Section 3.13 - Health and Medical Examination(1) Each applicant and each individual holding a Commission must be and must remain in good physical and mental health (as determined by the USCG or medical practitioner performing general fitness examination) and be at all times fit to perform the duties of a Pilot.(2) Each individual holding a Commission must have a physical examination (including eye examination) that meets the license requirements of the U.S. Coast Guard by a medical practitioner licensed and qualified to practice in the United States on an annual basis to demonstrate good physical and mental health. The Commissioned Pilot must submit to the Commissioner a copy of such medical report signature page (USCG Form 719K) each calendar year. The cost of such medical examination will be at the expense of the Commissioned Pilot.(3) In the event of a disagreement between any individual and the Commissioner as to the results of any such physical examination or as to the physical or mental health of any individual, the individual shall have a physical examination by a medical practitioner licensed and qualified to practice in the United States and to be determined by the Commissioner. A copy of the written report of each such physical examination shall be furnished by the relevant practitioner to the Commissioner and to the individual examined. This examination shall be at the cost and expense of the Commissioner.(4) Each such written report shall be not less extensive than that required by the U.S. Coast Guard and must include the signature page (page 9) of the USCG Form 719K, to be submitted to the Commissioner.(5) Each pilot must promptly report to the Commissioner in writing all medications (prescription or nonprescription), dietary supplements, and vitamins that were filled, or refilled, and/or taken within 30 days prior to the date the applicant signs the CG-719K and all medications (prescription or nonprescription), dietary supplements, and vitamins that were used for a period of 30 or more days within the last 90 days prior to the date the applicant signs the CG-719K. At any time, all medications (prescription or nonprescription), dietary supplements, and vitamins that have side effects that will impair judgment, balance, or any other requirements for effective and safe performance of routine and emergency duties on board must be promptly reported to the Commissioner in writing. (a) Pursuant to U.S. Coast Guard regulations, a Commissioned Pilot providing pilotage services under the authority of their U.S. Coast Guard Merchant Mariner Credential shall be subject to substance abuse screening, commonly referred to as "drug testing". Such drug testing shall conform to all elements of screening, including pre-employment (applicants), random selection, post-accident and probable cause. In the event that a drug test is reported as "positive" to the U.S. Coast Guard, the Commissioned Pilot shall immediately notify the Commissioner via the most expedient means of communication. The Commissioner shall immediately suspend the Commission of the Commissioned Pilot. If and when the Commissioned Pilot's Merchant Mariner Credential is reinstated, the Commissioner may or may not reinstate the Pilot's Commission but will permit the Commissioned Pilot a hearing to ascertain if reinstatement is appropriate, and if so the Commissioner may require recency trips and/or renewal application.(b) Commissioned Pilots who are involved in an "unusual incident" as defined in 995 CMR 3.02 or show probable cause to the U.S. Coast Guard shall be subject to urine screen for drugs and blood tests or breathalyzer for alcohol content of the Commissioned Pilot. If the Blood Alcohol Content (BAC) of the Commissioned Pilot is above 0.04%, then the Commissioned Pilot shall immediately notify the Commissioner via the most expedient means of communication. The Commissioner shall immediately suspend the Commission of the Commissioned Pilot. If and when the Commissioned Pilot's license is reinstated, the Commissioner may or may not reinstate the Pilot's Commission but will permit the Commissioned Pilot a hearing to ascertain if reinstatement is appropriate, and if so the Commissioner may require recency trips and/or renewal application.Adopted by Mass Register Issue 1488, eff. 2/3/2023.