The FAA issues three classes of airman medical certificates: first-class to airline transport pilots, second-class to commercial pilots and third-class to private and recreational pilots. In addition to periodic flight proficiency checks, a commercial helicopter pilot must obtain at least a second-class medical certificate once every 12 calendar months to exercise his or her commercial pilot privileges. “To be eligible for a second-class airman medical certificate … a person must meet the requirements of” Part 67 of the Code of Federal Regulations.

General Medical Condition

To hold a second-class airman medical certificate, a person must be in generally good health and have no condition that limits his or her ability to “safely perform the duties” of the certificate. A diagnosis of a condition that requires insulin or hypoglycemic drug disqualifies an applicant. In addition, it may not be the condition that makes an applicant ineligible but the affects of the medication used to treat it. Any medication that “makes the person unable to safely perform the duties or exercise the privileges of the airman certificate…” gives the FAA grounds to revoke an airman medical certificate.

Vision

Vision standards for FAA medical certificates are not as stringent as they are for military flight training. Candidates for an FAA medical certificate need not have natural 20/20 vision. Those who do not have 20/20 vision still qualify, as long as their glasses or contacts are able to correct their “distant visual acuity” to at least 20/20. The near distance requirement is 20/40 or better. As an individual ages, vision requirements change, but all “airman must have normal fields of vision,” and be able to see “those colors necessary for the safe performance of airman duties.”

Ear, Nose, Throat and Equilibrium

Holders of a second-class medical must have “clear and effective speech.” In addition they must be able to hear a “conversational voice in a quiet room.” Maladies that could cause vertigo or other middle ear conditions may disqualify a candidate from obtaining a medical certificate.

Neurological and Mental

Excessive use of alcohol (including a DUI convidtion) or any use of cocaine, marijuana or other controlled substances is grounds for revocation of a second-class medical certificate. In addition, neurological illness such as bipolar disorders, delusions or “grossly disorganized behavior” may be grounds for disqualification. An applicant must also have a “satisfactory medical explanation” for seizures, unconsciousness or a “transient loss of control of nervous system function.”

Cardiovascular

The FAA takes cardiac health seriously. Any life-threatening condition such as heart attacks or heart disease that has required treatment makes an individual ineligible for a second-class airman medical certificate. Pacemaker implantation and heart replacement are two other examples of disqualifying conditions.

Waivers

Part 67 (special issuance of medical certificates) allows for waivers. The FAA, for example, has issued second-class medical certificates to individuals missing an eye. If an applicant can demonstrate to the Federal Air Surgeon that they can perform the required duties for a medical certificate “without endangering public safety” the FAA may issue a “Special Issuance of a Medical Certificate (Authorization), valid for a specified period.” The waiver application can be a lengthy process.