March 2, 2022

How to Navigate the Captain’s License Medical Maze


The National Maritime Center (NMC) tells us that a total of 7,882 MMC applications in 2021 were delayed due to deficiencies in the medical certificate. We share here the top medical reasons that MMC certificates are delayed. 


The National Maritime Center (NMC) receives more than 50,000 applications annually from U.S. Merchant Mariners applying for medical certificates. According to the NMC, over 10 percent of those applications are missing information. This causes delays in the processing of applications and can be extremely  frustrating for mariners who often need this certification in order to continue working.

The NMC previously published Common Errors Mariners Make When Submitting CG-719K (04/17), so be sure to check that out as well as our recent post on the Top Five Reasons for Delays in Receiving Mariner Credentials. Both of these resources will help ensure that you have filled out your credential application package correctly.

According to the NMC, a total of 7,882 awaiting information (AI) reasons were issued in 2021 for medical certificate applications alone. The NMC compiled a list of the top medical reasons that mariners did not receive their certificate, which we will share below. 

At the Professional Captains Association (PCA), we know the license application process can be confusing and cumbersome. If you have any questions, feel free to reach out to us. We are here to help! This help is made possible through our membership. Join the PCA team today! Membership starts as low as $99/year.

The top medical reasons license applications are delayed include:

Visual acuity does not meet regulations as listed in Merchant Mariner Medical Manual,  (COMDTINST M16721.48), Chapter 5.

This chapter states that, 

“In accordance with 46 CFR 10.305(a)(1), applicants for any national endorsement or qualified deck rating must have vision in at least one eye that is correctable to 20/40 or better. Uncorrected vision in the same eye must not be worse than 20/200. The horizontal field of vision should not be less than 100 degrees in each eye. Applicants for an STCW endorsement must have vision in both eyes that is correctable to 20/40 or better in each eye. Uncorrected vision in each eye must not be worse than 20/200.”

The manual states that there are some exceptions to the rule, which you can read about further by clicking on the link to the manual above. 

Another reason for delays in the issuance of a certificate is when the additional eye tests needed after an abnormal vision exam are not provided. 

Sometimes conditions listed in COMDTINST M16721.48, Chapters 8, need further documentation. This requires a current written report from your treating provider documenting the current status of the condition, history of the condition, frequency and severity of symptoms, as well as a treatment plan with all medications/side effects. This allows for the NMC is ensure your  ability to perform all tasks as listed in Chapter 8.

Common conditions that often need further documentation include:

  • Diabetes
  • Sleep Apnea
  • Substance Abuse
  • Heart Condition
  • Seizure Disorder

Obviously, the objective of the certification is to ensure that you can carry out your duties as a mariner safely. If your care provider believes that with the right medication, you can carry out such duties without issue, then documentation of that is required.

Lastly, some more specific reasons for delays in certification:

  • Required tests are incompletely documented on Page 7.
  • Medications/Conditions are not explained or commented on Page 5.
  • Response not provided for Food Handler Certification (Section II, Page 3).
  • YES or NO response not provided for each condition listed (Section III (a), Page 4).
  • Incomplete details (date of onset/condition/treatment/status/limitations) of conditions identified on Page 4 (Section III (b), Page 5).
  • No response or incomplete response to medication section (Section IV, Page 6).
  • Missing height, weight, pulse rate, and/or blood pressure (Section V, Page 6).
  • NORMAL or ABNORMAL response not provided for each system/organ identified (Section V, Page 6).
  • Missing uncorrected vision (Section VI (a), Page 7).
  • Uncorrected vision tests with corrective lenses (Section VI (a), Page 7).
  • Missing field of vision (Section VI (a), Page 7).
  • Inappropriate color vision testing method, number of errors omitted, or determination not indicated (Section VI (b), Page 7).  If you fail the color vision testing your healthcare provider can help you avoid processing delays by  supplying a handwritten note in this section that indicates your ability to distinguish red, green, blue, and yellow; and by which method.
  • Hearing not marked as normal, abnormal, or hearing aid required (Section VII, Page 7).
  • Missing Physical Ability Results (Section VIII, Page 8).
  • Proof of identity not checked (Section IX (a), Page 9).
  • Certification recommendations (Recommended, Not Recommended, or Needs Further Review) not checked (Section IX (b), Page 9).
  • Significant risk of sudden incapacitation (Yes, No, or Needs Further Review) not checked (Section IX (c), Page 9).
  • If entry-level – Medical condition aggravated by service at sea (Yes, No, or Needs Further Review) for entry level rating not checked (Section IX (c), Page 9).
  • Provider failed to sign/date the form and/or provide license number (Section IX (e), Page 9).
  • Missing signature of Applicant (Section X, Page 9).

If you have questions regarding the application for the medical certificate, feel free to contact the NMC Help Desk at 1-888-IASKNMC (427-5662) or reach out to us at the Professional Captains Association, either call us at (401) 735-0100 or email us at info@procaptains.org.