6.5 Actions on medical certificates

Directions to provide medical information

CASR 67.230 provides for CASA to require medical examination of certificate holders. This may be by submitting to an examination or the disclosure of information. Given the wide range of pathologies and the diverse skills required of certificate holders, relevant information may be required from a wide range of sources.


Under CASR 67.240, if CASA directs the holder of a medical certificate to submit to an examination under regulation 67.230, or to authorise the disclosure of information to CASA under that regulation, CASA may, in writing, suspend the medical certificate.

Medical certificates are suspended, and applicants directed to provide the necessary authority or information relevant to the suspension. The suspension remains in effect until CASA has provided the applicant with written notice that the suspension has been lifted.

Applicants are given the opportunity to provide information relevant to their medical certificate, if they wish to dispute suspension notices. This is the 'Show cause' process.

Note: DAMEs are not delegated with powers to suspend medical certificates.

Note: In pregnancy, a pilot's medical certificate is taken to be suspended during the period beginning immediately after the end of the 30th week of gestation. No additional paperwork is required. However, a DAME is required to certify that the pilot is fully recovered following delivery or termination of the pregnancy. Refer CASR 67.235.


If, after undergoing an examination, the standard is not met, CASA may cancel a medical certificate under CASRs 67.255. Cancellation or suspension may also occur under 67.260 in various circumstances, for example, where the applicant has contravened a condition or failed to comply with a direction under 67.230. Failure to provide required information can lead to a cancellation of the certificate.

Note: DAMEs are not delegated with powers to cancel medical certificates.

Appeal options

If an applicant is dissatisfied with CASA's decision on an application for a medical certificate, there are a number of options.

  • Discussion with the DAME and CASA. Experience demonstrates that often questions or frustration with the process can be addressed when the applicant can talk over the matters of concern. This is the quickest and cheapest option for all concerned.

Where this is insufficient, disagreement about the decision (merits review) may be handled as follows:

  • reconsideration of the decision may be requested (there is a cost of $150, and this can take 6-12 weeks). This application is made through MRS in the same way as an application for a medical certificate. It must be made within 21 days of the date the applicant is advised of the certification decision. The reconsideration of an application submitted to CASA must not be carried out solely by the CASA officer who made the decision being reconsidered. [CASR 67.190]
  • the matter may be reviewed by the Commonwealth Administrative Appeals Tribunal (AAT). Applications must be made to the AAT within 28 days of the date of the certification decision. Legal advice should be sought in relation to the rights of review.

CASA recommends that applicants be advised to apply for reconsideration before seeking review in the Commonwealth Administrative Appeals Tribunal.

Note: Reconsiderations cannot be sought in relation to a decision to cancel a medical certificate.

Where the complaint relates to the process, for example how AvMed staff dealt with matters, disagreement with AvMed about extra reports or results, or delays in processing, and contact with AvMed has not resolved the problem, complaints should be referred to:

Updated: 11 April 2022
Online version available at: https://www.casa.gov.au//search-centre/manuals-and-handbooks/designated-aviation-medical-examiners-handbook/65-actions-medical-certificates
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