Overview: FAA Medical Flight Test for Pilots with Medical Deficiencies

Excerpts from 8900.1 Vol 5 [Airman Certification], Chapter 8

May 2014

Abbreviated Briefing:

Special medical flight tests (MFTs) are occasionally required for applicants who do not meet certain medical standards. Successful completion of an MFT leads to issuance of a medical certificate under part § 67.401. Such testing is conducted only after issuance of a Letter of Authorization (LOA). An LOA to authorize your MFT would be initiated by your local AME, but approval must come from higher up the aeromedical chain of command.  The formal LOA must be officially requested by the Federal Air Surgeon; the Manager, Aerospace Medical Certification Division (AAM 300); or by a Regional Flight Surgeon.

Operating limitations on pilot certificates issued to pilots with physical deficiencies may be added or removed as a result of the special medical flight test findings (results of your checkride). These tests are not conducted by regular Designated Pilot Examiners (DPEs) but instead, MFTs are conducted solely by special FAA aviation safety inspectors (ASI's) after receiving your unique LOA. Concurrence from the regional Flight Surgeon is required before any operating limitations on pilot certificates issued to pilots with physical deficiencies can be removed. Here are some key points and links for more info:

  • A. Medical Flight Test General Guidelines: Special Medical Flight Tests (MFTs) are conducted by aviation safety inspectors (ASIs) for applicants with physical deficiencies.
  • B. MFT and Practical Test can be combined for Certification and/or Ratings
  • C. It is Possible to Pass only the Medical Portion and Fail the Practical Portion
  • D. Letter of Authorization (LOA) is required in advance of the MFT
  • E. Hearing Impaired MFTs specify either open or closed cockpit. Details....
  • F. Defective Color Vision MFTs: 1st and 2nd class applicants must take and pass an Operational Color Vision Test (OCVT) and a color vision Medical Flight Test (MFT). Applicants for a 3rd class medical certificate need only to take and pass the OCVT which has these 2 parts:
    • Signal Light Test (SLT) SLT Details...
    • Demonstrate ability to read and identify colors on aeronautical charts during day +/- night conditions
  • G. Completion of Medical Test: If during any of non-SLT MFT sorties, the applicant fails to meet the test standard, the ASI will terminate the test before it is completed. If the test is an SLT flight the FAA requires that the entire SLT sortie be completed before an assessment is made regarding success or failure of the test.
  • H. Operating Limitations: Various restrictions may be placed on or removed from the pilot certificate.
  • Procedures (Except SLT) are described
  • Signal Light Test (SLT) Procedures are discussed
  • Possible Outcomes:
    • Medical Certificate
    • Statement of Demonstrated Ability (SODA)
    • Temporary Airman Certificate; or
    • Notice of Disapproval of Application

Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

Adapted from Paragraph 5-1523 GENERAL.

These are representative instructions for the inspector who will do your Medical Flight Test

A. General Process. Special medical flight tests, which may lead to the issuance of medical certificates under Title 14 of the Code of Federal Regulations (14 CFR) part § 67.401, are frequently required for applicants who do not meet certain medical standards. Such testing is conducted solely by aviation safety inspectors (ASI) and may be conducted only after issuance of a Letter of Authorization (LOA). The LOA for an airman who has requested a special medical test must be issued by the Federal Air Surgeon; the Manager, Aerospace Medical Certification Division (AAM-300); or by a Regional Flight Surgeon. Operating limitations on pilot certificates issued to pilots with physical deficiencies may be added or removed as a result of the special medical flight test findings.

B. Combined Special Medical Test and Practical Test for Certification and/or Ratings. If requested by the applicant, the special medical test may be given in conjunction with the usual practical tests for a pilot certificate when the applicant meets the flight experience requirements for the pilot certificate sought. At the outset, the ASI should consult the related airman certification section in this volume in addition to this section. Chapter 81 refers to medical certificate action. Any reference to the medical certificate also includes the combined Medical Certificate and Student Pilot Certificate. The applicant may be entitled to a separate pilot certificate.

C. Medical Portion Passed. If an applicant fails the certification portion of a combined test but passes the medical portion, any retest may be conducted by an ASI or a designated pilot examiner (DPE), except where the medical portion is dependent upon the demonstration of piloting skills in which case the decision to retest must be made in consultation with the Office of Aerospace Medicine.

D.Letter of Authorization.

1) The LOA for the special medical test contains guidelines and usually a handbook reference to help the ASI determine whether the applicant is able to safely operate an aircraft. When the applicant's abilities are compared to those of the ASI, it is assumed that the ASI's physical attributes are normal. If there is any doubt as to the ASI's qualifications to conduct a particular test, the test should be assigned to another ASI or the problem should be discussed with the medical office personnel authorizing the test. All of the medical flight test items listed on the LOA must be observed and evaluated by the ASI. The ASI may add test items if necessary.

2) A special medical test shall be conducted only by an ASI who has a copy of the applicant's LOA for the test. The LOA is normally sent to the jurisdictional Flight Standards District Office (FSDO) where the applicant resides; however, it may be forwarded to another office at the applicant's request. When the special medical test has been passed, the usual certification practical test, if required and if not conducted concurrently, may be conducted by another ASI or a DPE.

E. Defective Hearing Test. The ASI must note on the report whether the defective hearing test was conducted in an open or a closed cockpit.

F. Defective Color Vision.

1) Applicants who fail the color vision screening test as listed in the Guide for Aviation Medical Examiners, but desire an airman medical certificate without the color vision limitation, 'NOT VALID FOR NIGHT FLYING OR BY COLOR SIGNAL CONTROL,' may be given, upon request, an opportunity to take and pass additional operational color perception tests. The operational tests are determined by the class of medical certificate requested (see Figure 5-153A). Such testing is conducted solely by an ASI and may be conducted only on a LOA (see Figures 5-153B and 5-153C). Applicants for a first- or second- class medical certificate are required to take and pass an Operational Color Vision Test (OCVT) and a color vision Medical Flight Test. Applicants for a third class medical certificate need only to take and pass the OCVT.

2) The OCVT has two components, the Signal Light Test (SLT) and a demonstration of the ability to correctly read and identify colors on aeronautical charts. (See paragraph 5-1526E6) for instructions on how to conduct the OCVT.) Applicants for a medical certificate who have defective color vision must be initially tested in daylight conditions, and if specified in the LOA, a nighttime test may be authorized to be given only after the daylight test has been completed.

G. Completion of Medical Test. National Transportation Safety Board Safety Recommendation 97.269 committed the Federal Aviation Administration (FAA) to revising its guidance on conducting a special medical test to emphasize the conditions under which operating limitations may need to be placed on an airman certificate issued as a result of a medical flight test. The limitation is needed to further emphasize the ASI's responsibility to ensure that appropriate restrictions are placed on an airman's certificate issued on the basis of an MFT. If during any of the special medical tests (with the exception of a SLT), the ASI determines that the applicant has failed to meet the test standard, the ASI should terminate the test before it is completed. However, the SLT must be completed before an assessment is made regarding success or failure of the test.

H. Operating Limitations. A pilot certificate issued or reissued after a special medical flight test must bear any limitations the inspector who conducted the test finds necessary for safety. An inspector from the jurisdictional FSDO must have determined that no operational limitations (such as 'HAND CONTROLS ONLY') are required to be placed on a pilot certificate before a DPE accepts an application from an airman who has a SODA (Statement of Demonstrated Ability).

1) Operating limitations shall be entered on FAA Form 8060-4 (Figure 5-154). If the pilot certificate portion of the test is failed, the operating limitations are placed on FAA Form 8060-5 (Figure 5-155) so that, after a retest is passed, an inspector or DPE knows what operational limitations to place on the temporary certificate. These forms are then sent with the application to the Flight Standards Airmen Certification Branch, AFS-760.

2) Operating limitations required by physical deficiencies may restrict holders to certain aircraft types, special equipment or control arrangements, or special operating conditions. Examples are as follows:
  • LIMITED TO ERCOUPE 415 SERIES WITHOUT RUDDER PEDAL for an airman, with an inability to use rudder pedals possibly because of the loss of the use of the lower extremities, who takes the special medical test in an Ercoupe 415 series;
  • LIMITED TO AIRCRAFT WITH ALL CONTROLS BELOW SHOULDER LEVEL for an airman who is unable to use the upper extremities, possibly because of the loss of an arm;
  • NOT VALID FOR FLIGHTS REQUIRING THE USE OF RADIO for an airman who is speech or hearing impaired or both; or
  • LIMITED TO RECIPROCATING PISTON, NONREVERSING AIRCRAFT for an airman who has an arm prosthesis and is unable to use the reverse thrust function of a turbine aircraft. Also consider aircraft with variable pitch propeller considerations.
3) The inspector must be mindful that physical limitation(s) may not be compatible with all flight deck configurations. While limitations were traditionally constructed to eliminate the need for subsequent special medical tests, in the interest of safety, specific limitations such as make/model of aircraft, or specific assist devices may be appropriate.

4) If a pilot is returning to flying after receiving a disabling injury, such as a loss of limb or an injury to a lower extremity, it may be necessary for the pilot to re-demonstrate proficiency for each privilege authorized. Any rating not demonstrated that the inspector determines to be necessary must bear the limitation, 'NOT VALID,' until such time when competency in that category and class is demonstrated.

5) Any operating limitation may be deleted or amended only on the basis of an additional special medical test or upon qualification by the pilot for an appropriate medical certificate without waiver or exemption.

6) If a student pilot is taking a practical test for a pilot certificate and a medical flight test concurrently, the SODA may be issued if the airman satisfactorily demonstrates the appropriate operational ability.

7) If a student pilot fails the practical test for a pilot certificate but passes the medical test, the SODA may be issued and the Notice of Disapproval of Application should indicate all appropriate operational limitations for the entire practical test.

8) If a student pilot passes both the flight test and the medical test, the inspector must place all appropriate operational limitations on the Temporary Airman Certificate.

1FlightPhysical.com cites: FSIMS Document: 8900.1 Change 18, Volume 5 [Airman Certification], ,Chapter 8 [Conduct a Special Medical Test] portions accessed from FAA.gov web site on 20 Feb 2014

Commentary:

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Special medical flight tests (MFTs) are occasionally required for applicants who do not meet certain medical standards. Successful completion of an MFT leads to issuance of a medical certificate under part § 67.401. Such testing is conducted only after issuance of a Letter of Authorization (LOA). An LOA to authorize your MFT would be initiated by your local AME, but approval must come from higher up the aeromedical chain of command.  The formal LOA must be officially requested by the Federal Air Surgeon; the Manager, Aerospace Medical Certification Division (AAM 300); or by a Regional Flight Surgeon.

Operating limitations on pilot certificates issued to pilots with physical deficiencies may be added or removed as a result of the special medical flight test findings (results of your checkride). These tests are not conducted by regular Designated Pilot Examiners (DPEs) but instead, MFTs are conducted solely by special FAA aviation safety inspectors (ASI's) after receiving your unique LOA. Concurrence from the regional Flight Surgeon is required before any operating limitations on pilot certificates issued to pilots with physical deficiencies can be removed. Here are some key points and links for more info:

  • A. Medical Flight Test General Guidelines: Special Medical Flight Tests (MFTs) are conducted by aviation safety inspectors (ASIs) for applicants with physical deficiencies.
  • B. MFT and Practical Test can be combined for Certification and/or Ratings
  • C. It is Possible to Pass only the Medical Portion and Fail the Practical Portion
  • D. Letter of Authorization (LOA) is required in advance of the MFT
  • E. Hearing Impaired MFTs specify either open or closed cockpit. Details....
  • F. Defective Color Vision MFTs: 1st and 2nd class applicants must take and pass an Operational Color Vision Test (OCVT) and a color vision Medical Flight Test (MFT). Applicants for a 3rd class medical certificate need only to take and pass the OCVT which has these 2 parts:
    • Signal Light Test (SLT) SLT Details...
    • Demonstrate ability to read and identify colors on aeronautical charts during day +/- night conditions
  • G. Completion of Medical Test: If during any of non-SLT MFT sorties, the applicant fails to meet the test standard, the ASI will terminate the test before it is completed. If the test is an SLT flight the FAA requires that the entire SLT sortie be completed before an assessment is made regarding success or failure of the test.
  • H. Operating Limitations: Various restrictions may be placed on or removed from the pilot certificate.
  • Procedures (Except SLT) are described
  • Signal Light Test (SLT) Procedures are discussed
  • Possible Outcomes:
    • Medical Certificate
    • Statement of Demonstrated Ability (SODA)
    • Temporary Airman Certificate; or
    • Notice of Disapproval of Application

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