Answers for Pilots

FAR 61.53

June 1, 2003

Should you fly when you're on medication?

In 1994, one man's battle to keep his medical certificate became the basis for a little-known but sweeping change in the federal regulations. Benton Bullwinkel had been diagnosed with two forms of mental illness — bipolar disorder (more commonly known as manic-depressive illness) and attention deficit disorder (ADD). His doctor prescribed the drugs lithium for the bipolar condition and Ritalin for the ADD. After several months, Bullwinkel stopped taking Ritalin but was taking lithium at the time of his medical certification renewal. His application was denied based on the use of the medication.

At the time, the medical standards in FAR Part 67 included a section, (f)(2), that was a "catchall" dealing with general medical conditions not addressed in other parts of the regulation, says Gary Crump, director of AOPA's medical certification department. The FAA used this regulation when it considered an applicant ineligible for a medical certificate if the applicant was found to have any "organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon finds (1) makes the applicant unable to safely perform the duties or exercise the privileges of the airman certificate the applicant holds or for which the applicant is applying, or (2) may reasonably be expected within two years of the Federal Air Surgeon's findings to make the applicant unable to safely perform those duties or exercise those privileges."

Section (f)(2) was the basis for denying medical certification in cases where the Federal Air Surgeon had determined that an applicant's medication or medical treatment interfered with the ability to safely perform the duties or exercise the privileges of the medical certificate held or being applied for.

The Seventh Circuit Court of Appeals overturned the FAA's denial of Bullwinkel's medical certificate for use of medication. In Bullwinkel vs. FAA and NTSB, the court ruled that the FAA had not adequately established that a medical disqualification existed on the basis of the use of medication only and not the underlying medical condition for which the medication was being used.

The FAA implemented an emergency rulemaking establishing a new subsection of the general medical condition regulation, (f)(3), that included language that would disqualify a pilot for the use of any medication "that the Federal Air Surgeon finds (1) makes the applicant unable to safely perform the duties or exercise the privileges of the airman certificate the applicant holds or for which the applicant is applying, or (2) may be reasonably expected within two years of the Federal Air Surgeon's findings to make the applicant unable to safely perform those duties or exercise those privileges." When FAR Part 67 was amended in 1996, the emergency rulemaking became part of the regulations. The amended 61.53 reads:

Except as provided for in paragraph (b) a person who holds a current medical certificate issued under Part 67 shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person: (1) knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or (2) is taking medication or receiving treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

Adhering to FAR 61.53 requires a little homework, says Crump, as there are only 15 specifically disqualifying medications in FAR Part 67. "One of the reasons the system works so well is because pilots just don't fly when they don't feel well — medical incapacitation is cited in less than 1 percent of GA accidents. The language of 61.53 places the burden on the pilot to think twice about flying while using any medication," says Crump.

AOPA provides information for its members through an array of communications technologies. You can reach experts in all fields of aviation via AOPA Online ( www.aopa.org/members/), the AOPA Pilot Information Center (800/USA-AOPA), and e-mail ( inforequest@aopa.org). AOPA Online is accessible 24 hours a day, seven days a week. The toll-free AOPA Pilot Information Center is available from 8:30 a.m. to 6 p.m. Eastern time, Monday through Friday.

AOPA Web resources

This document contains an explanation of FAR 61.53 that sets forth the legality and appropriateness of exercising pilot privileges when there is a known medical condition that could be considered disqualifying under FAR Part 67 "Medical Standards and Certification."
www.aopa.org/members/files/medical/far61-53.html

This document contains the complete text of FAR Part 67, Medical Standards and Certification.
www.aopa.org/members/files/fars/far-67.html

This database, compiled by AOPA's medical certification department, contains information on medications that are generally allowed by the FAA.
www.aopa.org/members/databases/medical/search_faa_meds.cfm

This subject report discusses the FAA policy for medication usage.
www.aopa.org/members/files/medical/med_use.html