DOT/FMCSA frequently asked questions-Medical
  1. What medical conditions disqualify a commercial bus or truck driver?
    The truck driver must be medically qualified to not only drive the vehicle safely, but also to do pre- and post-trip safety inspections.  The bus driver have different demands
  2. Is a release form required to be completed in order for the employer to legally keep the medical certification card on file?
    No, the Medical Examiner is required to provide a copy of the Medical Examiners Certificate to the motor carrier that employs the driver.  A release form is not required. The motor carrier is required to keep a copy of the certificate in the driver qualification file.
  3. Can CMV drivers be qualified while being prescribed Provigil (Modadfinil)?
    Provigil is a medication to treat excessive sleepiness caused by certain sleep disorders-narcolepsy, obstructive sleep apnea/hypopnea syndrome and shift work sleep disorder. Provigil has several concerning side effects that could be potentially disqualifying.  It is recommended that until the individual knows how Provigil affects him/her, they may not drive, use machinery or do any activity that requires mental alertness.  Drivers should not be qualified for at least 6 weeks while taking Provigil and has been evaluated by the treating provider and Medical examiner that the Provigil is effective in preventing daytime somnolence and document that no untoward side effects are present.   Drivers taking Provigil should be re-certified annually.
  4. Is getting a medical certificate mandatory for all CMV drivers in the United States?
    In general, all CMV drivers in interstate commerce within the United States must obtain medical certification from a Medical Examiner.  CMV drivers from Canada and Mexico can be medically qualified in their own countries.
  5. Is Narcolepsy disqualifying?
      The guidelines recommend disqualifying a CMV driver with a diagnosis of Narcolepsy, regardless of treatment because of the likelihood of excessive daytime somnolence.
  6. Is Proteinuria disqualifying?
    Depending on the amount, protein in the urine may indicate significant renal disease.  The decision is based on whether the examiner believes that proteinuria may adversely affect safe driving.  The driver should be referred for follow-up.
  7. If a driver had a Myocardial Infarction (MI), followed by coronary artery bypass graft (CABG) several months ago, should he/she have an ETT (exercise tolerance test) as recommended in the MI guidelines but not in the CABG guidelines?
    Drivers should obtain an ejection fraction and ETT before returning to work and because of the CABG, keeping the driver off work 3 months (not 2 months as for MI)to allow time for sternal wound healing.
  8. Is sleep apnea disqualifying? 
    Drivers should be disqualified until the diagnosis of sleep apnea has been ruled out or has been treated successfully for a minimum of 1 month.  As condition of continuing qualification, it is recommended that a CMV driver agree to continue uninterrupted therapy such as CPAP, etc./monitoring and undergo objective testing as required.
  9. Where may I obtain an application for an epilepsy waiver? 
    At this time FMCSA does not have a waiver for epilepsy.  Only after meeting a ten (10) year waiting period off anti-seizure medication and being seizer free during that 10 year period can a driver be reconsidered for re-certification.
  10. Can a driver who takes nitroglycerine for angina be certified?
    Yes, Nitroglycerine use is not disqualifying?
  11. How soon may a driver be certified after CABG surgery?
    The driver should not return to driving sooner than 3 months after CABG, to allow the sternal incision to heal.  There are also other criteria that will need to be met.
  12. Can a driver on oxygen therapy be qualified to drive in interstate commerce?
    In most cases, the use of oxygen therapy while driving is disqualifying.
  13. Who can give a waiver or exemption?
    Only the FMCSA grants waivers or exemptions for certain medical conditions if the individual is otherwise qualified to drive.
  14. Is Meniere’s Disease disqualifying?
    Meniere’s Disease, a condition associated with severe and unpredictable bouts of dizziness (vertigo) is disqualifying.
  15. Can carriers set their own standards for CMV drivers who operate in interstate commerce?
    CFR Section 390.3(d) gives employers the right to adopt stricter medical standards. Motor Carriers (companies) cannot set less restrictive standards.
  16. What are the effects on driver certification based on FMCSA hypertension stages?
    A driver with a blood pressure (BP) 140/90 with no prior history of hypertension may be certified for 2 years. First time blood BP evaluated: 
    Stage 1 - BP 140-159/90-99 certification period 1 year

    Stage 2 - BP 160-179/100-109 certification period 3 months as one time certification
    Stage 3 - BP >180/110 Disqualified. When the BP is less than 140/90, the driver can be certified at 6 month interval
  17.  My medical certificate is still valid.  Am I prohibited from operating a CMV if I have a medical condition that developed after my last medical certificate was issued?
    Even if a driver currently has a valid medical certificate, the driver is prohibited from driving a CMV with any medical condition that would be disqualifying or may interfere with the safe operation of a CMV.
  18. May a driver who has non-insulin treated diabetes mellitus (treated with oral medication) be certified for 2 years?
    If the driver’s diabetes is adequately controlled, which determines certification-length of certification or disqualification, in general, FMCSA recommends a diabetic should have annual re-certification examination.
  19. What medications disqualify a CMV driver?
    A driver cannot take a controlled substance or prescription medication without a prescription from a licensed practitioner. If a driver uses a drug identified in 21 CFR 1308 (391.42(b)(12) or any other substance such as a amphetamine, a narcotic or any other habit forming drug, the driver is medically disqualified.  There is an exception: the prescribing doctor can write that the driver is safe to be a commercial driver while taking the medication. Anti-seizure medication used for the prevention of seizures is disqualifying, Methadone use is disqualifying, the use of insulin without a waiver is disqualifying.
  20. Can I drive a commercial vehicle after having angioplasty/stents inserted into my heart?
    Yes, drivers who have uncomplicated, elective Percutaneous Coronary Intervention (PIC) with or without stenting, to treat stable angina may return to work as soon as one week after the procedure. However there are other criteria that need to be meet to make that determination.
  21. Is it possible to get exemptions for some medical conditions?
    FMCSA currently has exemptions/waivers for vision and insulin-treated diabetes mellitus and offers a certificate program (FCE) for drivers with limb impairment.  FMCSA also has a special certification program for drivers with missing and/or impaired limbs (SPE) (49CFR 391.41(b) (1).
  22. Can a driver be qualified if taking prescribed medical marijuana?
    NO, drivers taking medical marijuana cannot be certified.
  23. Can a driver be certified who test positive for a controlled a substance on a urine test, but claims that the prescription was legally written 5 years before? 
    No. Controlled substances expire no later than one year after the date of the original prescription.
  24. What tests are used to determine if a driver has adequate hearing to drive safely?
    The test is either a forced whisper or audiometry.
  25. Can a driver receive a hearing waiver?
    Currently, there is no waiver program for hearing. 
  26. What happens if a driver is not truthful about his/her health history on the medical examination form?
    The FMCSA medical certification is designed to ensure drivers are physically qualified to operate commercial vehicles safely. Each driver is required to complete the Health History section of the examination report and certify that the responses are complete and true. The driver must also certify that he/she understands that inaccurate, false, or misleading information may invalidate the examination and the medical examiners certificate.  Deliberate omission or falsification of information may invalidate the examination and any certificate issued based on it. A civil penalty may be levied against the driver under 49 U.S.C. 521(b)(2)(b), either for making a false statement or for concealing a disqualifying condition.

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