1. If you disqualify a driver, and in 3-6 months they are able to return to work, present all documentation needed, and qualify. Do I date the card for the day they come back or retro it? (I dated it for the day they came back, was this correct?)
It is the medical examiner’s discretion as to whether or not to order pulmonary function testing in an asthmatic, depending on the degree of symptoms and control, but yes, generally you would order a pulmonary function test to check FEV1.
Cardiovascular questions that come up on DOT exams:
With history of unrepaired aortic aneurysm or thoracic aneurysm, am I to require ultrasound at the yearly recert? what about echocardiogram every 2-3 years with aortic valve replacement?
There are multiple medical program resources for your motor carrier clients and commercial driver examinees available on the FMCSA website.
Sorry for the hiatus, folks. I’m wearing the new hat of COO/CMO of ASAP Urgent Care, a start up with plans to open new UCCs in the northeast, so my blogging and article writing has been on a bit of a standby.
Except where absolute criteria exist (i.e., a current clinical diagnosis of alcoholism), as a medical examiner, you make the final determination as to whether the driver meets the Federal Motor Carrier Safety Administration (FMCSA) medical standards for driver certification. Use whatever tools or additional assessments you feel are necessary. If the driver shows signs of alcoholism, have the driver consult a specialist for further evaluation.
Here’s a question about diabetes exemption in DOT Commercial driver from one of our NRCME training program students:
Part of the work we do in urgent care is providing screenings, assessments and physical exams for particular purposes where no physician-patient relationship exists, such as for pre-placement or other work-related exams. Invariably, though, some of these folks are going to ask you for…
A waiver is temporary regulatory relief from one or more of the FMCSRs given to a person subject to the regulations, or a person who intends to engage in an activity that would be subject to the regulations. A waiver provides the person with relief from the regulation for up to three months. 49 CFR 391.64 provides waivers to CMV drivers who were in the initial vision and insulin programs in the early 1990’s.
Why are the diagnosis and treatment of hypertension important?
These criteria are important because there is strong prospective, randomized clinical-trial evidence that hypertension markedly increases the risk of cardiovascular disease and that effective treatment reduces cardiovascular morbidity and mortality. To be certified to drive, the driver should have ongoing hypertension management and be free of side effects that may impair safe driving.