685 

Federal Aviation Administration, DOT 

§ 68.9 

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 serve as a pilot in 
command 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: 

(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 

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