For many drivers, the DOT physical examination is far from a routine, biannual inconvenience. Trucking careers have been suspended, temporarily and permanently, due to negative results on medical exams. While it is never good for a driver to lose a livelihood over a medical exam, failure often motivates drivers to get treatment for conditions or to take better care of themselves. Whether temporary or permanent, it is sometimes safer for the driver and for the motoring public to disqualify the driver from operating a commercial motor vehicle. Fortunately, the FMCSA grants waivers or exemptions for some conditions and has, in recent years, changed the qualification criteria for other conditions.
Many medical conditions aren’t “black and white.” A person who is blind, for example, will obviously not be allowed to operate a vehicle, at least not until vehicles are completely autonomous and “operating” one is a matter of telling it where you want to go. There are many people, however, who can see, just not as well as others. Some have a vision deficiency in one eye, some are color-blind, some have depth perception issues. In the past, any of these might have disqualified a driver. Fortunately, the FMCSA has some programs that help make it possible for some drivers who may not have qualified in the past to get to work driving.
In the case of vision, a rules revision published in January 2022 made it possible for some with monocular vision to get back on the road. The revision involves the driver’s Ophthalmologist or Optometrist, who completes a Vision Evaluation Report, MCSA-5871, which is then provided to the medical examiner who performs the DOT physical. The form is good for 45 days, any longer and the driver must be re-evaluated.
The driver does not have to be blind in one eye to be considered to have monocular vision. It is only necessary that vision in the worse eye isn’t good enough to meet the FMCSA standard, with or without glasses. The revised regulation introduced an Alternative Vision Standard that requires the driver to have at least 20/40 vision in the good eye, at least a 70-degree field of vision and no color-blindness. Additionally, the vision deficiency must be stable, not deteriorating further, and enough time must have gone by to allow the driver to “adapt to and compensate for” the change in vision.
If the driver qualifies for the first time under the alternative vision standard, they must first pass a road test before being allowed to drive a commercial motor vehicle. The employer can administer the test and must issue a certificate of road test to the driver once passed.
Diabetes is another condition that has plagued drivers for decades. In the past, people with Type I diabetes who were dependent upon insulin to control the disease were prohibited from driving. The sedentary lifestyle of many trucking positions along with poor diet and lack of exercise often leads to weight gain for many drivers, leading some to Type II diabetes. As the disease got worse, drivers used diet and oral medications to try to control blood glucose, but insulin injections became the norm for some. They were also disqualified, although they could request a waiver under some conditions.
The rules were changed September 19, 2018. The changes apply to insulin-treated diabetes mellitus individuals. The new rules allowed medical examiners to determine if drivers were qualified based on whether their diabetic condition was controlled. The need to request a waiver from the rules was eliminated. The process requires the involvement of the clinician who is treating the driver for diabetes, who monitors blood sugar and other factors and completes an Insulin Treated Diabetes Mellitus (ITDM) Assessment Form, MCSA-5870. This form is then submitted to the medical examiner who performs the DOT physical exam. The goal of both the treatment and the exam is to make sure that the diabetic condition is controlled. If insulin is used, the regimen must be stable.
Diabetics are familiar with checking and recording their blood glucose levels, and these tests are an important part of the process. The treating clinician must, by regulation, have access to these records from an electronically downloadable glucometer. The glucose readings must consistently be within parameters. Three months of records must be provided to obtain a one-year medical certification. If less than three months is submitted, the certifying physician may only qualify the driver for three months.
Severe hypoglycemic (low blood sugar) episodes that result in passing out, seizure or coma will be cause for disqualification. Another diabetic condition, diabetic retinopathy (damage to the retinas) can also result in disqualification.
It isn’t a recent development, but the FMCSA Skill Performance Evaluation Program is for drivers who have missing or impaired limbs who have been fitted with prosthetic devices. Drivers may apply for themselves or jointly with a carrier that intends to employ them. Medical evaluation and road testing will be necessary.
More information about the SEP, including contact information for SPE Service Centers for each region can be found here
While the rules on deafness and seizures from conditions like epilepsy still disqualify drivers, it’s possible for some to obtain waivers to continue driving. A driver can apply for an exemption from the hearing or seizure standards by completing the appropriate application along with a medical release form. Because a waiver is an exception to federal law, the request undergoes a process similar to that of any proposed regulation or revision. The action, including the driver’s name and other information, is published in the federal register and time is allowed for evidence and comment submission.
More information about exemption applications and explanations of vision and seizure requirements, click here.
There are also occasional FMCSA pilot programs to evaluate the performance of drivers with other conditions. Check the FMCSA website to see if you qualify.
It’s important to remember that FMCSA waivers and exemptions only apply to interstate trucking. Intrastate is governed by the individual states, where rules can be tougher or more lenient than federal standards.
Cliff Abbott is an experienced commercial vehicle driver and owner-operator who still holds a CDL in his home state of Alabama. In nearly 40 years in trucking, he’s been an instructor and trainer and has managed safety and recruiting operations for several carriers. Having never lost his love of the road, Cliff has written a book and hundreds of songs and has been writing for The Trucker for more than a decade.
