- Part 1 [You Are HERE] – Can A DOT Medical Examiner Refuse You A Medical Card Unless You Have A Sleep Study Done?
- Part 2 – DOT Physical And Sleep Apnea Testing: Are Medical Examiners Caught Between A Rock And A Hard Place?
- Part 3 – Commercial Driver Awareness About The Sleep Apnea Issue
- Part 4 – OSA: How To Know If You Have It
- Part 5 – Commercial Drivers Can Manage Sleep Apnea And Maintain Their CDL
Commercial drivers are being told by some DOT medical examiners that they must be tested for sleep apnea before they can get a new medical card.
We’re seeing much confusion and frustration in the questions drivers are asking us on our FAQ forum.
“Does you neck have to be a certain size? They tell me I have to have a sleep study”
“The doctor our company sends us to says anyone with a BMI above 35 automatically has to take the expensive tests from his company’s sister sleep test division…”
“Some examiners are requiring drivers to go have sleep studies done based solely upon BMI and neck circumference. How can that be? “
“My husband who is 53yrs old just went for a physical to renew his medical card. They told him because he was over 50 and his neck was 17.5 he had to do the sleep study. I’ve been told by others that the age criteria is 55 and if neck is over 17in. Which is correct? “
“I recently went in to renew my CDL and everything checked out normal. However since I was over the age of 42 and I am a male, the doctor gave me a 45-day temp card and told me before he could give me my 1 year medical card I had to get a sleep apnea test done. My neck size and my BMI checked out normal. Can he do this to me? “
So why are so many people – doctors, as well as drivers – confused on this sleep apnea issue?
We’ve attempted to follow the breadcrumbs over time, to see how this predicament developed.
- 2008: The Medical Review Board recommended that the FMCSA require all drivers to be screened for obstructive sleep apnea.
- 2008: A health panel recommended to the Medical Review Board that CDL medical certification be conditional based on body mass index (BMI).
- The National Transportation Safety Board was one of the parties alleging a clear connection between driver sleep apnea and safety.
- May 2010: In response to such concerns, the American Sleep Apnea Association, the American Trucking Associations and the FMCSA co-sponsored a national Sleep Apnea & Trucking Conference about sleep apnea’s effect on truckers.
- April 20, 2012: FMCSA published a Proposed Regulatory Guidance for obstructive sleep apnea (OSA) and request for comment.
- April 27, 2012: FMCSA published a withdrawal notice on its Proposed Recommendations on Obstructive Sleep Apnea.
- September 12, 2013: A proposed sleep apnea bill was introduced, and passed the House and the Senate, requiring that FMCSA establish a formal rule rather than guidance relating to sleep disorders.
- October 15, 2013: The sleep apnea bill was signed into law by the President. The law forbids the Federal Motor Carrier Safety Administration from using guidance alone to address sleep apnea screening for drivers. It requires that if the agency take action regarding sleep apnea screening, that it do so via the formal rule-making process, and not guidance. Note: The law does not require that the FMCSA create a sleep apnea rule.
The ‘sleep apnea bill’ signed into law on October 15, 2013 forbids FMCSA from using guidance alone to address sleep apnea screening for drivers.
Put In A Nutshell
FMCSA has been called on their lack of proper rule making procedures regarding sleep apnea screening i.e. how to determine who should be tested.
The last response we can find from FMCSA on this issue is that “FMCSA will issue a notice to address obstructive sleep apnea through the formal rulemaking process after collecting and analyzing the necessary data and research.” As we publish this article, there is still no information available from FMCSA regarding sleep apnea screening.
There is currently no ruling by the FMCSA for sleep apnea screening on DOT physicals.
DOT Medical Examiners
DOT medical examiners are finding themselves caught between a rock and a hard place on this issue, as they are held responsible for ensuring that a driver is medically fit to drive a commercial motor vehicle.
Employers
Your employer may have more strict requirements and is allowed to impose their own screening criteria. A company must a least meet the FMCSA medical requirements. However, company policy may impose stricter standards than those required by FMCSA.
Thanks to Trucker Docs expert panel doctor, Dr. Kenn Seals, for contributing to this article.You can find Dr. Seals at Chiro Stop in Salt Lake City, UT.
Sleep Atnia test just another scam for medical organizations to get a referral kick back by referring you to some other faculty to get this unnecessary test done.
The formulation is flawed it does not take into consideration the fact that there are humans of different body frame size as in bone structure.
Small medium large and extra-large bone frame
And claiming that if you’re 6 feet tall and over 235 pounds and have a next size of 17 1/2 that you must be obeast overweight not true.
I’m pissed off I pay hundred dollars to get a physical for my DOT card and the next thing I know I’ve been told all you need to take a sleep Atnia test and pay $350-$400 nonsense .
This is nothing more than racketeering running a scam . Just a guess but I’m sure more drivers suffer a heart attacks strokes and seizures than have sleep Atnia.
Do they want to hook us all up to EKGs nonsense.
This is nothing more than a racket.
The Attorney General’s office needs to step in and shut this nonsense down.
The formulation used Texans no consideration the fact that humans come in different body bone structure size.
And to single out those who have A particular neck size or body weight and height is prejudice when body frame size is not part of the formulation for their determination.
How dare health organizations suck you in for a required physical for DOT and then say oh well going to recommend that you take a sleep acne test BS and it’s going to cost you $350-$400 more bullshit.
It’s not the law there are no statutes And all it is is doctors giving referrals and getting kickbacks.
Insult.
Your 100% right, it’s criminal. My DOT Doctor said ” look you gonna make a lot of money just get the test done. ” Now that’s gangster. Now I have no job and looking at homelessness.
Some things not true 1 out of 3 have sleep apnea they don’t need to be fat or have a high BMI my brother had it he is not a commercial driver and told that he don’t use it he will lose his license I been on it for eight years anyone can have it…yes it is discrimination but federal dot doc can lose their license if someone is in a crash with this condition…. there is a group of users pushing sleep study for all thru dot due to discrimination that means all people who drive a vehicle will have to undergo this testing it is in the works
@ James
If the examining doctor does a proper evaluation and uses in depth questioning, with honest answers, then testing would not be a mandatory issue. Unfortunately, there are those facilities which use the guidelines for profit, not honest evaluations of the drivers condition.
Drivers. Need to strike nation wide to protest this in justice to cdl drivers only this should require all licensed drivers to comply to this same rule
If my fiance has sleep apnea and is on a cpac machine. What are the chances of him being able to work again not longhaul but daily commercial driver in california. And how to deal with examination.
@Jill
Should not have any issues. He needs a medical release form from his doctor along with his most recent readout from his machine demonstrating a 70% compliance over the last thirty days.
Can DOT examiner force me to take a sleep study by telling me he will give me a 5 month card if I don’t get a sleep study done he will not Renew medical card
@Daniel
The CME can not force you to do anything. If you feel that he/she is being unfair in their determinations, then you can go elsewhere for a second opinion.
Hey the sleep center here in Alcoa Tennessee said I tested positive for sleep apnea but in my family we don’t have any trace of any medical condition I am like freaking out and don’t know what to do how can I handle this situation and I am only 37 and I am losing weight went from 325 down to 273 but still don’t know what to do.
@Curtis
Depends if the diagnosis was mild, moderate, or severe?
Not true because you have to tell the second doctor that it’s a second opinion and then they will agree with the first doc out of professional courtesy. Otherwise you say nothing and it’s doctor shopping
That’s why you don’t tell them about the first Dr. The 22nd opinion needs to be based solely on the new exam. If they both come to the same conclusion then there maybe a need to consider the test. If not then the 1st Dr could be misinformed or misunderstand DOT requirements since they have been trying to pass a law on it.
Went in today for my datacard to be read. it came back that i used the machince 25 out of the 30 days with 5 days not used and 2 days under 4 hours .. it sayd that i was 60% for over 4 hours. How is this figured out . According to my math 23/30 is like 76%. is there something im missing or do they just make this shit up
@Wesley
The Medical Expert Panel’s minimum recommended compliance is:
4 hours of CPAP sleep per day, 70% or more days.
23/30 is 76%!
Can I be forced to take this sleeping disorder test, because of my being a truck driver who is over 50?
@Terrence
No. There must be a number of medical conditions indicated before a sleep apnea screening is needed.
the way i understand it, there are no rules set in stone, it is totally at the discretion of the Dr.
It sucks, but I see the DR’s side, if you kill someone after they don’t test you, they could be liable.
I go at the end of the month, thinking i’ll have to get the damn thing, but figure out how to hack it, so that it records usage when not in use.
35 yrs safe record means nothing. BS!!
I was told I needed a sleep apnea test done based on 18 inch neck and BMI of 35 the doctor suggested the same affiliated hospital,how can I know they won’t say I have it just to get me for cpap machine costs?
I had a dot physical done based on my bmi and neck measurements the said I had to get a sleep test. They a device to wear at home to watch my o2 stats overnight. After they said they could give me a 3 month card and would have to have a full sleep test done during the 3 months. My problem is I am going to be with out insurance for 6 months before I get coverage from my new job. My question is can I get a second opinion before I turn paper work into the DMV and use that?
Here’s my thoughts. Went to our medical examiner today for my yearly recertification. I only get 1 year at a time because I take blood pressure meds. I answered all the questions truthfully about sleeping habits and snoring. I don’t snore. I don’t fall asleep in the middle of the day. I have had a CDL since it was a chauffer’s license. Been with the same company since 1991. I’ve never fallen asleep behind the wheel of a truck or anything. The doctor comes in and immediately starts in on me about my weight and my height and my BMI. It’s frustrating. It’s almost like discrimination. It’s fat shaming. It’s wrong. He says I need a sleep apnea study (again) based on his little numbers and his little chart. Starts telling me “where I need to be … and how much I should weight.” I tell him I don’t want one nor do I think I need one. I answered his questions truthfully. He goes into this long rant about losing weight. About how to eat right and how to exercise. Then he starts telling me about football players dying in their sleep.
Still, I refused. I said I don’t want or need a sleep apnea test. I don’t want Government and doctors telling me I need to sleep with some sort of contraption strapped to my face.
In the end, it’s like discrimination and I don’t like it. I don’t tell these people “where they need to be.”
I’m 50 years old. Been driving trucks since I was 21.
Do I have to give in to these people and accept the testing against my will just to keep my CDL license?
@Scott
No you don’t have to give in to people who treat you as a “transaction” rather than a professional driver.
Find a medical examiner who understands the commercial driving industry, who will give you a professional health examination according to the FMCSA regulations and guidelines and make a fair assessment that protects public safety.
Hi,
When I worked for Schneider National they MADE me get tested and pay $1,500 for machine. They monitor me while I was employed with them. Test was done mobile on my wrist. I stayed in a hotel room…Couldnt sleep well being in hotel and having the monitor on me. They said I failed test. Okay fine..I played there game lost $ Left SN and SA machine behind.
Ive been driving for 2 yrs at another company. They have NEVER brought up SleepApena.
Went to get re cert today and I checked box about SA..The Doctor said he needed my printout before he can approve. Is he right for asking me this? Personally, I dont think he has the right…He told me to come back with a weeks worth of monitoring before he will sign off on it.
How can you do that when your going for the new job and at the mercy of going to the new company doctor
I was told when one doctor request a study you are put in a federal data base and if another doctor signs you clear and then involved in a accident the second doctor would be liable. So I was under the assumption you couldn’t go to another facility. I’ve since lost my cdl and has impacted my life in a severe way. It’s been a horrible experience. I didn’t have insurance and couldn’t afford to jump through the hoops that were set in front of me.
I took the sleep study a few years ago, and have been using a cpap machine ever since. My doctor who did my dot physical this morning, for the second year in a row, told me that he was told that if I use a cpap machine for sleep apnia, he can not issue me the two year health card, only the one year certificate. I have all the compliance documents, including the printout proving that I use my machine. I was told by a MNDOT officer last year, that there is no requirement in regards to the two year health card, meaning that it is totally up to the examiner if he gives you the one or two year certificate. I want the two year, is my doctor misinformed? I think he is.
@Jon
FMCSA guidelines state that the CME should certify for one year only. So your CME is correct and the MNDOT is not using the same FMCSA guidelines. All of this is based on you being an interstate OTR Class A driver. If that situation is different then you may be falling under the states CDL variances. If that is the case then you want to check with your local drivers license department.
i have a CPAP machine, what length of time do I need to show the Dr. to get recertified ? I have been on the machine for just over a year, since being diagnosed at the medical examiners insistance at my last physical
@Chuck
Basically the last thirty days with a 70% compliance for at least 4 hours a day. If your unit will give a longer report that supports your usage, even better.
Hello, I am a driver of 28 years that has OSA and have been under the care of a DR for my OSA. I have an older machine that I am very comfortable with and maintain an excellent amount of sleep. I have to take a physical to return to work, which I have no problem with except for a Dr at an urgent care here in NJ that wants me to get a new machine. She said I will only give you a 3 month cert and I want 30 days of numbers, only then will I pass you for your re-cert. My OSA DR says I do not need a new machine if I am fine with the one I have. Granted my old machine only has hours of use not the numerical breakdown that newer machines have. I guess my question is, can I retain my old machine and fight this Dr about getting a new one. What can I do, it seems that this young Dr has this I know it all attitude. Thank you for your time
@Bill
Get a medical release form from your OSA doctor explaining that you are in good shape with what you have. Second, stay away from the “Doc in a box’ places. You will have a tough time finding someone who know their FMCSA business. Go and get a second opinion from somewhere else with the medical release form in hand.
I have been on the CPAP full faced mask for around two years now and I am miserable. I get way less sleep, constant headaches due to lack of sleep and have to put on mask hours before I fall asleep just to reach the four hour minimum per night. DOT doctor does not really care that I have these problems just as long as my print out from the machine says I am reaching the four hours. I simply can’t use this machine even with the help of sleep aids. I hear the commercials all the time about getting rid of the machine and getting a custom mouth piece for severe sleep apnea. But I do not know if this will be acceptable to the doctor or Colorado state law. And I can’t find any material stating the requirements. Does anyone know the requirements?
@Joe
First, were you diagnosed with OSA and if so to what extent, mild, moderate, severe?
Based on those findings would then determine the second question. Have you tried a low profile mask to date? If your OSA is a mild version and you have not tried a low profile mask, then try one out.
If your sleep doctor can support that you get as good or better sleep and are better rested following the use of a customized mouth piece, then get the doctor to complete a medical release form for you and have him explain his reasoning for shifting from the CPAP to a mouth piece.
The CME must meet FMCSA rules and needs the input from your primary doctors regarding this issue, but with proper documentation, you should have a better go at it.
Joe,
Where are you in Colorado? If you are in the Denver area give my colleague dentist Dr. Gary Radz a call and tell him I referred you (I’m in NJ). He is certified in constructing a MAS (mandibular advancement splint), or as you say mouthpiece, that should be able to solve all your problems. He can confer with your physician about your sleep study to see if you are a candidate.
Best,
Doc M