When do patients require a Skilled Performance Exam? correct answers IF they have a FIXED motor deficit of an extremity who cannot physically qualify to drive that needs a full evaluation by a specialist (Not for patients with a progressive motor deficit)
**These patients must provide proof of the exam by the specialist in order to obtain certification or be given a referral letter if you think they need an exam***
What two special populations of drivers are given exemptions by the DOT? correct answers 1. Patients with vision disorders
2. Diabetics
***The exemption allows the grandfathering in of certain drivers who participated in vision and diabetes waiver study programs***
***Drivers can be certified as long as they meet the provisions and have the certificate with them at the time of the DOT exam***
What are your duties as a DOT examiner? correct answers To detect the presence of any physical, mental, or organic conditions of such character and extent as to affect the ability of the driver to operate a CMV safely
What is the definition of Incapacitation? correct answers The onset of incapacitating symptoms so rapidly that they interfere with safe driving or that the driver may be unable to safely stop the vehicle before beocming incapacitated
If the patient has any side effects of medications, can they be certified? correct answers NO!! Any side effects such as drowsiness, dizziness, orthostasis, blurred vision or changes in mental status prohibit the driver from being certified
What conditions lead to AUTOMATIC DISQUALIFICATION for DOT certificates? correct answers DEFIBRILLATOR
DIALYSIS
What are the VISION requirements for DOT certification? correct answers 1. Distant visual acuity of at least 20/40 in EACH EYE with or w/o lenses
2. Distant BINOCULAR vision of at least 20/40 in both eyes, with or w/o lenses
3. Field of vision of AT LEAST 70 DEGREES in the horizontal meridian in each eye
4. Ability to recognize/distinguish among colors of traffic signals (RED, AMBER, GREEN)
Can a driver with monocular vision obtain a DOT certificate? correct answers YES, but the driver must be otherwise medically fit for duty and granted a FEDERAL VISION EXEMPTION CERTIFICATE
**Pt must return with the certificate of exemption before the DOT certificate can be given*** If a driver comes for a physical and is otherwise fit, you can disqualify them and the driver can apply for a federal vision exemption
What is MONOCULAR VISION? correct answers Monocular vision occurs when the vision requirements are only met in one eye, with or without corrective lenses
***MONOCULAR VISION IS AUTOMATICALLY DISQUALIFYING***
How do you certify a driver who is in the process of applying for a Federal vision exemption?
correct answers YOu can certify the driver for up to 1 year, mark the accompanied by EXEMPTION checkbox and write vision so that the type of federal exemption is specified
What are the hearing requirements to obtain a DOT certificate? correct answers 1. Driver must first perceive a whispered voice in one ear @ no less than 5 feet (only required in 1 ear)
2. NOT have an average hearing loss in one ear >40dB at 500 Hz, 1,000 Hz and 2,000 Hz
What are the BP regulations for a person with STAGE 1 HTN (BP of 140/90-159/99)? correct answers person is only certified for 1 year and if BP is >140/90 then they get 3 month cert at the 1 year recert
What are the BP regulations for a perston with STAGE 2 HTN (BP of 160/100 to 180/110? correct answers Person can only get a 3 month certificate and then at recertification if the BP is less than 140/90, they can get 1 year from the date of the original exam
What are the DOT regulations for a driver with STAGE 3 HTN (BP>180/110)? correct answers DRIVER IS DISQUALIFIED until the BP is <140/90
When BP is <140/90, they can only get a 6 month certificate forever
What does a urinalysis check for DOT certification? correct answers Specific gravity
Proteinuria
Hematuria
Glycosuria
What should the PE rule out in every driver? correct answers Presence of any current CV disease accompanied by and/or likely to cause symptoms of syncope, dyspnea, collapse or CHF
How long must a driver wait to be certified after having an AMI? correct answers There is a 2
months waiting period so driver is temporarily disqualified for 2 months and can only be certified for a max of 1 year if they are Asx, tolerating meds, has a satisfactory Exercise Tolerance test has resting EF >40% and no ischemic changes on EKG
***For the initial certification exam following an MI, an in-hospital post-MI echo showing LV EF>40% is sufficient***
What LV EF is required after an MI for a patient to obtain DOT certificate? correct answers LV EF>40%