Understanding Medical Disqualifiers for USCG Captain’s Licenses

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 operate safely, the crew members must be physically fit and free of debilitating illness and injury. Seafaring life is arduous and often hazardous, and 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 cruises continues, the ability of each crew member to perform his or her routine duties and respond to emergencies becomes even more critical. 

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: 

1. Cardiac disease 
2. Diabetes 
3. Psychiatric disorders 
4. Sleep apnea 
5. 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 are 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 the performance of these duties increase the risk to the 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 following 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:  

1. Medical Screening: A certified medical assistant (CMA) or Registered Medical Assistant (RMA) reviews 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. 
2. 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 or 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 regard to fitness for certification requirements or requested information.  
3. 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 that requires further clarification to determine fitness for medical certification. 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 of 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 the 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 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 

You must 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 are likely to cause disqualifying complications. 

Can I get a captain’s license if I have sleep apnea? 

You can still qualify for a captain's license if you have sleep apnea, as it is no longer an automatic disqualifier. The key is that your sleep apnea must be well-controlled and managed. 

Here's what you’ll need to do:

• Medical Documentation: Your doctor should provide a letter confirming that your sleep apnea is under control and managed effectively. This letter is essential for showing the Coast Guard that your condition doesn't impair your ability to operate a vessel safely.
• Sleep Study Requirement: Depending on the severity of your condition, the Coast Guard may request a recent sleep study. This is particularly common if your condition is moderate to severe, as it helps demonstrate that your treatment (such as CPAP therapy) is effective in managing the symptoms.
• Treatment Compliance: If you're using a CPAP machine or another treatment method, you may need to show proof of compliance, like usage reports, to confirm that you are consistently following your treatment plan.

If you meet these requirements and your sleep apnea is controlled, the Coast Guard is likely to approve your application for a captain's license.

Can I get a captain's license if I have a heart condition? 

Generally speaking, having a heart condition doesn't automatically disqualify someone from obtaining a captain's license. If a person has been free from any heart-related issues for more than 18 months, and their cardiologist is willing to provide documentation stating that the condition is stable, it's often considered manageable for licensing purposes.

However, specific cases may vary, and the Coast Guard is available to offer clarification regarding unique medical histories or any additional requirements.

Can I get a captain’s license if I am color-blind? 

Generally, color blindness is not an automatic disqualifier for a captain’s license. If an applicant is color-blind (only seeing in black and white), they may still obtain a license, although it may carry a restriction limiting professional use to daylight hours only.

💡 TIP! For individuals with color deficiency who are seeking a captain’s license, the Farnsworth Lantern Test (FALANT) is a recommended assessment. The FALANT is commonly used by maritime and military organizations to evaluate color vision in a way that is specifically relevant to duties at sea. It assesses the ability to distinguish between red, green, and white lights — a crucial skill for maritime navigation and identifying signals at sea. 

For more detailed information, our blog post Testing for Colorblindness and Restrictions for Captains provides additional insights into the requirements and considerations for color vision testing.

Can I get a captain’s license if I have bipolar? 

If you have bipolar disorder and are interested in obtaining a captain’s license, it's best to reach out directly to the Coast Guard for guidance. You can call them at (888) 427-5662 to discuss your specific situation, including any medications you’re taking. They will be able to provide more details on how your condition might impact your application and any additional requirements they may have.   

Can I get a captain’s license if I have Type 1 or 2 diabetes? 

If you have Type 1 or Type 2 diabetes, you may still be eligible for a captain’s license if your diabetes is well-controlled. Generally, the Coast Guard looks for an A1C level below 8 and no complications - such as insulin shock or other significant issues - in the past 18 months. However, requirements can vary, so it's a good idea to check with the Coast Guard for further clarification based on your specific situation. 

Can I get a captain’s license if I take prescription medicine?  

If you take prescription medication, you may still qualify for a captain’s license. For personalized guidance, it's best to contact the Coast Guard directly at (888) 427-5662. They can assess your specific situation, including any medications, and advise on whether your application may be accepted. 

What does my blood pressure need to be 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 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 acknowledges by the NMC that the condition was identified and requires the mariner to report any change in the 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. 

What is the Merchant Mariner Medical Manual?

The Merchant Mariner Medical Manual is a resource designed to assist medical practitioners, the maritime industry, individual mariners, and Coast Guard personnel in evaluating the physical and medical status of mariner applicants to ensure they meet the requirements for a merchant mariner medical certificate. The manual consolidates prior guidance from several Coast Guard documents and includes instructions on the medical certificate process, including how to apply for, issue, and cancel the certificate.

What is Subpart C of Part 10 in Title 46 of the Code of Federal Regulations (CFR), and what does it cover?

Subpart C of Part 10 in Title 46 of the Code of Federal Regulations (CFR) is titled Medical Certification and outlines the medical standards and procedures for evaluating individuals who are applying for or renewing their merchant mariner credentials (MMC). This section establishes the physical and medical qualifications that mariners must meet to ensure they are fit to serve on vessels. It includes specific guidance on medical conditions that may disqualify an applicant, the medical examinations required, and the process for obtaining or renewing a medical certificate.

The regulations are in place to protect both mariners and the public by ensuring that individuals operating vessels are physically capable of performing their duties safely.