- Part 1 – 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 [You Are HERE] – 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
The sleep apnea issue could affect both your livelihood and your life.
Ask yourself – “Am I ignoring or denying personal health problems (longer term life risk) because I can’t afford time off work (shorter term financial risk) or to lose my job?”
By being aware of the different circumstances and perspectives around sleep apnea, you get to manage this before it becomes an issue. Then you can do what you need to do to protect both your earnings and your health.
CHECK OUT THESE STEPS
Step 1: You’re At Reasonable Risk for Sleep Apnea.
A combination of symptoms and / or diagnosed medical conditions indicate that you may be at high risk for sleep apnea.
You can bet on these pointing at a sleep study test in your near future. And the Medical Examiner is justified in requesting a sleep study test.
Step 2: You May Suspect You Have Sleep Apnea But You Haven’t Been Diagnosed Yet.
Obstructive sleep apnea is a medical condition that can have serious life-threatening consequences if not treated.
If you have reasonable suspicion that you have sleep apnea, it’s recommended that you investigate it further, see your physician and do a sleep test if necessary — BEFORE it becomes an issue for your medical card — and while you still have time to look into OPTIONS that work best (financially, time wise, and health wise) for you.
Step 3: You Can Manage Sleep Apnea and Maintain Your CDL.
Obstructive sleep apnea does not necessarily disqualify you for CDL medical certification.
Treatment with a prescribed CPAP or Bi-PAP machine, and some manageable lifestyle changes, can help you take back control of your health, and maintain your commercial drivers license.
If You Feel You Are HONESTLY NOT AT RISK And Screening Seems To Be Overly-Cautious Or A Conflict of Interest…
If a medical examiner is picking single strikes e.g. neck size or BMI to send you for a sleep study, you should question the motive.
The examiner may be being overly-cautious, or work for an organization that has laid down a list of screening factors and is not considering the bigger picture. Or, the examiner may have ties with a sleep clinic, and have a conflict of interest.
Be aware that there are no FMCSA rules at this time regarding sleep apnea screening i.e. prescribing who should be tested. This does not mean you have a “get out of jail free” card to avoid the issue if you are at risk.
If, after understanding the indications of risk for sleep apnea, you feel that you are honestly not at risk, then you now have the information to stand your position if a medical examiner tries to assert screening guidelines rather than assessing your overall health situation.
Put In A Nutshell
You may be reading this article because you’re concerned about your livelihood – how sleep apnea could affect your DOT medical certification and that your CDL is at risk. If that’s the case, then you should be concerned about your health too – that this issue could become life-threatening.
Who Has Their Hand On The Steering Wheel Of Your Life?
If you don’t have your hand firmly on the steering wheel of your life, you can be sure someone else is going to be putting their hands on it. 
Commercial driving is an extremely challenging lifestyle. Will you let its constraints – health challenges, rules and regulations – control the way you live? Or will you take back the steering wheel of your life and manage your life and your livelihood, despite its challenges?
By knowing what the problems are, you can take action to make the outcome different, and maintain your CDL without hassles.
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.
Another money racket this rule should be imposed on all driving license police fireman all drivers. Screwed again
I know I’m late to this discussion but I’d like to add my experience.
I’m an EMT that’s been working on ambulances for 36 years. Since the DL51’s are renewed every two years I’ve been thru the exam 17 times with no issues until my most recent exam.
It started w/ a drug and urine test (my employer requires the drug test which is fine), then on to the exam. The doctor tells me my heart rate is elevated (that’s normal at the doctor). He stops the exam and orders cardiology referral.
I get home and all vitals normal.
I see my primary and get an EKG and echo on my heart then return for DL51 exam. I got three months until sleep apnea testing is done then I return for another exam.
What’s the next hoop I’ll have to jump thru?
He asks about my sleep…I work a 24 hour shift where it’s normal to not get a lot of sleep which means I sleep when I get home.
Let’s see what happens next
@ Mike McR
Unless you hold a class A cdl, then you should not be held to a class A standard. Lower class license fall under your states guidelines and variances. The examiner should know the differences and pass or fail according to the guidelines that you fit into. Go somewhere else for a second opinion in this case.
I took home sleep study. It said severe apnea. Now I am going to take in lab study. I was given CPAP and am compliant but can’t sleep. Can I get another physical and be cleared with that. Should I take the I’m lab study. I can’t wear the CPAP. Don’t know if In lab study comes back positive. Am I stuck. What if I change jobs and don’t tell them and pass new physical. Does dot know about it.
I was told to take a rest because my BMI was 36 and neck 17.25. I took the test and got a AHI of 10.4 and was told I have it. Was looking and they say DOT should be 20 and above for a cpac. I have lost 25 pounds and now have a BMI of 34.4. If the test said that I should have a cpac or lose weight which one should I follow?
@Jeff
Since there were no new rules regarding OSA and you lost weight, then try going somewhere else for a second opinion. If you feel that you do benefit from the CPAP, then by all means use it. Drivers who have OSA and use the units won’t leave home without it.
I just visited my local occupational health facility to get a new medical card. One of the questions on the questionnaire is “Have you ever had a sleep study test?”. I had a sleep study test performed in 2012 which came back negative of any sleep disorders. I told this to the nurse practitioner conducting the exam, she told me she could not give me a new medical card until I produced these said results. I tried to obtain the results, but the facility in which I had my test performed has gone out of business. I told the manager at occupational health facility this and now they’ve issued me a six month certification telling me I have to go and get another sleep study test done in order to get my two year card. I’ve been able to obtain four medical cards between the sleep study test and now, all certified by doctors and not nurse practitioners. I’m five feet four inches and 132 pounds, not exactly sleep apnea material. Is this a standard practice? What can I do? Can I go to a different facility in six months when my card expires to get my two year card?
@Alexander
No, it is not a standard. You just need to go somewhere else to get a second opinion. The facility you are at now is overreading the guidelines. It would be very helpful if you can find out where your records were sent though. Someone has them somewhere.
i had a sleep study done a little over three ago came back that was good no sleep apena how long is that good for . how offen do they want you to get tested
@Tony
There is no interval/time requirement for sleep apnea screening.
Sleep apnea screening should be based on health issues present that indicate potential sleep apnea.
Whent to dot physical card was failed because I was only at 40% usage for the full year. What do I have to do to get back in compliance?
@John
30 days worth of numbers with a 70% compliance.
I have CDL A I was hired to drive local I had to get a new medical card so I did my physical I noted I had a sleep study which three years ago I was diagnosed with sleep apnea I did not know this was a problem what do I have to do to get my medical card is there temporary card so I can start work I have cpac machine which I used
@George
Have a printout from your unit showing a 70% compliance for the past thirty days and you should be good to go. Medical card will be for one year at the time due to the OSA.
Two years ago I went for my dot physical they told me , I would have to go for a sleep study before my next one. so I did, and was advised I had sleep apnea . my insurance is crap so I ordered a cpap online, when it came I started using it, but something didn’t seem right. the next morning I found the mask was broken I tried to tape it, that didn’t work I ordered a new one it took about ten days to arrive. so I go in for my physical yesterday took my smart card, they ask me what that was they had no idea, I said the recording device for my cpap. they couldn’t down load the info so I had to find a place to take it now I have the info but because of the messed up mask I only have 66.3% instead of the 70% needed for dot regulations , I’ve drove safely for 40 years and try to do the right thing and it comes back and bites me in the ass what can I do ?
@Lee
Cover your ass. You might explain the situation and see if they can issue you a short card to allow you the time to get a new mask and get your compliance up to snuff.
My husband got a 2 yr certificate after his dot exam the dr stated no limitations etc but after he signed the paperwork and issued his new card he gave him back his sleep evaluation certificate and said he had 2 of the factors recommend a sleep apnea but gave him his 2yr so we are confused
@Sue
The two year medical card went into the FMCSA database and stands as good for two years.
If he has sleep apnea and has already been tested, then there are new questions here. Does he have sleep apnea, does he need a cpap unit, does he use the unit 70% of the time for compliance? If no unit is required, then you don’t need to do anything. If he does have sleep apnea and uses the unit then he should have received a one year medical card.
How long do you have to be 70% or more compliant using cpap to get a one year certification in the State of N.H?…been using mine for just over a month and half
@Eddie
30 days of compliance is what is a minimum requirement for CPAP usage. Any time frame longer is just icing on the cake.
I went to get my medical dot physical card yesterday and pass every test with flying colors. Now the Dr told me he couldn’t pass me cause of my bmi and I needed to go see a dr for this part to get my medical card and I looked at him why is he telling me this and he also told me I have to pay about 500.00 for this and I told him he was crazy. Asked me if I have problems sleeping or do I snore when I sleep and I’d told him no I don’t. I have no problem sleeping at all and on my days off I sleep in and get alot of rest. He told me my weight and height is why he couldn’t give me my medical card. My weight is 230 with clothing and wallet and shoes on and not one time the they asked me to remove them from me and then get weighed and then after that he told me he sent all this information to the DOT to let them know i was order to take that sleeping study. Bear in mind they didn’t do my physical properly nor did they do the measurements of my neck at all. So I’m asking what so I do my old dot card does expire till Aug of 2016. Don’t have the money to get this study and I did let them know all I have to do is lose 10 to 15 lbs and I know I’ll pass it. So what I’m asking what should I do next and what set do I need to take cause I just lost 100.00 on this physical and now they want me to spend 500 to 2000 on some test that’s bs.
@JD
We just answered your same question at http://dotphysicaldoctor.com/can-dot-medical-examiner-refuse-medical-card-unless-you-have-sleep-study/
Thank you and I will do this asap.
I had a sleep study done in 2011 minor was told I have minor sleep apnea and was given a CPAP. I tried to use it for the first year but found it made sleeping very difficult. At the time of the sleep test I was under a lot of marital stress. Since I have not been using the CPAP and do not have daytime sleepiness can the medical examiner give me a 2 yr certificate. I already had the exam today and he is reviewing the rules. He also had me fill out a Berlin sleep test and said it was a good score.
@Jim
It will be up to the examiner as to what he does with the findings. If there was no sleep disorder, then he may go for a two year card, but without retesting to make that decision, he may hold to one year at the time.
My husband did sleep apnea test 6 yeas ago. His dot doctor told us nothing about any results and my husband kept his medical CDL. Now he has gotten another Dot doctor who said my husband was diagnosed with sleep apnea 6 years ago. So, now Dot dr gave him a 3 month renewal and said he had to get a sleep study done. My husband has been driving more than 40 yeas and he is almost 60 yeas old. He never has had any bad driver records. So we don’t understand why it didn’t matter for 6 years that he has sleep apnea but now all of a sudden our doctor is concerned, and if he does have the disease is there anything he can do in order not to lost the CDL license?
@Olga
Some questions first.
When he was diagnosed with sleep apnea was he treated in any way, like a CPAP or mouth guard?
If he was not diagnosed with the condition and there was no treatment, then where is the last sleep study? With out more information we would be at a loss to try and answer any questions.
What is the percentage Allowed in 90 days for a dot physical with a cpap
@Steve
70%. See article Sleep Apnea Maintain CDL.
My personal story. d.o.t. dr. gave me a three month extension, sent me to get sleep study done,. then my card expired and got laid off for three weeks. i am still temporarily laid off from my company. This has been a waste of time and borrowed money. To me its another money grab.!. now i am in debt. Do not allow these d.o.t. doctors to assume you have sleep apnea,when you know you do not. The doctors are getting paid and truck drivers are going in debt. after talking with fellow drivers they all agree this is another racket.
i just went for new dot recert. dr. says new gudlines require sleep study because of bmi and neck size. only got three month recert. got into screaming match with dr, because i had just read there was no fmca guidelinse. he says he just recieved them from his co. do i neep to apollogise or keep telling him to pound sand.
@Tom
No you do not need to apologize, because there are no new rules regarding bmi or neck size. The rules and regulations regarding sleep apnea are vague at best.
So unless there are other signs and symptoms indicating the possibility of excessive daytime sleepiness, just go for another physical some where else, before your three month card is up.
well just went for recert again since three month card is ready toexpire. because i am fat, ave a large bmi, high blood pressure[had this before i even started driving 27 years ago]now over the age of 50 dr. says i have 4 points against me that says i must have sleep apenea test before i can get physicaly cleared.???? she says that is new guidelines. i looked at symptons they look for and i dont have any but these four symptons. am i gonna have to give in and have to have sleep test which i cant afford?
I have sleep Apnea and have a CPAP machine…I also have a Dental Device from my Doctor and i like it best and use it all the time and it works..I can tolerate it better than the CPAP machine. Will my Dental Device be acceptable for my DOT card?
@Robert
Just make sure you take a medical release form, completed by your doctors and the last readout from your CPAP unit to show compliance. With an explanation from the doctors regarding your CPAP and dental device. It will help the CME to make a more logical decision in your case.
My husband got his 3 month medical card which expires 10/1 he just had his first sleep study that says he has sleep apnea….he currently drives a school bus….but I was wondering what happens now? Will he have to take time off from work or can he still drive with his temp medical card?
@Jennifer
Once he has been diagnosed with sleep apnea, he will need a machine. Then there is a short waiting period to stablize his new sleep pattern.
Your husband is not driving long-haul or OTR, so there should be no problems getting a new short term medical card to drive a school bus.
Driver has current DOT medical card from previous employer which is vaid until 7/2015. He was sent for a new exam by new employer and given a 3mos card due to neck size and BMI and told a sleep study was necessary before they would issue a new card.
Since this Driver does not have a “diagnosed”” condition that would prevent him from driving, can/is his current DOT med card that is valid thru 7/15 suffecient after the newer 3mos card expires? Driver can not afford sleep study at this time but will persue in 2 months.
@Donna
The whole BMI and neck size issue is a major misunderstanding by some medical examiners. If you ask them to show you the regulation that makes this a requirement, they can’t, because it does not exist.
The employer is allowed to have stricter requirements and impose their own screening criteria.
So you need to find out if this issue is coming from the employer, or from the medical examiner.
You may be able to use the present valid medical card, and when it’s time for a new DOT examination, go somewhere else. Good Luck
Dot dr gave me a 3 month renewal and said I had to get a sleep study done. I did that and am going to get results tomorrow. What do do with the results? How often do I need to see a dr and will I have to get a test every year? Can’t afford that at all.
@JeffP
Well once you get your results, then I may be able to answer your questions. If you’ve been diagnosed with sleep apnea it’s one answer, if you don’t have sleep apnea it’s another.