We also revised the respective evaluation data associated with the medical conditions to remove the word current that formerly preceded many of status reports, evaluation reports or consultations in the table. Pay the necessary renewal fees at Pay.gov. It is not anticipated that the NVIC will result in significantly higher rates of disqualification for mariners, nor in increased processing time for credential applications with physical and/or medical issues. The Coast Guard agrees that such guidance may prove helpful and will work with MEDMAC to consider whether and what type of guidance would be appropriate for inclusion in a future version of the Medical Manual. The President of the United States communicates information on holidays, commemorations, special observances, trade, and policy through Proclamations. documents in the last year, by the Fish and Wildlife Service 25, 2013); and Implantable cardioverter defibrillators (77 FR 55174, Sep. 7, 2012). They can request the credential be issued if they want to immediately deposit it with the Coast Guard until such time as they are healed. A mariner having a disqualifying medical condition is not something addressed through S&R unless and until it has impacted vessel operation. WebWith a GPA of 3.6, United States Merchant Marine Academy requires you to be above average in your high school class. A Georgia Department of Corrections Residency One commenter asked whether a mariner who holds a medical waiver is required to report a material change in their medical condition. Three commenters asked whether employers have an obligation to report to the Coast Guard information regarding a change in condition. Fitness-for-duty status can change suddenly due to an acute illness, injury or incident. Finally, at the request of both MERPAC and TSAC, a new paragraph 11 was added to this enclosure authorizingbut not requiringthe Coast Guard to designate certain medical practitioners as trusted agents to perform physical examinations on mariners. The Coast Guard does not concur with these commenters. WebOffers are made based on operational needs and requirements and are determined by the U.S. Border Patrol. 552(a), 46 U.S.C. Application will be processed. If you meet United The third comment letter stated that the physical ability requirements should also include criteria for the speed and facility with which a mariner performs required tasks. A 1-797A or C. Other government-issued documents. The commenter noted that waivers seem not to have been consistently applied to conditions. The Medical Manual contains guidance on how the Coast Guard will conduct the medical certification evaluation for individuals who have been diagnosed with a substance abuse disorder. legal research should verify their results against an official edition of The Coast Guard understands the complexities associated with over-the-counter (OTC) medications and has revised the NVIC to strike a balance between the medical needs of mariners and public safety in response to comments. These markup elements allow the user to see how the document follows the Guidance on color vision, visual acuity, and hearing requirements are discussed in greater detail in Enclosure (3) of this NVIC. E8-22724 Filed 9-26-08; 8:45 am], updated on 11:15 AM on Friday, June 2, 2023, updated on 8:45 AM on Friday, June 2, 2023. This prototype edition of the Electronic Code of Federal Regulations (e-CFR), CHAPTER I - COAST GUARD, DEPARTMENT OF HOMELAND SECURITY, SUBCHAPTER B - MERCHANT MARINE OFFICERS AND SEAMEN. Various changes were made to the table itself to make compliance less burdensome for applicants. The Coast Guard developed the draft Manual in consultation with experienced maritime community medical practitioners and industry stakeholders serving on the Merchant Mariner Medical Advisory Committee (MEDMAC) and the Merchant Marine Personnel Advisory Committee (MERPAC). With respect to the table of medical conditions in enclosure (3), a number of changes were made to reduce unnecessary evaluations and clarify ambiguous criteria. 06/02/2023, 204 Medical Requirements. See requests for comment on proposed policies regarding: Diabetes, cardiomyopathy, and sleep disorders (80 FR 8586, Feb. 18, 2015); Medications (80 FR 4582, Jan. 28, 2015); Seizures (78 FR 17917, Mar. WebThe requirements for a complete application for an original MMC are contained in 10.225 of this part, the requirements for a renewal MMC application are contained in 10.227 of this This feature is not available for this document. Title 46 CFR 10.305(a) provides that mariners must demonstrate satisfactory color sense through one of the tests listed in the regulation, or through an alternative test acceptable to the Coast Guard. The NVIC guidelines apply if the applicant has an underlying medical condition. WebAll SSRG members are required to complete 12 days of ADT each Fiscal Year (FY). As pointed out by MERPAC, this caused confusion as to how old the evaluation data may be because there is no definition of the term current in the NVIC. documents in the last year, 18 Merchant Marines are a significant force that patrols the waters around the United States, keeping trade routes open, delivering supplies and transporting manufactured goods. The commenter mistakenly interpreted the clear error discussion to mean that the Coast Guard would not take responsibility for any erroneous certification decisions that might lead to mishaps or untoward medical situations at sea. The applicant must be at least 17 but not older than 25 by July 1 of the entrance year. The Coast Guard will accept Farnsworth D-15 Hue Test as a color vision test to meet the requirements of this paragraph. In these cases, the employer's fitness-for-duty determinations may differ from the medical certification determination because they are based upon different standards. How long will it take for me to receive my medical certificate from the NMC? You can compensate for a lower GPA with harder classes, like AP or IB classes. Since these requirements are established in regulation, changing them would require a rulemaking and is beyond the scope of this policy document. Merchant Mariner physicals are a type of military physical examination. One also requested that the Coast Guard add language to the Medical Manual requiring medical treatment for any mariner who fails a USCG required drug test. The quality of work is important. on After considering the comments, we decided to proceed with the proposed policy. This table of contents is a navigational tool, processed from the 7922; Mendenhall Glacier Recreation Area; Alaska, Safety Zone; Sausalito Fireworks Display; San Francisco Bay, Sausalito, CA, Energy Conservation Program: Test Procedure for Commercial Warm Air Furnaces, Agency Information Collection Activities; Migratory Bird Surveys, Migraine: Developing Drugs for Preventive Treatment, Moving Beyond COVID-19 Vaccination Requirements for Federal Workers, Imposing Sanctions on Certain Persons Destabilizing Sudan and Undermining the Goal of a Democratic Transition, Background and Discussion of the Merchant Mariner Medical Manual. As an example, an individual with no medical problems who has been issued a medical certificate and who normally performs their essential job functions without impairment, could become not-fit-for duty because of an impairing illness such as the flu, and/or due to impairing medications used to treat an acute illness. Reference to the Coast Guard standard of cure, which applies when credentials are subject to suspension and revocation but not necessarily when credentials are issued, has been deleted. daily Federal Register on FederalRegister.gov will remain an unofficial Paragraph 8 was revised to clarify that the NMC will inform the applicant of the results of their waiver review. A definitions section has been added to the enclosure, and a new prohibitions section dealing with illegal substances and intoxicants has been included. About the Federal Register at least 20/40 corrected vision in one eye and at least 20/200 This means that an individual who has properly reported a medical condition, and provided the requisite evaluation data regarding it, may be excused from having to resubmit evaluation data for that condition in the future, but only if authorized by the NMC. Pharmacologic stress tests evaluate coronary artery disease but do not provide information on cardiopulmonary capacity. are not part of the published document itself. include documents scheduled for later issues, at the request The role of a merchant mariner requires an MMC from the U.S. Coast Guard under the International Convention on Standards of Training, Certification and 2019-19370 Filed 9-6-19; 8:45 am], updated on 11:15 AM on Friday, June 2, 2023, updated on 8:45 AM on Friday, June 2, 2023. . Federal Register issue. 06/02/2023, 152 documents in the last year, by the Land Management Bureau In general, fitness for duty refers to an employee's ability to perform his/her essential job functions, as specified by the employer, without impairment from medical conditions or medications. All materials related to this NVIC are part of this docket and are available for inspection or copying at the Docket Management Facility (M-30), U.S. Department of Transportation, West Building Ground Floor, Room W12-140, 1200 New Jersey Avenue, SE., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. Now, the first paragraph discusses original credentials, the second paragraph discusses renewals, the third paragraph discusses raises in grade, and the fourth and fifth paragraphs discuss STCW endorsements and certificates of registry, respectively. The Coast Guard considered each of these comments and advises that this manual does not impose any new reporting requirements on anyone. Paragraph I discusses NMC medical evaluation procedures for mariners with existing waivers, and Paragraph I.3. The appellate rights of applicants, who are affected by a waiver determination, are now fully explained in this paragraph as well. Web2. This document has been published in the Federal Register. A Notice by the Coast Guard on 09/29/2008. Moreover, this enclosure, which is the central component of the NVIC because it lists the medical conditions subject to further review, underwent substantial revision. The Coast Guard would specify the criteria for designation as a trusted agent if/when the Coast Guard initiates this program. rendition of the daily Federal Register on FederalRegister.gov does not WebGuidance on color vision, visual acuity, and hearing requirements are discussed in greater detail in enclosure (3). The favorable commenters appreciated that the document provides medical evaluators, mariners and medical providers with needed and relevant information that will reduce the need for back and forth between the mariner and the National Maritime Center. The majority of medical evaluations and tests specified in the NVIC will be provided by the mariner's primary care provider or specialist as part of standard care. on The table now simply asks for pertinent medical records, pulmonology consultations, and names and dosages of medications. The recommended evaluation data for sarcoidosis, at the urging of certain maritime labor unions, was restated to be less extensive. These tools are designed to help you understand the official document There are two major routes that a young person can take to join the Merchant Marines: applying to and attending the Merchant Marine Academy, or attending a 24-week training course at the Seafarers Harry Lundeberg School of Seamanship. Director of Commercial Regulations & Standards. WebDid you know you can text with Marine Corps Recruiting? The President of the United States manages the operations of the Executive branch of Government through Executive orders. Register documents. Documentation of at least 90 days of objectively measured and sustained total abstinence is also recommended evaluation data for dependence. The physical ability guidelines listed in the table of enclosure (2) were significantly revised, based largely on input provided by TSAC. The Merchant Mariner Medical Manual, COMDTINST M16721.4, is available on the internet at: https://www.dcms.uscg.mil/Our-Organization/Assistant-Commandant-for-C4IT-CG-6/The-Office-of-Information-Management-CG-61/About-CG-Directives-System/ and on CGPortal at: https://cgportal2.uscg.mil/library/directives/SitePages/Home.aspx. Scholastic Requirements | U.S. On the issue of providing quality assurance for medical examiners, it is important to recognize that medical examiners are not regulated by the Coast Guard. The criteria for asthma was changed to include only clinically significant moderate to severe asthma. For information about this document or to suggest changes, call or email Adrienne Buggs, M.D., United States Coast Guard, Office of Merchant Mariner Start Printed Page 47142Credentialing; telephone: 202-372-2357, email: MMCPolicy@uscg.mil. These markup elements allow the user to see how the document follows the Information about this document as published in the Federal Register. The new NVIC is numbered 04-08, and it is entitled Medical and Physical Evaluation Guidelines for Merchant Mariner Credentials. It replaces NVIC 2-98, which is cancelled as of the effective date of NVIC 04-08. The use of anti-depressants for use in smoking cessation and other off-label indications was also allowed. Federal Register provide legal notice to the public and judicial notice Commenters were both supportive of, and objected to, the proposed medical certificate cancellation policy. One comment letter expressed a generally negative opinion of the draft Medical Manual. Register, and does not replace the official print version or the official to have correctable vision to at least 20/40 in one eye and uncorrected vision of at least 20/200 in the same eye. These provisions were included to reduce the burden of imposing and then removing waivers and restrictions for conditions that are expected to resolve in the short-term. Important changes were made to the newly renumbered enclosure (6), which was previously enclosure (5) in the September 2006 draft NVIC, in response to various public comments and MERPAC and TSAC input. Based on consultation with medical practitioners and MERPAC, we determined exams and documentation addressed by the NVIC are commonly required by current medical practice and will not represent a significant additional cost to the individual. Merchant Marine Academy Home Admissions Scholastic Requirements Candidates should pursue studies in high school that will prepare them for the Academy's rigorous program. should verify the contents of the documents against a final, official For every 100 applicants, 22 are admitted. For questions on this notice or on NVIC 04-08, e-mail or call Captain Matthew D. Hall, MD, USPHS at the National Start Printed Page 56601Maritime Center, 304-433-3551, e-mail: matthew.d.hall@uscg.mil. One letter commented that the Medical Manual should require all mariners to meet the same medical standard, and should provide specific acceptable parameters for many conditions to include BMI, pulmonary function, glucose levels, blood pressure, and cardiac function. NVIC 04-08 is effective on October 29, 2008. Use the PDF linked in the document sidebar for the official electronic format. One comment letter asserted that the discussion of alternative testing methodologies for demonstrating satisfactory color vision contained Paragraph A.1.d. The Coast Guard will be pursuing a change to CG-719K in the future to correct this change. This site displays a prototype of a Web 2.0 version of the daily The Public Inspection page may also on Processing times will vary depending on the medical condition (s) reported and supplemental information provided. It is not an official legal edition of the Federal Copyright 2023 Leaf Group Ltd. / Leaf Group Media, All Rights Reserved. Register, and does not replace the official print version or the official The use of motion sickness medications was also addressed to allow their use in accordance with directions. Webpublic about the importance of the sea services to include the Navy, Marine Corps, Coast Guard, and U.S.-lag Merchant Marine. More than 1, less than 3 years. 06/02/2023, 245 Current locations include Long Beach and San Diego, CA; Key Largo, These commenters found the guidance in the Manual to be thorough, straightforward and easy to use, and they found that it answered many questions that had arisen with previous medical policy documents. Nonetheless, the Coast Guard affirms that the activities of the NMC Medical Evaluations Division, particularly those related to medical certification, are supervised by a licensed medical officer. include documents scheduled for later issues, at the request This decision is necessarily a snapshot of the mariner's medical and physical condition at a single point in time. [FR Doc. Finally, audiometer test hearing standards were adjusted from 20 decibels or less in each ear (unaided) to 30 decibels or less in the best ear (unaided). As of 2021, the total for renewal applications is $95 , advises the USCG National Maritime Center. Unexpired Firearms or Merchant Marine Licenses. The color sense must be determined to be satisfactory when tested by any color-vision test listed in paragraph (a) of this section, or an alternative test acceptable to the Coast Guard, without the use of color-sensing lenses. To complete your medical certificate, you must demonstrate that youre physically able to fulfill the requirements of basic training, pass a hearing and vision test, and a color vision assessment. documents in the last year, by the Coast Guard With the exception of hearing, visual acuity, and color vision, none of these references contains specific standards for determining whether mariners are physically and It is also permanently available on the HOMEPORT internet Web site at: http://homeport.uscg.mil/mycg/portal/ep/browse.do?channelId=-25023. for better understanding how a document is structured but documents in the last year, 980 WebHave normal color vision as determined by USCG approved color vision testing or mariner could be restricted to sailing steward department. documents in the last year, 20 states that the Coast Guard is not bound to honor a medical waiver that was issued in clear error, contrary to duly promulgated policy in effect at time of issuance. documents in the last year, 291 Explore here April 1, 2022 by Sarah Warner The global Marine Vessel market is expected to grow to USD 188.57 billion in 2028 from USD 170.75 billion in 2021. NVIC 04-08 is available on the internet at http://www.regulations.gov,, under this docket number [USCG 2006-25080]. documents in the last year, 913 1001, criminal prosecution may result if false information is submitted to the Coast Guard with respect to the credential application process, by either the applicant or the medical practitioner responsible for the exams, tests, and/or physical demonstrations. Applicant will be advised that additional conviction (s) may jeopardize merchant mariner credentials. No consideration is being given to excluding broad classes of credential applicants from the guidance contained in the table, because for the most part, credentials issued by the Coast Guard are not vessel specific. headings within the legal text of Federal Register documents. New Documents In such cases, equivalent alternate testing methodologies may be used. Accordingly, the medical certificate cancellation and waiver processes set forth in the manual effectively address mariner medical qualification and fitness for duty concerns in ways that the S&R system cannot. In the preface to enclosure (3), we clarified that the term history means a single previous diagnosis or treatment of a medical condition, even once in the applicant's life, unless otherwise specified in the table listing the medical conditions. We discovered that in some places, the word current preceded the evaluation data, while in others it did not. The Merchant Marines, though not extremely well known, is an incredible organization. The Public Inspection page may also Both commenters noted that prior versions of the CG-719K and the Medical Manual only instructed mariners to disclose OTC medications if the medications were used for a period of 30 days or more within the 90 days prior to the date the applicant signs the application to the Coast Guard. However, the NTSB continues to find effects from impairing substances (alcohol and over-the-counter, prescription, or illicit drugs) to have contributed to the probable cause across all modes of transportation. Changes to the DOT and Coast Guard drug testing regulation and policy are beyond the scope of this policy document. Instead, the Coast Guard has already provided a fairly comprehensive discussion of the major changes in Paragraph 6 of the Letter of Promulgation for the Medical Manual. Ten comment letters provided a general opinion of the draft Manual, with the majority expressing an overall positive opinion. The second comment noted that the Manual does not contain any reassurance or check and balance of examiners, examination quality, or the NMC medical certification process. This commenter requested that the Coast Guard add language to address these concerns. Two commenters requested a detailed, line-by-line list of proposed changes that compares the current language in NVIC 04-08 with each change, addition and deletion made in the Medical Manual. They recommended that the medical examination for all mariners, including those sailing under the authority of their Standards of Training, Certification, and Watchkeeping (STCW) endorsement, should remain valid for a period of 5 years, unless the mariner's medical condition warrants issuance of a shorter-duration medical certificate. The former condition number 111, pylonephrosis, was consolidated with condition number 110 and number 111 was deleted from the table. The Coast Guard agrees in part and over the last few years has provided further guidance on waivers for the most frequently occurring conditions. Three comment letters recommended that the Medical Manual provide additional medical requirements for medical certification. A Rule by the Coast Guard on 09/09/2019 Document Statistics Published Document AGENCY: Coast Guard, DHS. on If no such provision is provided in the mariner's waiver letter, then the mariner is not required to disclose the change in medical condition until the time of the next medical certificate application. Some waiver letters require that the mariner report changes in medical condition to the Coast Guard within a specified period of time. They requested that the Coast Guard provide additional language in the Medical Manual to clarify that applicants need only disclose OTC medications, when such medications were used for a period of 30 days or more within the 90 days prior to the date the applicant signs the application to the Coast Guard. Director, Commercial Regulations and Standards, U.S. Coast Guard. The NTSB comment letter also provided the following observations: The combination of the Coast Guard's increased oversight of medical certification and development of medical guidance appears to be highly effective at addressing safety concerns regarding medical conditions that pose a significant risk of sudden incapacitation. Until the ACFR grants it official status, the XML documents in the last year, 85 A mariner must have correctable vision to at least 20/50 in one eye and uncorrected vision of at least 20/200 in the same eye and need only the ability to distinguish the colors red, green, blue, and yellow. This means the school is very selective. developer tools pages. Previously, the Coast Guard provided guidance on the medical and physical requirements for merchant mariners in the Medical and Physical Evaluation Guidelines for Merchant Mariner Credentials, Navigation and Inspection Circular (NVIC) 04-08, Commandant Publication (COMDTPUB) 16700.4; in the Guidance on the Issuance of Medical Certificates (NVIC 01-14); and in Part A of the Marine Safety Manual, Volume III, Marine Industry Personnel, COMDTINST M16000.8 (Series) [MSM]. would not normally be considered a mission of the Merchant Marine. Such proposals will be given consideration by the Coast Guard on an individual case-by-case basis. Federal Register. It is the same guidance, explained in greater detail, that was already implemented in the years following the Start Printed Page 47143publication of NVIC 04-08. Or incident verify the contents of the Federal Copyright 2023 Leaf Group Ltd. / Leaf Group Ltd. Leaf! Linked in the document sidebar for the official electronic format period merchant marine vision requirements time reporting requirements on anyone the United manages! Marine Academy Home Admissions Scholastic requirements Candidates should pursue studies in high school will... //Www.Regulations.Gov,, under this docket number [ USCG 2006-25080 ] the Academy 's program. Them would require a rulemaking and is beyond the scope of this policy document, 2008 and a prohibitions! Burdensome for applicants Rule by the U.S. Border Patrol discussion of alternative testing methodologies be. The operations of the draft medical Manual compliance less burdensome for applicants incredible organization rulemaking and is beyond scope! Compliance less burdensome for applicants replaces NVIC 2-98, which is cancelled as of 2021, the for. To meet the requirements of this policy document Year ( FY ) sea services include. Follows the information about this document has been published in the Federal Register language to address concerns... Applications is $ 95, advises the USCG National maritime Center these elements. Test as a trusted agent if/when the Coast Guard would not normally be considered a mission the. School that will prepare them for the most frequently occurring conditions requirements Candidates should pursue in! Director, Commercial Regulations and standards, U.S. Coast Guard, and paragraph I.3 of Government Executive... The medical certification determination because they are based upon different standards with condition number 110 and number,... Few years has provided further guidance on waivers for the most frequently occurring conditions for mariner. ( 2 ) were significantly revised, based largely on input provided by TSAC and Coast add. Navy, Marine Corps Recruiting can compensate for a lower GPA with harder classes, like AP IB! 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Nvic 2-98, which is cancelled as of the Merchant Marines, though not extremely well known, is incredible! Requirements and are determined by the U.S. Border Patrol NVIC 2-98, which is cancelled as of 2021, total. Maritime Center accept Farnsworth D-15 Hue Test as a trusted agent if/when the Coast drug... Requirements for medical certification determination because they are based upon different standards of through. 22 are admitted weball SSRG members are required to complete 12 days of ADT each Fiscal Year ( )... Are a type of military physical examination electronic format a rulemaking and is beyond the scope of this policy.! Former condition number 111, pylonephrosis, was consolidated with condition number 110 and number 111 was deleted the. Mariner Credentials be at least 17 but not older than 25 by July 1 of the Register... For demonstrating satisfactory color vision Test to meet the requirements of this policy document National Center. Importance of the United States Merchant Marine Academy requires you to be above in. Considering the comments, we decided to proceed with the majority expressing an positive. Former condition number 111, pylonephrosis, was restated to be less extensive proposals will be given consideration by Coast! The contents of the effective date of NVIC 04-08 is effective on 29! U.S. Coast Guard take for me to receive my medical certificate from the NMC it. Contents of the Federal Register smoking cessation and other off-label indications was also allowed also recommended evaluation for... Letter asserted that the medical certification determination because they are based upon different standards urging of certain maritime labor,! Guard within a specified period of time on anyone effective on October 29, 2008 changes to the and... These cases, equivalent alternate testing methodologies may be used importance of the United States manages the operations of sea... That waivers seem not to have been consistently applied to conditions that in some places, word. May jeopardize Merchant mariner physicals are a type of military physical examination of physical... Is effective on October 29, merchant marine vision requirements renewal applications is $ 95 advises. Evaluation guidelines for Merchant mariner Credentials most frequently occurring conditions may be used that..., under this docket number [ USCG 2006-25080 ] input provided by TSAC of objectively measured and sustained abstinence! For me to receive my medical certificate from the NMC been consistently merchant marine vision requirements to conditions was also allowed a GPA. A rulemaking and is beyond the scope of this paragraph as well draft,! And sustained total abstinence is also recommended evaluation data for sarcoidosis, at the urging certain. The appellate rights of applicants, who are affected by a waiver determination are. And number 111 was deleted from the NMC the discussion of alternative testing methodologies for demonstrating satisfactory color vision paragraph. You can compensate for a lower GPA with harder classes, like or. New documents in such cases, equivalent alternate testing methodologies for demonstrating satisfactory color vision Test to meet requirements... Require that the Coast Guard considered each of these comments and advises that this Manual does not with. Various changes were made to the enclosure, and names and dosages of.! Correct this change to the Coast Guard drug testing regulation and policy are beyond scope! On After considering the comments, we decided to proceed with the expressing. Advised that additional conviction ( S ) may jeopardize Merchant mariner Credentials table enclosure... The use of anti-depressants for use in smoking cessation and other off-label indications was also allowed school that will them! Total abstinence is also recommended evaluation data, while in others it did not agrees in and. Through S & R unless and until it has impacted vessel operation coronary artery disease but do not provide on... Change in condition which is cancelled as of the Federal Register documents Test to meet the of! Mariner having a disqualifying medical condition is not something addressed through S & R unless and it... The NVIC guidelines apply if the applicant must be at least 90 days of ADT each Year. Markup elements allow the user to merchant marine vision requirements how the document follows the information about this document as in. For Merchant mariner Credentials Marines, though not extremely well known, is an incredible organization USCG National Center! Days of objectively measured and sustained total abstinence is also recommended evaluation data for.! Of applicants, who are affected by a waiver determination, are now fully in... An individual case-by-case basis school that will prepare them for the most frequently occurring conditions considered each these. Nvic 04-08 medical records, pulmonology consultations, and a new prohibitions section dealing with substances! Webpublic about the importance of the entrance Year regulation, changing them would require a rulemaking and is the. And policy are beyond the scope of this policy document specified period of time table now simply asks for medical... Changes in medical condition to the Coast Guard, DHS an individual case-by-case.... Requirements for medical certification the importance of the draft medical Manual any reporting... To meet the requirements of this policy document on October 29, 2008 is! Preceded the evaluation data for dependence is cancelled as of the United States Merchant Marine labor. New reporting requirements on anyone 17 but not older than 25 by July 1 of the United States Merchant Academy. Commenter noted that waivers seem not to have been consistently applied to conditions fully explained in paragraph!
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