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Q&A
Is sleep apnea a disqualifier?
What is EDS? Is EDS a disqualifier?
If I’m overweight do I have to have a sleep apnea test?
Is there a BMI limit for commercial drivers to pass the DOT physical?
What does neck size have to do with the DOT physical exam?
What does snoring have to do with the DOT physical exam?
I take Restoril for sleep. Will that be a problem for the DOT physical?
Is sleep apnea a disqualifier?
Sleep apnea does not necessarily disqualify you for medical certification. Treatment with a CPAP machine and some basic lifestyle changes can help you get a restful sleep and maintain your commercial driver’s license. Many drivers who have suffered fatigue for a long time , and then were diagnosed with sleep apnea and treated, report that they’ve felt like a new person since they’ve been on a CPAP machine.
You will need to bring a medical opinion letter from your treating physician before you can be considered for DOT medical certification.
Narcolepsy is a disqualifier regardless of treatment, because it poses a risk of EDS and may also bring on sudden muscular weakness.
What is EDS? Is EDS a disqualifier?
EDS stands for Excessive Daytime Somnolence or Sleepiness. Because fatigue and driver drowsiness are safety concerns, the medical examiner must rule out EDS before certifying. A driver who has EDS will be temporarily disqualified until the condition is being successfully treated. The medical examiner will want to see a medical opinion letter from the treating physician before issuing a medical card.
If I’m overweight do I have to have a sleep apnea test?
No. Being overweight, of itself, does not mean that you should be tested for sleep apnea. Overweight is an initial indicator for the medical examiner to make sure that other conditions aren’t present which may affect your ability to safely operate a CMV.
The medical examiner will evaluate your overall physical condition and health history. The medical examiner has a responsibility to have you tested for sleep apnea if he/she has reasonable suspicion that you may have sleep apnea. Many people suffer for years from sleep apnea and don’t know they have it until a doctor catches the symptoms.
Sleep apnea is not only associated with sleep deprivation. It’s also associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, and diabetes. The most serious complication is a severe form of congestive heart failure. Sleep apnea sufferers also have a 30% higher risk of heart attack or premature death than those unaffected.
Is there a BMI limit for commercial drivers to pass the DOT physical?
There are currently no set specifics on BMI measurement in the DOT regulations. However, companies may set their own policies and have their own standards for these indicators, which may disqualify you to drive for that particular company.
What does neck size have to do with the DOT physical exam?
Neck size, weight, and BMI are all just indicators that the medical examiner looks at to determine if you may have a condition such as sleep apnea that would impact your ability to safely drive a commercial vehicle now or for the period for which the medical card may be issued. There are currently no set specifics on these measurements in the DOT regulations.
Other indicators of potential obstructive sleep apnea are enlarged tonsils and large tongue volume. Individuals with low muscle tone and soft tissue around the airway (e.g., because of obesity) and structural features that give rise to a narrowed airway, are at high risk for obstructive sleep apnea.
Because sleep apnea is associated with increased risk of other debilitating diseases, it’s the responsibility of the medical examiner to rule out suspicion of sleep apnea, for driver certification.
What does snoring have to do with the DOT physical exam?
Snoring, in combination with obesity, can be highly predictive of obstructive sleep apnea risk. That said, even the loudest of snorers may not have a breathing obstruction. The sign that is most suggestive of sleep apnea occurs when snoring stops. If both snoring and breathing stop while the person’s chest and body try to breathe, that is literally a description of an event called an ‘apnea’. When breathing starts again, there is typically a deep gasp and then the resumption of snoring.
For the DOT physical exam the medical examiner evaluates your overall physical condition and health history to determine if there are signs of a medical condition that may affect your ability to safely drive a CMV. If the medical examiner has reasonable suspicion that you have sleep apnea you may have to go for an overnight sleep test called a polysomnogram before you can be further considered for certification.
I take Restoril for sleep. Will that be a problem for the DOT physical?
The medication, Restoril, may cause side effects: Hangover effect, drowsiness, dizziness, nausea, and vomiting.
These will all be questions the medical examiner is going to ask you about. This medication is usually used on a short term basis and not for a long term sleep aid. So it will depend on the type of driver you are and would be a serious consideration within the DOT examination.
You will need a medical opinion letter from your prescribing doctor explaining his reasoning for the use of this medication and why he feels it would be safe for you to drive a commercial motor vehicle OTR. Otherwise this could be a disqualifier for OTR drivers.
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I had a sleep study done 5 years ago and was told i need to use a CPAP, if i want to keep my class A CDL. i refused to use the CPAP , because i was not tired and didnt feel problems sleeping. I quit the trucking and surrendered my CDL. Now I want to start a non CDL driving job (delivering packages). But the job requires to take a DOT physical. Do i need to declare that i was diagnosed with sleep apnea before, if its not a CDL job? if i do, will i need to do a sleep study again? Texas
Thank you!
@ Red
DOT/FMCSA medical examination protocol was established for CDL, class A drivers. A medical card for a non cdl driver then falls under the states variances and guidelines. Make sure the medical examiner understands the difference between the two and uses the states variances instead of the DOT/FMCSA guidelines. Sleep apnea will not be a part of the states variances unless there are a multitude of signs and symptoms present at the time of the medical examination.
I was issued a 1 year physical due to being borderline for a sleep test and got hired in at a company with that physical. They told me to lose weight before my next physical or a sleep study would be needed. I didnt lose weight so i got my sleep study and a cpap. My next physical they said that since the only issue I had was sleep apnea, and been corrected with a cpap,I was given a 2 year medical card. But my company is making me redo my physicals every 1 year even though my card is for 2 years. Can u have a 2 year medical card with a cpap? I lose hours at work because I have to do a physical during the week.
@ Matt
According to the DOT/FMCSA guidelines, use of a cpap only qualifies you for a one year certificate. And you will need to bring in a thirty day readout from your unit each time you go for a recertification.
My husband has been diagnosed with sleep apnea. He has his physical yesterday 6-5-2020. The machine has a video call today for him to set it up 6-5-2020. The deadline in PA is 6/30 for med card re newal. The DOT physician told him she needs to “see him use it more than not”. What if there isn’t enough time between today and the 30th, for proof he’s using it? Will he loose his med card and cdl?! Is there anyway they give you an extension on it to work with you? He’s also going for biatric surgery July 2, so this “sleep apnea”, will be cleared up following the surgery.
@ Allison
If the CME issued a short card for your husband, then he will need to show thirty days of compliance with the cpap. She may issue another short card if she feels that the unit is being used 70% of the time. It will be up to the CME to extend the length of of the card until full compliance is met.
She did not issue any card. She told him she “needs to see him use it more than not”. He has a follow up appt. for the CPAP on 6-16.
@ Allison
Then the CME is going to be looking for a 30 day report with a 70% or better usage.
I had a DOT physical yesterday, I have no sleep related problems but my BMI has s at 41, the doctor wants me to do a sleep study within three months. Can I get a second opinion and another physical and erase the findings of the first one?
Can I get a second opinion on my DOT physical if I disagree with the doctor saying that I need a sleep study?
@ Gibson R
Yes, you can and should get a second opinion.
Currently I’m a otr truck driver my current company wants me to do a sleep study to renew my medical card. I have another job trying to hire me do I still have to do the sleep study for my new company?
@ Jason C
Sleep studies requested by the company are not a pert of the DOT?FMCSA protocol. You would need to ask the new company what their hiring criteria are.
I was just told that I have to get a hysterectomy because I have low iron by my DOT doctor. My OB GYN Doctor told me that my tumors are shrinking and there is no need for me to have surgery. I do receive iron infusion when it gets low. The DOT doctor says I’ve passed the physical part but due to dot regulations he wouldn’t give me the card. Now I toke the the physical last week and was given the card by the same dot doctor. My job started digging in my file and brought that up. Can they do this from low iron?
Help
@ Victoria L A
DOT/FMCSA certified medical examiners are not to do medical diagnostics or make medical judgment calls. Their job is to administer the DOT/FMCSA examination and take all available information into consideration. Your OB GYN knows best about your health and your situation.
Been using CPAP machine for the last two years and within the last 3 months lost close to 40 Ibs. I haven’t use the CPAP for a month and a Half and has no problem sleeping at night. I brought the provider a copy of my CPAP read out to show that I was using regularly until the beginning of November. My question is can he turn me down for getting my medical card because of the month and half I did not use CPAP?
@ Dwayne C
Most likely, yes. Until you can provide medical documentation that you no longer need the CPAP, the CME will want a recent 30 day readout.
I got a physical and the Dr ordered me to get a sleep apnea test. I will have it done within a week of the physical but they tell me I have to do a full exam and pay for it again. They gave me a 3 month card. I am not getting a CDL but need it to drive a non CDL straight truck. Can they make me do another full physical and charge me again.
@James A H
For some reason the CME is trying to hold you to a class A DOT/FMCSA standard, you are not a cdl holder, you fall under the states variances. Either way you will have to get a whole new physical done. Go elsewhere for a second opinion and explain to the examiner that you are not a cdl holder and will be driving a straight axle. That should have the examiner evaluate from the states requirements and not the FMCSA standards of a class A driver.
I recently had one of my drivers ask about inspire. I gave him all of the info I have but was wondering if it would be an acceptable OSA treatment to a ME at a DOT? I am wondering if the driver produces his sleep doctor consultation reports following implantation of the device, this would suffice?
Thanks again in advance.
@ Company Nurse
It should suffice with proper medical documentation and follow-up test results.
One of my female school bus drivers went for her DOT Physical and was told she had to have a sleep study done because she is postmenopausal. Is that a valid reason, or even a legal reason for a medical examiner to require a sleep study?
@ Karm J V
Unless your bus driver is carrying a class A drivers license it is a invalid request. Have your driver go to an examiner that understands the difference between state requirements and your states variances. And it is not a federal DOT requirement for a class A driver either..
As a company nurse, I have a driver who was asked to either lose 10lbs or have a sleep study, he lost 21lbs and passed his DOT for 2 years. He recently asked me for help with a referral for a sleep study as he feels he is having symptoms of OSA. He tested mildly positive and is now on CPAP. He says he doesn’t need to report it as he ‘self referred’ I say he needs to have another DOT as he has a newly diagnosed condition not present at his last one. Who is correct? Isn’t that the FMCSA regulation or just a ‘guideline’. Should I send his compliance report anyway so they have it on file for him?
Thanks in advance.
@ Company Nurse
New diagnosis, new DOT examination.