For the first time in seven years, physicians have reliable guidance they can use to help determine if commercial truck drivers are physically fit to operate their vehicles.
The Federal Motor Carrier Safety Administration on Tuesday published a draft of its new Medical Examiner’s Handbook (MEH). The handbook provides information on driver health requirements and guidelines used by medical examiners (MEs) listed on FMCSA’s National Registry of Certified Medical Examiners to interpret regulations on physical qualifications for commercial drivers.
An ME is licensed, certified, and/or registered in accordance with state laws and regulations to perform physical examinations and must also be knowledgeable of the physical and mental demands associated with operating a truck.
“Other health care professionals, such as treating providers and specialists, may provide additional medical information or consultation, but the ME ultimately decides whether the driver meets the physical qualification standards of FMCSA,” according to the agency.
FMCSA also emphasized that, unlike regulations, the recommendations and guidance in the handbook “do not have the force and effect of law and are not meant to bind MEs, drivers or the public in any way. Rather, such guidance itself is only advisory and not mandatory.”
FMCSA first posted the MEH on its website in 2008 but had to withdraw it in 2015 because some of the information was “obsolete or was prescriptive in nature,” according to FMCSA, and therefore MEs and training organizations were told not to consider the MEH as guidance to interpret federal regulations.
Potential for sleep apnea rulemaking
While federal regulations do not include specific requirements related to testing drivers for obstructive sleep apnea (OSA), “the big question is whether FMCSA will use [the MEH] as a potential launchpad for a formal rulemaking on OSA,” P. Sean Garney, co-director of Scopelitis Transportation Consulting, told FreightWaves.
To address the issue, FMCSA would have to go through a formal rulemaking process, Garney noted. In 2016, FMCSA and the Federal Railroad Administration (FRA) issued an advanced notice of proposed rulemaking on OSA, but the Trump administration withdrew the proposal in 2017. “The agencies believe that current safety programs and FRA’s rulemaking addressing fatigue risk management are the appropriate avenues to address OSA,” the agencies stated at the time.
Over the last decade, however, “there is a lot more data available on [OSA], and the industry’s take on the issue has evolved as well. The time could be right,” Garney said.
FMCSA addresses OSA in the handbook by providing a link to recommendations made in 2016 by the Medical Review Board, an advisory committee to the agency. It includes suggestions on risk factors, screening, testing and medical certification of drivers with OSA.
Comments on the draft handbook must be received on or before Sept. 30.
Lawrence Newton
This is nothing the Medical exam on hearing is a joke, I recently had the DOT physical everything was fine till I got to the hearing test. This nurse told me to face the wall and then she spoke on a real low voice told me to repeat what she says which was numbers letters. So then the examiner came in and told me that I needed hearing aids and I asked her I go why did I face the wall she replied that’s the way we do it. Well that’s not the way you’re supposed to administer the test according to the guidelines you’re supposed to face the gentleman or driver this point. I replied you’re supposed to face the ear that you’re examining that’s actually in the regulations. So I went to Costco got a hearing test came back and showed her The results. 32 dB in one ear 42 dB in the other ear according to the guidelines this passes one ear is to be greater than 40 dB. It’s about 65 decibels inside a truck without the stereo playing. This Whisper test should be discontinued a driver should have to go to a relative audio center and get the individual ears checked for decibel readings and there should be like Costco Walmart these exams are free and the medical examining company should have to except them that’s what happened to me she wouldn’t except anything because she thinks she print it or something. I have a cute hearing I cannot hear women speak a woman’s voice is a very low decibel by itself then when they make your face a wall in the way that your ears are not really made to hear this whisper test is stupid whoever came up with that didn’t set the guidelines on the test because it’s given wrong every single day
Benito Mercier
Fmcsa I am a truck driver I quit driving OTR and trailer completely because of dispatcher the way they pushing you to pick up a load and drop off a load each time I read an article of the fmcsa never see anything regarding dispatcher I am wonder why
Tommy
Because the dispatcher works for the Cartier and have to comply with these regulations.
There is actually a whistle blower process in place for what you are talking about.
Richard Wesley Luebbert
If your CPAP machine breaks, the patient cannot just go out and buy a new one. The patient must go through another sleep study so he/she can get a prescription to buy a CPAP machine.
I just went through this. I had to purchase an in home sleep study apparatus, wait for it to come in, come home off the road and use it. Set up an over the phone doctor’s appointment which was about 10 days after the sleep study and purchase the new CPAP machine, and didn’t get the new one until I returned home. It took about a month from when one machine broke to getting my new one.
The doctor told me, I had to use the machine 70% of the nights for four or more hours. I lost many nights because of that.
Time could have been shortened if I could have just bought the machine. It’s not like buying drugs where I might hurt myself or others. I wasn’t using insurance money either, so I couldn’t scam the insurance company.
Lawrence Newton
It has nothing to do with the device it’s about the doctors and the people that make the devices make money
Anthony P
My mask recently broke. I found out that you cannot just buy another mask, you have to have a prescription first. I bought my CPAP out of pocket, as I was in career transition to Truck Driving and didn’t have any insurance at the moment. I will see what will happen here in the next couple of days when I go back to the Dr.
Nate
There is no such thing as sleep apnea, if anything it has been used by carriers aa a tool like “Concentra clinic” to medically discriminate against minorities in hiring against title 5 of the Civil Rights Acts of 1964. control, punish, medically experiment, and harass coworkers near retirement. There are no statistics regarding deadly crashes involving sleep apnea directly. Most cashes are from sleep deprivation because of having irregular sleep patterns and working long hours. Truck driving is a very stressful job with little opportunity for exercise, they keep pushing sleep apnea as a requirement there will be no more drivers left. I encourage drivers to apply for disability or social security benefits if they should end your career over something unfounded as sleep apnea. Do not allow anyone to turn you into a patient and disturb your healthy sleep, because they want to medically experiment on you and try new medical machines. There into making patients and selling medical products not helping you to be safe on the road. As the driver shortage continues, were going to see more carriers go out of business, no more mistreating the hand full of drivers lett, we are not a dime a dozen anymore for carriers to abuse and medically experiment on.
Andre
Thank you!
Tommy
Lol, ok Skippy.
Rodney Kern
Not just black people they do this to white people to
Richard
Anything that the Government touches turns to crap most people in Government have never been in business and don’t have any idea how to run one if they had to work for a business they would be fired.
CDL Ken
The real problem with drivers having accidents due to fatigue is not sleep apnea but something everyone seems to overlook. the drivers are over worked. for every day most people work ( 8 hrs ) a driver is working a day and a half ( 12hrs) to two days ( 16 hrs. ) without the overtime pay
Nick
Not to mention most people after working 8 hours get the next 16 hours off. Truckers are only given just enough hours to grab a shower and something to eat and sleep then get right up and start the next long work cycle. And to make matters worse, we don’t even have a normal sleep schedule since the odd number of work and sleep hours means that our start and stops are constantly changing. We’re expected to work and recharge like we’re robots. Under these conditions, I don’t think the problem is sleep apnea but insomnia brought on by the disruption to the normal chemical processes that happen in our brains when we’re allowed to actually live like human beings.
Mark Domer
This is nothing but a money maker ,why don’t you just take all the money from truck driver. Tax him more we knew that’s what its all about. A government out of control,that can’t live on a budget. Your over spending is out of control.
Term limits is what we need.
David Seward RPSGT
So I drove OTR for 20 years, now I am a sleep technologist. Your article failed to mention exactly what the guidance is.
Where are these guidelines?
I get drivers in my lab all too frequently that are denied a medical card by some “Doc-in-a-box” that says because they are obese or have a thick neck the driver has to get a sleep study.
Is this how things are going to go?
And who’s going to be paying for the sleep study?
Please do better journalism than this