merchant marine personnel advisory committee task

MERCHANT MARINE PERSONNEL ADVISORY COMMITTEE

TASK STATEMENT 101‐ADDENDUM B

Review and submit recommendations for revisions to six Coast Guard forms listed in the Task Statement

Draft Report and Recommendations

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Task Statement 101-Addendum B was proposed and accepted during MERPAC 50.

CAPT Ernest J. Fink was nominated to chair this Task Statement which was approved by the Committee.

A working group of approximately 10 participants was formed and reviewed all six forms during the working group sessions.

It was agreed that a draft report with recommendations be emailed to the working group for review and any changes or corrections before MERPAC reconvenes for its next meeting.

It was also agreed that a draft report be posted on the MERPAC website in Homeport so members of the public could also provide comments or recommended changes.

Encl: (1) MERPAC Recommendations (2) Task Statement 101-Addendum B with all 6 forms

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FORM CG-719 B – MERPAC recommends the following changes:

1. The Instructions (pages 1 & 2) should be broken up and moved to the beginning of each section of the form.

2. Delete the words “and applicants requesting a Medical Certificate” at the end of Instruction #1.

3. For applicants under 18 years of age, provide a sample statement (see Instructions 1.3 & IV.3).

4. Clarify Section II, paragraph 3 for Great Lake Pilots to eliminate confusion for Pilots submitting Great Lakes route applications to Coast Guard Headquarters vice the NMC.

5. Page 3 – Next of Kin/Emergency Contact – remove “Optional” as this information is required by statute for ratings.

6. Page 3, Section II – change the entire format to make this Section more user friendly. Consider using drop-down boxes for online application submission. No need to have all boxes listed for Renewal, just Renewal or Renewal with RIG. Add boxes for Limited, Restricted and Military service.

7. Page 4, Section III, #1 – bold “Exemption Statement” to stand out.

8. Page 4, Section III, #2 – Add note that previously disclosed convictions need not be reported as suggested in the Instructions on page 2 (III.2a-f).

9. Page 4, Section III, #2.c. – add a comma after any court and military court. Does Coast Guard have the authority to include BWI convictions?

10. Page 4, Section III, #2.f. – This questions need to be reviewed. Add “DOT” before drug test. Consider changing the words “other than negative” to include negative-dilute results and applicants who refuse to take a test.

11. Page 4, Section III, #3. – remove space in 46 USC 710(g) in last line.

12. Page 4, Section IV, #1 – verify MARAD website link at end of paragraph 1.

13. Page 4, Section IV, #2 - move paragraph #2 to Section II.

14. Page 4, Section IV, #4 – change title to read “Certification/Oath.” Reformat this section so a signature is below the first two bullets (certification) and a signature is below the third bullet for the oath. Where the dates appear next to the signatures add the words “signature date.” At the bottom of this page, in right corner, add Legal Name: Last, First Name, Middle Name format like the format at the top of page 3 of the form.

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15. Page 5, Section IV, #6 – Consider eliminating this section entirely and include a separate Third Party Release Form with the application that specifies the authority of the Third Party and whether the Third Party accepts authorization.

FORM CG-719 C – MERPAC recommends the following changes:

1. Page 1 – add to the instructions that this form need only be submitted for original applications and if/when an applicant is convicted since his/her last application.

2. Page 1 – when defining “conviction,” ensure the list (1-4 under A) is aligned with 46 CFR 10.107.

FORM CG-719 K – MERPAC recommends the following changes:

1. Replace the link to NVIC 04-08 with the link to the new Medical Manual on each page of the form where it appears.

2. Page 2 at the bottom – reformat the name box (see comment #14 above under CG-719 B).

3. Page 3, Section 1 – Don’t use the term “Endorsement” and delete the words “…or the Coast Guard will not accept the application)” in the middle of the page. Also, provide greater clarity for U.S. Registered Pilots, Great Lakes Pilots, First-Class Pilots and those who are authorized to serve as Pilot. Pilots must have annual physicals but receive a 2-year Medical Certificates.

4. Page 3, Section II, #2 – change 46 CFR 10.107 to 46 CFR 10.107(b).

5. Page 3 – delete the boxes at the bottom of the page for the Medical Practitioner’s initials and date.

6. Page 4, Section III(a) – delete “If YES, provide a copy to the Medical Practitioner, and mark the MW box below.” and “and if previously reported (PR), mark the PR box below.” Delete the PR and MW columns in the table of conditions. Add a note to the table that if “YES” is marked, the applicant must provide medical information about the condition. Also, change Condition # 32 to read “Have you ever been signed off or repatriated from a vessel for medical reasons within the last six years?” Delete the boxes at the bottom of the page (see comment # 5 above).

7. Page 5, Section III(b) – delete “For each condition marked Previously Reported (PR), the provider need only discuss” and “For each condition with a Medical Waiver (MW) review the applicant’s waiver letter and attach all waiver reporting requirements.” Delete the boxes at the bottom of the page (see comment # 5 above).

8. Page 6, Section IV – for medications (prescription or nonprescription), align what applicants must report with the policy in the new Medical Manual.

9. Page 6, Section V – consider eliminating #16 (Hernia) and delete the boxes at the bottom of the page (see comment # 5 above).

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10. Page 7 - delete the boxes at the bottom of the page (see comment # 5 above).

11. Page 8, Section VIII – consider simplifying the entire table by retaining only the third column and making the tasks more clear for medical practitioners who are not familiar with ordinary and emergency response shipboard functions performed by mariners. In paragraph #1 below the table highlight the first two sentences and change “unchanged” to “uncharged” in line 4. Delete the boxes at the bottom of the page (see comment # 5 above).

12. Page 9, Section IX – move/combine box b. certification recommendation with box e. Medical Practitioner information. In box c. – delete the last part of c.1. “…to include uncontrolled obstructive sleep apnea, diabetes mellitus or coronary artery disease.” Also, consider whether c.2. (Entry-level, only) paragraph is necessary to retain.

13. Page 10, Section XI – retain box a. Boxes b. and c. should either be removed and included in a separate form (see comment #15 above under CG-719 B), or redesigned to make it more clear to indicate in what capacity is the Third Party representing the applicant (e.g., Medical Certificate, AI, both?)

FORM CG-719 K/E – MERPAC recommends the following changes:

1. The Instructions (pages 1) should be broken up and moved to the beginning of each section of the form.

2. Page 1 – delete the boxes at the bottom of the page for the Medical Practitioner’s initials and date.

3. Page 2, Section I – add SSN with Reference Number since Ordinary Seamen do not have a Reference Number. Also, delete the boxes at the bottom of the page for the Medical Practitioner’s initials and date.

4. Page 3, Section IV – same comments as #11 above under Form CG-719 K apply. Move Physical Ability Results boxes to the bottom of the page after the comments box.

5. Page 4, Section V - move/combine box b. certification recommendation with box e. Medical Practitioner information.

14. Page 5, Section VII - retain box a. Boxes b. and c. should either be removed and included in a separate form (see comment #15 above under CG-719 B), or redesigned to make it more clear to indicate in what capacity is the Third Party representing the applicant (e.g., Medical Certificate, AI, both?)

FORM CG-719 P – MERPAC recommends the following changes:

1. Page 1, Section I (Applicant Consent) – use same text as in Form CG-719 B.

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2. Page 1, Section III – ensure drugs that are listed is consistent with 49 CFR 40.85. Also add “Negative-dilute” to the list (boxes) of possible results.

FORM CG-719 S – MERPAC recommends the following changes:

1. Page 1, Section I – highlight “(Note: Complete One Form Per Vessel).” The vessel information in this section should also include all of the required vessel information contained in 46 CFR 10.232. Also, change “Served As…Engine” to “Engineer.”

2. Page 1, Section II – it is recommended that Sea Service be a separate MERPAC Task Statement. At the bottom of this page, consider adding Inland and Near Coastal/Oceans below Number of days served on Great Lakes for greater clarity.

3. Page 2, Section III – move signature to page 1 since many applicants omit their signatures and require applicants, owners or masters to re-sign if information is altered.

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