Posted:
October 24, 2008
By Mike Murphy
AMO Director of Government Relations
On Sept. 15, 2008, the U.S. Coast Guard published the final version of the new medical guidelines in Navigation and Vessel Inspection Circular (NVIC) 04-08. This long awaited document formalizes the medical guidelines the Coast Guard has been using for the past six months. The NVIC can be downloaded at http://www.uscg.mil/hq/cg5/NVIC/2000s.asp#2008.
What has NOT yet been published is the new Medical Evaluation Form (CG-719). The new form is still under final review, but the draft document is approximately 12 pages long, versus the current form’s four pages, and it is significantly more detailed with respect to past and current health questions. Until the new form is published, AMO members will continue to download and complete the old CG-719K for their physicals. I will let everyone know when the new form comes into effect.
In this article, I will try to highlight some of the pertinent issues that will affect all of us when we have to take a Coast Guard physical. As I have said repeatedly in our outreach program over the past three months, this program is not what we wanted, but it is manageable with knowledge about the requirements and by applying for renewal early to ensure that waivers are granted in a timely fashion.
As a first step to understanding the requirements, I recommend that anyone who is renewing (or upgrading and needs a physical) within the next 18 months, download this document—it is more than 60 pages, so be prepared.
Second, use my comments below and read through the document. If you see any issues that affect you, whether it is one of the 201 medical conditions listed or any medication (prescription, over-the-counter or herbal), I recommend you contact your doctor 12 months before your renewal date and make an appointment to discuss the pertinent sections of the NVIC with him or her. If either you or your doctor have questions, you should contact the National Maritime Center at (888) 427-5662 and ask be connected to the medical evaluation section. Your doctor and NMC need to come to a clear understanding about what tests, examinations or documentation will be required to obtain a waiver. Some of the requirements could take up to six months to complete, so laying this early groundwork may save you many months of frustration when you are trying to renew your document.
The following points are worth noting as you read the new NVIC:
ENCLOSURE (1) MEDICAL CERTIFICATION STANDARDS
Demonstration of physical ability (Page 1): Anyone with a Body Mass Index over 40 will have to meet the requirements listed in Enclosure (2).
Physical periodicity (Page 3): Original and renewal documents require a physical within ONE year. Pilots require a physical every year. Raise in grade requires a physical within THREE years.
Application to pilots (Page 5 Paragraph 11b): Statement that first class pilots will be evaluated in accordance with this document, this includes Great Lakes pilots
ENCLOSURE (2) PHYSICAL ABILITY GUIDELIINES
Body mass index (BMI): Anyone with a BMI 40 or higher, must demonstrate physical ability through testing. There is some latitude with the actual tests and your doctor should coordinate this test with the AMO Clinic in Dania Beach, Fla. See section on "Wellness/Fit for Duty" below.
ENCLOSURE (3) MEDICAL CONDITIONS SUBJECT TO FURTHER REVIEW
It is very important to read and understand the first two pages of this enclosure because they explain how to use the matrix of 201 medical conditions that require a waiver. Additionally, at the end of the matrix is an alphabetical listing and page reference to help you locate specific conditions. Behind the alphabetical listing are the abbreviations used in the enclosure.
Most common conditions/drugs: The most common ailments seen at NMC are high blood pressure, diabetes, coronary issues, obesity and chronic back problems. There are also a significant number of mariners who are being treated for sleep-related health issues, including apnea and insomnia. All conditions listed in Enclosure (3) have detailed requirements that must be met prior to NMC issuing a waiver. In addition to requiring a waiver for the health issues, the drugs prescribed for these conditions all require a waiver. It is notable that some drugs can not be waived.
Alcohol or substance abuse and alcohol or substance dependency: If you have any alcohol or substance abuse issues, you must carefully read pages 29 and 30 of this enclosure. If you have any question about whether this discussion applies to you, contact your doctor or the NMC. These conditions have the potential to cause significant delays in processing if they are not addressed properly.
ENCLOSURE (4) MEDICATIONS
Definitions, prohibitions and descriptions: Carefully read all three pages, especially the section on prescription and over-the-counter (OTC) drugs. The new policy is you must report any prescription drugs that have been prescribed, filled or refilled within 30 days prior to signing the CG-719K physical form. AND, you will ALSO have to list any OTC drugs, vitamins or herbal supplements that have been taken for 30 or more days within the last 90 days.
ENCLOSURE (5) VISION AND HEARING STANDARDS
Vision: Vision standards are relatively unchanged for the moment, but a footnote says they are trying to make allowances for monocular vision. Great Lakes pilots’ vision standards remain the most stringent of all. The Coast Guard has added several conditions and waivers to help those mariners who have color vision issues—this is new and welcome.
Hearing: Hearing standards are much more stringent. If you have hearing issues contact an audiologist to interpret the new standards.
ENCLOSURE (6) MEDICAL REVIEW PROCESS
Review of denied waivers: This is a new section and it is worth reading. However, before you begin appealing a denial, contact your AMO representative. They will direct you to resources within the union to help you with an appeal. This is very important because, once your case is reviewed and the denial upheld, it could be extremely difficult to reopen your case.
Trusted agents: On the last page of the NVIC there is a discussion of "trusted agents." Trusted agents will be those health practitioners who are designated by the Coast Guard and whose physicals may get priority processing at NMC. The Coast Guard has not yet provided the guidelines to become a trusted agent. I will be monitoring this closely to ensure that AMO’s clinic is considered for designation.
AMO Wellness and Fit For Duty Program: As an answer to the more stringent medical guidelines, AMO Plans has established a Wellness and Fit for Duty Program at our Dania Beach medical facility. This two-week program is designed to assist any member who is either currently experiencing difficulties in meeting the medical guidelines or anticipates having difficulties with the guidelines. For further information concerning this program, contact any AMO representative.
In summary, the new medical guidelines represent a distinct departure from the Coast Guard’s previous program. However, as I said earlier, we can manage these new requirements and ensure that we all obtain any necessary waivers if:
A Mariner’s Guide to the new Coast Guard medical requirements: NVIC 04-08
By Mike Murphy
AMO Director of Government Relations
On Sept. 15, 2008, the U.S. Coast Guard published the final version of the new medical guidelines in Navigation and Vessel Inspection Circular (NVIC) 04-08. This long awaited document formalizes the medical guidelines the Coast Guard has been using for the past six months. The NVIC can be downloaded at http://www.uscg.mil/hq/cg5/NVIC/2000s.asp#2008.
What has NOT yet been published is the new Medical Evaluation Form (CG-719). The new form is still under final review, but the draft document is approximately 12 pages long, versus the current form’s four pages, and it is significantly more detailed with respect to past and current health questions. Until the new form is published, AMO members will continue to download and complete the old CG-719K for their physicals. I will let everyone know when the new form comes into effect.
In this article, I will try to highlight some of the pertinent issues that will affect all of us when we have to take a Coast Guard physical. As I have said repeatedly in our outreach program over the past three months, this program is not what we wanted, but it is manageable with knowledge about the requirements and by applying for renewal early to ensure that waivers are granted in a timely fashion.
As a first step to understanding the requirements, I recommend that anyone who is renewing (or upgrading and needs a physical) within the next 18 months, download this document—it is more than 60 pages, so be prepared.
Second, use my comments below and read through the document. If you see any issues that affect you, whether it is one of the 201 medical conditions listed or any medication (prescription, over-the-counter or herbal), I recommend you contact your doctor 12 months before your renewal date and make an appointment to discuss the pertinent sections of the NVIC with him or her. If either you or your doctor have questions, you should contact the National Maritime Center at (888) 427-5662 and ask be connected to the medical evaluation section. Your doctor and NMC need to come to a clear understanding about what tests, examinations or documentation will be required to obtain a waiver. Some of the requirements could take up to six months to complete, so laying this early groundwork may save you many months of frustration when you are trying to renew your document.
The following points are worth noting as you read the new NVIC:
ENCLOSURE (1) MEDICAL CERTIFICATION STANDARDS
Demonstration of physical ability (Page 1): Anyone with a Body Mass Index over 40 will have to meet the requirements listed in Enclosure (2).
Physical periodicity (Page 3): Original and renewal documents require a physical within ONE year. Pilots require a physical every year. Raise in grade requires a physical within THREE years.
Application to pilots (Page 5 Paragraph 11b): Statement that first class pilots will be evaluated in accordance with this document, this includes Great Lakes pilots
ENCLOSURE (2) PHYSICAL ABILITY GUIDELIINES
Body mass index (BMI): Anyone with a BMI 40 or higher, must demonstrate physical ability through testing. There is some latitude with the actual tests and your doctor should coordinate this test with the AMO Clinic in Dania Beach, Fla. See section on "Wellness/Fit for Duty" below.
ENCLOSURE (3) MEDICAL CONDITIONS SUBJECT TO FURTHER REVIEW
It is very important to read and understand the first two pages of this enclosure because they explain how to use the matrix of 201 medical conditions that require a waiver. Additionally, at the end of the matrix is an alphabetical listing and page reference to help you locate specific conditions. Behind the alphabetical listing are the abbreviations used in the enclosure.
Most common conditions/drugs: The most common ailments seen at NMC are high blood pressure, diabetes, coronary issues, obesity and chronic back problems. There are also a significant number of mariners who are being treated for sleep-related health issues, including apnea and insomnia. All conditions listed in Enclosure (3) have detailed requirements that must be met prior to NMC issuing a waiver. In addition to requiring a waiver for the health issues, the drugs prescribed for these conditions all require a waiver. It is notable that some drugs can not be waived.
Alcohol or substance abuse and alcohol or substance dependency: If you have any alcohol or substance abuse issues, you must carefully read pages 29 and 30 of this enclosure. If you have any question about whether this discussion applies to you, contact your doctor or the NMC. These conditions have the potential to cause significant delays in processing if they are not addressed properly.
ENCLOSURE (4) MEDICATIONS
Definitions, prohibitions and descriptions: Carefully read all three pages, especially the section on prescription and over-the-counter (OTC) drugs. The new policy is you must report any prescription drugs that have been prescribed, filled or refilled within 30 days prior to signing the CG-719K physical form. AND, you will ALSO have to list any OTC drugs, vitamins or herbal supplements that have been taken for 30 or more days within the last 90 days.
ENCLOSURE (5) VISION AND HEARING STANDARDS
Vision: Vision standards are relatively unchanged for the moment, but a footnote says they are trying to make allowances for monocular vision. Great Lakes pilots’ vision standards remain the most stringent of all. The Coast Guard has added several conditions and waivers to help those mariners who have color vision issues—this is new and welcome.
Hearing: Hearing standards are much more stringent. If you have hearing issues contact an audiologist to interpret the new standards.
ENCLOSURE (6) MEDICAL REVIEW PROCESS
Review of denied waivers: This is a new section and it is worth reading. However, before you begin appealing a denial, contact your AMO representative. They will direct you to resources within the union to help you with an appeal. This is very important because, once your case is reviewed and the denial upheld, it could be extremely difficult to reopen your case.
Trusted agents: On the last page of the NVIC there is a discussion of "trusted agents." Trusted agents will be those health practitioners who are designated by the Coast Guard and whose physicals may get priority processing at NMC. The Coast Guard has not yet provided the guidelines to become a trusted agent. I will be monitoring this closely to ensure that AMO’s clinic is considered for designation.
AMO Wellness and Fit For Duty Program: As an answer to the more stringent medical guidelines, AMO Plans has established a Wellness and Fit for Duty Program at our Dania Beach medical facility. This two-week program is designed to assist any member who is either currently experiencing difficulties in meeting the medical guidelines or anticipates having difficulties with the guidelines. For further information concerning this program, contact any AMO representative.
In summary, the new medical guidelines represent a distinct departure from the Coast Guard’s previous program. However, as I said earlier, we can manage these new requirements and ensure that we all obtain any necessary waivers if:
- We know how the guidelines apply to us
- Coordinate with our doctors and NMC
- We start our renewals early—12 months is what I recommend if you have any medical issues listed in the NVIC.