Union Continues Fight for Mariners


November 2012


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The SIU is looking out for its members’ interests with an advisory committee designed to simplify the Coast Guard’s mariner medical review process.


Chaired by Dr. Kenneth Miller, the Department of Homeland Security’s Merchant Mariner Medical Advisory Committee (MMMAC) met recently at the union-affiliated Paul Hall Center for Maritime Training and Education in Piney Point, Md., to do just that. Miller is the medical director of the SIU’s Seafarers Health and Benefit Plan’s clinic system.


“It’s important (mariners) know we’re there to protect their livelihoods and to ensure the Coast Guard provides fair medical standards to the credentialing process,” Miller said.


Established with the passage of the U.S. Coast Guard Authorization Act of 2010, the MMMAC is tasked with improving a medical review process that was widely seen as problematic and time-consuming.


Prior to the formation of the committee, the Coast Guard established the review process completely on its own. Miller said that resulted in a lengthy medical review process that often cost mariners money-making sea time while they awaited approval.


“We wanted to let the Coast Guard know what the industry thinks and how (the medical review process) is affecting people’s careers,” Miller said. “Part of the reason to get a specific committee was to advise the Coast Guard with mariner input and get union people to participate in the process.”


Miller said the SIU took an active role in establishing the MMMAC, adding the composition of the committee was also seen as very important. The MMMAC consists of ten health care professionals and four professional mariners – none of whom work for the federal government.


“The committee structure was to balance out the experience,” Miller said of the decision to include both professional mariners and doctors on the committee. “It wouldn’t be just a bunch of doctors talking to one another.”


While the MMMAC’s work could take some time, Miller said the committee is making progress. The most recent meeting had the committee discussing ways to streamline the review process and making the Coast Guard’s medical evaluation guide – known as the NVIC 04-08 – more transparent and current.


“At this stage, it’s still really early,” Miller said. “Down the road we might have more formal of an agreement.”


When it comes to streaming the review process, Miller said the committee is considering the establishment a nationwide network of Designated Medical Examiners (DMEs) who would evaluate mariners specifically for the Coast Guard’s medical review process. Currently, mariners are examined by their own doctors – a situation that can result in multiple visits and weeks of additional waiting if those doctors fail to fulfill all of the Coast Guard’s requirements.


“One of the big hold-ups (in the review process) is when people are asked to get more information from their doctors. By the time they go through that loop again it can take some time,” Miller said. Under the DME program, “the assumption would be – if you went to one of these (DME) doctors you would know before you submitted your application (what was needed) and they would be able to do some of the testing right there.”


Currently, the medical review process takes an average of three to six weeks, though it can sometimes take several months if there are issues. With the DME program, Miller said, the process would be shortened and many of those issues could be avoided.


“We’re working on making the credentialing process fairer for mariners so people can get their documents done more quickly,” Miller said.


He added a quicker review process is especially important since the time between renewals may get shorter. While many mariners are currently required to renew their medical credentials every five years, that might change to every two years once the Coast Guard adopts the STCW’s new international medical standards.


Regardless of when that happens, Miller said mariners should know MMMAC is there to look out for their interests.


“We wanted this committee so the unions would have some input into the Coast Guard’s process of credentialing our mariners,” Miller said. “It gives us a voice.”


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