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 operate 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 required 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 diagnosed with a mental health condition shall certify every 2 years, in conjunction 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 condition.
(d) Special rule for neurological conditions. (1) In the case of an individual with a clinically diagnosed neurological condition, the ability to operate 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 operate 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 required 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 neurological condition.
(2) Subject to paragraph (d)(1) of this section, an individual clinically diagnosed with a neurological condition shall certify every 2 years, in conjunction with the certification under § 68.3(b)(3), that the individual is under the care of a State-licensed medical specialist for that neurological condition.
§ 68.11   Authority to require additional information.
(a) If the Administrator receives credible or urgent information, including from the National Driver Register or the Administrator's Safety Hotline, that reflects on an individual's ability to safely operate an aircraft under § 61.113(i) of this chapter, the Administrator may require the individual to provide additional information or history so that the Administrator may determine whether the individual is safe to continue operating under that section.
(b) The Administrator may use credible or urgent information received under paragraph (a) to request an individual to provide additional information or to take actions under 49 U.S.C. 44709(b).