| GENERAL INFORMATION
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| KEYWORDS
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Marine medical certificate, diabetes, geographical limitations
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| FILE NO.
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MQ-0572-21
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| SECTOR (Marine or Aviation)
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Marine
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| SPECIFIC JOB
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Engineer function
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| DIAGNOSIS (Primary, Secondary, etc.)
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Type 1 Diabetes Mellitus
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| REVIEW
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| DATE OF DETERMINATION
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May 14, 2021
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| MEMBER
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Dr. Thomas V. Davis
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| DETERMINATION
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The member confirms the Minister of Transport’s decision to issue a marine medical certificate with limitations.
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| REASONS FOR THE DETERMINATION
Issuance of a marine medical certificate (MMC) with a limitation of “limited, contiguous waters voyage” — After receiving and reviewing the requested medical information, the Marine Medical Unit (MMU) informed the applicant that he was assessed as fit to hold an MMC with the above limitation due to the diagnosis of Type 1 Diabetes Mellitus and, as a result, his dependence on insulin. Subsequently, the MMU requested and received a report from the applicant’s family physician, as well as a blood sugar log, a medication list, an optometry report, and laboratory results. An assessment of this documentation confirms evidence of good control, full compliance with treatment recommendations and good hypoglycemia awareness, which are the requirements for an MMC with limitations, as per the International Labour Organization (ILO) and International Maritime Organization (IMO) Guidelines on the medical examinations of seafarers (ILO/IMO guidelines). As neither the diagnosis of diabetes nor the requirement for insulin is disputed, this assessment is consistent with both Seafarer Medical Examinations – A Physician Guide (Physician Guide) and the ILO/IMO guidelines. The applicant testified that he was initially assessed fit without limitations when he was newly diagnosed with diabetes and had just initiated insulin therapy. Then, two years later when he was closely monitoring his blood sugars, had his diabetes under good control, and was much more knowledgeable of the disease, he found that limitations were placed on his MMC, which he feels was unreasonable given his assessment in 2017. The applicant was not aware until the Tribunal hearing that his 2017 assessment was made in error due to the fast‑track program. The ILO/IMO guidelines and the Transport Canada Physician Guide are consistent in requiring a limitation of near coastal duties to the MMC of any seafarer with a diagnosis of diabetes who requires insulin. The decision of the Minister of Transport to place a limitation on the applicant’s MMC is confirmed.
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| APPEAL
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| DATE OF DECISION
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| MEMBERS
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| DECISION
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| REASONS FOR THE DECISION
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| OTHER/COMMENTS
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