Primary Legislation: Civil Aviation Act s27C & s27I
Secondary Legislation: Not applicable
Forms: Suspension of Certificate [PDF 923 KB]
Extension of Suspension of Certificate [PDF 922 KB]
Cancellation of Suspension of Certificate [PDF 922 KB]
Conditions, Restrictions and Endorsements of Certificate [PDF 950 KB]
Extension of Conditions, Restrictions and Endorsements of Certificate [PDF 922 KB]
Withdrawal of Conditions, Restrictions and Endorsements [PDF 923 KB]

Change in medical condition

Licence holders, MEs, aviation operators and registered medical practitioners all have an obligation, under section 27C, to report to the Director if they are aware of, or have reasonable grounds to suspect, any change in medical condition of a licence holder that may interfere with the safe exercise of the privileges to which the licence holder’s medical certificate relate.

Temporary Medical Conditions are medical conditions as described in the relevant General Directions that do not need to be reported.

Action by licence holder

Section 27C of the Act stipulates a licence holder’s obligations in the case of a change in medical condition as defined above:

  • The licence holder must advise the Director as soon as practicable. In practice this will be by contacting the licence holder’s ME, or the Aviation Medicine Team office.
  • The licence holder may not exercise the privileges to which the licence holder’s medical certificate relates.

It should be noted that changes in medication may also constitute a change in medical condition that requires reporting.

Action by Medical Examiner

Medical Examiners need to be familiar with the powers they hold under their delegations, as this determines how information about changes in medical conditions are to be handled. Medical Examiners usually hold the relevant delegations appropriate to the class of certificate for which they can examine.

Thus an ME who does not have delegated powers in relation to the class of medical certificate affected, must report the change of medical condition to the Director who will then take appropriate action.

An ME who holds a delegation to act under section 27I (i.e. delegation to suspend a certificate for instance) has the following options, depending on the nature of the medical condition:

Where the licence holder IS unable to exercise safely

'If the Director (or ME acting under delegation) has reasonable grounds to believe that an licence holder is unable to exercise safely the privileges to which the medical certificate relate the Director must . . .' – please refer to s27I(2) of the Act for action referred to.

Where the licence holder MAY be unable to exercise safely

'If the Director (or ME acting under delegation) has reasonable grounds to believe that the licence holder may be unable to exercise safely the privileges to which the medical certificate relates the Director may . . .' – please refer to s27I(1) of the Act for action referred to.

Medical Examiners with delegation to issue certificates are generally able to issue suspensions, impose conditions, place restrictions or endorsements on certificates of a class that they are able to issue. Such actions are limited to 10 working days with the possibility to extend for a further 10 working days. All such actions must be notified to CAA as soon as practicable by sending a copy of all documents and information available. If no action is taken, this must also be documented and forwarded to CAA.

If in doubt the ME should forward the information to, and seek advice from, a Medical Officer at the CAA.

Process for suspension of certificate or imposition of conditions, restrictions or endorsements

For the suspension of a medical certificate, use the Suspension of Certificate form 24067-401:

Suspension of Certificate form [PDF 923 KB]

For the imposition of conditions, restrictions, or endorsements, use the Restriction of Certificate form 24067-402:

Restriction of Certificate form [PDF 950 KB]

The notice should be served by hand if possible (i.e. if the participant is attending the ME’s rooms), emailed or mailed. If emailed or mailed, it is better for the ME to make, and document, a telephone call to the licence holder to explain the action taken.

A ME who has taken action on a medical certificate under s27I, can also cancel his/her own action, if satisfied that the licence holder’s change in medical condition is no longer affecting flight safety.

This should be done by using the Withdrawal of Conditions, Restrictions and Endorsements form 24067-403, or using the Cancellation of Suspension of Certificate form 24067-404 as applicable - with a copy sent to the CAA Aviation Medicine office.

Withdrawal of Conditions, Restrictions and Endorsements form [PDF 923 KB]

Cancellation of Suspension of Certificate form [PDF 922 KB]

Action by the Director (at CAA)

The Director should be informed as soon as possible of the suspension or conditions imposed. The Director will decide if further action is required. The process involves obtaining enough information to enable a considered decision. Medical Examiners should seek and forward any existing information as it becomes available.

Depending on the circumstances, one of the following actions may be taken by the Director.

  • Cancel the suspension;
  • Allow the suspension, or the conditions, restrictions or endorsements to lapse;
  • Withdraw any conditions, restrictions, or endorsements;
  • Impose or amend conditions, restrictions, or endorsements for a specified period;
  • Disqualify the licence holder from holding the medical certificate for a specified period;
  • Revoke the medical certificate.

Surrender of the medical certificate

Section 27I(9) of the Act requires a licence holder to surrender a suspended, revoked, withdrawn or disqualified medical certificate to the Director, a person authorised by the Director, or a member of the police. This is not optional and is not left to the discretion of the ME. The Director may also require surrender of the certificate under section 24(3)(a) of the Act. Failure to comply is an offence under section 50A of the Act.

During any period of suspension, it is appropriate for the ME, in his/her role as Director’s delegate, to act as safe keeper of the certificate, particularly if it is likely that the suspension may be cancelled soon. In such a case the ME should also inform the CAA that he/she is holding the medical certificate.

If the period of suspension / disqualification is likely to be prolonged the certificate should be forwarded to CAA.

If a notice of conditions, restrictions or endorsements has been issued the licence holder may hold on to the certificate until an amended certificate has been received.

Once an amended certificate has been received the original certificate must be surrendered to CAA.

Key points

In case of a change in medical condition, or suspected change in medical condition, that may interfere with the safe exercise of the privileges to which the licence holder’s medical certificate relate:

  • The licence holder may not exercise the privileges to which the medical certificate relates;
  • The licence holder must advise the ME / Director ASAP, except for those temporary conditions listed in the GD – temporary medical conditions;
  • The Medical Examiner with delegation / Director may or must suspend the medical certificate, or impose conditions, as appropriate;
  • The suspension is for a maximum of 10 working days;
  • The suspension can be extended for a further 10 working days;
  • The suspension may be cancelled only by the ME who issued suspension, under their delegation, or by the Director;
  • The Medical Examiner must report to CAA any action taken as soon as practicable, together with any available documentation;
  • The Director will then take further action as appropriate;
  • The Director only can take action under s27I(7)(a), (c) or (d), i.e. disqualification, revocation, as MEs currently do not have these delegations.