First-Class Medical Neurologic Standards

FAR 67.109 First-Class Medical Neurologic Standards

FAR 67.109 sets neurologic standards for a first-class medical certificate, including rules on epilepsy, loss of consciousness, and other conditions.

In Plain English

FAR 67.109 establishes the neurologic standards an applicant must meet to hold a first-class airman medical certificate — the certificate required for ATP privileges. It matters because neurologic events in flight can be sudden, incapacitating, and catastrophic, so the FAA disqualifies applicants whose history suggests that risk.

Under this section, you must have no established medical history or clinical diagnosis of:

  • Epilepsy;
  • A disturbance of consciousness without a satisfactory medical explanation; or
  • A transient loss of control of nervous system function(s) without a satisfactory medical explanation.

Beyond those automatic disqualifiers, the Federal Air Surgeon may also deny certification for any other seizure disorder, disturbance of consciousness, or neurologic condition if, based on the case history and qualified medical judgment, the condition either makes you unable to safely exercise the privileges of the certificate, or could reasonably be expected to do so during the certificate's maximum duration. In short: known epilepsy or unexplained blackouts are disqualifying, and other neurologic issues are evaluated case-by-case.

Regulation Text
14 CFR § 67.109
§ 67.109 Neurologic. Neurologic standards for a first-class airman medical certificate are: (a) No established medical history or clinical diagnosis of any of the following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause; or (3) A transient loss of control of nervous system function(s) without satisfactory medical explanation of the cause. (b) No other seizure disorder, disturbance of consciousness, or neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds— (1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or (2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
Oral Exam Questions a DPE Might Ask
Q1What neurologic conditions are automatically disqualifying for a first-class medical certificate?
Per FAR 67.109(a), an established history or clinical diagnosis of epilepsy, a disturbance of consciousness without satisfactory medical explanation, or a transient loss of nervous system function without satisfactory medical explanation is disqualifying.
Q2If a pilot has a neurologic condition not specifically listed, can they still be denied a first-class medical?
Yes. FAR 67.109(b) allows the Federal Air Surgeon to deny certification for any other seizure disorder, disturbance of consciousness, or neurologic condition if qualified medical judgment finds it makes — or may reasonably make — the pilot unable to safely exercise the certificate's privileges.
Q3Who decides whether a borderline neurologic condition disqualifies a first-class applicant?
Under FAR 67.109(b), the Federal Air Surgeon makes that determination, based on the case history and appropriate, qualified medical judgment relating to the specific condition.
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FAR 67.109 — First-Class Medical Neurologic Standards