- 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 currently use a cpap machine. Am I able to use a second machine for the truck so I am not transporting back and forth? Both would have a card reader. Would I need to have 2 separate readings done for the dot physical?
@Bill
As long as you can show compliance with the unit, you should be fine. If you’re driving OTR then there is enough data on the card. If not you may need both card read-outs.
I am 53 years young on 1/19/15 I went to dr. to get med cert my neck size is 17he said that my bmi was 42.8 and said I need sleep study done . my cdl is set to downgrade 1/30/15 there is no time to have done before deadline as of now I have 7 days left. Please help is there any thing I can do.I am a army vet but they cant get me in in less than 7 days THANKS
@roland
Check with your state drivers license department. Also you should be able to get a short term medical card while you wait for the test and the results, so talk with the examiner about it.
Back in 2009 I was told by the doctor that I had to have a sleep apnea study done in order to get my medical certification. The sleep doctor said I had severe sleep apnea. I spent thousands of dollars on a prescribed dental device. A sleep test with the dental device resulted in the sleep doctor issuing a ruling that I did not have sleep apnea while using the dental device. Since that time I have written on the DMV medical form “sleep apnea effectively controlled by a prescribed dental device”. I can only get a one year medical due to blood pressure medicine I take. This year the medical examiner tells me that due to new DOT rules, I must have my primary care doctor give me paperwork to verify that the dental device is effective 5 years after the sleep doctor said it was working fine. My primary care doctor wants me to go to the sleep doctor again. The sleep doctor wants to do another sleep test before anyone will give me a medical cert. I have to have my class A license for my job as a firefighter, even though I almost never drive. I have to have the commercial license just in case I have to drive in an emergency situation when the normal driver goes in with the ambulance and patient to the hospital. I have two questions. Did they have the right to force me into a sleep test 5 years ago, and if not…it seems to me they should have no current right to force me to continue to takes any more sleep tests. It seems the equivalent of a cop without a proper search warrant kicking in a door and then finding something illegal. What he finds cannot be used since the initial action was not legal. My second question is: since I was cleared by a sleep study 5 years ago with the dental device, can they require me to go through another sleep study 5 years later when it’s already proven effective? Thank you for all of your help.
@Jeff
There are no new rules regarding sleep apnea. The guidelines have been in place for a long time, but people are misreading the guideline, which are not regulation. So my question would be; why would the original sleep doctor, the one who cleared you 5 years ago, want a new sleep study? And secondly, if your doctor cleared you with the device, all he has to do is complete a medical release form stating that the device is and has been working for the past five years.
I went in to get another dot physical done and passed everything I have taken a sleep study test and results were that I didn’t need a cap machine but the examiner says they won’t accept results since I gained weight from last test and wants me to take another can they do that
@Jake
There are NO NEW LAWS regarding sleep apnea.
Go somewhere else for your examination. Someone is just taking advantage of you not knowing this. Be polite, just leave if they start this with you.
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