That Diver's Medical Form

One of our readers, Lisa Piatt from La Quinta, California, recently wrote to us, concerned about the medical forms required before a diver can dive. She wrote,

"I have heard some dive resorts around the world, some of them in more remote areas, are now utilizing a new diver-waiver form, which states if you are over 45 years old and are taking any prescription medications, birth control pills and allergy meds being excluded, you must present a doctor's note stating you are fit to dive before you are allowed to dive."

It's an important question, and we'll see if we can shed some light on it. It's not a waiver form but a decadesold medical form revised in 2020 by the Recreational Diving Screening Committee in collaboration with the Undersea & Hyperbaric Medical Society, DAN, and others. Divers are increasingly required to complete it before they step aboard their dive boat.

Older Divers

Over the years, we have reported on aging divers and their fitness to dive. In September and November 2023, we published articles regarding age limitations set by DAN and its insurance company, which concerned divers 80 and older. Their company was not accepting insurance purchases or renewals from DAN's octogenarian members. When we discussed this with various DAN leaders, we found their staff a bit confused, but they said their computer software was not working correctly. Shortly afterward, they eliminated any age restriction, updated their system so it would reject 80-year-old divers, and agreed themselves to underwrite the 80-year-old divers that their insurance company refused.

So, from DAN's perspective, one can dive at any age, the caveat being that if you harbor medical conditions that make you unfit to dive, they won't insure you.

Individual operators have always been able to establish rules they wish for their own customers -- we reported that Living the Dream in Grand Cayman wouldn't take divers 75 or older. John Miller, Director of Training at Texas Dive Center, wrote, "I have heard instances where an individual dive operator(s) is not permitting certified divers over a specific age to dive -- even with the MD sign-off." But that would be quite rare because no dive operator wants to turn away customers.

The Medical Form

Since the 1980s, the RSTC medical form has been available to dive operators. It was developed to determine whether potential trainees were sufficiently fit to get certified. However, some operators required anyone diving with them to complete it, and after reviewing the results, some would require a diver to get clearance from their physician. Before the internet, it was tough when only a fax machine was available. Occasionally, dive operators sent their customers to a local doctor for approval (some divers accused the shops of getting a kickback from the physician). In the last several years, more operators have required their divers to complete a medical form before diving.

In 2020, the form was revised. In addition to the first part to be completed by the diver, a second part, a Diver Medical Physician's Evaluation Form, is to be completed by the diver's physician if, based on the diver's answers, the operator requests. All certification agencies require trainees to fill out the form, but only some operators require certified divers to fill it out before taking them diving.

The form initially offers 10 questions, one of which is "Are you older than 45?" If you answer "yes" to that and none of the others, the operator could ask for a physician's release, which would be an easy way to go out of business.

However, if one says "yes" to any of three others (or additional follow-up questions), they may require (at the behest of their insurance carrier) a physician's signature. One of those questions: are you "taking prescription medications (with the exception of birth control or anti-malarial drugs other than mefloquine (Lariam)." And, for most aging divers, the honest answer is yes.

We contacted several liveaboards and resorts, and some indeed require a physician's approval. Kevin Purdy of All Star Liveaboards told us, "The RSTC medical form is the standard used throughout the industry.If someone answers a particular way, then the medical form does require a doctor's signature. In the past, it was only required if someone was to participate in dive instruction."

Papua Paradise Eco-Resort told us, "The nearest hospital is 40 miles, and there is no public transportation from or to our resort. As safety is our priority concern, we always ask our guests to fill out the Diver Medical Form and return it to us before their arrival. The form is to be reviewed to assure that you are fit to dive."

Alex Bryant of Emperor Divers, with dive operations in Egypt, Indonesia, and the Maldives, wrote, "Of course, it's a good practice to ask clients questions about their fitness to dive and to set standards which, if not met, you believe a medical should be done. CDWS [the Egyptian governing body] asks that we use the PADI medical form for all clients, including recreational divers, and has done so for about two years now. This is only applicable to Egypt."

Dive operators in territories governed by Spanish or French law require a medical certificate for all divers confirming their fitness to dive.

Mark Caney, who works for PADI Worldwide in the UK, told us, "More operators seem to require divers to complete medical forms and have refused some divers based on their answers. It seems that more operators are becoming wary of older divers not being truthful on self-declaration forms and may require a medical sign-off."

The Insurance Perspective

Peter Meyer, a well-respected diving insurance specialist in Vancouver, BC, insures Caribbean resort diving, liveaboards in the U.S., Costa Rica, and other global areas ("We do not insure any Red Sea fleets," he emphasizes).

He told us, "We (and other insurers) are tightening up requirements for medical disclosures . . . We see two scenarios: 1) older divers, asked to complete medical history forms, are answering "No" to questions that would require sign-off from a doctor, even though they know they have issues, which we eventually discover after an autopsy. 2) Divers actually not knowing they have issues and honestly saying "No" to questions because they believe they are healthy.

Both scenarios jeopardize the operator, intentionally or innocently, because the operator will need to deal with the eventual results.

"Historically, older folks passing would not lead to litigation, but that has also changed. We have paid out literally millions (US$6 million for two cases in Hawaii in the last two years) for fatalities involving 60-somethings, where their spouses or families take exception. We are also seeing a decline in the professionalism of diving supervisors on many boats.

"The simple reality is that diving puts strain on aging divers, and we are seeing the results. I believe mandatory medicals for aging divers is the only solution to protect operators.

"Interestingly, I was recently disqualified from participating in a trail horseback ride simply because I was 70. No exception, due to liability issues. Interesting, because I would have considered the trail ride far less stressful than a diving trip. Is the dive industry simply more cavalier than other industries? Me thinks so!"

What to Do

Before you travel to any destination to dive, it would be wise to find out whether you will be required to fill out a medical form. It should be stated on the operator's website, or your travel agent should know or find out. In those cases, it can be handled ahead of time.

If you can find out -- or perhaps even if the operator says no -- you might cover yourself by getting your physician's approval before departing. You can find the form here.

Finally, keep in mind that should you have an accident and have failed to answer the questions honestly, your dive operator's insurance will most likely reject your -- or your heirs -- claim.

-- John Bantin & Ben Davison