FAA Health Standards

Doctors and lawyers tend to communicate with their respective colleagues in their own professional languages, which are often largely unintelligible to outsiders. 14 CFR Part 67, which describes the medical standards and certification procedures for aviators, was written by doctors and lawyers in a not particularly readable mixture of the languages of both professions. To make sense of the specific FAA medical standards, it is helpful to bear in mind that each of these standards was designed to enable the FAA to answer the following basic questions about your health:

1.       Can you see well enough to control the aircraft, see and avoid other aircraft, distinguish runways from taxiways at night, and recognize light gun signals in the event of radio failure?

2.       Can you speak and hear well enough to effectively converse with other crewmembers on a noisy flight deck and with air traffic controllers?

3.       Are you likely to suffer disorienting vertigo or loss of equilibrium in flight?

4.       Are you likely to suffer a suddenly incapacitating medical event in flight?

5.       Are you likely to operate an aircraft irresponsibly so as to endanger other people?

The specific medical standards are designed so that if you have any medical condition that would result in an unfavorable answer to any of these basic questions, you are not qualified for an FAA medical certificate. Therefore, your aviation medical examiner (AME) should not issue you a medical certificate if you fail to pass the hearing and vision requirements of Part 67 or if you have a history or diagnosis of any of the following “specific disqualifying conditions”:

1.       Diabetes requiring insulin or other hypoglycemic medication for control. (If your diabetes can be controlled by careful attention to diet, you are not disqualified.)

2. Heart attack (myocardial infarction).

3. Angina pectoris (the crushing chest pain that is your clue that you are having a heart attack).

4. Other evidence of coronary artery disease (such as an irregular electrocardiogram (EKG).

5. Heart valve replacement.

6. Permanent cardiac pacemaker implantation.

7. Heart replacement (transplant).

8. A psychosis.

9. A personality disorder that has repeatedly manifested itself by overt acts.

10. A bipolar disorder (formerly known as manic depressive disorder).

11. Epilepsy.

12. A disturbance of consciousness without a satisfactory medical explanation of the cause.

13. A transient loss of control of nervous system function(s) without a satisfactory medical explanation of the cause (such as a so-called transient ischemic attack).

14. Substance dependence, abuse or misuse (including alcohol and a wide variety of drugs and controlled substances) within the previous 2 years.

Compare these “specific disqualifying conditions” to the previous basic questions the FAA is trying to answer about your health. The vision standards are designed to be sure that you can see well enough to control the aircraft, see and avoid other aircraft, distinguish runways from taxiways at night, and recognize light gun signals in the event of radio failure. Hearing and speech standards are to ensure you can communicate with other flight crewmembers on a noisy flight deck and with air traffic controllers.

Concern for risk of sudden and unpredictable in-flight incapacitation compels your AME to disqualify you if you have diabetes requiring insulin (putting you at risk of incapacitation by insulin shock), have suffered a heart attack or have coronary artery disease (which can lead to an incapacitating heart attack). The same concern requires your AME to disqualify you if are epileptic, or have experienced a loss of consciousness without a satisfactory medical explanation (so that your next seizure might happen while you’re at the controls of an aircraft in flight).

Concern over potential irresponsible operation of aircraft endangering others disqualifies people having a psychosis or other psychiatric problems that have led to irrational behavior, as well as substance abusers.

A “history or diagnosis” of any one of the specific disqualifying conditions prevents your AME from issuing you an FAA medical certificate regardless of how good your health may otherwise appear during the examination.

There are also catch-all subparagraphs that disqualify you for any other physical condition that in the opinion of the Federal Air Surgeon could make it unsafe for you to exercise airman certificate privileges, or if you are taking any medication or undergoing any course of treatment that could adversely affect your performance.

Some examples of physical conditions the Federal Air Surgeon has found disqualifying under this “other physical condition” catch-all, depending on severity and treatment, include arthritis, asthma, chronic lymphocytic leukemia, colitis, colon cancer, glaucoma and ocular hypertension, hepatitis C, hyperthyroidism, hypothyroidism, lymphoma and Hodgkin’s disease, migraine syndrome, prostate cancer, sleep apnea, and urolithiasis (kidney stones).

Some examples of medications the Federal Air Surgeon presently considers disqualifying include antidepressant or serotonin blocker drugs (SSRIs) such as Prozac, Paxil, and Zoloft.