The form is a legal declaration. If a diver is found to have been untruthful and an accident occurs then that diver will be uninsured and may be held liable for the consequences.
The diver needs to review the form annually to be sure there are no new conditions. If there are no changes they can just photocopy Page 3, which the Referee has signed indicating that signature is valid for longer. The diver does not have to get a new Referee signature each year if the form indicates the Referee’s signature is valid for longer.
As above, simply include details of your previous assessment when completing the form. The Referee’s signature may be valid for a certain time period or even indefinately (unless there is a change in health). Provided you have been given the all clear then there will not be a problem.
Telephone or email your local Medical Referee. Check the UK Diving Medical Committee’s website (ukdmc.org) or your Diving Organisation for the most up-to-date list of Referees. The telephone/email enquiry to a Medical Referee may result in:
- From the information you give, the referee may say that you can complete the self declaration form yourself indicating the answers are “No” as the issue is so trivial it need not even be declared (such as athlete’s foot or temporary upper respiratory tract infection).
- From the information you give the Referee you will also need to download and complete the Medical Referee Form which can be found on this website and the BSAC website sending all pages of the form to the Referee (keeping copies for your own records of Pages 1 and 2) with the required fee and a stamped addressed envelope for return of Page 3 of the endorsed form to you.
- The Referee may need to contact your own doctor or specialist for further information and on obtaining this may endorse your self-declaration form as above, although the fee is likely to be greater.
- The Referee will require you to visit for a medical examination before a certificate of fitness to dive can be issued.
This is any self-limiting condition requiring no or minimal medical input such as the common cold (for which a visit to a doctor should not be necessary anyway), athlete’s foot, or such as a simple boil or other minor skin condition. If unsure telephone or email a Referee for advice.
This would also not need to be declared unless a medical issue had been detected.
If you are answering “no” to all the questions then you are not revealing any medical problem. However, if you are answering “Yes”, you will also need to download and complete the Medical Referee Form which can be found on this website and the BSAC website sending all pages of the form to the Referee (keeping copies for your own records of Pages 1 and 2) with the required fee and a stamped addressed envelope for return of Page 3 of the endorsed form to you. If you answer “yes” the Referee will sign the endorsement on Page 3 of the Medical Referee form (and will keep pages 1 and 2 for his/her own records) and again it is only Page 3 of the form that you need to give to your Diving Officer. There is no medical information on this section. If an examination is required the Referee will supply a Fitness to Dive Certificate and it is only the right hand side of the A4 examination form that needs to shown to your Diving Officer – again this section does not reveal any medical information.
The Medical Referees have diving medicine expertise and incur significant expense maintaining their knowledge, performing medicals or arranging investigations. There are significant costs to be able to undertake this work including premises, staff, equipment, course fees and medical defence insurance. The NHS does not cover this work.
The change to a self-declaration system has saved divers money, as the previous system required everyone to have a full medical even if they did not have any medical issues.
We do not stipulate charges as they will vary considerably depending on the amount and complexity of work required. Divers should expect to pay even for email or phone advice as this still takes time and usually has medicolegal and clinical governance implications. Charges are usually made based on the doctor’s hourly rate for private work. This amount may vary between individuals and it is suggested that charges are clarified at the outset.
There is no longer a cut-off, unless there are other risk factors that also need to be taken into account, which would be assessed on an individual basis. If you are able to complete the pool training then this is used as an indication of your fitness to dive. A high BMI does not necessarily reflect a poor level of fitness, just as a low BMI does not guarantee good fitness.
The Self-Declaration process in conjunction with the Referee referral system has been approved by the diving organisation insurance companies. In terms of your own private diving insurance, if you have this, it would be wise to contact your insurer to check whether they will accept a self-declaration form or whether they require you to have a medical.
You can continue to have medicals if you choose to do so in addition to the Self Declaration system – but you should not be falsely reassured by their screening value for diving fitness. Only doctors qualified in diving medicine can advise you about your fitness to dive.
Check the medical standards on the website (www.ukdmc.org), or contact your local Medical Referee.
You are free to pass on any information you wish to your own doctor. If something of significance is found that the Referee feels your doctor should know about the Referee will ask for your written permission to pass this on to your doctor. You are free to withhold this permission but the Referee will explain the possible risk to your own health by doing this so that you are able to make an informed decision.
The UK Diving Medical Committee is the final court of appeal for divers, and Referees are able to refer to the committee for advice. If you wish to appeal a decision made by a Medical Referee, contact the secretary of the UK Diving Medical Committee via the ‘Contact Us’ page of this website (please put ‘Appeal’ in the Subject Heading) or via the BSAC website.
The diving medical referee can only do this with your consent. If it is thought to be necessary, they will discuss this with you. The referee may either email or telephone another diving medical expert or post the query on the diving medicine forum. This is a closed, confidential forum which can only be accessed by approved diving doctors and your information is posted anonymously with only the minimum information required to answer the query. Although you are not referred to by name, in a small number of cases, the unique nature of the medical condition being discussed may make it possible for you to be identified.
The DO should contact their respective organisation for a further response by their UK Diving Medical Committee representative.
The UKDMC continually monitors the safety of diving in the UK and it is because of the ongoing research programme that this change was originally made. Other organisations use questionnaires but the UKDMC system is based on published evidence and has been continually monitored since 2001.
This was published in the British Journal of Sports Medicine 2000; 34: 375-378, “Medical supervision of sport diving in Scotland: reassessing the need for routine medical examinations” Glen S, White S and Douglas J. Reprints are available from the British Journal of Sports Medicine, BMJ Publishing Group, BMA House, Tavistock Square, London, WC1H 9JR, UK. See the article abstract.
Employment medicals are a different situation entirely because of the concern of employer liability. Although some employers insist on screening medicals there may be little supporting evidence for this for most types of employment. Some types of employment require statutory medicals.
These should be declared by the diver. We have had instances of hypertensive divers developing acute pulmonary oedema (fluid on the lungs) from left ventricular failure when diving in cold water. This was mostly in the days of the neoprene wet suit. Now that dry suits are more common, this is less often a problem. The current medical system does not prevent the occasional diver developing pulmonary oedema. However, if the diver has treated hypertension they should contact a Referee in any case.
Mental problems significant in a diving context would normally be detected during training.
Substance abuse is a fact of life these days and a medical examination would not normally detect it. Do not forget that by far the commonest drug to be abused is alcohol, and the night in the pub before diving is often a silent contributing factor to diving accidents the following day.