- 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 just got a promotion to a great new job driving truck for the city. I need a new medical card and went to renew and discovered that I will most likely need a sleep study. What the hell! I am wondering if all medical examiners require this or just some. Are there any who dont? I really can’t afford a sleep study right now!
@Jonathan
There are no new rules or regulations regarding sleep study needing to be done. If you do not demonstrate a multitude of other symptoms other that neck size and BMI, then find someone who understands the FMCSA guidelines and have them administer the DOT examination.
I am having the same problems getting my medical card based on my physical appearance and nothing else, they all been telling me unless I go have a sleep study done they can not issue me a medical card, so now I am unemployed because of it, is there anyone out there that knows if we can file a class action lawsuit on the medical industry for denying us a medical card strictly based on our general appearance only, because it sounds a little like discrimination and profiling and nothing more than a money making scheme and the trucking industry is losing a lot of good drivers over it. p.s. one of the reasons I don’t go out an humor these so called doctors is because I am unemployed and I have no insurance to cover the expensive cost that would be involved. please let me know if we are entitled to open a class action lawsuit. thank you
If you find out anything I would like to know please. I was just told I have to have a study done or will not be recertified.
I was waiting to see if any suits have popped up and nothing yet. I am suspecting that most drivers are told this is the law and they believe it. I am considering a visit to an attorney in June if they try to force me into the testing. You should get a lawyer and start the process by yourself. From there they will start a notification process to see how many drivers they can get involved. If the FMCSA sees this happening I think we would see them back up on this issue. To me this is nothing more than a money grab.
Why is there a rumor going around that once you have a DOT physical by one doctor you can’t get a second opinion? I was given a 90 card by a DOT physician set up by a new employer. The reasoning was that my BMI was 2 points higher than limit (mines was 35 and the limit for my height was 33). I was told I had to have a sleep study done and due to the high demand for these studies in my area my card expired 2 days ago and I just got an appointment today for a clinic 60 miles away on the 15th of Oct. I went back to the doctors on the 23th thinking that they would give me another 90 day card until i got the sleep study worked out. The doctor told me to spite that fact that there is not one thing wrong with me she couldn’t give me another card, which I believe she is lying. My bosses want to send me to another doctor but are under the belief that I must always go to the same doctor. I didn’t think this sounded right and after reading your comments on here i now know it isn’t. I will be calling my employer tomorrow and set up an appointment with another doctor. Thanks
My husband got a dot physical at concentra in erlanger ky, the dr. Told him he needed a sleep apnea test and only gave him a 90 day physical card, I read this and he got a second dr today 11-5-2016, he got his physical card for 1 yr.hurray and the dr.is dot certified, so concentra is running a skam
Very similar situation for me. 5-star urgent care wouldn’t issue a temporary card as they felt my CPAP compliance reports were not meeting 70% 4 hr./ day jargon.
Can anybody find a rule that says 30 day temporary can’t be issued while I ‘ earn’ an acceptable 30 day compliance report.
Yep they just pulled the same b.s. on me at 5 star in Jamestown. Everything was good for a 1yr card but because they have their own policy about sleep studies I was only given a 3 month card and “required to get a sleep study”. This is noting more than a money making scam for these greedy pricks.
Not all Concentras are jerks
Last yr I was in Tulsa PASSED
This yr in Memphis NOT PASS
Concentra just did it to me said I’m 50 yrs old and a BMI of 35 gave me a 30 day card I’ve been driving 30 yrs. I’m fucking done with driving thanks government and concentra for profiling
BTW trucking jobs pay less/ the same as then 30 yrs ago.
You bet concentra is running a scam!!! My husband has been out of work for months due to them! They gave him 30 day card and told him come back with your mandatory is a results. Again, unemployed no insurance, had to wait for medicaid to start. Then concentra changed mind. Said no card without another exam plus another fee AND our medical board will decide if you get a card at all.
What do these rent a doctor’s know about osa ?????
Concentrate in okc told me that doctors were fmsca certified and my files was shared with other doctors and if they issued me a card and I was in a accident the second doctor could loose their license. So hearing this and no insurance my career was over
Concentra as of 4/13/ 2017 was told from head office all doctors will require a sleep study for anyone 30 to 35 BMI or above. REGUARDLESS of anything else. Still thank that doc in TN that called me to tell me not to use them anymore. No other symptoms of Sleep apnea got my 2 year with out a problem but my BMI is 37. So drivers until one of us wins the lottery and wastes it on a lawsuit we will never win this fight unless WE change it. Wait we cant even give a Sh$T about each other anymore. Anyways avoid Concentra period
Don’t worry about getting your freight moved guys. Hillery has promised to bring in 600,000 Syrians in her “first 100 days.” With the new automatic transmissions it will only take a couple weeks to turn out a bunch of new drivers who won’t need c-pap machines.
Schneider National has told me that I have to have a sleep test. I expect to lose my job in the next couple days.
I have been a hard charger for every company I have worked for since 1989. I won’t “comply.”
Go get another physical done by a dot dr look it up
help what docs dont require a sleep study i just lost my job
Don’t feel bad I am facing the same discrimination out look, because I have been unemployed now for around 3 months and I trying to receive unemployment Insurance but so far not much luck. I wish that enough of us could find a way to file a class action lawsuit on Concentra Urgent care for discrimination because that is the only reasons I was denied was my BMI & Neck size and nothing else.
OK I was told the same thing and when I went to my personal doc she said that I don’t have sleep apnea and I don’t need this but set it up anyways only to find out that he sleep study place is backed up 5 months out so I will have the same problem I will lose my job also now what can be done for us people
So, what is the legal recourse we have as drivers against being forced to take a sleep apnea test? The FMCSA guidelines seem awfully discriminatory as is singles out drivers that are overweight. From what I’ve heard about the testing it sounds like the system is set up so you fail no matter what.
@Shane
If you read these articles on sleep apnea testing you’ll see that overweight is not an FMCSA regulation to single out drivers for testing.
If you feel that you have been singled out and you do not have sleep apnea, then go to a different CME for a second opinion, or choose your DOT doctor wisely as we say on this site!
My son’s company requested and paid for a physical so that he could continue to drive a box truck for his company. Due to the circumference of his neck and BMI they are now requiring him to go through his own insurance for a sleep apnea test that could potentially cost him more than $1500. He has no symptoms of sleep apnea and sleeps quite well. He works in Virginia and we live in Maryland. Does my son have to pay for this test? He drives with a regular class C license. Thanks for any assistance you can provide.
@Mona
Get a note from his doctor that says he has no signs of sleep apnea and go to a different CME for a second opinion.
Will do! Thank you!
I just had some dealings with this and the DOT physicians have requested a letter from a sleep study physician and not from a regular physician. Another hurdle.
Can my husbands employer force him to pay for the sleep testing here in Washington State? He isn’t even driving a truck that requires a CDL yet they want him to take this test which will coast us over $2000 out of pocket.
@Amber
Check with the states laws, but it would be unreasonable to suspect that they can demand such a thing.
Does DOT recognize any other form of treatment for sleep apnea other than a CPAP machine?
@Annette
Corrective surgery. Also depends on how extensive the OSA is. But usually testing is still required if confirmed OSA and you need a print out of your compliance record.
Hi Trucker Doc,
I had sinus surgery back in Aug 04 and I will tell you it helped. My nose doc said he spent 4 hrs on my bridge because it was broken, yet I never knew it. Even still, I am 6’2, take BP meds and that was my mistake, because it made my weight grow from 250 to 290 my BMI is 43, yet its belly fat from fluid retention thanks to the drugs in the BP meds.. I think more on the lines of cortisol is the reason along with the 5 med combo (3 tablets) I was taking. Ive been looking at alternatives to prescribed meds and havent found anything yet. No company should be telling any NEW driver HE has to pay for a sleep study, when he isnt employed, thats discrimination and so is this sleep apnea.
Whoever this Medical board is comprised of, DOT is putting blame on innocent truckers and NOT looking at the REAL culprits, Those driving their cars and texting, along with motorcyclists who think they can pass on the dashed lines on the highway and make that mistake by jeopardizing the trucker they just cut off and the other cars AHEAD that create panic to where everyone SLAMS on their brakes and truckers who cant stop fast going 65 on a 4-5 lane highway. I seem to see the Trucking Industry is MORE focused on making complaints to the government about finding great drivers, yet discriminate us by cutting down those who are over weight. and they judge by the cover rather than whats inside.
Since now Marijuana is being legalized across the nation, Im wondering how many more deaths with be caused from it and the use of SECOND HAND SMOKE giving truckers a false positive on a random drug screenings. Its something that NEEDS to be addressed and stopped.
I have seen products out here like a dental device where you put it in your mouth and it protrudes the lower jaw OUTWARD and removes the sleep apnea altogether
Also lets NOT forget the TRUCKERS who dont monitor there hours of sleep. Stay up all night watching tv movies
At the bar watching pole dancers…etc etc….they are to blame as well
My son is 25 and has been driving CDL for 2 years. His first certificate was good for 2 years as he has no health problems. He had to renew so he went in to a DOT doctor up by his company in Tennessee. He had no health problems but he is overweight and has a large neck size so they gave him a 3 month certificate and told him to go get a sleep study done. I found out someone close to where we live that is supposed to be good so he met with him. He has no issues with snoring or sleeping. The doctor was nice but told him the only way to tell if he has sleep apnea is to have the study done. He had to wait to have it approved through his insurance but they called today (2 weeks later) and scheduled him to go in next week for the sleep study. He has a $1,000 deductible for his insurance and they are only covering $100 of the study so he is going to have to pay $1900 for the study which he really can’t afford but they told him he could make payments. He really does not want to pay that much money for something he doesn’t need plus from reading this page and other information, it seems to be alot of money scams going on with these sleep doctors.
My question is should he risk doing the sleep study or just try another DOT doctor? He has about 2 months left on his certificate. How do you go about finding a doctor that is not using BMI or neck size alone as a criteria for sending him to a sleep study? I thought about calling a few in the area and talking to them about it but didn’t know if that would make it worse or better. Any suggestions about whether to try the study or not. Or any suggestions about finding a doctor that doesn’t over read the guidelines? I’m worried that if he has the study, he will be stuck in something that he doesn’t need and won’t want to wear.
@Julie
Go for a second opinion.
There were no new rules regarding testing for sleep apnea and if he has zero other symptoms then he should not be being held to a bogus set of criteria that are not a part of the FMCSA guidelines.
If he exhibits other symptoms of day time sleepiness or having trouble staying awake, then have the test otherwise, second opinion.
Thank you. I actually called the truck driving school he went to and asked them about who they use and if they have seen an increase in students needing sleep studies for being overweight. They said they hadn’t and gave me the name of where they have students get their exams. I called them and specifically asked them if they use weight alone as a reason to send drivers to a sleep study. They told me no and that they only send them if they have real concerns based on the whole exam. He went today and everything checked out just fine and he was given his 2 year certificate without any problem. They didn’t even bring up weight to him. They told him his blood pressure and blood work was good. I guess my advice for anyone who is told they have to do a sleep study that they don’t need is to call and ask directly what the guidelines are that they use. I am so glad it saved him the hassle and expense. We paid $60 for this exam but it was well worth it.
@Julie
That’s good news Julie. And a good example for others to follow. Thank you!
Still going through a hassle with this. His employer said they have a dilemma because 2 different doctors came to different conclusions. He went to talk to the original doctor that wanted him a do a sleep study. That doctor said it is because of his weight. My son brought up the fact that weight alone should not force a sleep study. The doctor said it wasn’t a rule but it was a guideline that states sleep study for anyone overweight. He also said that the sleep specialist he saw recommended testing to rule out apnea which is crazy because of course they are going to recommend testing but he even said that it doesn’t sound like he has it but the test is the only way to be sure. The original doctor said that he would send him home with a test to do on his own and then bring back to read the results. He said absolutely not because those are inaccurate. His employer is trying to work it out with him. They told him if he can get a third opinion from another DOT doctor, that will be fine. He can do it up there at one of their clinics and they will pay or do it on his own and pay for it. I told him he needs to do it on his own so I guess he will be paying for another physical but at least it will be at the doctor he chooses. He was straight up with his employer that he will not have the sleep study and they are working with him.
@Julie
Good that you are taking matters in your own hands!
When you call to make an appointment for a new medical examiner, ask the examining office if/how they handle sleep apnea screening. Then make your decision based on them doing an appropriate overall health / fitness-for-duty evaluation or not.
Great news Julia! Will you please share where he had his DOT physical done! My fiance, based on weight and neck circumference alone is going through the same thing! Thank you!
I just did my DOT physical and I passed everything with flying colors and Dr asked me if I problems sleeping or I snore and I told him no I don’t. Now he told me my bmi is what is stopping my from getting my DOT card. I know they did not do my physical correctly and they never checked my neck size properly nor did they tell me remove things out of my pocket and remove my shoes. My weight was 230 and my height is 5’7″
@JD
Go somewhere else for a second opinion.
Read the comments for @Julie whose husband got a 2 year card on a second opinion.
I wrote to the FMSCA to ask them about the issue of sleep studies that some doctors are requiring. Here is their response:
The Federal Motor Carrier Safety Regulations do not prohibit commercial motor vehicle (CMV) drivers from seeking second opinions.
If both medical examiners are on the National Registry of Certified Medical Examiners, considerations include:
· What are the local policies concerning medical certification of CMV drivers, (i.e. does the employer require all drivers to seek medical certification from the same provider or a company sponsored provider?), etc.
· Medical examiners may vary in their decision of whether the driver meets the Federal Motor Carrier Safety Administration’s physical qualification standards for commercial drivers based on their individualized assessments and evaluations.
· Some medical examiners may be more or less conservative in their evaluation and medical judgment of whether the drive meets the physical qualification standards.
· It is the employer’s decision which medical certification to accept.
· Drivers and/or employers may agree to engage in and apply for the resolution of medical conflict process found in the Federal Motor Carrier Safety Regulations (FMCSRs) where (1) there are conflicting medical opinions between the medical examiner of the employer and the medical examiner of the driver and (2) the employer will not accept the opinion of the driver’s medical examiner. ( 49 CFR 391.47). The link to the regulation is provided here.
· http://www.fmcsa.dot.gov/content/39147
If you need additional information please contact us by phone at 202-366-4001.
@JulieC
Thank you for taking the time to help other drivers in this issue that is unnecessarily costing some drivers time, money, and even their job.
(we tried the link and unfortunately FMCSA has removed the information from their website)
Tell him to come to work for dart TRANSIT here we don’t go thru crap like that. Sleep apnea its a big money scam done by bad doctors and bad big trucking companies… My name is victor garcia. And. I. Had to tell Schneider national flat bed division.. In sequin tx where to shubb they’re sleep study. They we’re forcing me to undergo a sleep study… And the reality of this is that. Big companies are crashing in on this sleep test.even if you haven’t being diagnosed with sleep apnea…in turn they turn this Big and Costly test in as losses… Crete Carrier tried to do the same with me. They had made the TV room turned in to a sleep apnea study room. And they tell driver’s they have to have sleep apnea study done…hiding under government regulations they said. Guessed what. I told them too what to do with it….in other words.. don’t . take any sleep apnea study’s by big companies.. Unless is you’re very own Doctor prescribing you the study….. Remember its all a money scam.
A sleep Dr has nothing to do what so ever with what is required for a DOT physical . These drivers that are required to have a sleep study are 1. Obese/ BMI greater than 35. 2. Large neck due to obesity 3. hypertension, all DOT guidelines not the sleep Dr and 97% have sleep apnea that needs to be treated . Lord forbid a truck driver falls asleep behind the wheel and kills someone, it has happened time and time again . Be safe and get tested and treated .
OK I have bmi of 35 neck size of 18 and diabetes I take blood pressure meds to protect my kidneys from diabetes my personal doc that i see as many times as 12 in a year said I dont have sleep apnea but the dot doc that i see once a year or less said I have it what do I do
@Joe
No new rules or regulations regarding OSA, so go somewhere else for a second opinion. The present CME may be over-reading the guidelines.