ALCOAST 061/26 - FEB 2026 UPDATE TO MEDICAL PHYSICAL STANDARDS FOR COLOR VISION DEFICIENCY (CVD) AND ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)

R 171630Z FEB 26 MID120041028055U
FM COMDT COGARD WASHINGTON DC
TO ALCOAST
BT
UNCLAS
ALCOAST 061/26
SSIC 6000
SUBJ: UPDATE TO MEDICAL PHYSICAL STANDARDS FOR COLOR VISION
DEFICIENCY (CVD) AND ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)
A. Medical Standards for Military Service: Appointment, Enlistment,
or Induction, DoDI 6130.03 VOL 1
B. Medical Standards for Military Service: Retention,
DoDI 6130.03 VOL 2
C. COMDT COGARD WASHINGTON DC 211415Z MAY 25/ALCOAST 232/25
D. Medical Accession Records Pilot (MARP) Standards List - Update
E. Coast Guard Medical Manual, COMDTINST 6000.1F
1. This ALCOAST promulgates policy for accession and retention
standards for Color Vision Deficiency (CVD) and Attention-Deficit/
Hyperactivity Disorder (ADHD). This policy reflects the CG's
commitment to accessing and retaining the maximum number of
personnel able to perform their duties while maintaining safety and
operational readiness standards.
2. This policy maintains alignment with the physical standards of
other services as found in REFs (A) and (B), and it expounds on
policy set forth in REF (C).
3. When processing or adjudicating accession and retention waivers,
the Coast Guard will use the standards specified in REFs (A), (B),
and (D) according to the process described in REF (E).
4. CVD Accession Standards.
     a. The following are the only acceptable tests for color vision
screening.
       (1) Ishihara Pseudoisochromatic Plates (PIP) test, passing is
correctly identifying at least 10 out of 14 plates.
       (2) Rabin Cone Contrast Test (RCCT), passing is a score
greater than or equal to 55 in all three colors (Red, Green, Blue).
     b. All commissioning accessions will pass either test above.
Adoption of different color vision standards for different officer
specialties is still under review.
     c. Enlisted applicants for ratings that require color vision will
pass either test above.
     d. Accession authorities may, according to their needs and
processes, consider waivers on a case-by-case basis and shall
coordinate decision with the Personnel Service Center (PSC).
     e. The CG will establish accession standards allowing up to 3% of
personnel entering programs leading to a commission to have less
than normal color vision. Details for this will be in the
forthcoming Physical Exams and Standards Commandant Instruction,
which shall be released no later than 31 December 2026.
5. CVD Retention Standards.
     a. For commissioned officers and members in a rating or specialty
that requires normal color vision, retention waivers for new or
developing CVD will be considered on a case-by-case basis.
6. ADHD Accession Standards
     a. The active use of DEA Class 2 stimulant medication is not
acceptable for accession.
     b. Accession standards for ADHD remain consistent with REFs (B)
and (E).
7. ADHD Retention Standards.
     a. Members with a new or existing diagnosis of ADHD who require a
(DEA Class 2) stimulant medication will require a retention waiver.
Members who are already on these medications will have 18 months to
meet these waiver requirements. The waiver package must include the
following:
       (1) Formal neuropsychological testing to confirm the diagnosis
of ADHD.
       (2) Failure of at least two non-stimulant medication trials.
       (3) A positive command endorsement addressing performance and
reliability.
       (4) A plan for annual follow-up with a military medical
provider.
       (5) A plan for managing and supplying the medication during
deployed or underway periods, with any duty limitations clearly
identified.
8. COMDT (CG-CMO) is working closely with the Directives System
Program office to incorporate these changes into a new Commandant
Instruction for medical standards.
9. This ALCOAST will be cancelled on 17 FEB 2027.
10. POC: CDR Joel Fulkerson, Aviation Medicine Standardization
Officer, Joel.Fulkerson@uscg.mil, (251) 441-5757.
11. RADM Paul Jung, USCG Chief Medical Officer (CG-CMO), sends.
12. Internet release is authorized.