The Triton


USCG medical needs fix


Three U.S. mariner unions have submitted comments to the U.S. Coast Guard saying its merchant mariner medical review program is flawed and should be replaced.

The International Organization of Masters, Mates & Pilots (MMP), the Marine Engineers’ Beneficial Association (MEBA) and the American Maritime Officers (AMO) urge changes in the program to align it with commonly accepted national and international norms for fitness-of-duty evaluations.

Congress had directed the Coast Guard to seek public comment on its merchant mariner medical evaluation program. The Coast Guard commandant must submit to Congress an assessment of its current program, as well as alternatives to it. The commandant’s assessment must include an analysis of how the Coast Guard could make medical fitness determinations for mariners using a system similar to the Federal Motor Carrier Safety Administration (FMCSA) National Registry of Certified Medical Examiners program and the Federal Aviation Administration (FAA) Designated Aviation Medical Examiners program.

Under its current system, the Coast Guard employs a staff of “evaluators” who rely on paperwork to monitor changes in the medical condition of more than 200,000 mariners nationwide. Because the evaluators don’t actually examine the mariners whose condition they are called on to evaluate, they can require medical specialty consultations, imaging procedures and laboratory tests, which are often costly and time consuming.

Of major concern to mariners employed in the international trades — where assignments are four months aboard ship and four months off — is that the indefinite time lines, delays in the process and the scheduling of multiple appointments for doctors, testing and evaluations can result in the medical evaluation not being completed in time to meet their reassignment date.

The result for the mariner can be four months of lost employment and eight months loss of income and benefits.

Another factor: the cost of procedures.

“A mariner without insurance coverage may be subject to many thousands of dollars in expenses as a result of these burdensome and medically questionable procedures,” the unions say. “In some instances these costs will be shifted to insurance carriers and ultimately to maritime employers and health plans. But more likely these tests will be deemed to be ‘medically unnecessary’ by most insurance carriers, so that the costs must be borne by the mariner.”

The unions argue in favor of decentralizing the medical examination process to a network of designated and qualified medical practitioners, a system that has been used successfully for years in the airline and trucking industries.

To read the unions’ comments in their entirety, go to and click on “Breaking News.”

Reported in a recent edition of Wheelhouse Weekly, a newsletter of the International Organization of Masters, Mates & Pilots. It has been reprinted with permission.

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