AMERICAN SEAMEN

§ 32.11 Scope of benefits.

(a) 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 or, in accordance with these regulations, at Service contract medical facilities at the expense of the Service.

(b) Where medical facilities of the Service are not available, medical care and services may be obtained from contract medical providers designated by the Service. Expenses for medical care and services obtained from nonService providers or in non-Service facilities not arranged for by the Service in behalf of seamen is not an obligation of the Service and will not be paid.

§ 32.12 Provision of services.

(a) When a seaman requires medical, surgical and dental treatment or hospitalization which the Service is unable to provide in the local Service operated facility, or in the case of an emergency, arrangements for such medical, surgical, and dental treatment or hospitalization at the expense of the Service shall be made by an authorizing official.

(b) If eligibility cannot be established at the time of application by the seaman 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.

§ 32.13 Application for treatment.

(a) in nonemergency cases, a sick or disabled seaman, in order to obtain the benefits of the Service, must apply in person, or by proxy if too sick to do so, to an authorizing official as specified in § 32.12, and must furnish satis

factory evidence of his eligibility for such benefits.

(b) In emergency cases, a sick or disabled seaman shall, upon admission for such condition or as soon thereafter as is practicable under the circumstances, either personally or by proxy, notify the nearest authorizing official of the fact of such admission and treatment and shall furnish appropriate identification and satisfactory evidence of eligibility for such benefits.

§ 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

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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 exclude 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.

§ 32.23 Certificate of discharge from treatment.

A certificate of discharge from treatment may, at the discretion of the officer in charge, be given to a hospital patient, but such certificate, when presented at another medical care facility shall not be taken as establishing the seaman's eligibility for further care and treatment, but may be considered in connection with other documentary evidence of eligibility submitted by the seaman.

SEAMEN; STATE SCHOOL SHIPS AND VESSELS OF THE UNITED STATES GOVERN

MENT

$32.46 Conditions and extent of treatment.

Seamen, not enlisted or commissioned in the military or naval establishments, who are employed on State school ships, on vessels of the United States Government of more than five tons burden, or on vessels of the Mississippi River Commission or of the Fish and Wildlife Service, 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.

OWNER-OPERATORS OF COMMERCIAL FISHING VESSELS

§ 32.57 Conditions and extent of treatment.

Persons who own vessels registered, enrolled, or licensed under the maritime laws of the United States, who are engaged in commercial fishing operations, and who accompany such vessels on such fishing operations, and a substantial part of whose services in 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.

§ 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; 10 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 seam: n 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

§ 33.1 Definitions.

When used in this part:

(a) "Act" means the Public Health Service Act, approved July 1, 1944, 58 Stat. 682.

(b) "Habit-forming narcotic drug" or "narcotic" has the meaning prescribed in section 2(j) of the Act, i.e., "opium and coca leaves and the several alkaloids derived therefrom, the best known of these alkaloids being morphia, heroin, and codeine, obtained from opium, and cocaine derived from the coca plant; all compounds, salts, preparations, or other derivatives obtained either from the raw material or from the various alkaloids; Indian hemp and its various derivatives, compounds, and preparations, and peyote in its various forms; isonipecaine and its derivatives, compounds, salts, and preparations; opiates (as defined in sec. 3228(f) in the Internal Revenue Code)."

(c) "Addict" has the meaning prescribed in section 2(k) of the Act, i.e., "any person who habitually uses any habit-forming narcotic drugs so as to endanger the public morals, health, safety, or welfare, or who is or has been so far addicted to the use of such habit-forming narcotic drugs as to have lost the power of self-control with reference to his addiction."

(d) "Hospital" means the United States Public Health Service Hospital at Lexington, Kentucky, or the United States Public Health Service Hospital at Fort Worth, Texas, and such other hospitals operated by the United States Public Health Service as may be hereafter designated by the Surgeon General as being especially equipped for the accommodation of addicts.

(e) "Prisoner" means an addict who has been sentenced to confinement upon conviction of an offense against the United States, including convictions by general courts-martial or by consular courts.

(f) "Probationer" means an addict who has been placed on probation by any court of the United States which has imposed as one of the conditions of such probation that he submit himself for treatment until discharged as cured.

(g) "Voluntary patient" means an addict who signs an application requesting, agreeing, and consenting to submit to treatment and who receives care and treatment at a hospital.

(h) "Ex-prisoner" means a prisoner whose sentence has expired and who, prior to the expiration thereof, applies for and receives further care and treatment.

(i) "Patient" means a "prisoner," "ex-prisoner," "probationer," or "voluntary patient" who is an inmate of a hospital.

(j) "Good conduct allowance" refers to commutation of sentence for good conduct provided by the act of June 21, 1902, as amended (18 U.S.C. 710), made applicable by section 343 of the Public Health Service Act to addicts confined in any institution in execution of a judgment or sentence imposed upon conviction of an offense against the United States.