- 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.
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.
When is this sleep study law come infect in Michigan going to this Dr. I get only one year card because of diabetes wanted a1c did blood work got never got card call them oh know he wants sleep study done 10 days left then no cdl is this the law I need to work
@Cliff
As this article explains – THERE IS NO SLEEP STUDY LAW.
Please read all the parts of this sleep apnea article so you understand your position as a driver, and how to establish if you may be at risk for having sleep apnea.
The final call on sleep apnea screening rests with the medical examiner, but it is based on your overall health picture, not a check list of items such as BMI, neck size, age, etc.
He will not give me a card work tells me they need me now or there replacing me no work no unployment not med. Ready for work this Dr. Making me lose my job whant do I do got a sleep study DEC 29 but I’ll be job less by then please help
@Cliff
There is no new law requiring you to take a sleep study.
So go somewhere else and get your new medical card.
So I am hoping you can help clear up my confusion. I went to the CME that my employer sent me to last week. Was given a 1 year physical. I have a blood pressure issue and understand this. But during the exam the CME, he asked me about any sleep or being tired issues. I marked no on the medical form, and honestly told him I wake up feeling awake and refreshed and do not get tired during the day. But he measured my neck, 17.25”, my BMI is over the 35, and I am over 40, so he said I had to have a sleep apnea study before next year’s physical. Tried to discuss with him, he stated as he walked out “it is mandatory, the law as of May 2014” and would not talk to me anymore. So I have talked to other CME’s that said odds are they would have not put the sleep apnea study requirement on me, but because he did, and now have to do it. I called the Regional Office of FMCSA, and was told that because he wrote it on my paper work that now I have to do the study. But I see in other posts here that it seems recommend that a person should/could wait 30 days and go to different CME. So my confusion is when my year is up can I go to a different CME as option, or do I have to do the sleep apnea study route now?
Also 1 of my co-workers went to the same CME Clinic in May and was flat out failed till he does the sleep apnea study. He is also a big man, over 40. But I was given a year, and he was just failed, same clinic different CME’s. He has not done anything as of yet, he is the shop foreman and does not drive that often. Could he just go to a different CME?
Just total confused and flustered, looking for good direction.
Do the CME’s submit their notes and results or only pass fail and time frame of physical to FMCSA and the State? If so HIPPA laws don’t apply?
Thank you,
@Bob
When it seems out of line, ask to see the law. It does not exist and you are not mandated by anyone, including the FMCSA to do such.
Just go somewhere else when its time for the next DOT. You will still be on a one year card with the blood pressure medication and unless you can get your doctor to remove you from those meds, it will stay that way.
But there is no law or guidelines for neck and bmi in relation to sleep apnea.