Medical Examination Standards of Airmen

2021-11-11
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Chapter One-General Provisions
Article 1
This Medical Examination Standards of Airmen (hereinafter the “Standard”) is enacted in accordance with the paragraph 2 of the article 26 of Civil Aviation Act of the Republic of China.
Article 2
The medical certificates shall be issued to airmen in accordance with this Standard.
Article 3
The medical examinations to airmen may be given by the Civil Aviation Administration of (hereinafter “CAA”). Nevertheless, CAA may designate aviation medical examiners (hereinafter the “AME”) to give medical examinations to airmen.
The guideline governing the aforesaid designation of AME shall be enacted by CAA.
Article 4
Airmen shall be classified in medical standards as class A and class B (hereinafter “Class A” and “Class B” respectively). Such respective classifications in medical standards apply to the following airmen:
1. Class A:
(1) Airline transport pilot.
(2) Commercial pilot engaged in Airline transport and General Aviation business charter operation.
(3) Multi-crew pilot.
2. Class B:
(1) Student pilot.
(2) Private pilot.
(3) Commercial pilot engaged in General Aviation other than business charter operation.
(4) Commercial pilot - free balloon.
(5) Commercial pilot - glider.
(6) Private pilot - airship.
(7) Flight engineer.
(8) Air traffic controller.
(9) Flight instructor.
Article 5
Any airman applying for the medical examination (hereinafter the “Medical Exam”) physical check shall correct enter in each item which required in the Medical Exam record sheet and sign such record sheet.
Article 6
As deemed necessary for the reference of their respective evaluations, CAA or AME may require relevant information be provided by the airmen or give the examinations by delegate clinics or specialized physicians to the airmen. The associated expenses shall be burden by the applicant.
Article 7
If it’s determined that an airman’s physical check is evaluated to meet the requirements in the Standards or is granted a waiver on the Medical Exam (the “Waiver on Medical Exam”), CAA shall issue to the airman a Medical certificate (hereinafter the “Medical Certificate”) which shall be carried by the certification holder while performs his duties. If the applicant fails to meet the requirements in the Standard, CAA shall so notify the airman in a writing containing the reasons for the determination for such failure and the rules concerning the application for reconsideration of such determination.
Issuance fee of 250 NT dollars will be charged for each medical certificate in initial issuing, supplemental issuing, or renewal.
Article 8
If an application does not agree with the check result, the airman shall be in written to CAA for reconsideration of the determination within 30 days from the following day of the date on which the notification of the determination is received.
Article 9
The Medical assessment issue shall be valid from the day of the Medical Exam for a period not greater than:
1. 12 months for Aircraft pilots for Civil Air Transport Enterprise and business jet service provided by General aviation Enterprise, 6 months for the aforementioned pilots aged over 40, and 4 months for those aged over 60.
2. 12 months for Student pilots, private pilots, aircraft pilot of General Aviation excluding those for business jet service and flight instructor, 6 months for the aforementioned pilots aged over 60.
3. 12 months for Flight engineers and Air Traffic Controllers.
CAA, if required, may randomly give the Medical Exam to any airman who is a holder of the Medical Certificate.
In the event of an airman being unable to have his/her Medical Exam completed before the expiration date as set out in the paragraph 1 herein during a time when Central Epidemic Command Center is established due to the pandemic, their service unit shall submit the application to CAA for the approval of a limited validity Medical Certificate up to one calendar month.
Article 10
An airman shall apply for and complete each Medical Exam within the applicable period as required in subparagraphs of the first paragraph of the preceding Article. Nevertheless, if part of the Medical Exam is not completed within the required period due to the further verification of such part is needed, the following shall be deemed as a matter law:
1. If the result of the further verification passes the requirement in the Standard, the first date of actual exercise of the Medical Exam shall be deemed to be the date starting to run for the period within which the Medical Exam shall be completed.
2. If the period from the date on which the further verification is completed to the deadline for completing the next Medical Exam is less than three months, the airman may choose to take a re-examination, in which case, the deadline for completing the next Medical Exam shall be deemed running from the date of the completion of the re-examination.
Article 11
The airman who has failed to perform the duties for two weeks or more due to his illness or injury, shall consult CAA or the designated AME, through the institute the airman is working with.
Article 12
If the airman knows that his physical condition is so weak or his deficiency of health condition is so aggregated that he would not pass a Medical Exam, as having been certified in the Medical Certificate, the airman is required to timely request the institute he is working with, to discontinue his performance of duties, and such institute shall consult CAA or the designated AME.
After the consultations mentioned in the preceding Article and the preceding paragraph in this Article, if deemed necessary, the airman shall apply to CAA or the designated AME for the medical re-examinations, only until the airman passes which, the airman is permitted to resume performing his duties.
Article 13
The Medical Exam of airmen shall be implemented in accordance with Airmen’s Medical Examination Handbook written by CAA. The records of Medical Exams shall be kept by CAA or by the designated AME, for ten (10) years.
Article 14
The applicant shall burden the following expenses:
1. Medical Exam and assessment fee.
2. As deem by CAA or AME, if necessary may require the application to provide the expenses of delegate clinics or specialized physicians.
The expenses of doctor to attain the evaluation who employed by Medical Review Committee.
Chapter Two-Class A Medical Standard
Article 15
Airman to be classified as passing Class A shall pass the standards set out in this Chapter.
Article 16
An airman shall not have any diseases, whether congenital or acquired, impairing normal functioning of his physical or mental condition to the extent that it affects his ability to safely perform his duties.
Article 17
The medical standards for mental and neurologic systems are as follows:
1.Mental illnesses- none of the followings shall be found in the airman’s medical history or had by the airman the latter of which is confirmed by verification:
(1) schizophrenia spectrum and other psychotic disorders.
(2) severe neurotic, stressor-related disorders and somatoform disorder.
(3) a personality disorder or disorganized behavior that is severe enough to have repeatedly manifested itself by overt acts.
(4) psychoactive substance-related disorders and addiction.
(5) behavioral and emotional disorders with onset usually occurring in childhood and adolescence.
(6) mental illnesses severe enough to affect the airman’s ability to safely perform duties.
2.Diseases of neurologic system- none of the followings shall be found in the airman’s medical history or otherwise:
(1) epilepsy.
(2) disturbance of consciousness without identified causes.
(3) cerebral vascular diseases.
(4) migraine and/or headaches, collectively cause the disturbance of neurologic functions.
(5) any other progressive of non-progressive central, peripheral or automatic nervous system diseases severe enough to affect the airmen’s ability to safely perform duties.
3. Head injuries- none of the followings shall be found in the airman’s medical history or otherwise:
(1) head trauma to the intra cranial and the brain tissues or cerebral meninges remain partially injured.
(2) head trauma to dura mater.
(3) after brain surgery, injury to skull bone.
(4) any other trauma of head severe enough to affect the airmen’s ability to safely perform duties.
4. No spinal injury severe enough to affect the airmen’s ability to safely perform duties shall be found.
Article 18
During surgical examinations, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Any wounds, injuries, complications after operations or congenital or acquired physical malformation.
2. Sequels in functions, caused by any progressive disease or all congenital or acquired diseases in the aspect of bones, joints, muscles or tendons.
3. Diseases or complications after operations in the aspect of digestive system or its connected organs.
4. Complications after operations in the aspect of thoracic wall, ribs or mediastinum.
5. Any kidneys or urinary tract diseases or the complications therefor after operations.
Article 19
The examination standards in respect of internal medicine are as follows:
1. No disease or malfunction that affects the airmen’s ability to safely perform duties shall be found.
2. In respect of heart, no coronary artery disease shall be had or found in the medical history.
3. None of the followings which affect the airmen’s ability to safely perform duties shall be found:
(1) severe hypertrophic cardiomyopathy or dilated cardiomyopathy.
(2) left bundle branch block of heart.
(3) congenital heart disease.
(4) valvular heart disease.
(5) Arrhythmia: atrial flutter, sustained atrial fibrillation, paroxymal supraventricular tachycardia needing medications after ablation, ventricular tachycardia or sick sinus syndrome.
(6) abnormal atrioventricular conduction: Mobitz II second degree atrioventricular block, third degree atrioventricular block and atrioventricular dissociation.
(7) having had pericarditis, endocarditis or myocarditis.
(8) heart murmurs.
4. The systolic blood pressure shall be 140 mmHg or lower; the diastolic blood pressure shall be 90 mmHg or lower.
5. No apparent abnormality, either functional or structural, in circulatory system.
6. No acute diseases in lung tissues, mediastinum or pleura, or asthma requiring medication for control.
7. No spontaneous pneumothorax shall be found in medical history.
8. No chronic obstructive lung diseases with or without complication.
9. No verified diagnosis of active tuberculosis.
10. No malfunction or disease in gastrointestinal tract, liver, gallbladder or pancreas, so severe that affect the airman’s ability to safely perform duties.
11. No disease in urinary tract or genital organs, so severe that affect the airman’s ability to safely perform duties.
12. No local or systemic lymphadenopathy, splenomegaly or blood diseases, so severe that affect the airman’s ability to safely perform duties.
13. No malignant tumor.
14. No dysfunction in metabolism, nutrition or endocrine system, so severe that affect the airman’s ability to safely perform duties.
15. No type Ⅰ diabetes mellitus, or any other type D.M.(diabetes mellitus) requiring medication for control.
16. No uncured syphilis or its sequelae.
17. No Acquired Immunodeficiency Syndrome evaluated to have safety concerns when performing duties.
18. Pregnant airwomen shall be suspended for air duty and shall be entitled to resume.
Article 20
The standards for eye examinations are as follows:
1. Both eyes and the adnexa shall be in normal condition. There shall be no diagnosis of any acute or chronic pathological condition that will probably interfere progressively with the normal condition to the extent that the airmen become unable to safely perform their duties.
2. Normal fields of vision of each the right and the left eyes.
3. The equilibum function of the right and left eyes muscles shall be normal.
Article 21
Visual acuity shall be as follows:
1. The distant visual acuity in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/20. However, in case of corrective visual acuity, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
2. The near vision in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/40. However, in case of corrective vision, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
3. For the airmen aged 50 or more, the intermediate visual acuity in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/40. However, in case of corrective visual acuity, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
4. The ocular movement shall normal. The vertical phoria shall not be over one (1) prism diopter in heterophoric case and shall not be over six (6) prism diopters in each esophoric and exophoric cases.
5. The night vision shall normally function.
6. The eyes shall have normal stereopsis function. The depth perception shall not be over than 50 second farc.
7. Applicants whose uncorrected distant visual acuity in either eye is worse than 20/200 shall be required to provide a full ophthalmic report every five years.
The airmen by ways of corrections other than those corrective methods mentioned above, to meet the standards of visual acuity set out in the paragraphs 1 through 2 of this Article 21, shall be verified by CAA.
Article 22
Airmen shall be able to perceive the colors necessary to safely perform the airmen’s duties.
Article 23
In respect of the examinations for ear, nose and throat, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Diseases of middle ear or inner ear.
2. Diseases of mastoid process.
3. Unhealed perforations of the eardrum.
4. Blockage of the Eustachian tube.
5. Malfunction of vestibulum.
6. The abnormal nasal passages in two sides.
7. Deformity of upper respiratory tract.
8. Other pathological conditions in, or diseases of, ear, nose or throat.
Article 24
The standards for hearing acuity examinations are as follows:
1. The unaided hearing acuity of each (right and left) ear, shall demonstrate the ability to hear the 35 dB or less of a signal at the frequency of 500, 1000 or 2000 hertz (cycles per second) and to hear the 50 dB or less of a signal at the frequency of 3000 hertz (cycles per second).
2. While the better ear (either right and left) of a airman shall demonstrate the ability to hear the 30 dB or less of a signal at the frequency of 1000 or 2000 hertz (cycles per second), the poorer ear shall demonstrate the ability to hear the 50 dB or less of the signal at the same frequency.
Article 25
In respect of the examination for mouth, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Speech difficulty, unclear speech or having stuttering.
2. Deformity or other pathological conditions.
Article 26
Airmen shall not have any communicable diseases which are statutorily classified by the Act of Prevention and Control of Communicable Diseases (of the Republic of China).
Chapter Three-Class B Medical Standard
Article 27
Airman to be classified as passing Class B shall pass the standards set out in this Chapter.
Article 28
An airman shall not have any diseases, whether congenital or acquired, impairing normal functioning of his physical or mental condition to the extent that it affects his ability to safely perform his duties.
Article 29
The medical standards for mental and neurologic systems are as follows:
1. Mental illnesses- none of the followings shall be found in the airman’s medical history or had by the airman the latter of which is confirmed by verification:
(1) schizophrenia spectrum and other psychotic disorders.
(2) severe neurotic, stressor-related disorders and somatoform disorder.
(3) a personality disorder or disorganized behavior that is severe enough to have repeatedly manifested itself by overt acts.
(4) psychoactive substance-related disorders and addiction.
(5) behavioral and emotional disorders with onset usually occurring in childhood and adolescence.
(6) mental illnesses severe enough to affect the airman’s ability to safely perform duties.
2. Diseases of neurologic system- none of the followings shall be found in the airman’s medical history or otherwise:
(1) epilepsy.
(2) disturbance of consciousness without identified causes.
(3) cerebral vascular diseases.
(4) migraine and/or headaches, collectively cause the disturbance of neurologic functions.
(5) any other progressive of non-progressive central, peripheral or automatic nervous system diseases severe enough to affect the airmen’s ability to safely perform duties.
3. Head injuries- none of the followings shall be found in the airman’s medical history or otherwise:
(1) head trauma to the intra cranial and the brain tissues or cerebral meninges remain partially injured.
(2) head trauma to dura mater.
(3) after brain surgery, injury to skull bone.
(4) any other trauma of head severe enough to affect the airmen’s ability to safely perform duties.
4. No spinal injury severe enough to affect the airmen’s ability to safely perform duties shall be found.
Article 30
During surgical examinations, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Any wounds, injuries, complications after operations or congenital or acquired physical malformation.
2. Sequels in functions, caused by any progressive disease or all congenital or acquired diseases in the aspect of bones, joints, muscles or tendons.
3. Diseases or complications after operations in the aspect of digestive system or its connected organs.
4. Complications after operations in the aspect of thoracic wall, ribs or mediastinum.
5. Any kidneys or urinary tract diseases or the complications therefor after operations.
Article 31
The examination standards in respect of internal medicine are as follows:
1. No disease or malfunction that affects the airmen’s ability to safely perform duties shall be found.
2. In respect of heart, no congenital or acquired disease that affects the airmen’s ability to safely perform duties shall be found:
(1) Myocardial infarction.
(2) Angina pectoris or coronary artery disease.
(3) Pathological hypertrophy of myocardium or dilation of heart chamber.
(4) Left bundle branch block of heart.
(5) Second or higher degree atrioventricular block or dissociation.
3. The systolic blood pressure shall be 140 mmHg or lower; the diastolic blood pressure shall be 90 mmHg or lower.
4. No apparent functional and structural abnormality in circulatory system.
5. No acute diseases in lung tissues, mediastinum or pleura, or bronchial asthma which required medicine.
6. No spontaneous pnemothorax.
7. No chronic obstructive lung diseases with or without complication.
8. No verified diagnosis of active tuberculosis.
9. No malfunction or disease in gastrointestinal tract, liver, gallbladder or pancreas, so severe that affect the airman’s ability to safely perform duties.
10. No disease in urinary tract or genital organs, so severe that affect the airman’s ability to safely perform duties.
11. No local or systemic lymphadenopathy, splenomegaly or blood diseases, so severe that affect the airman’s ability to safely perform duties.
12. No malignant tumor.
13. No dysfunction in metabolism, nutrition or endocrine system, so severe that affect the airman’s ability to safely perform duties; No taking hypoglycemic medicine or having insulin injections is allowed; Diabetics shall not take medicine in order to control blood glucose.
14. No type 1 diabetes mellitus and any other type diabetes mellitus requiring medication for control.
15. No uncured syphilis or its sequels.
16. No Acquired Immunodeficiency Syndrome evaluated to have safety concerns when performing duties.
17. Pregnant airwomen shall be suspended for air duty and shall be entitled to resume the flight duties when she passes the Medical Exam after the laboring.
The pilot to be classified as passing Class B in respect of internal medicine shall pass the Class A examination standards.
Article 32
The standards for eye examinations are as follows:
1. Both eyes and the adnexa shall be in normal condition. There shall be no diagnosis of any acute or chronic pathological condition that will probably interfere progressively with the normal condition to the extent that the airmen become unable to safely perform their duties.
2. Normal fields of vision of each the right and the left eyes.
3. The equilibum function of the right and left eyes muscles shall be normal.
Article 33
Visual acuity shall be as follows:
1. The distant visual acuity in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/20. However, in case of corrective visual acuity, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
2. The near vision in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/40. However, in case of corrective vision, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
3. For the airmen aged 50 or more, the intermediate visual acuity in each (either right or left) naked eye or the eyes corrected with spectacles or monofocal, non-tinted contact lenses shall be 20/40. However, in case of corrective visual acuity, the airmen shall wear those corrective lenses when they are performing the duties privileged by the certificates issued to such airmen.
4. The ocular movement shall normal. The vertical phoria shall not be over one (1) prism diopter in heterophoric case and shall not be over six (6) prism diopters in each esophoric and exophoric cases.
5. The night vision shall normally function.
6. The eyes shall have normal stereopsis function. The depth perception shall not be over than 50 second farc.
7. Applicants whose uncorrected distant visual acuity in either eye is worse than 20/200 shall be required to provide a full ophthalmic report every five years.
The airmen by ways of corrections other than those corrective methods mentioned above, to meet the standards of visual acuity set out in the paragraphs 1 through 2 of this Article 21, shall be verified by CAA.
Article 34
Airmen shall be able to perceive the colors necessary to safely perform the airmen’s duties.
Article 35
In respect of the examinations for ear, nose and throat, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Diseases of middle ear or inner ear.
2. Diseases of mastoid process.
3. Un-healed perforations of the eardrum.
4. Blockage of the Eustachian tube.
5. Malfunction of vestibulum.
6. The abnormal nasal passages in two sides.
7. Deformity of upper respiratory tract.
8. Other pathological conditions in, or diseases of, ear, nose or throat.
Article 36
The standards for hearing acuity examinations are as follows:
The unaided hearing acuity of each (right and left) ear, shall demonstrate the ability to hear the 40 dB or less of a signal at the frequency of 500, 1000 or 2000 hertz (cycles per second) and to hear the 50 dB or less of a signal at the frequency of 3000 hertz (cycles per second).
Article 37
In respect of the examination for mouth, none of the followings which affect the airmen’s ability to safely perform duties shall be found:
1. Speech difficulty, un-clear speech or having stuttering.
2. Deformity or other pathological conditions.
Article 38
Airmen shall not have any communicable diseases which are statutorily classified by the Act of Prevention and Control of Communicable Diseases (of the Republic of China).
Chapter Four-Waiveron Medical Exam
Article 39
An airman who failed to pass the Medical Exam may, in addition to seeking for the remedy provided under Article 8 hereof, submit to CAA an application with relevant documents within 30 days for the Waiver on Medical Exam from the date on which the notification of the determination of the failure is received. After CAA evaluation, recognizes through the working experience or cured by medical therapy,will not affect the safety of the flight, such fail items may be waived.
While The applicant request the Waiver on Medical Exam,the reconsideration of determination period should be suspended.
Upon the reason for suspension of such period of time specified in the preceding paragraph ceases to exist, the period of time shall resume accruing taking into account of the time having accrued before such suspension.
Article 39-1
The application form for the Waiver on Medical Exam is noticed by CAA.
Article 40
An applicant who failed pass on physical check and his illness(or defect) is being developing and not in a stable condition, or one of the following illness(or defect) is found in his medical history, such airman shall not be eligible to apply for the Waiver on Medical Exam:
1. Personality or behaviors disorders or psychological disturbances.
2. Chronic alcoholism or drug addiction.
3. Epilepsy.
4. Having had loss of consciousness in the medical history without identified cause.
5. Having had heart transplant surgery.
6. Wearing cardiac pacemaker.
7. Type 1 diabetes mellitus.
8. Cerebral vascular diseases.
Article 41
The Waiver on Medical Exam may be granted by any of the followings:
1. It may be granted by the results of assessments made by the medical institutes or specialized aviation medical doctors.
2. It may be granted by perform the actual duty, assessed by CAA authorized personnel.
Article 42
When CAA grants the Waiver on Medical Exams, the following item waived shall noted on medical certificate:
1. Expiration period of the waiver items.
2. The condition of healthcare of the aviation medicine.
3. The limitation of the aviation duties.
4. The conditions of operation environments.
Airman shall not perform any duty which was limited by the defect.
Article 43
The items of failures which were granted for Waiver on Medical Exam shall nevertheless be required to be medical examined routinely. However, when CAA considers necessary or AME considers the condition of disease changes, such items shall be verified again for the Waiver on Medical Exam.
Article 44
CAA may at any time cancel the Waiver on Medical Exam previously granted, or may require the airman to suspend his performance of duties before any examination of assessments.
Article 45
This Standard shall take effect on and from the date of promulgation.