From the Pilot Examiner’s Handbook: FAA Order 8710.3
Medical Flight Tests
Section 1 Background
1. WPMS ACTIVITY CODE: 1531
3. OBJECTIVE. The objective of this task is to determine if an applicant is eligible for a medical certificate and/or Statement of Demonstrated Ability based on the appropriate test. Successful completion of this task results in the issuance or non-issuance of a Medical Certificate and/or a Statement of Demonstrated Ability.
- General Process Special medical flight tests leading to the issuance of medical certificates under FAR 67.401 to applicants who do not meet pertinent medical standards may be conducted only on the basis of a Letter of Authorization (See Figure 27-1). The Letter of Authorization for a person who has requested a Special Medical Flight Test must be issued by the Office of Aerospace Medicine or the Chief of the Aerospace Medical Certification Division, AAM-300. Concurrence from the Regional Flight Surgeon is required before any operating limitations on pilot certificates issued to pilots with physical deficiencies can be removed.
- 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 inspector should consult the related task for airman certification in addition to this task.
- Medical Portion Passed. If an applicant fails the certification portion of a combined test but passes the medical portion, an inspector or a designated pilot examiner may conduct a retest.
- Letter of Authorization.
- The Letter of Authorization for the special medical test contains guidelines and usually a handbook reference to help the inspector determine whether the applicant is able to safely operate an aircraft. When the applicant's abilities are compared to those of the inspector, it is assumed that the inspector’s physical attributes are normal. If there is any doubt as to the inspector’s qualifications to conduct a particular test, the test should be reassigned to another inspector, or the problem should be discussed with personnel of the medical office authorizing the test. All of the medical flight test items listed on the Letter of Authorization must be observed and evaluated by the inspector. The inspector may add test items if necessary.
- A special medical test shall be conducted only by an inspector who has a copy of the applicant's Letter of Authorization for the test. The Letter of Authorization is normally sent to the district serving the area in which 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 inspector or a designated pilot examiner.
- Defective Hearing Test The inspector must note on the report whether the Defective Hearing Test was conducted in an open or a closed cockpit.
- Defective Color Vision - First Class Medical Applicants for a first class medical certificate who have defective color vision must be tested at twilight or at night. The applicant must be evaluated for his or her ability to see the following:
- Colored lights of other aircraft in the vicinity
- Runway approach lights
- Airport boundary lights
- Taxiway lights
- Red warning lights on TV towers, high buildings, stacks, etc.
- All color signal lights normally used in air traffic control
- Aviation Signal Light Test - Commercial. Night testing may be very important to airmen since applicants able to identify colors appropriately at night (but not during daylight) may have the night restriction removed from the medical certificates.
- Completion of Medical Test. If, during any of the special medical tests, with the exception of a signal light test, the inspector determines that the applicant has failed the test, the inspector should terminate the test before it is completed. The signal light test, however, must be completed even if the inspector determines during the test that the applicant has failed.
- 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.
- Operating limitations shall be entered on FAA Form 8060-4, (Figure 27-2). If the pilot certificate portion of the test is failed, the operating limitations are placed on the FAA Form 8060-5, (Figure 27-3) so that, after a retest is passed, an inspector or examiner knows what operational limitations to place on the temporary certificate. These forms are then sent with the application to AVN-460.
- Operating limitations required by physical deficiencies may restrict holders to certain aircraft types, special equipment or control arrangements, or special operating conditions. Examples are:
- "LIMITED TO ERCOUPE 415 SERIES WITHOUT RUDDER PEDALS" (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)
- "LIMITED TO RECIPROCATING PISTON, NON-REVERSING AIRCRAFT" (for an airman who has an arm prosthesis and is unable to use the reverse thrust function of a turbine aircraft)
- Limitations should be as general as possible to eliminate the necessity of additional special medical tests when the pilot desires to fly additional aircraft types for which he or she is physically competent.
- 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 and which the inspector determines to be necessary must bear the limitation, "Not valid until such a time when competency in that category and class is demonstrated”.
- Any operating limitation may be deleted or amended only on the basis of an additional special medical test, or upon the qualification by the pilot for an appropriate medical certificate without waiver or exemption.