Driver's Information - ANSWER-Name, address, telephone numbers
Social Security, DOB, Age, Sex
Driver License Number, License Class, State of Issue
New C
... [Show More] ertification, Recertification, Follow-Up
Required Components of all Exams - ANSWER-Vision
Hearing
Blood Pressure/Pulse
UA
Who Can Sign in the Exam Form - ANSWER-Medical Examiner (CME)
Optometrist
Opthalmologist
Non-Discretionary Standards = you must follow the regulation or guideline and may not vary from this - ANSWER-1. Vision
2. Hearing
3. Epilepsy
4. Blood Pressure
Vision - ANSWER-1. Must be 20/40 in each and both eyes
2. Must have 70 degrees of peripheral vision
3. Distinguish signal red, green, and amber
* If they do not meet these, they may apply for a vision exemption. Provide a copy of the certificate and check off "Accompanied by a ___ waiver/exemption".
* May wear glasses or contacts and should mark this in the certification section
Hearing - ANSWER-1. Must have less than or equal to 40 db measured at 500 Hz, 1000 Hz, and 2000 Hz
2. Perceives whispered voice at 5 feet in at least 1 ear
* If they use a hearing aide, mark it in the long form and PE section
* If they do not meet the criteria, they can apply for a hearing exemption. Provide a copy of the certification and check off "Accompanied by a ___ waiver/exemption"
* Also look at the tympanic membrane on every exam
Conversion from ISO to ANSI - ANSWER-Substract 14 from the hearing loss at 500 Hz
Subtract 10 from the hearing loss at 1000 Hz
Subtract 8.5 from the hearing loss at 2000 Hz
Add those numbers up and divide by 3 to obtain the avg hearing loss in ANSI
UA - required on all exams - ANSWER-Specific Gravity - 1.005-1.030
Protein - negative
Blood - negative
Glucose - negative
Epilepsy - ANSWER-By definition, epilepsy is 2 events or the use of anti-seizure meds
Always disqualify the driver with a clinical diagnosis of epilepsy
* If the driver suffers from epilepsy or has a seizure disorder from an unknown cause (controlled or uncontrolled), they may apply for a seizure exemption. Provide a copy of the certificate and check off "Accompanied by a __ waiver/exemption"
Blood Pressure - ANSWER-Follow Stage 1, 2, or 3.
Once diagnosed, they will always have a shortened certification time, usually 1 year, whether they are treated or not.
They may treat with meds, diet or exercise.
Health Hx - ANSWER-Note if the driver is a smoker or non-smoker and record this in the long form
Regulations VS. Guidelines - ANSWER-Regulations are enacted by law
Guidelines are intended for you to follow
1% Rule - ANSWER-If there is in the examiners opinion, greater than 1% chance in the next year of a sudden incapacitation, you must DQ the driver
Certification: Benign hx, negative exam - ANSWER-2 years
Certification: Diabetes: Non-Insulin Dependent - ANSWER-1 year
Certification: Diabetes: With Insulin (Diabetic) Exemption or Waiver - ANSWER-1 year
Certification: Hearing Exemption - ANSWER-1 year
Certification: Epilepsy/Seizure Exemption - ANSWER-1 year
Certification: Other endocrine disorders - ANSWER-2 years
Certification: Mental Disorders - ANSWER-If able to certify, max 1 year during tx
Certification: Vision Exemption - ANSWER-Certified for 1 year only
Certification: BP - ANSWER-1. Anyone with a hx of HTN (tx with med, diet or weight loss and exercise), and their BP is below 140/90 at the time of the exam, may be granted a 1 year certificate unless they have a hx of Stage 3 HTN.
2. With a hx of stage 3 HTN, then the max certification period is for 6 months only
Stage 1 - ANSWER-140-159/90-99
1. If this is the first time diagnosed, confirmed by 2 readings taken on the same day, grant a 1 year certificate
3. If they have a hx of HTN, such as a previous reading on another exam (you will notice they have a 1 year card already, or they are currently taking HTN meds, then they can only receive a 1 time 3 month certificate.
- Within 3 months, they must have a BP reading from a provider of less than or equal to 140/90.
- Date the card for the original date of the exam
- If they do not lower their BP to less than or equal to 140/90 within the 3 month time frame, they will be disqualified
* If it is greater than 3 months before they lower their BP to an acceptable level, they should undergo another examination
Stage 2 - ANSWER-160-179/100-109
- They are granted a 1 time 3 month certificate and follow the requirements for Stage 1
* The maximum certification will be for a 1 year
Stage 3 - ANSWER-180 or above/110 or above
They are automatically disqualified until their BP is less than or equal to 140/90
* Their maximum certification will be for 6 months for the rest of the driver's career
BP 2 year Certification - ANSWER-If the driver were to improve their health situation by loosing weight, exericse etc, and were taken off of their hypertensive medication, and it remained stable for a period of 2 years
Certification of Cardiac conditions: Ischemic heart disease, valvular heart disease, congestive heart failure, cardiac arrhythmias including pace makers, congenital heart problems, peripheral vascular disease, including intermittent claudication that is asymptomatic at rest, DVT and pulmonary embolism, AAA, and those drivers with multiple coronary heart disease risk factors (modifiable and non modifiable) - ANSWER-Most will be certified for 1 year
Certification: Heart Transplant - ANSWER-6 months
Certification: Some valvular conditions - ANSWER-May be less than 1 year
Certification: PCI (angioplasty) - ANSWER-Initial certification is 3-6 months
Certification: Respiratory Conditions - Infectious Diseases, Non-Infectious diseases, allergies, post pneumonectomy/ lung resection, trachestomy, primary and secondary lung carcinoma, pulmonary HTN, lung transplant - ANSWER-2 years
Certification: Obstructive Sleep Apnea, DVT, and Pulmonary thromboembolism - ANSWER-1 year
Certification on Abdominal Conditions: GU, GI, hematologic disorders, neoplastic disorders, and hernias - ANSWER-2 years
Certification on Orthopedic/Neurologic Conditions - ANSWER-2 years
Hx of embolic or thrombotic stroke - ANSWER-1 year
Hx of Intracerebral and Subarachnoid hemorrhage - ANSWER-1 year
Hx of TIA - ANSWER-1 year
Hx of mild or moderate TBI - ANSWER-1 year
Acute seizures - structural insult to the brain - ANSWER-1 year
FMCSA definition of epilepsy - ANSWER-2 or more events or use of an anti-seizure medication to control seizures
Epilepsy - if 1 event of unknown cause, and no anti-seizure medication is required - ANSWER-Wait 5 years
Epilepsy - if from a known cause (med rxn, high fever), - ANSWER-Wait 0-6 months
Epilepsy - if the driver has met or exeeded 10 years without the use of antiseizure med and has not suffered a seizure - ANSWER-Consider medication certification
Severe depression/thoughts of suicide or suicide attempt - ANSWER-Wait 1 year
Non-psychotic major depression, no suicide attempt - ANSWER-Wait 6 months
Brief episode of psychosis - ANSWER-Wait 6 months
Tx of Psychosis involves the use of electroconvulsive therapy - ANSWER-Wait 6 months
Post MI - ANSWER-Wait 2 months
PCI (angioplasty) - ANSWER-Wait 1 week
Most surgical procedures except heart transplant - ANSWER-Wait 3 months
Heart Transplant - ANSWER-Wait 1 year
Post-percutaneous balloon mitral valvotomy - ANSWER-Wait 4 weeks
Surgical Commissurotomy (valvular procedure) - ANSWER-Wait 4 weeks
Post Balloon Valvuloplasty - ANSWER-Wait 1 month
Pacemaker for sinus node dysfunction, and AV block - ANSWER-Wait 1 month
All other pacemakers - ANSWER-Wait 3 months
Anticoagulation therapy - ANSWER-Wait 1 month
Pulmonary Embolism/Deep Vein Thrombosis - ANSWER-Wait 3 months
Definition of OSA - ANSWER-30 hypo-apnea events per hour
OSA Waiting Period - ANSWER-Wait 1 month with CPAP,
Wait 3 months with surgery
Use of Chantix for smoking after discontinuing use - ANSWER-Wait 2 weeks
Neuro disorders without risk of seizures - ANSWER-Wait 1 year
Neuro disorders with risk of seizures - ANSWER-Wait 5 years
Stroke with risk of seizures - ANSWER-Wait 5 years
TIA - ANSWER-Wait 1 year
Intracerebra or Subarachnoid hemorrhage - ANSWER-Wait 5 years
Surgically repaired AV malformation or aneurysm with no seizure risk - ANSWER-Wait 1 year
Surgically removed infratentorial meningiomas, acustic neromas, pituitary adenomas, and benign spinal tumors - ANSWER-Wait 2 years
Surgically removed supratentorial or spinal tumors - ANSWER-Wait 2 years
Viral encephalitis with early seizures - ANSWER-Wait 10 years
Bacterial encephalitis with early seizures - ANSWER-Wait 5 years
Infection of the CNS (bacteria meningitis, viral encephalitis without early seizures) - ANSWER-Wait 1 year
Mild Traumatic Brain Injury (TBI) without early seizures - ANSWER-Wait 1 year
Mild TBI with early seizures - ANSWER-Wait 2 years
Moderate TBI without early seizures - ANSWER-Wait 2 years
Moderate TBI with early seizures - ANSWER-Wait 5 years
Benign Paroxysmal Vertigo and Vestibulopathy - ANSWER-2 months
Normal A1C - ANSWER-4-6.5
Any 10 or below is certifiable
Exercise Tolerance Test - ANSWER-Required for all Ischemic heart disease
Must be above 6 METS
Able to exceed 85% of age predicted maximal heart rate or ventricular dysrrythmia
Must be done twice a year
INR - ANSWER-Must be done monthly and maintain 2-3 and be stable
CPAP - ANSWER-Must be at least 70%
PFT - ANSWER-FEV1 minimum 65%
FVC minimum 60%
FEV1/FVC minimum 65%
Pulse Ox minimum 92%
ABGs minimum 65%
Folstein test or Mini Mental State Exam - ANSWER-A score of 25 or greater out of 30 indicates they meet needed conginitive requirements
Diabetes Counseling - ANSWER-1. Advice the driver to carry a form of a rapidly absorbing glucose, self-monitoring kit
2. Self-monitor blood glucose levels 1 hour before driving and 1 time every 4 hours
3. The driver should also plan to submit blood glucose monitoring logs at the time of the exam to the medical examinder
Vision Counseling - ANSWER-Those who need corrective lenses, bring a spare pair of glasses
Contact users should also have a spare of glasses
Drivers who use monovision (one contact lens for distance, and one for near vision) cannot certify and must be counseled that this is not allowed
Hearing Aides Counseling - ANSWER-Should bring a spare power source
12 Hour Rule - ANSWER-Many OTC decongestants and narcotic cough syrups cause drowsiness.
A driver should not drive for 12 hours following using such meds
Hx of DVT Counseling - ANSWER-Inform driver of risks of prolonged inactivity
Diabetic Waiver - ANSWER-Grandfathered program that has been discontinued but there still exists a small number of waivers, which are granted within the driver population
Diabetic Exemption - ANSWER-If the driver is an insulin dependent diabetic, they may apply for a waiver from the FMCSA, exemption program
To apply, the driver will need contact info to obtain info on the exemption program, a copy of the Medical Certification Card and Medical Examination (Long) Form both marked "accompanied by an insulin waiver/exemption"
Vision Exemption - ANSWER-If the driver does not meet the minimum vision requirements, they may apply for a vision exemption.
Must provide a card and long form marked accompanied by a vision waiver/exemption
Neurologic Waiver - ANSWER-For minor MS and malignant tumors (marked on the medical certification card and exam form "accompanied by a neurologic waiver/exemption"
SPE - ANSWER-Required for loss of limb or limb impairment with a fixed deficit
The first, second, and third digits are most important for prehensal ability and grip strength, with the fourth and fifth being less important
When the driver is missing only a part of their hand, determine if the driver's grip strength and prehensal ability is adequate enough to drive
If SPE is needed, provide a card and form and "accompanied by an SPE"
SPE is good for 2 years as long as there are no other conditions or tx that would affect this
Diabetes Insulin Dependent without an exemption or waiver - ANSWER-Disqualify
Epilepsy - ANSWER-Disqualify
Schizophrenia - ANSWER-Disqualify
Flat or blunt affect - ANSWER-Disqualify
Active Psychosis - ANSWER-Disqualify
Active drug or alcohol abuse - ANSWER-Disqualify
Monocular Driver - ANSWER-Disqualify without a waiver or exemption
Stage 3 BP - ANSWER-Disqualify until it is below 140/90
If the driver is provided with a 1 time 3 month certificate, and the 3 months expires prior to them lowering their blood pressure to 140/90, they should undergo a new exam
Pulse Rates - ANSWER-Disqualify when below 60 and above 100
ICD: Implantable Cardioverter Defibrillator - ANSWER-Disqaulify
Grade 3 or above Murmur - ANSWER-Disqualify
Left ventricular hypertrophy, if does not meet minimum required testing requirements, or is symptomatic - ANSWER-Disqualify
Cor pulmonale - ANSWER-Disqualify
AAA or thoracic aneurysm that exceeds 5 cm (3.5 cm for thoracic aneurysm or there is a greater than .5 cm increase in size over a 6 month time frame - ANSWER-Disqualify
Intermittent claudication - ANSWER-Disqualify if pain at rest
Respiratory conditions to DQ - ANSWER-TB during active tx
Chronic TB tx with Streptomucin
COPD with cough syncope
2 or more spontaneous pneumothorax on the same side
Bronchiectasis with hemoptysis
Narcolepsy
Abdomina, GU to DQ - ANSWER-Renal Failure
End Stage kidney disease
Hernias - non reducible and symptomatic (pain on exertion)
Hematologic, GI, GU disorders based on severity, episodic nature and side effects of tx
Neoplastic disease
Orthopedic Conditions to DQ - ANSWER-Loss or impairment of limb (fixed deficit), without SPE
Any current limitation or disability that may impact the safe operation of a CMV
Cervical Rotation must be examined to determine if the driver has enough rotation to see their mirrors and to change lanes
They should exhibit 45 degrees to the left and 30 degrees to the right, but this is not defined by regulation [Show Less]
