Federal Register, Volume 82 Issue 7 (Wednesday, January 11, 2017)


[Federal Register Volume 82, Number 7 (Wednesday, January 11, 2017)]
[Rules and Regulations]
[Pages 3149-3167]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31602]


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DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

14 CFR Parts 61, 68, and 91

[Docket No.: FAA-2016-9157; Amdt. Nos. 61-140, 68-1, and 91-347]
RIN 2120-AK96


Alternative Pilot Physical Examination and Education Requirements

AGENCY: Federal Aviation Administration (FAA), Department of
Transportation (DOT).

ACTION: Final rule.

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SUMMARY: This final rule will allow airmen to exercise pilot in command
privileges in certain aircraft without holding a current medical
certificate. This rule, which conforms FAA regulations with
legislation, is intended to ensure that pilots who complete a medical
education course, meet certain medical requirements, and comply with
aircraft and operating restrictions are allowed to act as pilot in
command for most part 91 operations.

[[Page 3150]]


DATES: This rule is effective on May 1, 2017.
Docket: Background documents may be read at http://www.regulations.gov at any time. Follow the online instructions for
accessing the docket or go to the Docket Operations in Room W12-140 of
the West Building Ground Floor at 1200 New Jersey Avenue SE.,
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday,
except Federal holidays.

FOR FURTHER INFORMATION CONTACT: John Linsenmeyer, General Aviation and
Commercial Division, AFS-800, Flight Standards Service, Federal
Aviation Administration, 55 M Street SE., 8th floor, Washington, DC
20003; telephone: (202) 267-1100; email: 9-AWA-AFS-BasicMed@faa.gov.

SUPPLEMENTARY INFORMATION:

I. Executive Summary

The Federal Aviation Administration (FAA) Extension, Safety, and
Security Act of 2016 (Pub. L. 114-190) (FESSA) was enacted on July 15,
2016. Section 2307 of FESSA, Medical Certification of Certain Small
Aircraft Pilots, directed the FAA to ``issue or revise regulations to
ensure that an individual may operate as pilot in command of a covered
aircraft'' without having to undergo the medical certification process
under 14 CFR part 67 if the pilot and aircraft meet certain prescribed
conditions as outlined in FESSA. The FAA is amending parts 61 and 91
and creating a new part 68 to conform to this legislation.
This final rule implements, without interpretation, the
requirements of section 2307 of FESSA. This rule reiterates the
provisions of section 2307 of FESSA and describes how the FAA is
implementing those provisions.

II. Legal Authority and Administrative Procedure Act

A. Authority for This Rulemaking

The FAA's authority to issue rules on aviation safety is found in
Title 49 of the United States Code (49 U.S.C.). Subtitle I, Section 106
describes the authority of the FAA Administrator. Subtitle VII,
Aviation Programs, describes in more detail the scope of the agency's
authority.
This final rule is promulgated under the authority described in
Subtitle VII, Part A, Subpart iii, section 44701, General Requirements;
section 44702, Issuance of Certificates; and section 44703, Airman
Certificates. Under these sections, the FAA is charged with prescribing
regulations and minimum standards for practices, methods, and
procedures the Administrator finds necessary for safety in air
commerce. The FAA is also authorized to issue certificates, including
airman certificates and medical certificates, to qualified individuals.
This rule is within the scope of that authority.
This rule is further promulgated under section 2307 of Public Law
114-190, the FAA Extension, Safety and Security Act of 2016. Section
2307, Medical Certification of Certain Small Aircraft Pilots, provides
the requirements and terms of this rule.

B. Administrative Procedure Act

The Administrative Procedure Act (5 U.S.C. 553(b)(3)(B)) requires
an agency to conduct notice and comment rulemaking except when the
agency for good cause finds (and incorporates the finding and a brief
statement of reasons therefor in the rules issued) that notice and
public procedure thereon are impracticable, unnecessary, or contrary to
the public interest. The FAA finds that notice and the opportunity to
comment are unnecessary and contrary to the public interest in this
action because the FAA has simply adopted the statutory language
without interpretation and is implementing that language directly into
the regulations. The FAA further finds that delaying implementation of
this rule to allow for notice and comment would be contrary to the
public interest as to do so would delay the new privileges Congress
sought to provide.

III. Background

A. Current Situation

In general, a person may serve as a required pilot flightcrew
member of an aircraft only if that person holds the appropriate medical
certificate.\1\ 14 CFR 61.3(c)(1). There are a few exceptions to this
requirement, such as for pilots flying gliders, balloons, and/or light-
sport aircraft. 14 CFR 61.3(c)(2).
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\1\ When referring to a ``medical certificate'' in this final
rule, the FAA is referring only to a current and valid first-,
second-, or third-class FAA airman medical certificate issued under
14 CFR part 67, which may have been issued under an authorization
for special issuance (``special issuance medical certificate'').
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A medical certificate provides validation that a person meets FAA
medical certification requirements. Title 14, Code of Federal
Regulations (14 CFR) part 67 provides for the issuance of three classes
of medical certificates--first-, second-, and third-class medical
certificates.\2\ At minimum, a third-class medical certificate is
required for operations requiring a private pilot certificate, a
recreational pilot certificate, a flight instructor certificate (when
acting as pilot in command or serving as a required flight crewmember
in operations other than glider or balloon), or a student pilot
certificate. An applicant who is found to meet the appropriate medical
standards,\3\ based on a medical examination and an evaluation of the
applicant's history and condition, is entitled to a medical certificate
without restriction or limitation.
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\2\ In most cases, a first-class medical certificate is required
for operations requiring an airline transport pilot (ATP)
certificate. At minimum, a second-class medical certificate is
required for operations requiring a commercial pilot certificate.
The requirement to hold a first or second class medical certificate
when exercising the privileges of a commercial or airline transport
pilot certificate is not changed by this rulemaking.
\3\ Part 67 contains the requirements for medical standards and
certification.
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A person obtains a medical certificate by completing an online
application (FAA form 8500-8, Application for Medical Certificate)
using the FAA's medical certificate application tool, MedXPress, on the
FAA Web site and undergoing a physical examination with an FAA-
designated Aviation Medical Examiner (AME). The majority of applicants
are issued an unrestricted medical certificate by an AME. An AME may
defer an applicant to the FAA for further review (which may include
further examination by a specialist physician) when there is
information indicating the existence or potential of an adverse medical
finding that may warrant further FAA medical evaluation and oversight.
Title 14 CFR 61.23 specifies the duration of validity for unrestricted
medical certificates based on the applicant's age on the date of
examination. For third-class medical certificates, certificates for
airmen under age 40 are valid for 5 years and for airmen age 40 and
over are valid for 2 years.

B. Section 2307, Medical Certification of Certain Small Aircraft Pilots

Section 2307, Medical Certification of Certain Small Aircraft
Pilots, provides that, within 180 days of enactment of Public Law 114-
190, the FAA Extension, Safety and Security Act of 2016, the
Administrator of the FAA shall issue or revise regulations to ensure
that an individual may operate as pilot in command of a covered
aircraft if certain provisions stipulated in section 2307 of FESSA are
met. Those provisions, discussed further below, include requirements
for the person to:
Possess a valid driver's license;
Have held a medical certificate at any time after July 15,
2006;
Have not had the most recently held medical certificate
revoked, suspended, or withdrawn;

[[Page 3151]]

Have not had the most recent application for airman
medical certification completed and denied;
Have taken a medical education course within the past 24
calendar months;
Have completed a comprehensive medical examination within
the past 48 months;
Be under the care of a physician for certain medical
conditions;
Have been found eligible for special issuance of a medical
certificate for certain specified mental health, neurological, or
cardiovascular conditions;
Consent to a National Driver Register check;
Fly only certain small aircraft, at a limited altitude and
speed, and only within the United States;
Not fly for compensation or hire.
The FAA notes that the use of this rule by any eligible pilot is
voluntary. Persons may elect to use this rule or may continue to
operate using any valid FAA medical certificate.\4\ The FAA recognizes
that a pilot who holds a medical certificate may choose to exercise
this rule and not to exercise the privileges of his or her medical
certificate. Even though a pilot chooses not to exercise the privileges
of the medical certificate for a particular operation, the FAA retains
the authority to pursue enforcement action to suspend or revoke that
medical certificate where there is evidence that the pilot does not
meet the FAA's medical certification standards. 49 U.S.C. 44709(a).
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\4\ Section 2307(k) states the provisions and requirements of
the section do not apply to anyone who elects to operate under Sec.
61.23(b) and (c)--which govern operations not requiring a medical
certificate and operations requiring either a medical certificate or
U.S. driver's license, respectively. Because this final rule amends
Sec. 61.23(c) to include the relief outlined in FESSA, the
reference to Sec. 61.23(c) in section 2307(k) applies to that
section as it was written at the time the legislation was enacted.
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IV. Pilot Requirements of Section 2307 of FESSA

Section 2307(a)(1) through (7) contains several requirements the
pilot must meet in order to act as pilot-in-command (PIC) of a covered
aircraft. The FAA is implementing those requirements by revising Sec.
61.23(c)(1) and by adding new Sec. 61.23(c)(3).\5\ The following
sections discuss the pilot requirements of section 2307 and the FAA's
implementation of those requirements in more detail.
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\5\ Section 61.23(c) currently addresses operations that may be
conducted using either a medical certificate or a U.S. driver's
license.
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A. Applicability of Section 2307

Section 2307(a) states that an ``individual'' may operate as PIC of
a covered aircraft in accordance with the requirements of FESSA. Thus,
the privileges of this rule are not limited to persons holding a
private pilot certificate; it also applies to persons exercising
student pilot, recreational pilot, and private pilot privileges and to
persons exercising flight instructor privileges when acting as PIC.\6\
Accordingly, Sec. Sec. 61.3 and 61.23 indicate that persons exercising
the privileges of these certificates may act as PIC of an operation
conducted under the conditions and limitations set forth in Sec.
61.113.\7\ However, persons exercising privileges of a student pilot or
recreational pilot certificate must continue to operate consistent with
the limitations on their certificate.\8\ The FAA is therefore adding
new Sec. Sec. 61.89(d) and 61.101(k) to make clear that while
individuals exercising the privileges of a student pilot or
recreational pilot certificates may operate under Sec. 61.113(i), they
must comply with the limitations in Sec. Sec. 61.89 and 61.101, as
applicable, when those limitations conflict with Sec. 61.113(i).
Individuals holding a private pilot certificate issued on the basis of
a foreign pilot license under Sec. 61.75 may also operate under this
rule, provided they meet the requirements of Sec. Sec. 61.23(c)(3) and
61.113(i). However, an individual who is applying for a U.S. private
pilot certificate under Sec. 61.75 is still required to hold a medical
certificate issued under part 67 or a medical license issued by the
country that issued the person's foreign pilot license.\9\ Section 2307
does not apply to persons exercising privileges of a commercial pilot
certificate or an airline transport pilot certificate because section
2307 prohibits operations for compensation or hire.\10\ Persons
exercising privileges of a commercial pilot or ATP certificate must
continue to hold a first or second class medical certificate in
accordance with Sec. 61.23(a)(1) and (2).
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\6\ The FAA has found that, in conducting flight training, the
PIC is not carrying passengers or property for compensation or hire,
nor is acting as PIC of an aircraft for compensation or hire. Final
Rule, ``Pilot, Flight Instructor, Ground Instructor, and Pilot
School Certification Rules,'' 62 FR 16220, at 16242 (Apr. 4, 1997).
\7\ Section 61.113(i) contains the operating requirements of
section 2307. Section 61.23(a)(3) requires a person to hold a third
class medical certificate when taking a practical test in an
aircraft for a recreational pilot, private pilot, commercial pilot,
or airline transport pilot certificate, or for a flight instructor
certificate. Accordingly, this rule contains a conforming amendment
to allow these pilots to operate under the conditions and
limitations of Sec. 61.113(i) when taking a practical test.
\8\ Section 61.89 contains the general limitations of a student
pilot. Section 61.101 contains the privileges and limitations for
recreational pilots.
\9\ Under Sec. 61.75(b), a person who holds a foreign pilot
license issued by a contracting State to the Convention on
International Civil Aviation may be issued a U.S. private pilot
certificate based on the foreign pilot license without any further
showing of proficiency, provided the applicant meets the
requirements of Sec. 61.75. One of these requirements is to hold a
medical certificate issued under part 67 or a medical license issued
by the country that issued the person's foreign pilot license. 14
CFR 61.75(b)(4).
\10\ The FAA notes that Sec. 61.113 provides that certain
activities conducted by a private pilot acting as PIC are excepted
from the general prohibition on operations conducted for
compensation or hire. These activities are listed in Sec.
61.113(b)-(h). Although the FAA considers these activities to be
operations involving compensation or hire, the compensation or hire
exceptions for these operations permit these operations to be
conducted under this rule.
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B. Valid Driver's License (Sec. 61.23(c)(1) and (c)(3))

Section 2307(a)(1) of FESSA requires that, to be eligible to act as
PIC without a medical certificate, an individual possess a valid
driver's license issued by a State, territory, or possession of the
United States and comply with all medical requirements or restrictions
associated with that license. As with other FAA regulations, the FAA
interprets ``valid driver's license'' to mean a current and valid U.S.
driver's license. Each State will determine what, if any, medical
requirements or restrictions are necessary and associated with each
driver's license issued.
The FAA is implementing section 2307(a)(1) by revising Sec.
61.23(c)(1) and by adding new Sec. 61.23(c)(3). The FAA is adding
paragraphs (v) and (vi) to Sec. 61.23(c)(1) to require a person
exercising a student pilot certificate, recreational pilot certificate,
private pilot certificate, or flight instructor certificate (while
acting as the pilot in command or as a required flight crewmember) to
hold and possess either a medical certificate or a driver's license
issued by a State, territory, or possession of the U.S. when operating
under this rule. Additionally, the FAA is adding new Sec. 61.23(c)(3)
to require a person using a U.S. driver's license to meet the
requirements of Sec. 61.23(c)(1) while operating under section 2307 of
FESSA to comply with all medical requirements or restrictions
associated with his or her U.S. driver's license.
The FAA notes that, while some pilots use an official passport as a
valid form of photo identification under Sec. 61.3(a)(2), it does not
meet the requirements of section 2307(a)(1) of FESSA. All pilots,
including pilots who were issued U.S. private pilot certificates in
accordance with Sec. 61.75,

[[Page 3152]]

must hold a U.S. driver's license to operate under this rule. An
international driver's license or any driver's license issued by a
country or territory other than the United States does not suffice to
meet this requirement.
Individuals who do not have a medical certificate and whose
driver's license has been revoked or rescinded for any reason are not
eligible to use this rule, unless and until the driver's license is
reinstated. Any restrictions on a driver's license (e.g., corrective
lenses, prosthetic aids required, daylight driving only) also apply
under this rule.
Since FESSA requires the individual to possess a driver's license,
pilots are required to have the driver's license in their personal
possession when operating using this rule.

C. Medical Certificate Issued by the FAA (Sec. 61.23(c)(3)(i)(B))

Section 2307(a)(2) of FESSA requires that the individual (1) hold a
medical certificate issued by the FAA on the date of enactment of
Public Law 114-190, (2) have held a medical certificate at any point
during the 10-year period preceding the date of enactment, or (3)
obtain a medical certificate after the date of enactment. Because
Public Law 114-190 was signed into law on July 15, 2016,\11\ the FAA
calculates the 10-year period preceding the date of enactment as
beginning on July 15, 2006. Thus, at any point after July 14, 2006, a
person must have held a medical certificate issued under part 67. The
FAA is implementing this requirement in Sec. 61.23(c)(3)(i)(B).
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\11\ Public Law 114-190.
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Consistent with section 2307(a)(3) of FESSA, the medical
certificate required under Sec. 61.23(c)(3)(i)(B) may have been a
first-, second-, or third-class medical certificate, including a
medical certificate issued under an authorization for special issuance
(``special issuance medical certificate'').
A person who has not held a medical certificate at any point after
July 14, 2006, must obtain a medical certificate issued under part 67.
After that medical certificate expires, that person may use, or
continue to use, the alternative pilot physical examination and
education requirements, provided that person meets the other conditions
and limitations.
For individuals relying on an already expired certificate, a person
should use the date that his or her most recent medical certificate
expired to determine whether it meets the 10-year period look-back
described in FESSA. Special-issuance medical certificates are always
time-limited and will explicitly state the date when the certificate
expires or is no longer valid. Therefore, any special-issuance medical
certificate with an expiration date on or after July 15, 2006, would
meet the 10-year look-back requirement.
Unrestricted (``regular issuance'') medical certificates do not
list a specific expiration date. Therefore, persons with an
unrestricted FAA medical certificate should refer to the ``Date of
Examination'' displayed on the certificate, and then use Sec. 61.23(d)
to determine when it expired for operations requiring a third-class
medical certificate.\12\ The expiration date is based on a person's age
on the date of the examination as calculated from his or her date of
birth (i.e., ``under age 40'' vs. ``age 40 and over''). For example, a
person born on January 2, 1963 would be ``under age 40'' if the date of
examination was January 1, 2003, but would be ``age 40 and over'' if
the examination occurred one day later on January 2, 2003. The FAA
advises individuals to carefully review Sec. 61.23(d), which specifies
the duration of medical certificates.\13\
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\12\ The FAA notes that a first or second class medical
certificate lapses into a third class medical certificate when it
exceeds the duration period for first or second class medical
certificates under Sec. 61.23(d). For example, for a pilot under
the age of 40, a first class medical certificate expires on the 12th
month after the month of the date of examination shown on the
medical certificate. Upon the date of expiration for a first class
medical certificate, the certificate would lapse into a third class
medical certificate.
\13\ On July 24, 2008, the FAA published a final rule,
``Modification of Certain Medical Standards and Procedures and
Duration of Certain Medical Certificates,'' that extended the
duration of certain medical certificates (73 FR 43059). Before the
2008 final rule, first-class medical certificates had a maximum
duration of 6 months, regardless of the person's age, while third-
class medical certificates had a maximum duration of 3 years for
individuals under age 40. With publication of the final rule, the
duration of first- and third-class medical certificates for
individuals under age 40 was extended to 1 year for first-class
medical certificates and 5 years for third-class medical
certificates. For persons over age 40, the duration of first- and
third-class medical certificates remained 6 months and 2 years,
respectively.
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Persons age 40 or over on the date of their examination would meet
the 10-year period described in FESSA if their examination was on or
after July 15, 2004. This date is based on the two-year validity period
for third class medical certificates issued to persons age 40 or over.
Persons under age 40 on the date of their examination would meet the
10-year period described in FESSA if their examination was on or after
July 15, 2003. This date is based on the three-year validity period for
third class medical certificates issued to persons under 40 years of
age that was in effect prior to 2008.\14\
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\14\ Under the 2008 final rule that extended the duration of
third class medical certificates for persons under the age of 40
from three years to five years, the FAA construed the extended
validity period as ``reviving'' expired medical certificates if
those certificates would have been valid under the extended period.
For example, a third-class medical certificate issued in 2004 (four
years before the effective date of the 2008 rule) expired in 2007.
When the 2008 final rule became effective, the FAA applied the new
five-year duration to the expired certificate. Thus, the medical
certificate was revived and remained valid until 2009.
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Individuals operating under this rule are not required to carry or
possess the expired medical certificate when operating under this rule.

D. Requirements of a Medical Certificate (Sec. 61.23(c)(3)(ii) and
(iii))

Section 2307(a)(3) of FESSA requires that the most recent medical
certificate issued by the FAA to the individual: (1) Indicates whether
the certificate is first-, second-, or third-class; (2) may include
authorization for special issuance; (3) may be expired; (4) cannot have
been revoked or suspended; and (5) cannot have been withdrawn.
The requirement that the medical certificate indicate whether the
certificate is first-, second-, or third-class is captured in Sec.
61.23(c)(3)(i)(B), which requires the medical certificate to have been
issued under part 67.\15\ The FAA is implementing the remaining
requirements of section 2307(a)(3) in Sec. 61.23(c)(3)(ii) and (iii).
Accordingly, Sec. 61.23(c)(3)(ii) now states that the most recently
issued medical certificate: (1) May include an authorization for
special issuance; (2) may be expired; and (3) cannot have been
suspended, revoked, or withdrawn.
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\15\ Under part 67, a person may be issued a first-, second-, or
third-class medical certificate.
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Thus, the most recently issued medical certificate, which the
person must have held at any point after July 14, 2006, may have been a
special issuance medical certificate and may be expired. However, it
may not have been suspended or revoked, or in the case of an
authorization for a special issuance (i.e., a restricted medical
certificate), it may not have been withdrawn. Unrestricted medical
certificates can be suspended or revoked if the certificate holder does
not meet the medical standards of part 67 or as the result of
noncompliance with other regulatory requirements. The FAA may also
suspend or revoke a medical certificate on the basis of a reexamination
of that certificate under section 44709 of Title 49 of the United
States Code.
Section 2307 of FESSA states that the medical certificate ``cannot
have been revoked or suspended.'' Accordingly, if

[[Page 3153]]

a person's most recently issued medical certificate has been suspended
or revoked, the person must apply for and be issued a new medical
certificate prior to using the privileges afforded under this rule.
This holds true even if the medical certificate was suspended and
reinstated because FESSA expressly states that the certificate ``cannot
have been . . . suspended.'' \16\ Therefore, if a person's last medical
certificate was under suspension at any point in time that medical
certificate cannot be used for relief under this rule.
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\16\ If a person's medical certificate is suspended, modified,
or revoked under Sec. 67.413(b), that suspension or modification
remains in effect until the person provides the requested
information, history, or authorization to the FAA and until the FAA
determines that the person meets the medical standards set forth in
part 67. 14 CFR 67.413(c).
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Further, if the person's medical certificate expired while under
suspension, the person must apply for and be issued a new medical
certificate to use the privileges of this rule. This requirement is
based on the language in FESSA stating that the certificate ``cannot
have been suspended.'' The fact that the certificate expired while
under suspension does not change the fact that it was suspended (for
purposes of exercising relief under this rule).
Finally, Sec. 2307 requires that the most recently issued medical
certificate ``cannot have been withdrawn.'' The FAA notes that
unrestricted medical certificates may be denied, suspended, or revoked
and authorizations for special issuances (i.e., restricted medical
certificates) may be denied or withdrawn. Accordingly, the requirement
that the most recently issued authorization for special issuance cannot
have been withdrawn is implemented in Sec. 61.23(c)(3)(iii).

E. Application for an Airman Medical Certificate (Sec.
61.23(c)(3)(iv))

Section 2307(a)(4) of FESSA requires that the most recent
application for airman medical certification submitted to the FAA by
the individual cannot have been completed and denied. The FAA is
implementing this requirement in Sec. 61.23(c)(3)(iv).
Consistent with the Guide for Aviation Medical Examiners and online
information on the Aerospace Medical Certification Subsystem (AMCS),
the FAA considers an application to be completed once the AME imports
the individual's MedXPress application data into AMCS.\17\ If an
individual submits a MedXpress application but the information is never
imported into AMCS by an AME (e.g., the individual never makes an
appointment or does not show up for the appointment), then the un-
imported application would not be completed and, as such, the FAA would
have no basis to make a denial or other certification action.\18\
Therefore, any un-imported application would not be subject to the
portion of section 2307 relating to ``completed and denied''
applications, and the individual would look to the most recent
application where the FAA either issued or denied a medical certificate
in order to determine eligibility under this rule.
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\17\ ``Information for Aviation Medical Examiners Processing
MedXPress Applications'' instructs AMEs that ``MedX applications
must be imported before the applicant leaves your [the AME's]
office'' and ``As soon as you [the AME] import an application into
AMCS, it is a signed FAA form and should be treated accordingly.''
(https://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/media/MedXPress%20AME%20Procedures_Jan%202012.pdf.)
\18\ When an individual does not follow up a MedXPress
application by presenting to an AME for an examination, the data
entered through MedXPress system remains valid for 60 days, after
which the application expires and is deleted from the MedXPress
system. (https://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/media/MedXPress%20AME%20Procedures_Jan%202012.pdf.)
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After importing a MedXPress application into AMCS, the AME may take
one of three actions on the completed application. The AME may: (1)
Issue a medical certificate; (2) defer issuance to the FAA; or (3) deny
the issuance of a medical certificate. Guidance to AMEs makes clear
that once the AME has imported the individual's application in
MedXpress, the AME is required to transmit the application to the
FAA,\19\ regardless of whether (a) the applicant leaves the AME office
in the middle of the examination, (b) all elements of the AME's
examination have been accomplished, or (c) the applicant does/does not
provide all additional information required by the AME or the FAA.\20\
Whenever an AME defers an examination, the FAA makes a determination on
that application (denial or issuance).
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\19\ The AME Guide states that all completed applications and
medical examinations, unless otherwise directed by the FAA, must be
transmitted electronically via AMCS within 14 days after completion
to the AMCD (https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/general/disposition/.
\20\ The AME Guide states that, when an applicant is advised by
an Examiner that further examination and/or medical records are
needed, the applicant may elect not to proceed. The Examiner is
directed to note this in Block 60 [of the FAA form 8500-8,
Application for medical certificate]. No certificate should be
issued, and the Examiner should forward the application form to the
AMCD, even if the application is incomplete. (https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/app_review/item62/.)
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An individual's application is considered completed and denied and
that individual is unable to use the privileges of this rule when:
(1) An AME denies an application immediately after completing the
examination and the FAA does not reverse that decision.
(2) The FAA denies the application after the applicant has been
deferred by the AME.
(3) A denied application remains under judicial appeal (e.g., to
the National Transportation Safety Board), since no valid medical
certificate has been issued.
Additionally, if a person held a medical certificate within the 10-
year period preceding July 15, 2016, but subsequently submitted a new
application that was completed and denied, that person could not revert
to the previous medical certificate meeting the 10-year look back
requirement. That person would need to re-apply and be issued a new
medical certificate to use the privileges of this rule.

F. Completion of Medical Education Course (Sec. 61.23(c)(3)(i)(C))

Section 2307(a)(5) of FESSA requires the individual to have
completed a medical education course during the 24 calendar months
before acting as pilot in command of a covered aircraft and demonstrate
proof of completion of the course. The FAA notes that section 2307(c)
prescribes the medical education course requirements, which are
implemented in new part 68 and discussed in section VI of this
preamble.
Section 61.23(c)(3)(i)(C) implements the requirement to have
completed the medical education course during the 24 calendar months
before acting as PIC of an operation under Sec. 61.113(i).\21\ The
term ``24 calendar months'' as used throughout 14 CFR means ``24 unit
months,'' and ``unit months'' is defined as beginning on the first of
the month and ending on the last day of the month.\22\ Thus, a pilot
has from the beginning of the 24th calendar month before the month in
which he or she wants to act as PIC of an operation under Sec.
61.113(i) to complete the medical education course. For example, if a
pilot wants to act as PIC of an operation under Sec. 61.113(i) on
August 19, 2019, that pilot must have, since August 1, 2017, completed
the medical education course.
---------------------------------------------------------------------------

\21\ Section 61.113(i) implements the operating requirements of
section 2307 of the Act.
\22\ Legal Interpretation to Mr. Sean Conlin (Feb. 24, 2000).

---------------------------------------------------------------------------

[[Page 3154]]

G. Care and Treatment by a Physician (Sec. 61.23(c)(3)(i)(E))

Section 2307(a)(6) of FESSA requires that the individual, when
serving as PIC, is under the care and treatment of a physician if the
individual has been diagnosed with any medical condition that may
impact the ability of the individual to fly. This requirement is
implemented in Sec. 61.23(c)(3)(i)(E).

H. Receipt of Medical Exam During the Previous 48 Months (Sec.
61.23(c)(3)(i)(D))

Section 2307(a)(7) of FESSA requires the individual to have
received a comprehensive medical examination from a State-licensed
physician during the previous 48 months. This requirement is
implemented in Sec. 61.23(c)(3)(i)(D). The FAA notes that section
2307(a)(7) contains additional requirements regarding the comprehensive
medical examination. Those additional requirements are implemented in
new part 68 and discussed in section VII of this preamble.
In implementing section 2307(a)(7), the FAA notes that section
2307(a)(5) uses the term ``calendar months'' and section 2307(a)(7)
uses the term ``months.'' As evident from a legal interpretation issued
on February 24, 2000,\23\ the FAA interprets the terms ``calendar
months'' and ``months'' differently. The term ``calendar months'' means
``unit months,'' as previously discussed, which is defined as beginning
on the first day of the month and ending on the last day of the month.
The term ``months,'' however, means months from the exact date at
issue. For example, under Sec. 61.23(c)(3)(i)(D), if an individual
wants to act as PIC of an operation under Sec. 61.113(i) on July 19,
2021, that individual must have received a comprehensive medical
examination on or after July 19, 2017.
---------------------------------------------------------------------------

\23\ Id.
---------------------------------------------------------------------------

V. Covered Aircraft Requirements and Operating Requirements

Section 2307(j) of FESSA contains the covered aircraft requirements
and section 2307(a)(8) contains the operating requirements. The FAA is
implementing these requirements in new Sec. 61.113(i).\24\ The
following sections discuss the FAA's implementation of the covered
aircraft and operating requirements in more detail.
---------------------------------------------------------------------------

\24\ Section 61.113 currently addresses private pilot privileges
and limitations.
---------------------------------------------------------------------------

A. Covered Aircraft Requirements of Section 2307 of FESSA

Throughout section 2307, FESSA refers to a ``covered aircraft.''
Section 2307(j) of FESSA defines a covered aircraft as an aircraft that
(1) is authorized under Federal law to carry not more than 6 occupants;
and (2) has a maximum certificated takeoff weight of not more than
6,000 pounds.
The FAA is implementing these requirements for type certificated
aircraft in Sec. 61.113(i)(1). For type certificated aircraft, the
aircraft's design approval would authorize the number of occupants the
aircraft may carry and would contain the maximum certificated takeoff
weight. The aircraft's design approval may be a type certificate (TC),
a supplemental type certificate (STC), or an amended type certificate
(ATC). The FAA recognizes that changes could be made to an aircraft's
type design. For example, an aircraft type certificated to carry more
than 6 occupants may be altered to carry 6 or less occupants. In order
to make such a change, that aircraft would have to obtain a new design
approval, such as an STC or an ATC. So long as an aircraft's design
approval (i.e., TC, STC, or ATC) authorizes the aircraft to carry no
more than 6 occupants, that aircraft would meet the requirement of
section 2307(j)(1). Additionally, if an aircraft with a maximum
certificated takeoff weight of more than 6,000 pounds is altered to
have a maximum certificated takeoff weight of less than 6,000 pounds,
that aircraft would meet the requirement of section 2307(j)(2).
The FAA is implementing the requirements of section 2307(j) for
experimental aircraft by adding paragraph (j) to Sec. 91.319.
Experimental aircraft, which are not type certificated, are issued
special airworthiness certificates. The FAA prescribes operating
limitations to accompany the special airworthiness certificates.
Additionally, Sec. 91.319 prescribes operating limitations for
aircraft having experimental certificates. Consistent with section
2307(j) of FESSA, Sec. 91.319(j) states that no person may operate an
aircraft that has an experimental certificate under Sec. 61.113(i)
unless the aircraft is carrying not more than 6 occupants. The FAA is
adding this paragraph to make clear that experimental aircraft meet the
requirements for covered aircraft under this rule.
The FAA notes that the maximum takeoff weight of an experimental
aircraft is determined as part of the special airworthiness
certification process. Prior to issuing a special airworthiness
certificate, the FAA checks the current weight and balance information
for an aircraft, which includes the maximum gross weight established by
the operator.
While a person may operate an aircraft that meets the requirements
of section 2307(j) under this rule, the FAA notes that section 2307
does not relieve an aircraft from the requirement to be operated in
accordance with its operating limitations.\25\ Accordingly, if an
aircraft being operated under this rule has any operating limitations
that conflict with Sec. 61.113(i),\26\ that aircraft must comply with
its operating limitations.
---------------------------------------------------------------------------

\25\ 14 CFR 91.9(a).
\26\ As noted previously, Sec. 61.113(i) implements the covered
aircraft requirements and operating requirements of the Act.
---------------------------------------------------------------------------

B. Operating Requirements of Section 2307 of FESSA

Section 2307(a)(8) of FESSA requires that the individual operate in
accordance with the following operating requirements:
The covered aircraft is carrying not more than 5
passengers.
The individual is operating the covered aircraft under
visual flight rules or instrument flight rules.
The flight, including each portion of that flight, is not
carried out--
for compensation or hire, including that no passenger or
property on the flight is being carried for compensation or hire;
at an altitude that is more than 18,000 feet above mean
sea level;
outside the United States, unless authorized by the
country in which the flight is conducted; or
at an indicated airspeed exceeding 250 knots.
The following sections discuss the FAA's implementation of these
requirements in more detail.
1. The Covered Aircraft Is Carrying Not More Than 5 Passengers
Section 2307(a)(8)(A) of FESSA requires that the covered aircraft
carry no more than five passengers. This requirement is implemented in
Sec. 61.113(i)(1).
As previously discussed, section 2307(j) of FESSA requires the
covered aircraft to be authorized to carry no more than six occupants.
While section 2307(j) and section 2307(a)(8)(A) may appear to conflict,
the FAA notes that it interprets the terms ``occupants'' and
``passengers'' differently. The term ``occupants'' includes all persons
onboard an aircraft including any required flightcrew members.\27\ A
flightcrew member is required if he or she is required by type
certification of the aircraft or by regulation. The term

[[Page 3155]]

``passengers'' does not include required flight crewmembers. Therefore,
under this rule, a covered aircraft may be authorized to carry up to 6
occupants (including any required flight crewmembers) and may be
operated with up to five passengers on board. For example, a person may
operate an aircraft type certificated for one pilot flightcrew member
under this rule with up to five additional occupants on board. An
aircraft type certificated for two pilot flightcrew members may be
operated under this rule with up to four additional occupants on
board.\28\ An occupant in the aircraft (other than the pilot operating
under this rule) may be a passenger, a required pilot flightcrew member
(if the aircraft is type certificated for more than one pilot or if the
regulations require more than one pilot), or a flight instructor (if
the flight is a training operation). If a pilot operating an aircraft
under this rule carries another pilot on board who is not a required
pilot flightcrew member, that additional pilot would be a passenger
under the FAA's regulations.
---------------------------------------------------------------------------

\27\ A flightcrew member means a pilot, flight engineer, or
flight navigator assigned to duty in an aircraft during flight time.
14 CFR 1.1
\28\ An operation requiring two pilots could not carry five
passengers under Sec. 2307(a)(8)(A) because it would exceed the
number of occupants allowed under Sec. 2307(j). The FAA considers
that, due to the limitations for maximum certificated takeoff
weight, all, or nearly all, covered aircraft will require only a
single pilot.
---------------------------------------------------------------------------

The operations under this rule include training operations. As
such, a person may receive flight training from an FAA-authorized
flight instructor while the person receiving flight training is acting
as PIC and operating under this rule. Alternatively, an individual may
receive flight instruction from a flight instructor while the flight
instructor is acting as PIC and operating under this rule.
This rule is applicable only to the person acting as the PIC. Thus,
for any flight operated under this rule, the status of the medical
certificate of any other pilot aboard who is not acting as the PIC is
irrelevant. For example, flight instructors meeting the requirements of
this rule may act as PIC while giving flight training without holding a
medical certificate, regardless of whether the person receiving flight
training holds a medical certificate. While flight training for
compensation is considered ``other commercial flying'' for flight and
duty requirements under parts 121 and 135,\29\ ``a certificated flight
instructor who is acting as PIC and is receiving compensation for his
or her flight instruction is exercising flight instructor privileges
for the flight training being provided and is exercising private pilot
privileges while acting as PIC of the flight.'' \30\
---------------------------------------------------------------------------

\29\ Legal Interpretation to Richard Martindell (March 11,
2009); Legal Interpretation to Arturo Rodriguez (July 2, 2012).
\30\ Pilot, Flight Instructor, Ground Instructor, and Pilot
School Certification Rules, 62 FR 16220 (Apr. 4, 1997).
---------------------------------------------------------------------------

2. Operate the Aircraft Under Visual Flight Rules or Instrument Flight
Rules
Section 2307(a)(8)(B) of FESSA permits an operation under that
section to be conducted under visual flight rules or instrument flight
rules. An individual operating under this rule may, therefore, conduct
the flight in visual meteorological conditions or instrument
meteorological conditions. The FAA notes, however, that FESSA does not
relieve an individual from the requirement to hold an instrument rating
and be instrument current to act as PIC under instrument flight rules.
Nor does FESSA relieve an aircraft from the requirement to be approved
for IFR operations in order to be operated under instrument flight
rules.
3. The Flight, Including Each Portion of the Flight
Section 2307(a)(8)(C) requires that the flight, including each
portion of the flight, is not carried out: (i) For compensation or
hire, including that no passenger or property on the flight is being
carried for compensation or hire; (ii) at an altitude that is more than
18,000 feet above mean sea level; (iii) outside the United States,
unless authorized by the country in which the flight is conducted; or
(iv) at an indicated air speed exceeding 250 knots.
Because the statute includes the phrase ``. . . flight, including
each portion of the flight,'' all of the limitations for the operation
set forth in section 2307(a)(8)(C)(i)-(iv) (i.e. compensation/hire
prohibition, altitude, geographic, and airspeed limitations) apply to
the entire flight. Accordingly, if this rule is being exercised in any
flight, it must be applied for the entire flight (takeoff to full-stop
landing) and all the operational restrictions apply for the entire
flight. The FAA is implementing the requirements of section
2307(a)(8)(C)(i)-(iv) in Sec. 61.113(i)(2)(i)-(iv). These requirements
are discussed in more detail below.
i. Flight Is Not Conducted for Compensation or Hire
Section 2307(a)(8)(C)(i) of FESSA requires that the flight,
including each portion of that flight, is not carried out for
compensation or hire, including that no passenger or property on the
flight is being carried for compensation or hire. Section 61.113(a)
already prohibits private pilots from acting as PIC of an aircraft that
is carrying passengers or property for compensation or hire and from
acting as PIC for compensation or hire. Accordingly, this FESSA
requirement is already addressed by the existing regulation.
ii. Altitude Restriction
Section 2307(a)(8)(C)(ii) of FESSA requires that the flight,
including each portion of that flight, is not carried out at an
altitude that is more than 18,000 feet above mean sea level (MSL). This
requirement is implemented in Sec. 61.113(i)(2)(ii).
For pilots operating aircraft capable of flight above 18,000 feet
MSL, the pilot's preflight planning must accommodate the altitude
limitation. For instance, if weather phenomena like icing or
thunderstorms are forecast (or is within reasonable possibility) within
the pilot's route of flight that would necessitate climbing above
18,000 feet MSL, the FAA considers initiating such a flight to be
contrary to this rule. The aircraft must operate at or below 18,000
feet MSL during the entire flight.
iii. Geographic Restriction
Section 2307(a)(8)(C)(iii) of FESSA requires that the flight,
including each portion of that flight is conducted within the United
States, unless authorized by the country in which the flight is
conducted. This requirement is implemented in Sec. 61.113(i)(2)(iii).
Title 14 CFR 1.1 defines the United States as the States, the
District of Columbia, Puerto Rico, and the possessions, including the
territorial waters, and the airspace of those areas. Thus, a pilot
operating in the United States, as defined in Sec. 1.1, may elect to
use this rule.
Airmen certificated by the FAA are represented to the International
Civil Aviation Organization (ICAO) as compliant with ICAO standards for
private pilots, among other requirements. As FESSA and this final rule
describe standards that divert from ICAO requirements,\31\ flights must
be geographically limited to operations within the United States.
---------------------------------------------------------------------------

\31\ Annex 1 to the Convention on International Civil Aviation,
``Personnel Licensing,'' Chapter 6 ``Medical Provisions for
Licensing,'' 11th Edition (July 2011).
---------------------------------------------------------------------------

iv. Airspeed Restriction
Section 2307(a)(8)(C)(iv) of FESSA requires that the flight,
including each portion of that flight, is conducted at an indicated
airspeed not exceeding 250 knots. The FAA is implementing this
requirement in Sec. 61.113(i)(2)(iv).

[[Page 3156]]

Recognizing that many aircraft have airspeed indicators that read
in miles per hour (mph), 250 knots is equivalent to 288 mph. No
aircraft may be operated in any phase of flight at an airspeed greater
than 250 KIAS (knots indicated airspeed).

VI. Medical Education Course Requirements of Section 2307 of FESSA

The following sections describe the medical education course
requirements of section 2307 of FESSA and the FAA's implementation of
those requirements.

A. Development and Availability of the Medical Education Course

Section 2307(c)(1) requires the medical education course to be
available on the internet free of charge. Section 2307(c)(2) requires
the course to be developed and periodically updated in coordination
with representatives of relevant nonprofit and not-for-profit general
aviation stakeholder groups.
To implement these requirements, the FAA will work with nonprofit
and not-for-profit general aviation stakeholder groups to coordinate
and develop a medical education course that meets the requirements of
FESSA, which are discussed in more detail below. A nonprofit or not-
for-profit general aviation stakeholder group may submit a medical
education course to the FAA for consideration. Upon receipt of the
submission, the FAA will verify the course meets the requirements of
Sec. 68.3. If the FAA accepts the course, the FAA will provide a link
to the course on the FAA public Web site. Thus, for public awareness,
the FAA's Web site will contain a list of each medical education course
that the FAA has accepted.
The FAA has determined that it is appropriate to enter into
agreements with nonprofit or not-for-profit general aviation
stakeholder groups who elect to provide the course.

B. Course Requirements

Pursuant to the requirements of section 2307(c)(3) through (9) of
FESSA, the course must:
Educate pilots on conducting medical self-assessments;
Advise pilots on identifying warning signs of potential
serious medical conditions;
Identify risk mitigation strategies for medical
conditions;
Increase awareness of the impacts of potentially impairing
over-the-counter and prescription drug medications;
Encourage regular medical examinations and consultations
with primary care physicians;
Inform pilots of the regulations pertaining to the
prohibition on operations during medical deficiency and medically
disqualifying conditions; and
Provide the checklist developed by the Federal Aviation
Administration in accordance with section 2307(b).
The FAA is implementing these requirements in Sec. 68.3(a)(1)-(7).
The FAA notes that the requirements for the checklist, which the course
must provide, are implemented in Sec. 68.5.

C. Documents the Course Must Provide to the Individual and Transmit to
the FAA

Pursuant to the requirements of section 2307(c)(10) of FESSA, upon
successful completion of the course, the medical education course must
electronically provide to the individual and transmit to the FAA--
A certification of completion of the medical education
course;
A release authorizing the National Driver Register through
a designated State Department of Motor Vehicles to furnish to the FAA
information pertaining to the individual's driving record;
A certification by the individual that the individual is
under the care and treatment of a physician if the individual has been
diagnosed with any medical condition that may impact the ability of the
individual to fly;
A form that includes information regarding the individual,
the physician, the comprehensive medical exam, and a certification by
the individual that the checklist was followed and signed by the
physician; and
A statement signed by the individual certifying that the
individual understands the existing prohibition on operations during
medical deficiency. A copy of this signed statement must be provided to
the pilot and retained by the pilot.
These requirements are implemented in Sec. 68.3(b)(1)-(5) and are
discussed in more detail below.
1. Certification of Completion
Section 2307(c)(10)(A) requires the certification of completion of
the medical education course to be printed and retained in the
individual's logbook and made available upon request. This
certification of completion must contain only the individual's name,
address, and airman certificate number.\32\ The FAA is implementing
this requirement in Sec. 68.3(b)(1).
---------------------------------------------------------------------------

\32\ The term ``certification'' was used in the legislation. The
FAA notes that this term may cause confusion with the general use of
that term within FAA regulations. This document need only contain
the information required by FESSA as set forth in Sec. 68.3(b)(1).
---------------------------------------------------------------------------

The PIC must maintain the certification of completion along with
his or her pilot logbook. The certification must be available along
with the logbook at any time the pilot is presenting the logbook to
comply with any regulatory requirement (such as applying for a
certificate or rating), or upon request by a representative of the FAA
Administrator. Under the terms of FESSA, there is no requirement for
pilots to carry compliance documentation that shows their compliance
with the relief described in this rule.
The FAA recognizes that many pilots maintain logbooks
electronically. Pilots may carry an electronic facsimile or
representation of the certification along with their pilot logbook
entries, as long as that representation of the certification is
available and clearly legible when the logbook is being used to comply
with a regulatory requirement or upon request by a representative of
the FAA Administrator.
2. Authorization for Access to National Driver Register
Section 2307(c)(10)(B) requires a release authorizing the National
Driver Register through a designated State Department of Motor Vehicles
to furnish to the FAA information pertaining to the individual's
driving record. Section 2307(d) states that the authorization under
section 2307(c)(10)(B) shall be an authorization for a single access to
the information contained in the National Driver Register. The FAA is
implementing these requirements in Sec. 68.3(b)(2).
The National Driver Register (NDR) is a division in the National
Center for Statistics and Analysis under the National Highway Traffic
Safety Administration (NHTSA). The NDR maintains the computerized
database known as the Problem Driver Pointer System (PDPS), which
contains information on individuals whose privilege to operate a motor
vehicle has been revoked, suspended, canceled or denied or who have
been convicted of serious traffic-related offenses.
Each time an individual indicates his or her consent for the NDR
release, the FAA will conduct a single NDR check in an identical manner
to the NDR check currently conducted when a person applies for a
medical certificate. Similarly, the information the FAA receives from
the NDR check will be used in the same way as for an applicant for a
medical certificate.

[[Page 3157]]

3. Certification That the Individual Is Under the Care and Treatment of
a Physician
Section 2307(c)(10)(C) requires a certification by the individual
that the individual is under the care and treatment of a physician if
the individual has been diagnosed with any medical condition that may
impact the ability of the individual to fly, as required by section
2307(a)(6).\33\ This requirement is implemented in Sec. 68.3(b)(3).
---------------------------------------------------------------------------

\33\ Section 2307(a)(6) requires the individual, when serving as
PIC, to be under the care and treatment of a physician if the
individual has been diagnosed with any medical condition that may
impact the ability of the individual to fly. This requirement is
implemented in Sec. 61.23(3)(i)(E).
---------------------------------------------------------------------------

The FAA recognizes that there are many thousands of diagnosable
medical conditions, as well as innumerable medical treatments and
medications. Many conditions, treatments, or medications are unlikely
to impact a person's ability to safely operate an aircraft. However,
there are numerous conditions, treatments, and medications that are
aviation safety risks. Potential adverse effects may result from sudden
incapacitation (e.g., epilepsy, coronary artery disease, implantable
cardioverter-defibrillators, etc.) or reduced cognitive, mental or
physical abilities (e.g., visual impairments, neurological diseases,
psychiatric diseases, diabetes or other metabolic diseases, sedative-
hypnotic medications, etc.). Each of these, independently or in
combination, can adversely affect the pilot's ability to safely perform
pilot duties and are a hazard to the national air space. Additionally,
the adverse effects of many medical conditions and medications are
exaggerated under typical flight conditions, including reduced air
pressure, available oxygen, or acceleration forces. Pilots should
consult with their physician or other medical care provider for care
and treatment of their conditions, but also for guidance on the impact
their conditions may have on flight safety. Pilots, in discussion with
their physician/medical care provider, should also consult available
aeromedical resources on the flight hazards associated with medical
conditions/medications. The Do not Issue/Do not Fly list (www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/) is readily available in the AME Guide on the FAA Web site.
Chapter 8 of the FAA's Aeronautical Information Manual (AIM 8-1-1) also
addresses medical factors for pilots. Additional resources include the
FAA's AME Guide, other FAA flight safety Web sites, and the Web sites
of non-profit and not-for-profit general aviation stakeholders.
While the pilot is required to attest that he or she is under the
care and treatment of a physician for any condition that affects safe
flight, the FAA emphasizes that all pilots are expected to exercise
good judgment (whether operating under this rule or not) and conduct a
personal self-assessment of their condition before every flight.\34\
The FAA's recommended self-assessment guidance is found in the
``IMSAFE'' checklist found in Chapter 8 of the FAA Aeronautical
Information Manual at https://www.faa.gov/air_traffic/publications/media/aim.pdf.
---------------------------------------------------------------------------

\34\ Section 61.53(c) requires that for operations provided for
in Sec. 61.23(c), a person must meet the provisions of Sec.
61.53(b). That paragraph states that a person shall not act as pilot
in command, or in any other capacity as a required pilot flight
crewmember, while that person knows or has reason to know of any
medical condition that would make the person unable to operate the
aircraft in a safe manner.
---------------------------------------------------------------------------

The FAA notes that under section 2307(e) of FESSA, which prescribes
requirements for the special issuance process, an individual clinically
diagnosed with a mental health condition or a neurological condition
shall certify every 2 years,\35\ in conjunction with the certification
requirement of section 2307(c)(10)(C), that the individual is under the
care of a State-licensed medical specialist for that mental health or
neurological condition.\36\ The requirements for the special issuance
process are discussed in section VIII of this preamble.
---------------------------------------------------------------------------

\35\ The FAA notes that section 2307(e) uses the phrase ``two
years'' when discussing the certifications made as part of the
medical education course, whereas section 2307(c) uses the phrase
``24 calendar months.'' For purposes of these certifications, the
FAA anticipates that the certification will occur in conjunction
with completion of the medical education course.
\36\ Section 2307(e)(3) contains the special rules for mental
health conditions. Section 2307(e)(4) contains the special rules for
neurological conditions.
---------------------------------------------------------------------------

4. Form
Section 2307(c)(10)(D) of FESSA requires the form, which must be
electronically provided to the individual and transmitted to the FAA
upon successful completion of the course, to include the following
information:
The name, address, telephone number, and airman
certificate number of the individual;
The name, address, telephone number, and State medical
license number of the physician performing the comprehensive medical
examination \37\ required in section 2307(a)(7);
---------------------------------------------------------------------------

\37\ The FAA notes that the comprehensive medical examination
occurs every 48 months while the medical education course must be
completed every 24 calendar months. As such, a pilot may be
reporting a medical exam that occurred 24 calendar months prior.
---------------------------------------------------------------------------

The date of the comprehensive medical examination required
in section 2307(a)(7); and
A certification by the individual that the checklist
described in subsection (b) was followed and signed by the physician in
the comprehensive medical examination required in section 2307(a)(7).
These requirements are implemented in Sec. 68.3(b)(4)(i)-(iv).
5. Certification Regarding the Prohibition on Operations During Medical
Deficiency
Section 2307(c)(10)(E) of FESSA requires the individual to sign
\38\ a statement certifying that the individual understands the
existing prohibition on operations during medical deficiency by
stating: ``I understand that I cannot act as pilot in command, or any
other capacity as a required flight crew member, if I know or have
reason to know of any medical condition that would make me unable to
operate the aircraft in a safe manner.'' This statement shall be
electronically provided to the individual and transmitted to the FAA
upon successful completion of the course. The FAA is implementing this
requirement in Sec. 68.3(b)(5).
---------------------------------------------------------------------------

\38\ Section 2307 indicates that the statement should be
``printed and signed'' prior to being transmitted to the FAA. The
FAA is construing this requirement to allow for electronic signature
and electronic retention of this statement. See Government Paperwork
Elimination Act (GPEA), Public Law 105-277 Title XVII.
---------------------------------------------------------------------------

The Advisory Circular (AC) 68-1, Alternative Medical
Qualifications, contains additional information about the medical
education course requirements.

VII. Comprehensive Medical Examination

In order to act as PIC under this rule, an individual must receive
a comprehensive medical examination from a State-licensed physician
during the previous 48 months in accordance with section 2307(a)(7).
This requirement is reflected in Sec. 61.23(c)(3)(i)(D).
Section 2307(a)(7)(A) requires that prior to the examination, the
individual do the following: (1) Complete the individual's section of
the medical examination checklist described in section 2307(b); and (2)
provide the

[[Page 3158]]

completed checklist to the physician performing the examination. The
FAA is implementing these requirements in Sec. 68.5(a)(1)-(2).
Section 2307(a)(7)(B) of FESSA requires the physician to: (1)
Conduct the comprehensive medical examination in accordance with the
checklist; (2) check each item specified during the examination; and
(3) address, as medically appropriate, every medical condition listed
and any medications the individual is taking. The FAA is implementing
these requirements in Sec. 68.5(b)(1)-(3).

VIII. Comprehensive Medical Examination Checklist

A. Checklist Requirements of Section 2307 of FESSA

Section 2307(b)(1) of FESSA requires that the FAA develop a
checklist for an individual to complete and provide to the physician
performing the required comprehensive medical examination.
Section 2307(b)(2) of FESSA requires the checklist to contain three
sections: (1) A section for the individual to complete; (2) a section
with instructions for the individual to provide the completed checklist
to the physician performing the examination; and (3) a section for the
physician to complete, which contains instructions for the physician
performing the examination. Section 2307(b) prescribes requirements for
each of these sections, which are discussed below. The FAA is
implementing the comprehensive medical examination checklist
requirements in Sec. 68.7 and has developed the checklist in
accordance with these requirements.
1. Section for the Individual To Complete
Section 2307(b)(2)(A)(i) of FESSA requires the checklist to contain
a section for the individual to complete, which contains boxes 3
through 13 and boxes 16 through 19 of the FAA form 8500-8, Application
for Airman Medical Certificate (3-99).\39\ This requirement is
implemented in Sec. 68.7(a)(1). The AC contains the specific
information required by boxes 3 through 13 and boxes 16 through 19.
---------------------------------------------------------------------------

\39\ Section 2307 of FESSA specifically references the FAA form
8500-8 revision dated 3-99. The FAA notes that since that revision
the FAA has revised the form several times, most recently with
publication of the final rule Student Pilot Application
Requirements, 81 FR 1292 (Jan. 12, 2016). In accordance with the
requirements of FESSA, the FAA has developed the comprehensive
medical examination checklist using boxes 3-13 and 16-19 as they
appeared on the FAA form 8500-8 revision 3-99.
---------------------------------------------------------------------------

Section 2307(b)(2)(A)(ii) of FESSA requires the checklist to
contain (in the section for the individual) a signature line for the
individual to affirm that:
The answers provided by the individual on that checklist,
including the individual's answers regarding medical history, are true
and complete;
The individual understands that he or she is prohibited
under Federal Aviation Administration regulations from acting as pilot
in command, or any other capacity as a required flight crew member, if
he or she knows or has reason to know of any medical deficiency or
medically disqualifying condition that would make the individual unable
to operate the aircraft in a safe manner; and
The individual is aware of the regulations pertaining to
the prohibition on operations during medical deficiency and has no
medically disqualifying conditions in accordance with applicable law.
The FAA is implementing these requirements in Sec. 68.7(a)(2)(i)-
(iii).
2. Section Containing Instructions for the Individual
Section 2307(b)(2)(B) requires the checklist to contain a section
with instructions for the individual to provide the completed checklist
to the physician performing the comprehensive medical examination. The
FAA is implementing this requirement in Sec. 68.7(b).
3. Section for the Physician To Complete With Instructions for the
Physician
Section 2307(b)(2)(C)(i) of FESSA requires the checklist to include
a section for the physician to complete, that instructs the physician
to perform a clinical examination of the following:
Head, face, neck, and scalp;
Nose, sinuses, mouth, and throat;
Ears, general (internal and external canals), and eardrums
(perforation);
Eyes (general), ophthalmoscopic, pupils (equality and
reaction), and ocular motility (associated parallel movement,
nystagmus);
Lungs and chest (not including breast examination);
Heart (precordial activity, rhythm, sounds, and murmurs);
Vascular system (pulse, amplitude, and character, and
arms, legs, and others);
Abdomen and viscera (including hernia);
Anus (not including digital examination);
Skin;
G-U system (not including pelvic examination);
Upper and lower extremities (strength and range of
motion);
Spine and other musculoskeletal;
Identifying body marks, scars, and tattoos (size and
location);
Lymphatics;
Neurologic (tendon reflexes, equilibrium, senses, cranial
nerves, and coordination, etc.);
Psychiatric (appearance, behavior, mood, communication,
and memory);
General systemic;
Hearing;
Vision (distant, near, and intermediate vision, field of
vision, color vision, and ocular alignment);
Blood pressure and pulse; and
Anything else the physician, in his or her medical
judgment, considers necessary.
The FAA is implementing these requirements in Sec. 68.7(c)(1)(i)-
(xxii).
Section 2307(b)(2)(C)(ii) requires the physician to exercise
medical discretion to address, as medically appropriate, any medical
conditions identified, and to exercise medical discretion in
determining whether any medical tests are warranted as part of the
comprehensive medical examination. The FAA is implementing this
requirement in Sec. 68.7(c)(2).
Section 2307(b)(2)(C)(iii) of FESSA requires the checklist to
instruct the physician to discuss all drugs the individual reports
taking (prescription and nonprescription) and their potential to
interfere with the safe operation of an aircraft or motor vehicle. The
FAA is implementing this requirement in Sec. 68.7(c)(3).
Furthermore, section 2307(b)(2)(C)(iv) of FESSA requires the
checklist to instruct the physician to sign the checklist, stating: ``I
certify that I discussed all items on this checklist with the
individual during 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
examination 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 interfere with the individual's ability to safely
operate an aircraft.'' The FAA is implementing this requirement in
Sec. 68.7(c)(4).
Lastly, section 2307(b)(2)(C)(v) of FESSA requires the checklist to
instruct the physician to provide the date the comprehensive medical
examination was completed, and the physician's full name, address,
telephone number, and State medical license number. This requirement is
implemented in Sec. 68.7(c)(5).
The FAA relies on the determination of each State (as well as each
territory and possession of the United States) as

[[Page 3159]]

to which persons it will license as physicians. If the person holds a
license as a physician issued by any State, territory, or possession,
then he or she meets the requirement as a State-licensed physician. The
FAA notes that all States license medical doctors (M.D.s) and doctors
of osteopathic medicine (D.O.s) as physicians, although Federal and
some State laws may permit the licensure of other persons, such as
doctors of dental surgery (D.D.S.) as physicians. While the FAA expects
that a specialist physician, (e.g., D.D.S., dentist, podiatrist) who
does not also hold an M.D. or D.O. would not have the breadth of
training to conduct a medical exam as required in this rule, the FAA
will rely on each State-licensed physician to determine whether he or
she is qualified to conduct the medical exam required by FESSA.
Existing FAA prohibitions against self-endorsements would apply,
prohibiting a State-licensed physician from conducting the physical
examination on himself or herself.

B. Inclusion of the Completed Checklist in the Pilot's Logbook

Section 2307(b)(3) of FESSA requires that the completed checklist
be retained in the pilot's logbook and be made available upon request.
The FAA is implementing this requirement in Sec. 61.113(i)(3).
The FAA recognizes that many pilots now maintain logbook
information electronically. Similar to the requirements described
previously for the course completion certification described in section
2307(c)(10)(A), the FAA notes that pilots may retain an electronic
version of the completed checklist using whatever method they choose so
long as an accurate electronic or physical representation of the
document can be made available upon request.

C. FAA Implementation of the Comprehensive Medical Examination
Checklist Requirements of Section 2307 of FESSA

Section 2307(c)(9) of FESSA requires the medical education course
to provide the medical examination checklist developed by the FAA. For
purposes of implementation, the FAA will require that any nonprofit or
not-for-profit general aviation stakeholder group that provides a
medical course for this rule make the checklist available at that
group's Web site.
To implement the medical checklist provisions of FESSA, the FAA has
developed the Comprehensive Medical Examination Checklist. The
checklist is a fillable PDF form available on the FAA Web site, in
addition to the location discussed immediately above. Pilots may
complete the form either electronically or may print it out and
complete it. Regardless of how the pilot chooses to complete the form,
the pilot must print the form, sign it, and take it to the State-
licensed physician performing the medical examination. The FAA will
provide the blank Comprehensive Medical Examination Checklist but will
not be collecting and maintaining the checklist in any FAA system of
records. As noted, the pilot will be required to retain the checklist
as one of the items necessary for verification that he or she is
eligible to operate under this rule.

IX. Special Issuance Process

A. Requirements of Section 2307 of FESSA

Section 2307(e)(1) of FESSA states that an individual who has
qualified for the third-class medical certificate exemption under
subsection (a) of section 2307 and is seeking to serve as a PIC of a
covered aircraft shall be required to have completed the process for
obtaining an Authorization for Special Issuance of a Medical
Certificate if that person has any of the following: (1) A mental
health disorder; (2) a neurological disorder; or a (3) cardiovascular
condition.
Section 2307(e)(1)(A) states that a mental health disorder is
limited to an established medical history or clinical diagnosis of:
Personality disorder that is severe enough to have
repeatedly manifested itself by overt acts;
Psychosis, defined as a case in which an individual: (i)
Has manifested delusions, hallucinations, grossly bizarre or
disorganized behavior, or other commonly accepted symptoms of
psychosis; or (ii) may reasonably be expected to manifest delusions,
hallucinations, grossly bizarre or disorganized behavior, or other
commonly accepted symptoms of psychosis;
Bipolar disorder; or
Substance dependence within the previous 2 years, as
defined in Sec. 67.307(a)(4) of title 14, Code of Federal Regulations.
Section 2307(e)(1)(B) states that a neurological disorder is
limited to an established medical history or clinical diagnosis of any
of the following:
Epilepsy.
Disturbance of consciousness without satisfactory medical
explanation of the cause.
A transient loss of control of nervous system functions
without satisfactory medical explanation of the cause.
Section 2307(e)(1)(C) states that a cardiovascular condition is
limited to a one-time special issuance for each diagnosis of the
following:
Myocardial infarction.
Coronary heart disease that has required treatment.
Cardiac valve replacement.
Heart replacement.
The FAA is implementing the requirements of section 2307(e)(1)(A)-
(C) in Sec. 68.9(a)(1)-(3).
1. Special Rule for Cardiovascular Conditions
Section 2307(e)(2) of FESSA states that in the case of an
individual with a cardiovascular condition, the process for obtaining
an Authorization for Special Issuance of a Medical Certificate shall be
satisfied with the successful completion of an appropriate clinical
evaluation without a mandatory wait period.\40\
---------------------------------------------------------------------------

\40\ Current guidance establishes mandatory wait periods for
certain cardiovascular conditions. For example, there is a 3-month
recovery time after a myocardial infarction from non-coronary heart
disease before an applicant may be considered for a medical
certificate. 2016 Guide for Aviation Medical Examiners.
---------------------------------------------------------------------------

The FAA is implementing this requirement in Sec. 68.9(b).
2. Special Rule for Mental Health Conditions
Section 2307(e)(3)(A)(i) of FESSA states that in the case of an
individual with a clinically diagnosed mental health condition, the
ability to operate without a third-class medical certificate under
subsection (a) of section 2307 shall not apply if in the judgment of
the individual's State-licensed medical specialist, the condition: (1)
Renders the individual unable to safely perform the duties or exercise
the airman privileges described in the operating requirements of
subsection (a)(8); or (2) may reasonably be expected to make the
individual unable to perform the duties or exercise the privileges
described in the operating requirements of subsection (a)(8).
Additionally, section 2307(e)(3)(A)(ii) states that in the case of
an individual with a clinically diagnosed mental health condition, the
ability to operate without a third-class medical certificate under
section 2307(a) shall not apply if the individual's driver's license is
revoked by the issuing agency as a result of a clinically diagnosed
mental health condition.
The FAA is implementing section 2307(e)(3)(A)(i)-(ii) in Sec.
68.9(c)(1)(i)-(ii).
Section 2307(e)(3)(B) of FESSA requires that an individual
clinically

[[Page 3160]]

diagnosed with a mental health condition shall certify every 2 years,
in conjunction with the certifications under subsection (c)(10)(C),
that the individual is under the care of a State-licensed medical
specialist for that mental health condition. The FAA is implementing
this requirement in Sec. 68.9(c)(2). This certification will be
incorporated into the medical education course process. The FAA notes
that the certifications required under subsection (c)(10)(C) of FESSA
are implemented in Sec. 68.3(b)(3).
3. Special Rule for Neurological Conditions
Section 2307(e)(4)(A)(i) states that in the case of an individual
with a clinically diagnosed neurological condition, the ability to
operate without a third-class medical certificate under subsection (a)
of section 2307 shall not apply if in the judgment of the individual's
State-licensed medical specialist, the condition: (1) Renders the
individual unable to safely perform the duties or exercise the airman
privileges described in the operating requirements of subsection
(a)(8); or (2) may reasonably be expected to make the individual unable
to perform the duties or exercise the privileges described in the
operating requirements of subsection (a)(8).
Section 2307(e)(4)(A)(ii) states that in the case of an individual
with a clinically diagnosed neurological condition, the ability to
operate without a third-class medical certificate under subsection (a)
of section 2307 shall not apply if the individual's driver's license is
revoked by the issuing agency as a result of a clinically diagnosed
neurological condition.
The FAA is implementing the requirements of section 2307(4)(A) in
Sec. 68.9(d)(1)(i)-(ii).
Section 2307(4)(B) of FESSA requires that an individual clinically
diagnosed with a neurological condition shall certify every 2 years, in
conjunction with the certification under subsection (c)(10)(C), that
the individual is under the care of a State-licensed medical specialist
for that neurological condition. As with the requirements for certain
mental health disorders, this certification will be incorporated into
the medical education course process.
Regarding the certification related to mental health disorders and
neurological disorders, the FAA recognizes that the inclusion of such a
certification could create confusion. So to clarify, the FAA has
written the certifications for the individual to attest (1) that the
individual does not have a mental health disorder or neurological
disorder or, (2) if the individual has a mental health disorder or
neurological disorder, that the individual is under the care of a
State-licensed medical specialist for that mental health condition or
neurological condition. The FAA's intent is to ensure that no medical
information is collected. Rather, the FAA views these certifications as
a place for the individuals to attest that if they have a mental health
or neurological disorder listed in section 2307, then they meet the
section 2307 requirement that they are under the care of a State-
licensed medical specialist for that condition.

B. Special Issuance Medical Certificates

All persons who currently hold an FAA-issued special issuance
medical certificate, or who have held an FAA-issued special issuance
medical certificate within the 10-year period preceding the enactment
of FESSA, for conditions other than the specified cardiovascular,
mental health, and neurological conditions listed in FESSA, may elect
to use this rule. These persons are no longer required to maintain
their special issuance medical certificate if they choose to comply
with the requirements of section 2307 of FESSA. The FAA emphasizes that
it expects all pilots, including persons who hold or have held a
special issuance medical certificate, to comply with care and treatment
protocols recommended by their State-licensed physician.
If a pilot, while using this rule, is diagnosed with a condition
that would have, in the past, required the pilot to be considered for a
special issuance medical certificate, but is not one of the specified
conditions described in FESSA, then that pilot may continue to exercise
the privileges of this rule so long as all other requirements of
section 2307 of FESSA are met.
FESSA prescribes specific responsibilities and prohibitions that
must be met for pilots who have certain cardiovascular, neurological,
or mental health conditions. Persons who have, or are newly diagnosed
with, a cardiovascular, neurological, or mental health condition
described in FESSA, may not use this rule until they have been found
eligible for special issuance of a medical certificate. Once issued a
medical certificate, the person may then use this rule if he or she
meets all other requirements of FESSA.

X. Authority To Require Additional Information

Section 2307(l)(1) of FESSA states that if the Administrator
receives credible or urgent information, including from the National
Driver Register or the FAA Hotline Program, that reflects on an
individual's ability to safely operate a covered aircraft under the
third-class medical certificate exemption in subsection (a) of section
2307, the Administrator may require the individual to provide
additional information or history so that the Administrator may
determine whether the individual is safe to continue operating a
covered aircraft. Section 2307(l)(2) states that the Administrator may
use credible or urgent information received to request an individual to
provide additional information or to take actions under section
44709(b) of title 49, United States Code.
The FAA has implemented the provisions of section 2307(l) in new
Sec. 68.11.

XI. Advisory Circular

To further implement this final rule, the FAA has developed
Advisory Circular 68-1, Alternative Pilot Physical Examination and
Education Requirements. The advisory circular describes the relief and
provides guidance on how to comply with the rule's provisions. It also
includes frequently asked questions and guidance on how a nonprofit or
not-for-profit general aviation stakeholder group can offer an approved
course under this rule.

XII. Section-by-Section Discussion of the Final Rule

In part 61, Certification: Pilots, flight instructors, and ground
instructors, Sec. 61.3, requirement for certificates, ratings, and
authorizations, is revised to add operations conducted under this rule
to the list of exceptions to the requirement to hold a medical
certificate.\41\ Section 61.3 is also amended to add the documents
establishing alternative medical qualification under part 68 to the
list of documents available for inspection under paragraph (l).
---------------------------------------------------------------------------

\41\ The FAA notes that Sec. 61.113(i) contains the operating
requirements for this rule. The FAA also notes that persons
operating under this rule without a medical certificate must hold a
valid U.S. driver's license.
---------------------------------------------------------------------------

Section 61.23, medical certificates: requirement and duration, is
revised to provide an exception for operations conducted under this
rule for persons otherwise required to hold a third-class medical
certificate.
For operations requiring either a medical certificate or U.S.
driver's license, Sec. 61.23(c)(1) is amended to state that a person
must hold and possess either a medical certificate or a U.S. driver's
license when exercising the

[[Page 3161]]

privileges of a student, recreational or private pilot certificate and
operating under this rule, or when exercising the privileges of a
flight instructor certificate and acting as the PIC or as a required
flight crewmember if the flight is conducted under this rule.
The FAA is also adding Sec. 61.23(c)(3), which contains the
requirements for persons using a U.S. driver's license to operate under
this rule.
In Sec. 61.89, the FAA is adding paragraph (d) to allow the holder
of a student pilot certificate to operate under this rule without
holding a medical certificate.
In Sec. 61.101, the FAA is adding paragraph (k) to allow a
recreational pilot to operate under this rule without holding a medical
certificate.
Section 61.113 is revised to add paragraph (i), which contains the
operational requirements of section 2307.
The FAA is adding part 68, Requirements for operating certain small
aircraft without a medical certificate, to title 14 of the Code of
Federal Regulations. Section 68.1 provides the applicability of the
part.
Section 68.3 provides the Medical Education Course Requirements.
Section 68.5 implements the requirements for the Comprehensive
Medical Examination, including the requirements for the physician and
the individual.
Section 68.7 provides the requirements for the Comprehensive
Medical Examination Checklist.
Section 68.9 implements the requirements for the Special Issuance
Process.
Section 68.11 provides the FAA with authority to require additional
information as described in FESSA.
In Sec. 91.319, the FAA is adding paragraph (j) to make clear that
experimental aircraft may operate under the conditions and limitations
of Sec. 61.113(i).

XIII. Regulatory Notices and Analyses

A. Regulatory Evaluation

Changes to Federal regulations must undergo several economic
analyses. First, Executive Order 12866 and Executive Order 13563 direct
that each Federal agency shall propose or adopt a regulation only upon
a reasoned determination that the benefits of the intended regulation
justify its costs. Second, the Regulatory Flexibility Act of 1980 (Pub.
L. 96-354) requires agencies to analyze the economic impact of
regulatory changes on small entities. Third, the Trade Agreements Act
(Pub. L. 96-39 as amended) prohibits agencies from setting standards
that create unnecessary obstacles to the foreign commerce of the United
States. In developing U.S. standards, the Trade Agreements Act requires
agencies to consider international standards and, where appropriate,
that they be the basis of U.S. standards. Fourth, the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104-4) requires agencies to prepare a
written assessment of the costs, benefits, and other effects of
proposed or final rules that include a Federal mandate likely to result
in the expenditure by State, local, or tribal governments, in the
aggregate, or by the private sector, of $100 million or more annually
(adjusted for inflation with base year of 1995). This portion of the
preamble summarizes the FAA's analysis of the economic impacts of this
final rule. We suggest readers seeking greater detail read the full
regulatory evaluation, a copy of which we have placed in the docket for
this rulemaking.
In conducting these analyses, FAA has determined that this final
rule: (1) Has benefits that justify its costs, (2) is not an
economically ``significant regulatory action'' as defined in section
3(f) of Executive Order 12866, (3) is not ``significant'' as defined in
DOT's Regulatory Policies and Procedures; (4) will not have a
significant economic impact on a substantial number of small entities;
(5) will not create unnecessary obstacles to the foreign commerce of
the United States; and (6) will not impose an unfunded mandate on
State, local, or tribal governments, or on the private sector by
exceeding the threshold identified above. These analyses are summarized
below.
Total Benefits and Costs of This Rule

Total Savings and Costs of the Rule
[2017 to 2026]
----------------------------------------------------------------------------------------------------------------

----------------------------------------------------------------------------------------------------------------
SAVINGS COSTS
----------------------------------------------------------------------------------------------------------------
Medical Examination: 3rd Class Medical $290,421,038 Physical Examinations by $262,656,213
Certificates for Pilots Age 40-and-Over. State-Licensed Physician:
Pilots Age 40-and-Over.
Physical Examinations by $3,055,973
State-Licensed Physician:
Special Issuance.
Medical Examination: 3rd Class Medical 90,679,136 Online Training Course....... 42,004,478
Certificates with a Special Issuances.
FAA Savings................................ 1,782,230 NDR Checks................... 7,422,763
Total Savings.......................... 382,882,405 Total Costs.................. 315,139,427
Present Value (7% discount rate)... 272,835,610 Present Value (7% discount 227,799,517
rate).
----------------------------------------------------------------------------------------------------------------
Totals may not add due to rounding.

Who is potentially affected by this Rule?
All pilots with eligible pilot certificates are affected by this
rule. Eligible pilots will need to have held a valid FAA medical
certificate within the 10 years preceding the date of enactment of
FESSA, July 15, 2016, and will need a valid U.S. driver's license.
Assumptions:
Costs and benefits are estimated over 10 years from 2017
through 2026.
Costs and benefits are presented in 2016 dollars.
The present value discount rate of seven percent is used
as required by the Office of Management and Budget.
An FAA medical examination with an AME is approximately
$117.
An FAA follow-up evaluation with an AME is approximately
$58.50.
A pilot's medical examination with a state-licensed
physician is approximately $225.\42\
---------------------------------------------------------------------------

\42\ Four Coding and Payment Opportunities You Might Be Missing,
American Academy of Family Physicians. 2016 May-June;23(3):30-35.
http://www.aafp.org/fpm/2016/0500/p30.html.
---------------------------------------------------------------------------

An annual growth rate of 1.0 percent per year is applied
to hourly

[[Page 3162]]

wages per Department of Transportation Guidance.\43\
---------------------------------------------------------------------------

\43\ 2015 Department of Transportation Value of Travel Time
Guidance; https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

Vehicle operating cost per mile (VOC) as determined by the
Internal Revenue Service (IRS) is $0.19.\44\
---------------------------------------------------------------------------

\44\ Internal Revenue Service (IRS) Standard Mileage Rate for
2016, 0.19 cents per mile driven for medical or moving purposes;
https://www.irs.gov/uac/newsroom/2016-standard-mileage-rates-for-business-medical-and-moving-announced Dec. 17, 2015.
---------------------------------------------------------------------------

The hourly rate of a pilot's travel time (VTTS) as
determined by the Department of Transportation (DOT) is $12.50 in 2013.
This value is augmented by 1.0 percent per year to project future
benefits of travel time saved from 2013 to 2026.\45\
---------------------------------------------------------------------------

\45\ 2015 Departmental Guidance on Valuation of Travel Time in
Economic Analyses; Table 4: Recommended Hourly Values of Travel Time
Savings (Personal category for local surface modes of
transportation). https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

The hourly rate of a pilot's time (VPT) as determined by
DOT is $25.00 in 2013. This value is augmented by 1.0 percent per year
to project the annual growth rate of real median household income from
2013 to 2026.\46\
---------------------------------------------------------------------------

\46\ 2015 Departmental Guidance on Valuation of Travel Time in
Economic Analyses; Table 3: Recommended Hourly Earning Rates for
Determining Values of Travel Time Savings, https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

The FAA assumes 0.5 hours to complete the MedXpress form.
The FAA assumes that the time required to fill out the
MedXpress form will be the same time required to fill out section 1 of
the medical checklist that must be partially completed by the pilot and
taken to the physician.
The FAA assumes 1 hour to complete a medical examination.
The FAA assumes 0.5 hours to complete a follow-up
evaluation.
The value of FAA time to review medical applications per
hour is shown in table 1 and includes fringe benefits for federal
employees.\47\
---------------------------------------------------------------------------

\47\ http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.

Table 1--2016 Weighted Average of Hourly Wage for FAA Employees Reviewing Applications for Medical Certificates
----------------------------------------------------------------------------------------------------------------
Wages with Number of
benefits people
A b a x b
----------------------------------------------------------------------------------------------------------------
Legal instrument examiners \48\................................. $50.46 42 $2,119
Regional Flight Surgeons \49\................................... 139.59 9 1,256
Senior Executives \50\.......................................... 139.59 3 419
Civil Aerospace Medicine Institute (CAMI) Medical Officers \51\. 139.59 6 838
Civil Aerospace Medicine Institute (CAMI) Physicians \52\....... 139.59 3 419
Total....................................................... .............. 63 5,051
Weighted Average Wage Rate = $5,051/63.................. .............. .............. 80.17
----------------------------------------------------------------------------------------------------------------
Totals may not add due to rounding.

Benefits of this Rule
---------------------------------------------------------------------------

\48\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf ; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
\49\ SALARY TABLE NO. 2016-ES plus fringe benefits; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/ES.pdf, Agencies with a Certified SES Performance
Appraisal System Maximum; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
\50\ SALARY TABLE NO. 2016-ES plus fringe benefits; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/ES.pdf, Agencies with a Certified SES Performance
Appraisal System Maximum; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
\51\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
\52\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf ; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
---------------------------------------------------------------------------

The FAA estimates potential savings to pilots, based on age and a
pilot's medical condition, from eliminating medical examinations with
an AME. The elimination of these examinations will save pilots the time
to complete the online medical application (MedXpress), travel time to
the medical examination, the time required to complete the medical
examination, vehicle operating costs based on miles traveled to the
examination, and the cost of the medical examination. For pilots with
special-issuances, the FAA anticipates added savings by eliminating
follow-up medical evaluations, determined by their medical condition,
with an AME. Additionally, the FAA will save time by reducing the
number of applications reviewed for special-issuance medical
certificates. Total savings are estimated at $382.9 million ($272.8
million at a 7 percent present value) over 10 years.
Costs of this Rule
Costs for this rule are attributed to the physical examination
completed by a State-licensed physician every 48 months, the medical
education course that pilots will complete every 24 calendar months,
and an increase in NDR checks for pilots under age 40 with a special
issuance medical certificate. Unlike pilots 40 years of age and older,
who the FAA expects will benefit from the elimination of the AME
examinations, the FAA expects the savings to pilots under 40 years of
age will only occur for those pilots requiring Authorization for a
special issuance medical certificate. Total costs are estimated at
$315.1 million ($227.8 million at a 7 percent present value) over 10
years.
Overall, the rule results in a net benefit of $67.7 million over 10
years.

B. Regulatory Flexibility Determination

The Regulatory Flexibility Act of 1980 (Pub. L. 96-354) (RFA)
establishes ``as a principle of regulatory issuance that agencies shall
endeavor, consistent with the objectives of the rule and of applicable
statutes, to fit regulatory and informational requirements to the scale
of the businesses, organizations, and governmental jurisdictions
subject to regulation. To achieve this principle, agencies are required
to solicit and consider flexible regulatory proposals

[[Page 3163]]

and to explain the rationale for their actions to assure that such
proposals are given serious consideration.'' The RFA covers a wide-
range of small entities, including small businesses, not-for-profit
organizations, and small governmental jurisdictions.
Agencies must perform a review to determine whether a rule will
have a significant economic impact on a substantial number of small
entities. If the agency determines that it will, the agency must
prepare a regulatory flexibility analysis as described in the RFA.
The FAA believes that this final rule would not have a significant
impact on a substantial number of entities for the following reason:
Pilots that choose to use this alternative requirement will receive a
savings, however this final rule is voluntary hence there are no costs
imposed on small entities.
If an agency determines that a rulemaking will not result in a
significant economic impact on a substantial number of small entities,
the head of the agency may so certify under section 605(b) of the RFA.
Therefore, as provided in section 605(b), the head of the FAA certifies
that this rulemaking will not result in a significant economic impact
on a substantial number of small entities.

C. International Trade Impact Assessment

The Trade Agreements Act of 1979 (Pub. L. 96-39), as amended by the
Uruguay Round Agreements Act (Pub. L. 103-465), prohibits Federal
agencies from establishing standards or engaging in related activities
that create unnecessary obstacles to the foreign commerce of the United
States. Pursuant to these Acts, the establishment of standards is not
considered an unnecessary obstacle to the foreign commerce of the
United States, so long as the standard has a legitimate domestic
objective, such as the protection of safety, and does not operate in a
manner that excludes imports that meet this objective. The statute also
requires consideration of international standards and, where
appropriate, that they be the basis for U.S. standards. The FAA has
assessed the potential effect of this final rule and determined that it
will only have a domestic impact and therefore will not create
unnecessary obstacles to the foreign commerce of the United States.

D. Unfunded Mandates Assessment

Title II of the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-
4) requires each Federal agency to prepare a written statement
assessing the effects of any Federal mandate in a proposed or final
agency rule that may result in an expenditure of $100 million or more
(in 1995 dollars) in any one year by State, local, and tribal
governments, in the aggregate, or by the private sector; such a mandate
is deemed to be a ``significant regulatory action.'' The FAA currently
uses an inflation-adjusted value of $155.0 million in lieu of $100
million.
This final rule does not contain such a mandate; therefore, the
requirements of Title II of the Act do not apply.

E. Paperwork Reduction Act

The Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)) requires
that the FAA consider the impact of paperwork and other information
collection burdens imposed on the public. According to the 1995
amendments to the Paperwork Reduction Act, (5 CFR 1320.8(b)(2)(vi)), an
agency may not collect or sponsor the collection of information, nor
may it impose an information collection requirement unless it displays
a currently valid Office of Management and Budget (OMB) control number.
As required by the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)),
the FAA will submit these information collection amendments to OMB for
its review.
To implement the Act, the FAA is establishing one new information
collection. This information collection includes the medical education
course as well as the Individual Checklist for Medical Examination.
Pursuant to the requirements of the Paperwork Reduction Act, the FAA
published a 60-day notice seeking comment regarding this new
information collection.
For those individuals who elect to use this rule the FAA considers
that they no longer possess any airman medical certificate. Thus, the
FAA is making a corresponding change to information collection 2120-
0034, Application for Airman Medical Certificate, to reduce the burden
associated with that information collection. The FAA published a 60-day
notice seeking comment regarding the revision of this existing
information collection.

F. International Compatibility and Cooperation

In keeping with U.S. obligations under the Convention on
International Civil Aviation, it is FAA policy to conform to
International Civil Aviation Organization Standards and Recommended
Practices to the maximum extent practicable. The FAA has reviewed ICAO
Standards and Recommended Practices (SARPs) applicable to private
pilots.
The FAA has filed new differences and modified certain existing
differences to reflect that certain U.S. private pilots no longer are
required to hold a current FAA airman medical certificate. A filing is
required for certain ICAO Annex 1 SARPs found in Chapters 1, 2, and 6.

G. Environmental Analysis

FAA Order 1050.1F identifies FAA actions that are categorically
excluded from preparation of an environmental assessment or
environmental impact statement under the National Environmental Policy
Act in the absence of extraordinary circumstances. The FAA has
determined this rulemaking action qualifies for the categorical
exclusion identified in paragraph 5-6.6f and involves no extraordinary
circumstances.

XIV. Executive Order Determinations

A. Executive Order 13132, Federalism

The FAA has analyzed this rule under the principles and criteria of
Executive Order 13132, Federalism. The agency has determined that this
action will not have a substantial direct effect on the States, or the
relationship between the Federal Government and the States, or on the
distribution of power and responsibilities among the various levels of
government, and, therefore, will not have Federalism implications.

B. Executive Order 13211, Regulations That Significantly Affect Energy
Supply, Distribution, or Use

The FAA analyzed this rule under Executive Order 13211, Actions
Concerning Regulations that Significantly Affect Energy Supply,
Distribution, or Use (May 18, 2001). The agency has determined that it
is not a ``significant energy action'' under the executive order and is
not likely to have a significant adverse effect on the supply,
distribution, or use of energy.

C. Executive Order 13609, Promoting International Regulatory
Cooperation

Executive Order 13609, Promoting International Regulatory
Cooperation, (77 FR 26413, May 4, 2012) promotes international
regulatory cooperation to meet shared challenges involving health,
safety, labor, security, environmental, and other issues and to reduce,
eliminate, or prevent unnecessary differences in regulatory
requirements. The FAA has analyzed this action under the policies and
agency responsibilities of Executive Order 13609, and has determined
that this action would have no effect on international regulatory
cooperation.

[[Page 3164]]

XVI. Additional Information

A. Availability of Rulemaking Documents

An electronic copy of rulemaking documents may be obtained from the
Internet by--
Searching the Federal eRulemaking Portal (http://www.regulations.gov);
Visiting the FAA's Regulations and Policies Web site at
http://www.faa.gov/regulations_policies or
Accessing the Government Publishing Office's Web site at
http://www.fdsys.gov.
Copies may also be obtained by sending a request to the Federal
Aviation Administration, Office of Rulemaking, ARM-1, 800 Independence
Avenue SW., Washington, DC 20591, or by calling (202) 267-9677.
Requestors must identify the docket or amendment number of this
rulemaking.
All documents the FAA considered in developing this final rule,
including economic analyses and technical reports, may be accessed from
the Internet through the Federal eRulemaking Portal referenced above.

B. Small Business Regulatory Enforcement Fairness Act

The Small Business Regulatory Enforcement Fairness Act of 1996
(SBREFA) requires FAA to comply with small entity requests for
information or advice about compliance with statutes and regulations
within its jurisdiction. A small entity with questions regarding this
document may contact its local FAA official, or the person listed under
the FOR FURTHER INFORMATION CONTACT heading at the beginning of the
preamble. To find out more about SBREFA on the Internet, visit http://www.faa.gov/regulations_policies/rulemaking/sbre_act/.

List of Subjects

14 CFR part 61

Aircraft, Airmen, Aviation safety, Reporting and recordkeeping
requirements.

14 CFR part 68

Aircraft, Airmen, Health, Reporting and recordkeeping requirements.

14 CFR part 91

Aircraft, Airmen, Aviation safety.

The Amendment

In consideration of the foregoing, the Federal Aviation
Administration amends chapter I of title 14, Code of Federal
Regulations as follows:

PART 61--CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND
INSTRUCTORS

0
1. The authority citation for part 61 is revised to read as follows:

Authority: 49 U.S.C. 106(f), 106(g), 40113, 44701-44703, 44707,
44709-44711, 44729, 44903, 45102-45103, 45301-45302; Sec. 2307 Pub.
L. 114-190, 130 Stat. 615 (49 U.S.C. 44703 note).


0
2. In Sec. 61.3, revise paragraphs (c)(2)(viii) and (x) through (xii),
add paragraphs (c)(2)(xiii) and (xiv), and revise paragraph (l)
introductory text to read as follows:


Sec. 61.3 Requirement for certificates, ratings, and authorizations.

* * * * *
(c) * * *
(2) * * *
(viii) Is exercising the privileges of a flight instructor
certificate, provided the person is not acting as pilot in command or
as a required pilot flight crewmember;
* * *
(x) Is operating an aircraft within a foreign country using a pilot
license issued by that country and possesses evidence of current
medical qualification for that license;
(xi) Is operating an aircraft with a U.S. pilot certificate, issued
on the basis of a foreign pilot license, issued under Sec. 61.75, and
holds a medical certificate issued by the foreign country that issued
the foreign pilot license, which is in that person's physical
possession or readily accessible in the aircraft when exercising the
privileges of that airman certificate;
(xii) Is a pilot of the U.S. Armed Forces, has an up-to-date U.S.
military medical examination, and holds military pilot flight status;
(xiii) Is exercising the privileges of a student, recreational or
private pilot certificate for operations conducted under the conditions
and limitations set forth in Sec. 61.113(i) and holds a U.S. driver's
license; or
(xiv) Is exercising the privileges of a flight instructor
certificate and acting as pilot in command for operations conducted
under the conditions and limitations set forth in Sec. 61.113(i) and
holds a U.S. driver's license.
* * * * *
(l) Inspection of certificate. Each person who holds an airman
certificate, medical certificate, documents establishing alternative
medical qualification under part 68 of this chapter, authorization, or
license required by this part must present it and their photo
identification as described in paragraph (a)(2) of this section for
inspection upon a request from:
* * * * *

0
3. In Sec. 61.23, revise paragraphs (a)(3), (c)(1)(iii) and (iv), add
paragraphs (c)(1)(v) and (vi), revise paragraph (c)(2) introductory
text, and add paragraph (c)(3) to read as follows:


Sec. 61.23 Medical certificates: Requirement and duration.

(a) * * *
(3) Must hold at least a third-class medical certificate--
(i) When exercising the privileges of a private pilot certificate,
recreational pilot certificate, or student pilot certificate, except
when operating under the conditions and limitations set forth in Sec.
61.113(i);
(ii) When exercising the privileges of a flight instructor
certificate and acting as the pilot in command or as a required
flightcrew member, except when operating under the conditions and
limitations set forth in Sec. 61.113(i);
(iii) When taking a practical test in an aircraft for a
recreational pilot, private pilot, commercial pilot, or airline
transport pilot certificate, or for a flight instructor certificate,
except when operating under the conditions and limitations set forth in
Sec. 61.113(i); or
(iv) When performing the duties as an Examiner in an aircraft when
administering a practical test or proficiency check for an airman
certificate, rating, or authorization.
* * * * *
(c) * * *
(1) * * *
(iii) Exercising the privileges of a flight instructor certificate
with a sport pilot rating while acting as pilot in command or serving
as a required flight crewmember of a light-sport aircraft other than a
glider or balloon;
(iv) Serving as an Examiner and administering a practical test for
the issuance of a sport pilot certificate in a light-sport aircraft
other than a glider or balloon;
(v) Exercising the privileges of a student, recreational or private
pilot certificate if the flight is conducted under the conditions and
limitations set forth in Sec. 61.113(i); or
(vi) Exercising the privileges of a flight instructor certificate
and acting as the pilot in command or as a required flight crewmember
if the flight is conducted under the conditions and limitations set
forth in Sec. 61.113(i).
(2) A person using a U.S. driver's license to meet the requirements
of paragraph (c) while exercising sport pilot privileges must--
* * *

[[Page 3165]]

(3) A person using a U.S. driver's license to meet the requirements
of paragraph (c) while operating under the conditions and limitations
of Sec. 61.113(i) must meet the following requirements--
(i) The person must--
(A) Comply with all medical requirements or restrictions associated
with his or her U.S. driver's license;
(B) At any point after July 14, 2006, have held a medical
certificate issued under part 67 of this chapter;
(C) Complete the medical education course set forth in Sec. 68.3
of this chapter during the 24-calendar months before acting as pilot in
command in an operation conducted under Sec. 61.113(i) and retain a
certification of course completion in accordance with Sec. 68.3(b)(1)
of this chapter;
(D) Receive a comprehensive medical examination from a State-
licensed physician during the 48 months before acting as pilot in
command of an operation conducted under Sec. 61.113(i) and that
medical examination is conducted in accordance with the requirements in
part 68 of this chapter; and
(E) If the individual has been diagnosed with any medical condition
that may impact the ability of the individual to fly, be under the care
and treatment of a State-licensed physician when acting as pilot in
command of an operation conducted under Sec. 61.113(i).
(ii) The most recently issued medical certificate--
(A) May include an authorization for special issuance;
(B) May be expired; and
(C) Cannot have been suspended or revoked.
(iii) The most recently issued Authorization for a Special Issuance
of a Medical Certificate cannot have been withdrawn; and
(iv) The most recent application for an airman medical certificate
submitted to the FAA cannot have been completed and denied.
* * * * *

0
4. In Sec. 61.89, add paragraph (d) to read as follows:


Sec. 61.89 General Limitations.

* * * * *
(d) The holder of a student pilot certificate may act as pilot in
command of an aircraft without holding a medical certificate issued
under part 67 of this chapter provided the student pilot holds a valid
U.S. driver's license, meets the requirements of Sec. 61.23(c)(3), and
the operation is conducted consistent with the requirements of
paragraphs (a) and (b) of this section and the conditions of Sec.
61.113(i). Where the requirements of paragraphs (a) and (b) of this
section conflict with Sec. 61.113(i), a student pilot must comply with
paragraphs (a) and (b) of this section.

0
5. In Sec. 61.101, add paragraph (k) to read as follows:


Sec. 61.101 Recreational pilot privileges and limitations.

* * * * *
(k) A recreational pilot may act as pilot in command of an aircraft
without holding a medical certificate issued under part 67 of this
chapter provided the pilot holds a valid U.S. driver's license, meets
the requirements of Sec. 61.23(c)(3), and the operation is conducted
consistent with this section and the conditions of Sec. 61.113(i).
Where the requirements of this section conflict with Sec. 61.113(i), a
recreational pilot must comply with this section.

0
6. In Sec. 61.113, add paragraph (i) to read as follows:


Sec. 61.113 Private pilot privileges and limitations: Pilot in
command.

* * * * *
(i) A private pilot may act as pilot in command of an aircraft
without holding a medical certificate issued under part 67 of this
chapter provided the pilot holds a valid U.S. driver's license, meets
the requirements of Sec. 61.23(c)(3), and complies with this section
and all of the following conditions and limitations:
(1) The aircraft is authorized to carry not more than 6 occupants,
has a maximum takeoff weight of not more than 6,000 pounds, and is
operated with no more than five passengers on board; and
(2) The flight, including each portion of the flight, is not
carried out--
(i) At an altitude that is more than 18,000 feet above mean sea
level;
(ii) Outside the United States unless authorized by the country in
which the flight is conducted; or
(iii) At an indicated airspeed exceeding 250 knots; and
(3) The pilot has available in his or her logbook--
(i) The completed medical examination checklist required under
Sec. 68.7 of this chapter; and
(ii) The certificate of course completion required under Sec.
61.23(c)(3).

0
7. Add part 68 to subchapter D to read as follows:

PART 68--REQUIREMENTS FOR OPERATING CERTAIN SMALL AIRCRAFT WITHOUT
A MEDICAL CERTIFICATE

Sec.
68.1 Applicability.
68.3 Medical education course requirements.
68.5 Comprehensive medical examination.
68.7 Comprehensive medical examination checklist.
68.9 Special Issuance process.
68.11 Authority to require additional information.

Authority: 49 U.S.C. 106(f), 44701-44703, sec. 2307 of Pub. L.
114-190, 130 Stat. 615 (49 U.S.C. 44703 note).


Sec. 68.1 Applicability.

This part prescribes the medical education and examination
requirements for operating an aircraft under Sec. 61.113(i) of this
chapter without holding a medical certificate issued under part 67 of
this chapter.


Sec. 68.3 Medical education course requirements.

(a) The medical education course required to act as pilot in
command in an operation under Sec. 61.113(i) of this chapter must--
(1) Educate pilots on conducting medical self-assessments;
(2) Advise pilots on identifying warning signs of potential serious
medical conditions;
(3) Identify risk mitigation strategies for medical conditions;
(4) Increase awareness of the impacts of potentially impairing
over-the-counter and prescription drug medications;
(5) Encourage regular medical examinations and consultations with
primary care physicians;
(6) Inform pilots of the regulations pertaining to the prohibition
on operations during medical deficiency and medically disqualifying
conditions; and
(7) Provide the checklist developed by the FAA in accordance with
Sec. 68.7.
(b) Upon successful completion of the medical education course, the
following items must be electronically provided to the individual
seeking to act as pilot in command under the conditions and limitations
of Sec. 61.113(i) of this chapter and transmitted to the FAA--
(1) A certification of completion of the medical education course,
which shall be retained in the individual's logbook and made available
upon request, and shall contain the individual's name, address, and
airman certificate number;
(2) A release authorizing single access to the National Driver
Register through a designated State Department of Motor Vehicles to
furnish to the FAA information pertaining to the individual's driving
record;
(3) A certification by the individual that the individual is under
the care and treatment of a physician if the individual has been
diagnosed with any medical condition that may impact the ability of the
individual to fly, as

[[Page 3166]]

required under Sec. 61.23(c)(3) of this chapter;
(4) A form that includes--
(i) The name, address, telephone number, and airman certificate
number of the individual;
(ii) The name, address, telephone number, and State medical license
number of the physician performing the comprehensive medical
examination;
(iii) The date of the comprehensive medical examination; and
(iv) A certification by the individual that the checklist described
in Sec. 68.7 was followed and signed by the physician during the
medical examination required by this section; and
(5) A statement, which shall be signed by the individual certifying
that the individual understands the existing prohibition on operations
during medical deficiency by stating: ``I understand that I cannot act
as pilot in command, or any other capacity as a required flight crew
member, if I know or have reason to know of any medical condition that
would make me unable to operate the aircraft in a safe manner.''.


Sec. 68.5 Comprehensive medical examination.

(a) Prior to the medical examination required by Sec. 61.23(c)(3)
of this chapter, an individual must--
(1) Complete the individual's section of the checklist described in
Sec. 68.7; and
(2) Provide the completed checklist to the State-licensed physician
performing the medical examination.
(b) The physician must--
(1) Conduct the medical examination in accordance with the
checklist set forth in Sec. 68.7,
(2) Check each item specified during the examination; and
(3) Address, as medically appropriate, every medical condition
listed and any medications the individual is taking.


Sec. 68.7 Comprehensive medical examination checklist.

The comprehensive medical examination required to conduct
operations under Sec. 61.113(i) must include a checklist containing
the following:
(a) A section, for the individual to complete that contains--
(1) Boxes 3 through 13 and boxes 16 through 19 of the FAA Form
8500-8 (3-99); and
(2) A signature line for the individual to affirm that--
(i) The answers provided by the individual on that checklist,
including the individual's answers regarding medical history, are true
and complete;
(ii) The individual understands that he or she is prohibited under
FAA regulations from acting as pilot in command, or any other capacity
as a required flight crew member, if he or she knows or has reason to
know of any medical deficiency or medically disqualifying condition
that would make the individual unable to operate the aircraft in a safe
manner; and
(iii) The individual is aware of the regulations pertaining to the
prohibition on operations during medical deficiency and has no
medically disqualifying conditions in accordance with applicable law;
(b) A section with instructions for the individual to provide the
completed checklist to the State-licensed physician performing the
comprehensive medical examination required under Sec. 68.5; and
(c) A section, for the physician to complete, that instructs the
physician--
(1) To perform a clinical examination of--
(i) Head, face, neck, and scalp;
(ii) Nose, sinuses, mouth, and throat;
(iii) Ears, general (internal and external canals), and eardrums
(perforation);
(iv) Eyes (general), ophthalmoscopic, pupils (equality and
reaction), and ocular motility (associated parallel movement,
nystagmus);
(v) Lungs and chest (not including breast examination);
(vi) Heart (precordial activity, rhythm, sounds, and murmurs);
(vii) Vascular system (pulse, amplitude, and character, and arms,
legs, and others);
(viii) Abdomen and viscera (including hernia);
(ix) Anus (not including digital examination);
(x) Skin;
(xi) G-U system (not including pelvic examination);
(xii) Upper and lower extremities (strength and range of motion);
(xiii) Spine and other musculoskeletal;
(xiv) Identifying body marks, scars, and tattoos (size and
location);
(xv) Lymphatics;
(xvi) Neurologic (tendon reflexes, equilibrium, senses, cranial
nerves, and coordination, etc.);
(xvii) Psychiatric (appearance, behavior, mood, communication, and
memory);
(xviii) General systemic;
(xix) Hearing;
(xx) Vision (distant, near, and intermediate vision, field of
vision, color vision, and ocular alignment);
(xxi) Blood pressure and pulse; and
(xxii) Anything else the physician, in his or her medical judgment,
considers necessary;
(2) To exercise medical discretion to address, as medically
appropriate, any medical conditions identified, and to exercise medical
discretion in determining whether any medical tests are warranted as
part of the comprehensive medical examination;
(3) To discuss all drugs the individual reports taking
(prescription and nonprescription) 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 during 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 examination 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 interfere with the individual's ability to
safely operate an aircraft.''; and
(5) To provide the date the comprehensive medical examination was
completed, and the physician's full name, address, telephone number,
and State medical license number.


Sec. 68.9 Special Issuance process.

(a) General. An individual who has met the qualifications to
operate an aircraft under Sec. 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 following:
(1) A mental health disorder, limited to an established medical
history or clinical diagnosis of--
(i) A personality disorder that is severe enough to have repeatedly
manifested itself by overt acts;
(ii) A psychosis, defined as a case in which an individual--
(A) Has manifested delusions, hallucinations, grossly bizarre or
disorganized behavior, or other commonly accepted symptoms of
psychosis; or
(B) May reasonably be expected to manifest delusions,
hallucinations, grossly bizarre or disorganized behavior, or other
commonly accepted symptoms of psychosis;
(iii) A bipolar disorder; or
(iv) A substance dependence within the previous 2 years, as defined
in Sec. 67.307(a)(4) of this chapter.
(2) A neurological disorder, limited to an established medical
history or clinical diagnosis of any of the following:
(i) Epilepsy;
(ii) Disturbance of consciousness without satisfactory medical
explanation of the cause; or

[[Page 3167]]

(iii) A transient loss of control of nervous system functions
without satisfactory medical explanation of the cause.
(3) A cardiovascular condition, limited 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 conditions. In the case of an
individual with a cardiovascular condition, the process for obtaining
an Authorization for Special Issuance of a Medical Certificate shall be
satisfied with the successful completion of an appropriate clinical
evaluation without a mandatory wait period.
(c) Special rule for mental health conditions. (1) In the case of
an individual with a clinically diagnosed mental health condition, the
ability to operate an aircraft under Sec. 61.113(i) of this chapter
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 operate an aircraft under
Sec. 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 required to operate an
aircraft under Sec. 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 diagnosed with a mental health condition shall certify every
2 years, in conjunction with the certification under Sec. 68.3(b)(3),
that the individual is under the care of a State-licensed medical
specialist for that mental health condition.
(d) Special rule for neurological conditions. (1) In the case of an
individual with a clinically diagnosed neurological condition, the
ability to operate an aircraft under Sec. 61.113(i) of this chapter
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 operate an aircraft under
Sec. 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 required to operate an
aircraft under Sec. 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 neurological condition.
(2) Subject to paragraph (d)(1) of this section, an individual
clinically diagnosed with a neurological condition shall certify every
2 years, in conjunction with the certification under Sec. 68.3(b)(3),
that the individual is under the care of a State-licensed medical
specialist for that neurological condition.


Sec. 68.11 Authority to require additional information.

(a) If the Administrator receives credible or urgent information,
including from the National Driver Register or the Administrator's
Safety Hotline, that reflects on an individual's ability to safely
operate an aircraft under Sec. 61.113(i) of this chapter, the
Administrator may require the individual to provide additional
information or history so that the Administrator may determine whether
the individual is safe to continue operating under that section.
(b) The Administrator may use credible or urgent information
received under paragraph (a) to request an individual to provide
additional information or to take actions under 49 U.S.C. 44709(b).

PART 91--GENERAL OPERATING AND FLIGHT RULES

0
8. The authority citation for part 91 is revised to read as follows:

Authority: 49 U.S.C. 106(f), 106(g), 1155, 40101, 40103, 40105,
40113, 40120, 44101, 44111, 44701, 44704, 44709, 44711, 44712,
44715, 44716, 44717, 44722, 46306, 46315, 46316, 46504, 46506-46507,
47122, 47508, 47528-47531, 47534, Pub. L. 114-190, 130 Stat. 615 (49
U.S.C. 44703 note); articles 12 and 29 of the Convention on
International Civil Aviation (61 Stat. 1180), (126 Stat. 11).


0
9. In Sec. 91.319, add paragraph (j) to read as follows:


Sec. 91.319 Aircraft having experimental certificates: Operating
limitations.

* * * * *
(j) No person may operate an aircraft that has an experimental
certificate under Sec. 61.113(i) of this chapter unless the aircraft
is carrying not more than 6 occupants.

Issued in Washington, DC, under the authority of 49 U.S.C.
106(f) and Sec. 2307 of Public Law 114-190 on December 22, 2016.
Michael P. Huerta,
Administrator.
[FR Doc. 2016-31602 Filed 1-10-17; 11:15 am]
BILLING CODE 4910-13-P