The letter you received was written with the expressed intent for you to take to your medical practitioner who can explain the tests that have been requested. The evaluator who has requested information is doing so based on information that your medical practitioner documented on your physical exam. If your medical practitioner has questions regarding the letter or the standards against which your physical is being evaluated, please provide his/her name, and phone number and/or email address and the best time to contact him/her. One of our medical evaluators will use this information to contact your medical practitioner and work to provide clarification. The medical division receives phone calls and e-mails through our Call Service Center (CSC), at 1-888-I-ASK NMC (427-5662) or IASKNMC@uscg.mil, or you can find information on our CSC web page.
The information we have requested is based on current policy and guidelines established to assist our medical evaluators with determining your fitness for duty. While your medical practitioner may feel that you are healthy and further tests are not indicated as it pertains to your general health, the National Maritime Center must show, based on the information documented on your physical, that you do not pose a risk to maritime safety. Without the information requested, we will not have the information required to complete the evaluation of your physical. This can significantly delay the processing of your application and may increase the amount of time before you receive your credential. If your medical practitioner has questions regarding the letter or the standards against which your physical is being evaluated, please provide his/her name, and phone number and/or e-mail address, as well as the best time to contact him/her. One of our medical evaluators will use this information to contact your medical practitioner and work to provide clarification.
If you received a letter stating that you are not medically qualified, you have the following options:
First Option: In accordance with 46 CFR 1.03-40, you may request reconsideration of this decision. Your request for reconsideration should address any possible errors, provide new facts or information, and/or provide extenuating circumstances in order to mitigate the decision. The request for reconsideration must be made in writing and postmarked no later than 30 days after the date of the denial letter. Your request for reconsideration will be reviewed and you will then be notified that the NMC has either: (1) reversed/modified the initial decision, or, (2) upheld the decision to deny your application. If you disagree with the reconsideration decision, then you may make a formal appeal to the Director of Prevention Policy (CG54) at Coast Guard Headquarters, within 30 days of the date of the reconsideration letter.
Please send the request for reconsideration to this office at the following address:
Medical Evaluations Division
United States Coast Guard
National Maritime Center
100 Forbes Drive
Martinsburg, WV 25404
Fax: (304) 433-3407
While a request for reconsideration is pending, the original decision or action remains in effect, unless otherwise stated. Failure to submit a formal request for reconsideration in accordance with these procedures and time limits will result in the decision or action becoming final agency action. It is recommended you retain copies of all material you send with any request for reconsideration. Please attach a copy of the letter you received to any documentation you provide us with in response to this notification.
Second Option: Apply for a Document of Continuity by submitting a separate application via a CG Regional Examination Center and return your credential with the application in accordance with 46 CDR 10.227 (e). Documents of Continuity do not expire and are issued solely to maintain an individual’s eligibility to renew once qualified.
The responsibility for submitting a complete package lies with the mariner. Please take any letter you receive requesting additional information with you to your medical provider to insure your submission is complete. Submission of incomplete information will result in your file being placed in Administrative Hold until the end of the allotted submission period. If the information is not received by then, a decision will be rendered with the information available. Again, it is the mariner's responsibility to insure that we possess all of the requested information. Please contact the NMC if you have submitted information and are unsure of your status or if you have any questions.
The new CG-719K form has errors that were identified early on; unfortunately the change to the form will take months. In the interim, it is important to advise your medical practitioner to provide his/her license number, address, and phone number on the last page of the CG 719K physical form. Without this information, processing of the physical will be delayed until we can obtain it.
If an applicant decides to decline to sign the release authorization, they do so with the understanding that it may result in a risk of prolonging the time to process their application. Without that authorization, requests for amplifying information, missing information, or discussions with their physician would not be allowed and would prevent the physical from being processed.
When medical is awaiting the receipt of information from a mariner, the application is placed in the Awaiting Information State. While the application is in that state, no progress is being made; the application is not forwarded to the next step in the credentialing process. It basically sits on a shelf until the information is received. Thus, it is in an administrative hold.
In order for the NMC Medical Division to make a fitness for duty determination, the applicant’s physical examination is evaluated against the Coast Guard’s standards for fitness. In the course of reviewing the physical, many illnesses and injuries (both past and present), as well as medications (active prescriptions) are thoroughly evaluated. When any of these conditions are deemed not to be significant risk to maritime safety, a medical waiver is granted for that item as acknowledgement of our review of that condition. Additionally we instruct the mariner that any significant change in their medical condition must be reported to the NMC as soon as possible or that waiver becomes invalid. The waiver is a positive endorsement of the condition that requires monitoring for the duration of the mariner’s license. Mariners should carry a copy of their waiver letter with them whenever they are operating under the credential.
I answered “YES” to several of the blocks on page 5 of the CG-719K when I completed my physical exam, however, I received a letter a couple of weeks later that stated that I needed to answer the questions in greater detail.
At the bottom of page 4 of the CG-719K there are instructions for how the medical practitioner completing the CG 719K should document the answers marked “YES”. Additionally, the CG 719 K job aid located on our website provides specific guidance for medical practitioners on how to properly fill out the entire physical exam form.
A team of qualified physicians reviews all reconsideration requests to determine if your eligibility has changed.
It is the right of any applicant who has been denied because of medical reasons to request reconsideration by providing additional information that may potentially prove their fitness for duty. A detailed explanation of the reconsideration process can be found on any letter of denial.
Reconsideration Approvals: Reconsideration approvals will be forwarded to Professional Qualifications Evaluations (PQE) for processing of your credential. A medical waiver may be included with your credential. (See Medical Waivers)
Reconsideration Denials: Your reconsideration package has been reviewed by our physicians who have determined that your eligibility is unchanged. The NMC takes every step to ensure that reconsiderations are thoroughly reviewed. If we deny your reconsideration, your reconsideration denial letter is forwarded to the NMC Commanding Officer for final review and signature.
If your reconsideration request has been denied, there are two options for you to consider:
1. Formal Appeal: First, in accordance with 46 CFR 1.03-40, you may request a formal appeal. Your formal appeal should address any possible errors, provide new facts or information, and/or provide extenuating circumstances in order to mitigate the decision. The formal appeal must be made in writing and postmarked no later than 30 days after the date of the denial letter. Please send the formal appeal to the National Maritime Center (NMC). The NMC will then forward your appeal and your complete NMC file to Director of Prevention Policy (CG54) at Coast Guard Headquarters for consideration of your appeal.
While a formal appeal is pending, the original decision or action and reconsideration decisions remain in effect, unless otherwise stated. Failure to submit a formal appeal in accordance with the aforementioned procedures and time limits will result in the original decision or action becoming final agency action.
2. Document of Continuity: Your second option is to apply for a Document of Continuity. To apply for a Document of Continuity, you need to submit a separate application via a Regional Examination Center and return your credential with the application as per 46CFR 10.227(e). There is a 1-year grace period to renew once the MMC expires. If more time is needed, you also have the option to place your credential in a continuity status. For more information on a Document of Continuity go to the NMC website.
If an applicant has been denied, and has subsequently had a requested reconsideration denied, then the applicant can have their entire case reviewed by U.S. Coast Guard Headquarters for final agency action. A detailed explanation of the appeal process can be found on any reconsideration denial letter. Requests for a formal appeal following a reconsideration denial must be made in writing to the NMC.
The NMC shall forward all appeal requests to the Director of Prevention Policy (CG54) at Coast Guard Headquarters. The Director of Prevention Policy (CG54) oversees all aspects of the appeal process. For information regarding the status of your appeal, please contact the Director of Prevention Policy (CG54) at Coast Guard Headquarters.
What if the physician has passed away and I am unable to get my old medical records?
You will need a new physician to re-evaluate the condition, and you will need to provide the new information to NMC.
The NMC only expects you to go back as far as you can remember, and can provide documentation for any pertinent information that may require further explanation. Childhood ailments like acne, mumps, chicken-pox, or adolescent asthma are not required to be listed, unless you are still being treated for those conditions.
The responsibility for submitting a complete package lies with the mariner. Please take any letter you receive requesting additional information with you to your medical provider to insure your submission is complete. Submission of incomplete information will result in your file being placed in Administrative Hold until the end of the allotted submission period. If the information is not received by then, a decision will be rendered with the information available. Again, it is the mariner's responsibility to insure that we possess all of the requested information. Please contact the NMC if you have submitted information and are unsure of your status or if you have any questions.
Cardiac testing is performed to determine your risk for an adverse event or episode of sudden incapacitation. Certain tests need to be be performed for a minimum amount of time in order for the results to be considered valid or predictive. Please discuss this issue with your cardiologist or contact the NMC for any further questions.
From time to time the NMC will receive a physical in which the treating provider will indicate that a mariner is cleared without any restrictions, however, there are no supporting documents to verify that statement. As a regulatory agency we are required to trust, but verify all information during the medical evaluation. When items are discovered that require further information (testing, records, etc.), we are required to request those items for verification. If a medical provider ever has a question as to what information should be submitted with any physical examination, they can contact us at 1-888-IASKNMC (427-5662).
In order for the NMC Medical Division to make a fitness for duty determination, the applicant’s physical examination is evaluated against the Coast Guard’s standards for fitness. In the course of reviewing the physical, many illnesses and injuries (both past and present), as well as medications (active prescriptions) are thoroughly evaluated. When any of these conditions are deemed not to be a significant risk to maritime safety, a medical waiver is granted for that item as acknowledgement of our review of that condition. Additionally, we instruct the mariner that any significant change in their medical condition must be reported to the NMC as soon as possible or that waiver becomes invalid. The waiver is a positive endorsement of the condition that requires monitoring for the duration of the mariner’s license. Therefore, it should not impact your current job or any job you would be applying for.
Regulations and policies change as medical standards of care change. What may have been acceptable in the past may no longer be acceptable as the regulations and policies catch up with new medical standards of care.