---
kind: "section"
citation: "14 C.F.R. § 68.9"
title: "14"
number: "68.9"
heading: "Special Issuance process."
url: "https://uscodex.org/cfr/14/68.9"
---

# §68.9. Special Issuance process.

- (a) **General.** An individual who has met the qualifications to operate an aircraft under [§ 61.113(i)](/cfr/14/61.113.md?p=i) of this chapter and is seeking to act as a pilot in command or serve as a required flightcrew member 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 [§ 67.307(a)(4)](/cfr/14/67.307.md?p=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
    - (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 [§ 61.113(i)](/cfr/14/61.113.md?p=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 [§ 61.113(i)](/cfr/14/61.113.md?p=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 [§ 61.113(i)](/cfr/14/61.113.md?p=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)](#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 [§ 68.3(b)(3)](/cfr/14/68.3.md?p=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 [§ 61.113(i)](/cfr/14/61.113.md?p=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 [§ 61.113(i)](/cfr/14/61.113.md?p=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 [§ 61.113(i)](/cfr/14/61.113.md?p=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)](#d-1) of this section, an individual clinically diagnosed with a neurological condition shall certify every 2 years, in conjunction with the certification under [§ 68.3(b)(3)](/cfr/14/68.3.md?p=b-3), that the individual is under the care of a State-licensed medical specialist for that neurological condition.

## Notes

### Amendments

[Docket FAA-2016-9157, Amdt. 68-1, 82 FR 3165, Jan. 11, 2017, as amended by Docket FAA-2021-1040, Amdt. 61-152, 87 FR 71238, Nov. 22, 2022]

### Authority

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. 828 of Pub. L. 118-63, 138 Stat. 1330 (49 U.S.C. 44703).

### Source

Source: Docket FAA-2016-9157, Amdt. 68-1, 82 FR 3165, Jan. 11, 2017, unless otherwise noted.

### Amendments

[Docket FAA-2016-9157, Amdt. 68-1, 82 FR 3165, Jan. 11, 2017, as amended by Docket FAA-2021-1040, Amdt. 61-152, 87 FR 71238, Nov. 22, 2022]