The designated aviation medical examiner (DAME) Handbook (the Handbook) has been developed by CASA to provide to DAMEs guidance or impose requirements in performing their role. It also explains the approach CASA takes in dealing with a range of medical conditions that it is expected that a DAME would adopt.
It also helps to inform what investigations or specialist reviews may be helpful in assisting CASA or the DAME in making a medical decision. Medical science progresses rapidly, new developments in medicine become accepted as best practice, and thereby change the existing practice. While it is desirable for the Handbook to be accurate and up-to-date, this is not always possible due to resource limitations.
Irrespective of the state of currency of the contents of a section of the Handbook, it is important to recognise that the decisions that CASA makes are on a case-by-case basis, and will from time-to-time not match the generic information that is provided in the Handbook. This is either because the Handbook is not adequately up-to-date, or because the decision is based on the individual circumstances of the applicant under consideration.
As noted above, the Handbook is meant only as a source of guidance to DAMEs on issues which are of relevance in considering aero-medical certification of pilots with certain conditions and injuries. It is not intended to be a policy statement that sets out the manner in which CASA will proceed to make decisions in any given case.