DOT - Musculoskeletal Exam Questions & Answers

Skill Performance Evaluation (SPE) certificate - ANSWER-A driver with an impairment of an arm, leg, hand, or foot who is otherwise medically qualified, may be certified if the driver applies for and is determined by the FMCSA to be qualified for a SPE certificate. Issued by FMCSA, not Medical Examiner. Issued up to two years; may be renewed. To legally operate a CMV, the driver must carry a SPE certificate and a valid Medical Examiner's certificate. The driver is responsible for ensuring that both certificates are renewed prior to expiration. The SPE application and renewal application must include a medical evaluation summary completed by a board-certified orthopedist or physiatrist. Examinations must document that the driver is eligible for a SPE certificate. Follow-up examinations must document that there has been no change in the driver's condition that would affect the driver's eligibility for a SPE certificate (determination that the deficit remains fixed and stable). The Medical Examiner determines, on a case-by-case basis, that a Skill Performance Evaluation (SPE) is required when the severity of the limb loss or impairment is less than the whole hand or foot. If the driver is otherwise qualified, the Medical Examiner should check the SPE certificate box on both the Medical Examination Report and the Medical Examiner's certificate that indicates the driver is qualified when accompanied by a SPE certificate. Physical Exam - ANSWER-Is there a diagnosis that is rheumatic, arthritic, orthopedic, or muscular? Examination findings need to go beyond minimums; the medical examiner determines appropriate specialist(s) that could or should be consulted. Is the clinical course reversible, episodic, degenerative, or fixed? Fixed and stable, affecting a hand, foot, arm, or leg, driver may qualify for a Skill Performance Evaluation (SPE) certificate.