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Today is a day when I feel terribly tired. I'm not ill, but I could sleep all the day, though I had enough sleep last night.

This is not a problem if you have an office job where you can probably be not as productive than on other days. But what about pilots? They are expected to have a high level of concentration and vigilance during the whole flight?

This question, What should a pilot do if they feel sleepy? concentrates more on upcoming sleepiness during the flight. The accepted answer says:

If a pilot is not rested enough to safely operate the aircraft, they should not fly. [...]

Well, "should not" sounds more like advice than a rule.

You may say that there are always two pilots on (not so long) commercial flights, but then you can also start with one faulty engine, because the second engine still could bring you to your destination. For me, this breaks the safety concept.

So, can a pilot go to a doctor and tell, "I'm tired today so I can't work"?

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So if you are well rested and not ill, but still feeling tired, there has to be something else wrong. From your description, it appears to be fatigue. The common signs for fatigue are:

  • Falling asleep
  • Yawning
  • Poor visual acuity
  • Feeling "sluggish" or "drowsy"
  • Decreased reaction time
  • Decreased concentration

Although, the most commonly known reason for fatigue is lack of sleep, but any or all of the following can cause fatigue:

  • Lack of quality sleep
  • Sleep disturbances
  • Interruption of circadian rhythm
  • Mental or emotional stress
  • Physical exertion, such as heavy exercise
  • Poor health, including dehydration or poor diet

Pilots can assess their own fitness to fly by the IMSAFE mnemonic. FAA has a small handout about fatigue.

Now what pilots (and generalizing, people) can do and actually do are two very different aspects. A survey about European pilots mention:

... many are afraid their fatigue reports could have negative consequences for their professional future (i.e. reprisals by management) ...

FAA has a new rule which states:

The FAA expects pilots and airlines to take joint responsibility when considering if a pilot is fit for duty, including fatigue resulting from pre-duty activities such as commuting. At the beginning of each flight segment, a pilot is required to affirmatively state his or her fitness for duty. If a pilot reports he or she is fatigued and unfit for duty, the airline must remove that pilot from duty immediately.

The answer to your question is: Yes, they can!

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    $\begingroup$ Although it really doesn't happen a lot - compare the number of days you feel exhausted in work, with the proportion of flights you've ever known to be cancelled (for any reason) $\endgroup$ – Jon Story Nov 5 '14 at 21:25
  • $\begingroup$ @JonStory When did I say that it really happens a lot? Regarding the comparison between my job and a commercial pilot, they cannot be compared as they are entirely different. Commercial pilots do not work 8-9 hours a day, 5 days a week, every single week. What is your point? $\endgroup$ – Farhan Nov 5 '14 at 21:49
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    $\begingroup$ @Farhan: Commercial pilots do work as much as you and at irregular schedule to make things worse. I asked about that some time ago and while they have 100 flight hours monthly limit, the additional duty time on ground (pre-flight, post-flight, time while loading etc.) can easily make once as much (especially when flying short routes) and they end up with ~180 hours like normal office worker. $\endgroup$ – Jan Hudec Nov 6 '14 at 6:17
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    $\begingroup$ never underestimate mental stress as a big reason for fatigue. $\endgroup$ – jwenting Nov 7 '14 at 9:09
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    $\begingroup$ @JonStory the flight isn't likely to be cancelled because a pilot is tired, that is why airlines have standby crews. $\endgroup$ – Notts90 Mar 9 '17 at 7:57
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"So, does a pilot go to the doctor and say "I'm tired today, I can't work"?"

Simply put, "Yes. Say you cannot work.".

If a surgeon cannot operate with full facilities, he doesn't operate. The patient can have surgery tomorrow (in most cases).

If a pilot cannot be assured that he can perform, regardless of weather, mechanical issues, ATC delays, whatever, the passengers can be inconvenienced.
It is better than the alternative, which is ending up dead.

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If you feel so tired and fatigued that you cannot safely operate an aircraft or perform your duties as a member of a multi-person flight crew, it is your call to do so, but yes, you can call in to a supervisor and tell them you are simply unable to fly. I don't know what the law is exactly but it is probably illegal for an employer to discipline you or to terminate your employment for a single instance of this.

Multiple and/or frequent infractions could lead you into trouble with an employer as it is your responsibility to plan ahead and be well rested and nourished for a duty shift.

This issue garnered a lot of attention with the crash of Colgan Air (Continental) 3407 in Buffalo in 2009. CVR tapes revealed a flight crew frequently yawning, and the FO complaining about long duty schedules as well as being ill and the cost of getting a hotel in order to get well. It turned out that many commuter outfits were working pilots through 14-16 hour duty shifts plus commuting with very little concern for their well being aside from management demands that they "move the rig". See the program Frontline: Flying Cheap.

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