Medical Waivers and Limitations: Addressing Health Concerns in Captain’s License Applications
What are the medical requirements for a captain’s license?
For a vessel to be operated safely, it's essential that the crew members be physically fit and free of debilitating illness and injury. The seafaring life is arduous, often hazardous, and the availability of medical assistance or treatment is generally minimal.
The following medical guidelines are just that: guidelines. They're not intended to be absolute or all-encompassing. Some individuals may have medical conditions or physical limitations that would render them incompetent to perform their duties aboard a vessel, while others may be capable of working at sea without posing a risk to themselves, their ship, or shipmates even though one of the listed conditions exists.
As the trend towards smaller cruise continues, the ability of each crew member to perform his or her routine duties and respond to emergencies becomes even more critical.
Watch this video for more on the medical requirements for a captain’s license.
Do I need a physical exam to get a captain’s license?
Captain’s licenses, such as the OUPV and Master license, require a physical exam to be completed as part of the application process. The form you need for your captain’s license physical is the CG- 719K Application for Medical Certificate. Most of our students go to their family doctor to get this done.
What are the common captain’s license medical disqualifiers?
Here are the top five medical conditions that can delay your captain's license application or cause the application to be denied:
- Cardiac disease
- Diabetes
- Psychiatric disorders
- Sleep apnea
- Chronic use of narcotics
What does the doctor check for during my medical review process?
Seafarers work in a multitude of environments and conditions that can impact their physical condition and may prevent them from obtaining timely medical care. Remote locations with minimal, if any, medical resources is common and the loss of a functioning mariner on a vessel can significantly impact the rest of the crew, both in regards to routine and emergency duties.
Medical conditions that preclude performance of these duties increase the risk to remaining crew, property and public safety.
Recommendations for issuing a Medical Certificate by treating practitioners are taken into consideration by the National Maritime Center (NMC) personnel evaluating the medical condition of the mariner. It should be noted, however, that treating practitioners often make recommendations without fully understanding fitness for certification guidelines and the marine transportation system (MTS) safety needs. Final determination will be made in accordance with the overriding safety needs of the MTS.
The determination of whether or not a mariner is fit for certification is based on a medical evaluation of the physical examination form and supporting documentation submitted by the applicant. The medical evaluation is a three-step process; however, not all applicants are subject to all three steps:
- Medical Screening: Certified medical assistant (CMA) or Registered Medical Assistant (RMA) review every physical examination arriving at the NMC. The CMAs/RMAs have a limited ability and clear approximately 70 percent of the files without any further review required.
- Initial Medical Review: Any medical condition deemed outside of the scope of the CMA or RMA is then reviewed by a mid-level medical provider, a physician assistant (PA). The PAs review all application files which require a more comprehensive assessment. These evaluators could grant waivers, request additional information and are authorized to speak with the applicant’s physician when there are questions with regards to fitness for certification requirements or requested information.
- MD Review: If a physical examination has been evaluated and determined that the mariner may not be fit for certification, the file is then submitted to our senior evaluation staff for final determination.
Supporting Medical Documentation
Frequently a mariner’s medical examination will indicate treatment for an illness, injury or prescription medication which requires further clarification in order to make a fitness for medical certification determination. Awaiting information (AI) refers to additional information requested by the medical evaluation staff to complete the medical evaluation.
What is the medical certificate?
As of January 24, 2014, the Coast Guard began issuing medical certificates to all mariners holding valid international endorsements, per the Final Rule titled, Implementation of the Amendments to the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978 (STCW), as Amended, and Changes to National Endorsements.
The medical certificate is a document that serves as proof that a mariner meets the required medical and physical standards. In order to receive a Merchant Mariner Credential or Medical Certificate you will need to complete the correct applications.
The Medical Division is responsible for determining the medical fitness for mariners to serve in the capacities specified by the domestic and international endorsements for which they apply.
To qualify for a medical certificate, a mariner must provide evidence of meeting the medical and physical standards found on Application for Merchant Mariner Medical Certificate (CG-719K), as appropriate.
What does the medical certificate authorize?
A medical certificate is a document that serves as proof that a mariner meets the required medical and physical standards, per the publication of the Federal Register (FR). This FR incorporates the 2010 Amendments to the STCW Convention into the U.S. regulations. It also makes other necessary changes to our national regulations for the purposes of reorganization, clarification, and needed updates.
The medical certificate is the Coast Guard’s authorization that mariners have met the following requirements:
- Have the physical capability to fulfill all the requirements of basic training as required by Section A-VI/1 of STCW
- Demonstrate adequate hearing and speech to communicate effectively and detect any audible alarms
- Have no medical condition, disorder or impairment that will prevent the effective and safe conduct of the seafarer’s routine and emergency duties
- Are not suffering from any medical condition likely to be aggravated by service at sea or to render the seafarer unfit for service or to endanger the health and safety of other personnel on board
- Are not taking medication that has side effects that will impair judgment, balance or any other requirements for effective and safe performance of routine and emergency duties on board
It's important that you provide medical documentation from your doctor if you have one or more of these medical conditions. Any cause for rejection is disqualifying only while the conditions persist or is likely to cause disqualifying complications.
Can I get a captain’s license if I have sleep apnea?
In today's world sleep apnea is not an automatic disqualifier. If you sleep apnea is controlled and managed, your doctor will write a letter stating so, then you should be good to go. Depending on the severity the Coast Guard may require a sleep study be done.
Can I get a captain’s license if I have a heart condition?
Generally speaking, if you have had no heart issues in more than 18 months and your cardiologist is willing to write a note indicating so, then your heart condition should not be a disqualifier.
If you have any concerns about how your specific medical history may affect your application, it is recommended to reach out to the Coast Guard for clarification.
Can I get a captain’s license if I am color blind?
If you are color blind and can only see black and white, this is not a disqualifier. You can still get your license. There will be a restriction on your license if you wanted to use it professionally from sundown to sunrise. Captain Bob, the owner of Mariners Learning System, has this issue!
If you are color deficient, we recommend the FARNSWORTH lantern test.
Read over our blog: Testing for Colorblindness and Restrictions for Captains.
Can I get a captain’s license if I have bipolar?
We recommend calling the Coast Guard at (888) 427 - 5662. Explain your situation and any medications you are taking. They will best be able to say if they will accept your application or not.
Can I get a captain’s license if I have Type 1 or 2 diabetes?
If your A1C is below 8 and your diabetes is under control, this is not a disqualifier. You will also need to have not had any complications in the past 18 months from it, such as insulin shock.
Can I get a captain’s license if I take prescription medicine?
For personalized guidance on your specific medical situation and any medications you are taking, we suggest reaching out to the Coast Guard at (888) 427 - 5662. They will provide you with the best advice on whether your application will be accepted.
What does my blood pressure need to be to get a captain’s license?
Your blood pressure needs to be less than 150 over 90 to be able to get a captain’s license.
Does the Coast Guard offer medical waivers?
Medical waivers are granted for conditions 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.
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 innumerable diagnoses with possible associated requirements. NVIC 04-08, however, does state that one of the outcomes of the NMC medical review may result in a determinate that “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.”
The waiver is an acknowledgement by the NMC that the condition was identified and places a responsibility on the mariner to report any change in the identified condition. Conditions that have progressively worsened may potentially affect a mariner’s fitness for certification.
The mariner should carry this waiver letter at all times while acting under the authority of the credential.
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.