Medical clearance for working on a ship

So, here’s the deal—I noticed that during the medical clearance for working on a merchant vessel, they do a full blood panel. Now, I’ve been dealing with epilepsy, though honestly, I haven't had a single issue or seizure in about seven years—it's been smooth sailing since then—but I am still on medication. This got me thinking... if they run these tests, is there any chance they'll pick up traces of my meds in my system? One doctor mentioned to me that when you're getting cleared for maritime work, the bloodwork is mostly focused on various toxicology screens to ensure everything is clean. He suggested that because I've been consistently taking my Depakote and Lamictal for the last seven or eight years, they wouldn't even register as "drugs" in the way people usually think. I'd love to hear your thoughts or if anyone else has navigated this kind of thing before.

Anthony Nelson4 said:So, here’s the deal—I noticed that during the medical clearance for working on a merchant vessel, they do a full blood panel. Now, I’ve been dealing with epilepsy, though honestly, I haven't had a single issue or seizure in about seven years—it's been smooth sailing since then—but I am still on medication. This got me thinking... if they run these tests, is there any chance they'll pick up traces of my meds in my system? One doctor mentioned to me that when you're getting cleared for maritime work, the bloodwork is mostly focused on various toxicology screens to ensure everything is clean. He suggested that because I've been consistently taking my Depakote and Lamictal for the last seven or eight years, they wouldn't even register as "drugs" in the way people usually think. I'd love to hear your thoughts or if anyone else has navigated this kind of thing before.

They probably will.
Let's be real here: you're just trying to hide the fact that you have epilepsy, aren't you?
Smola 😢

Angela Wright said:They probably will.
Let's be real here: you're just trying to hide the fact that you have epilepsy, aren't you?
Smola 😢

Well, yeah—but like I was saying before, that specialist my agency suggested I talk to—the one who told me I should clear up any questions I have with him directly—he mentioned that they wouldn't be checking specifically to see if the medication is present in my bloodstream. Instead, he explained that the whole reason they’re pulling blood is just to run those standard toxicology panels. It's funny how those things work sometimes, isn't it? You think they're looking for one thing, but then there's this whole other layer of testing happening behind the scenes... anyway, that was his take on it.

Anthony Nelson4 said:Well, yeah—but like I was saying before, that specialist my agency suggested I talk to—the one who told me I should clear up any questions I have with him directly—he mentioned that they wouldn't be checking specifically to see if the medication is present in my bloodstream. Instead, he explained that the whole reason they’re pulling blood is just to run those standard toxicology panels. It's funny how those things work sometimes, isn't it? You think they're looking for one thing, but then there's this whole other layer of testing happening behind the scenes... anyway, that was his take on it.

Your best bet is to check out this resource instead: http://www.epilepsy.com/?page_id=124

Angela Wright said:Your best bet is to check out this resource instead: http://www.epilepsy.com/?page_id=124

Thanks!

If you want to actually "see" a medication in your system, you need a very specific type of lab test.
The term "toxicology screen" is pretty broad, so the real question is what substances they're actually looking for in their panel.

I'm honestly not entirely sure if your specific meds will even show up on a standard test.

To whom it may concern,

According to the Federal Maritime Regulations regarding health fitness standards for maritime crew members on ships, boats, and yachts (link), the requirements state:

A medical examination must include:
– laboratory tests (ESR, CBC, blood glucose, urinalysis),
– screening for drugs and alcohol.

The Coast Guard guidelines concerning health fitness for crews on ocean-going vessels and inland waterway craft (link) provide more specific details on the testing parameters:

drug tests (psychoactive substances), specifically targeting major metabolites (cannabinoids/THC, opiates/morphine, codeine and heroin, cocaine/benzoylgoine, ecstasy, speed, amphetamine, methamphetamine, methadone).

Based on this list, it follows that the medications mentioned will not be detected by these specific screenings.

That said, much like any occupational medicine exam, you are required to provide documentation from your primary care physician detailing any chronic or mental health conditions. The physician is obligated to provide accurate data in this certification. This should naturally include information regarding epilepsy and your current medication regimen.

I am uncertain, however, if your specific role falls under these particular regulations or if different criteria apply to your position. If it does fall under these rules, an epilepsy diagnosis would likely result in being deemed unfit for duty.

Nicholas Myers said:To whom it may concern,

According to the Federal Maritime Regulations regarding health fitness standards for maritime crew members on ships, boats, and yachts (link), the requirements state:

A medical examination must include:
– laboratory tests (ESR, CBC, blood glucose, urinalysis),
– screening for drugs and alcohol.

The Coast Guard guidelines concerning health fitness for crews on ocean-going vessels and inland waterway craft (link) provide more specific details on the testing parameters:

drug tests (psychoactive substances), specifically targeting major metabolites (cannabinoids/THC, opiates/morphine, codeine and heroin, cocaine/benzoylgoine, ecstasy, speed, amphetamine, methamphetamine, methadone).

Based on this list, it follows that the medications mentioned will not be detected by these specific screenings.

That said, much like any occupational medicine exam, you are required to provide documentation from your primary care physician detailing any chronic or mental health conditions. The physician is obligated to provide accurate data in this certification. This should naturally include information regarding epilepsy and your current medication regimen.

I am uncertain, however, if your specific role falls under these particular regulations or if different criteria apply to your position. If it does fall under these rules, an epilepsy diagnosis would likely result in being deemed unfit for duty.

I need to adjust my previous point above. Looking closer at the regulations, it turns out epilepsy is explicitly listed as a contraindication for only certain maritime positions. It isn't mentioned for others, which leaves the question open as to whether this restriction applies to all crew roles or just a select few.

Nicholas Myers said:I need to adjust my previous point above. Looking closer at the regulations, it turns out epilepsy is explicitly listed as a contraindication for only certain maritime positions. It isn't mentioned for others, which leaves the question open as to whether this restriction applies to all crew roles or just a select few.

So, I went ahead and had a chat with the doctor who's authorized to handle the medical clearances for the shipping company—you know, the one who does the official physicals—and I asked him point-blank if he actually requires a secondary note from a private physician stating I'm fit to work without any health issues. He told me straight up that I don't even need to bring that in; instead, I'll just have to sign some kind of waiver or declaration—I can't remember the exact wording, honestly, but that's the gist of it.

Anthony Nelson4 said:So, I went ahead and had a chat with the doctor who's authorized to handle the medical clearances for the shipping company—you know, the one who does the official physicals—and I asked him point-blank if he actually requires a secondary note from a private physician stating I'm fit to work without any health issues. He told me straight up that I don't even need to bring that in; instead, I'll just have to sign some kind of waiver or declaration—I can't remember the exact wording, honestly, but that's the gist of it.

It’s likely a declaration where you swear under penalty of perjury that you aren't suffering from any physical or mental health issues that would prevent you from performing the job duties. Or, more simply, you'll probably fill out a questionnaire covering things like chronic illnesses, current medications, or surgical history, then sign off stating everything is accurate and consenting to drug testing.

The role you're taking on probably doesn't fall under those high-stakes maritime safety categories that require deep dives into your medical records. In my experience working in general practice, a self-disclosure is often sufficient—unless regulations have shifted recently.

Hey there. I’ve got a bit of a dilemma regarding some medical stuff—specifically about an old injury. Back in 2009, I had surgery for an inguinal hernia, and the doctors were pretty clear about not overexerting myself... but here's the kicker: when you sign up for a cruise, you have to check a box saying you're capable of lifting and carrying around 45 to 50 pounds. Given that I only weigh about 115 pounds, that feels like a massive amount of weight to move around, right? Has anyone else dealt with this kind of thing before? Because, honestly, people tell me I should just keep quiet about it, but if things actually go sideways, who’s going to step up and help me when everyone else is just looking out for themselves?