| 03 March 2010
When I speak with mariners who are in the throes of attempting to renew their Coast Guard license I cringe and visualize a blind monkey, crouched in a bushel basket wistfully stroking a deflated football. New medical regulations are stopping many older licensed mariners figuratively dead in their tracks.
So, you’ve been licensed for thirty years and are on your seventh renewal? So what? Does the Coast Guard care that you have operated an eighty-foot sportfishing boat all over the world without a blemish on your record? No! But they do care if you have diabetes, high blood pressure, are overweight with a BMI (Body Mass Index) of 40 and above. With a BMI of 40 you will have to prove to a physician that you are physically able to perform several functions necessary for safe vessel operation.
The twenty-nine page Medical NVIC (Navigation Circular) that took effect September 19, 2008, with its 202 possible disqualifying conditions, is an eye-opener! If you think that you have a physical, or medical condition that may affect your license renewal check it out at the Coast Guard’s web site www.uscg.mil/nmc or www.homeport.uscg.mil.
Recently I received a call from a frantic mariner who received a letter from the NMC’s (National Maritime Center) Medical Evaluation Branch advising him that because he has Hepatitis C he must provide a mountain of information to be considered for a medical waiver including a liver biopsy, a physical report from a gastroenternologist, and a series of blood and liver function tests. It will cost him hundreds of dollars and the required tests are not covered by medical insurance.
What about medical waivers for diabetes, high blood pressure, anxiety and depression?
Diabetes Approval of a waiver for diabetes was simple before the new Medical NVIC came out. The new requirement is: An Internal Medicine consultation documenting the history of your diabetes, two HgA1C tests separated by 90 days, the latest not more than 90 days old, with readings of less than 8.0, plus a blood test that provides an evaluation of fasting plasma glucose level, a consultation report from an ophthalmologist, and if you are taking oral medication – a graded exercise (stress) test is necessary. If your blood tests fall within range, and your doctor provides documentation of when your diabetes was diagnosed, your current condition and a good prognosis approval is almost assured.
High blood pressure? It can be as high as 160/100 and you will be approved. However, if you are taking an Alpha, Beta, or Calcium Blocker or a blood thinner such as Coumadin, or Warfarin a medical waiver is required. That requires a letter from your physician as to when your high blood pressure was diagnosed, the medication prescribed, any side effects and his prognosis for the future.
Depression and anxiety In the past applicants taking Zoloft, etc., or any psychotropic medication (mind altering drugs) were automatically disqualified. Today to get a medical waiver all you need are: A psychiatrist or clinical psychologist’s clinical status report documenting DSM Axis I through V and addressing any disturbances of thought, recurrent episodes, and psychotropic medications to include documenting the period of use, name and dosage of any medications and side effects.
The current physical form is under revision and the new, but not yet approved, version will be eight pages in length! Just think what a doctor will charge to fill out eight pages compared to two.
Plan to file your license application three months in advance of the expiration date if you have any medical issues because the NMC Medical Group is weeks behind in processing paperwork.
Captain
Paul McElroy has been involved in licensing issues and regulations for almost
thirty years. He was a member of a Coast Guard Quality Action Team charged with
developing ways to improve the Coast Guard's licensing service.
He can be
reached at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
or (772) 288-1066.
