- 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.
Are there any legal cases against Concentra regarding me needing a sleep study and not accepting my regular doctor’s opinion that I do not need a CPAP machine and do not have any symptoms of sleep apnea. HE filled out the required forms, we got all the requested paperwork to Concentra and the physicians assistant who did the test says she wants a sleep study anyway, Holding me hostage as I can’t get an extension on the CDL medical card from them.
It seems there should be a CLASS ACTION suit somewhere!!
@ Verle
Since there is no DOT/FMCSA regulation or law regarding a sleep study for cdl holders, then this company is acting irresponsibly. Go some where else and have your medical exam done there. No known class action suit that we know of, but there should be.
Can I get a recertification for 3 months while I wait for my “cpap” machine? My DOT Med card expired last week.
@ Jay
Check with your examining physician.
I recently had to return to concentra for a physical. I had gone over 2 years ago and doc wanted me to do a sleep study I knew I didn’t need and gave me 3 months. I went to a different clinic for another opinion told them what the first said and they gave me a year no sleep study needed. Now I was forced to go back to concentra this year and doctor refused to give me any medical card because I was told over 2 years ago to do a sleep study which I didn’t do. I explained I got a second and even third opinion that deemed it not needed. He didn’t care refused to give me anything other than disqualified and even threatened to report me to dot and fmcsa. I spoke with e screen who we use for our physicals they double check it. They told me to ask my safety manager to go elsewhere. When I asked my safety manager he refused saying that would be “doctor shopping” and he’s not sure how the other clinics let it go before. He said apparently “by law” this doc isn’t allowed to give me another certification because I didn’t do the study before. I was gonna pay out of my pocket for a different clinic and was told doing so they wouldn’t be allowed to certify me and if it got back to work that they did I would lose my job. Being forced to do a sleep study to which they already scheduled for me to get equipment the day after study even though they don’t know I need it yet. I feel stuck and don’t know how to fight this any further. Currently on loa as they won’t let me work because I technically don’t have a medical card now. What should.i do from here? Can my personal doctor give a exception?
@ Dale W
Get a note from your primary physician stating there is no need for a sleep study, because you do not show the multitude of signs that should accompany OSA. It seems that you are being held against your will by a company and a facility [Concentra] that is in bed with a sleep study group. (conflict of interest?) Everybody has the right to a second opinion. Elon Musk famous words come to mind. Tell em’ ‘go @#&%* themselves’ A better job awaits you. Get a new medical examination done, elsewhere, and a new valid medical card. They can’t report you to DOT/FMCSA, for requesting a second opinion. Scare tactics?
I got a 2 year clean dot physical from my certified dot examination guy who by the way is a Chiropractor At a health And rehabilitation center That is on a national registry for d o t physicals I went to get a new job at a company who does not accept. Chiropractor dot physicals and required me to get another physical done by concentra and they said that I was recommended to get a sleep study done does that Super seed the d o t physical I got done by my dot that I already had done
@ Jonathan s
If the clinic input your data to the national registry and gave you a short medical card, then yes it will supersede you other card. The facility you went to is in bed with sleep. study groups (conflict of interest?)
So I got a dot medical for 3 months because of my BMI and neck the dot physician recommended I get a sleep test done and gave me 3 month
3 months pass and I go to another doc same clinic same thing 3 months pass after that and I go to another clinic and got my 2 years without my sleep test can I get in trouble for not doing the sleep test?
@ John
Nope.
Weight on paper first time 300 5’7
Second time 270 third time 200
If a DOT driver fails a physical because the doc wants him to have a sleep study, how long does he have to return those results before he’ll have to have another DOT physical? And, does he have to have another DOT drug test as well?
@ Carrie L M
Your driver should have been given a short medical card to allow him the opportunity to get the sleep study done. If the driver feels this is an incorrect assumption by the medical examiner, he can go else where for a second opinion.
There is no drug testing done at the time of a medical certification examination. Urine sample is for blood, protein and sugar only. It is likely that he will have to repeat the medical examination. That is a DOT/FMCSA recommendation.
D.o I have to use the machine for 30 days.
@ Miguel B
30 to 90 days with a 70% usage compliance, according to DOT/FMCSA for Class A drivers.
How do you get medical card if I’m for CPAP machine
@ Michael L H
See your other answer, then take your readout when you go for a new medical card.
My medical card is basically being held hostage over a sleep study for apnea. Something I don’t have, *MY* Drs. know I don’t have, do not have the symptoms or signs of, no issues with, etc., & he’s making a mountain out of mole hills to order it. This jerk isn’t even my Dr. He’s not even a “Dr.” He’s a Physician’s Assistant. He is also known throughout the company for sending anyone he possibly can for a sleep study any chance he gets for any excuse he can come up with. His excuse for me is I have high BP, BMI, & asthma. But not really—I’m a mild asthmatic. So mlld that sometimes my inhaler usually expires before I use it all. & it’s only a problem in the winter. He tried to put me on preventative steroids with 5 mins.! I have mild fibromyalgia & don’t take meds for it because it caused me more issues, so yes, the chronic pain elevates my a BP little to the high end of normal & I had a migraine the day I was sent to him. I have hypothyroidism, even weight loss surgery failed & I hadn’t been on medication for it because I lost my previous job & had no insurance. All reasonable explanations & no serious issues or limitations. He’s an arrogant jerk, not using any common sense, & only issued my medical card for 3 months. Personally, I think he’s running a sleep study racket. He wouldn’t be the first. My company insists that I have to finish this with him or else it’s “Dr. hopping” & I’m not allowed to choose my own Dr. How do I get around this, get my medical card, & stop this abusive jerk?
@ Sher C
You are not doc shopping if you demand a second opinion, especially if you know you do not have a sleep disorder. Go elsewhere for a second opinion.
If your doctor says you don’t need one then have him write it down for you and give it to your medical examiner. They can’t go against your doctor. I know I had the same problem and my doctor said a lot of times the place is working with the sleep study to make profit.
@ Mark
We agree.
So I’ve decided to get a 2nd opinion for my Dot Card. One I found through this website. Previous examiner wants results from a sleep study bc my BMI is 33.5 and neck is 17.5 and I’m 48. Even though I told the examiner I’ve never had issue with sleeping in my life. Anyways, I did call some sleep study places and almost all of them are like “Wait list for a study is like 2-3 months out” WHAT? I can’t go that long without working. So my question is, if this new examiner I get a 2nd opinion from somehow tells me I need to get a study done, do they at least give you a temporary DOT card for 3 months or so, so you can at least still work while you’re waiting to take this unnecessary sleep test?
@ John Z
DOT/FMCSA NEVER established a required sleep study be done, based solely on BMI and neck size. You must present with a multitude of signs and symptoms before a sleep study is requested. Go for the second opinion with a CME that is not in bed with a sleep study group.
I am going through the same process right now