New FMCSA Regulations governing medical examiners are now in effect!

I know I have posted a lot here already but need to add to with my experience so far. Basically if you have any medical issues it could be difficult in the past but it is even more difficult now. My Medical was due before October 4, 2014 and I was notified of this by letter the end of August 2014. I started the process for looking for a Medical Examiner middle of September basically looking for one in a walk in clinic so no appointment needed and of course cost. On September 29,2014 went for the physical and did not pass. I had 2 issues one hearing which did not surprise me and I did not have the necessary clearances, etc because I had triple bypass surgery December 2013.

Ok hearing first I did not pass the 5 foot forced whisper test. I made an appointment that same day with an Audiologist and one week later had $6500 hearing aides. Good deal this was done before October 4, 2014 so ahead of schedule and this would not prevent redo of the physical before medical expiration and wife happy.

The same day I found out what was required to satisfy the Medical Examiner which their on-line guidelines says I needed. Clearance by physician (usually cardiologist), resting echocardiogram with an LVEF >40% after CABG, Asymptomatic status with no angina". Needles to say it took almost 2 weeks to obtain this as I had to schedule the electrocardiogram and then allow time for a report be generated along with the Doctors clearance(still have not got the bill for this yet).

Now my Medical Certificate is expired on October 4, 2014 but my certificate was not suspended tell October 7, 2014 because this happened on a weekend. On October 22, 2014 went back in to re-exam cardio paperwork satisfactory good deal. Hearing redo of the Whisper test I almost failed even though I have all this money invested in hearing aides not a happy camper.

Still though passed the physical and it was signed of for 1 year. Yes one year!!!!! In the Medical Examiners "guidelines" it says " Current FMCSA guidlines state that individuals who have undergone coronary artery bypass surgery that meets the requirements for certification should be re-certified on an annual basis for 5 years. After this time, such individuals should undergo an exercise tolerance test annually".

No indication of what subsequent paperwork will be required for the 5 years which I hope will not be as extensive as this time. Also no indication how long the annual exercise tolerance test is for could be forever I suppose.

Federal DOT says "The handbook is not regulation it is supplemental information a medical examiner can use, if they chose to do so." At least mine is using it as regulation or law and will not deviate from the guideline they are using.

Now if you want to make a filing for regulations instructions for filing a resolution of medical conflict can be found at:
http://www.fmcsa.dot.gov/regulations/title49/section/391.47
It seems to me a very involved and cumbersome to do and probably very expensive for individuals to do. Even companies it would be easier to fire the driver than go through the process at least in my opinion.

Talking to a certified Audiologist he said the whisper test is one of the poorest ways to test hearing as no sound waves involved rather it is air escaping. Been used for a long time though so what can you do, nothing. I have had my hearing aides adjusted today so hopefully I should pass the hearing test next time with ease.

Oh my Medical has been re-instated(after 15 days) even though my Medical Examiner made a cross out and correction on the short card we carry and I did not notice it. So I have to get another card completed with no errors and get it faxed to DOT.

Bottom line if you suspect you have any medical issues don't wait. Find an registered Examiner and call and find out what you are going to need so you have time to get what you need. Even if no medical issues he may want a year of medical history if you not his regular patient or he may not want anything but you and your money. Finding one while you are on the road and on your route could be problematic.

Sorry for being so long winded but if this helps one person it was worth it and your time reading this.

Good luck.

October 24, 2014 21:48:26 PM

This may turn out to be nothing but it appears the potential is there for a problem. Certainly you need to contact whomever you choose for the physical. Determine what they are going to require and react accordingly. I am sure there are other medical examiners who will not ask for medical history of any kind as it was before. Just as the cost for the physical varies; I have gotten quotes from $25 to $175 and some you can walk-in others have to make an appointment.

Anyway I hope this will help some to understand what could happen and in some instances it maybe harder than just looking up a certified medical examiner on the internet as I found. Company drivers may have specific certified medical examiners for you to use and will not have a problem at all. Now Owner Operators or Independent Drivers will need be more careful.

September 26, 2014 21:38:39 PM

Wow Robert, thanks for the information. That's very scary stuff and I appreciate you sharing it. I have to get my physical next month so I'm interested to see how it will go.

September 25, 2014 15:51:00 PM

Update a response from DOT on this subject and appear they could ask for 20 years if they choose!!!!

The Federal Motor Carrier Safety Regulations (FMCSRs) does not identify a mandatory 5 year pass history to make a determination whether to certify a drivers fitness.

However, the FMCSA requires that the medical examiner, prior to making a determination, be knowledgeable about the Federal Motor carrier Safety Regulations (FMCSRs), consult with the treating physician, implement current medical best practices, and have knowledge of the duties and responsibilities of the commercial driver to make an individual determination as to whether a particular condition would interfere with the driver’s ability to operate a CMV safely.

The decision whether to medically certify a driver rests with the medical examiner.

Please refer to the physical qualification regulations

http://www.fmcsa.dot.gov/regulations/title49/section/391.41

September 25, 2014 13:34:48 PM

I just learned if you have for instance diabetes and/or high blood pressure which is medicated(diabetes not using insulin) the registered medical examiner I went to wants 5 years of medical history!!! In my case my primary care physician who provided CDL physicals as a courtesy decided not to get registered. If your on the road this is not going to be easy as you need to get a release form completed(probably signed and notorized) for your primary care physician so he can FAX to whomever you are going to have do the exam and usually not going to happen overnight. Hard copies for me was going to be $50 or FAX for free. And they said this was not going to be a undue burden!!!!! Other irritation I was home and had my normal annual physical which is far more thorough than the one for the CDL but is useless for this purpose.

I found no where that there is a requirement like this for 5 year medical history;. over zealous medical examiner maybe I don't know. Someone needs to remind me again this is not going to be and undue burden and exactly why they are doing this?

September 25, 2014 13:22:19 PM

Craig, you may be correct, however I wasn't aware of that issue. Prior to the change-over, an M.D., P.A or a Nurse Practioner could conduct and sign the physical. That's still in effect, so no change there. The FMCSA wants more control over the process and special attention for health concerns that affect drivers and the safety of all on the road. Most doctors don't consider the damage an 80,000# rig would do when it's operator goes into a diabetic coma for example.

May 26, 2014 6:48:26 AM

Please correct me if I'm wrong, but wasn't part of FMCSA's reasoning because some drivers were getting their medical card signed by unqualified individuals, ie not doctors or physicians assistants? I'm not even sure how that would work but I do remember reading about it more than once.

May 25, 2014 20:55:15 PM

HEY DON'T WORRY ABOUT IT,JUST KEEP DOING WHAT YOUR DOING AND YOU SHOULD BE JUST FINE.....LET'S JUST SIT BACK AND WATCH.

May 25, 2014 17:50:32 PM

As a doctor or P.A. they are already qualified, but the FMCSA thinks they need to be certified especially for truck drivers. I expect that the FMCSA will continue to tighten the noose with more restrictions on obesity with Body Mass Index (BMI) requirements. Sleep apnea and CPAP devices will continue to receive increased scrutiny as well.

May 24, 2014 8:39:00 AM

It had gotten out of hand. In this case the FMCSA came up with a cure that may have gone too far. Truck drivers need to be pro active about their health care. Unfortunately too many of us get a DOT physical and that is it. If the only medical professional that we see is an every 2 year physical, I would hope that person would be qualified.

May 24, 2014 3:51:44 AM