UK 

Civil Aviation 
Authority Guidance 
Material 
Version 3.0 May 2018 
  www.caa.co.uk/medical 
UK CAA Head Injury Certification Guidance 
Assessment content
Classification* Criteria Fitness Assessment by Aircrew Medical Category Class 1 cases to be assessed by CAA apart from minimal (AME) Class 2
cases to be assessed by AME
All must be present
 Any concussive or mild head injury symptoms which have
recovered within 48hrs
 Initial Glasgow Coma Score (GCS) 15 Class 1, 2, 3 & LAPL
Medical report from attending doctor
Minimal OR
 No loss of consciousness (LOC) Unfit until 7 days after full recovery without symptoms AME clinical assessment (if not seen by A+E or GP)
 No post traumatic amnesia (PTA)
 No focal neurological deficit
 No seizure
The presence of 2 criteria in the most severe category determines the category to be used for certificatory assessment.
*Any early (<=7 days) seizure must result in a classification of severe

 Any concussive or mild head injury symptoms lasting Class 1, 2 3 & LAPL Medical report from attending doctor including investigations
greater than 48hrs Unfit for 6 weeks after full recovery without symptoms Class 1& 3 applicants must be referred to CAA for decision
Mild  Initial Glasgow Coma Score (GCS) 12-15
Class 1 AND
 LOC less than 30 minutes
 PTA less than 30 minutes Then OML for further year AME clinical assessment after resolution of symptoms

Class 1, 3
Unfit 6 months after full recovery without symptoms
Then Class 1 OML for 2 years, Class 3 unrestricted Medical report from attending specialist including investigations.
 Initial GCS 9-12 CT/MRI mandatory before recertification
 LOC 30 mins to 24 hours Class 2 Class 1& 3 applicants must be referred to CAA for decision
Moderate
 PTA 30 mins to 24 hours Unfit for 3 months after full recovery without symptoms
Then OSL for further 3 months AND
 Linear Skull fracture
AME clinical assessment after full recovery without symptoms
LAPL
Unfit for 3 months after full recovery without symptoms
Class 1,3 Class 1,3
 Initial GCS less than 9 Unfit 2 years after full recovery without symptoms applicants must be referred to CAA for decision
 LOC more than 24 hours Then Class 1 OML long-term, Class 3 unrestricted Medical report from attending specialist including investigations. CT/MRI
mandatory before recertification
 PTA more than 24 hours
Class 2 Neurocognitive testing must be performed
 Transient Focal neurological deficit
Unfit for 1 year after full recovery without symptoms or Satisfactory Medical Flight Test / Simulator Proficiency Check
Severe  Brain contusion(s) on CT/MRI or Intracranial haemorrhage demonstration of stable, non-disabling symptoms Then
on CT/MRI OSL for 1 year
 Complex skull fracture Class 2, LAPL
 Any operative intervention LAPL Medical report from attending specialist including investigations. CT/MRI
Unfit for 6 months after full recovery without symptoms or mandatory before recertification
 Early seizure*
stable, non-disabling symptoms AME clinical assessment
Then OSL/OPL for 6 months Satisfactory Medical Flight Test
LAPL
 Penetrating brain Injury Class 1 2 & 3
Medical report from attending specialist including investigations.
 Significant parenchymal damage i.e. Brain contusion on Unfit long-term CT/MRI mandatory before recertification
Very Severe CT/MRI (NB multiple unilateral or bilateral increase risk) +/- LAPL AND
Intracranial haemorrhage on CT/MRI Satisfactory Medical Flight Test
Unfit 1 year after full recovery without symptoms or
 Enduring focal neurological deficit demonstration of stable, non-disabling symptoms AND
 Early* and /or late (>7 days) seizures Then OSL/OPL long-term AME clinical assessment