Section 217.15 - Fitness Evaluation; Description of Medical Assessment; Detailed Standards(a) A medical assessment shall consist of a comprehensive physical and medical evaluation process, to include, at minimum, a document review, a thorough physical examination, an agility test (subject to the exceptions listed in subsection (d)(1), a toxicological test, a review of prescribed medications, and an evaluation by the Medical Review Officer as provided by this section.(b) A person required by this article to undergo a medical assessment shall provide documents to an examining physician as part of the medical assessment. (1) The following documents shall be submitted within 30 days prior to the physical examination: (A) the 719K form most recently completed for the applicant, all supporting documentation for medical conditions and medications requiring further review or waiver under the guidance set forth in the Merchant Mariner Medical Manual, and, as soon as available, any correspondence from the U.S. Coast Guard concerning the person's right to act under the authority of the pilot endorsement to the federal merchant mariner credential, including all waivers issued by the U.S. Coast Guard, with the exception of waivers previously provided to an examining physician;(B) a complete list of prescribed medications;(C) a complete list of prescribed durable medical equipment;(D) a signed Disclosure of Information form (Version September 24, 2020), hereby incorporated by reference, setting forth any information required by Section 1176.5(a) and (b) of the Code; and(E) upon the initial medical assessment of a pilot trainee and of an applicant for an original pilot license, and upon the annual medical assessment of both thereafter, a signed Notice, Disclosures, and Acknowledgment and Consent to Disclosure form (Version September 24, 2020), hereby incorporated by reference, that (1) acknowledges having read the notice required under the Information Practices Act of 1977 and the disclosures concerning the nature and use of the health information obtained in the course of fitness evaluations, and (2) consents to the disclosure of that information in connection with the fitness evaluations and Board processes requiring review of the information.(2) Submission of these documents shall be required each time a person is subject to a medical assessment to evaluate fitness for duty.(3) The document review shall be conducted by an examining physician, and the results shall be used to evaluate fitness for duty, shall be reviewed by the Medical Review Officer, and shall also, unless otherwise provided herein, be used by the Medical Review Officer to make an independent evaluation of fitness for duty.(c) The physical examination shall be conducted by an examining physician and shall include evaluation of general patient appearance, behavior, and organ systems. (1) Completion of the physical examination shall be required upon any of the events listed in subsections (a)(1) through (a)(4) of Section 217.10 and upon direction by a Board-appointed physician under Section 217.25(a).(2) The physical examination shall be conducted by an examining physician chosen by the person subject to such examination unless otherwise directed by the Executive Director or the Medical Review Officer.(3) The results of the physical examination shall be used by the examining physician to evaluate fitness for duty, shall be reviewed by the Medical Review Officer, and shall also, unless otherwise provided herein, be used by the Medical Review Officer to make an independent evaluation of fitness for duty.(d) The agility test shall simulate the physical demands of piloting and shall include the following observations: balance, pilot ladder circuit climb, stair climbing, floor to waist lifts, a single rope slide, and heart rate recovery after activity. (1) Completion of an agility test shall be required within 90 days prior to entry into the pilot trainee training program, unless the Executive Director, for good cause shown, increases the time for not to exceed 30 days; biennially thereafter, unless the trainee has completed an agility test with 90 days prior to the next biennial test; within 90 days prior to issuance of an original pilot license and biennially thereafter, unless the trainee has completed an agility test within 90 days prior to licensure or a pilot seeking license renewal has completed an agility test within 90 days prior to license renewal; and upon direction of a Board-appointed physician under Section 217.25(a).(2) The agility test shall be conducted by a tester who is a personal trainer, physiotherapist, occupational therapist, or kinesiologist and who is acting under the direction of a Board-appointed physician.(3) The results of the agility test shall be reviewed by the examining physician as part of the review to evaluate fitness for duty, shall be reviewed by the Medical Review Officer, and shall also, unless otherwise provided herein, be used by the Medical Review Officer to make an independent evaluation of fitness for duty.(e) The toxicological test shall include the U.S. Department of Transportation tests for dangerous drugs, and also tests for the presence of anti-depressants, anti-psychotics, anti-convulsants, barbiturates, amphetamines, benzodiazepines, sedative hypnotics, and opiates contained in pain medication. (1) Completion of the toxicological test shall be required upon any of the events listed in subsections (a)(1) through (a)(4) of Section 217.10, upon direction by a Board-appointed physician under Section 217.25(a), and as directed by the Port Agent under subsections (g) or (h) of Section 218.(2) The toxicological test shall be conducted by a laboratory certified by the U.S. Department of Health and Human Services and selected by the Medical Review Officer.(3) The results of the toxicological test shall be reviewed by the examining physician as part of the review to evaluate fitness for duty, shall be reviewed by the Medical Review Officer, and shall also, unless otherwise provided herein, be used by the Medical Review Officer to make an independent evaluation of fitness for duty.(f) Except as provided in subsection (f)(2) below, the medical assessment shall be concluded by the issuance of statements of fitness for duty by each of the Board-appointed physicians involved. These statements shall be submitted on the Statement of Fitness for Duty form (Version September 24, 2020), hereby incorporated by reference. (1) At the conclusion of the medical assessment, the examining physician shall make a determination of fitness for duty of the person subject to the medical assessment and shall issue a statement of fitness for duty accordingly.(2) The medical information compiled during the medical assessment and the fitness evaluation made by the examining physician shall be reviewed by the Medical Review Officer. Except in situations in which the examining physician's determination is Not Fit for Duty, the Medical Review Officer shall make an independent evaluation of fitness for duty of the person subject to the medical assessment, shall complete a statement of fitness for duty accordingly, and shall indicate whether the Medical Review Officer concurs with the fitness determination made by the examining physician.(g) Except in situations in which the examining physician's determination is Not Fit for Duty, in which case only the examining physician must submit a Statement of Fitness for Duty form, at the conclusion of their respective roles both in a medical assessment and in fitness evaluations generally, both the examining physician and the Medical Review Officer shall provide the results of their respective evaluations to the Executive Director by stating, on a Statement of Fitness for Duty form, one of the following possible determinations: (1) Fit for Duty ("FFD"), which shall signify that the person evaluated is mentally and physically qualified for duty as a pilot or pilot trainee. That determination shall be effective until the next event for which a medical assessment is required under Section 217.10(a), unless the FFD determination is made effective for a shorter period.(2) Not Fit for Duty ("NFFD"), which shall signify that the person evaluated is mentally or physically unqualified for duty as a pilot or pilot trainee.(h) In the case of nonconcurrence between the examining physician and the Medical Review Officer, the final determination of fitness for duty shall be NFFD in situations in which one of the determinations is NFFD. In situations in which the FFD determinations are for different periods, the FFD determination shall be for the shorter period.(i) The completed Statement of Fitness for Duty shall be submitted to the Executive Director. The Executive Director shall acknowledge receipt of a Statement of Fitness for Duty form by recording the final determination and notifying the pilot, trainee, or applicant of the fitness determination, using the Fitness for Duty Notification form (Version September 24, 2020), hereby incorporated by reference.Cal. Code Regs. Tit. 7, § 217.15
1. New section filed 1-24-2014; operative 4-1-2014 (Register 2014, No. 4).
2. Amendment of section heading and section filed 7-29-2021; operative 10-1-2021 (Register 2021, No. 31). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20. Note: Authority cited: Section 1154, Harbors and Navigation Code. Reference: Sections 1101, 1141, 1157, 1157.1, 1157.2, 1157.3 1157.4, 1171, 1171.5, 1176, 1176.5, 1180, 1181, 1182 and 1183, Harbors and Navigation Code.
1. New section filed 1-24-2014; operative 4-1-2014 (Register 2014, No. 4).
2. Amendment of section heading and section filed 7-29-2021; operative 10/1/2021 (Register 2021, No. 31). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20.