Discretionary issuance

This regulation provides a pathway for pilots who don't meet the standard medical requirements for a first-class medical certificate. If you fail to meet any of the specific medical standards listed in §§67.103 through 67.113 (covering vision, ear/nose/throat, mental health, cardiovascular conditions, and other medical requirements), you're not automatically disqualified.

Instead, you can apply for special issuance under §67.401, where the FAA has discretionary authority to issue a medical certificate anyway. This typically happens when you can demonstrate that despite not meeting a specific standard, you can safely perform pilot duties. You'll need to provide additional medical documentation showing your condition is sufficiently managed or compensated for.

This is an important safety valve in the medical certification system—it allows qualified pilots with certain medical conditions to continue flying when they can prove they don't pose a safety risk, rather than being automatically grounded by a single disqualifying condition.

*This is a plain-English summary for study only. The official 14 CFR text on this page is controlling — always read the current regulation and consult a CFI.*