CASA uses multi-crew endorsements as a means of risk mitigation. Their use enables pilots to continue flying despite the presence of medically-significant conditions which would otherwise pose an unacceptable risk to the safety of air navigation.

When a Class 1 or Class 2 medical certificate is endorsed with the condition Holder to fly as or with a qualified co-pilot or Holder to fly with safety pilot only, all of the following conditions apply:

  1. The holder is restricted to operating either as or with a qualified co-pilot while exercising the privileges of the licence validated by the medical certificate Note: It is sometimes possible for an applicant to have an ‘as or with co-pilot’ restriction on a Class 1 medical certificate but an unrestricted Class 2 medical certificate.
  2. Aircraft requirements:
    1. the aircraft flown must be configured with side by side seating in the cockpit
    2. the aircraft being flown must have a full set of dual flying controls.
  3. Certificate holder requirements:
    1. wear a shoulder restraint harness at all times when occupying a control seat
    2. be prepared to relinquish command or control of the aircraft at the onset of any incapacity
    3. ensure that the other pilot has read the requirements in this document.
  4. Other pilot’s requirements:
    1. occupy a control seat, except for short absences (absences only in the cruise with the autopilot engaged)
    2. be endorsed and current on the aircraft type being flown
    3. be appropriately rated for the in-flight conditions
    4. have a medical certificate not restricted to multi-crew flight operations
    5. be aware of the type of incapacity the pilot may suffer in flight
    6. be prepared to take over the aircraft controls during critical phases of flight
    7. be competent and capable of concluding the flight safely from the control seat. Note: This condition does not:
      1. preclude the medical certificate holder from being left on the flight deck alone in a 2-pilot operation
      2. preclude the medical certificate holder from operating as a single pilot on a flight deck should the other pilot in a 2-pilot operation become incapacitated.

Class 3 ‘proximity’ restriction

When a Class 3 medical certificate is endorsed with the condition Holder is required to inform employer of the nature and extent of his/her medical impairment and to co-operate in establishing mitigation strategies to minimise the effect of this impairment, the following applies:

The holder who has such a restriction on a Class 3 medical certificate is required to inform his/her employer of the nature and extent of his/her medical impairment and to co-operate with the employer in establishing strategies to minimise the risk of his/her impairment causing acute incapacitation. Relevant strategies may include, but are not limited to, measures such as special roster or shift arrangements, specified meal breaks, or guaranteed access to prescribed facilities.

When a Class 3 medical certificate is endorsed with the condition ‘Holder may exercise the privileges of the licence without supervision, but there must at all times be another licensed air traffic controller who is aware of the holder’s impairment present and able to assume the holder’s air traffic management duties should the holder experience sudden incapacitation’, the following applies:

The holder who has such a restriction on a Class 3 medical certificate is not permitted to undertake duty alone and is required to ensure, at the beginning of each shift, that his/her co-workers are aware of the type of incapacity the individual may experience while working and that at least one co-worker is available at all times to take over the individual’s air traffic management duties should such a sudden incapacitation eventuate.

Source – https://www.casa.gov.au/search-centre/manuals-and-handbooks/designated-aviation-medical-examiners-handbook/73-multi-crew-endorsement