CG-719K Physical · Vision & Color Vision · Medical Waivers · Drug & Alcohol Testing

USCG Physical & Medical Requirements for a Captain's License

Every USCG Merchant Mariner Credential (MMC) applicant must pass a physical examination on form CG-719K, a federal drug test on form CG-719P, and hold current First Aid and CPR certifications. This guide covers every medical standard — and what to do if you don't meet one.

Physical Exam Form
CG-719K
Valid 2 years from exam date
Drug Test Form
CG-719P
Application must arrive within 185 days
Distant Vision Standard
20/200 → 20/40
Uncorrected / corrected in better eye
BAC Alcohol Standard
0.04% or less
DOT standard, same as commercial drivers

The CG-719K Physical Examination

Form CG-719K is the official USCG physical examination form for Merchant Mariner Credential (MMC) applicants. It must be completed by a licensed physician (MD or DO), Nurse Practitioner (NP), or Physician Assistant (PA). A chiropractor, naturopath, or any non-licensed provider cannot sign this form — the NMC will reject it.

The CG-719K covers all major body systems: vision (distant, near, and color), hearing, cardiovascular, neurological, musculoskeletal, endocrine, and mental health. The examining provider signs and dates the form and certifies whether the applicant is fit for duty as a mariner.

A completed CG-719K is valid for two years from the date of the examination. If your application sits at the NMC for review and the physical expires during that process, you may need to redo it before approval. Plan accordingly, especially if you anticipate a waiver review that could extend processing time.

Who Can Complete the CG-719K?

Provider TypeAccepted?
Medical Doctor (MD)Yes
Doctor of Osteopathy (DO)Yes
Nurse Practitioner (NP)Yes
Physician Assistant (PA)Yes
Chiropractor (DC)No
Naturopath (ND)No
Pharmacist (PharmD)No
Dentist (DDS/DMD)No
Optometrist (OD) — vision onlyAccepted for vision section only if MD/DO countersigns

Tip: Use an Occupational Health Clinic

Occupational health clinics at major hospital systems often have staff familiar with CG-719K requirements, DOT physicals, and SAMHSA drug testing — making it easy to complete your physical and drug test in a single visit.

Vision Requirements for a Captain's License

Vision is evaluated in three dimensions: distant visual acuity, near visual acuity, and color vision. Each has its own standard, and failing one does not automatically disqualify an applicant — there are pathways to accommodate visual impairments with corrective lenses or a restriction on the credential.

Distant Vision

EyeMinimum UncorrectedMinimum Corrected
Better eye20/20020/40
Lesser eye20/20020/100

If you need corrective lenses to meet these standards, your credential will carry a "must wear corrective lenses while on watch" notation. This is common and does not limit the type of license you can hold.

Near Vision

Near vision must be at least 20/40 in the better eye, corrected or uncorrected. This ensures the mariner can read charts, navigational instruments, and vessel documentation at a normal reading distance. Reading glasses are acceptable.

Color Vision Testing

Color vision is required because mariners must be able to identify the colors of navigation lights (red, green, white), day signals, and buoy markings. The testing sequence matters: the standard test is administered first, and the FALANT is only used if the applicant fails the standard test.

Step 1

Ishihara Pseudoisochromatic Plate Test

The most common color vision test. Consists of numbered plates with colored dots. Applicants who fail the Ishihara are NOT automatically disqualified — they proceed to the FALANT. Note: Failing Ishihara is very common, especially among men (roughly 8% of men have some form of red-green color deficiency).

Step 2

Farnsworth Lantern (FALANT) Test

The FALANT tests color discrimination using actual colored lights — red, green, and white — which is the relevant task for mariners identifying navigation lights. Many applicants who fail the Ishihara pass the FALANT. Passing the FALANT fully satisfies the color vision requirement with no restriction on the credential. The FALANT must be administered by the examining physician or a qualified technician using calibrated equipment.

Result

"Not by Colors Alone" Restriction

If an applicant fails both the Ishihara and the FALANT, the credential is issued with a "not by colors alone" restriction. This means the mariner may not use color as the sole identifier of a light or mark — they must also use position, character (flashing pattern), and other attributes. This restriction does not prevent operation of a vessel; it merely requires using multi-attribute identification of lights and marks.

Important: Ishihara vs. FALANT

If your physician only administers the Ishihara and you fail, specifically request the FALANT before assuming you have a color vision deficiency that will restrict your license. Not all providers have FALANT equipment in-office. You may need to find an occupational medicine clinic or ophthalmologist who can administer it.

Hearing Requirements

Mariners must be able to hear sound signals — fog horns, vessel horns, shouted commands, and radio communications — which are safety-critical aboard a vessel. The CG-719K requires the examining provider to assess hearing and document the results.

The standard requires the ability to hear a forced whispered voice in the better ear at not less than five feet with or without the use of a hearing aid. The examining physician documents whether hearing is within normal limits or whether a hearing aid is required.

Hearing aids are generally acceptable. If a hearing aid is required to meet the standard, the credential may carry a "must wear hearing aid while on watch" notation, similar to the corrective lenses notation for vision.

Hearing Standard Summary

  • Forced whispered voice at 5 feet in the better ear
  • Hearing aids are permitted
  • Audiogram may be requested if the examiner has concerns
  • Severe sensorineural hearing loss may require a waiver evaluation

Blood Pressure & Cardiovascular Requirements

There is no single blood pressure number that automatically disqualifies an applicant. The CG-719K physical requires the examining provider to evaluate cardiovascular health overall and document whether the applicant is fit for maritime duty. The physician exercises clinical judgment.

In practice, well-controlled hypertension managed with medication is typically acceptable. The NMC considers cardiovascular conditions that could cause sudden incapacitation at sea to be disqualifying — because loss of capacity while underway is a direct hazard to the vessel, crew, and passengers.

Blood Pressure Guidelines

Blood Pressure RangeTypical NMC Treatment
Below 140/90Generally acceptable, no issue
140–159 / 90–99 (Stage 1), controlled with medsGenerally acceptable
160–179 / 100–109 (Stage 2), controlled with medsCase-by-case; provider judgment
160+ / 100+ uncontrolledMay disqualify; waiver may be required
Hypertensive crisis (180+/120+)Disqualifying until controlled

Cardiovascular Conditions That May Disqualify

The NMC evaluates cardiovascular conditions based on risk of sudden incapacitation. Conditions of concern include:

  • Recent myocardial infarction (heart attack) within the past 6–12 months
  • Unstable angina or severe symptomatic coronary artery disease
  • Congestive heart failure with functional limitation (Class III or IV)
  • Severe valvular heart disease causing symptomatic limitation
  • Uncontrolled cardiac arrhythmias (atrial fibrillation, ventricular tachycardia)
  • Recent cardiac surgery or stent placement (recovery period applies)
  • Implanted cardioverter-defibrillator (ICD) — typically disqualifying without waiver

Applicants with a history of cardiovascular events who have recovered and are stable may qualify for a waiver. A cardiologist's letter documenting current cardiac status, exercise tolerance, and absence of high-risk features is generally required.

Seizure Disorders and Captain's Licenses

Seizure disorders are treated with particular caution by the NMC. A mariner who experiences a seizure while at the helm could cause a collision, capsize, or catastrophic loss of control. As a result, the NMC's medical standards reflect a conservative posture toward epilepsy and seizure history.

General Framework

Disqualifying

Seizure within the past 2 years (general standard). Any unprovoked seizure with high recurrence risk. Poorly controlled epilepsy despite medication.

Waiver Possible

Single provoked seizure (e.g., from alcohol withdrawal or metabolic cause) with identified and resolved cause. Seizure-free for 2+ years on stable medication with neurologist documentation. Childhood epilepsy in long-term remission off medication.

Generally Acceptable

Febrile seizures in childhood with no adult recurrence. A single isolated seizure that occurred more than 5 years ago with no recurrence and neurologist confirmation of low recurrence risk.

For any seizure history, a neurologist's evaluation and letter are essential. The letter should address: the diagnosis and classification of the seizure disorder, current medications and adherence, seizure-free interval, EEG findings if relevant, and the neurologist's opinion regarding fitness for maritime duty.

Mental Health Conditions and the MMC

Mental health conditions are evaluated on a case-by-case basis under NVIC 04-08 and related USCG guidance. Having a mental health diagnosis does not automatically disqualify an applicant. The NMC's concern is whether the condition impairs the ability to safely operate a vessel — particularly judgment, situational awareness, impulse control, and the ability to respond appropriately to emergencies.

Conditions and Their Typical Evaluation

ConditionTypical NMC Approach
Mild to moderate depression, well controlledGenerally acceptable with documentation
Anxiety disorder, stable on medicationGenerally acceptable with documentation
ADHD on stimulant medicationCase-by-case; medication type matters
Bipolar disorderCase-by-case; stability, med compliance
PTSDCase-by-case; functional impact evaluated
Schizophrenia or psychotic disorderTypically disqualifying; waiver difficult
Active suicidal ideationDisqualifying until resolved
History of psychiatric hospitalizationEvaluated based on reason and stability since

For any mental health condition, the CG-719K requires the examining physician to document the diagnosis, current treatment, and their clinical assessment of fitness for maritime duty. Applicants with significant mental health histories should obtain a letter from their treating psychiatrist or psychologist in addition to the physical examination form.

Medication Matters: Sedating Drugs

Some medications used for mental health conditions — particularly benzodiazepines, sedating antihistamines, and certain antipsychotics — can impair alertness and reaction time. The NMC evaluates medication as part of the overall fitness determination, not just the diagnosis. A well-controlled condition managed with a non-sedating medication is viewed more favorably than the same condition managed with a sedating drug.

Diabetes and the Merchant Mariner Credential

Diabetes mellitus is one of the most common conditions NMC applicants disclose on the CG-719K. It is not automatically disqualifying. The primary concern is hypoglycemia — sudden low blood sugar causing confusion, loss of consciousness, or impaired judgment while operating a vessel.

Type 2 Diabetes: Oral Medications

Type 2 diabetics managed with oral medications (metformin, sulfonylureas, DPP-4 inhibitors, SGLT-2 inhibitors, etc.) are generally evaluated favorably if the condition is well controlled (HbA1c within target range) and there is no significant end-organ damage. The examining physician documents the treatment regimen and most recent HbA1c on the CG-719K. Significant complications — advanced peripheral neuropathy, diabetic retinopathy affecting vision below standards, or severe nephropathy — are evaluated separately.

Insulin-Dependent Diabetes Waiver

Insulin use requires additional evaluation because insulin can cause hypoglycemia. The NMC's policy has evolved, and insulin-dependent mariners can obtain waivers under the right circumstances. The documentation package typically includes:

  1. Completed CG-719K signed by the examining physician
  2. Endocrinologist's letter documenting: diagnosis, insulin regimen, current HbA1c, frequency of hypoglycemic events, and fitness opinion
  3. Recent bloodwork (HbA1c, renal function, lipid panel)
  4. Documentation of glucose monitoring practices
  5. Written management plan for hypoglycemia while underway

The NMC evaluates insulin-dependent mariners for: HbA1c level (high values suggesting poor control are a concern; very low values suggesting tight control with hypoglycemia risk are also evaluated), history of severe hypoglycemic episodes, hypoglycemia unawareness, and presence of end-organ complications.

Waiver Tip

If you are insulin-dependent and pursuing a captain's license, consider contacting the NMC's medical office directly before submitting your application to understand the current waiver requirements. Policy evolves, and an informal pre-submission inquiry can save you from a denial based on an incomplete package.

Prescription Medications and Mariner Fitness

The CG-719K requires disclosure of all prescription medications. The NMC evaluates medications from two angles: first, what the medication reveals about the underlying condition; and second, whether the medication itself could impair safe maritime operations.

Many medications are completely compatible with maritime duties. Others require additional evaluation. The categories of greatest concern to the NMC are:

Sedating Medications

Examples: Benzodiazepines (Xanax, Valium, Klonopin), sleep aids (Ambien, Lunesta), certain antihistamines (Benadryl), opioids

Impair alertness, reaction time, and judgment. Often reviewed closely even if the underlying condition is minor.

Controlled Stimulants

Examples: Amphetamine salts (Adderall), methylphenidate (Ritalin, Concerta) for ADHD

Evaluated case-by-case. The stimulant may itself be acceptable; the underlying ADHD diagnosis is also evaluated.

Anticoagulants

Examples: Warfarin, rivaroxaban (Xarelto), apixaban (Eliquis), dabigatran

Reveals an underlying cardiac or thromboembolic condition. The condition (not the drug itself) is the primary evaluation focus.

Antiseizure Medications

Examples: Levetiracetam (Keppra), lamotrigine (Lamictal), carbamazepine, phenytoin

Triggers evaluation of the seizure disorder, which is evaluated on its own merits.

Antipsychotics

Examples: Quetiapine (Seroquel), olanzapine (Zyprexa), haloperidol, risperidone

Often sedating. The underlying psychotic disorder is also evaluated.

Common medications for common conditions — antihypertensives, statins, thyroid medications, most antidepressants (SSRIs/SNRIs), proton pump inhibitors, and most antibiotics — are not concerning to the NMC and do not typically affect the fitness determination.

The NMC Medical Waiver Process

A "medical disqualification" is not necessarily a permanent denial. The NMC has a formal waiver process that allows applicants with disqualifying conditions to present evidence that they can safely perform maritime duties. Many applicants who receive initial disqualifications ultimately receive credentials after submitting a waiver package.

Waiver Process — Step by Step

1

Receive Notice of Medical Disqualification

The NMC issues a Notice of Medical Disqualification (NOMD) identifying the specific condition and the regulatory basis for the disqualification. Read this carefully — it tells you exactly what documentation is needed.

2

Consult a Specialist

For the specific condition identified in the NOMD, see the relevant specialist (cardiologist, neurologist, endocrinologist, psychiatrist). Explain that you need documentation for a USCG medical waiver for a Merchant Mariner Credential.

3

Gather Supporting Documentation

Assemble the specialist's letter, relevant test results (EKGs, Holter monitor reports, HbA1c labs, EEG results, etc.), current medication list, and any other documentation specifically requested in the NOMD.

4

Complete the Waiver Request Form

The NMC will provide a waiver request form. Complete it fully and attach all supporting documentation. Incomplete packages are returned without decision, which delays the process.

5

Submit Waiver Package to the NMC

Send the complete package to the NMC. Keep copies of everything. Note the submission date. The NMC will acknowledge receipt and assign it to a medical reviewer.

6

NMC Medical Review

The NMC medical department reviews the package. Processing times vary but commonly take 4–12 weeks depending on case complexity. For complex cardiovascular or neurological cases, they may consult federal medical advisors.

7

Decision: Approval, Denial, or Request for More Information

The NMC issues a decision. Approval may include a restriction on the credential (e.g., operating hours, vessel size). Denial can be appealed through the USCG administrative appeal process. A request for more information restarts the review clock once submitted.

Appeals: You Have Options

If your waiver is denied, you may appeal to the USCG Commandant through the administrative appeals process. The appeal must be filed within a specified period from the denial notice. Applicants pursuing an appeal for a complex medical condition should consider consulting a maritime attorney who practices before the USCG — the administrative process has specific procedural requirements.

The CG-719P Drug Test

All MMC applicants must submit a chemical drug test on form CG-719P. The test must be collected at a SAMHSA-certified laboratory or a DOT-certified collection site. A home drug test, a physician-ordered standard urine test, or any non-certified collection does not satisfy this requirement.

The NMC must receive your completed application — including the CG-719P result — within 185 days of the collection date. The 185-day clock starts when the sample is collected, not when results are returned. If your application is delayed past 185 days, you must collect a new sample.

The DOT 5-Panel Drug Test

The USCG uses the DOT 5-panel urine drug test. The five substance categories are:

Marijuana (THC)

Includes all forms — CBD products may cause trace positives

Cocaine

Cocaine and metabolites (benzoylecgonine)

Amphetamines

Amphetamine, methamphetamine, MDMA

Opioids

Heroin, morphine, codeine, oxycodone, oxymorphone, hydrocodone, hydromorphone

Phencyclidine (PCP)

Angel dust

Marijuana: No Federal Exception for State Law

Marijuana remains a Schedule I controlled substance under federal law. The USCG drug testing program operates under DOT regulations, which are federal. A positive THC test result disqualifies an applicant regardless of whether marijuana is legal in the applicant's state, regardless of whether it was used for medical purposes, and regardless of whether the applicant holds a state medical marijuana card. There are no exceptions.

Urine Test vs. Hair Follicle Test

The USCG CG-719P program uses urine testing — this is the DOT standard. Hair follicle testing is not part of the initial MMC application process. However, hair follicle testing has a much longer detection window than urine (up to 90 days vs. 2–30 days for urine depending on the substance and frequency of use). Some employers in the maritime industry use hair follicle testing as part of private pre-employment screening, separate from the federal CG-719P requirement.

Medical Review Officer (MRO) Process

All confirmed positive drug test results are reviewed by a Medical Review Officer (MRO) before being reported. The MRO contacts the applicant to determine whether there is a legitimate medical explanation for the positive result — for example, a valid prescription for an opioid pain medication. If the MRO determines a medical explanation is valid, the result may be reported as negative. If no valid explanation exists, the result is reported as positive to the NMC.

The MRO process protects applicants from false positives due to legitimate prescription medications. This is why it is important to have documentation of any controlled substance prescriptions readily available — the MRO will ask for it.

Pre-Employment vs. Random Drug Testing

The CG-719P initial drug test for MMC application is a pre-employment (or pre-credential) test. But once you hold an MMC and work in the maritime industry, you are subject to an ongoing drug and alcohol testing program.

Test TypeWhen It OccursNotes
Pre-EmploymentBefore MMC issuance (CG-719P) or before starting a new DOT-covered job185-day window for NMC applications
RandomUnannounced, during active employmentSelected by random computer process; employer must test a percentage of workforce annually
Post-AccidentFollowing a marine casualty or serious incidentMandatory; must occur within specific time windows
Reasonable CauseWhen a supervisor has reasonable suspicion of impairmentTwo trained supervisors must document observations
Return-to-DutyAfter a positive test and completion of SAP programMust be negative before return; follow-up testing continues
Follow-UpAfter return to duty, ongoing for up to 5 yearsMinimum of 6 tests in first year; unannounced

Positive Drug Test: Consequences and Return-to-Duty

A confirmed positive drug test result — one that has been through the MRO review process and not explained by a legitimate prescription — has serious consequences for both initial applicants and credentialed mariners.

For Initial Applicants (CG-719P)

A positive result on the initial CG-719P drug test will result in denial of the MMC application. The applicant may reapply after completing the return-to-duty process:

  • Evaluation by a Substance Abuse Professional (SAP)
  • Completion of recommended education or treatment program
  • Return-to-duty drug test (must be negative)
  • Follow-up testing plan as recommended by the SAP

For Credentialed Mariners

A positive test for a credentialed mariner results in removal from safety-sensitive duty immediately. The NMC may initiate action against the credential. The mariner is referred to a Substance Abuse Professional (SAP) and cannot return to safety-sensitive maritime duty until completing the return-to-duty process and testing negative.

Refusal to Test

Under DOT regulations, refusing to test is treated the same as a positive result. Refusal includes: not appearing for testing within the required time, leaving the collection site before providing a specimen, refusing to provide a specimen, adulterating or substituting a specimen, and certain other behaviors indicating an attempt to obstruct the testing process.

Prior Drug Test Results Must Be Disclosed

When applying for a new DOT-covered position or credential, prior drug and alcohol violations must be disclosed. If a prospective employer requests drug testing history from previous DOT employers (standard practice), they will receive information about prior violations. Non-disclosure of prior violations when asked is itself a disqualifying violation.

Alcohol Testing and the 0.04% BAC Standard

The federal alcohol standard for mariners operating under DOT regulations is a BAC of 0.04% or less. This is half the 0.08% standard applicable to non-commercial drivers in most states, and reflects the higher safety stakes of maritime operations. The standard applies while the mariner is on duty or on call.

BAC LevelResult / Consequence
0.00% – 0.019%No violation
0.02% – 0.039%Action level — mariner is removed from duty for 24 hours; not a formal violation but requires documentation
0.04% or higherViolation — immediately removed from duty; must complete SAP evaluation and return-to-duty process before resuming safety-sensitive duties

The USCG also has broad authority under 33 CFR Part 95 to take action against any mariner operating a vessel in a negligent or grossly negligent manner while under the influence of alcohol — regardless of BAC test results. This authority exists parallel to the DOT alcohol testing program.

Substance Use Disorders and the MMC

Alcohol and substance use disorders are evaluated as medical conditions by the NMC. A diagnosis of substance use disorder (SUD) does not automatically disqualify a mariner. The evaluation focuses on: current status (in active addiction vs. in recovery), duration of sobriety, engagement with treatment, and the specific substance(s) involved.

Mariners in active recovery who can document sustained sobriety (commonly 2+ years for alcohol use disorder), participation in a treatment or support program, and support from a treating addiction medicine specialist may qualify for a credential. The NMC may impose periodic drug and alcohol testing as a condition of the credential.

TWIC Card Requirements for Captain's License Applicants

The Transportation Worker Identification Credential (TWIC) is a tamper-resistant biometric smart card issued by the TSA that provides unescorted access to secure areas of maritime facilities and vessels. Most captain's license applicants are required to hold a valid TWIC card as part of the MMC application.

TWIC enrollment involves a background check that covers criminal history, immigration status, and terrorism-related watchlists. The TWIC background check is conducted by TSA and is separate from the USCG's suitability review — but a permanent TWIC disqualification will also prevent issuance of an MMC.

TWIC Disqualifying Offenses

Certain criminal convictions disqualify an applicant from obtaining a TWIC card. There are permanent disqualifications (no waiver available) and interim disqualifications (waiver may be available after a specified waiting period). Permanent disqualifications include:

  • Espionage, treason, or terrorism-related convictions
  • Federal crimes of terrorism
  • Crimes involving a transportation security incident
  • Certain murder convictions

Interim disqualifications — those for which a waiver may be available after a waiting period — include many felonies including drug distribution, firearms offenses, and other serious crimes. The specific list is defined in 49 CFR Part 1572. Applicants with a criminal history should review the TWIC regulation carefully and consider consulting an attorney before investing significant time and money in pursuing a captain's license.

Timing: Apply for TWIC First

Strategic Recommendation: TWIC First

TWIC applications take 4–8 weeks to process. If your application is delayed — or denied — it can hold up your entire MMC application. Apply for TWIC first, as soon as you decide to pursue your captain's license. Do everything else while you wait for TWIC to process.

You must hold a valid, activated TWIC card — not just a pending application — before your MMC can be issued. An applicant who completes their physical, drug test, sea time documentation, and exam, but has not yet received their TWIC card, cannot receive their MMC.

First Aid & CPR Certification Requirements

All USCG captain's license applicants must hold current First Aid and CPR certifications. These certifications reflect a minimum standard of emergency medical competency expected of the person responsible for a vessel and its passengers.

CertificationValidity PeriodNotes
First Aid2 yearsMust include hands-on skills component
CPR / AED1–2 years (varies by provider)Must include hands-on skills; online-only not accepted

Accepted Certification Providers

American Red Cross (ARC)

Widely available; combined First Aid/CPR/AED courses common

American Heart Association (AHA)

Heartsaver First Aid CPR AED is the typical course

American Safety and Health Institute (ASHI)

Less common but accepted by the NMC

YMCA

Accepted if affiliated with a recognized certifying body

National Safety Council (NSC)

Accepted; less common than ARC or AHA

Local Fire Departments

Some offer community First Aid/CPR courses; verify provider acceptance

Online-Only CPR Courses Are Not Accepted

The NMC requires that CPR certification include a hands-on skills assessment component. Online-only courses — including online portions of blended learning programs where you never complete the in-person skills session — do not satisfy this requirement. Many ARC and AHA courses use a blended format where you complete the knowledge portion online but must still attend an in-person skills session. Make sure you complete the in-person component and receive a card that reflects hands-on certification.

Cost and Convenience

Combined First Aid, CPR, and AED courses typically run $50–$100 and take 4–8 hours. They are offered by community centers, hospital systems, occupational health clinics, fire stations, and YMCAs. Scheduling one of these courses on the same day as your CG-719K physical examination at an occupational health clinic is an efficient way to handle multiple requirements in one visit.

Recommended Timing and Sequence

The medical and physical requirements each have their own timelines and validity windows. Approaching them in the wrong order can cause delays — most commonly, applicants complete their drug test too early and it expires before their application is submitted, requiring a repeat test.

1

Apply for TWIC first

TWIC takes 4–8 weeks to process. Apply immediately and let it process in the background while you complete other requirements.

2

Accumulate sea time and assemble documentation

Begin gathering your sea service documentation (logbooks, employer letters, vessel documentation). This is often the longest lead-time item.

3

Complete the physical (CG-719K)

Schedule and complete your CG-719K physical. Valid for 2 years, so you have flexibility on timing. Get this done early.

4

Get First Aid and CPR certified

Complete a hands-on course from ARC, AHA, or ASHI. Can often be done same-day as your physical if using an occupational health clinic.

5

Take the drug test — last before submission

The 185-day window means you should take your drug test as close to submission as practical. Do not take it too early and risk expiration.

6

Submit complete package to the NMC

Submit everything together: CG-719K, CG-719P, TWIC copy, First Aid/CPR card, sea time documentation, and application fee. Incomplete packages cause delays.

Common Mistakes to Avoid

Drug test expires before submission

The 185-day clock starts at sample collection. If your application sits around — waiting for other documents, an exam slot, or NMC processing — the test can expire. Coordinate timing carefully.

Wrong provider signs the CG-719K

Chiropractors, naturopaths, and pharmacists cannot sign the CG-719K. The NMC will reject it. Use an MD, DO, NP, or PA.

Drug test collected at a non-certified site

A physician-ordered urine test from your GP does not satisfy the CG-719P requirement. It must be from a SAMHSA-certified laboratory or DOT-certified collection site.

Not requesting the FALANT after failing Ishihara

Many applicants fail the Ishihara and assume they have a disqualifying color vision deficiency. The FALANT test is specifically designed for mariners — many Ishihara failures pass the FALANT. Always ask for it before accepting a restriction.

TWIC applied too late

TWIC processing takes 4–8 weeks. Applicants who apply for TWIC late hold up their entire MMC issuance while waiting. Apply for TWIC on day one.

Online-only CPR certificate submitted

The NMC will reject CPR certificates from online-only courses. The certification must include a hands-on skills session. Verify that your course includes in-person practice.

Not disclosing a condition on the CG-719K

Failing to disclose a known medical condition on the CG-719K is a false statement on a federal form — a far more serious problem than the underlying condition itself. Disclose everything and let the NMC make the fitness determination.

Frequently Asked Questions

What are the vision requirements for a USCG captain’s license?

Distant vision must be at least 20/200 in each eye, correctable to 20/40 in the better eye and 20/100 in the lesser eye. Near vision must be 20/40 or better in the better eye. Color vision is also required; the FALANT test is available for applicants who fail the Ishihara plates.

Can I get a captain’s license if I have diabetes?

Yes, in many cases. Type 2 diabetics managed with oral medications are generally evaluated favorably with documented HbA1c control. Insulin-dependent diabetics may qualify for a waiver with endocrinologist documentation and a demonstrated management plan. Cases are evaluated individually.

What happens if I test positive on the USCG drug test?

A confirmed positive result on the CG-719P will result in denial of your initial MMC application. You must complete a Substance Abuse Professional (SAP) evaluation, recommended treatment, and a return-to-duty drug test before reapplying. State-legal marijuana is not a defense.

What is the blood pressure limit for a USCG captain’s license?

There is no single cutoff, but Stage 2 hypertension (above 160/100) that is uncontrolled may result in a medical disqualification. Well-controlled hypertension managed with medication is typically acceptable. The examining physician documents their clinical judgment on the CG-719K.

How does the USCG color vision testing process work?

The Ishihara pseudoisochromatic plate test is administered first. If you fail, you may proceed to the Farnsworth Lantern (FALANT) test, which uses actual colored lights similar to navigation lights. Passing the FALANT satisfies the requirement without restriction. Failing both results in a 'not by colors alone' notation on your credential.

Can a seizure disorder disqualify me from getting a captain’s license?

A recent seizure history (within the past 2 years) is generally disqualifying. Applicants who have been seizure-free for an extended period on stable medication may qualify for a waiver. Neurologist documentation and a letter supporting fitness for maritime duty are required.

Do mental health conditions disqualify you from a USCG MMC?

Not automatically. Stable, well-managed conditions are often acceptable. The NMC evaluates functional impact on maritime safety, not just the diagnosis. Sedating medications that could impair alertness are evaluated carefully. Psychotic disorders are more likely to disqualify.

What are the First Aid and CPR requirements for a captain’s license?

Current First Aid (valid 2 years) and CPR (valid 1–2 years) certifications are required. Accepted providers include ARC, AHA, and ASHI. Online-only CPR courses are not accepted; the certification must include an in-person hands-on skills session.

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