Thanks for revealing your personal information which many of us find relevant in the performance of our day to day driving duties.
The following lengthy but useful info may clarify other health issuesfor the EO members.
Guidance from the Federal Highway Administration
Most primary care physicians are familiar with the physical examination form published in the FMCSRs. This form, which contains brief instructions for performing the certification examination, is used almost universally, even though it was published only as an example. Physicians may devise their own examination form if it covers at least the same information as the published form.
The FMCSRs also list 13 conditions that can disallow driver certification. Four of these conditions always require denial of certification: insulin-treated diabetes mellitus, seizure disorders, significant vision deficits and significant hearing deficits. The 13 sections of the regulations are summarized in Table 1.1,3-8 Detailed regulatory criteria statements on each of these conditions are available from the Federal Highway Administration (FHWA).
TABLE 1
Summary of Federal Motor Carriers Safety Regulations, Regulatory Criteria and Reports of Expert Panels
Condition
--------------------------------------------------------------------------------
Recommendation
--------------------------------------------------------------------------------
Loss of foot, leg, hand or arm
The driver is medically disqualified unless a waiver has been obtained from the regional director of motor carriers. If the driver is otherwise medically qualified, the examining physician should check the statement "medically unqualified unless accompanied by a waiver" on the examination form and certificate.
Impairments of hand or lower extremity
Any significant limb defect that interferes with the ability to perform tasks associated with operating a motor vehicle is disqualifying or requires a waiver (e.g., fused or immobile knee or hip, partial paralysis, etc.).
Insulin-controlled diabetes
A driver taking insulin cannot be certified for interstate driving. However, a driver who has diabetes that is controlled by oral medications and diet may be qualified if the disease is well controlled and the driver is under medical supervision. Documentation from the driver's physician should be obtained. If diabetes is untreated or uncontrolled, certification should not be given.
Current diagnosis of cardiovascular disease
Any condition known to be accompanied by sudden and unexpected syncope, collapse or congestive heart failure is disqualifying. Conditions such as myocardial infarction, angina and cardiac dysrhythmias should probably be evaluated rigorously by a cardiologist before certification is issued. Holter monitors and exercise stress tests may be needed when a driver has multiple risk factors and other questions need to be answered. Tachycardia or bradycardia should be investigated to rule out underlying cardiac disease. Asymptomatic dysrhythmia with no underlying disease process should not be disqualifying.
Established history or diagnosis of respiratory dysfunction
If a driver has clear symptoms of significant pulmonary disease, basic spirometry and lung volume tests are recommended. If the forced expiratory volume in one second (FEV1) is less than 65 percent of predicted value, the forced vital capacity (FVC) is less than 60 percent of predicted or the ratio of FEV1 to FVC is less than 65 percent, pulse oximetry should be performed. If pulse oximetry on room air is less than 92 percent, an arterial blood gas measurement is recommended. If the partial pressure of arterial oxygen is less than 65 mm Hg or the partial pressure of arterial carbon dioxide is more than 45 mm Hg, disqualification is recommended.
Hypertension
If the blood pressure is 160/90 mm Hg or lower, a full two-year certification is appropriate. If the blood pressure is higher than 160/90 mm Hg (either systolic or diastolic) but lower than 181/105 mm Hg, temporary certification may be granted for three months to allow time for the driver to be evaluated and treated. If the initial pressure is 181/105 mm Hg or higher, the driver should not be certified. Once treatment has brought a driver's blood pressure under control, certification should be issued for no more than one year at a time. Note that several readings should be taken over several days to rule out "white coat" hypertension. Significant target organ damage and additional risk factors increase the risk of sudden collapse and should be disqualifying.
Musculoskeletal, neurologic or vascular diseases
Depending on severity, any condition (physical, mental or functional) can be disqualifying if it can significantly impair a driver's ability to control a motor vehicle or to react to emergencies.
Epilepsy
A driver with a clinical diagnosis of epilepsy and recurrent seizures of any etiology should never be certified. A driver who has had an isolated seizure or episode of syncope may be certified, but only if the driver is not taking medications and has been free of seizures for five years following an isolated idiopathic seizure and for 10 years following multiple seizures. Febrile seizures of childhood are not disqualifying. All questionable cases should be cleared by a neurologist.
Mental, nervous, organic or psychiatric disorders
Mental conditions that can affect judgment, perception of reality and reaction times may be disqualifying. When in doubt, the examining physician should have the driver obtain clearance from a psychiatrist or a neurologist. Medications required for mental conditions may be disqualifying if they can alter consciousness or reaction times.
Vision less than 20/40 in each eye
Vision must be at least 20/40 in each eye with or without correction. Certification can be given once vision has been corrected, but not until. The driver should be advised to have his or her eyes evaluated, obtain corrective lenses and then return for certification. Field of vision must be at least 70 degrees in each eye. Color vision must allow recognition of standard traffic signals (i.e., red, green and amber).
Hearing loss
of more than an average of 40 dB in the best ear at 500, 1,000 and 2,000 Hz The driver should pass a whispered voice test at five feet in at least one ear. A hearing aid may be worn for the test. If the test result is questionable, an audiogram is recommended. The better ear must not have an average hearing loss of more than 40 dB at 500, 1,000 and 2,000 Hz (to obtain an average, add the three decibel losses together and divide by 3).
Use of schedule I drugs and consciousness-altering drugs
Use of a schedule I drug or any other consciousness-altering substance, an amphetamine, a narcotic or any other habit-forming drug is cause for the driver to be found medically unqualified. Use of other prescription medications is not an automatic disqualifier; however, the condition being treated, the medications prescribed and the dosage level must be consistent with the safe performance of the driver's duties.
Current diagnosis of alcoholism
The term "current diagnosis" is meant to encompass those instances in which the physical and mental condition of the driver with alcoholism has not fully stabilized, regardless of the time element. If the severity or extent of the problem is uncertain, the examining physician may refer the driver to a substance abuse counselor for evaluation and clearance.
--------------------------------------------------------------------------------
