AMERICAN SEAMEN

§ 32.11 Scope of benefits

American seamen (hereinafter referred to in §§ 32.11 to 32.23, inclusive, as seamen) shall, on presenting evidence of eligibility, be entitled to medical, surgical, and dental treatment or hospitalization at medical care facilities operated by the Service. Depending upon the availability of funds and other management considerations, health care and services from non-Service providers and at non-Service facilities may be arranged for and authorized at the expense of the Service upon such terms and conditions as the Secretary or his designee may from time to time announce by publication of a notice in the FEDERAL REGISTER.

[46 FR 25624, May 8, 1981]

§§ 32.12-32.13 [Reserved]

§ 32.14 Evidence of eligibility.

(a) As evidence of his eligibility a seaman must present a properly executed master's certificate, or a continuous discharge book, or a certificate of discharge, showing that he has been employed on a registered, enrolled, or licensed vessel of the United States. The certificate of the owner or accredited commercial agent of a vessel as to the facts of the employment of any seaman on said vessel may be accepted in lieu of the master's certificate where the latter is not procurable. When an applicant cannot furnish any of the foregoing documents, his certification as to the facts of his most recent (including his last) employment as a seaman, stating names of vessels and dates of service, may be accepted as evidence in support of his eligibility. Documentary evidence of eligibility, excepting continuous discharge books and certificates of discharge, shall be filed at the medical care facility of the Service where application is made. Where continuous discharge books and certificates of discharge are submitted as evidence of eligibility, the pertinent information shall be abstracted therefrom, certified by the officer accepting the application, and filed at the station.

(b) Except as otherwise provided in §§ 32.11 to 32.23, inclusive, documentary evidence of eligibility must show that the applicant has been employed for 60 days of continuous service on a registered, enrolled, or licensed vessel of the United States, a part of which time must have been during the 180 days immediately preceding application for relief. There may be included as a part of such 60 days of continuous service as a seaman time spent in training as (1) an active duty enrollee in the United States Maritime Service, (2) a member of the Merchant Marine Cadet Corps, (3) a cadet at a State maritime academy, or (4) a cadet on a State training ship. The phrase "60 days of continuous service" shall not be held to exclude seamen whose papers show brief intermissions between short services that aggregate the required 60 days: Provided, That any such intermission does not exceed 60 days. The time during which a seaman has been treated as a patient of the Service shall not be considered as absence from the vessel in determining eligibility. When the seamen's service on his last vessel is less than 60 days, his oath or affirmation as to previous service may be accepted.

§ 32.15 Sickness or injury while employed.

A seaman taken sick or injured on board or ashore when actually employed on a vessel shall be entitled to care and treatment without regard to length of service.

§ 32.16 Seamen from wrecked vessels.

Seamen taken from wrecked vessels of the United States and returned to the United States, if sick or disabled at the time of their arrival in the United States, shall be entitled to care and treatment without regard to length of service.

§ 32.17 Lapse of more than 180 days since last service.

(a) Where more than 180 days have elapsed since an applicant's last service as a seaman, he will no longer be eligible for benefits from the Service: Provided, That if he can show that he has not definitely changed his occupation, such period of time shall not ex

clude him from receiving care and treatment (1) if due in whole or in part to closure of navigation or economic conditions resulting in decreased shipping with consequent lack of opportunity to ship; or (2) if he provides satisfactory evidence that he has been under continuous medical supervision and treatment at other than Service expense for a condition which occurred or arose during any period of treatment at a Service facility or at Service expense.

(b) Where a seaman receives care and treatment by the Service or at Service expense during a period of eligibility for a condition or illness which requires, in the opinion of the attending physician, continuing and recurring care and treatment on a regular and frequent basis, such periods of continuing and recurring care and treatment whether obtained privately by the seaman or at Service facilities or Service expense shall not be included in the computation of the 180 day period above.

§ 32.18 Procedure in case of doubtful eligibility.

When a reasonable doubt exists as to the eligibility of an applicant for service, the matter shall be referred immediately to the appropriate authorizing official or Hospital Director for decision. If, in the opinion of such person the applicant's condition is such that immediate care and treatment is necessary, temporary care and treatment shall be given pending the decision as to eligibility.

§ 32.19 False document evidencing service.

The issue or presentation of a false document as evidence of service with intent to procure the treatment of a person as a seaman shall be immediately reported to the Headquarters of the Service.

§ 32.20 Treatment during voyage.

The Service shall not be liable for expenses incurred during a voyage for the care of sick and disabled seamen.

§ 32.21 Care while in custody.

Seamen shall not be provided treatment at the expense of the Service while in police custody.

connection with such fishing operations are comparable to services performed by seamen employed on such vessel or on vessels engaged in similar operations shall be entitled to care and treatment by the Service under the same conditions, where applicable, and to the same extent as is provided for American seamen.

MARITIME SERVICE ENROLLEES AND
MERCHANT MARINE CADETS

§ 32.61 Use of Service facilities.

(a) Enrollees in the United States Maritime Service on active duty and members of the Merchant Cadet Corps shall, upon written request of the responsible officer of the station or training ship to which such enrollees or cadets are attached, identifying the applicant, be entitled to medical surgical, and dental treatment or hospitalization at medical care facilities of the Service or at Service expense. Whenever an enrollee or cadet applies for care without the above-mentioned written request and in the opinion of the responsible Service officer the applicant's condition is such that immediate care and treatment is necessary, temporary care and treatment shall be given pending verification of the applicant's status as an enrollee or cadet.

(b) If eligibility cannot be established at the time of application by the enrollee or cadet or by the person who applies in his behalf, the applicant shall be notified that the authorization for treatment is conditional and that the payment of reasonable expenses by the Service for such treatment shall be subject to proof of eligibility.

(c) The authorizing official shall keep himself informed regarding the progress of the case in order that treatment or hospitalization shall not be unnecessarily prolonged.

§ 32.62 Injury while in custody.

Enrollees on active duty or cadets shall not be provided treatment at the expense of the Service while in police custody.

§ 32.63 Absence without leave.

Enrollees on active duty or cadets shall not be entitled, when absent

without leave, to receive medical care except at a medical care facility of the Service or under contract to the Service.

CADETS AT STATE MARITIME ACADEMIES OR ON STATE TRAINING SHIPS

§ 32.76 Conditions and extent of treatment.

Cadets at State maritime academies or on State training ships shall be entitled to care and treatment by the Service under the same conditions and to the same extent as is provided for American seamen. Provided, however, That the written request of the superintendent or other responsible officer of an academy, including the master of a training ship, shall be accepted in lieu of the documentary evidence of eligibility required of American

seamen.

PERSONS WITH HANSEN'S DISEASE AUTHORITY: Sec. 331 and 332, 58 Stat. 696, 698 as amended; 42 U.S. C. 255, 256.

§ 32.86 Admissions to Service facilities.

Any person with Hansen's disease who presents himself for care or treatment or who is referred to the Service by the proper health authority of any State, Territory, or the District of Columbia shall be received into the Service hospital at Carville, Louisiana, or into any other hospital of the Service which has been designated by the Secretary as being suitable for the accommodation of persons with Hansen's disease.

§ 32.87 Confirmation of diagnosis.

At the earliest practicable date, after the arrival of a patient at the Service hospital at Carville, Louisiana, or at another hospital of the Service the medical staff shall confirm or disprove the diagnosis of Hansen's disease. If the diagnosis of Hansen's disease is confirmed, the patient shall be provided appropriate inpatient or outpatient treatment. If the diagnosis is not confirmed, the patient shall be discharged.

[40 FR 25816, June 19, 1975; 40 FR 36774, Aug. 22, 1975]

§ 32.88 Examinations and treatment.

Patients will be provided necessary clinical examinations which may be required for the diagnosis of primary or secondary conditions, and such treatment as may be prescribed.

§ 32.89 Discharge.

Patients with Hansen's disease will be discharged when, in the opinion of the medical staff of the hospital, optimum hospital benefits have been received.

§ 32.90 Notification to health authorities regarding discharged patients.

Upon the discharge of a patient the medical officer in charge shall give notification of such discharge to the appropriate health officer of the State, Territory, or other jurisdiction in which the discharged patient is to reside. The notification shall also set forth the clinical findings and other essential facts necessary to be known by the health officer relative to such discharged patient.

SEAMEN ON FOREIGN FLAG VESSELS

§ 32.106 Conditions and extent of treatment; rates; burial.

(a) Seamen on foreign flag vessels may, when suitable accommodations are available and on application of the master, owner, or agent of the vessel, be provided treatment at medical care facilities of the Service at rates prescribed by the Secretary.

(b) Upon application, the Service may assist in arranging for private hospitalization of such seamen or private services in connection with their treatment at the expense of the master, owner, or agent of the vessel.

(c) If any such seaman dies while receiving treatment by the Service, the expenses of burial shall be paid directly to the vendors by the master, owner, or agent.

NONBENEFICIARIES: TEMPORARY
TREATMENT IN EMERGENCY

§ 32.111 Conditions and extent of treatment; charges.

(a) Persons not entitled to treatment by the Service may be provided temporary care and treatment at medical

care facilities of the Service in case of emergency as an act of humanity.

(b) Persons referred to in paragraph (a) of this section who, as determined by the officer in charge of the Service facility, are able to defray the cost of their care and treatment shall be charged for such care and treatment at the following rates (which shall be deemed to constitute the entire charge in each instance): In the case of hospitalization, at the current interdepartmental reciprocal per diem rate; and, in the case of outpatient treatment, at rates established by the Secretary.

PART 34-MEDICAL EXAMINATION OF ALIENS

Sec.

34.1 Applicability. 34.2 Definitions.

34.3 Examinations; female aliens. 34.4 Scope of examinations.

34.5 Aliens free of defect, disease, or disability.

34.6 Aliens afflicted with defect, disease, or disability.

34.7 Certificates and notifications; Class A. 34.8 Certificates and notifications; Class B. 34.9 Class A or Class B certificates; helpless aliens.

34.10 Certificates and notifications; Class C.

34.11 Deferral of examinations; adequacy of facilities.

34.12 Applicability of Foreign Quarantine Regulations.

34.13

Medical and other care; death. 34.14 Reexamination; convening of boards; expert witnesses; reports.

AUTHORITY: Sec. 215, 58 Stat. 690, as amended, sec. 234, 66 Stat. 198; 42 U.S.C. 216, 8 U.S.C. 1224; sec. 322, 325, 58 Stat. 696, as amended 697, as amended, secs. 212, 326, 66 Stat. 182, as amended 200; 42 U.S.C. 249, 252, 8 U.S.C. 1182, 1226.

SOURCE: 21 FR 9829, Dec. 12, 1956, unless otherwise noted.

§ 34.1 Applicability.

The provisions of this part shall apply to:

(a) The medical examination of (1) aliens applying for a visa at a consulate of the United States, (2) aliens arriving in the United States, and (3) aliens presented or referred by the Immigration Service in connection with

determination of their admissibility into the United States, and

(b) The medical and other care, and burial, of aliens admitted to Public Health Service stations and hospitals at the request of the Immigration Service.

§ 34.2 Definitions.

As used in this part, terms shall have the following meanings:

(a) Immigration Service. The Immigration and Naturalization Service of the Department of Justice.

(b) Dangerous contagious disease. Any of the following diseases:

(1) Chancroid.

(2) Gonorrhea.

(3) Granuloma inguinale.

(4) Leprosy, infectious.

(5) Lymphogranuloma venereum.
(6) Syphilis, infectious stage.
(7) Tuberculosis, active.

(c) Medical certificate. A document issued to the Immigration Service by a medical examiner, reporting the presence of any physical or mental defect, disease, or disability, or the previous occurrence of one or more attacks of insanity, in an alien.

(d) Medical notification. A document issued to a consular authority by a medical examiner, reporting the presence of any physical or mental defect, disease, or disability or the previous occurrence of one or more attacks of insanity, in an alien. Medical notification shall be made on the form prescribed for reporting the results of the medical examination of applicants for visas.

(e) Medical officer. A physician of the Public Health Service assigned or detailed by the Surgeon General of the Public Health Service to make mental and physical examinations of aliens.

(f) Medical officer in charge. A medical officer charged by the Surgeon General with responsibility for the conduct and supervision of all medical examinations made at a designated place or in a designated area.

[21 FR 9829, Dec. 12, 1956, as amended at 26 FR 9856, Oct. 20, 1961; 35 FR 15289, Oct. 1, 1970]

§ 34.3 Examinations; female aliens.

Female aliens shall be examined only in the presence of a female nurse or other female, or by a female physician.

§ 34.4 Scope of examinations.

(a) General. In performing examinations and reexaminations, medical examiners shall give consideration to only those matters that relate to the physical or mental condition of the alien and shall issue certificates or notifications of a defect, disease, or disability or previous occurrence of one or more attacks of insanity as hereinafter provided only if the presence of such defect, disease, or disability or previous occurrence of one or more attacks of insanity has been clearly established.

(1) Persons subject to requirement for chest X-ray examination and serologic test. Except as provided in paragraph (a)(2) of this section, a chest Xray examination for tuberculosis and a serologic test for syphilis shall be required as part of the examination of:

(i) All applicants for immigrant visas;

(ii) All students and exchange visitors who are required by a consular authority to have a medical examination upon application for a nonimmigrant visa;

(iii) All other applicants for a nonimmigrant visa who are required by a consular authority to have a medical examination if such X-ray examination and serologic test are considered necessary by the medical examiner; and

(iv) All aliens outside the United States who apply for conditional entry and all aliens in the United States who apply for adjustment of status, under the immigration laws and regulations.

(2) Exceptions. Neither a chest Xray examination nor a serologic test for syphilis shall be required if the alien is under the age of 15: Provided, That a tuberculin test may be required where there is evidence of contact with a known case of tuberculosis or other reason to suspect infection with tuberculosis and a chest X-ray examination required in the event of a positive reaction, and a serologic test