- 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.
CME said I had to have a sleep study. Results were at level 5.8. Sleep study doctor said that D.O.T. regulations require me to use a cpap is this true?
@Mark
According to the FMCSA @ 5 +, you may have a diagnosis of mild sleep apnea.
The primary sleep study and sleep doctor can now make a decision as to whether you need to be on a CPAP unit. I would check with the doctor and ask a few questions regarding this issue. If you do not suffer from any of the principle issue of sleep apnea then he can fill out a form that explains his standing on this issue. The FMCSA does not have a standing regulation/law that demands that you be on a CPAP, unless the doctor feels sure that you suffer from other signs and symptoms of sleep apnea.
I currently have a class A commercial license. I went to tractor trailer school in 1978. I had retired from the Teamsters recently, but I haven’t driven for over two years, so my medical card had expired and it’s been too long for a recert. I was offered a position to drive elderly to and from the doctors, but the company requires a DOT physical. I do have sleep apnea and I have been using it nightly for a couple of years. Would this be sufficient for the medical examiner if I take my C-PAP with me to my physical?
@Joe
Your best bet may be to downgrade your class A to a lower class, and then get your medical card.
Have your primary complete your medical release form for you before you go for the examination for your medical card. That will include the stats from your CPAP. That release will answer many of the examiner’s questions right up front. Good Luck
Hello I just now found out about this sleep study thing.I used to have sleep app but had my tonsils and my uvila snipped. I went back for a sleep study and was cured. Question is that my test was done in 2006 is it to long ago to take this record to the cert exam for dot or will they except it.thanks in advance…Dom
@Dom
No, they will not expect anything. You have far surpassed any requirements. So just answer any questions and you should be good to go.
Thank you very much …very good forum
@Dom
You are very welcome. Thank you for visiting.
Please support our doctors and you will have a very good DOT physical experience.
I was forced to take a sleep apnea test for work i drive tanker trucks and was diagnosed with mild sleep apnea i have a ahi of 10.1 and was given a cpap machine and i really dont feel i need one was never sleepy in the daytime i dont snore even the test said no snoring no urination in the night no limb movement just a bmi of 40 and a neck size of 17.5 i looked up and the guidelines say u have to be at a ahi of over 20 to be on a machine i dont know what to do
When the new guidelines were published, I realized that I could retire rather than go through the training and certification to continue doing DOT exams. So I’m now a full time gardener rather than a miserable doctor having to take drivers’ livelihood away without real evidence that it will improve safety. Mammograms and the PSA test are being questioned because – – although they find disease – – it’s not clear that they save lives. The new guidelines were put into practice with no requirement for assessing risk, cost, and benefit. Evidence based medicine apparently has no place at the FMCSA. They were satisfied with showing that they could tighten up the DOT medical exam process, without balancing it against the enormous cost to individual drivers and society as a whole, and also without showing that more rigorous testing would actually improve safety on the roads. They just assume – – like the promoters of mammograms and PSA tests – – that a “better” test will automatically lead to a better outcome. I am so glad to be out of this business and spending my days with tomatoes and beans (and not having to wonder whether there will be any drivers left to move my vegetables).
Does a driver have to recertifiy when he is put to sleep gor a medical procedure
@Monty
FMCSA states that any illness, injury, or condition that takes a driver from behind the wheel and has him at less that “medical fit for duty” must be re-certified for duty.
So my understanding is, Yes, you would need to re-cert.
I went ahead & recertified anyway . Thanks for the info
@Monty
You are welcome. Glad to hear all went well.
Question, my husband is in the process of going for his CDL and he is in the DOT process. They told him that he needed to have a sleep study done because of his BMI and bcs of his father has sleep apnea and of course he did and they dx him with a very mild case that does not need any sort of tx and that he would be fine to drive. The DOT examiner then told him that his results from the sleep study would only give him a year cert. Is he just going to keep having to do these expensive sleep studies every year? Or should we try with a different examiner the next time he goes to get DOT certified?
@TinaBear
Your last option is your best option.
Since its all about money.I have been on cpap for 14 years and used every night .because I sometimes would hold my breath.sleep study said I had sleep apnea. Not any body decided on the medical side thought it was a big deal until now . I just need data compliance to prove to medical examiner that I use my machine.with high deductible im looking at at least $1500.00 out of pocket to keep my card for 1 year what a deal
can’t afford sleep study. want to buy c pap machine that has Data feature without going to insurance . can I get places like apria to check machine without buying machine from them.what will I need to do . its all about saving money.
@Mark
Sorry we cannot help you with product/vendor information or recommendations.
Our advice is limited to questions about the DOT physical exam and medical card.
TRY SECOND WIND CPAP WHERE YOU CAN PURCHASE SLIGHTLY USED CPAP MACHINES THAT COME WITH A WARRANTY AT REDUCED PRICES. HOPE THIS HELPS YOU OUT.
My question I am a large guy. Went to place for my medical card dr told me only will get 1 yr card due to BP meds ok np but she telling me I need 90 days or history on my cpap I only had 30. Got them the 90 finally. What are the requirements on percent of use. I can’t find any were this info is available.
@Jon
The Medical Expert Panel’s minimum recommended compliance is: 4 hours of CPAP sleep per day; 70% or more days.
Your company/carrier is allowed to impose stricter standards than those recommended by the Medical Review Board.
Some companies are requiring at least 6 hours of CPAP use, 80% of days.
This is explained in Part 5 of this series of articles on Sleep Apnea.