DOT GUIDE QUESTIONS AND ANSWERS SOLVED

DOT GUIDE QUESTIONS AND ANSWERS SOLVED Motor Carrier Safety Improvement Act of 1999 Established Federal Motor Carrier Safety Administration (FMCSA) within Department of Transportation (DOT) "The Federal Motor Carrier Safety Administration (FMCSA) is focused on reducing crashes, injuries, and fatalities involving large trucks and buses." FMCSA (Federal Motor Carrier Safety Administration) Develops and enforces data‐driven regulations that balance motor carrier (truck and bus companies) safety with industry efficiency. • Harnesses safety information systems to focus on higher‐risk carriers in enforcing safety regulations. • Targets educational messages to carriers, commercial drivers, and the public. • Partners with stakeholders including Federal, State, and local enforcement agencies, the motor carrier industry, safety groups, and organized labor on efforts to reduce bus and truck‐related crashes. The mission of the Office of Medical Programs is to promote the safety of America's roadways through the promulgation and implementation of medical regulations, guidelines and policies that ensure commercial motor vehicle drivers engaged in interstate commerce are physically qualified to do so. Office of Medical Programs • Oversees the national medical certification process for commercial motor vehicle drivers who operate in interstate commerce. • Develops and implements medical regulations, policies, and procedures. • Oversees and supports the Medical Review Board in accordance with the Federal Advisory Committee Act. • Develops and implements the national registry program — a national medical examiner system and a linked national driver medical reporting system. • Conducts and oversees the Agency's medical exemption and certificate programs. • Serves as the lead Federal agency for the regulation of commercial motor vehicle driver health and safety and conducts relevant medical research. National Registry of Certified Medical Examiners (NRCME) The primary mission of the National Registry of Certified Medical Examiners is to improve highway safety by producing trained, certified medical examiners (CMEs) who can effectively determine if a commercial motor vehicle driver's health meets Federal Motor Carrier Safety Administration standards. Goals of the Medical Examiner Program Improve highway safety • Ensure that medical examiners understand FMCSA medical standards and guidelines and how they apply to interstate CMV drivers • Maintain training and testing program for medical examiners • Promote public confidence in the quality of the medical examiners who certify CMV drivers • Establish an online list of certified medical examiners NRCME Enables FMCSA to Rely On State scope of practice to demonstrate clinicians' general clinical knowledge • NRCME training to convey baseline knowledge on FMCSA CMV physical qualification standards Medical guidelines Medical examiners Application of clinical knowledge in determining CMV fitness for duty • NRCME testing to validate baseline knowledge Medical Examiner Qualifications Professional licensure and scope of practice that includes performing physical examinations. • Licensed, certified, and/or registered, in accordance with applicable State laws and regulations, to perform physical examinations. e.g. physicians, APNs, PAs, and chiropractors. • Roles Demonstrate an understanding of FMCSA physical qualification requirements and the demands of commercial driving, driver tasks, and the work environment. Perform driver certification examinations in accordance with FMCSA physical qualification requirements and medical guidelines. Which drivers require CMV exam Interstate drivers of a vehicle that: • Has a gross vehicle weight rating or gross combination weight rating, or gross vehicle weight or gross combination weight, of 26,001 pounds or more, whichever is greater; or • Is designed or used to transport more than 8 passengers (including the driver) for compensation; or • Is designed or used to transport more than 15 passengers, including the driver, and is not used to transport passengers for compensation; or • Is used in transporting material . . . hazardous . . .in a quantity requiring placarding Interstate: Transports material that originated in, will be delivered in, or travels through another state • State laws and requirements often mirror federal • MEs performing state CMV exams must be familiar with state‐specific requirements CMV Driver Requirements (391.11) (1) Is at least 21 years old; (2) Can read and speak the English language sufficiently to converse with the general public, to understand highway traffic signs and signals in the English language, to respond to official inquiries, and to make entries on reports and records; (3) Can, by reason of experience, training, or both, safely operate the type of commercial motor vehicle he/she drives; (4) Is physically qualified to drive a commercial motor vehicle in accordance with subpart E—Physical Qualifications and Examinations of this part; (5) Has a currently valid commercial motor vehicle operator's license issued only by one State or jurisdiction; (6) Has prepared and furnished the motor carrier that employs him/her with the list of violations or the certificate as required by § 391.27; (7) Is not disqualified to drive a commercial motor vehicle under the rules in § 391.15; and (8) Has successfully completed a driver's road test and has been issued a certificate of driver's road test in accordance with § 391.31, or has presented an operator's license or a certificate of road test which the motor carrier that employs him/her has accepted as equivalent to a road test in accordance with § 391.33. Acceptable risk Risk=probability of an event occurring within a certain period of time. Determining "acceptable risk" is a medical AND societal determination "Acceptable risk" defined as 1% Non-discretionary qualifiers -Insulin treated DM -Epilepsy -Vision -hearing Discretionary qualifiers -loss of a limb -limb impairment -CV -Resp -HTN -Rheumatic, ortho, arthritis, muscular -Mental d/o -alcoholism -drug use Hearing for CMV driver -First perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid - -if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to American National Standard Hearing test CMV -Forced whisper test -Audiometric test Either may be conducted first, testing both ears -Both ears must be tested, even if first tested ear "passes" -Second test ONLY indicated if results of initial test do not meet requirements -Disqualify when both the forced whisper and the audiometric test are failed -Hearing standard must be passed in at least one (the better) ear Forced Whisper test -Allows assessment with or without hearing aid in place by ME -Perform in controlled environment for consistency -Avoid extraneous noise -Ensure minimum of 5' between examiner and driver -Document distance between examiner and driver -Technique: Driver positioned with "tested" ear away from examiner and tragus of ear nearest examiner occluding auditory canal At end of normal exhalation, examiner forcibly whispers three 2‐syllable words, avoiding sibilant words; ask driver to repeat Interpretation: Driver must repeat three words accurately from at least one ear Audiogram -Audiometry can be conducted with or without hearing aid *If hearing aid required, audiogram should be conducted by audiologist using appropriate equipment Audiometry must be reported to ANSI Standard Z24.5‐1951* -Three pitches only are recorded: 500 Hz, 1000 Hz, and 2000 Hz Audiogram results Audiogram Right Ear Left Ear 500 Hz __35___ 1000 Hz __45___ 2000 Hz __45___ 500 Hz __35___ 1000 Hz __30___ 2000 Hz __30__ Average (right): __42__ Average (left): __32__ Qualification average detection at 40 dB or less in at least one ear Hearing exemption -In 2013, 40 drivers were provided hearing exemptions -There is a current recommendation in consideration to allow certification of drivers who do not meet the currently published regulatory audiometric levels -If you encounter a rare driver with hearing exemption who otherwise is qualified, the ME certification must indicate exemption required -Drivers disqualified based on hearing acuity may contact FMCSA and request consideration for hearing exemption 2‐month, symptom‐free waiting period for any diagnosis of -Acute and chronic peripheral vestibulopathy -Benign positional vertigo (BPV) --Recommendation not to certify if diagnosis of -Uncontrolled vertigo -Meniere's Disease -Labyrinthine fistula -Nonfunctioning fistula HEARING AIDS -Driver using hearing aid for ME certification must use the hearing aid (s) while driving. -ME must check box indicating hearing aid used for test. -Counsel driver that must carry extra battery(ies) for hearing aid at all times while driving. Convert ISO to ANSI -If using ISO, ME must convert the test results to ANSI: -Subtract 14 dB from ISO for 500 Hz -Subtract 10 dB from ISO for 1000 Hz -Subtract 8.5 dB from ISO for 2000 Hz Vision for CMV -Has distant visual acuity of at least 20/40 (Snellen) in each eye without corrective lenses or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses, distant binocular acuity of at least 20/40 -(Snellen) in both eyes with or without corrective lenses, field of vision of at least 70° in the horizontal Meridian in each eye -ability to recognize the colors of traffic signals and devices showing standard red, green, and amber Required Tests & Results -Visual acuity, peripheral horizontal visual fields, color -VA measured each eye individually and both eyes together • Distant VA of at least 20/40 (Snellen) in each eye, with or without correction • Distant binocular VA of at least 20/40 (Snellen) in both eyes, with or without correction -Field of vision of at least 70o in horizontal meridian in each eye -Color vision sufficient to recognize traffic signals and devices showing the standard red, amber, and green traffic signal colors -When corrective lenses are used to meet vision qualifications, corrective lenses must be used while driving -A medical examiner, ophthalmologist, or optometrist may perform and certify vision results. The ME determines driver certification status. Monocular vision is disqualifying * * Drivers may not wear monocular contact lenses, where one eye is corrected for distance vision and the other for near vision. Required Tests & Results for visual acuity -Visual acuity, peripheral horizontal visual fields, color -VA measured each eye individually and both eyes together • Distant VA of at least 20/40 (Snellen) in each eye, with or without correction • Distant binocular VA of at least 20/40 (Snellen) in both eyes, with or without correction -Field of vision of at least 70o in horizontal meridian in each eye -Color vision sufficient to recognize traffic signals and devices showing the standard red, amber, and green traffic signal colors -When corrective lenses are used to meet vision qualifications, corrective lenses must be used while driving -A medical examiner, ophthalmologist, or optometrist may perform and certify vision results. The ME determines driver certification status. Monocular vision is disqualifying * * Drivers may not wear monocular contact lenses, where one eye is corrected for distance vision and the other for near vision. Central Vision Acuity: Snellen Chart or Titmus Vision Tester -Eyeglasses/contacts can be worn; if used to meet vision requirements, driver must wear the lenses while driving -Snellen wall chart should be 20 feet from driver -Mark distance/testing location for consistency -Ensure chart illuminated with white light -If driver reads large lines easily, ME may ask driver to skip to smaller lines -Minimally must demonstrate distant VA of at least -20/40 in each eyes individually and both eyes together -Results must be recorded in Snellen‐equivalent values if other test used