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Certified CDL Medical Exam

Truck driver Compliance

DRUG TESTING


 
Trucker Exam Inc. works with companies to design execute and manage your drug testing program. We offer complete and professional drug and alcohol screening services including:
- Drug Testing (i.e. Pre-employment, Random, Post Accident, Reasonable Suspicion, etc.) by Hair, Urine, or Saliva with results for DOT in less than 24 hours and administrative in less than 15 minutes
- Private on line storage of: Chain of custody forms, Results, Quarterly Random selections and results, Annual MIS forms, Consortia contract, D/A Policy and Reasonable suspicion certificates for each company
- Free Drug and Alcohol Policy Development for US DOT and administrative companies
- Free employee awareness training and supervisor training
- US DOT Consortia random selection services
Access to a total of 2,500 collection sites across the United States .
- On line assistance in identifying a Substance Abuse Professional (SAP)
- On-site drug and alcohol screening services
- After-hour drug and alcohol screening services
- On line US DOT drug and alcohol compliance forms
- Results can be reported on line, fax, or e-mail
- Non-DOT Pre-employment Instant Drug Test exams are reported within 25 minutes or less
Specialties
Drug Testing US DOT and NON -DOT, Alcohol Testing US DOT (BAT, STT) and Corporate, Hair Drug Testing.
Website
http://www.dotmedicalexam.com

California Only

30,000.00 Health Professionals

The Federal Motor Carrier Safety Administration announced Friday that 8,000 more health professionals have been added to the National Registry of Certified Medical Examiners since the new system for U.S. DOT medical examinations launched last month with 22,000 providers.
Another 22,500 medical professionals have also initiated the process for gaining their certification, according to the agency.
All interstate commercial truck and bus drivers must pass a U.S. DOT medical examination at least once every two years in order to obtain a valid medical certificate and maintain their commercial driver’s license.
As required by federal regulation, effective May 21, 2014, all new USDOT medical examinations for interstate truck and bus drivers, both CDL and non-CDL drivers, are required to be performed by a medical examiner who has completed the required training and passed a certification test.
Some trucking groups called for a delay in the start of the medical registry requirement claiming there would be a shortage of certified medical examiners.
The U.S.DOT medical examination looks at a range of conditions to assess a driver’s ability to safely operate a commercial vehicle, including cardiovascular disease, respiratory and muscular functions, vision, and hearing.
Most drivers will not need a new physical exam right away. Certificates are valid until the expiration date on a driver's medical card.
To meet the needs of professional drivers throughout the country, FMCSA said there are certified examiners in every state, and dozens or hundreds in most cities.
A listing of medical providers in the registry is available on the FMCSA website.

Medical Examiner Registry

Medical Examiner Registry
 
Rule Goes into Effect on May 21
 
Starting on May 21, drivers will only be allowed to get DOT physicals from medical examiners that have been listed on an FMCSA database.Medical examiners must pass an exam before they can be placed on the national registry.
 
Effective May 21, interstate Commercial Motor Vehicle (CMV)drivers will no longer be able to get a valid medical certificate from any healthcare provider. Drivers will have to go instead to a medical examiner that has been listed on the Federal Motor Carrier Safety Administration’s national registry.
 
In order to get on the National Registry, a medical examiner must have passed an exam certifying that they have sufficient knowledge of adriver’s job to safely determine if the individual is medically qualified to perform it.
 
National Registry
 
At Trucker Exam Inc. you will find certified medical examiner serving California and Nevada
 
At www.dotmedical exam.com you will be able to find a link to the Team CME for divers who are out of the services area of Trucker Exam Inc. Once inside, you can use the available widget to map out the medical examiners in your local area.
 
Fewer Examiners
 
In a lot of  rural areas, drivers may have to drive in to find an examiner.
 
The Bottom Line
 
We advise giving you plenty of time to find a certified examiner and to get an appointment. call 559-431-2648
 
1.800.542.2225
 

Sleep Apnea Guideline Delayed Indefinitely

Sleep Apnea Guideline Delayed Indefinitely    US Congress Passes Public Law 113-45
 
To ensure that any new or revised requirement providing forthe screening, testing,
 
Or treatment of individuals operating commercial motorvehicles for sleep disorders
 
Is adopted pursuant to a rulemaking proceeding, and forother purposes.
 
Those opposed to new guidelines being developed for FMCSAlobbied for passage of Public Law 113-45 which requires the DOT to use the"Rule Making" process before making any change to the current sleepapnea guidelines.  The rule makingprocess was the process used to create the National Registry and it is a longan arduous process.  You should notexpect any new sleep guidelines for quite some time.
 
So what is the guideline that is in place?
 
Definition of Sleep Apnea: 30 hypopnea events per hour
 
 NeckCircumference:  17" males,   16" female
 
 The one monthrequirement to be on CPAP and the direction that CPAP or surgery is the onlyaccepted treatment for sleep apnea is now in question.  The requirement for yearly objective testingmay also be in question.
 
I have spent quite some time thinking what to tellDrivers.  There is still a very greatconcern with drivers and motor carriers out there.  But here is what I believe is an ethical andfair solution.  Of course, none of thisis binding on Trucker Exam Inc. and should not be consider as medical advice.
 
First let’s talk about who I think should be referred for asleep test:
 
1)     I believe that a driver who discloses thatsomeone has told him that he pauses in breathing and when asleep should have asleep test.
 
2)     A driver with a BMI over 35 with a history ofhypertension, diabetes, MI or stroke should be tested for sleep apnea.
 
3)     If driver snoring loud, I will decide to givehim a current Epworth in my office. 
 
4)     I do not believe that drivers who simply have a17" or 16" neck should be tested on that basis alone.
 
In regard to yearly objective testing, in my own practice Iam asking for a current compliant report bases on Medicare guidelines conductedby the sleep specialist and yearly clearance. The driver will receive a one yearmedical cert.
 
 
 
 
 

FMCSA Note Medical Exam

FYI:  From FMCSA 04/22/14
 
Driver/Carrier:
By now, you’ve heard about the National Registry law that goes into effect May 21, 2014. After that date, all interstate commercial motor vehicle (CMV) drivers must get their medical certificates from a certified medical examiner listed on the Federal Motor Carrier Safety Administration’s National Registry of Certified Medical Examiners.
Find a certified medical examiner in your area—or anywhere in the country—by following these three simple steps.
  1. Visit the National Registry Web site and search by Zip Code, State, or examiner name.
  2. Choose a certified medical examiner from the list and call to make an appointment.
  3. If your preferred health care professional isn’t on the list, simply refer him or her to the Certified Medical Examiners page to learn more about getting certified.
If you’ve already had an exam and have a current certificate that certificate will be valid until its regular expiration date.
Please spread the word and encourage your fellow CMV drivers to find a Certified Medical Examiner by May 21st. They can find more information in the Fact Sheet for Drivers or by going to the National Registry Web site, so pass it along!
Thank you for your commitment to safer roadways!

Certified MedicalExaminers

 
 
Trucker Exam Inc., the nation's Truck stop DOT MEDICAL exam and Drug testing r Offices Company, announced today that all of their medical providers are credentialed with the National Registry of Certified medical examiners (NRCME) for the Federal Motor Carrier Safety Administration's (FMCSA)physical qualifications standards and guidelines to perform Department of Transportation(DOT) physicals.
 
Trucker Exam Inc. ensures each of its health care professionals complete the necessary training and testing to meet the certification requirements for the evaluation of CMV drivers. Utilizing the FMCSA guidelines and standards  all divers is able to get  test results after the completion of their exam.
 
For more information about the NRCME or to find Trucker Exam Inc.' credentials, visit: https://www.dotmedicalexam.com
 
About Trucker Exam Inc.
 
As the largest Truck Stop DOT Medical Exam provider on the West coasts,Trucker Exam Inc. is a full service for transportation companies and truck drivers conduct sleep apnea testing,  pre-employment services and Drug testing , and offers log book audits and safety audit consulting.
 
Trucker Exam Inc. is base in Las Vegas Nevada and has expanded it’s to California .
 

California Truck and Bus Regulation Cleaner Air

This page created March 7, 2014

The Board will consider amendments to the Truck and Bus Regulation at its April 24-25, 2014 meeting. The staff proposal is intended to help ensure that the air quality benefits originally envisioned by the regulation will be achieved, by providing some additional compliance flexibility to vehicle owners. The proposed amendments are subject to change at the Board hearing and are currently not in effect.

Fact sheets
  • Regulation Update and Benefits
  • Description of Proposed Amendments
    • More time for rural areas with cleaner air (area map)
    • Additional time for 2nd and 3rd truck in small fleets
    • Additional time for owners that cannot finance compliance
    • Adjusted compliance timelines for low-use or vocational trucks
      • Work truck extension (up to 20,000 total miles/year)
      • Low-use vehicle exemption (up to 5,000 total miles/year)
      • Low mileage agricultural vehicles
      • Heavy cranes
    • Recognizing early actions already taken by fleets to comply
      • Extending use of existing PM filter retrofits
      • Extending use of phase-in option credits

You can get more information, including the Staff Report, at the Rulemaking Document page. You can make a commenton the proposed changes if interested. Additional supporting documentation and analyses for the proposed amendments are available at the AB1085Compliance page.

MVR within 15 days

Motor Carriers would need to run a new MVR within 15 days ofa driver
 getting a new DOT physical and certifying their card with their SDLA.  49 CFR 391.51. This rule will discuss the MVRand the 15 day requirement.
 
 § 391.51 General requirements for driver
 
 qualification files.
 
   The medicalexaminer’s certificate as required by § 391.43(g) or
 
 a legible copy of the certificate.
 
 ·         (ii) Exception. For CDL drivers
 
 beginning January 30,2012, if the CDLIS motor vehicle record contains medical certification status information, the motor carrier employer must meet this
 
 requirement by obtaining the CDLIS motor vehicle record defined at
 
 § 384.105 of this chapter. That record must be obtained from the current
 
 licensing State and placed in the driver qualification file. After January 30,
 
 2014, a non-excepted,interstate CDL driver without medical certification
 
 status information Anthe CDLIS motor vehicle record is designated ‘‘not certified’’
 
to operate a CMV in interstate commerce. For up to 15 days from the
 
 date stamped on the receipt of the medical examiner’s certificate, provided
 
 to the driver by testate driver licensing agency, a motor carrier may use that receipt as proof of the driver’s medical certification.
 

on-site services


Trucker Exam Inc. (TEI) on-site services recently added certified medical examiners to their Fresno, Ca. Madera Ca. and Las Vegas NV. Offices, to accommodate the increase of DOT exams and drug tests by local employers. With seven examiners, TEI maintains the largest network of certified medical examiners on the FMCSA National Registry in California and Nevada. TEI DOT examiners are also available for on-site and remote examinations and drug testing

TEI works to meet a FMCSA deadline of 5/21/14 when all DOT exams must be performed by a certified medical examiner. Previously, any private doctor was able to perform the exam without any prior specific training or certification. As part of this new regulation, a National Registry will maintain a database of all certified medical examiners.

To set appointment you can:

Call 1-800-542-2225

Go to the TEI portal also allows for scheduling appointments and retrieving results all through one website. www.dotmedicalexam.com

Drug and Alcohol Testing Clearinghouse for Commercial Truck and Bus Drivers

U.S. Department of Transportation
Office of Public Affairs
1200 New Jersey Ave., S.E.
Washington, DC 20590
                                                                         
FMCSA 09-14
Wednesday, February 12, 2014
Contact: Marissa Padilla
Tel.: (202) 366-9999

FMCSA Proposes National Drug and Alcohol Testing Clearinghouse for Commercial Truck and Bus Drivers
Employers would be required to check clearinghouse before hiring and annually
WASHINGTON - The U.S. Department of Transportation's Federal Motor Carrier Safety Administration (FMCSA) today announced a proposed rule to establish a drug and alcohol clearinghouse for all national commercial driver's license (CDL) holders. The clearinghouse would help improve roadway safety by making it easier to determine whether a truck or bus driver is prohibited from operating a commercial motor vehicle for failing to comply with federal drug and alcohol regulations, including mandatory testing.
"Safety is our highest priority, and we will continue to embrace new tools and opportunities that protect the travelers on our nation's roads," said U.S. Transportation Secretary Anthony Foxx. "Today's proposal will help ensure dangerous drivers stay off the road, while encouraging the employment of the many safe drivers who follow our drug and alcohol requirements."
Current federal regulations require employers to conduct mandatory pre-employment screening of a CDL driver's qualifications based upon his or her driving record. However, there has not been a single federal repository recording positive drug and alcohol tests by CDL holders that employers would be able to search to ensure that the driver is able to perform safety-sensitive duties.
The proposed rule announced today would create such a repository and require employers to conduct pre-employment searches for all new CDL drivers and annual searches on current drivers.
"We are leveraging technology to create a one-stop verification point to help companies hire drug and alcohol-free drivers," said FMCSA Administrator Anne S. Ferro. "This proposal moves us further down the road toward improving safety for truck and bus companies, commercial drivers and the motoring public everywhere."
Under the proposed rule announced today, FMCSA-regulated truck and bus companies, Medical Review Officers, Substance Abuse Professionals, and private, third party USDOT drug and alcohol testing laboratories would be required to record information about a driver who:

  • Fails a drug and/or alcohol test;
  • Refuses to submit to a drug and/or alcohol test; and
  • Successfully completes a substance abuse program and is legally qualified to return to duty.

Private, third-party USDOT drug and alcohol testing laboratories also would be required to report summary information annually. This information would be used to help identify companies that do not have a testing program.
To ensure the privacy of drivers involved, each CDL holder would need to provide his or her consent, before an employer could access the clearinghouse.
Drivers who refuse to provide this information could still be employed by the truck or bus company; however, they could not occupy safety-sensitive positions, such as operating a commercial motor vehicle.
It is a violation of federal regulations to drive a truck or bus under the influence of controlled substances or alcohol. Federal safety regulations require that truck and bus companies that employ CDL drivers conduct random drug and alcohol testing programs. Carriers must randomly test 10 percent of their CDL drivers for alcohol and 50 percent of their CDL drivers for drugs each year.
For each of the past three years, federal and state safety inspectors have conducted approximately 3.5 million random roadside inspections of commercial vehicles and of their drivers.
In 2013, on 2,095 occasions, or in 0.23 percent of the unannounced inspections, a CDL holder was immediately placed out-of-service and cited for violating federal regulations governing alcohol consumption. In 2012, FMCSA records show that there were 2,494 violations of this regulation.
In 2013, on 1,240 occasions, or in 0.13 percent of the unannounced inspections, a CDL holder was placed immediately out-of-service and cited for violating federal regulations governing controlled substances. In 2012, FMCSA records show that there were 1,139 violations of this regulation.
In addition to random testing, truck and bus companies are further required to perform drug and alcohol testing on new hires, drivers involved in significant crashes, and whenever a supervisor suspects a driver of using drugs or alcohol while at work.
The proposed rule announced today was directed by Congress in the most recent transportation bill, the Moving Ahead for Progress in the 21st Century Act.
###

Do the circumstances warrant DOT post-accident tests?

 
To maintain high standards of safety and professionalism,commercial drivers are subject to federal regulations outlined by the FederalMotor Carrier Safety Administration (FMCSA), which is a part of the U.S. Departmentof Transportation (DOT).
 
One component of maintaining your Commercial Driver’sLicense (CDL), is complying with the FMCSA’s drug testing regulations via yourcarrier or employer. Below is an overview of how and why carriers in thetrucking industry may use drug and alcohol screening to ensure safety.
 
When Are Drivers Tested need for a truck accident?
 
The federal government requires a driver test negative fordrugs prior to employment. If a driver is involved in a certain type ofaccident, the carrier must screen the driver for drugs and alcohol. FMCSArequires random testing throughout the year and when a carrier has a reasonablesuspicion that driver is using drugs or alcohol. If a driver tests positive orrefuses testing, there are federal requirements for follow-up or return-to-dutytests.
 
Do the circumstances warrant DOT post-accident tests?
 
Suppose your CDL driver calls in saying there's been anaccident.  Everyone's adrenaline isrunning, and you may have to pry the details out of him or her to determine ifDOT post-accident drug and alcohol testing is required.  The following checklist will aid in decidingyour course of action:
 
If the driver is in a CMV and if the received a ticket or ifsomeone dies do to the accident you must do a Drug test and Alcohol tests
 
You cannot test "just in case" circumstanceschange.  This is a misrepresentation of thetest and a violation.
 
If you conduct testing in "all post-accidentcircumstances" as a matter of company policy, it must be done using anon-DOT form and represented as a non-DOT test to the driver.  The collector must also be aware that it isnot a regulated test.  The drug testresults must be linked to a separate non-DOT lab account for reportingpurposes.  The results of these non-DOTtests hold no DOT consequences.  Inaddition, if circumstances change and a DOT post-accident test is required, thesenon-DOT tests cannot be substituted to satisfy the DOT requirements.  The driver must be sent again for anotherround of tests.
 

Motor Carrier

Dear Motor Carrier,
 
Next week, FMCSA will publish a final rule extending the requirement for interstate commercial drivers to have paper copies of their medical examiner’s certifications with them when operating a commercial motor vehicle. An advance copy of the rule has been posted to FMCSA’s website. This requirement will stay in effect until January 30, 2015. This requirement applies to any drivers with either a commercial driver’s license (CDL) or the commercial learner’s permit (CLP) who must be medically certified under 49 CFR part 391. Please note that drivers are still required to certify their status (e.g., interstate or intrastate, exempt or non-exempt) with the State Driver License Agency (SDLA) agency before January 30, 2014 and to provide the SDLA a copy of any new medical certificate received after January 30, 2012.
 
FMCSA also extended the requirement for interstate motor carriers to retain copies of their drivers’ medical certificates in their driver qualification files. This extension of the requirement to carry a medical certificate card was needed to ensure that all SDLAs are prepared to accept and transmit the medical qualification of CDL and CLP holders on the Commercial Driver’s License Information System (CDLIS) driver record.
 
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medical examiner's certificate

Do Date Certify Medical Exam

The best gift you can give your transportation company is to have your drivers complete you’rea Certify medical examiner. Doing so will ensure that your drivers will be ableto drive after the May 21, 2014 compliance date. After this date, drivers can only see a certified medical examiner that is listed on the National Registryfor their DOT exam. Make sure that your all driver in 2014 are medically certified
 

DOT rules

DOT News:

Part 382 D & A = 10% random alcohol/50% drug + pre-employment drug test before the driver drives + post accident drug & alcohol tests when required

Part 383 CDL = Make sure drivers have a current CDL

Part 387 = Have a copy of MCS Form 90 on site and ensure the MCS Form 90 reflects the level of insurance required. It annoys me the insurance industry will only issue a MCS Form 90 for what a carrier list on their application for authority; if a carrier has $1,000,000 policy and their authority indicates the carrier is a non-HM requiring $750,000 that's what the MCS 90 will reflect. If a carrier transports ANY amount of HM they must have $1,000,000 insurance. It's a violation of Part 387 to not have:

1. Inadequate levels of insurance

2. Insufficent insurance on file for the commodity transported, i.e. HM

3. No MCS Form 90

4. MCS Form 90 doesn't reflect the level of insurance required

Part 390 General Record Keeping = Records available when asked for; many carriers are under the assumption they have 48 hours to produce the records... The 48 hour rule applies to carriers with multiple terminals that allows the terminals to store records at the terminal.

Part 391 DQ = See Part 391.51 for a list of all files REQUIRED in the DQ file. Make sure your company has a tracking tool to keep track of DOT medical renewals; Outlook or other calendar programs work wonders in providing pops ups to remind the user tasks are due. Pick one month a year and pull all of your drivers' MVR; if you use June then do ALL drivers in June including those hired in the 11 months preceeding the annual pull. Make sure you do the employment inquires required.

Part 392 Driving a CMV = Thou shall not speed Part 392.2; if a driver logs a trip at 70 mph in a state with a 65 mph speed limit your company can be cited and prosecuted for Part 392.2.

Part 395 HOS = Driver's record of duty status (RODS)... No flase RODS; no missing RODS; RODS turned in on time; RODS complete with all required information

Part 396 Maintenance = Annual inspections, DVIRs, scheduled maintenance program with a record maintenance is being performed on time and road side inspections, proof repairs were completed

 

FMCA Sleep Apnea

FMCSA - MRB/MCSA Joint Committee Recommendations
Full language of the recommendations as I best followed their drafting/revision follows. (Note: there may be further revision as yet before they are sent formally to FMCSA, though their intention as outlined here should largely remain. Italics represent committee annotations about intentions.)
RECOMMENDATION LANGUAGE:
Recommendation 1 — General
  • Obstructive sleep apnea (OSA) diagnosis precludes unconditional certification.
  • A driver with OSA diagnosis can be certified if:
    • The driver has untreated OSA with apnea-hypopnea index (AHI) < 20 (i.e., mild-to-moderate OSA) AND
    • The driver does not admit to experiencing sleepiness during the major wake period OR
    • OSA is being effectively treated.
A driver with an OSA diagnosis may be recertified annually, based on demonstrating compliance with therapy.
  • Minimally acceptable compliance with PAP means at least 4 hours/day of use 70 percent of days.
    • § Drivers should be encouraged that more hours of PAP use is preferable.
    • § Optimal treatment efficacy occurs with 7 hours or more of daily use during sleep.
 
  • The intent behind the AHI threshold is to prioritize those drivers with OSA that need immediate treatment.
    • Drivers with mild OSA (AHI levels as low as 5) may benefit from OSA treatment, and should be encouraged to explore treatment options.
    • Drivers with an AHI between 5 and 20 should be encouraged to seek treatment, if they have a history involving a fatigue-related crash or a DOT-defined single vehicle crash [footnote reference: crash involving a CMV that results in a fatality or injury treatable away from the scene or disabling damage requiring tow away], or if they report sleepiness while operating a motor vehicle.
  • Why set the AHI threshold at 20?
    • Crash risk in the moderate-to-severe OSA range is statistically higher than for drivers with mild OSA.
From a practical perspective, setting the AHI limit at 15 or above makes it more difficult to get a patient under treatment to that AHI level. Although AHI of 15 is likely a safer threshold, there is not data to show this.
 
RECOMMENDATION 2 — Drivers with any of the following should be disqualified immediately or denied certification:
  • Report excessive sleepiness during the major wake period while driving, OR
  • Experienced a crash associated with falling asleep, OR
  • Have been found non-compliant in treatment per Recommendation 1.
 
RECOMMENDATION 3 — Drivers with any of the following may be granted conditional certification per Recommendation 4:
  • Have AHI > 20 until compliant with PAP, OR
  • Have undergone surgery and are pending post-op findings per Recommendations 10-12, OR
  • Have a BMI > or equal to 35 kg/m (pending sleep study).
Notes:
  • BMI cutoff of 33 is supported by studies (MRB).
  • BMI cutoff should be objectively related to crash risk (Conway).
 
RECOMMENDATION 4 — Conditional certification
  • Driver with BMI > or equal to 35 kg/m may be certified for 60 days pending sleep study and treatment (if diagnosed with OSA).
  • Within 60 days, if a driver being treated with OSA is compliant with treatment (per Recommendations 8-12), the driver may receive additional 90 day conditional certification.
  • After 90 days, if the driver is still compliant with treatment, the driver may be certified for no more than 1 year.  Future certification dependent on continued compliance.
Refer to Recommendation 1 for definition of minimal compliance. [Insert clinical evaluation educational footnote]
 
[CLINICAL EVALUATION EDUCATION FOOTNOTE]
  • Medical examiners should screen all drivers for OSA.
  • The driver is judged at-risk for OSA based on:
  • The driver’s answers to a validated questionnaire (e.g., Berlin), OR *Some other validated screening tool.
  • Symptoms:  loud snoring, witnessed apneas, sleepiness during major wake period.
  • Risk factors may include the following. A single risk factor alone may not infer risk. Need to look at multiple factors.
  • Factors contributing to high risk
  1. Small or recessed jaw
  2. Neck size > 17” male, 15.5” female (strongly correlated with obesity, which is associated with sleep apnea)
  • Other factors
  1. Age 42 and aove
  2. BMI > 28 kg/m
  3. Small airway (Mallampati Scale score of Class 3 or 4)
  4. Family history
  5. Male or post-menopausal female
  6. Experienced a single-vehicle crash
  • Conditions associated with high risk:
  1. Hypertension (treated or untreated)
  2. Type 2 diabetes (treated or untreated)
  3. Hypothyroidism (untreated)
 
RECOMMENDATION 5 — Method of diagnosis and severity
  • Methods of diagnosis include in-laboratory polysomnography, at-home polysomnography OR a FDA-approved limited channel ambulatory testing device which ensures chain of custody.
  • In-laboratory polysomnography, which is more comprehensive, should be considered when the clinician suspects a sleep disorder in addition to sleep apnea.
  • Note that new technologies will likely emerge that will be able to screen for OSA.
  • Driver should be tested while on usual chronic medications.
  • Note that the joint medical committee did not consider AHI levels from unattended studies, but only in-lab sleep studies, which detect the arousal component of hypopneas (not just saturation).
  • An in-home sleep study may underestimate AHI when compared to an in-lab sleep study.
  • An AHI detected on an in-home sleep study may be less than an in-lab study because the in-home study likely does not consider total sleep time.
  • Therefore, the medical examiner should use clinical judgment when interpreting results of an unattended sleep study.
  • If the clinician believes the level of apnea is greater than the level reported by the in-home study, the clinician should consider recommending an in-laboratory sleep study.
 
RECOMMENDATION 6 — Treatment, PAP
  • All individuals with OSA should be referred to a clinician with relevant expertise.
  • PAP is the preferred OSA therapy.
  • Adequate PAP pressure should be established through one of the following:
    • Titration study with polysomnography
    • Auto-titration system
A driver who has been disqualified may be conditionally certified (per Recommendation 4) if successfully treated for 1 week AND
  • The driver can demonstrate at least minimal compliance (4 hrs/use 70% of nights) AND
  • The driver does not report excessive sleepiness during major wake period.
 
RECOMMENDATION 7 — Treatment alternatives
There are limited data regarding compliance with and the long-term efficacy of dental appliances cannot be demonstrated currently, so these technologies are unapproved alternatives at this time.
Surgical treatment is acceptable (see Recommendations 10, 11 and 12).
 
RECOMMENDATION 8 — Bariatric surgery
After bariatric surgery, a driver may be certified if:
  • Compliant with PAP, OR 6 months have passed since surgery (for weight loss), AND
  • Cleared by treating physician, AND
  • No reported excessive sleepiness during major wake period.
  • After six months have passed since surgery, a repeat sleep study may be considered to evaluate for the presence of ongoing sleep apnea.
Annual recertification
  • Maintain stable weight
If clinically indicated, repeat sleep study.
 
RECOMMENDATION 9 — Oropharyngeal surgery, facial bone surgery
After oropharyngeal or facial bone surgery, a driver may be certified if:
  • 1 month has passed since surgery, AND
  • Cleared by treating physician, AND
  • No reported excessive sleepiness during major wake period.
After 1 month has passed since surgery, if the apnea appears to have resolved, a repeat sleep study should be considered to test for the presence of ongoing sleep apnea.
Annual recertification
  • If clinically indicated, repeat sleep study.
 
RECOMMENDATION 10 — Tracheostomy
After tracheostomy, a driver may be certified if:
  • 1 month has passed since surgery, AND
  • Cleared by treating physician, AND
  • No reported excessive sleepiness during major wake period.
After 1 month has passed since surgery, if the apnea appears to have resolved, a repeat sleep study should be considered to test for the presence of ongoing sleep apnea.
Annual recertification
  • If clinically indicated, repeat sleep study.

Drug Testing

 
Trucker Exam Inc. is assisting trucking and transportationclients with achieving their compliance standards for possible Drug testing DOTaudits. As it is the season when the Department of Transportation typicallyaudits start up and establishing trucking companies, Trucker Exam Inc. hasreceived numerous Blogs from transportation companies asking for assistance ingetting them in line with its Drug testing program.
 
This year we have experienced a greater number of signups inthe trucking and transportation industry, said Ted Lopez, Trucker Exam Inc. Director.Transportation companies have a lot of concern about their random drug program
 
Lopez explained that in order to be compliant even thesingle trucker must be a member of a random drug management consortium. Alltransportation must be part of a pool so that is part of a larger group wherehalf the drivers in that group are mandated to take random drug tests at leastonce a year.
 
Call 1-559-431-2648 to sign –up with Trucker Exam Inc.
 
With this  no annual fees on new clients.
 
 
 

PPACA

 
Transportation Companies May Be Affected by PPACA-Related
 
Health Insurance Marketplace Changes
 
Under the Patient Protection and Affordable Care Act(PPACA), employers covered by the Fair Labor Standards Act (FSLA) must providenotification to their employees about other aspects of the new health insurancemarketplace. This generally includes offices that have at least one employeeand conduct a minimum of $500,000 in annual business. Eligible employers--thismay include chiropractic offices--are required to provide this notice to allcurrent employees by Oct. 1 and to each new employee at the time of hirebeginning Oct. 1.
 
Your office may fall under the FLSA even if the gross salesor volume of business does not meet the requisite dollar volume of $500,000annually. Employees may still be covered if they individually engage ininterstate commerce, the production of goods for interstate commerce or in anoccupation closely related and directly essential to such production.Interstate commerce includes such activities as transacting business viainterstate telephone calls or the U. S. Mail (such as handling insuranceclaims), ordering or receiving goods from an out-of-state supplier, or handlingthe accounting or bookkeeping for such activities. It would also include thehandling of credit card transactions since that involves the interstate bankingand finance systems.
The U.S. Department of Labor (DOL) has providedemployers with two sample notices they may use to comply with this rule, onefor employers who do NOT offer a health plan and another for employers who DOoffer a health plan for some or all employees. For more information on whetheryour office falls under this requirement, please click here or refer to DOL'sTechnical Guidance or contact your attorney

Hours-of-ServiceLog book

FMCSA's new hours-of-service final rule:
 
·         Limits themaximum average work week for truck drivers to 70 hours, a decrease from thecurrent maximum of 82 hours;
 
·         Allows truckdrivers who reach the maximum 70 hours of driving within a week to resume ifthey rest for 34 consecutive hours, including at least two nights when theirbody clock demands sleep the most - from 1-5 a.m., and;
 
·         Requirestruck drivers to take a 30-minute break during the first eight hours of ashift.
 
The final rule retains the current 11-hour daily drivinglimit and 14-hour work day.
 
Companies and drivers that commit egregious violations ofthe rule could face the maximum penalties for each offense. Trucking companiesand passenger carriers that allow drivers to exceed driving limits by more thanthree hours could be fined $11,000 per offense, and the drivers themselvescould face civil penalties of up to $2,750 for each offense.
 
Further information, including "Hours-of-ServiceLogbook Examples," is available on FMCSA's web site at www.fmcsa.dot.gov/HOS.
 
 
 
 
 

DOT Medical Exam

 
The staff at Trucker Exam Inc. believes that buildingcollaborative relationships with Transportation industry for the lasts nineteenyears. Our Certified DOT Doctor here to help achieve the best outcomes with truckdriver.
 
One call to our staff at 1.800.542.2225 will tell youeverything you need to know to refer a truck driver to Trucker Exam Inc. and,you can download DOT Medical order form you need right here.
 
Referral / Consult Form Process
 
Test and procedure referral forms are required Trucker Exam Inc.to schedule procedures. These forms must be completed and faxed to Trucker ExamInc. at 1.800.542.2225 Scheduling Center as indicated on each form.
 
 
All referral / consult forms are provided in .pdf format.
 
Offices in:
Fresno Ca , Las Vegas NV, Madera Ca
 

Hours of Service

Federal Register:
76FR 81134
RIN: 2126–AB26  Docket #: FMCSA–2004-19608 49 CFR Part:385, 386, 390, 395
Publication Date:12/27/2011 Effective Date:2/27/2012 Compliance Date: 7/1/2013
Action :Final Rule
 
Summary:
FMCSA revises the hours of service (HOS) regulations to limit the use of the 34-hour restart provision to once every 168 hours and to require that anyone using the 34-hour restart provision have as part of the restart two periods that include 1 a.m. to 5 a.m.
 
It also includes a provision that allows truckers to drive if they have had a break of at least 30 minutes, at a time of their choosing, sometime within the previous 8 hours.
This rule does not include a change to the daily driving limit because the Agency is unable to definitively demonstrate that a 10-hour limit—which it favored in the notice of proposed rulemaking (NPRM)—would have higher net benefits than an 11-hour limit.
 
The current 11-hour limit is therefore unchanged at this time. The 60- and 70-hour limits are also unchanged.
The purpose of the rule is to limit the ability of drivers to work the maximum number of hours currently allowed, or close to the maximum, on a continuing basis to reduce the possibility of driver fatigue.
 
Long daily and weekly hours are associated with an increased risk of crashes and with the chronic health conditions associated with lack of sleep. These changes will affect only the small minority of drivers who regularly work the longer hours.
 

DOT Medical Card Verification

DOT Medical Card Verification
 
The Federal Motor Carrier Safety Administration announced that during “enforcement activities‿ such as roadside inspections it will start validating drivers’ medical cards by contacting the certifying medical examiner to verify a driver’s name and date of birth and the card’s date of issuance and any restrictions it indicates. The FMCSR requires the th DOT medical card to be kept in the DQ file not the long form at present.

The FMCSR has a requirement for the long form and explains to physicians how it must be completed; however, the FMCSR does not address how the long form will be stored once it's filled We are waiting to see how the National Board of Physicians pans out as I know that doctors spend less than five minutes with a patient that most work is done by staff.  
 
 
 
 FMCSA Refocusing Their Attention With New Safety Audit Procedures

Asthma

Asthma is a common disease. Individuals with asthma generally exhibit reversible airway obstruction that can be treated effectively with pharmaceutical agents such as bronchodilators and corticosteroids; however, asthma ranges in severity from essentially asymptomatic to potentially fatal.
In some drivers, complications of asthma and/or side effects of therapy may interfere with safe driving. You are responsible on a case-by-case basis for ensuring that the driver is medically fit for duty.

CDL Medical Exam

MEDICAL QUALIFICATIONS FOR COMMERCIAL DRIVERS LICENSE (CDL).

A person shall not drive a commercial motor vehicle unless he/she is physically qualified to do so and, except as provided in §391.67, must have on his/her person
the original, or a photographic copy, of a medical examiner's certificate to show that he/she is physically qualified to drive a commercial motor vehicle.

For more detailed information, please refer to the following:

Regulations
 

No texting while driving

                                  No texting  while driving
CMV drivers are prohibited from testing while driving. So what qualifies as testing? Texting means manually entering alphanumeric text into, or reading text from, an electronic device. This includes, but is not limited to, short message service, e-mailing, instant messaging, a command or request to access a Web page, or pressing more than a single button to initiator terminate a voice communication using a mobile phone.
Use of mobile phones is restricted for CVM drivers
This ruling restricts a CVM driver from reaching for or holding a mobile phone to conduct a voice communication, as well as dialing by pressing more than a single button. CVM drivers who use a mobile phone while driving can only operate a hands-free phone located in close proximity. Inshore, the rule prohibits unsafely reaching for a device, holding a mobile phone, or pressing multiple buttons.
What happens if a driver is caught using a hand-held phone or texting while driving?
The rules impose sanctions for driver offenses, including civil penalties up to $2,750 and disqualification for multiple offenses. Motor carriers are also prohibited from requiring or allowing their drivers to text or use a hand-held mobile phone while driving and may be subject to civil penalties up to $11,000. Violations will impact ISMS results. Texting and calling on a hand-held phone carry the worst possible violation severity weights against a driver’s results!
 

Hearing Standards Exemption

 
 
The Federal Motor Carrier Safety Administration has granted the first exemption to rules for interstate commercial drivers when it comes to hearing standards.
 
Forty individuals received permission to operate commercial vehicles in interstate commerce effective last Friday. It’s good for two years and may be renewed.
The request was made of the agency last May, with comments taken until the end of July. FMCSA received 570 responses.
 
Several of the applicants had previous experience driving interstate and became unable to pass the required hearing test, while others had been involved in intrastate commerce, were bus drivers, had driven smaller commercial vehicles or were looking to become first-time truckers.
 
In announcing its decisions, the FMCSA said “granting exemptions for these CMV (commercial motor vehicle) drivers will provide a level of safety that is equivalent to or greater than the level of safety maintained without the exemptions.
Current FMCSA standards for hearing were adopted more than 40 years ago.
The applicants received assistance from the National Association of the Deaf. The association cited and FMCSA Medical Review Board study from 2008 that examined the relationship between hearing loss and crash risk exclusively among CMV drivers, as well as evidence from studies of the private bus driver license holder population, saying these studies do not support the contention that individuals with hearing impairment are at an increased risk for crash.
For the rest of the story:cal 800.542.2225

NRCME News:

 
 
NRCME News:  

NRCME announces that there is a new Hearing Exemption that has been added to the insulin, vision, and Epilepsy/Seizure exemption programs.  Certain drivers that do not meet the hearing standard in either ear may apply for the hearing exemption.  The phone number for criteria used for those who may apply to either the hearing or seizure exemptions is thru the Medical Programs phone number at 202-366-4001.  The insulin and vision exemption program contact number is still 703-448-3094.

Who can perform FMCSA medical examinations for CMV drivers?

 
Who can perform FMCSA medical examinations for CMV drivers?

FMCSA's current regulations require that all MEs be licensed, certified, and/or registered in accordance with applicable State laws and regulations to perform physical examinations. This includes but is not limited to doctors of medicine, doctors of osteopathy, physician assistants, advanced practice nurses, and doctors of chiropractic.

MEs must be knowledgeable of the specific physical and mental demands associated with operating a CMV and the requirements of Section 391.43(c), including the medical advisory criteria prepared by the FMCSA as guidelines to aid the medical examiner in making the individual determination whether a driver should be issued a medical certificate, and be proficient in following the medical protocols necessary to adequately perform the medical examination.

Beginning May 21, 2014, all MEs who wish to conduct medical examinations for interstate CMV drivers must complete training about FMCSA's physical qualifications regulations and advisory criteria and pass a certification test to be listed on the National Registry of Certified Medical Examiners. All medical certificates issued on or after this date must be issued by examiners listed on the National Registry of Certified Medical Examiners.

National Transportation Safety Board (NTSB)

 
 
Are there any National Transportation Safety Board (NTSB) recommendations related to the establishment of the National Registry of Certified Medical Examiners?

The National Registry final rule addresses four NTSB recommendations on a comprehensive medical oversight program for interstate drivers that include the following elements:
  • Individuals performing medical examinations for drivers are qualified to do so and are educated about occupational issues for drivers (H-01-017);
  • A tracking mechanism is established that ensures that every prior application by an individual for medical certification is recorded and reviewed. (H-01-018);
  • Medical certification regulations are updated periodically to permit trained examiners to clearly determine whether drivers with common medical conditions should be issued a medical certificate. (H-01-019); and
  • Individuals performing examinations have specific guidance and a readily identifiable source of information for questions on such examinations (H-01-020).
FMCSA staff will meet with NTSB staff to provide a briefing on the rule. The Agency will provide any additional technical assistance necessary for the NTSB to determine whether the recommendations have been satisfied through the rulemaking.

Why is the National Registry necessary?

 
Why is the National Registry necessary?
FMCSA developed the National Registry of Certified Medical Examiners final rule as part of the agency's commitment to enhancing the medical oversight of interstate drivers, and preventing commercial vehicle-related crashes, injuries and fatalities. The final rule addresses four NTSB recommendations on a comprehensive medical oversight program for interstate drivers.

Who is impacted by this program?
The program impacts medical examiners who need to obtain certification in order to continue issuing medical certificates for truck and bus drivers, CMV drivers who need to obtain medical certificates from examiners on the National Registry, motor carriers who must ensure their interstate drivers have been medically certified by an examiner on the registry, and training and testing organizations that will deliver these aspects of the program.

What is the National Registry of Certified Medical Examiners?

 
 
 
What is the National Registry of Certified Medical Examiners?

The National Registry of Certified Medical Examiners (National Registry) is a Federal program that establishes requirements for healthcare professionals that perform physical qualification examinations for truck and bus drivers.

To become a certified medical examiner (ME) and be listed on the National Registry, healthcare professionals must complete training and testing on the Federal Motor Carrier Safety Administration's (FMCSA) physical qualifications standards and guidelines. The National Registry web site is accessible to carriers, drivers, enforcement officials, and the general public.

All healthcare professionals whose scope of practice authorizes them to perform physical examinations, as defined by the state in which they practice, and who intend to perform physical examinations and issue medical certificates for commercial motor vehicle (CMV) drivers to meet the requirements of Section 391.41 of the Federal Motor Carrier Safety Regulations (FMCSRs) must be certified and listed on FMCSA's National Registry by May 21, 2014.

Disqualify DOT Medical Exam

A medical examiner, you must disqualify the driver who does not meet one or more of 49 CFR 391.41 physical qualification standards. You should complete the physical examination of the driver and discuss with him/her the reason(s) for disqualification and any steps that can be taken to meet certification standards.
 
Disqualify — Discuss and Document Decision
 
  Regulations — Disqualify driver who does not meet standards
As a medical examiner, you must disqualify the driver who:
  • Fails to meet a physical qualification requirement cited in the standards (e.g., vision test result, hearing loss test result, epilepsy, or insulin use).
  • You believe has a medical condition that endangers the health and safety of the driver and the public.

Medical Certification FAQ: Part Threeof Three Parts

 
Medical Certification FAQ: Part Threeof Three Parts:
 
Once I provide the driver licenseagency with my medical examiner certification, will I still need to carry mymedical card?
 
Yes. Driversare currently still required to carry their medical certification with themwhen operating a commercial motor vehicle.
 
I am an independent operator who worksfor two different companies, a long haul trucking firm and a company involvedin Apiarian Industries (beekeepers seasonally transporting bees – exempt fromproviding medical certification). Which category should I certify under?
 
Since youwill be operating, at times, in non-excepted interstate commerce for a longhaul trucking firm, you must certify in Category A – Non-excepted Interstate,and you must have a medical certificate.
 
I am a CDL holder in the military whohas been deployed overseas and my medical certificate is going to expire priorto my return. What will I need to do?
 
All CDLholders required to have a valid medical certificate must comply with theregulations in Part 383. The regulations provide no exceptions to servicemembers on active deployment. If a service member can provide an acceptablemedical certificate, his/her medical certification will continue. Otherwise, the state will have to begin thedowngrade process.
 

Medical Certification FAQ: Part Two of Three Parts

 
Medical Certification FAQ: Part Two of Three Parts:
 
If my current job only requires me tooperate intrastate, but I want the option to operate interstate, can I certifyin Category A instead of C as long as I have a current medical card?
 
Driversoperating only in intrastate commerce are advised to consider self-certifyingin the non-excepted interstate category (Category A) if eligible. Drivers noteligible to certify in Category A include drivers under 21 years of age anddrivers with certain medical conditions who do not have a federally issuedmedical variance. Drivers self-certifying in Category C who are not eligible toself-certify in Category A will have restrictions to intrastate commerce placedon their CDL
 
I recently renewed my license and wasrequired to provide medical certification at that time. My CDL is valid until2015, but my medical card expires in 2012. Will I be required to submit a newmedical card before my next renewal?
 
Yes. You arerequired to maintain current medical documentation on file. Failure to do somay result in CDL disqualification.
 

Medical Certification FAQ: Part One ofThree Parts

 
Medical Certification FAQ: Part One ofThree Parts:
 
My CDL expires soon. What will I needto renew my license?
 
Federal MotorCarrier Safety Regulations now require all drivers obtaining an original CDL,or renewing their CDL, to certify with the driver license office in one of fourcategories. Drivers certifying in non-excepted interstate or non-exceptedintrastate commerce must also provide valid medical documentation.Certification categories are listed above.
 
My CDL is valid until 2015 and I havea current medical card. With the new requirements, is there anything else Ihave to do?
 
All CDLholders will be required to self-certify prior to January 31, 2014. You will benotified of the new requirements and provided with instructions. Thenotification process will be phased in over several months, starting in July2012, to allow drivers time to comply by the January 2014, deadlineam not currently using my CDL and donot have a current medical card.
 
I want to keep my commercial licensein case I hire on with a company that may require me to have one. What do Ineed to do?
 
CDL holderscan no longer claim exemption from medical certification requirements becausethey are not currently operating in non-excepted interstate or intrastatecommerce. If not specifically included in category B or D, you must maintain yourmedical certification or downgrade to a non-commercial license. If youdowngrade to a non-commercial license and later need to upgrade back to acommercial license, you may do so without additional testing.
 

Certify with the driver license

Federal Motor Carrier Safety Regulations require all Commercial Driver License holders to certify with the State’s Driver License Agency in one of the four categories below prior to the issuance or renewal of a CDL. Those certifying in non-excepted interstate or intrastate commerce (Category A or C) must also ensure their medical documentation is on file with the state issuing agency and that it remains current. Failure to present valid medical documentation, when required, will result in the denial of the issuance or renewal of the CDL. Failure to maintain current medical documentation on file may result in CDL disqualification.
  1. Non-excepted Interstate - I operate or expect to operate in interstate commerce and am required to maintain federal medical certification. (Medical Card Required)
  2. Excepted Interstate - I operate or expect to operate in interstate commerce, but engage exclusively in operations that qualify me for exception from the requirement to maintain federal medical certification.
  3. Non-excepted Intrastate - I operate or expect to operate only in intrastate commerce and am required to meet state of Florida medical certification requirements. (Medical Card Required)
  4. Excepted Intrastate - I operate or expect to operate only in intrastate commerce, but engage exclusively in operations that qualify me for exception from state of Florida medical certification requirements.
-
CDL holders can no longer claim exemption from medical certification requirements because they are not currently operating in non-excepted interstate or intrastate commerce. If not specifically included in category B or D above, they must maintain their medical certification or downgrade to a non-commercial license.
Note: If you self-certify in a category exempt from medical certification requirements (Category B or D) and later change to a non-exempt type of operation (Category A or C), you must recertify in the appropriate category and provide proof of valid medical certification to avoid potential enforcement actions.
Start of FAQ section
Medical Certification FAQ
  • My CDL expires soon. What will I need to renew my license?
  •  
    Federal Motor Carrier Safety Regulations now require all drivers obtaining an original CDL, or renewing their CDL, to certify with the driver license office in one of four categories. Drivers certifying in non-excepted interstate or non-excepted intrastate commerce must also provide valid medical documentation. Certification categories are listed above.

    Alcoholism

                                                                  Alcoholism
     
    When an interstate driver tests positive for alcohol or controlled substances under Part 382, the driver is not required to be medically re-examined or to obtain a new medical examiner’s certificate provided the driver is seen by a SAP who evaluates the driver and does not make a clinical diagnosis of alcoholism. The SAP provides the driver with documentation allowing the driver to return to work.
     
    If the SAP determines that alcoholism exists, the driver is not qualified to drive a commercial motor vehicle in interstate commerce. The ultimate responsibility rests with the motor carrier to ensure the driver is medically qualified and to determine whether a new medical examination should be completed.

    Transient Ischemic Attack :

    Transient Ischemic Attack :
     
    A transient ischemic attack (TIA) is an episode of focal neurological dysfunction reflecting inadequate blood supply to one portion of the brain. The attack usually lasts more than a few seconds but less than 20 minutes. In exceptional cases, the symptoms can persist up to 24 hours. Resolution of symptoms is complete.
     
    At the time of physical examination, the driver is usually normal; however, a TIA episode is an important warning for a potentially severe stroke or other vascular event. The risk of recurrent events is highest during the first few weeks and months following the TIA, declining by year 1 to less than 5% per year. The risk of recurrent strokes may be lowered by medical or surgical interventions.
     
    The medical examiner determines certification on a case-by-case basis considering the interval history, general health, neurological examination, and compliance with the treatment program.

    Blood

     Driver,
     
    What are the guidelines for Blood disease and Sickle trait?
     
     There are no specificregulations relating to Blood disease. As with any chronic disease, your medical examiner needs to make thedetermination based on knowledge of the work of commercial driving and whetherthe condition interferes with those tasks and responsibilities or safeoperation of a commercial motor vehicle.
     
    This may require interpretation of blood work, e.g. anemia,letters from PMDs and specialists treating the driver, and consideration of any additional diagnostic testing needed.
     
     You may recieve a two medical certicate
     

    Documents to Carry:

    Documents to Carry:
    To operate commercial vehicles in California, the following documents must be carried and shown to enforcement personnel when requested:
    • Drivers license documents and any related certificates.
    • Registration documents (cab cards, permits, etc.).
    • Proof of insurance.
    • Special permits for oversize and overweight loads, if required.
    • Hazardous materials shipping papers, if required.
    • Fuel tax permits.
    • Hours of service records (log book).
    • Bills/Invoices etc. showing content and origin of agricultural products, if required.
    • Proof of sales tax payment if applicable.
    Evidence of Financial Responsibility -- U.S. Domiciled Carriers: Proof of the required financial responsibility, such as the MCS 90 or the MCS 82, shall be maintained at the motor carrier's principal place of business.
    The display of any one of the following identifiers on a commercial motor vehicle shall be considered acceptable evidence of financial responsibility:
    • A valid TCP or PSC number issued by the California Public Utilities Commission (CPUC) for passenger carriers.
    • A CA number issued by the CHP and displayed by the holder of a Valid Motor Carrier Permit (MCP) whose name or logo is displayed on the vehicle or combination of vehicles.
    • A valid MC or MX number issued by the Federal Motor Carrier Safety Administration (FMCSA).
    Evidence of Financial Responsibility -- Foreign domiciled carriers (Mexican & Canadian): Proof of the required financial responsibility, such as the MCS 90 or the MCS 82, shall be maintained in each vehicle operated in the United States

    DOT Medical exam stringent requirements

    Safety Manger,
     
    Motor carriers can have more stringent requirements of drivers than what are outlined in the FMCSA regulations--what do you think of this:

    One of our trucking company will not accept any drivers that do not qualify for for a 2 year card.  The patient was a recertification and presented with Stage 2 HTN.  I gave him a 3 month card and advise he see his medical provider and bring documentation.  He came back a week later with a note and on anti hypertensive meds.   He said if he did not get a 2 year card he would lose his job.  I called the company and they confirmed that they will not have a driver if he cannot qualify for a 2 year card regardless. Is this legal?

    As to the legality of requiring drivers to have a two year certification, well first of all, you should certainly not certify a driver for 2 yrs with stage 2 HTN. Motor carriers may impose more stringent requirements on drivers above and beyond that required for FMCSA certification. To supersede ADA laws, they would have to show that this is necessary for safety reasons, and not be arbitrary just to avoid having unhealthy workers. This would violate the spirit of the ADA. Legal advice can only weigh in all the factors, and we are not attorneys.

    The EEOC (Equal Employment Opportunity Commission) has lawyers on call to answer these types of questions, available in every metropolitan area, just goggle for your area for your local EEOC office.
     

    truck Accident

    Most states require you to file an accident report form at your DMV or other state driver license or motor vehicle agency (for purposes of this grid, “DMV” covers all those) or law enforcement agency following a car accident. Many states provide the forms online or in your local office, but you might need to obtain one from the police or your insurance agency.

    Each state sets its own accident criteria (i.e. how much property damage, whether an injury or death occurred) and the amount of time you have to file the accident report form. Be sure to file within that time period; otherwise, you could face penalties such as fines or license suspension.

    Note that even if the grid doesn’t mark the police for your state, you might still be required to contact them immediately following a car crash.

    Check for your state in the grid below.

    ExcludeStart:
     
    Alabama    Submit SR-13 to DPS with 30 days if there was death, personal injury, or more than $250 in damages. Alaska    Mail or submit online the Motor Vehicle Accident Form to the DMV within 10 days; submit a Certificate of Insurance to the DMV if there's $501 or more in damages. Arizona    Only if there's injury/death. Arkansas    Submit SR-1 if injury/death/$1,000 or more in damages. California    Submit SR-1 to the DMV if there's $750 or more in damages. The police and your insurance agent might require a copy. Colorado    Mail or submit online all accidents. The police might notify the DMV for you. Connecticut    The CT DMV no longer handles accident reporting; obtain a copy already prepared by involved police officer. Delaware    If more than $500 damages, injuries, deaths, or DUIs. Obtain a report from your insurance company. Florida    File with police if $500 in damages, injury, or death; file with DMV if there's no police report. Georgia    Contact police if there's $500 or more in damages, injuries, or death. Create a Personal Accident Report for your records. Hawaii    If there's more than $3,000 damages, injury, or death. Idaho    If $1,500 or more in damages, injury, or death. Illinois    Report all accidents to the DOT; those with $1,500 or more in damages, injury, or death to police. Indiana    If $1,000 or more in damages. Iowa    Report $1,000 or more in damages, injury, or death to DOT within 72 hours; obtain form from police, who may also file. Kansas    If $1,000 in damages, injury, or death. Kentucky    If $500 or more in damages, injury, or death; must be state police. Louisiana    Report all accidents. Maine    If $1,000 or more in damages, injury, or death. Maryland    Report injuries and death to police; report injuries to the MVA within 15 days; don't report if only property damage. Massachusetts    If $1,000 or more in damages, injury, or death; always file with DMV, police presence or not. Michigan    If $1,000 or more in damages, injury, or death. Minnesota    Report property damage to police; injury and death to police. Mississippi    Missouri    Within 30 days if $500 in damages, injury, or death. Montana
      In municipality, report to police $500 or more damage, injury, death; outside municipality, report to Highway Patrol $1,000 or more damage, injury, or death. Nebraska 
      If $1,000 or more in damages, injury, or death. Nevada    Within 10 days if $750 or more in damages, injury, or death. New Hampshire    Within 15 days if $1,000 or more in damages, injury, or death. New Jersey    MVC if less than $500 in damages and no injury or death; police if more than $500 in damages, injury, or death. NewMexico    Within 5 days if $500 or more in damages, injury, or death. New York    Within 10 days if more than $1,000 in damages; police if injury or death. NorthCarolina    If $1,000 or more in damages, injury, or death. North Dakota    If $1,000 or more in damages, injury, or death. Ohio    Within 6 months if $400 or more in damages, injury, death, or if an uninsured driver is involved. Oklahoma    If $300 or more in damages, injury , or death. Oregon    If $1,500 or more in damages, injury, or death. Pennsylvania    If there's injury, death, or vehicles that can't be driven from the scene. Rhode Island    If $1,000 or more in damages, injury, or death. South Carolina     If $1,000 or more in damages, injury, or death. South Dakota    If $1,000 or more in damages, injury, or death. Tennessee    Within 20 days if $400 or more in damages, injury, or death. Texas    Within 10 days if $1,000 or more in damages, injury, or death and the police didn't file. Utah    If $1,000 or more in damages, injury, or death and the police didn't file. Vermont    If $1,000 or more in damages, injury, or death. Virginia    If $1,000 or more in damages, injury, or death. Washington    Within 4 days if police don't file; $700 or more in damages, injury, or death. West Virginia    Within 10 days if police don't file; $500 or more in damages, injury, or death. Wisconsin    Within 10 days if police don't file; $1,000 or more in damages, injury, or death. Wyoming    If $1,000 or more in damages, injury, or death. Washington DC
     

    Is there a special form for the DOT physical?

    Yes, your examination results need to be recorded on a DOT Medical form by a certified licensed medical examiner. This includes a doctor of medicine (MD), physician assistant (PA), advanced practice nurse (APN), doctor of osteopathy (DO) or doctor of chiropractic (DC).

    Most doctor offices have these forms. However, just to be sure, you can download your DOT medical exam form from various sources on line (including the federal government) and take it with you to the doctor's office.

    You must pass the DOT physical in order to qualify for a CDL as your health plays a pivotal factor in driving safety, especially considering the vehicles you'll be driving.

    Medical Exam Requirements

    Medical Exam Requirements:
     
    Before you can become a California CDL driver, you have to be certified medically fit by a medical exam. Your doctor, physician's assistant, or nurse practitioner must sign the medical form. Take the form to the CA DMV when you apply for a CDL.
    The medical conditions that may prohibit you from driving a commercial vehicle include anything that could impair your ability to drive safely, such as:
    • Mental disorders that might prevent you from driving safely.
    • Vision of less than 20/40 with corrective lenses.
    • Diabetes.
    • Seizure history.
    • Unconsciousness disorders.
    • Impaired hearing.
    • Impairments of the hands that prevent you from grasping.
    • Alcoholism (as diagnosed by the doctor).
    Be aware this isn't an all-encompassing list; there may be additional disorders which will prevent you from getting a commercial license.

    High Blood Pressure-FMCSA

     
    Question:
     
    Drivers -- When you go back for a re-certification check during a 1-time, 3-month certificate for HBP what paperwork is required to be completed?  Do you complete the medical examination Report Form or what do you do since a full physical is not being completed? You need to know this information. It will save you money so you will not get charges for two CDL medical EXAMS.
     
    FMCSA guidelines:
     
     In a driver whose BP is greater than 140/90 but less than 160/100, a one-time certificate for 3months can be issued. An individual diagnosed with Stage 2 (BP is160/100-179/109) should be treated and a one-time certificate for 3-month certification can be issued. Once the driver has reduced his or her BP to equal to or less than 140/90, he or she may be re certified annually thereafter. An individual diagnosed with Stage 3 hypertension (BP equal to or greater than180/110) should not be certified until his or her BP is reduced to 140/90 or less, and may be re certified every 6 months."
     
    Answer:
     
     When they come in for the 6 month re- certifications for stage 3 HBP, you do a complete recertification exam on a new exam form.
     
    For a one-time 3 month certificate, you don't need to complete an entire new physical.  In the comments section of the original exam put in the date of the recheck visit,updated BP readings, document any interim diagnostics, notes from MD,specialists, etc., and note (if BP now below 140/90) that you are issuing a tone-year certificate from the date of the original exam. Driver that whole a CDL licenses from the state of California a new exam form musts be done on a three month certificate.
     
     
     
     
     
     
     
     
     
     
     
     
     

    Personality Disorders:

                                                                FMCSA
    Personality Disorders:
     
    Any Truck Driver that has a personality disorder characterized by excessive, aggressive, or impulsive behaviors warrants further inquiry for risk assessment to establish whether such traits are serious enough to adversely affect behavior in a manner that interferes with safe driving.
     
     
     A person is medially unqualified if the disorder is severe enough to have repeatedly been manifested by overt acts that interfere with safe operation of a commercial vehicle.
     
    NOTE: Alcohol and drug dependency and abuse are profound risk factors in the presence of personality disorder
     
     The doctor must not certify the driver until the etiology is confirmed and treatment has been shown to be adequate/effective, safe, and stable. Than you the driver may be certify for one year.
     
     The driver:
     
    Complies with treatment program.
     
    Tolerates treatment without disqualifying side effects(e.g., sedation or impaired coordination).
     
    Has a comprehensive evaluation from an appropriate mental health professional who understands the functions and demands of commercial driving.
     
     
     
     
     

    Resolution of conflicts of medical evaluation

     
    Safety Department,
     
     (Q) Is it real smart to have your company doctor to do a CDL Medical Exam or should you set up a panel of certify CDL doctors and establish a national doctor list?
     
    CDL Medical exam must be a non-bias exam in which the doctor musts follow the medical guidelines  that the FMCSA put forward.
     
    (A)  Let me answer this question for you. The trend in the transportation industry is to establish medical panels of certify DOT doctors in each state, in which the driver pays for his own medical CDL medical exam (company may repay the driver for CDL medical exam). It appears that when the company doctor does the CDL Medical exam that this could be a conflict of interests of the medical evaluation. That is if you only send all your drivers to one medical group. If the Driver disagree with the results on his/her CDL Medical Exam.The driver can requests’ a conflict of medical evaluation.
     
    To resolve this problem have the driver go to a DOT certify doctor that they pick from your panel lists of doctors.
     
    Trucker Exam Inc. wants to be on your panel.
     
    Goggle - § 391.47 Resolution of conflicts of medical evaluation
     

    Free screenings for Truck Driver

    medical exam
     
    **Free screenings will be available to participant’s truck drives at Trucker Exam Inc. at the E-Z Trip Truck Stop in Fresno California, checking blood glucose levels for diabetes,blood pressure checking for CVD, a pulse ox for lung disorder , eye check’s and a Sleep Apnea screening.  These are five are most reason that truck driver fail their CDL medical Exam.
     
    Dr. Edwards can send you out for a low-cost for comprehensive metabolic profile and lipid panel and include: cholesterol,triglycerides, HDL, LDL, coronary risk ratio, calcium, alkaline, phosphatase,glucose, ALT, AST, bilirubin, BUN, creatinine, albumin, sodium, potassium, and chloride. Thyroid (TSH) .
     
    Prostatic Specific Antigen (PSA) is also available for an additional charge. It is recommended for men over the age of 50 or a man who is 40 with a family history of prostate cancer.
     
      As a service to the transportation industry Trucker Exam Inc. will be glad to screen any trucker driver at no costs to them.  Dr. Edwards’s goal is to promote good health with in the trucking industry. Dr Edwards feels that we have healthy drivers this will help the safety on our highways across the nation. It will also help prolong the life of our truck driver who provide a great services to our nation.
     
                                          Call 1.800.542.2225
     
                          **Free services are provide if time aloud .Walk in will been seen as soon as possible
     

    Diabetes

     
                                                  Diabetes
     
    Drivers,
     
    An incretin mimetic, such as exenatide (Byetta), is used toimprove glycemic control in people with Type 2 diabetes by reducing fasting andpostprandial glucose concentrations. An incretin mimetic is indicated asadjunctive therapy todrivers  who are takingmetformin or a combination of other oral agents. Use of an incretin mimetic inconjunction with a sulfonylurea has an increased risk of hypoglycemia.
     
    Incretin mimetics are not insulin and can be used without anexemption.
     

    Alcoholism:

     
    Alcoholism:
     
    If the driver has current clinical diagnosis of alcoholism amedical examiner, make the final determination as to whether the driver meetsthe Federal Motor Carrier Safety Administration (FMCSA) medical standards fordriver certification.
     
    If the driver shows signs of alcoholism, have the driverconsult a specialist for further evaluation.
     
    You may be tested for alcohol is warranted, contact FMCSA orcontact the employer of the driver directly for information on controlledsubstances and alcohol testing under Part 382 of the Federal Motor CarrierSafety Regulations.
     
     As a driver MUSTsubmit to alcohol testing if there is reasonable suspicion that the U.S.Department of Transportation (DOT) prohibitions concerning alcohol areviolated. Suspicion MUST be based on specific observations concerning driverbehavior, speech, or body odor.