- 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.
My husband and I drive team and my husband stops breathing constantly throughout the night; so I suggested we go and get a sleep study done on our own, not through our company or a DOT DR. He just got his 2year medical card. Well we had the study done and he got his results back and they said my husband has severe sleep apnea and needs to come get his cpap and mask fitting; we said okay we will be home at the end of May. The nurse then calls back demanding my husband come in asap, asking what state his CDL is in and that the DR will report him to DOT. My husband wants the cpap but we have family and bills and can’t just rush home right now!
How can this happen if we got this study done on our own? Does hippa not apply? Can he be reported to the state DOT and his CDL is at risk even though he is going to get the cpap, just not immediately?
Thank you in advance!
@Annie
Not sure why any nurse would be calling you and reporting you to state or FMCSA.
Technicallly speaking, once the severe sleep apnea diagnosis is in, his medical certificate becomes invalid. Cpap, even on your own, requires a 30 day waiting period before returning to driving.
FMCSA leaves certification to be determined by the medical examiner. You may be able to find an examiner who will work with you. This may help you keep driving.
1. Short card for 1 month while getting started on cpap. You must show a report of 70% compliance with the unit during this month.
2. Short card for 2 months to demonstrate further compliance.
3. Then a 1 year card.
With the new forms, conditional certification is no longer an option. The examiner will have to conduct a new examination each time, and issue a new medical card.
For more information see our blog post Commercial Drivers Can Manage Sleep Apnea And Maintain Their CDL.
Once your husband tested positive for sleep apnea it became a federal mandate. Him driving without his cpap machine put him in non compliance with the fmsca
This is nothing more than a cash grab pure and simple. Public safety issue huh. Make the cops, firemen, EMS, Air Traffic Controllers, Airline Pilots take the BMI test. Lets not forget about the retirees driving around the heavy RVs.
What about people with prostate issues that have to get up and urinate multiple tiles a night. What about heart burn? What about the driver that cant sleep cause he worries about his bills…should we test him for anxiety.
This is the biggest snake oil pitch of BS I ever saw. The best thing to fix this is to let the drivers sleep when they want….AKA FIX THE 14 HR RULE.
Drivers cant just sleep on demand at a drop of a hat. The best sleep is when a driver chooses when he wants to sleep. I need to quit driving and invest in a CPAP company.
AMEN
I had my DOT physical done three weeks ago. I have sleep apnea and use a machine. They downloaded my info and it said that I am 91%compliant and have an apnaic episode less than 2X ah hour. The Examiner said it wasn’t good enough and said I had to go to a pulmonologist for a check up and a stability letter. What should I do? I’m missing a lot of work trying to figure this out.
@Steve
Your compliance is well within normal limits and the note from the pulmonologist stability letter will be helpful for supporting a CME’s decision making process. Get a second opinion too.
My husband went for his DOT physical last week. He has sleep apnea and gives them his readings from his Cpap machine. Last year that was all they required but this year they saif DOT is requiring a Wakefulness test be given and signed off on.
Does that sound right? this is costing time, which is money. The doctor has to see him first and his calendaar is fukk for a couple of months. Because his last study was 2 years ago he was told he has to visit first before study can be scheduled.
How can we know if this is required of DOT?
@Adena
Nothing has changed in the regulations. As long as he can show compliance from his cpap readings that’s all he should need.
Go get a second opinion somewhere else.
When I went for my recertification of my DOT Phyical the Doc tells me I need to supply them with the past yr results of my Cpap compliance? How many months do I need to supply them with?
@Jerry
At least thirty days, but more is nice. You do not need to supply a years worth of data to prove proper compliance with your CPAP unit.
Just got a 90day card the nova “Doctor” says since I have been using cpap machine without a follow up a 90 day card is all I can get until a signed form from a sleep study Doctor
My husband failed his DOT physical in Dec due to a change in his diabetes meds. He was off work for 30 days, placed back on previous meds and sugar under control within the month of Dec. He went back in Jan and examiner gave him a 3 month DOT card but said he had to have a sleep apnea test done. He had to schedule this sleep test through his personal physician and the test was originally set for April 9 but his DOT physical is set for April 4. We’ve pushed the specialist to get him into the sleep study sooner and he had the first one just a couple days ago and we went in for the results today. Now, he has to have another test tomorrow night using a cpap. We’ve been told he will definitely have to start using a cpap but he can’t get that until all the red tape is gone through (final results, insurance approval, order for cpap machine, etc.). We can’t seem to get a clear answer from anyone about how many days he must actually be on the cpap before he can get his DOT physical card renewed. Even if he gets his machine on Tue or Wed of next week he still won’t be on it but for a few days before his physical on April 4th. Some drivers are saying you have to be on it for at least 7 days, others say 30 days, and Dept. of Safety in my area is having trouble getting a straight answer as well. So, to sum it up, I guess what I am asking is this, “Will they not let him drive until he has been on the machine for so many days or will they reissue him a 3 month card?” He’s already lost the month of Dec and now may lose April…WITHOUT PAY!!! Any answer you can give me will be greatly appreciated!!! THANK YOU!!!
@ Sue
FMCSA wants to have a thirty (30) day readout from the clap machine before letting a driver back behind the wheel. Not sure if any CME is going to issue a three month card while he is getting accustomed to the unit.
If there’s no current rules why are companies testing? Also, what does it mean not based on criteria alone?
My company recently decided to start sleep testing all its fat drivers and throwing 10 15 20 years of accident free driving right out the window. Also the at home test is a guaranteed fail. Very few pass it. It records yawning, sighs, and so on as events. There’s 2 or 3 people that retested and passed it after this company said they failed miserably. I have been placed on a cpap after 10 years of safe driving and am now forced to quit my job. This has ruined my quality of life not improved it. It’s just for money. Look at the criteria bmi, neck size, then age as a factor. We all get older.
@ Robert
This sounds like it is company policy, and the at home test are not accurate. Sounds like you may want to talk to a good lawyer
I challenge you to find a lawyer that will take a case on a sleep apnea testing bull, I mean really I challenge you to find a lawyer take your will take your case because you were discriminated against for being fat and overweight! and now a cme judges you ! And to cover their own butt determinds you fat boy will not be allowed to feed ,clothe,or shelter! Your family any longer together the insurance companies the Federal Motor Carrier safety administration the congressman that passed the stupid bill it’s all about discriminating against fat people basically so good luck truckers! the powerful are against us. 22 years safely driving our roadways ,and now the dot rules haveput me and my family in dierstraits… ( what to do?)
Apply for welfare that’s what I going to have to do
question i have had sleep apnea for years . Do i have to submit my machine data if i have had sleep apnea on my long form medical card 10 plus years with a letter from my medical doctor
@ doug
Yes. The CME is looking for supportive information from your doctor and from the cpap report demonstrating proper compliance.
I would like to personally thank truck docs as well as everyone who’s comments an stories I have read because of this web page I was able to avoid a headache I too was told all of these untrue statements by a CME that the company I work for uses I knew absolutely nothing about sleep apnea so I goggled an read an researched trust an believe you all helped me an I’m so grateful I tried to tell other people but they were afraid an had too much at stake than to look for a better solution can’t wait to turn in my medical card to my job they didn’t believe me again thank you all