- 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.
Hi,
I just had a sleep study done, after a request from my current employer. I haven’t researched the issue in advance and felt pretty confident, that I will NOT be diagnosed with apnea. I was wrong. I was diagnosed with sleeping apnea and now I am told by my employer, that I have to use a CPAP machine in order to keep driving for them.
Is there anyway, that I can refuse using the CPAP machine and keep my job or at least keep my CDL license? If once diagnosed with sleep apnea, am I required to use a CPAP machine in order to maintain my CDL license?
Thank you for your help!
@Chicagski
It’s a little confusing. You must maintain a valid medical card to maintain a valid drivers license.
So in your state you most likely need to use the cpap to maintain a valid medical card.
Since your employer is following the letter of the law, not sure if you can bypass the situation. If you leave their employ, then it goes to the state DLD to make the next decision regarding maintaining your driver’s license.
If it has to go to federal, then yes you must show ongoing compliance with the cpap to maintain a valid medical card.
Hi, I recently went to get my dot physical and was told that I need a sleep apnea study done, my bmi was 42.8. I passed everything else, they also said they found microscopic blood in my urine, which I’ve been told is actually somewhat normal. The Dr., only cleared me for two months pending a sleep apnea screening. Do I need to have it done or can I just go somewhere elsein two months from now? Thank you..
@Henry
The CME should have found a multitude of findings before he requested the sleep study.
If you have daytime sleepiness, then consider the sleep study, if not go somewhere else.
Do question blood in the urine, it may be nothing and it may be an early warning sign. Have your primary doctor check it out and confirm that it may be normal for you. He could then give you a note stating his findings and it would help the CME out also.
Thank you. I, and I’m sure everyone else here appreciate you taking the time out of your schedule to answer our questions.
You are welcome Henry!
I was diagnosed with sleep apnea about 8 yrs ago but I’ve only been a cdl driver for 6 yrs. I had been able to my medical card with no problems before because CME weren’t required to check for neck size and bmi required now by fmcsa and sleep study. And i never admitted to having sleep apnea to my examiner when going through the dot physical. My question is, now that it’s the law when i go for my renewal physical and the if dr orders sleep study because my bmi is way over 35 and my neck is over 18in do i tell him I’m already using cpap machine and should be in compliance.
@smiley
You should answer the questions honestly and that will tell the examiner that you already are using a cpap. You will need to have a recent readout with you and a medical release form from your doctor also. With the new physical coming out in late December of this year, you really are going to have to support all information that the CME needs. Falsifying your DOT examination could cost you your CDL.
Last year I was diagnosed with sleep apnea went for new job sent for re-cert was given 90 day cert CME was extremely rude wanted another sleep study done I waited two months & just went to a different CME they gave me a 2yr cert without even asking to see compliance with my cpap machine am I OK with my new card or should I be worried about dot coming after me
@Johnny
Everything about this smells bad. So, if you reported to the first examiner you had sleep apnea and he wanted another sleep study, then the examiner didn’t fully understand his position as a CME. If you went to another examiner and didn’t give him the same information, then you falsified the medical report.
The first examiner has already reported his findings on the FMCSA database. So you should have received a one year medical certificate at the time of the first examination.
If the second examiner reports that you have no issues and no sleep apnea, then both you and he are going to be up for questioning if the system kicks it out because of factual discrepancies.
You should provide proper information to a qualified medical examiner who understands the readout and sees that you are in compliance with your CPAP and you should receive a one year medical certificate.
I’m getting ready to get my physical done within the next three months. The last time I went where my employer sent me they tried to say I was required by law to have a sleep apnea test done based on my weight and bmi. My employer then sent me elsewhere and I was given a 2 yr card. Where can I find the laws and or recommendations concerning this In case they try again so that I am familiar with them. I have no problems sleeping. U really don’t want my employer or myself to have to pay thousands of dollars for something I know I don’t need. Thanks.
@Mighty Joe
As stated in this series of articles “There is currently no ruling by the FMCSA for sleep apnea screening on DOT physicals.“
I am a 69 year old school bus driver taking Tramadol 50 mg twice a day FOR KNEE PAIN ,DOT EXAMINER disqualified from driving until my doctor takes me off this medication. Last year I was taking Tramadol and didn’t have any problem getting my 1yr card.
@Robert
Your DOT examiner is over-reading his job description and is not in a position to make you do anything.
I would have your doctor fill out a medical release form and go somewhere else to do your DOT examination.
I had a new employee dot physical done the examiner gives me a 3 month medical card. Three days later another new employer sends me for another dot physical the examiner gives me a 1 year medical card. I put the same thing on both about my medical history. Is this considered doctor shopping and will I get my medical card pulled?
@Mike
If you were sent by your employer, then there shouldn’t be any real issues.
I have a friend that has been a truck driver for over 10 years. He uses a CPAP machine but not constantly. He is extremely active at work and with his son playing hockey. He doesn’t drive overnight.
I’ve read through the Mayo Clinic website about sleep apnea (and also DOT site about it) and one of the things they say “may” be a factor in having it is a large neck circumference. He has always had that even as a child. Also he does not use his machine every night but he is told he has to use it at least 70% of the week. How is that so when not everyone is the same and not everyone is that bad off? He also has a little weight to him but is still healthy. Just would like some of this clarified, please… Thank you
@Carter
FMCSA set the rules and regulations on this one.
Start with a medical release form from his primary doctor stating that the driver is using his machine at least 70% of the time.
That will answer most of the CME’s questions.
Since everybody is different the FMCSA tried to keep it pretty simple, but it still does not fit everybody, just the majority.
Does a Class B license holder (schoolbus driver) have to meet the same physical standards as a Class A truck driver?
@Shelley
If you are going to be driving interstate, then yes.
If intra-state only, then you have to meet your state Drivers License Department rules. Check with your state DLD and confirm what those requirements are.
I recently went for my dot physical 1-31-15 I was told my bmi is to high and neck size is 18.25. My vision is 20/20,hearing is good, blood pressure is 120/80, and not diabetic. I was told I need to have a sleep study. Is this true? If not what can a do about it?
I was given a physical card that expires in 90 days. Do I have to wait to go seek another opinion?
@Len
No it is not true. If there are a multitude of other signs and symptoms, then there may be good cause. Otherwise go somewhere else to get your next DOT card.