EXPERT SOLUTIONS PROVIDED
⫸ What if a driver from another country has a variance/waiver?
Answer: They are not qualified in the US.
⫸ What are the 13 physical qualifications for drivers? Answer: 1 + 2.
No loss/impairment of foot/leg/hand/arm.
3. No IDDM (new waiver)
4. No dx of heart dz that might cause syncope, SOB, collapse, or CHF
5. No respiratory dysfunction likely to interfere
6. No HTN likely to interfere
7. No hx or dx of MSK dz likely to interfere
8. No hx of epilepsy or dz causing LOC
9. No mental/psych dz likely to interfere
10. Distance vision of 20/40 in each eye and together, 70 degrees
horizontal field, and ability to recognize red/green/yellow
11. Whisper at 5 feet in BETTER ear or no average HL in better
ear>40 DBs at 500,1000,and 2000 hz
12. No schedule 1, amphetamine, narcotic, habit forming drugs except
when prescribed by someone who says it will not affect ability to
operate CMV
13. No dx of alcoholism
,⫸ Can a medical examiner grant a waiver? Answer: No. They have to
go through the online FMCSA processes.
⫸ Don't certify until etiology is _______, and _____ is shown to be
_____, ______, and _____. Answer: Confirmed, treatment, safe,
effective, stable.
⫸ What if multiple waiting periods for multiple comorbidities?
Answer: Wait until longest one is done.
⫸ When to get additional tests/consults? Answer: Case by case basis
to adequately address fitness for duty. No required to accept the
consult/testing.
⫸ What are the only required regulations? Answer: Vision, hearing,
epilepsy, IDDM.
⫸ What to do if choose not to follow a guideline? Answer: Document
extensively why you did not.
⫸ What testing MUST be done for the exam? Answer: Height,
weight, vision, hearing, BP, pulse, urinalysis.
⫸ What optional testing may be done? Answer: BMI, audiometry,
PFTs, ECHO, EKG, sleep study, CT scan, etc, based on H&P and
your determination. CAUTION: If you require these, you CANNOT
,be the one ordering or paying. Must be employer or driver's private
health insurance or private pay.
⫸ 4 possible options for determinations for medical exam? Answer:
1) Qualified
2) Not qualified
3) Determination pending
4) Incomplete
⫸ What is the date for the certificate expiration? Answer: The date of
determination, NOT necessarily of the exam.
⫸ Is dialysis disqualifying? Answer: Yes
⫸ Is monocular vision okay? Answer: No. Need to have 20/40 in
BOTH eyes. No corrective contacts that make one eye see far/one
near. No telescopic lenses.
⫸ Meniere's disease - DQ? Answer: Yes, if active dx due to risk of
incapacitation from vertigo spells. If in remission, no episodes for 10
years, probably fine.
⫸ What to do if proteinuria? Answer: Nephrologist consult
⫸ Nitroglycerine use - DQ? Answer: No, but need cardiologist letter
certifying angina is stable.
, ⫸ Sustained V-tach > 15 seconds? Answer: Disqualifying
⫸ Narcolepsy? Answer: DQ
⫸ Provigil (modafinil)? Answer: Not DQ but be cautious.
⫸ Uncontrolled vertigo? Waiting period? Answer: DQ. WP is 2
months sx free.
⫸ Labyrinthine fistula or nonfunctioning labyrinth? Answer: DQ
⫸ Vision acuity requirements? Answer: 20/40 in each eye and
together.
⫸ If can't determine colors? Answer: Need further testing.
⫸ Exemption for contact monovision? Answer: No.
⫸ Exemption for natural monovision? Answer: Yes, if one is is
>20/40, can apply.
⫸ Vision exam includes? Answer: PERRLA, EOMs, confrontation,
nystagmus, eval for exopthalmos