Fitness for Certification
Under the USCG fitness for certification are required, these certifications require that medical practitioners comprehend any underlying physical conditions, how that specific condition is impacted by service in the maritime environment, and how the condition itself can impact maritime and public safety.
What should medical Examiners consider?
Seafarers work in a variety of environments and conditions that may impact their physical condition and may also prevent them from obtaining timely medical care. Oftentimes these are remote locations with very minimal, if any, medical resources. This is common and the loss of a functioning mariner on a vessel can significantly negatively impact the rest of the crew, both in regards to routine and emergency duties.
National Maritime Center Providing Credentials to Mariners
What is a Medical Screening?
The medical screening consists of a DOT physical in conjunction a review of the CG-719K or CG-719K/E Merchant Mariner Credential Medical Evaluation Report, which is then submitted to the National Maritime Center (NMC).
Medical screeners review the physical examination form and determine if the applicant’s file requires a medical evaluation or operational limitation. The scope of the medical screener’s ability to grant an operational limitation is delegated pursuant to guidance in NMC work instructions and guidance from the Medical Division chief. Typically approximately 70 percent of applications processed through the medical division are reviewed, approved and move on to the next credentialing step without further medical review.
What is a Medical Evaluation?
The medical evaluation process is a consultative review of the Merchant Mariner Credential Medical Evaluation Report submitted to the NMC. This evaluation review occurs after a unsuccessful screening due to medical history, condition, medications or any contradicting information noted on the physical examination form or supporting documentation submitted with the application.
Mariners applying for entry level positions (719 k/e) (Ordinary Seaman, Wiper or Food Handler) are not held to the same medical standards as mariners applying for qualified rating positions.
What is a medical waiver?
Medical waivers are granted for certain conditions that must be documented on the physical examination form or supporting documentation submitted by the applicant when the condition has been identified as not posing a significant risk to maritime safety.
The waiver serves an acknowledgement by the NMC that the condition was identified and places a responsibility on the mariner to report any change in the specific identified condition. Conditions that have progressively worsened may potentially affect a mariner’s fitness for certification. When granting a waiver, the NMC may apply a requirement or limitation to the waiver. It is the mariner’s responsibility to read the waiver letter and any applicable requirements/limitations in order to maintain the waiver.
46 CFR does not specifically address the numerous diagnoses with all possible associated requirements. NVIC 04-08 does however state that one of the outcomes of the NMC medical review may result in “the application does not possess the vision, hearing or general physical condition necessary, but a credential may be issued with appropriate limitation, waivers and/or other conditions for issuance of the credential specified by the NMC.”
Under this circumstance, the mariner should carry this waiver letter at all times while acting under the authority of the credential. It is important to keep in mind that waivers may be rendered invalid due to changes in a mariner’s medical condition and/or if a mariner fails to comply with waiver requirements.
How do I make sure my 719 k or 719k/e is properly filled out?
Physical Examination Checklist
When reviewing the CG-719K or CG-719K/E form, confirm that all blocks are filled in completely. Forms with missing information will incur delays in processing.
Section II (a) Medical Conditions:
Medical practitioners will review and verify the medical history as reported by the mariner/applicant. At this time, the medical practitioner should provide details of conditions as indicated on the form and aid the mariner in submitting the supporting medical documentation needed for the noted conditions.
Click here for examples of supporting documentation that are listed in NVIC 04-08. (https://www.federalregister.gov/documents/2008/09/29/E8-22724/medical-and-physical-evaluation-guidelines-for-merchant-mariner-credentials)
Section III Medications:
Medical practitioners will verify that ALL medications, vitamins, dietary supplements and/or performance-enhancing substances are listed with dosage and frequency. Make sure you have this information readily available and that it includes both prescription and non-prescription substances.
Section IV (a) Visual Acuity:
Ensure that both corrected AND uncorrected visual acuity is recorded, if applicable.
Section IV (b) Color Vision:
Ensure that test name and results are clearly marked. Use of color sensing lenses is not authorized.
Section VI Hearing: Instructions are as follows:
- Hearing Test: During this test, the audiometer should include testing at the following thresholds:
- 500 Hz,
- 1,000 Hz,
- 2,000 Hz, and
- 3,000 Hz.
The frequency responses for each ear should be taken at an average to determine the measure of an applicant’s hearing ability. Applicants must demonstrate an unaided threshold of 30 decibels or less in at least one ear.
Section VI Physical Examination:
Ensure that the medical practitioner completes all boxes in the section. The practitioner should utilize the comments section to describe any abnormalities found on physical examination.
Section VIII Demonstration of Physical Ability:
This section occurs when the medical practitioner doubts the applicant’s ability to meet the guidelines contained within this table, the practitioner should require that the applicant demonstrate the ability to meet the guidelines.
- During the demonstration of ability, the applicant must complete without assistance.
- If the applicant has any prosthesis or any other aid devices such as prescription glasses that is normally worn, they may be used by the applicant in all physical demonstrations unless when the use would prevent the proper wearing of mandated personal protective equipment (PPE).
What happens if my certification gets denied?
Denial of Medical Certification If your application has been denied for medical reasons, consider:
In accordance with 46 CFR 1.03–40, an applicant may request reconsideration of this decision.
- The request for reconsideration should address any possible errors,
- provide new facts or information, and/or
- provide extenuating circumstances in order to mitigate the decision.
The request for reconsideration must be made in writing and postmarked no later than 30 days after the date of the denial letter.
Once the request for reconsideration has been reviewed, the applicant will be notified that the NMC has either:
(1) reversed/modified the initial decision, or
(2) upheld the decision to deny your application.
The final step if you disagree with the reconsideration decision, an applicant may issue a formal appeal to the Director of Prevention Policy (CG-5P) at Coast Guard Headquarters within 30 days of the date of the reconsideration denial letter.