PEMEs/REMEs: What Are They and How Can They Assist Shipowners?

What is a PEME/REME? 

A pre-employment physical, commonly known as a pre-employment medical examination (PEME), is a health assessment conducted before employment, primarily for roles with health and safety implications – such as maritime work. It ensures that individuals are fit for duty and helps employers mitigate risks of illness or injury at work. A basic PEME will typically list a number of health conditions and ask the employee to self-report whether or not they have experienced any of those conditions in the past and will require the employee to undergo a basic medical examination with a qualified physician. A more advanced or enhanced PEME may require a potential employee to also undergo some minimally invasive medical testing – such as a basic metabolic bloodwork panel, which tests for glucose levels, kidney and liver function, and other conditions, and/or basic cardiac testing. While the additional testing comes at an additional cost for a shipowner/employer, the testing can help shipowners/employers avoid the expense of costly medical care for the treatment of pre-existing conditions that may later become symptomatic while an employee is working on board a vessel. As shipboard employees often spend months shoreside in between periods of shipboard employment, shipowners/employers can also require shipboard employees to submit to additional health assessments either before the start of each contract and/or at regular intervals (e.g. every 1 to 3 years). These additional health screenings are commonly known as re-employment medical examinations (REME).  

How can a PEME/REME requirement assist shipowners? 

The maritime environment – and, specifically, the unique tasks that shipboard employees are required to undertake as part of their employment on board a maritime vessel – can be both physically and mentally demanding. As such, the primary purpose of a PEME/REME is to ensure that a prospective shipboard employee can meet the physical requirements of their shipboard employment prior to signing on the vessel.   

Instituting a robust PEME/REME program can benefit shipowners/employers in a number of other ways. Not only does a PEME/REME provide shipowners/employers with confidence that an employee can handle the challenging environment of working at sea, a PEME/REME can also help identify underlying medical conditions, physical limitations, or health risks that an employee may not report (or may not even be aware of) that could impact their ability to perform their duties effectively on the ship.  

Additionally, implementing a PEME/REME requirement can also reduce the risk, frequency, and cost of medical emergencies occurring while a vessel is at sea, which can be expensive. If a crew member is injured or becomes ill while the vessel is days away from the nearest port, not only could a shipowner/employer incur expenses for a medical evacuation and emergent hospitalization and/or medical treatment for the crew member, but the shipowner/employer could also sustain commercial consequences – for example, if the ship is required to deviate from its itinerary in order to provide the necessary medical assistance to the crew member. Undetected, and undisclosed, medical conditions can also pose serious safety risks to other crew members on board and/or the vessel itself, should a crew member suddenly become ill while in charge of the ship or its machinery. An enhanced PEME/REME can identify pre-existing and/or dormant health conditions and allow the shipowner to make hiring decisions accordingly.   

Maintaining a PEME/REME program can also protect shipowners/employers from expensive claims arising from medical conditions that crew members had prior to their employment. Even vessels that are not flagged in the United States, and which are staffed by foreign crew members, can still be subject to litigation in the United States. Under US maritime law, the intentional non-disclosure or concealment of known pre-existing medical conditions during the PEME/REME process can be a defense to certain types of claims that arise when a crew member is injured or becomes ill while working on board a maritime vessel – specifically, where the undisclosed facts would have materially affected the employer’s decision to hire the crew member and there is a connection between the undisclosed condition and the crew member’s injury and/or illness at issue in the litigation. This is known as a ‘McCorpen Defense.’ The ability of shipowners/employers to raise a McCorpen Defense often turns on whether the company required a PEME/REME and, if so, the types of questions that were asked, the extent of the examination and/or testing that the crew member was required to undergo before being hired/rehired, and what the company does with the information it obtains during the PEME/REME process (e.g. if it would have chosen not to hire the employee had the pre-existing condition been disclosed in the PEME/REME process).    

As noted above, a basic PEME/REME typically only asks the crew member to self-report certain categories of pre-existing conditions and then undergo a basic medical examination with a physician. However, additional testing, such as laboratory blood testing and/or cardiac testing, can provide additional safeguards for shipowners/employers. These additional tests can screen for pre-existing conditions including, but not limited to, hypertension, diabetes, abnormal liver or kidney function, kidney stones, STIs, hepatitis, cardiac issues, and other conditions that could become costly for a shipowner/employer to treat later down the road should a crew member begin to experience related symptoms while working on board a vessel. The upfront cost of the additional testing (e.g. often only a few hundred dollars per crew member) is typically far outweighed by the savings a shipowner will experience by avoiding paying for costly treatment of these conditions later.  

The Club has also recently seen an uptake in mental health complaints made by shipboard employees across all types of maritime vessels. Accordingly, in addition to recommending our Members implement a robust PEME/REME program to screen for pre-existing physical conditions which might impact an employee’s ability to work shipboard, we also recommend that our members consider including a mental health screening as part of their PEME/REME programs. Mental health assessments can help to evaluate not only the crew member’s current psychiatric state and cognitive function at the time of the screening, but also can help screen for signs of pre-disposition to anxiety, depression, psychosis, and alcohol or substance abuse. Understanding a potential crew member’s mental health history can help shipowners/employers make decisions about the individual’s ability to work in a high-pressure and often isolating maritime environment.   

Additional Resources:  

It is crucial that shipowners/employees utilize standardized physical and mental health screenings and that the screenings are completed by qualified medical providers. The Club has an exemplary PEME/REME evaluation service available to its members. The medical examination is delivered by an extensive network of trusted medical providers throughout the world with maritime experience in PEME/REME provision. If you would like more information about the Club’s PEME program, please visit our website: https://www.ukpandi.com/manage-risks/crew-wellbeing/physical-wellbeing/