Third Class FAA Medical Reforms




On July 15, 2016 President Obama signed The FAA Extension, Safety, and Security Act of 2016.  Reforms include an option to the Third Class Medical, it limits when a Special Issuances (SI) is required, and it directs the FAA to increase the number of “Conditions for which an AME Can Issue” (CACI).  The new Third Class Medical option can be used for flying singles and twins up to 6,000 pounds. There is a ceiling of 18,000’, and the TAS cannot exceed 220 K. Day or night and VFR or IFR operations are permitted, and one may transport up to five passengers plus yourself.  Below 18,000’ there is no limitation to the type of airspace you can operate in.  Of course the pilot and equipment must have the appropriate certifications for the flight contemplated.  

The current Third Class Medical will still be available and shall not be going away. 


The legislation is  proscriptive in delineating the process for the Third Class Medical Option

Every four years you will need to complete an FAA medical history form covering items found in boxes 3 through 13 and 16 through 19 of the current Medxpress 8500-8 History and Physical (H&P) You sign the attestation statement, take this to the physician of your choice and he/she will be required to perform a physical exam based on a check list which is quite similar to the current one done by an Airman Medical Examiner (AME). The physician then needs to sign the following attestation statement:  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 their 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.   

Generally in qualification H&Ps, whether they be for a semi-truck driver, police officer, or pilot, the physician certifies that the applicant meets a set of predefined standards. The doctor does not have to comment on the person’s ability or lack thereof to drive an 18 wheeler, perform as a police officer or fly a plane.  The reference in the attestation statement to the “ability to safely operate an aircraft or motor vehicle." ..and.. "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." will make some physicians uncomfortable due to a limited expertise in aviation medicine, and/or liability concerns. As the elements comprising the H&P and the attestation verbiage is specifically delineated in the legislation, I do not believe they will be changed. When making the appointment, discuss with your doctor what he/she will need to sign so there are no last minute disappointments.

       Every two years you need to take an FAA generated, free, online training course covering flying and medical issues. There will be an attestation statement saying that you understand that you cannot fly if you develop a medically disqualifying condition and you give the FAA permission to access the National Drivers Registry.  

        Neither the results of the H&P or the documentation of the online training should be sent to the FAA, however both need to be provided on request. Consequently it is important to keep a copy and make an entry in your log book.

       This alternative to the current Third Class Medical should be available within 180 days of July 15, 2016 which is when the legislation was signed.  If you never had a Third Class Medical or if your last one was before July 15, 2006, you will need to go to an AME and have one last Class III exam before you can use this new option. Until the new system is implemented you should still use the current process. As of December 18, 2016  the FAA has not published the regulations pertaining to this change.


Pilots requiring a Special Issuance (SI)

Currently if you have a SI, ongoing re-evaluations are required to maintain your medical certificate. These are proscriptive, often are required annually regardless of the medical class, and depending on your condition can be costly. Under the new standards if you have an SI, generally you do not  need to update it assuming your condition is stable.  Periodic visits to your physician  is important however the time frequency and tests ordered will be based on patient and doctor judgment and not that of the FAA. . These reforms do not apply to certain  cardiac, mental health and neurological conditions  and for these situations the SI will remain time limited. 

Condition for which AMEs can Issue (CACI)

      Certain conditions are disqualifying, however, if the airman can bring in documentation that meet the CACI standard, the AME can issue the certificate as opposed to deferring it. For instance, if you have hypothyroidism and your condition is stable, asymptomatic, on an approved medication and you had a normal Thyroid Stimulating Hormone laboratory value during the past year the AME can issue the Medical Certificate.  Visit the  CACI  page for further details.

There are 16 general CACI categories as of August 2, 2016 and this legislations directs the FAA to develop new ones so more common medical conditions are covered. CACIs often apply to all classes of medical certificates so this would help other pilots too.

Summary and my take on the whole process

    These reforms are far from self-certification using a driver’s license which AOPA and the EAA initially requested, and there are not a lot of differences between the current  FAA Third Class Medical and the new option. The history and physical is essentially unchanged from the current Class III. Exam frequency favors the new system if you are over 40 (every four years vs. every two) and slightly favors the Class III FAA Medical exam system for younger pilots.  Regardless of age the new system requires the biennial course which is not required for a regular Class III. If you fly outside the United States be sure that this option to the Third Class Medical is acceptable. Having this new alternative gives the private pilot a second path to medical certification, and once the final regulations have been published by the FAA make your decision.

This page was last updated on 02/10/17