Thanks for all the replies - really appreciate all the suggestions.
Never heard of the RFA before but this looks like a possibility, although collapsed lung is mentioned on the medical requirements it sounds like it isn’t necessarily a certain exclusion …..
“Notes
1. Numbers 1–4 in the last 3 columns of the table refer to fitness categorisations to be used on seafarer medical certificates. See para 3.5 above These are:
Category 1 : Fit for sea service, with no restrictions
Category 2 : Fit for sea service but with restrictions
Category 3 : Temporarily unfit for sea service Category 4 : Permanently unfit for sea service
2. For those seafarers under regular surveillance and monitoring for a progressive condition, limiting the duration of their certificate to correspond with their next surveillance appointment should be considered. This would enable the fitness decision to be modified to take account of any new findings or changes to therapy. (N.B. A time limitation is not a restriction and no ENG 3 should be issued).
3. For some conditions, continuity of follow up is essential. Such conditions are identified by “C”. Where this is indicated, the seafarer should attend the same Approved Doctor for all medicals subsequent to diagnosis. If this proves impossible, any new Approved Doctor should only perform an examination when they have received a full report, records of previous examinations and details of the criteria being used by the previous Approved Doctor, to determine the adequacy of control of the condition.
4. Complex conditions will often require a specialist assessment of fitness for return to seafaring. Such conditions are identified by ‘S’. Approved Doctors who are not registered specialists in occupational medicine should, if they are in any doubt about fitness;
- either refer the seafarer to an Approved Doctor who is a registered specialist; or
12- obtain a report from a specialist in the relevant clinical speciality, asking specific questions which address risks relevant to the illness under working conditions at sea and fitness for the duties proposed, prior to issuing a certificate.
Condition = Pneumothorax – spontaneous traumatic
Rationale, risk basis/Justification = Acute disability from recurrence
Advice to seafarers and maritime industry. Preventative measures = blank
New diagnosis or current condition (see note 11 above) = 3 – normally for 12 months after initial episode or shorter duration as advised by specialist
Fitness category after investigation/resolution Reasonable adjustments = Based on advice of treating specialist - S, 4 - after recurrent episodes unless pleurectomy or pleurodesis performed”
Thanks again everyone.