- 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.
I went for a pre-employment dot physical, doctor refused to give me the medical card issued for 2 years due to employer requested that the medical card be sent to them. Doctor also refused to provide me a copy. So my question is. it is legal for them to that since we can’t operate without the medical card? And if is not legal what can I do?
@ Lisa R
It’s a strange thing, but it seems that if the company pays for the test then they feels they have the right to keep the information. Best bet would be to talk to a legal expert.
Let’s start a class action lawsuit. Write down your story in a notebook from the beginning with dates, doctors name, the company you worked for and how long you been unemployed. Also call those doctors and ask for all your medical records and the sleep study doctors and cpap supplies company.
Ask who have they shared your information with? Your company, the DOT database the cPap supplier. Also ask for all the up loaded information that has been sent to the dot doctor and cpap supply company. Ask and get the name of who is reading that information and you want a copy of all results from the beginning. We all know what is happening is wrong and we need to do something about it. I worked for Averitt Express and their DOT doctor is having fraudulent home sleep studies done in a hotel room in orientation and putting that on drivers medical cards and it’s not a supervised sleep study in a sleep lab. I am going to sue all three. But if you want to start a class action lawsuit I will make it happen and working on it right now. Richard Burnette 423 355 4025 call if your interested.
I’m interested. I’m 59yrs young, been driving for my employer 24 yrs. Asthmatic, diabetic, hbp, bmi slightly over limit for my height 5 ft. Since my initial DOT for this year, my company has changed DOT places due to they say contract ran out n they only had 2 companies to reply n they went with the cheapest of course. 1st place gave me a 3 month card n I went got a statement from my doctor whom had said he had monitored me n don’t see no need for a sleep study n he will not order one. If they want me to take one then they should order it n pay for it. I haven’t had no accidents, no falling asleep. 2nd company will not accept my doctors statement. Being diabetic I questioned there procedures in how they were doing things (one size cuff for blood pressure, no pricking of finger for correct reading of blood sugar, etc) we end up having words n they fudged my numbers were I wouldn’t pass physical all because I’m challenging sleep study. They will not accept another companies certification. I’m out of work now.
I’m interested Joel Goldman 43, Joelgoldman5454@gmail.com
Celadon
I did not get the job with celadon after I was Forced into a sf sleep study, which according to them I just went over the company policy limit, of 21 limit was 20.
They had a machine for me which I had to pay for, but b4 I could drive I had to do 1 night with the CPap to prove compliance. 1st night failed I couldnt sleep and ended up with a asthma attack and allergy attack, night 2 (RETRY) failed even though I had the mask on for bout 5.5 hours it only registered 3.75 hours of recording. I told the company I sf keeping way worse now then b4 this testing. Celadon said you must repeat again to be hired. I said I had enough I wasnt going to retake the test for a 3rd time. There for I was let go
Is this law suit still going on
@ Terri
Since there was never a FMCSA regulation regarding the issue of a mandatory sleep study, then anyone suing, must be suing the doctor or facility.
I am a class B driver just told to go get a sleep study. Do you know of any lawsuits against individual DOT docs? Were any successful for the patient or is it “fighting City Hall”?
@ Mark McG
You are a class B driver and fall under the states variances, not FMCSA. You should not be tested as a class A driver. Get a second opinion from a CME that understands the difference. There is no mandatory sleep study testing, unless there are a multitude of additional symptoms.
Tucker Docs, This is not true. I work at a bus company right now and am at war with my insurance company over getting an approval. They say I don’t meet the symptoms. Well, It was ordered and I cant get the test all because of the Insurance company wont approve the 350 dollar test. Our bus company is regulated under the FMCSA. I assume it is because we go out of state.
@ Kdawg
First, what is your cdl class. This determines the level of testing and requirements of the examiner. Second, unless you have a multitude of signs and symptoms for OSA, there is no mandatory test requirement from DOT/FMCSA. Go get a second opinion.
I went to get a pre-employment medical card recertification, I was told I was a male, over 50, bmi was over 35, and neck size is 17 1/2 inches that they would not and no-one will give me a card until I have done a sleep study. Does this have to be done? Can they refuse to give me a card?
@ Bryant J
Go somewhere else, other than a doc in a box facility, and get a second opinion. You are being taken for a money ride that FMCSA does not require, unless there are other OSA indicators.
Can we get a 2nd opinion? I was told the results are put into a national data base. Will the DMV see that we had 2 test completed and then take our CDL away? The whole thing is BS. DOT needs to step in and fix this.
@ Vince
If you feel the need for a second opinion, then you have the right for one and the DOT can question the examiners not you.
I am a new CDL driver with just a permit. I do not have a Class A license yet. My DOT Medical Card expires before I can take a sleep study test. I have already visited the “Sleep Dr.” I have documentation of the appointment and scheduled test. Concentra is telling me they can not extend my 3 month card.
What can I do?
Do I let it expire and go see another DOT qualified physician?
@ Eric
Unless you suffer from excessive daytime sleepiness or show any other signs of OSA, we would recommend you go get a second opinion from another CME.
Dont use concentra, stay away from them
I went to renew my medical card in mid January. He gave me a 6 month card and said I needed a sleep test before performing any of the physical. I have no symptoms other than my weight and my neck is 17 inches. He told me I was going to be entered into a data base with Fmcsa. He said if I don’t take care of it in the 6 months that fmcsa would pull my license. He also gave me paper work for my dr and said I have to come back to him and can’t get a second opinion because it’s already sent off to the fmcsa. And if I do get a second opinion and they give me a card for 1 to 2 years that it won’t be good. Can someone give me a straight answer?
@ Jason
Someone is really taking advantage of this situation. Fire this guy. Go get a second opinion from any registered DOT medical examiner. Who ever enters the last information to FMCSA is the new / active medical card.
This is exactly verbatim word for word what is currently happening to me. I went to get a DOT physical from a specific DOT physical doctor that my company required. Because I am overweight weight and my neck size is 17.5 in he said I have to go get a sleep study done I have never had sleep apnea and I sleep just fine through the night no symptoms whatsoever. The DOT physical examiner issued me a six-month card and told me the exact same thing the other guy said I would be entered into a National Database I can’t go get a second opinion anywhere and if I tried to get another opinion it wouldn’t be valid and it would red flag be in the system. I do not have the money to go get all of these tests and I do not feel they are necessary on top of that I have severe claustrophobia I cannot wear anything on my face I can’t even go get a test done because I will completely wig out. I only have one month left on that 6 month medical card I really need to find out what I can do if I can go get a second opinion or not. I’m afraid this will cause me to lose my CDL my career and my means of income
@ Pat
Go get a second opinion, you are being mis-lead.
So I went for my recert today, 10/27/17 and everything was good except that I’m 51 over weight and my neck size it 19in. I was given a 4 month medical card, and was told I need to get a sleep apnea test within those 4 months. Also my employer tells me I am only allowed to go to the doctor/clinic they tell me to go to. So? what are my rights concerning this? MUST I get a sleep apnea test done, and MUST I only utilize the doctor/clinic that my employer sends me to? And if I refuse can they fire me?
I don’t see a response to this question. I am basically in the same boat and was wondering what the answer would be.
Thank You
I”M exactly in the same situation .
I’m in that same situation..sence they try to force this on me my blood pressure is up.(never before)I’ve not laid down in bed in days.i nap at my desk in the truck.its almost 2am. Now, still up at my desk..had 3 nose bleeds today.im barely making it.and the company says they will take the sleep study and machine cost out of my check every week..I didn’t have any sleep trouble till this .I never had high blood pressure till this..I passed two physicals, one in deer Park Texas, then again in Pittsburgh PA.now I have a blood pressure issue..the med make me cough and that makes my nose bleeds..Concentra created my health issue.so now after having my license to drive trucks with hazmat for 39 years, Concentra uses them to black mail me.?!!
I am 29.5 year teamster .I drive for a waste co.. I have over 30 years driving experience with no major accidents in either my work or private vehicles. I have also never been injured on the job. Last Jan I made an appointment to have sleep study done after listening to my wife complain on how load my snoring was and how she had heard /read that it could be a sign of sleep apnea. I took the ” in home test ” . I was contacted by the sleep study company and told I had sleep apnea. I then met with a representative from Cape Medical who supplied e with c/pac machine. I was informed that I had to be in 70% compliance over a 90 day period for my insurance to pay for the machine. I f i did not meet the required aamopu8nt of usage I would have to pay for the machine myself. After a month or so I could not get used to this machine and sent it back. My deposit was returned and that was the end of it. So I thought. Last Tuesday 10-10-17 my company sent me to the clinic to get my physical to renew my D.O.T health card. I had told them 2 weeks prior that it was to expire on the 11th . But I end up the 24 hours before it expires ? Now during my physical the dr. asks if I ever had sleep test done and I say yes. I tell them the story and they inform me I am in error by not staying on the machine and now they will not sign off on my card ? I m totally in the dark on this ? I was never told by anybody that I had to stay on the c/pac and show I use it a minimum of 4 hours per night. At this point im pissed off and uncertain on what to do. I contact my Dr. and they say they can’t do anything . I call Cape medical who supplied me with my c/pc and they say i need to see my dr. and do the sleep study all over aging ? I then offer to just buy the machine out of pocket so i can begin using c/pac and get my health card and they say ok. My cost would be $1200 + . I tell the Dr. of my plan nd he grants me 3 month health card.Today I see my Primary DR. and I ask him instead of getting a c/pac machine can I simply get off this whole system. I said I don’t snore and have incorporated more exercise into my lifestyle. He is a good guy and writes up a report stating I feel I am in no need of machine and in good health. I take the letter to the other Dr. and he is not happy to say the least. Threatens to void my card there on the spot. he says he made a deal with me that I would pay and get a machine .I tell him for the last 5 days myself and my wife have been on the phone with the supplier of the c/pac and my insurance and have gotten the run around. My ins. says they wil pay for it and Cape Medical says several different things. 1- I need to see my primary Dr. and have a sleep study done all over again. My ins. says not the case. If sleep test was done within a year I don’t have to ? Bay Medical then says well the prescription my Primary sent over is not good enough ?? My ins. says thats bs. The lack of info and the contradicting info from Bay medical was beyond belief. My head and my wifes was spinning .I told the d.o.t Dr I was never told anything about this sleep study having any impact on my Commercial license . Not by My Doctor . Not by Bay Medical or by my employer at any given time. I was 100 % in the dark on this issue . As I write this I am not even sure I will have a job .Im distressed and aggravated. The DOT DR. was going to call my Primary Dr. but that office was closed for lunch from 12-2. So as I stated I have no idea what will happen to my livelihood. I f I do infract lose my health card what is if any recourse do I have .
My co. sends me to get dot physical day before expiation. Back 6 month ago I took a in home sleep test cause on some days I felt a little tires and wife said I snore more often. OK. No biggy. I do test they say I have a sleep disorder. I get machine and jut cant adapt to it. I notice no difference anyways on nights I kept it on. I say it not working send it back n end of story. WRONG ! I am not tired at work and have since altered my lifestyle so I naturally cured my occasional tiredness. Now yesterday at dr. office im told they have no records of my sleep compliance and they will not sign off on my card ?? I am dumbfounded ?I said at no time was I was never told such a thing by the company that issued the machine or my Dr.that I had to keep using this machine to get my card. So as of today my card expires. The lack of info on this issue is deafening ! If I had known prior I would NOT do the test. I don’t know if I can salvage my card today or not when I talk to my primary care Dr. by either getting a waver or going for anew tet . Talk about a fuckn mess ! This is why we need less Government in our lives!