4.4 Special reports and periodic tests required for medical certification

Periodic tests required in association with applications are listed in the reference chart. Automatic reminders are provided by the online system.

Designated aviation medical examiner's reference charts

Coronary heart disease risk factor prediction chart (CRI)

Use this profile for professional pilots 5 yearly (or private pilots, if clinically indicated) and every year for pilots over 60 years of age:

  1. Find points for each risk factor
  2. Sum points for all risk factors
    • Age + HDL-C + Total-C + SBP + Smoker + Diabetes + ECG-VVH = Point total
  3. For stress ECG if greater than 14 Points
  4. If LBBB needs stress echo or perfusion scan.

A PDF version of the Coronary heart disease risk factor prediction chart is also available.

Coronary heart disease risk factor prediction chart (CRI)
Age (Female) Points (Female) Age (Male) Points (Male) HDL Cholesterol HDL cholesterol points Total cholesterol Total cholesterol points Systolic BP Systolic BP points Other Other points (0 points assigned for each negative answer)
30 -12 30 -2 0.65-0.68 7 3.60-3.99 -3 98-104 -2 Cigarettes 4
31 -11 31 -1 0.69-0.76 6 4.00-4.30 -2 105-112 -1 Diabetic (M) 3
32 -10 32-33 0 0.77-0.84 5 4.31-4.69 -1 113-120 0 Diabetic (F) 6
33 -8 34 1 0.85-0.90 4 4.70-5.19 0 121-129 1 ECG-LVH 9
34 -6 35-36 2 0.91-0.99 3 5.20-5.69 1 130-139 2 - -
35 -5 37-38 3 1.00-1.09 2 5.70-619 2 140-149 3 - -
36 -4 39 4 1.10-1.19 1 6.20-6.79 3 150-160 4 - -
37 -3 40-41 5 1.20-1.30 0 6.80-7.49 4 161-172 5 - -
38 -2 42-43 6 1.31-1.43 -1 7.50-8.19 5 173-185 6 - -
39 -1 44-45 7 1.44-1.56 -2 8.20-8.55 6 - - - -
40 0 46-47 8 1.57-1.70 -3 - - - - - -
41 1 48-49 9 1.71-1.89 -4 - - - - - -
42-43 2 50-51 10 1.90-2.07 -5 - - - - - -
44 3 52-54 11 2.08-2.25 -6 - - - - - -
45-46 4 55-56 12 2.26-2.49 -7 - - - - - -
47-48 5 57-59 13 - - - - - - - -
49-50 6 60-61 14 - - - - - - - -
51-52 7 62-64 15 - - - - - - - -
53-55 8 65-67 16 - - - - - - - -
56-60 9 68-70 17 - - - - - - - -
61-67 10 71-73 18 - - - - - - - -
68-74 11 74 19 - - - - - - - -

Minimum class for licence type, special reports and tests

Aviation Medicine contacts, CASA medical processing fees, minimum class for licence type, special reports and tests
AvMed Reference Chart

Valid medical tests and specialist reports

  • Periodic tests and reports should be no more than 90 days old at the time of the medical application.
  • Special medical tests and reports required to fulfil surveillance requirements must be provided as specified by CASA (or DAME) in surveillance letters.
  • To avoid delays, DAMEs should remind applicants requiring tests or reports to make appointments in advance wherever possible.
  • All reports performed in connection with aviation medical requirements should be uploaded to MRS in full (see chapter 6.1 Electrocardiographs for more information). This enables minor abnormalities to be tracked over time, for example, with stress electrocardiograms and echocardiograms.
  • Tests must be undertaken consistent with the Clinical Practice Guidelines (the Guidelines).

Note: On occasions, applicants may have undergone certain of these tests or specialist reviews independently of the CASA requirement. If they fulfil the recency requirement these reports are acceptable to CASA and should be uploaded to MRS.

Note: DAMEs should ensure all documentation conforms to accepted standards for medical record-keeping. They must be careful to ensure correct identity of the subject of the report, the nature of the report, relevant dates, authorship etc.

Note: DAMEs must recognise their duty of care to an applicant. Where a medical finding is identified, the DAME must ensure the information is conveyed promptly to the appropriate doctor for further investigation or other action.

Over 60 ATPL requirements

According to the Chicago Convention (ICAO) Annex 1, section 1.2.5.2.1, once an Airline Transport Pilot Licence (ATPL) holder passes their 60th birthday, they must sit six monthly medical examinations. Whilst this is not expressed in the CASR, CASA has a discretion as to the minimum period of a medical certificate.

Note: ATPL applicants 60 years or over, undertake all the routine periodic tests at the first medical undertaken at that age. This is termed the 'Major' medical. Six months later, at the second medical at that particular age, termed the 'Minor' medical, the periodic tests do not need repeating unless specific concerns are identified requiring fresh review, or there is an existing surveillance requirement.

Note: DAMEs and applicants should carefully consider dates of periodic tests to ensure they don’t fall out of sync thus incurring additional cost and effort.

Scenario 1

Once an applicant turns 62 years of age, the first medical after their birthday will be a major medical examination. (refer to MRS which shows requirement for glucose and lipids, cardiac risk index, and eye examination) Six months later the applicant will then be required to complete a minor medical examination which would not require these periodic tests.

Scenario 2

For a 62 year old applicant with a surveillance requirement, the first medical after the birthday will be a major medical examination. (periodic tests must be provided as per requirement). In addition, the surveillance reports must also be considered as required in the direction from CASA.

Table of over 60 years ATPL testing requirements

Age Major Minor Medical Questionnaire and Examination ECG Serum Bloods and Fasting Glucose Audio Eye Report Calculate Cardiac Risk Index CASA Audit Requirements Glucose Tolerance Test Stress ECG
60 - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
60.5 - - - - - - If CAR specifically states 6 month requirements - -
61 - - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
61.5 - - - - - - If CAR specifically states 6 month requirements - -
62 - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
62.5 - - - - - - If CAR specifically states 6 month requirements - -
63 - - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
63.5 - - - - - - If CAR specifically states 6 month requirements - -
64 - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
64.5 - - - - - - If CAR specifically states 6 month requirements - -
65 - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
65.5 - - - - - - If CAR specifically states 6 month requirements - -
66 - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
66.5 - - - - - - If CAR specifically states 6 month requirements - -
67 - - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
67.5 - - - - - - If CAR specifically states 6 month requirements - -
68 - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
68.5 - - - - - - If CAR specifically states 6 month requirements - -
69 - - - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
69.5 - - - - - - If CAR specifically states 6 month requirements - -
70 - If applicable If fasting blood glucose is 5.5 or above If CRI Score > 14
Published date: 24 November 2021
Online version available at: https://www.casa.gov.au//search-centre/manuals-and-handbooks/designated-aviation-medical-examiners-handbook/44-special-reports-and-periodic-tests-required-medical-certification
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