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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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My husband recently went to see the doctor and was told that he should be tested for sleep apnea due to his migraines (he was told his migraines plus the symptoms of possible sleep apnea could be directly correlated to having sleep apnea). We are due with our first child soon so we can’t afford for him to be out of work/lose his CDL due to this test so can anyone answer these questions for us (we live in MN if that makes a difference):
1. Will he lose his CDL if he is diagnosed with sleep apnea?
2. What will happen to his med card – will it be taken away or will he just need to report the sleep apnea and have a note from his doctor saying he is being treated and then follow up with a 30-90 day readout from the machine proving compliance?
We are just extremely worried that he will lose his med card/CDL and therefore won’t be able to continue working. He only has a Class B currently but the company he works for wants him to get his Class A in the near future so answers based on Class A and B would be appreciated.
Thank you in advance
@ Brittany
1. The cdl is a state issued license and a diagnosis of sleep apnea would not revoke his cdl.
2. Get a second opinion on the DOT medical card examination. Your husband is a class B driver and falls under the states variances and guidelines, not DOT/FMCSA at this time.
Doing a follow up with the sleep testing would provide useful information and may be a huge help with his migraines. As a class A driver, he will fall under DOT/FMCSA regulations and guidelines. Mandatory sleep apnea testing is not part of the FMCSA unless other signs or symptoms indicate a need for additional information.
Get the medical card for his class B license.
AHIs per night were 5.6 and now we have a CPAP machine, I thought I read that the standard 20 AHI or more was the threshold?
What can I do to battle this nonsense?
@ Scotty B
Get a second opinion, especially if you feel that the first opinion is incorrect.
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.
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.
During my DOT physical i was told due to my body mass i will have to due a sleep study. They gave me a temporary certification. I completed the study, used my bipap machine for 30 days brought the results to the medical examiner. I was infomed i have to take another physical before i received my certification.
Is this correct? 2 physical by the same examiner within 2 months.
@ Samuel B
New DOT each time. FMCSA guidelines require a new examination each time.
I am a 51 year-old male, and am considering getting a Class A CDL for the first time. I am in good health, and have a BMI of 23.
A long time ago (I think it was in 1997), I had a sleep study and was diagnosed with moderate obstructive apnea and moderate central apnea. I was prescribed a Bi-PAP machine, which I was never able to tolerate.
Not long after, I was found to have a severely deviated septum and enlarged tonsils. I had the septum corrected, and then my tonsils and adenoids removed. It was life changing, and I’ve done fine ever since without using the Bi-PAP. About 10 years ago I had another sleep study, and the doctor told me that I don’t have sleep apnea.
I’m concerned about the impact this will have on the DOT physical, both initially and going forward. Do I need to even mention it? Will I need to get the records from that later sleep study, or have to have another one done? Thanks for the help.
@ Paul
If things have been corrected some 10 years ago, then go for the DOT examination. You should not have any issues regarding the sleep study, since you have had the issue corrected. Unless other issues require further investigation you should be fine without any additional sleep study testing.
My employer pays for employee CDL medical evaluations in accordance with California Labor Code Section 231 – “Any employer who requires, as a condition of employment, that an employee have a driver’s license shall pay the cost of any physical examination of the employee which may be required for issuance of such license, except where the physical examination was taken prior to the time the employee applied for such employment with the employer.” My Medical Examiner is now recommending a Sleep Apnea Test. Is my employer mandated to pay for all costs associated with this test, or am I out of pocket?
@ Stacey A
You will need to check with the human resources department, or legal department, on this issue
How many months back do I have to print out from my machine to prove I’m using my machine to take in for my physical
@ Scott
FMCSA wants 30 days, if you are new to a unit, the examiner may want to see 90 days.
Hello, quick question to piggy back to Scott’s question. I read that the sleep apnea law was never passed. How is the sleep apnea requirement being enforced?
@ Quintin D C
Just follow the money. The examiners that are pushing the issue are in a conflict of interest, or have done more homework and utilize additional test protocol to make their final decision.
Doctor wants a printout of useage. My cpap is 15 years old and doesn`t have any provision for an sd card or anything else. I see no reason to get a new machine when the old one works perfectly. Cpap has worked well for my sleep problems.
@ David H
How does your doctor get a readout from your machine. If he can have him provide you with the latest readout to show compliance.
Does the state of Texas have a minimum number of obstructive episodes on a sleep study before they will remove the requirement of wearing a CPAP device
@ Grady
You need to check with Texas on this issue.
I was told that you need to be using a cpap machine for a minimum of 30 days, after your diagnosis, before a re-certification will be issued. Is this true?
Hi Earl. I am in the same situation as you. I was told by my pulmonologist that I need a 30 day c pap reading in order to keep my medical card. I am devastated by this as I was diagnosed with mild sleep disorder and cannot get a reading off my machine. I have tried many masks and nasal pillows and still have no reading. I have been fighting for my medical card for 3 weeks now. I am praying with all I have that the DOT examiner will override this decision as I also have COPD which I believe is the cause of my hypopneas. I wish you all the best
@ Earl
FMCSA would like to see 90 days immediately following preliminary diagnosis. You may get a 90 card so the CME can do proper follow-up.
How far in advance of my physical may I take my CPAP test? For example if my anticipated date of hire is November 1 and I took the physical October 28 would my CPAP of August 1 be accepted. If not when is the earliest date that I could take my CPAP test to be accepted by Oregon DOT?
@ Sandy
Take your most recent reading as close as possible your examination date. Make sure it’s for the last thirty days and shows a 70% compliance.
My bf was a semi truck driver. At the dot physical, Dr suspected sleep apnea and wanted a sleep study done before giving a full year medical card. He no longer has that job, and does a local job at waste management. Would the sleep study still be necessary since the stress of long distance driving was likely causing his possible apnea? Can he get another Dr opinion? We have no insurance to pay for a sleep study.
stress does not cause sleep apnea. sleep apnea is caused by restriction in the airflow to the lungs. hope this helps
@ Traci J
Go get a second opinion.
Hello! Im looking into getting my class A license. I am concerned though about sleep apnea. I was diagnosed back in 2012 with this condition. I am 50 years old male and am 5’11” tall and weigh 175 lbs and my neck size is 15″. Even with all those good numbers I just took a most updated sleep test and my AHI was 1.5 but my RDI was 19 so in the end the sleep Dr classified me with moderate sleep apnea. Also I don’t use a CPAP machine. I use a dental device which brings my bottom jaw forward. I am concerned because of my RDI score was high and the mere fact that I have had sleep studies and been diagnosed with sleep apnea. I have heard of experienced truck drivers who later in life usually due to weight gain developed sleep apnea and tried to move to another company and couldn’t get on due to their sleep apnea. They had experience and couldn’t get on. I have no experience and have sleep apnea. What are my chances of getting hired??
Thanks
Dan
@ Dan
Just make sure you explain your situation and bring any supporting medical documentation and test results with you for the examination. A medical release form from your sleep doctor will be a great help in the decision making process for the CME.
If you are using a Dental Device (as I am), your “Sleep Dentist” can provide a letter to indicate control of the Sleep Apnea. You should have had at least ONE Sleep Study while wearing the device. The results from that study will determine adequate treatment.
As a FMCSA Certified Examiner, I would accept that letter (and review of the Sleep Study Results) and issue a ONE YEAR Medical Certificate.
The debate about the Medical Requirements and FMCSA regulation is baseless. The regulations are in place for SAFETY of the Driver and the Public. Expert panels of Physicians make the recommendations based on sound and verifiable evidence and statistics.
Would you accept advice for a home plumbing issue from your vehicle mechanic or ask you Physician about which type of roofing material lasts longer?
Why solicit medical or legal advice from a fellow driver?
Was put on cpap machine , was given an in home test that scored me at 5.6 AHI which they said just a score o 5 AHI was their limit anything over 5 was considered sleep apnea. Now a year later , I was told by sleep center staff that DOT regulations were anything under 20 Did not require cpap machine. If so just how are these doctors getting away with this ??
Thanks for your help and advice
SN
Nashville TN
@ Scotty B
FMCSA does not accept in home sleep studies, so someone is taking advantage of the situation. Go get a second opinion from another CME.
This is a blatantly untrue response. The FMCSA has no regulation regarding sleep apnea (the propsed rule was withdrawn in 2017). Sleep apnea is addressed as a general respiratory condition. Medical examiners follow the FMCSA MRB recommendations from 2016, which specifically allow at home testing with proper chain of custody.
@ Laura P
You are absolutely correct and most ( a generalization, not to include all, but more than 50% ) of the CME and the organizations that they work for will not accept a home study. They do this because they will not look any further than the notes they took during the class. And if they are tied into a sleep study facility, then they follow the $.
I apologize about the length of this message in a advance.
I currently hold a class A cdl with passenger endorsement. I have been diagnosed with sleep apnea for the past 3 years. I am 26 years old, Husband, Father of a 2 year old girl in a situation that is causing me to miss work. Now I know that I may not get the answers I want but I want to know the correct response for what is happening to me currently. Thank you ahead of time for your patience with me.
I was hired by Walt Disney World in Feb of this year 2019. I took a DOT physical on their property. I showed them at the time that I had 70% of the last 30 days over 4 hours using the sleep apnea machine. They gave me a 1 year DOT Physical card.
On May 10th, 2019 only a few months after the dot physical my managers approach me stating that I am not allowed to work and that I have been placed on medical leave without my knowledge or understanding.
I then call the Disney Health services to find out what happened. They are stating that I had missed a appointment for a 90 day dot compliance for sleep apnea. I stated that I have never herd of a 90 day dot compliance and I that I have received DOT physicals in the past while having sleep apnea. I stated that the only time 90 days comes into play is when you are first diagnosed with sleep apnea you are given a 90 day DOT physical card in which time you must complete the 70% of 30 days with 4 hours min using the sleep machine. They then stated that DOT requires 90 because i’m working for a new company.
I made a new app with the doctor. At the time I did not have the 30day compliance on the machine. They stated that untill I have 90 day compliance I can not work at all and that I should not have passed the dot physical because I did not have 90 days compliance.
He stated that until I get the compliance I wont get a year dot. I then stated to him that the doctor that did the first exam in Feb gave me a 1 year dot. The doctor was confused and then took the dot physical to exam it. He left the room with it then when he came back in he stated that my dot physical was now VOID and that I currently do not hold a dot. Also, the only reason I received the 1 year dot card was because doctors are no longer allowed to give 3month temporary dot physical cards,
When the doctors asked why I did not have the compliance right now I stated them that quite often after using the machine I would wake up tired and feeling ill. Also, that there are many times that i knock the mask off my face in the middle of the night. waking up to find I have to quickly put it on and sit away with it on. In order to get the needed compliance time. I stated to them that I have tried different things like changing the ramp speed, pressure, temperature of the humidifier, ect. Non of which were giving me any better results.
I stated to them that I am planing on seeing another sleep specialist once my insurance kicks in so I can afford to do so.
During all this I was also asked about how I was tested for sleep apnea. When I was tested I was in a hotel room on werner enterprise property in Dallas TX. I shared a room with another driver and only did one sleep test. From What I have read currently my test was not conducted correctly.
This I also stated to the doctors at Walt Disney World.
I do thank you for taking the time to read this long message. Now my questions if you can clarify
1. How many days are required compliance for sleep apnea to get a 1 year DOT?
2. Are temporary dot cards (3 month) no longer allowed to be used?
3. Is the doctor allowed to pull me off work on unpaid disability without my consent?
4. Can the doctor take the 1 year dot physical card away from me and state that it is now void before its expiration date?
5. If on the ground I only need 30 days compliance with the sleep machine to get a 1 year dot. Can my employer request my sleep results checked when ever they want?
6. What actions should I take next. Please help me.
if there are any official documents that you can attach to a response email so I may add to my documents. Thank you for your time and I pray you have a good day.
@ Kyle
1. 30 days @ 70% compliance.
2. 90 Day cards are only for individuals that are trying to get further information or to get a condition/situation under control.
3. Company policy, check with the HR department.
4. No
5. Company policy, check with HR and ask to see it in writing.
6. Talk to the HR department @ Disney and state your concerns. They should be able to help.
I have worked the last 7 years for a company who monitors DOT mandated drivers. Until 3 yrs ago DOT examiners only wanted to see a 30d usage history report with 70% or higher compliance, 4 hrs or more avg hrs usage and AHI under 5. All the DOT examiners across the USA that we deal with require 90d usage history. The reason they started s=doing this is because drivers were not using device compliantly through out the year and then using a month or so before their DOT card expired to have 30d @ 70%. Unfortunately the “bad apples” spoiled it for the good ones!
Also an individual company can go by any rule/regulation they choose. Example: I have seen trucking companies make their DOT mandate employees have 80% compliance instead of the 70% required. This is a companies choice.
Definitely talk to your HR department. Good Luck.
Say you got a year medical, do you have to get the full year of 70% or of 30days?
I’m an Idaho class A holder but drive class ready mix cocncrete truck in town that’s class B…question is how many hours of sleep do I have to have before I can drive since I’m a CPAP user.
@ Ryan M
If you follow the guidelines set forth from FMCSA for class A drivers, 10 hours rest time.
Doctor. I have BMI 41 and neck size 17″. Was sent to primary care Doctor. Primary Doctor say no reason for Sleep study did blood work no enlargement of cells. Is this enough to pass or do I still need sleep study?
@ Nick
As long as there are no other signs of OSA, then you should be good to go FMCSA never put mandatory sleep studies based solely on bmi. If the CME recommends it, go get a second opinion.
I am a 39 year old school bus driver in colorado. I recently went for my D.O.T physical and was told to get a sleep study done. My question is did the examiner have a right not to give me an extension on my D.O.T card.
@ Tracia J
You are a school bus driver and should not be being held to FMCSA guidelines. There is no extension, but you may want to go elsewhere for a second opinion. Sleep studies are not a requirement unless there are a multitude of indicators.
Is this State specific? I am a school bus driver. I hold a Class B license. This doesn’t sound like the guide lines for Washington State? Our requirements just recently changed and they are ridiculous. “We” feel it is a money grabber for the State and the approved clinics.
@ Sammie M
FMCSA guidelines were established for class A long haul drivers and is federal DOT. You are class B bus driver and fall under your states variances.
I’ve been seeing a sleep nurse practitioner in Fort Wayne, IN. And it will be the last time with this individual. I’ve been using my C-Pap machine at 85.6%. I thought it was 70%? This nurse practitioner rudely stated she wants my cpap usage at 100.0% & DOT now requires 100% usage. Is this true? Said she’s fed up with putting her license on the line for semi drivers. Stated how sick she was of truck drivers. So she failed me & wrote that I’m noncompliant. I’m a female who’s lost 81 pounds & I started crying when she told me to park it at home with my CDL. She refuses to write an order for me to get new cpap supplies. She accused me of falling on the ground which I never did. I was livid! Please tell me what percentage DOT requires drivers to be at on their cpaps. P.S. I’m getting a new sleep apnea doctor.
@ Eileen C
First question, no this is not true. Go get a second opinion from someone who understands the FMCSA guidelines. Second question, FMCSA 70% within a thirty day cycle. Get a new sleep doctor and write this one off.
Question : When you have to prove that you are wearing your cpap machine to get your cdl renewed , Is that a federal law or state law ?
@ Waterboy
Federal lawif cld is class A. States vary on this issue.
Question: I was recently diagnosed with Mild sleep Apnea 1month ago. I went in to do a recertify 2 weeks ago and the doctor disqualified me. Since then I’ve been on the CPAP machine for 2weeks now. Am I required to be on CPAP for 30 days before going back to recertify? Can I go in sooner if my doctor says that the machine is showing great results? Also, in MN for interstate driving, dont i get to be certify for 30days until I get my 30 day results?
@ Tou
If you’re class A, interstate, FMCSA requires at least a thirty day readout.
Need new DOT physical. I am switching to a new CPAP device from my older model. Still have my usage history from the older model. Do I need to have 30 days before the physical on the new CPAP machine? thanks
@ Vance G
It would work to your advantage, if it is at all possible, to be on the new unit for thirty days prior to your medical examination.
I have a driver who we have recently taken off the road as he has fallen asleep at the wheel twice. The company is paying for him to have a sleep study and he’s been advised to visit his PCP for a check up. His DOT physical does not expire until 10/19. Will he need to get this repeated sooner once all his testing has been done even if the test proves negative for OSA.
Thanks!
@ AJ
Yes he would need to have a new DOT medical certification examination done, even if he tested negative for OSA
I was diagnosed with moderate OSA roughly 10 years ago. I tried for several months to use a CPAP without success (multiple style masks were tried.) I finally gave up the idea of using the CPAP and went back to sleeping as usual, complete with loud snoring. I am trying to renew my DOT physical and the doctor wants me to repeat the sleep test. Is there any alternative to the CPAP that is DOT approved for OSA? Specifically, is the Inspire treatment system acceptable? I have heard good things about it, but has DOT accepted it yet?
@ Rick C
The Inspire system would be acceptable, once you are fully recovered and been on the system for a period of time, without incidence.
I was recently told to get a sleep study done. went to the in house sleep center had a panic attack was unable to complete. can I take a home test will that be accepted by the doctor. I also was told nothing about this 30 day comp thing will she be able to issue me another 90 day card or will I just lose my job
@ jerry j
Not sure that the DOT has fully approved any home sleep study packages. If you don’t experience day time sleepiness, regularly, then you may not be a candidate for a sleep study. Check on getting a second opinion.
My husband has been told by the DOT CME that he needs a sleep study because his BMI is 39 and his neck is 18 and to have his primary physician to write the prescription for the sleep study. However his primary DR, said the he does not need a sleep study. So now how does my husband get his CDL for longer than the 3 months the CME gave it to him for.
@ Linda W
He needs to get a second opinion at another facility, when his 3 months is nearly over. FMCSA does not have regulations on this issue, only guidelines for the CME’s.
I am going through the exact same thing. Got a 6 month card in Jan. I’m 35 yrs old and my bmi is high and neck is 18 inches which wasn’t even measures properly. Been this way for 15 years never any issues as I don’t have any symptoms of sleep apnea. Before the CME even did my physical he walked in and said I had to have a mandatory sleep test. Here’s my question. I told him I was going to get a second opinion. He told me that he was sending my info into a data base with fmcsa. He said even if you get a 2 year somewhere else your in a data base and if the fmcsa doesn’t get results for the sleep test In the 6 months that fmcsa would suspend my license. Is this true or can I go to a new Dr and get a second opinion and a 2 year card? I don’t want to be in a weight station 10 months down the road and them tell me I don’t have a liscence.
@ Nate F
That is complete ‘Bull Nuggets’. You are welcome to get a second opinion anytime, for any reason.
If you pass on a second opinion, then the new FMCSA entry is the medical card on file and valid.
I went to get medical card deiny because I didn’t do a sleep study on a ninety day card in Jan to April of 2018 however I did not use this card did not did not take the job went to addiffer job use a different dot clinic pass no problem jot a one-year card company now uses same dot clinic because didn’t do study won’t issue 90 day card can they do that company shut me down till I get one does it get reported to the state company safety said it did however second clinic had no issues never used it
@ Gerald b
You have the right to get a second opinion.
Just got a DOT physical and received only a 3 month card, CME wants me to get a sleep study done. How much time do I have to get a second opinion? Have to still get referral for study from my primary doctor. My BMI was 33 neck size 17.5 6’4″ 266. Just 4 yrs ago same CME while I was 295 lbs BMI 36 NECK 18.5 gave me a 1 yr no problem. How can the be?
@ Steve B
You can request a second opinion within the 90 day period, before your current medical card expires.
Follow up question. If I already handed in the long form with osa evaluation written on it to mvd. Will the second opinion supercede that one if it clears me for a year?
@ Steve S
Yes.
My husband wants to go get his cdl license. He has sleep apna and is already using a cpap machine. He is also on medication for high blood pressure. He uses his cpap and takes his medications as directed. Will he have a problem getting his license? Should he continue to pursue this career? We live in New Hampshire.
@ Joanna
State CDL may require a medical certificate. If so, take your latest test result from your cpap with you and a medical release form from your cardiologist or primary prescribing doctor.
Found this online. BMI over 40 is automatic sleep study. If BMI is 33, and you are a man older than 42, then only ONE of these factors makes it automatic. That’s almost everybody that’s middle aged.
Medical Review Board recommendations on obstructive sleep apnea August 2016
Referral for diagnostic sleep study for OSA if:
BMI of 40 or higher
OR
BMI of 33 – 40 in addition to at least 3’of 11 risk factors below:
• Hypertension’ (treated’or’untreated)
• Type’2’diabetes’ (treated’ or’untreated)
• Neck’size:’male’>17’inches,’female’>15.5’inches
• History’of’stroke,’coronary’artery’disease,’or’arrhythmias
• Loud’ snoring
• Micrognathia or’retrognathia (small’or’recessed’jaw)
• Witnessed’apnea’symptoms
• Hypothroidism (underactive’ thyroidm’untreated)
• Age’42’or’older
• Male’or’post@menopausal’ female
• Mallampati Scale’score’of’Class’3’or’4′(small’airway)
@ Bob’s
FMCSA guidelines?
I retired 2 years ago,was useing cpap machine,i have lost weight and no longer take blood pressure meds,my neck measures 17in, will be taking another dot physical for new class a job do i need to tell dr i had been diagnosed with sleep apena
@ Frank m
It is a question on the intake form. You can explain to the examiner, but he may require documentation from your primary physician.
So i recently graduated truck driving school and had recieved a 2yr DOT card. I applied to a company, arrived at the terminal and was told i had to have another physical by there examiner. After having the physical there, the company examiner said he was going to issue me a 3mo card pending a sleep test. Soo does that mean my 2yr card is null and void?
NO your 2yr card is still good go to a different company YRC Freight best company for new drivers Teamster union stay at hotels don’t sleep in truck only on team runs.
@ Daniel
If the three month certificate was reported to the FMCSA, then the two year card is invalid. But if you qualified for a two year card before and the company doctor is sending you in for a sleep study, you need to be asking some serious questions. Sounds like a conflict of interest. Go some where else.
So I have had 3 physical in the last 5 months one doctor told me to loose 25 to 30 lbs and she would pass me but I lost 50 lbs and did not go back to her because I started a different job so I went to another doctor he gave me my one year card so just this passed week I changed jobs and went to another doctor and he gave me a six month card and said he wants me to do a sleep study now can I go get a second opinion
@ Leroy a
Yes.
I was diagnosed with minor sleep apnea with 5.8 breath disturbance per hour at 88% oxygen level 3 years ago. it was recommended I get a oral appliance an have not done so, now that I go for my yearly physical they denied me my medical card because it was untreated. I read on this site that I don’t need to treat mild sleep apnea but moderate to Severe I do. If that it indeed correct can someone tell me the federal statute number or where I can find such information? Thanks
I was given a 45 day pending determination on my recent D.O.T physcial due to a suspicion of sleep apena . I went for the sleep study and was found to have sleep apena . Anyways, my 45 day pending determination expired before I was able to get in with the sleep Dr. and get the results. Just yesterday saw sleep dr and he gave me a 30 day fit to drive letter and my 2 week print out of 100% usage of the cpap machine . Will my Dr. Be able to write me a 30 temporary medical certification and be able to go back to work for 30 days as a school bus driver In Tennessee or is the 2 week print out of 100% compliancy letter insufficient and she will still need a 30 day print of compliancy letter ?
@ F.m
If you hold a class A license you fall under the FMCSA regs and will be required to produce a 30 day readout before re-testing and certification. If you hold a lesser class license, then you fall under your states variances and not FMCSA. Check with your local DLD for the best answer.
I took sleep test. I was 100%compliant 0n the use of my CPAP. the machine had a data card problem and information was etaken off the hard drive and that was only the last 30 days. I then purchased a new CPAP machine to comply. My Dr. sent a letter asking for a 90 day extension on my current phycial. The examiner told me that their is no extension available. Is this FACT or is this her plessure I amaretired Fire fighter, and a Vet. Medic. I feel that this person in giving all over weight people problems even after they comply with her request.
@ Shelton M Jr
Examiners need a 30 day readout showing compliance, but FMCSA does not have an extension policy.
Was issued a 3 month card because of Sleep Apnea. I am getting Cpap and will use it
My question is must I return to the same doctor when the time is up? I will have the readout from the sleep doctor. Just not comfortable with where I was send
@ John D
You have the right to go to any DOT certified examiner you wish. Make sure you take a 30 day, or more, readout when you go for the new examination.
I went to get my card for a new job (they paid for the physical and drug screen) that I’ll be hopefully at in September and the examiner ordered a sleep test because my BMI was 0.5 over. Literally 5 pounds. He gave me a 3 month card. Am I now required to do the sleep test? Could I not just lose 10 pounds to be safe and go back in before the 3 month card is up and be good to go?
@ Mike
A 0.5 over BMI is not a FMCSA requirement, so lose the weight and try again. There is no new ruling regarding sleep studies, it’s examiners not understanding the regulations and guidelines.
I have been on cpap for 22 years. I couple of years ago I had to buy a new machine that would record use. I thought you had to use it for a minimum of 4 hours 70% of the time. My doc says different. I cannot find any time requirement for this. Where might I be able to see it and print it out?
@Greg
See info at this link http://dotphysicaldoctor.com/commercial-drivers-manage-sleep-apnea-maintain-cdl/
There is no written rule by FMCSA.
The Medical Expert (to FMCSA) Panel’s minimum recommended compliance is: 4 hours of CPAP sleep per day, 70% or more days.
Your company/carrier is allowed to impose stricter standards than those recommended by the Medical Review Board.
Some companies are requiring at least 6 hours of CPAP use, 80% of days.
The most effective treatment is 7 or more hours of CPAP use during sleep.
I have an employee who can’t get his medical card. Due to the fact instead of a cpap machine he got dental implants that where recommended by his dr. DOT dr said he needs a cpap machine is this correct
@ Paul
No, it is not correct. Proper documentation may be needed, but a dental implant is acceptable by FMCSA with documentation from his doctor. Get a second opinion from someone who understands the FMCSA guidelines.
I train new drivers. And they often wake me up to ask questions or get my help multiple days students waking me up causes me to not use it every “day” for 4 hours. Somedays I register 3 and the next I register 12, because of the per “day” understanding. But I use it 6-8 hours each “night” or more exactly each time I go to sleep. Also with each of us having a 14 hour clock we have a 28 hour “day” fairly often. Where can I find the dot regulations on cpap usage? If I take my logs and usage report showing I’m in compliance with the spirit of the law, which is to use it 4 hours each time I go to sleep, 70% of the times I got to sleep. Or do I really have to get a new job to be in compliance with the “letter of the law”?
@ Jordan B
FMCSA issues guidelines in this case and your situation should be considered by the guidelines , not regulations.
I was told due to an 18 inch neck o needed to due an at home sleep apnea test. I took it and was told I have moderate sleep apnea. Noe I am being told I must purchase a cpac machine that my insurance will not cover for hundreds of dollars or I won’t get my medical card signed. I read here that it’s only in severe cases that a cpac machine is required. I live and work in California and I deliver gasoline. Can you clarify what my requirements are. What are my options?
Thank you.
@ George
1. 18 inch neck is not grounds for a sleep study. 2. Home sleep studies are not acceptable for a DOT medical card.
If you are driving within the state and not traveling interstate on a routine basis, then we would recommend you go get a second opinion.
where is it stated that Home sleep studies are not acceptable for a DOT medical card? there is no mention of that any where, plus most companies that require a sleep study st you up with a Home sleep study !
@ Dave
Check on the FMCSA website. The guidelines that the CME’s have to follow are, or were, available there.
Typical they are lying to you and requiring a CPAP. Get a second opinion. Apnea and CPAP are a huge game of corruption and making dirty money! ALWAYS QUESTION ANY DOC THAT ORDERS A SLEEP STUDY! CPAP can kill you!
if the federal gov. has NO laws for sleep apnea how are these doctors threating our license??the DOT has no regulations about sleep apnea.
I was diagnosed more than 8 years ago with severe OSA. I tried a CPAP and it didn’t work well for me, so instead I had two surgeries on my sinuses. After that was finished I had another sleep study that showed I no longer had severe OSA. This was a few years ago, and I haven’t needed a DOT physical card recently. I’m about to apply for one again, only Class B intrastate driving if that matters. Since my last sleep study showed my OSA was corrected I am no longer regularly seeing a sleep doctor, only my regular physician. What chance do I have to getting a DOT card if I pass the physical? Would it be for 1 year or 2?
@ John
You should not have any issues. Make sure you have some documentation to support the success of the surgeries.
I took sleep apnea test for DOT exam passed no problems. When will I have to retest any guidelines or regulations on this thxs
@ Steve
If you passed with no issues, then keep a copy for future reference and you should not be ask to do it again.
I have been driving non cdl commercial box trucks for 5-6 years. Was asked to get a dot physical and which the doctor referred me for a sleep study. The day of the test i worked 22 hours, drove 4 hrs without stopping. 3p-7p. Went in for the test. Just got my results back and it says i have narcolepsy. I really feel that its misdiagnosed since ive been driving ans never fell asleep at the wheel. I also train as a bodybuilder 4-5 days of the week. So definitely no loss control of my muscles. How do i go about getting a second opinion. Because of thid diagnosis my company that ive been driving for took me out of my truck and i was preparring to get my cdl’s. Please help, i feel that the test wasnt done under right circumstances, and i was given a prescription for somethin that i feel i dont have. Please help
@ Brad
You fall under your states regulations and not FMCSA, so the sleep study may not have been necessary. Check with your local drivers license department for the states guidelines of non-commercial drivers and then get your medical certificate done with the states guidelines and not FMCSA guidelines. Your CME should know the difference.
I’ve held a CDL for almost 10 years without incident. Worked a regular 40hr shift to full capacity. Due to the conditions of the job (emergency call outs, winter storm outages, MVA’s and etc) on any given night or day, you can assume a 24hr night or consecutive nights. I’ve complained of minor exhaustion but NEVER a drop off in the middle of any event. I’ve been recently diagnosed with CHRONIC NARCOLEPSY from a sleep study. Even never showing any symptoms, except minor fatigue from the lack of sleep, I am able to maintain wakefulness for several days on less than minimal sleep. More like insomnia tendencies than narcoleptic. Question #1-has this been heard of? #2-Can this be a misdiagnosed condition if one is able aware for 48hrs after a2 to 3hr rest? #3-Is such conditions determined by one test or a series of tests to confirm of clarify a positive or negative diagnosis? #4- Is there any such thing as controllable narcolepsy? I’m a lineman. I’ve worked multiple 75 to 80 plus hours for a straight 3 months and never dosed off behind a wheel.
Looking for answers as I’m about to lose my home, my freedom to drive and my rights I’ve earned to live as a normal person. I understand narcolepsy. I understand apnea. I can sleep for 45mins and Work for 2 days or more But if I’m narcoleptic…I would not be able to. What are tests taken to give a definitive diagnosis? Help!!!
@ David
It sounds like the sleep study has been mis-read and you should request a second opinion based on your work. And unless you are a class A OTR driver, you fall under the states guidelines and not FMCSA’s guidelines. Go get a second opinion, if you need and check with your local drivers license department for your states guidelines.
I’m scheduled for a second opinion plus additional tests. Had a sleep study before @25years ago because I thought I was having apnea attacks, not being able to breathe, which tests were negative. But narcolepsy tests were positive. I achieved REM Levels in 2 to 3 minuets when falling asleep but only laying in bed. I’ve had another test just within last 6 months that shown the very same. Not understanding if and why I’ve not displayed symptoms. So far the doctors I’ve come across say that they’ve never heard of anyone having this issue. I can’t be the only one. I’ve been said to have controllable narcolepsy?!?! And at the same time I’m considered a danger. I’m up against a wall and having my life stripped from me. Are there any doctors who have had any abnormal situations such as this? I’m pushing for a HLA Test to check my DNA, if covered. Also, I’m wearing a monitor so my sleep patterns are recorded. I’m lost soul in this realm. Need help.
I was diagnosed with narcolepsy at 14. I went to a sleep doctor because of my “insomnia”. I had trouble falling asleep because I was entering rem sleep while I was awake and it was disrupting my sleep patterns. If you had sleep apnea hours of sleep wouldn’t hold you over. Deep level rem is what makes you feel well rested and takes most people hours to achieve. With narcolepsy you can achieve it in minutes and it’s why you can function off of few hours of sleep. That being said it’s extremely disruptive to sleep cycles. You need to have an extremely structured sleep schedule. One of the biggest misconceptions about narcolepsy is falling asleep at random. This is narcolepsy with cataplexy. Cataplexy is only diagnosed in about 35-40% of narcolepsy patients and is defined as sudden and involuntary loss of muscle control or tension often brought on by extreme emotions or stress.
This compliance issue is causing more health problems & sleepiness nights then it resolves.
My DOT doctor ordered the sleep study when it was a medication causing my drowsiness, which when stopping the medication, completely stopped the drowsiness
I wear the the CPAP 30 days, some months compliant, some fall short.
I still have no drowsiness during waking hours, but move around in my sleep causing mask to leak.
This nightmare is causing me financial problems being out of work for more than a year. It is the financial worries making everyone’s health worsen.
How do I get a medical release from this nightmare?
@ Mario
Have you been retested for any sleep disorders? If not, have your doctor complete a medical release form stating that you do not suffer from OSA and take the form in to the examiner. If you need the mask, then you have OSA, if you don’t have OSA then you don’t need the mask. Just get it confirmed one way or the other.
I’ve been Diagnosed with mild sleep apnea by my family doctor. What are the ramifications of not disclosing this to the medical examiner? Does the medical examiner have the power to check your family doctor files? Is that a regular practice they do with patients? Or do they just take your word for it if you tell you you don’t have it?
I was diagnosed with severe sleep apnoea Based on nothing more than the home sleep study I have never been to a sleep lab. I have no problem staying awake during the day I just feel tired in general. and I cannot tolerate cpap .if I downgrade my CDL to intrastate driver only can i just lose weight to treat the apnea.? I live in Pennsylvania and I am a local driver I only drive During daylight hours and rarely work more than 8 hours A day.
I was forced to take a sleep study three years ago by dot dr. My ahi was 14. They still wanted compliance to get my year card. Am I required to use the machine even though my ahi is in the mild category.
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If you were issued a 3 month card for suspected sleep apnea and then was determined to have mild sleep apnea (new diagnosis), received your CPAP and have been compliant for 30 days (over 70%) can you get a 12 month card or do you have to wait 90 days. On the letter at the Medical Examiner’s office it stated if new diagnosis 30 days if compliant for a 12 month card. They stated that was for the suspected not the confirmed diagnosis on the letter, which did not specify that and will not give me a 12 month card. I am compliant and passed everything else. My job requires a 12 month card is there anything I can do? Class B license – Delaware
I ve been on my sleep apnea machine for almost 2 years. This year I have struggled with it just the same as last year. I ve tried all the masks. And my sleep is worse then ever. I wake up in 4 hours and take it off. So I stopped using it. I found a nose pillows mask i think they are called. And i like it. Mu question is ill have 4 months on it everynight. Will i pass of fail the compliance. Please help
They only need last 90 day report. And have to be 70% compliant
We are in Washington State and our drivers are intrastate. The medical examiner we send our DOT drivers to is requiring almost all of our drivers do the sleep apnea test. 99% of them come back stating they have sleep apnea, when they may or may not have it. I think they are doing it for the $$$. Is there a way a CDL driver can renew their medical certificate without being required to wear the sleep apnea mask? A lot of the guys say it keeps them awake at night; rather them help them, so they really don’t need to wear the mask. The problem is the medical examiner can run a test on the machine while doing their physical, and if they see the driver isn’t wearing the mask, they can deny their renewal for their medical certificate. I’m just wondering if their is some type of waiver the medical examiner could sign indicating the driver isn’t required to wear the mask, or how we can get around having these guys do the expensive sleep test and have to wear the mask every night. Any information would be very helpful.
Why not change the DOT facility that you send your drivers to if you think this one is acting unreasonably? Are the drivers having their reports explained to them?
I am an Illinois school bus driver, class B license. Our bus driving physical form does not address sleep apnea in any form. However when I went to get my physical the doctor stated due to some standard measurements he suggested I go and get a sleep apnea test done and said I could drive for three months. School bus drivers do not have a three month card option in the state. My question is since I technically passed every part of the physical required by the state, is this doctor allowed to require this. I think he is wrong since this is only a class B license. Thanks for the information
If you have sleep apnea and it’s moderate does dot still want you or its required to still use the cpap device
@Edward
Yes, cpap compliance is required for moderate sleep apnea.
I was diagnosed with mild sleep apnea in 2010. I have had the same doctor over the time period to now. I had a home sleep study done in 2014 and it showed positive changes in my OSA. The dr encouraged me to continue cpap therapy but didnt give me a definite yes or no answer. Up until October 5, 2017 I have not used cpap since November of 2014. I went to orientation with another trucking company earlier this month and was told I needed to show 85% compliance over 90 days. I have also read 70% over 30 days is suffecicent. My medical card expires November 2, 2017 and I am currently unemployed at the moment because of it. Which time frame will I have to follow?
@Justin
70% over 30 days, unless there’s a company policy in place that requires stricter compliance.
I have a question in regards to cpap compliance. I was diagnosed with mild sleep apnea just over a year ago. I have not been using the machine for the past 3 1/2 months. I went yesterday to renew my dot medical card and was told to get a compliance report, well that’s where the problem is, my doc can’t generate a report because I haven’t use the machine. So, can I simply go to another physician and not disclose I use a cpap, and get a medical card? I only had less than 5 episodes per hour when diagnosed. Does the results of dot physicals get reported directly to the dot? I have been given a 45 day temp card in order to get the compliance report. In other words will the dot know if I simply find another doctor who will give me a physical and issue me another card even though I saw another doc who is telling me I have to get the report.
Quick question, I got my medcard for only 3 months because the Dr recommended a sleep study due to neck size and bmi. My question is, if I go to another DR will the result be the same? Will they recommend the sleep study based on the previous examination?
@Roman
Neck size and BMI are not conditions on their own to necessitate sleep apnea screening.
Read these articles to understand sleep apnea screening issues.
Go for a second opinion.
I only see questions and answers pertaining to Obstructive Sleep Apnea. Can a person being successfully treated for Central Sleep Apnea get a DOT Medical Card?
@Alan
Yes.
Has the DOT changed requirement for sleep apnea testing for medical card
@George
No. And because there has been so much misunderstanding about it the DOT has withdrawn the proposed rule to set sleep apnea screening criteria for truckers.
The medical examiner is still responsible to make a decision to refer drivers for apnea testing if they “believe the driver’s respiratory condition is in any way likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle.”
Is this documented any where? Went to get my recert. Dr. Would not recert until test was done per new law.
If a driver is diagnosed with sleep apnea and requires a Cpap machine, what are the ramifications if they don’t use the machine at night, but sit in a chair during the day and use it, then turn in that data to the doctor?
Can I get a 2 year renewal on a DOT physical if I am diagnosed with CPAP and using it correctly?
@Curt
No. With everything else being fine FMCSA still wants you checked once a year.
I am about to go to school and get my CDL and start a trucking career. I am worried that the DOT physical I need before I start school will tell me need a sleep apnea test as my neck is 18 or 18.5″. I am 5.9 1/2″ weigh 2215, BMI maybe 31? I think I might really have sleep apnea. If it is proven I have sleep apnea, how will that affect me going to trucking school and my first job. The school already set me up with a company . Will it delay school? Will it delay me starting with this company. I need to start ASAP. I need the work. I am also doing this with my spouse . They will pass with flying colors. The new job is with us a a team . Trained as a team so I don’t want any delays on my part.
@Steve
If you think you have sleep apnea, you probably do. You need to get this checked out before you go any further.
If you are required to use CPAP to manage your apnea, you can still drive as long as you meet the CPAP 70% compliance.
What about after today 8/9/2017? Now that the trump administration scrapped the sleep apnea regulations from the federal government. What is that going to do to the people already dealing with cpap compliance?
The regulations are for determining the criteria for sending the patient out for a sleep study. Whether those regulations change or not has no bearing on the condition of sleep apnea itself. If a CME suspects that a driver is at high risk of sleep apnea, it is the CME’s responsibility to send the patient out for a sleep study, regardless. Sleep apnea is a respiratory condition that can affect safe driving and ignoring it would be like ignoring diabetes, high blood pressure, or any other condition that can affect a patient’s ability to drive safely.
Ruling out sleep apnea is still an important part of the DOT exam.
I was told by my employer that I was only 59 % compliant and that they were going to monitor my machine closely and when I got to 70% they would set me. a co up for work. How long would it take for me to get that 11%????
@David
Compliance is at 70% for 30 days straight. That’s it!
So what if i was out of work for a week or two and wasn’t driving a commercial vehicle or didn’t have my machine for a week or two…was i still required to wear it?.. Even if i wasn’t driving?!?
I drive a school bus in Michigan. I made the mistake of going to a DOT physical exam a few months back in between my morning and afternoon run. This means that I had a full breakfast and half a pot of coffee which raised my BP beyond its normal reading but still under the 140/90. I’m a big guy so my bmi is not very flattering. They looked at that and my neck and that was all it took for them to want a sleep study done and only issue a 3 month card. I have always had two year cards prior to this. The examining doctor gave me a form to take to my doctor which if he signed off on it would’ve waived the sleep study. My own doctor threw me under the bus and wouldn’t sign it. Instead he gave me a referral to a sleep study specialist. I didn’t do anything about it because there was a “Driver friendly” doctor near me when i checked your site at that time. Now its not showing any in the entire state of Michigan. My 3 month card expires August 9th. What are my options? Help!
@Awesome
Go get a second opinion at any medical examiner that understands the type of driving you do, and that you should not be held to the conditions of a class A driver.
If that examiner thinks you need a sleep study then you do, if not, then you’ll have a new medical card.
My husband had his DOT physical yesterday, Passed everything. THEN the doc told him since he is on CPAP he has to get a letter from his doctor stating he is compliant and CPAP is effective. He hasn’t seen pulmonary Doc in years. CPAP is fine, no problems. Also, there is currently no ruling by FMCSA for sleep apnea!! The doctor refused to renew his medical card which expires today. Can he go to another DOT doc and explain this and possibly get card renewed? If not, as of today he will no longer be a truck driver!!!
@Susan
If his CPAP unit will give a readout that demonstrates 70% compliance that is all he needs. If his unit does not provide a readout then the CME is simply looking for supporting documentation.
He finally got a letter of compliance from pulmonary doc which is what DOT doc asked for. When he went back to DOT doc he said it doesn’t have the results of the test on it so will not accept it. This was not stated on the form the DOT doc gave him. Just a letter of compliance from pulmonary doc, signed by pulmonary doc!!! He is back on his way over to pulmonary to get results. It seems like the DOT doctor is deliberately being difficult!! Very frustrating.
If I get diagnosed with severe sleep apnea, and get the testing/machine. I know I’d be disqualified from getting my cdl. I didn’t start showing symptoms until my weight gain though. So if I lost weight after getting the machine, could I be retested and be able to get my cdl then of my apnea went away or at least calmed down quite a bit?
@Pokie
You’ll need to get a new sleep study to make that determination.
I was given a 90 day card at my last exam. I was told I have to do a sleep study because my bmi is too high. I wasn’t happy, but I went to see my doc to get the process started. He referred me to a sleep center. Problem is, my 90 day card expires this month (July) and the sleep center can’t get me in until the end of August. Can I get another card to get me through to my appointment with the sleep people? If so, should I go back to the same examiner? Or should I try someone else? The whole thing is stressing me out. Any guidance you can offer would be appreciated.
@Bob
Recommend that you get a second opinion from a different medical examiner.
I’m a School Bus Driver. I’ve had my CDL since 1999. My company sends all their drivers (over 500) to the same Work Clinic for our DOT exams. A lot of drivers are failing the exam for the same reason-Sleep Study. I took my Physical in January- 2017. I have always received a 2 year card. Blood Presure- 120/69, Eyesight-20/30 etc. Everything is good. At the end of the exam, I only qualified for a 6 month card- yup, Sleep Study. I went to my Doctor. He set me up with a Sleep Clinic. Unfortunately, my medical insurance had to okay the Sleep Study. That took 2 months. It was almost 3 months before I received the CPAP and learned how to use it. I had a follow up with my Sleep Study Doctor on 6/23/17. I did my required 30 days (42 days) and passed. Yesterday, 6/26, I went to the Work Clinic to get my DOT card. I gave them all my paperwork. They said since it’s been almost 6 months (my card ex. 7/6/17), I have to take the DOT Physical again. Why? This doesn’t make sense. Shouldn’t the DOT go by the date for my Sleep Study? Not the date of my original Physical?
@Jo
Yes, you are required to have a new DOT physical. And the new FMCSA medical forms require the CME to complete a whole new medical certification.
First, thank you for providing this service. I am a Class A, Interstate CDL holder. I have TennCare (Medicaid). I need advise on initiating a sleep apnea test or not. I am overweight, hereditary high blood psi and I might have sleep apnea. I lost enough weight before my last DOT physical to get my BMI “under the limit”. My dilemma is do I continue to lose weight right before the physical to avoid any sleep apnea testing or go ahead and have the testing done while I have coverage that might pay for all of the costs? If I were eventually tested and didn’t have the coverage I have read the cost can be very high. On the other hand do I avoid having the “scarlet letter” of sleep apnea attached to my personal medical file for the rest of my life? Your advice would be greatly appreciated. Understand in no way am I asking for medical advice or diagnosis, simply broad general opinion of the matter.
@Zak
If you feel that you may have any OSA symptoms then go get the test.
I went for my physical today and I have used a cpap machine for the last 26 years I have a machine that does not have a chip in it because it is older I do not know how I am supposed to get a record like they are asking me for what do I do I have had this license since I was 19 years old so basically 50 years
@Danny
If you can, get a medical release form from your doctor explaining that you are fully compliant with your unit and have no issues. Then when you go for your medical card examination take the release and explain to the examiner that your unit is older, but still functional. Drivers who need the units will not leave home without it.
Otherwise you may need to update your unit to a newer one.
Please help my job depends on it. 31yo Class A holder, overweight, other wise healthy. No drinking, smoking, or drugs. I was out of work from January 2017 til May 2017. Just started working again. 2 different jobs I applied to made me take a DOT physical as part of the pre-employment hiring process. Both Dr’s gave me 3 month medical cards and refered me to get a sleep apnea test. No insurance or money to do that before my 3 month card runs out. Can I see one of your trucker friendly Drs for a second opinion? My new job is driving a dump truck locally during normal hours, I feel there is no risk of me falling asleep behind the wheel. Please help advise. If I had more time I would gladly comply and go get the sleep study. Thank you very much.
@Jon
You need to find a CME that fully understands your job requirements. These doctors are evaluating you as a interstate longhaul driver, which is not what your job is.
You can request a second opinion at any time. Sleep studies should be at a request from the CME because he sees or suspects a multitude of signs and symptoms which present as a risk/safety issue. So even a second opinion may not be the answer if there are possible risk of OSA.
hello, I am a school bus driver in the state of Tennessee , was recently diagnosed with mild to moderate sleep apena and was given a cpap machine , I am due in two months for my dot physical ., am I going to get disqualified ….I am over weight but other than having sleep apena , im healthy ….
@Carol
A lot will depend on the class drivers license you have. As a bus driver we suspect that with proper documentation and a recent cpap readout indicating a 70% compliance for the last thirty days, that you should be alright. You may want to confirm this fact with your local drivers license department.
Class b with ps Endorsements
how long after your sleep study do you have to wait to go back to work
@Alfred
The CME will want to see a 30 day readout with a 70% compliance before he would issue a new medical certificate. That’s if you were found to have OSA. If the test was negative for OSA, then you should be able to return to driving as soon as you have the results.
HOW MANY HOURS A NIGHT ARE YOU REQUIRED WARE THE DEVICE
@Ralph
The most effective treatment is 7 or more hours of CPAP use during sleep.
The Medical Expert Panel’s minimum recommended compliance is: 4 hours of CPAP sleep per day at 70% or more days.
Some companies are requiring at least 6 hours of CPAP use, 80% of days.
I do not snore nor do I smoke. I do not have daytime drowsiness but I am overweight. Do I have the right to refuse the test if suggested by a doctor at the time of physical since it is not Federally mandated?
@Dan
The CME can request the test if, in his opinion, there is a question. Many CME’s are trying to cover their behinds and over read the FMCSA guidelines.
You are entitled to go else where for a second opinion.
I have two? 1- If I go to a different medical examiner for my dot card, does my information follow me to the next? 2- Do I need to take a Nap study every yr, for mild sleep apnea?
@Troy
1. Your information is in the FMCSA data base, so it can be accessed.
2. If you are using a CPAP then you need only show 70% compliance for the last thirty days. You do not need a new study done each year.
If your sleep apnea is mild and you have not been diagnosed to need CPAP at this time, then it will be up to the medical examiner when you take your next DOT physical to determine whether your current health conditions point to the need to take another sleep test or not.
It’s been determined that I don’t need cpap… I have a mild case. So two years ago I took a nap study, to show no daytime sleepiness… I passed with flying colors… dr certified me for two yrs… Then I go for my dot physical last week, she says I need to take another nap study… Do I need to take another another nap study?
@Troy
Go somewhere else for a second opinion. There should be a multitude of things present before a sleep study is requested. Some of the CMEs are over reading the FMCSA guidelines for class A drivers.
i was diagnosed with a mild case of sleep apnea, when i took my first test, it was inconclusive, when i took my second sleep study the examiner kept coming in every 30 minutes pulling out wires plugging some back in, how can this be accurate? i used the machine for 3 months but gave it back to my insurance provider after recieving my 1 year medical card, now in august my card is expiring, will the non use of the machine for the past 5 months hinder me from getting a new medical card?
@SG
If you were diagnosed with OSA then the medical examiner is probably going to require another sleep study if you cannot show 30 day compliance on CPAP.
My husband was diagnosed with narcolepsy over 30 years ago. He has never experienced cataplexy or unconsciousness. He’s been on the same medication at the same dosage since his diagnosis.
He drives a BUS for a LOCAL transit company. That outfit hired him knowing – from his first interview – that he has narcolepsy; he’s been issued DOT cards each year that he’s worked there. His attendance record is spotless. He’s earned back-to-back safety citations throughout his tenure.
The medical examination firm that this bus company’s been sending all of its drivers to has been replaced by someone entirely unfamiliar with narcolepsy. He “gave it away” by asking how that CPAP machine was working out. CPAPs are for apneic patients – not for narcoleptics.
Certified Medical Examiners are REQUIRED to understand the role of the commercial driver. Clearly, this one does *not* and further can’t distinguish between OTR truckers and bus drivers and between narcolepsy and sleep apnea.
Therefore, while my husband’s DOT card was STILL VALID, he was taken out of service (unpaid, of course) because of it.
There are only FOUR parts of the DOT medical examination that are absolute and do not allow for discretion on the part of the physician: vision, hearing, diabetes requiring insulin and epilepsy. My husband has none of these and PASSED THE PHYSICAL in its entirety. Yet he was “disqualified”.
There are other disqualifying conditions such as tachycardia and Menier’s that are disqualifying. My husband has NONE of these, either and his treating physician has signed off, indicating there is no risk of his becoming incapacitated while driving. He, therefore, passes the §391.41(b)(8) and (9) tests.
There are medications that are disqualifying. My husband’s on methylphenidate – a Schedule II drug – which, by definition, is not on the 21 CFR 1308.11 Schedule I substances list. Ergo, his medication is not at issue per §391.41(b)(12).
The FMCSA clearly says – in its own rules that have not changed since April 2014 – that they provide GUIDELINES (not statutes) to assist the Medical Examiner in determining a driver’s fitness and that the “Medical Examiner MAY OR MAY NOT CHOOSE TO USE THESE GUIDELINES.”
MAY OR MAY NOT. Yet no doctor – on the “trucker-friendly” list or otherwise – seems to believe that they have ANY discretion in this matter at all. When they try to contact FMCSA for verification, they get no response.
You need to get the word out to these doctors that they DO have discretion.
SAFETY IS PARAMOUNT; DESTROYING CAREERS IS OPTIONAL.
UPDATE: Today, my husband drove an hour and a half to the regional FMCSA. The medical expert there said – definitively – that doctors have discretion as to whether to follow the guideline (or not).
Your husband got the “Pork without the Beans” I would recommend that he starts drinking heavily then after the hangover is gone, going and talking to a Manager at the Bus Co to explain the situation. If he has a good record like you say I’m sure they will work with him to find another CME. Drivers with a Class A/B CDL with Air Brakes are not easy to find.
Good Luck!
I already took a sleep test a little over a year ago. My blood pressure was elevated when I took my DOT physical again. The test says there is no sleep apnea present but the doctor says I need a new test done. I understand the need to control my blood pressure. But if I get that under control can she still prevent me from obtaining a new card? Is there anything else I can do?
@Stressed out
Get the blood pressure under control and if you have the results from the last sleep study available, take then with you. There is no need for a further OSA examination if you do not suffer from it. You might want to get a second opinion from another medical examiner.
I was recently diagnosed with “sleep apnea”. I put it in quotation marks because it seemed the place I had the study done that everyone walked out with a cpap machine. I’m overweight, smoke, and have 18″ neck. Recently had knee surgery and spent 20 years as a paramedic. My sleep is marginal at best buy yet I function with little sleep as is. Since I’ve started the cpap, I’m more tired after using it than when I don’t. No one listens to what I have to say. All I hear is I’ll get taken out of service if I don’t use the machine. I was taught to treat the patient not the machine. Is there anyway to fight this and if I change companies will it follow me? My primary care at the VA said to follow up with doctor who prescribed the cpap machine but I never saw a doctor.
I had a sleep study done 12 years ago. 2 years ago I went back to the sleep doctor. They wanted to do another sleep study. Insurance denied the request and stated to put me on an Apap. Always have passed dot physical with flying colors. New dr for work only certified me tI’ll sept. To loose weight and get another sleep study. I told them my insurance will not pay for it. Obamacare. My new insurance when goes into effect might. But can he require me to do that. Another sleep study and loose weight. He also kept insisting that I could use them as my primary care dr. What to do about this. Work sends all there drivers there.
@Michael
Go somewhere else for a second opinion. The CME can request another study, but it is not his role to tell you what your primary doctor should have told you. As far as the company goes, they probably have a contract with the clinic and by doing so they get a financial break.
@Trucker Docs
I have been on a Bipap machine for 5 years now and I always had a 2 year medical card, Today the company doctor issued me a 1 year medical card because I have a Bipap machine. My question is, Can the company doctor only give me a 1 year medical card since I provided them with a compliance printout from my Pulmonary Special and Provider of my Bipap machine?
@Anthony
Yes. FMCSA guidelines request a one year medical certificate for your condition, with supporting documentation at each certificate examination.
My cpap machine is malfunctioning and cannot get the print out I need for my cdl medical exam. I have a loaner machine but only will have 4 weeks of readings before my medical card expires. They say they need 3 months. What can I do?
@Troy
FMCSA really needs a 30 day readout. Yes it is nice to have 90 days, but you have a situation that should be understood by the CME. Just explain your situation and have the thirty day readout in hand when you go for your examination.
That is great news. I thought the 30 days was only for newly diagnosed sleep apnea patients who had just started cpap therapy.
I have been a long haul truck driver in Alaska for about 3 years. At the end of November my wife said I stopped breathing while sleeping as well as was snoring really loud and I made an appointment with my general practitioner. The GP suggested I go get a sleep study done. The same day I was told to get a sleep study done I went to my employer and spoke with the Dispatcher as well as the safety director. I informed them my doctor thought I had bad sleep apnea. The safety director stated it wasn’t a big deal and I would just need to comply with DOT requirements in regards to sleep apnea.
I did my sleep study on December 20th 2016 and on January 15th 2017 I was involved in a rollover accident on the haul road. To this day I do not remember the accident or the events that happened. I was looking over the peoplenet electronic logs and they were those of someone who fell asleep at the wheel. I was shocked! I could have died or killed someone else and this has shaken my world in more ways than one. I called to inform my boss that I was just diagnosed with severe sleep apnea and the same day he fired me from my job. They ruled the accident preventable. I had an appointment on the 25th of January to get set up with a CPAP and unfortunately with getting fired I am having to pay out of pocket cause they cancelled my insurance 7 days after termination of my employment.
I was confused as to how they were justified in firing me and I started doing some digging and called the medical examiners office to get my records. My last medical card was issues in October 2016. They were shocked when I told them what had transpired and how severe my sleep apnea was. In my records it showed my BMI was 35 but had the wrong neck size written down. I am a male 38 years old and considered obese. I was informed by the clinical manager that I would have to get a new medical card and be compliant with my CPAP which I have been for the 3 weeks I have been using it. I went in today to get a new medical card and was told by the CME that I didn’t need to do anything. He admitted that I was only suppose to have a yearly card if that but he left my original 2 year medical card as the current one. I am horribly concerned at this point and cant afford to pay for another medical exam for my medical card until I start working. I don’t understand why I wasn’t flagged at the appointment in October 2016 as I fit most of the criteria. I am doing everything I can to make sure I am compliant but feel like this CME doesn’t know what hes doing or is purposely trying to get my license suspended. I did speak to the FMCSA in regards to this and they told me that I needed to get a whole new physical and medical card that would be for a month or 3 months until they have more compliance records and after that I would have to renew yearly. Is there something else I need to be doing or is this CME correct in keeping the original 2 year medical exam card in place where my sleep apnea wasn’t ever listed? Any help with this is greatly appreciated. Thanks
@AKtrucker38
FMCSA requires a 30 day with 70% compliance report with your cpap unit before you can test for your DOT medical certificate. Your card will be good for one year at the time and will need a compliance report each time you test, along with a medical release form from your doctor.
Your two year medical card should have been suspended / disqualified at the time of the accident.
A new medical certificate may have been issued for a short term to get the remainder of the sleep compliance report, or you are disqualified until you can support the 30 day / 70% compliance.
I am a school bus driver in Charlotte county FL. The school district has its own clinic and the nurse practitioner who does the dot medicals is sending almost all the male drivers for sleep apnea testing and a few female drivers. most of our drivers are over 50. The CME says everyone is lying to her so she is sending most everyone for testing. My question is can she get away with doing that?
@Ron
Not if all of you file complaints about how you were treated during the examination. File your grievances with the FMCSA and put this to an end. FMCSA needs to know that someone is not following the FMCSA guidelines and besides, you drive a school bus and they are trying to hold you to an OTR interstate drivers standard. ????
I took my sleep study in August 2016. At the time I was skeptical that I had apnea, especially after the technician seemed to confirm my suspicion. Lo and behold, the doctor called me 2 weeks later to inform me of having “severe SA.” My problem is that I am up against the end of my second (and presumably last) extention but still can’t manage to keep the mask on for at least 4 hours a night. Is it possible to get another extention, or should I be re-tested?
@Patrick
Getting another extension will be up to the examining CME. And retesting is not going to work since you have to show 70% compliance for a thirty day period. Have you checked into a low profile mask? Check with your sleep doctor to see what options you may have. Good Luck.
I went down to get my DOT medical exam on 2-4-17, I’ve kept up on my CDL license and Medical certificate every year since not driving a commercial truck since 2011. On the exam theirs a question that says : Has your USDOT/FMCSA medical certificate ever been denied or issued for less then 2 yrs? I said “yes” and the Doctor who was doing my exam put down “NO”. I even told her in front of my girlfriend that my CDL was suspended once for not having a up to date medical card on file. In the note section on the physical exam, the doctor put down in her notes after i had already sign the certificate,that and I quote” he later reported in front of his girlfriend,PO,BM, and myself that he had his CDL suspended and has had to get his license renewed every year. He is aware that I called our medical director DR.Poon and that his license is being revoked” end Quote. She disqualified me for having OSA and C-PAP. She says I misrepresented myself on a federal form. I didn’t, she didn’t hear me correctly. They also asked me if I had a sleep study done and I said “yes, back in Dec 23,2016. The doctor asked why I had it done and I said cause I felt I wasn’t sleeping well enough. She asked what the report said and I told her I have a mild case of sleep apnea. She asked if I had a CPAP machine and I said “no” coz i didn’t know I had to say anything about it. Then she left the room and came back with another person and that’s when I told her that I had a CPAP machine at home. I feel like the examiner had it out for me from the beginning. Can the doctor put notes down on my exam report that is sent to DOT after I had already signed it? What Options do I have now,if any at all? I already called my primary care doctor to get a second exam done and for him to fill out the medical release form opinion that shows my use of the CPAP machine as I”ve only had it Since Jan 2017. I’m lost in what direction can I go. Thank you.
@Ronald
Sounds like you and the CME are at odds. Best bet is to get a medical release form from your doctor explaining your need for the CPAP machine, along with your most recent compliance report. Then go and get a second opinion somewhere else. The new medical certificate will over-ride the last one. That should do the trick, good luck.
Having similar problem. Medical card came due Jan 26-17. Went on Jan 27. First time asked about cpap machine.Reluctantly admitting to having one but explaining not much data on it cause of mask problems and loosing more sleep.Doctor still required 30 day read out. finally got appt with VET hospital on March 2. Got read out and fitted different masked,but not enough data on readout.Started using cpap on march 3 finally averaging 6hrs/night.Knowing this doctor is going to fail me called other doctors explaining situation and need time to comply cause my 45 days is running out.Can not find doctor to work with me on this problem.This is my third year having my cdl and the first time i am being asked about cpap machine.What rights do i have if any or what can I do?
@Tim
The FMCSA is holding pretty strict on this and has the CME’s between a rock and a hard place. Best bet is to learn from this experience and have the documentation ready before you go for the examination. Now that you are in the FMCSA database as a CPAP user, you should only need a read out just prior to doing your medical certificate examination. Good luck.
I have mild OSA. Prior to renewing my CDL last May I purchased a Resmed S9 variable with a nasel pillow mask. Three months later my medical provider, Kaiser, provided me with a Phillips cpap. I keep one machine in my truck and the other one at home. We very quickly discovered that the AHI number on the Phillips consistently runs three time higher that the Resmed. So I purchased another Resmed S9 identical to my first machine. I am set at 5.6 pressure and my AHI runs from 0.6 to 5.0 with the average under 3. I am 95% compliant with 4 hours or more.
My dilemma is…only the combination of the two machines will show these numbers. Is that acceptable? Also, what exactly is the Fed DOT looking for? If they have the hours and the AHI number, are they looking for anything else?
My Kaiser doctor is giving me a hard time. I don’t fit his medical learning profile. He wants me to take another sleep study which will most likely show a higher pressure. I don’t tolerate pressure higher than 6.0 well. It suddenly involves mask leaking and difficulty breathing out. He refuses to accept the work I’ve done to minimize the pressure for minimal AHI numbers.
@Lee
You may want to get a second opinion from another CME. You numbers appear within normal limits and your usage/compliance are within the FMCSA requirements. Once those criteria are met, then the FMCSA is OK as long as everything else checks out satisfactory.
I was told by ME that because of my bmi I must take a sleep apnea test I have a pulmonary Dr that the Me sent me too for a pulmonary evaluation sign off and gave me an OK my primary doctor who I see 3 or 4 times a year signed off it but the ME still says because of my bmi I need the test.1 week left on my med card can I get a second opinion?
@Rochard
Go somewhere else for a second opinion. No new rules regarding BMI or neck size, so your best bet is to get a second opinion.
I am in a similar boat. I only have until the end of the month before my card runs out!
Original exam was told “too fat” and neck too big that I had to get sleep test done. Was told only to do that and bring results back within 90 days to centra care. Did that and saw a different doctor who lost his temper because even though I was never told to do so, said I should have already undergone treatment and been able to show compliance. He would only give me a 30 day extension. I takes 21-28 days just to make the device I’m seeking for treatment.
To that, I am claustrophobic and deathly afraid of cpap. There is an alternative called an Oral Devise but I am meeting with resistance to that. If centra care doesn’t agree to this treatment and my card runs out I will automatically lose my job on the 31st.
My company won’t let me go anywhere else to seek a second opinion.
What can I do? Do I have any options for some kind of appeal or anything? Doesn’t the ME have to help me if I’m seeking treatment l, even if it’s other than cpap?
If you have a mild case of sleep apnea can the medical examiner require you to use a cpap machine if your registration dr just told you to lose weight and quit smoking
I am very interested in becoming a OTR driver. I was recently told I have Sleep apena, was given a CPAP and I can not sleep with this thing. had it for 5 months and can Only sleep all night with it, if I take a sleeping pill. Other wise I wake up and freak out, rip the mask off and throw it. I’ve recently been in contact with a sleep center that offers sleep appliances. In hopes I can sleep with it and get some good sleep. Do you know if these are approved by the DOT, or does it have to be a CPAP machine? If it has to be a CPAP, then I’ll have to figure something out, the mask they said would fit me SUCKS!
@Cory
If you are working with a sleep facility, then anything that they finds that works for you and that they will provide a medical release for should be fine. Make sure you have the doctor sign off on a medical release form explaining his findings and what modifications he felt worked best for you.
Is a complete new DOT physical required after satisfying the sleep apnea testing?
@Judy
Yes, unless your previous medical examination was put in ‘pending’ status, and you were not issued another medical card. ‘Pending’ – it’s up to the discretion of the medical examiner.
I have printed out a “Compliance Summary” from my CPAP machine, regularly, with one going to our company doctor when it’s time for my CDL physical. What are the numbers on this report that the examining doctor looks at to see if I am “fit for duty”?
@John
CME and FMCSA want to see a medical release from your doctor and a 70% compliance of use with your unit.
I have a driver that is 5 feet three and weighs 305 pounds. BMI is off the chart and neck size over 16″. and is 42 years old femaleShe denies snoring, sleepy, tired, drowsy, etc. I sent her for a sleep apnea evaluation. Now she keeps calling telling me that I mis-read the FMCSA Medical review board sleep apnea Guidelines. Is she correct?
@Stuart
It’s a tough call. If all you use for the sleep apnea determination is BMI and neck measurements, then she is correct. FMCSA does not have any new guidelines regarding the use of these two measurements.
And at the same time you can’t find the FMCSA guidelines anywhere, since they are being revamped (for the last two years).
You need to be using other criteria to make your final decision. Drivers should be demonstrating a multiple of signs/symptoms before call for the testing. Do more research on the other signs and symptoms so you could make a better decision if the test is need for sure. FMCSA is looking at a list of about five things that must be considered before requesting the testing. But a good google search will be a huge help.
Hello I recently was in an inpatient drug rehabilitation program for 30 days and while I was there they suggested that I should get a sleep test sleep study. It was a 30 day inpatient facility and while there I went and got the sleep study done. I was there at the treatment center to get off of a prescription drug that I had been taking for a while. Back to the sleep study the first night when I was there I guess it was to check if I had sleep apnea which I did not. So the following day they did the five nap sleep study 20 minutes for each nap and told to try to fall asleep. Well each nap for 20 minutes only I did fall asleep before the Time was up. I am a UPS driver and have been for almost 13 years. I started at 21 and 35 now. The sleep study results from the naps said the “The findings are suggestive of a diagnosis of narcolepsy”. Now being told to try to fall asleep I found that seems to be now unfair. I went to my doctor to get my DOT physical and was just trying to be honest and I guess I offered to much information about my sleep study and the results were temporarily not fit for duty. What do I need to do to get that stupid narcolepsy word to go away. I don’t fall asleep when I’m walking or anything I do get tired and fatigue at times but not nothing to wear I would be endangering The lives of the people in public. I have never had an accident zero in 13 years while being employed there. I am a little lost on what I need to do to try to get this issue resolved. I’m reaching out and looking for some help but I think when you are told to try to fall asleep which I did but the results say I have narcolepsy. And now I can’t drive which is bullshit. I feel like I was being too honest and now I’m paying the price but any help from here and from what I’ve gathered from this site it seems to be a lot of great help for drivers.
@Jesse
Go get a second opinion from another CME or another doctor. Somehow you have been tagged and are having difficulty overcoming the earlier findings so see if you can start fresh with a second opinion.
Can you go out medically with sleep ampnia from the georgia department of corrections?
@Brian
Only GDC can answer this.
Does mild OSA (found out because I was snoring), that is treated with an Oral Appliance require a retest every year? My last sleep study was great, and the examiner said he could only give me one year card. I am not overweight 5’9″, 185# (workout 3-4 days a week), and my neck is not too big.
@Jesse
If the oral device is working and you can support the findings with a medical release from your primary physician, then you should not need to redo the testing each year.
I was diagnosed with sleep apnea and had to get the CPAP machine. I can’t sleep with it. I went through another state and another company got approved for med card for one yr. I did not tell them of the sleep apnea test. I can’t sleep with it. It makes me sleep worse. Am I good to go. Or will they find out about previous test.?
@Davey
Your last medical card over rides the previous medical certificate, but now you have not provided correct and truthful information on a federal form. It could be found out and then what????
Had Dot physical 7/13/2016. Got 3 month card so I could get sleep apnea test and equipment. Doc told me to come back within 3 months with my printout and if compliant a year card would be issued. Went back 9/22/2016 with my printout that shows 80% time useage of greater than 4 hours. Had to have an new complete DOT physical (with the accompanying full physical fee) before PA would issue new card. Why complete physical?
@Bonnie
The new FMCSA forms require the CME to redo the exam with a new set of forms. There is no longer the option to update a previous exam. The new medical certificate overrides the previous one.
if im on the cpap machine and my med card expires do i have to take the sleep study test everytime i recertify or just show that im using the cpap machine
@Carlton
You just need a recent print-out to show proper compliance with your unit.
You do not need any such thing. Fact: FMCSA does not require any specific treatment or equipment in its regulations and Advisory Criteria. This may be a standard of practice in the medical community, but it isn’t an FMCSA requirement.
I went for dot today. My cpap printout states as follows.
77% of days used overall. 219/240
62% of days greater than 4 hrs use
14% of days lesser than 4 hours
Is this in compliance? My NRCME wasn’t even sure so he gave me a 2 month MedCard too keep me going. He it’s to follow up and let me know and explained if he made mistake, he will issue me a new one for a year. If it’s not in compliance, he was nice enough to give me an extension of a 30 day CPAP report and if it’s satisfactory with 70% of days greater than 4 hrs, he will extend my expiration to a year. I use this machine all the time, even during short naps, I get better rested. I don’t understand why it’s lower. I don’t however use if when I get home, but Im only home 2 days a month on average.
I have new health card that is only a month old. I went to a trucking company and they diagnosed me with sleep apnea during a new dot health screening. I did not take the job or their health card. I am going to get me a CPAP machine at a dot certified sleep doctors office tomorrow. If the doctor that diagnosed me said he was faxing the results to the dot, will that affect my current health card while I am in the process of getting my CPAP machine, I have a job that I applied for and got before I was diagnosed with my month old 2 year health card and at the time I was not diagnosed. like I said I made an appointment and I am getting the machine but can I drive until it comes in. my employer doesn’t pay for health cards I had to get it my self. pre diagnoses ?
@Matt
If you did not get a long form from the last CME that stated you were disqualified or gave you a short term card to get the cpap in order, then it would seem that a ‘complete’ exam was not done. Results are not ‘faxed’ to DOT, they are entered into an online database.
Check with your local DMV to find out which medical card they have on file.
Does the DOT have any regs on which CPAP machines are acceptable or will any machine be ok as long as the driver can get a reading from it for compliance? Thanks again..
@Employer
As long as the machine can give a reading to show compliance, that’s okay.
I took a sleep study on my own and it was determined that I have sleep apnea. I was placed on a cpap machine. Am I under any violation
@Kelcey
No, but now you need to show compliance on the cpap.
I have a driver who tested positive for OSA and now has a machine and is doing well with his compliance 10 days in. Unfortunately due to financial hardship it took a while to get a machine organized for him. His DOT expired on 8/11 after a 3 month cert. We work with a sleep specialist and in the past we have provided weekly downloads of CPAP compliance to enable our drivers to stay on the road. The ME’s we have worked with seem to be happy with this arrangement so long as we send the downloads regularly every Friday for the week. This drivers ME will have non of that and just wants to see 30 days. My question is, are we able to send him to another doctor as his cert has expired. We will of course disclose whats been happening with our driver and all relevant medical records. There may be another ME out there who will work with us to try and keep our driver on the road or he will suffer further financial hardship. Thanks for a fantastic website, we need you guys every day….
@Employer
You are welcome to send your driver to any NRCME examiner.
Also explain to the driver that FMCSA guidelines do request a thirty day on the unit compliance report, but your input should be taken into consideration.
We did send this driver to another facility and he has been given 3 months to produce his 30 day compliance (of which he is almost halfway there) he will then get his years cert. He keeps his job, we keep our driver safely on the road. Thanks again!!
@Employer
You are welcome. Thanks for keeping your drivers safely driving.
I have a driver who went to a Concentra for his DOT. He was told he needed a sleep study but that they would not accept a home test. We work closely with a company who does a great job with our drivers. They do 2 home sleep tests, unless the first one is totally conclusive as positive for OSA. Concentra told me that the DOT will no longer accept home studies. I can’t find anything to support this can you clarify for me please? My driver (and many others) simply cannot afford a lab test, he is struggling to afford the home test. I feel my only option is to ask if I can refer him to somewhere that will accept HST. I was wondering if anyone else was having the same issues with Concentra, could it be a new’ Company policy’ we have to deal with?
Thanks again..
@Employer
It falls in a very gray area.
FMCSA stated that the home studies were not as accurate as the lab studies.
Now, if you are working with a company and the overseeing doctor can and will support the finding, then the CME should be able to accept the results.
The CME just needs supporting information to be able to provide the best decision about the drivers safety.
Some of the ‘doc in a box’ facilities are tied together with sleep study companies and will not budge on the issue: follow the money.
But good supporting information from the study with a medical release from the provider should be all you need. If the driver is found to have OSA, then he would want to move forward with whatever the doctor is recommending.
I have a current fed med card without the diagnosis of sleep apnea.
I have taken upon myself to go have a test taken to find out if I have it.
I was scared about having my fed med card revoked till the study took place so i told the doctor i didn’t have a cdl not knowing the seriousness of my actions.
What do I have to worry about taking a test on my own free will?
I had to schedule months in advance for the test also
@John
You have not had the test and there is no functional diagnosis to worry about at this time. Once you get your test results back, there may be a thirty day waiting period, if you test positive for OSA. That waiting period is for you to get accustomed to the new device. Then you need to redo your fed med card.
Hi I have a California class c drivers license. my dot examiner is making me take a sleep test am a local delivery driver to local supermarkets. Its a 10 minute drive fron my warehouse to my first stop and after that its 5 minute drives going supermarket to supermarket i drive a regular bread similar to a catering truck…ive been doing this for 12 years no problem. Do i have to be taking this test ir the dot examiner thinks i drive a class a trailer? Thanks
@Raul
You just need to inform the examiner that you are a class C driver of a bread truck and that all you need is a medical card to operate an in-state only vehicle.
And since there were no new rulings on sleep apnea, you may want to go somewhere else for a second opinion.
Hello, and thank you for your input!
My spouse is a class B, local delivery driver. He has been on a 1 year card dt controlled hypertension for a few years. Last year however after a particularly awful round of bronchitis he quit smoking and gained some weight. The clinic that his company subsidizes his Dot physical through immediately pegged him for OSA, which is fine. They made him pay for a “home sleep study” ($350 out of pocket). Which declared that he has severe OSA. Now we’re trying to wrangle these doctors to order the cpap machine so that he can wear it and get back on his 1 year card. However, in a effort to have something explained to him he made another appointment with this same clinic (different provider) who did not perform a physical in anyway, but who after looking at the sleep test printout told him that she was going to revoke his medical card immediately.
My questions are:
*Is she allowed to do that if a 3 month card has already been issued?
*What is the significance of a second opinion? As in which one does the government go by?
*if so would it be in our best interest to go to his family doctor and give him all the information and ask if he will reinstate his card – if that’s possible- for 3 months until we can get this worked out.
* if his medical card was actually revoked, what happens to his license status, does he have to retest for his CDL entirely?
Again, thank you so much for your input we are completely lost in this process and appreciate all the help and information we can get!
Ema
@Ema
If the last provider did not do any examination, then she/he can not make a change on the FMCSA data base.
Since there is no change on the data base, then a true second opinion would be worthwhile and the second opinion, then placed on the FMCSA data base, becomes the new medical certificate.
Unless your primary doctor is on the national registry with the FMCSA, he can’t do anything that will change the medical card. He can provide a medical release form explaining his findings, but that information will be used by the CME on the national registry.
And if a medical certificate is revoked or disqualified, it does not directly influence the CDL until the issuing state for the CDL becomes aware that there is no valid medical certificate. Then it becomes a state issue which most likely will downgrade the license.
I had been a bus driver for 8 yrs took a break for 2 years. I have sleep apnea and since i wasn’t driving wasn’t faithful to wear it . So now want to go back to driving and so now I don’t have 3 months of data on machine . I have used it everynight since found out school had opening. Is there a way I can drive like on a probationary period until I get 3 months under my belt on cpap?
@Janita
You should be OK with a 30 day compliance report and they may do a short card until you do have a 90 readout.
Thank you so much.
@Janita
You are welcome. Please tell others about our website, and support our driver friendly(TM) doctors if you have one in a convenient location.
I’ve been required to submit proof of CPAP compliance since I was diagnosed with Sleep Apnea several years ago. I’ve lost over 40 pounds no longer need any sleep appliance. My wife tells me I hardly snore at all and I’ve even recorded myself while sleeping – practically zero snoring, not to mention I feel better and more rested than I ever did using a CPAP.
How do I get the “OSA” designation removed from my DOT Medical report? Is a sleep test required? If so, where do I go to get one?
@Alex
Start with your primary doctor and have a medical release form from him stating that the CPAP is no longer needed. If that does not get the job done,then check with your local doctor as to who does sleep tests and go from there.
DOT doctor said I needed to get sleep study done and gave me a 3 month card. I did sleep study and was diagnosed with sleep apnea. They put me on a cpap machine and I could not tolerate it . I went a little over a month with little or no sleep just to get compliance. After going back to the doctor to get recertified he only gave me another 3 month card and said I have to do it all over again. I cannot handle or tolerate a cpap machine I just can’t sleep with it. I am working with my sleep clinic to try and find an alternative, one being the oral appliance that I cannot afford(about $2000-3000). What options do I have to keep my job of 17 years with the same company.what does the dot allow . please help
@Scott
Try getting a second opinion from another CME. Someone who has sleep apnea and truly needs the unit, won’t leave home without it. So try for a low profile mask if they feel that you truly need the unit.
I tryed several masks and could never get comfortable with any of them. What I really need to know is does the dot approve use of an oral appliance or if I have surgery or the inspire implant. I am just a local truck driver not otr do the same rules apply. There is just limited info on the web and everyone I talk to tells me something different. Even my dot doctor did not know what to tell me. I have been going to the same clinic through my work forever.
@Scott
If you fall in the local driver intra-state only category, then you should not be required to do the sleep study, unless all of the other OSA criteria are met. So check with your local drivers license department and ask them. FMCSA will accept the surgery, but if you are state wide only, it’s not an issue for you. Just inform the CME that you are in-state only and fall under the state variances.
CAN A DRIVER BE DENIED A DOT CARD ON BMI ONLY
@John
No.
Question I also got my neck over 17 inches and a 37 on bmi, yhe doctor sent me for a home sleep study, after thats takrn care of whats next? Ig I have OSA or Regular sleep apnea will I be disqulified? Please help. Tks Ivan
@Ivan
If you were diagnosed with OSA and were put on a cpap unit, then you need to be on it for at least thirty days with a 70% or better compliance before you go for your next DOT medical certificate. Take your latest report with you and you should be good.
Last year inhad a sleep study done and it showed I didn’t have sleep apnea and was issued at 1 year medical card. My question is how long are my test results good for? Am I going to be asked to have a sleep study done ever year? Thanks
I found the answer to my question.
@Alex
Negative results should be good for years on end, unless other conditions develop and indicators show that there needs to be a new test. Not just neck measurements and BMI.
I work for an auto parts company and am a delivery driver. I do not go out of state and have just a class C license. My company makes us drivers get a DOT card every 2 years. Last year I was diagnost with slight sleep apnea and did the cpap machine for a month just to get a 1 year card. Today I went into the dr’s office to renew and she asked for my cpap readout. No one ever explained to me that I needed one. Now my DOT card expires at the end of month and by the time I finish another month of cpap use, I may not have a job to go back to. Any help would be most appreciated.
@Gene
All you need is a readout from your unit. You can get that anytime from the cpap prescriber. Check with them and have them help you out here.
I was diagnosed with mild sleep apnea 2 years ago. AHI of 7. Since then I have had 3 DOT physicals and got certified with no problem. Today I went for a DOT physical and presented the DOT Certified Nurse Practitioner with the sleep test results and was denied a card. The (Doc) said that because I was diagnosed with sleep apnea that I had to do treatment to be certified. The FMCSA recommendation clearly states that AHI > or equal to 15 is moderate to severe obstructive sleep apnea and requires treatment. It says under 15 with no excessive daytime sleepiness should be certified.
What can I do about this.
The Nurse Practitioner says that not only do I not know what I’m talking about, but the clinic that did the sleep test and analyzed it doesn’t know what they are doing or talking about and surely are not DOT certified. The company that did the test is contracted to some of the biggest commercial trucking companies in the USA and does all of the sleep tests for them.
@Joe
Go get a second opinion elsewhere.
I’m having the same issue! My AHI is only 5 and have no daytime sleepiness or snoring. I am being forced to use a cpap. I can not tolerate the machine and was told at my physical last week that if I don’t show compliance in 90 days I will not be certified. Everyone has said I and they have to do what the sleep doctor says. He is having me do an at home sleep study now to see if it will show no apnea at all but I feel like they are just trying to get more money. Should I get a second opinion from another sleep doctor or family doctor? This is wrecking my life.
@Jacob
Best bet is to get a second opinion. Most drivers that actually need the CPAP won’t leave home without it. If you do not truly need the unit, then you fight with it all the time. Second opinion is the direction to go.
Tested positive for sleep apnea,how long will I need to be on treatment before going back to dmv to show improvement dealing with sleep apnea
@Alvin
At least thirty days with a minimum of 70% compliance for at least 4 hours a day.
I had neck of 19 1/2″ and BMI of 32 and was sent to get sleep study before I could get longer than a 6 month card. Did home sleep test (worst I’ve ever slept if you can call it that, slept 2 hours maybe) and they said results show I now need to do lab test. I told them to get screwed. I don’t believe their results have been submitted to DOT because they are separate from my med examiner who did physical. I have a co-worker who is just as big as me and got cleared no problem. Can I get second opinion or will I get in trouble even though I’ve already done home study?
@Alex
Yes you can get a second opinion.
No one is going to accept the home study results. They are too inconsistent for any CME to accept for DOT.
So do I need to get lab study or am I clear to just see another ME for physical? After initial visit when I was told to get study, I received 6 month card until I came back with study results.
@Alex
Get second opinion first and go from there.
Just went for 2nd opinion and this doctor cleared me. Thanks for your help
Long story short….Last year I got flagged for sleep apnea during my DOT physical. I went & had the sleep test & my ahi was 11. The sleep Doctor set me up with a cpap machine. I’ve used it 100% the whole year. I went today for my yearly DOT physical & the doctor made the comment while looking at my sleep report that my ahi is low & that my use is optional. However he only recertified me for one year because of sleep apnea! I am so confused! So do I HAVE to continue using CPAP? It definitely hasn’t helped at all, it’s made my sleep worse to the point I feel drunk when I wake up. I’ve been prescribed Nuvigil to help with this.
What do I do to be able to quit using CPAP?
@Leslie
Check with your sleep study facility and ask them if you truly need the unit. If it is just a mask thing, then see what options they have.
As long as you use the CPAP your DOT medical card will only be good for one year at the time. If the sleep facility says that you do not need to use the unit, make sure you have them put it in writing so you can take it off your medical examination findings.
Will do! Thanks ????
Okay finally got with my sleep doc & because I’ve been diagnosed with sleep apnea even though it’s just an ahi of 11 he will not sign off stating I’m clear to NOT use cpap to maintain my certification. So I’m stuck using cpap even though it’s made my sleep worse & I’m having to take Nuvagil just to function everyday! ????
I’m from Iowa and wondering about sleep apnea test guidelines. My neck was larger than the guidelines so I took the sleep apnea test and it came back 19.8 events per hour. I was told this is borderline for my CDL. Are more tests required? I can’t get an answer from the dr. He thinks I need more tests..What are the guidelines for Iowa..I’ve been driving school bus for 19 yrs.
@Dale
If all you are driving is a school bus, then you should not need any additional testing. You should not be being held to a class A interstate drivers standard, so check with your local drivers license department and see what they have to say. Since there were no new regulations regarding OSA and you drive locally and are home each day, you should only check with the sleep study group and see what they have to offer.
My husband had a TIA 1 1/2 years ago. The Neurologist (who also ran and owned a sleep study center) required he go through a sleep test. His employer required him to complete the doctors request and receive a clean bill of health before he could return to work. It just so happened that my husband had very slight sleep apnea. Strapped with a cpap he went on with life in order to keep his job. This year he had an at home study done and was told by his PCP that he didn’t need a cpap and took him off of it. His employer released him from any further requirements. Now he is trying to get his medical card renewed. The doc. at Concerta will NOT accept at home test results. He is requiring him to either show him an in clinic study results or 70% cpap usage. Do we have to comply? His employer will ONLY use Concerta.
@P S
The CME is going to question the at home studies because there is no verification printout to go along with the study. So they will require a new study be done, with readouts to support the no need for the cpap. Also a medical release form from your primary doctor will be helpful in this situation too.
Husband had his DOT physical Monday. Was disqualified due to his eyes. Had an eye exam got his glasses. Called to make his f/u appt. and was told by the examiner since his BMI, Age and because he is male she is now asking for a Sleep Apnea test. Nothing is on the form but to see an eye doctor. What should we do?
@Linda
Go somewhere else for a second opinion. No FMCSA guidelines on age or BMI, so second opinion time.
My son was told He needs a sleep apnea test because of his neck size and being overweight. Does he have to take the test or should he try elsewhere. If he does go elsewhere does he have to tell the second Doctor that the first one suggested the sleep apnea test.
I’m in the exact same boat. Just got out of cdl school and never had a family Dr.
Went to get the i itial physical from the dr the cdl school referred me to, who gave me a 90 day card. The cme told me to have my family Dr get me a sleep test to get the full length med card.
Now found a family Dr, and he wants me to get the sleep test also, but the initial appointment with the sleep dr is 2 weeks after my 90 card expires! So now I dont know what to do, as I lose my cdl status if I dont have a valid med card. I’m hoping a dot physical fairy drops a card under my pillow as I’m sleeping….without apneas of course!
If only there were a dr like the old days with car inspections where you pay double, and they give you a card…lol
Seriously though, it’s absolutely outrageous .
I got my results back today from sleep clinic I see online that levels 20 or below of ahi dont require u to wear a cpap machine to Maintain my medical certificate card is that true my level is 12.5 does anyone have an answer for me
@Kyle
Your results indicate mild sleep apnea which most likely do not need a cpap.
The medical examiner should be looking at a combination of medical conditions to assess your overall risk of sleep apnea.
See these articles on our blog to better understand sleep apnea screening for the DOT medical qualification. http://dotphysicaldoctor.com/category/sleep-apnea/
Not sure what to do now. My son went for his physical at a place near the company he drives for and they gave him 3 month certificate based on him needing a sleep study because of his neck size and weight. They told him to go back to his primary doctor. He went in and talked to a sleep specialist who told him that he may not have sleep apnea but the only way is to test. Because of his deductible, it will cost him $1900 to have the split test.
After reading what was said on here and waiting 30 days, he went to a local DOT doctor for a physical and filled the form with the exact same information and was given a 2 year certificate as he has no problems with blood pressure, urine test or any of the other tests and is not on any medication. His employer’s safety department will not accept the new certificate because 2 different doctors have 2 different opinions. They want him to do sleep study and/or have the 2 doctors discuss it and come to an agreement. He told them that all he did was go for a 2nd opinion and disclosed the same information. They still refuse to accept the 2 year certificate.
I’m not sure how he needs to handle this because his other certificate expires at the end of July. He is talking about just going to another trucking company but do not know if this is going to be an issue once he turns in the 2 year certificate to the state (which his employer told him not to do). Any advice would be appreciated on how to handle this and what will happen if he uses the new certificate.
@Julie
The last DOT examination done will have been reported by the medical examiner to FMCSA and over-rides the previous one. That’s how the system works.
It is your son’s responsibility to get a copy of the last medical certificate to his local drivers license department, to be filed with his driver’s license.
Thank you. That is what I needed to know. So he should go ahead and send it to the DMV and it will override the other? It sounds like the argument is with the company on what they will accept which is why they told him not to file it with the state DMV. He has already been looking at some different companies that have more local routes than he does now. I just wanted to make sure that his new certificate will be valid if he leaves his company. I appreciate your advice. There are way too many competing interests in this whole sleep apnea/DOT physical problem.
I was told to do sleep test. So I took my referral back to my primary doctor and he told me I didn’t need the test. So he cleared me to wrk and I took it back to the clinic and they’re saying no no I need to have it done!! But there the ones telling me to get cleared by my primary Doctor which I did now they’re telling me I have to get it done. Is this true can they tell me to do it after being cleared by my doctor ? I really can’t afford this test or afford to lose my job???
@Matt
Go somewhere else for a second opinion.
No new rules on OSA according to the FMCSA. See articles on Sleep Apnea Screening.
I do not hold a CDL but am a contract driver for a RV delivery company in Indiana. They do not require a CDL to drive for them. Am I still required to do the Sleep study to get my DOT physical card?
@Monte
Your state drivers license department will have your answer. You should not be falling under FMCSA class A interstate regs. So explain to the CME what you do and since there were no new rules regarding sleep apnea test, then you should not be held to those guidelines.
what dot law gives a doc the right to force all of use drivers to get tested and hold us from making a living everything i have found states a guide no law and not requirement for fmcsa.
@Robert
There is no law. Read these articles to better understand Sleep Apnea Screening.
Is a surgical implant known as, inspire sleep, done as an out patient be an alternative to the cpap machine
@Mike
Only if it fully corrects the OSA. You may need to retest following the surgery to confirm.
Hi my husband was just told he has mild sleep apnea. He was at 93% the whole night he took the test at home . His doctor did not write him a passing letter and is considering cpap
Anyone else go through this?
Oh Yea, This is a big liberal government take over policy to punish the people who work that pay for the people who don’t. Get ready commercial drivers.. This ones on us.. Anyone that has a commercial drivers license and who is going to vote for Hillary Clinton should reconsider quickly. Do you really want more of what the last 8 years have given us ?
So true!
I didn’t meet the 30 day requirement to be recertified, Sleep Doctor said I need to take another Sleep Study and Awake Test to obtain Compliance Letter. Are both test required by DOT ?
@Jeff
This sounds like something that the sleep doctor wants to be sure that you are OK, before he signs off on the sleep test results. FMCSA wants to see a 70% compliance if the diagnosis confirms a sleep disorder.
Per company CDL doctor my husband was told he had to have a sleep apnea test done. He has no symptoms, no snoring, no stop breathing etc. I sleep next to him every night he sleeps like a rock. He is never tired during the day or takes naps. He gets 7-8 hours of sleep every night.
He was told he had 60 days to see a Dr and get the test done. Needless to say it is peak allergy season and he has severe spring allergies, can barely breath, stuffy nose, sneezing and everything else. He had to take the sleep test while suffering with his allergies, He flunked of course, they told him he stopped breathing 29.5 times in an hour. The first night on the machine he scored a 99 out of 100. with a stopped breathing of .5 per hour. He has noticed no difference in how he feels, since he always got a good nights sleep. My question? Should the sleep test be given to sever allergy sufferers in allergy season? or should it be given after the allergies go away.
@Carol
Ideally it would be given after allergy season. And if he did not demonstrate any signs or symptoms of sleep apnea he does not need to subject himself to a sleep test. There were no new rules regarding sleep apnea testing from FMCSA.
The company physical is every March, no way to change it, during allergy season and he was given 60 days to see a Dr and get tested. No one seemed to care if he has allergies, we got the paperwork/results from his test today and nowhere does it state he was suffering from allergies during the test, or taking numerous medicines for his allergies. Even sadder is they made him do the test on a work night, He works for the electric company and they were doing 13 hr days, he barely got any sleep at the test (less then 4 hrs, do to not being able to sleep on his back, pulling the wires off every time he rolled over etc. he is a stomach sleeper) They then sent him off to work a 13 hr day when he was so tired from lack of sleep, he actually had to take a nap to make it through the day. So unsafe on there part.
He has been using the machine and now wakes up feeling tired, instead of rested. He told me today he has never felt so tired during the day. We go online every morning to his sleep results and he gets a 100% every night, with less then 1 stop breathing every night. Sad part is there is no one to talk to about it, they just do the test, tell you your results, give you a machine and send you home. The rest is up to you. You are then told you have to use this machine for as long as you continue to be a lineman. Makes him think about becoming a dispatcher.. so sad when he loves his job.
He was made to take the test because he has a very large neck, 19″ always has, even when he was young and in great shape, he is overweight, but doesn’t snore or wake from not breathing. I have slept next to him for over 26 yrs, the only one to snore in our bed is the dog!
on another note.. are you required to use this stupid machine when you are on vacation?
@Carol
You really need to find a new CME and get a second opinion.
Vacation, if he is on the unit it needs to show a 70% compliance over a thirty day period.
Also what class license is your hubby? There is no reason for a lineman to be tested at the level of an OTR driver, and it sounds like that’s what’s happening to him.
He has a class A, even though the truck he drives is only 18,000 lbs. (he is a troubleman so he drives the smaller truck), but he has to be licensed to drive the 45,000lb trucks even though he doesn’t.
They really need to set different standards for over the road truck drivers and those that use them as their daily work trucks.
He has no choice of company Dr, they come to his work to do the physical every March. I just wish there was someone to talk to about it. It is- go to this Dr. get tested, here’s a machine, we’ll see you in a year.
If this is such a big thing you would think there would be follow up visits to explain the results, if there is any way to get retested after allergy season, and if you can do something to not need this machine.
If you have a commercial drivers license but only do classroom and yard teaching, an instructor, and never drive on the road, is there any type of waiver to be able to keep your license even with a medical problem as long as you only teach in classroom and not go on the road?
@Carol
You need to check with your local drivers license department for the best answer. Most states require a valid medical certificate to maintain a valid class A license, but check with your state DLD first.
Question is it true that if you use a Cpap machine you can only get a one you med card? And if so can you get a waiver for two year card with high usage from download from Capp machine?
@J
FMCSA has made its position clear, that they want a re-examination done once a year if you use a CPAP, even with 70% or better compliance.
I have a question…my husband has been a truck driver (local) for a long time and has weighed the same for years (actually has lost 20 now) but he has NEVER EVER been required to do a sleep study by a DOT doctor for just saying he has a 17″ neck and is overweight. Now in checking into this, our insurance will not pay for any of the sleep study and he is almost at the end of the 3 month temporary card they gave him. Should he go somewhere else? He has never had any daytime sleepiness, is an excellent driver with no accidents or tickets. This has never come up before and there is another driver at his work that is bigger than him and he wasn’t required to do this study. This is just an opinion by some flunkie DOT doctor by looking at my husband. What should we do? He will be out of a job soon if we don’t get this resolved!
@ Ms. Moon
Go elsewhere for a second opinion.
I went for my dot test today and was rejected based on the fact I snore along with my anti depressant medication which has drowsiness listed as a side effect. These doctors that we are required to go to now are ridiculous.
My regular dr. Has to write a statement stating that I’ve had no side effects such as drowsiness from my medication. Now call me an idiot, but what is the difference between me telling my doctor or me telling the DOT doctor that I don’t get drowsy? Oh, and how many medications of there list drowsiness as a side effect?
I’ve never fallen asleep at the wheel never been tired during the day besides a nap on Sundays once in awhile. I only drive locally in a landscape truck with materials. However because our possible WEIGHT can go over 10000 pounds I need a medical card.
I understand the philosophy behind everybody having some type of physical to be issued a medical card however some of this is completely ridiculous and quite honestly a waste of the working man’s money, when we have to pay for the unnecessary sleep apnea test. And how come they can issue a temporary Dot card based on having to get a sleep test if it’s really that much of a hazard? It’s rather contradictory?!
Hello I was wondering if any one could tell be if you have sleep apnea an have had a Cpap for years is it true you only get a one year dot medical card? I have had a Cpap for years use it every day I’m otherwise a healthy man in my late 30’s this time I went in to redue my dot medical card an the dr lady said that cause I have sleep apnea I can only get a 1 year card. That cause the apnea the DOT only allows one year card.
I also was told by her that I could not get a second opinion. Witch seemed odd to me? Is that true what ever they say is it no second opinions?
@Seth
Second opinion is not going to help here.
@Seth
One year according to the FMCSA guidelines is all any CME is going to provide you with.
Why would you ever choose a female doctor, can’t understand that one.
I have Sleep Apnea. I use a CPAP machine. I made the mistake (I believe) of using an over the counter nasal spray (phenylephrine) to open up my sinuses, making use of the machine possible.
I’ve read some things that this medication could/would show a false positive for Amphetamines.
My MedCert is up for renewal….anyone else have some experience with this? Have you had a false positive? I’m kind of backed into a corner here….
@Mike
If it is an over the counter medication, simply keep the medication packaging do you can support the MRO’s questions if it does come back positive. The MRO can re-test the split sample and confirm that is the medication in the sample and you may be able turn a positive test to a negative test result.
How many time a year do I have to have my C Pac machine read to be in compliance with DOT
@Brenda
As long as you demonstrate a 70% compliance for a minimum of thirty days, you should be OK. It is nice if you have a couple readings throughout the year, but it isn’t mandatory.
Ok .So I was diagnosed 10-12 years ago with sleep apnea. I get a cpap machine : (if anyone has snoring problems or they are tired all the time i recommend the cpap/sleep test or machine after getting used to the machine i would get out of the truck at bottom of grade and push it up the grade hahahahaha i sure felt like i could push the truck up the hill.) I use to sleep 10 hr a nite, after the cpap i couldn’t sleep more than 5 hours a nite if i wanted to. Sorry had to let it be known.
I had a heart attack almost two years ago. I went to renew my dot card and they told me I had to do a sleep study for sleep apnea, because my neck is 17″ and I take two blood pressure meds. One is 10 mg lisinophril and the other is 5 mg amlodipine. My doc did two, because the amlodippine is for spasms of the heart mainly. My question is, does taking these meds and my neck size warrant a sleep study? I’m not obese, but I am a fairly muscular and I’m tall (6’2″ 220 IBS). I need to know, because the owners of the company have strong ties with the company that does physicals and I want to see if they are making me jump through hoops for no reason.
@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.
“@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.”
Can I get a link to those OSA protocols?
Also I am looking for this study not the tech pamphlet: Pack AI, Dinges DF, & Maislin G. (2002) A Study of Prevalence of Sleep Apnea among Commercial Truck Drivers (Report No. DOT-RT-02-030). Washington, DC: U.S. Department of Transportation, FMCSA.
Thanks.
-john
Are the results of sleep studies automatically reported anywhere or is it up to the driver to honestly report potential conditions?
@Heather
It is reported to the FMCSA database and can be viewed if there are any questions.
And you need to bring a report or printout from your unit to demonstrate proper compliance usage.
I had a sleep study done in 2002. I had surgery to correct a mild sleep apnea and snoring, which was successful. Since 2002 I have lost 35lbs (from 225 down to 190) I began driving professionally in 2009 and have had 4 dot physicals clear me since then. I recently went for a dot physical and the doctor only cleared me for 90 days and required me to do a sleep study because of my diagnosis in 2002. Do I need to stay with this doctor or can I go somewhere else and get my med certificate?
@Rowdi
You can go for a second opinion with any NRCME you would like.
I’ve gone thru sleep study, found out I have sleep apnea , i have CPAP machine, adjusted to it well,
been on it one week, DOT Dr. refuses to give me a 30 day temp card,he says i need to show compliance for 30 days, I proved to him it was his judgment, not a LAW, so do I have to show 30 days or the 70% {21days} to get back to work. I live in Ohio
Thank You
@George
Guideline are guidelines and are left to the CME’s discretion as to how they want to use them.
FMCSA guidelines are 30 days with 70% compliance. He may be viewing this as a safety issue and may not budge from his stance.
The way the FMCSA has written this is that the risk falls on the examining doctor and any safety issue would hold him personally responsible.
Many years ago I had a sleep study done on my own and was positive for sleep apnea. I used a CPAP but found I did not tolerate it as I would awake through out the night feeling like I was strangling. They tried adjusting my machine and different masks, all to no avail. In the end I just gave up. Fast forward to today. I have lost a significant amount of weight(+ quit smoking and drinking) and am driving a school bus part time. I have some health issues (type 2 diabetes, well controlled with metformin and hypertension well controlled with lisinopril) but based on this and my neck size (I am 6’2″ and 18.5″ neck) My DOT examiner ordered a sleep study. Fine. I went to the sleep clinic where I had been diagnosed years before for an overnight study. I completed the study but the analysis takes weeks (or more) to complete, so my personal physician ordered the raw data and My license is about to expire but here is the kicker, my physician says the data shows NO incidence of sleep apnea! (episodes of not breathing), Great, except that apparently it does indicate desat down to 87% at some point. So here is my question; Does the D.O.T. consider this “sleep apnea” ? and if they do would they consider ANY other treatment than a CPAP? (i.e. Inhaler, oxygen at night, ANYTHING other than the CPAP-which prevents me from getting any sleep at all now) Needless to say I am very anxious about what this means. I have been driving (with my C.D.L. “B”) for several years without an accident and no daytime sleepiness.
Thanks for your consideration,
@L.W.
Look into your states driving intra-state only rules. You are not driving interstate and the CME is holding you to interstate regs. So check with your local drivers license department and see what they have to say.
If there is no noted sleep disorders then the CME only needs a medical release form from your primary doctor stating so.
My husband’s company had a voluntary program where they went for a sleep study in a hotel setting. All volunteers, but 1, had sleep apnea. The company provided the machine and my husband was always in compliance. Recently my husband was let go and had to return the machine. He has no documentation of the results of his study. He is with another company now, should he go for a sleep study with another physician so he can possibly get this diagnosis removed? What is his best alternative?
@Carrie
If he was diagnosed with sleep apnea, then he should work on getting a new machine, if he did not have sleep apnea, then he will need to have a doctor documentation remove the diagnosis.
So it all really depends on how he is sleeping and whether he has sleep apnea or not. Based on how he is doing now will tell you the direction to go in next.
If my BMI is above 35 witch is the number they are using and I lower my BMI below that, should I still be required to do a sleep study?
@Kennard
Read these articles and you’ll know that BMI alone is not cause to require a sleep study.
That being said, if you are overweight, changing lifestyle habits, as best you can given the lifestyle challenges of professional drivers, would be a good thing to protect your health and your livelihood for the future.
If a person is required to have a sleep study, are they allowed to have a home-based study done instead of a facility-based study? Does Vermont have any DOT Physical Doctors?
@Linda
Best supporting results are coming from the facility based studies. The at home studies are on the questionable side.
in Oklahoma have a sleep study scheduled insurance will only pay for in home test will that work.
@Eugene
What class drivers license?
FMCSA class A interstate will probably not do. Home test is not reliable.
I have a diagnoses of sleep apnea (obstructive sleep apnea syndrome and excessive daytime fatigue). I am being treated successfully by my sleep clinic with CPAP and modafinil (Provigil). I have been under a doctors care for this for 5+ years and I am 97% compliant with my CPAP treatment.
I am applying for a vehicle maintenance job that will require a Class A CDL and a DOT pre employment physical (I currently hold a Class B CDL with no medical card).
Will I be required to retake a sleep study or will a medical release from my sleep clinic Dr. be sufficient to satisfy the requirement? Also should I get the release form filled out prior to the physical or wait to see what the DOT DR. says? (I have a current letter from my Dr but I don’t know if this will be good enough to meet the requirement).
@Christian
You should not be ask to redo a sleep study. Take a copy of your last readout from your machine (within the last thirty days) and a medical release form from your doctor and you should be good to go.
I hate to bother you but I went to get my physical done and the pa said I needed a sleep study. I went to my family doctor who has had me under for surgery twice and he said I did not have sleep apnea. He said if I did he would have seen it while I was under. There is no way I can afford the sleep study and there is no way I can afford to lose my CDL. CAN I go to another doctor to get my physical done over without the sleep study? Thank you.
@David
You have the right to a second opinion. The whole sleep study issue is completely out of hand. So go somewhere else for a second opinion, and choose your DOT doctor wisely!
Thank you so much for the response. Merry Christmas and Happy New Year.
How often do I need to get a new medical call if I have sleep apnea ?
@Greg
If all else is normal, you will need to renew every year.
My questions is what are the numbers that required me to have a Cpap? My sleep study numbers were 7.6 the examining doctor said I need a Cpap. The sleep study doctor said I don’t. Therefore I would like to know the FMCSA numbers that require a Cpap?
@Kevin
Not real sure where your examiner is getting his numbers from. If you do not exhibit a wide variety of signs and symptoms, then your sleep study physician is on the money. Sounds like there may be other issues here, so without further information, we would be hesitant to try an answer further.
FMCSA has their guidelines and within those guidelines, and they are guidelines, not regulations, they want the CME to do a full and complete history and evaluation. There are a multitude of signs and symptoms that should be present before asking for a sleep study.
If your sleep doctor does not feel that you need a CPAP, then take those results to someone else for a second opinion.
Hello Dr,
Okay here we go,,,,Last year got 3month card. Had to go into sleep study, had ahi 17. So i did get the sleep doctor to sign off no CPAP, per FMCA <20 not needed CPAP, Feb 2015,
Now fast foward went to DOT doctor yesterday my card is about to expire Nov ..Went to the doctor appoved by my work and passed with flying colors. ( went out of town to another approved company doctor). Now my works says i must get sleep doctor to sign off that I am good to drive. Guess what he will not do it unless I have another study done. SO ,,,now what did FMCA think we all have to be tested every year for sleep study. My weight is down and I am taller from the OVERBOARD DOT DOCTOR LAST YEAR. I would think it is in the hand of the FMCA approved doctor that i just went to yesterday if he thinks i need tested or not? Please reply on what your thoughts are..
Thanks
@Sam
It is up to the DOT approved examiner to make the final decision regarding your need for the sleep study. So if you are good to go, then where does the company come into this? And once you are cleared from the need for the CPAP, why would the company want you to get a sign off? And the FMCSA does want to see a running record of an individual who is on the CPAP, but FMCSA does not want the test done each and every year.
The company i work for uses a hire company to watch over the Med cards. The LPN with this company is telling the company i work for these are the rules. Seems that it is her way or no way. I did speak to FMCA and they told me to ask her where does she get this information from? FMCA says it is not out there. The final word is up to CME to make that final call and FMCA says this is why we have the classes to train them.
Now, the employer tells me no more contact with this LPN from Hire company and just have the sleep doctor sign off. Per FMCA I am in compliance.
Looks like they will have to fire me and then the employer and Unemployment judge can go over that I am in compliance with FMCA. I sleep fine with daytime sleepiness.
What a shame that it has to come to this…but they leave me no choice. I will NOT do another sleep study…the first one was all because of bad rules and guidelines that some folks do and did not understand. Any more ideas for you? I am trying to keep a postive outlook on this. Thanks for your reply.
Hi, my AHI is 8.8 and my doctor still does not want to clear me off without a CPAP. She does not want to go by the FMCSA website regulations. How did you get your doctor to clear you off. I do not know what to do anymore, they are driving me crazy.
@ UPS NC
Is your doctor a CME? If they do not want to go by the FMCSA guidelines, then you need to know what the issue is and then address it. If your doctor feels that there is a safety issue here then you need to address it, if there is no safety issue, then what is the problem and how do you correct it. The examination is supposed to be about safety, not anything else.
Print off the guidelines on AHI <20 WITH NO DAYTIME SLEEPINESS AND NO ACCIDENTS NO TREATMENT NEEDED. IT MAY CAUSE YOU MORE PROBLEMS THAN GOOD.
THEN SHOW THAT TO THE DOCTOR.
GOOGLE SEARCH THE AHI <20 FMCA ,,PRINT THAT OFF. TELL THE DOCTOR THAT HE IS DOING DOUBLE STANDARDS.IF THEY ARE GOING TO FOLLOW RECOMMENDATIONS ….IT GOES BOTH WAYS.
THERE IS NO LAW,,ONLY GUIDELINES ON OSA. IF YOU ARE IN GOOD HEALTH SHOULD BE NO PROBLEM. ALSO, YOU MAY HAVE TO FILE A COMPLAINT WITH FMCA ON THIS CME. JUST DO NOT BACK DOWN,,,YOU ARE IN COMPLIANCE WITH FMCA! STAND YOUR GROUND AND RESEARCH. THE FIRST CME THAT DID MINE IS NO LONGER A CME???
GOOD LUCK!
My husband went in August to get his DOT cert and due to the size of his neck, his physician told him he needed to get a sleep study. He only certified him for 90 days. My husband ordered the home study from place doc recommended. The results came back mild to moderate sleep apnea. Doc then referred him to Pulmonologist who we thought was gonna determine IF he was gonna need a CPAP. We went there today and paid another $171 for doc to tell him what he already learned from home study. He looked at his throat and checked his blood pressure. He’s an overweight guy, but has always had a perfect blood pressure. He doesn’t get sleepy during the day nor does he get sleepy while driving. The Pulmonologist told him today that he has to do another study at the hospital which I “assume” is to determine settings on machine. They don’t know cost and we are paying out of pocket. The hospital said that depending on which test is required, it’s either $1200 or $1900. His 90 days ends in 5 days and his CDL expires on the same day. He is our only income and he’s already missing a paycheck for this bs. Is there anything else we can do? We already can’t afford all of these tests out of pocket, but missing a week of work definitely isn’t helping our situation. We have a little one to take care of! He also has a good driving record with many years OTR experience. Please help!
What are the readings from AHI? If <20, and no daytime sleepiness…Then PER FMCA NO CPAP NEEDED, you must get some prints outs on fmca on ahi <20 and give them to dot dr and sleep dr. We went through the same BS and finally got dr's to read it and sign off. I told them both, double standards..if you are making me follow recommendations by fmca and no new laws…Then step up and follow the same ! Stand up for yourself,,,fight them to the end. From the get go, the sleep dr looked at me and did his test and said I DONT THINK YOU HAVE OSA…BUT, WE HAVE TO PROVE IT TO DOT. I so wished i would have had my recorder on. If i have to go through this ever again, I will record all DOT EXAMINES FROM NOW ON. Good luck to you !
remember that there are at least two types of sleep apnea OSA, CSA and or a mix, Most home study can only detect OSA. Day time sleepiness isn’t the only factor here It also involves alertness to say the least. Untreated sleep apnea above 5 AHI can lead to medical conditions that will be unsafe for driving. there are even studies that show untreated SA for ten years can and does contribute to Dementia which is a NQ condition no make what the degree is.
Mr. Dr, at this time…we are talking about OSA,,I have NO PROBLEM SLEEPING AT NIGHT. WHEN THE SLEEP DOCTOR TELLS ME…I DONT THINK YOU HAVE IT BY DOING HIS IN OFFICE SCREENING…BUT, WE HAVE TO PROVE IT TO DOT !! THIS IS WRONG! THEN,,,DOES NOT MARK OFF MY SHEET MEDICAL NEEDED FOR THE SLEEP STUDY MACHINE I HAVE TO PAY OUT OF POCKET FOR THIS RACKET,,YES, I DO HAVE A PROBLEM WITH THIS SO CALLED GUIDELINE. I DID NOT WRITE THE FMCA GUIDELINES ON THE AHI <20. FROM WHAT I HAVE BEEN TOLD, IF AHI IS LOW AND THEY MARRY YOU TO CPAP IT MAY CAUSE YOU MANY MORE PROBLEMS!
ITS ALL ABOUT THE MONEY! I AGREE, IF YOU HAVE PROBLEMS AND YOU KNOW IT, THEN TELL THE CME AND SLEEP DOCTOR AND RUN IT UNDER YOUR INSURANCE. THANK YOU! REMEMBER DRIVERS,,,WE MUST FILE COMPLAINTS ON THE OVER THE TOP CME. FOLLOW THE MONEY TRAIL. MY TOWN,,THE HOSPITAL OWNS ALL OF IT!
I was sent to get sleep study done, was told I have mild sleep apnea ,was told I scored a 22 at the time . I have over2 million miles on my cdl with no accidents. Now I must use machine every night, can’t sleep , nose runs , sneezing , all they tell me is I need another type of mask, of course it always cost around $200 , this is a money scam all the way. Now I’m just ready to quit driving and get on welfare
@Tracey
Go some where else to get another DOT examination. That will cover your need for a new medical card. There were no new rules or regulations regarding sleep apnea, so you may be being taken advantage of. If you have daytime sleepiness and high blood pressure and restless leg syndrome and a list of other symptoms, then get a sleep study done. If you don’t, then just go get a new physical.
I have held a MA CDL for twenty yrs with a pristine driving record. I am 6 foot and weigh 280. I bench 285 lbs and miitary 325 lbs so i am not weight porportinate and have a 18 inch neck. I experience no symptoms of sleep apnea but to Dr ordered a take home test. I scored 2.6 which is below the standard that is 5 for mild apnea. insted of giving a thumbs up he said the test was inconclusive. Can I see a different Dr with my results and get certified
@Paul
Yes. If you do not have to do the new examination quickly, then give yourself a few weeks before you go for a new examination. FMCSA sees it as doc shopping if you do a follow-up one on top of the other.
Do you have to disclose that the previous dot doc wants you to go for the test?
@Angela
If the test was required because you failed the examination and you pose a safety issue, then the next CME is going to require the same thing.
Without knowing what was requested, then you need to ask yourself if the test would be beneficial or not. Think safety first. The new DOT physicals are asking new questions and you would be lying if you did not disclose the previous information.
The DOT doctor in question did not ask and questions just said his neck was a size 17 and he was a little over weight so was going to require him to go for the test. We went to a ENT doctor because we needed a prescription for the test, which I called the DOT doctor for and said he only referrers to this one who’s card he had right next to where he examined my husband. Anyways the ENT doctor examined my husband and told him he would not send him for this test if it was not for the DOT doctor requiring it. He also said I would know if he had because I sleep next to him every night. Today our insurance told us the would not cover it so it will have to come out of our pockets. So it has been over a month now and time is running out and after seeing the ENT doctor could we see another DOT doctor for a second opinion? Btw, he had just received a physical 8 months before and passed with flying colors. He was only going for again for a new job. His old medical card was still good for a year or more.
Thank you.
@Angela
Best bet is to go some where else and get a second opinion. Since the first examiner is over reading the guidelines and neck measurements are nowhere to be found in the FMCSA guidelines.
Hello, My fianće has had his class A CDL for 15 years. He leases a truck from his company, so hes a contractor not employee-As we all know, the sleep apnea laws are hazey at best. Almost 3 months ago he went for his DOT physical at Concentra in Nashville, they would only give him a 3month temp and said he needed a sleep study! He is 285 lbs, 5’9, has high bp and pre diabetes which he is being treated for. They gave him a questionaire in which all of his reponses would NOT warrant a sleep study. We feel the drs decision was solely based on neck, being a smoker and bmi. Is this legal? We have no insurance for the $2k exam that we cant afford, plus machine if needed and we have a $500 a wk truck payment lease so he cant be out of work! Its not fair bc we are about to be ruined financially bc we feel our rights are being violated. His company says Concentra is the only company he can get his DOT from, so no second opinion. Is that even legal when hes not an employee? Is tjere anything he can do? We have 3 weeks until his dot expires and are grasping at straws here. He is obese and checked yes to neing a smoker at tje time, however he quit on the patch a week later! Any advice on how to stop tjis or laws we can quote to them or his company would be appreciated! Heres a better question, what exactly does a DR need to demand a sleep study? Thank you kindly!
@Joy
CDL’s and medical cards are two separate things and they work in unison with one another, so a CME is not the issuer of CDL licenses.
As an operator you can go to any CME that is on the National Registry, so unless it is some type of company policy, you can go to whomever you want. The company you spoke of is quoting rules and regulations that simply are not so, but very financially lucrative (to them) if you don’t know any better. Go somewhere else and get a new DOT examination.
I am a CDL truck driver and had to take a sleep apnea test which I passed no problem. My question is while my results were put on my medical records that I passed,but how long is that good for? At what point can they demand another test.
@Harold
If you did not have sleep apnea, then it should not be an issue at all. And since there were no new laws about sleep apnea and the need for testing, then it should not have been noted on your records, other than the study was done and you do not have OSA. And they can’t ask for another one unless you demonstrate signs and symptoms of OSA.
How long are the results of a sleep study good for??
@Carlos
Positive or negative findings?
I had a positive findings can I get this reversed anytine?
@Matt
Define positive findings??!
Is the BMI test a law or I mean is it a law that if the doctor or the PA said everything is good but your BMI is not good because your neck is over 17 1/2. So everything else is good but the PA I passed and could have a 2 yr. card but only gave a 90 day card. Can they do that?? This is my Job or my Boyfriends job so how can this be and in the past 3 physicals in the past year no one ever brought this up. What should he do? and at the same point I would like to say does this mean that bodybuilders that have buffed up and have a large neck, have a bad BMI?
According to NOVA medical centers in Humble, Texas if you have a certain BMI you are required by law to get a sleep study done, according to them, and on top of that you will only have 3 months to get it done. Out of that 3 months you have to be on the machine at least a month. I’ve had my cdl over 20 years with NO accidents and never had this problem. Good luck trying to get everything done in 3 months. Now I’m going to be automatically downgraded and not legally able to drive even a tricycle if it’s for commercial use. Good ole government regulation.
Can i get retested for sleep apnea, and have it removed from my CDL, if I loose a 1/2 inch off of my neck size, and loose about 20 pounds. Thank You Keith
@Keith
If the test comes back negative for sleep apnea, then yes, why not.
But it wont. I asked the people where I had my study done and they told me 99% of people that have it done get a machine.
NATURAL! NO COST, NO MED’S,NO PM PILLS with natural deep sleep.
While laying in bed, breathe in nose, hold for count of 7, exhale through mouth slowly. Repeat this 3 to 4 times and goodnight. Sleep like a baby. Wake up feeling refreshed and ready to start day. ( From Yoga breathing class).
I was diagnosed with a mild form of Narcolepsy more than 3 years ago and have been on medications since that have brilliantly controlled my symptoms. I have never actually had a narcoleptic episode, however I suffered from excessive EDS and had enough REM cycles in a sleep and nap study to qualify for a Narcolepsy diagnosis. Both my primary care doctor and sleep specialist feel I am capable of driving a commercial vehicle and performing the duties of an Emergency Medical Technician safely. When looking at the DOT guidelines, it says that the guidelines RECOMMEND disqualifying anyone with a Narcolepsy diagnosis regardless of treatment due to the likelihood of EDS. I have already provided a letter from my sleep specialist saying he feels I am capable of performing these duties safely and will get both my primary care physician and sleep specialist to fill out the Medical Release Opinion form. Do you know if there is any other information that I could provide the Medical Examiner with that may help argue my case? If not, is there any way that I can get around or combat this because I have multiple physicians I have worked with for years saying I am capable of both driving an ambulance and performing the job specific tasks safely while the Medical Examiner is the only person who is both new to my history, and disagrees with the other two practitioners?
@Kelsey
Start with what classification of your drivers license – Do you have to have to drive an emergency vehicle?
The FMCSA guidelines are aimed more at the over-the-road drivers.
So with a lesser class license you may only need a medical card and not the class A version of a medical certification.
Also if you only drive intra-state you may fall under the states rules and not in the federal regulations. Each state is different so check with your state DLD.
Do I need data off my cpap every time I renew my medical card? If so how many months back do they need?
@Dwight
You would want to take a copy of the last couple months report each time you have a DOT medical examination done. The examiner is looking for proper compliance, so you might want to take a medical release form from your doctor stating that you have been compliant and how long you have been on the unit and how long he has been monitoring you.
Arizona wants 1 year report. Unless you just started then 3 months. Until your next physical.
I recently started at a new company in July, and of course getting my d.o.t physical done I got ordered to get sleep test, well my general manager (who I’ve known since childhood ) said no biggie just wait till your insurance starts then get dr. Appt scheduled, well went to schedule appt I could only get one that was 9 days past the expiration date that was juse the consultation then order the test after. I was told oh they give extension all the time, we’ll fast forward. I was denied the extension, been unable to drive since Sept 1st, can’t get anyone to help figure out what to do, now my company says if I can’t get it figured out I have to resign or I’m terminated by 5:00 pm on Sept 11th could I go and try to pass there b.s again and try bypass the sleep test . Been driving 19 years , all my actual physical results were in the great range, the only reason for test was neck measurement, but I have been a body builder for years it’s from working out and taking care of myself, ,,,, is there anything I can do?? Sorry for babbling but I’m running out of time and just needing a miracle
@Rob
Why not just go somewhere else and have the DOT examination redone.
There were no new laws regarding sleep apnea and this neck measurement and BMI are the laziest way to trick you into getting the test when you may not need it.
Now if you do have issues with daytime sleepiness, then by all means get the test done as soon as you can.
To better understand this contentious issue, read this series of articles on Sleep Apnea Screening.
Hello, I also was told YOU HAVE TO HAVE SLEEP TEST by CME, The Sleep doctor did the oxygen finger test, looked down throat and said I dont think you have it., but we have to prove it to DOT.. Anyway, sleep test done at home came back with 17, I told them i am NOT SLEEPY and per Guidelines i do not need CPAP machine if AHI <20 and no daytime sleepiness. So the CME gave me my one year card due to Blood pressure meds. Now, when I go back into to renew for my 1year again do i state anything about test showed <20 AHI and no treatment needed. Or do i just leave this blank on form. I will be going to new CME. Thank you for helping me understand .
@Steve
The one year card due to blood pressure medications is correct.
You have had the test for OSA and it was negative, so I would just mark “NO” for snoring or sleep disorders. That should fly just fine on your next DOT physical exam.
during june i had a prob with driving did blood and stress tests passed both advised to see a neurologist and did a EEG 7/27at hospital -passed but on the sleep night test 7/28 at clinic wr doc works out of, was told i had sleep apnea and put on a cpac for 30 days
no medical rel giving and out of work for 2.5 mo so far
how to i get a 2nd option w/o being taged shoping
55 age with 21yrs exp +2yr current =23yr driving CDL
solo 3300mi /wk for 5mo gets hard and it seems like I’m being hit and made to pay $ for co. working my ars off at the same time told i cannt work
@Mike
If they put you on a CPAP unit, then you need the 30 days to show compliance.
If you want a second opinion, then go find a CME that understands the guidelines and test with them.
Doc shopping only occurs when you go from one office to the other in a quick fashion, usually with an intention to hide relevant health information.
Just wait till your existing card is about to expire and then go somewhere else for another opinion.
Is it mandatory for a CME to only give a 1 year medical card to a driver with treated sleep apnea? I have had both 2 year and 1 year while being treated.
@Brett
New FMCSA guidelines recommends that drivers being treated for sleep apnea should be re-examined every year or medical cards are not to exceed one year at the time.
So I just listen to a live radio show with the FMCSA this morning with many questions and concerns reguarding this statement of weather or not that the medical examiner is required to only give a one year card if diagnosed with sleep apnea.
There reply from the FMCSA was stated by there representative that there is no restriction of us with getting a two year card when we present them that we are under the care of a sleep specialist and are compliant then there is nothing law or written anywhere that states we only get a one year card! So can you show us in writing where it says anywhere that you can only give us a one year card ore any other medical examiner when FMCSA stated otherwise!
@Chris
Look in the FMCSA guidelines for the certified medical examiner handbook on the FMCSA’s own website.
It is a recommendation from the FMCSA that is being held to. With proper documentation and at the discretion of the examiner, a two year or a one year card will be given.
I am a non cdl driver that requires A dot physical I only drive 55-60 miles a day. I was told my BMI was hi and have to go for a sleep study Is this even legal please give me advise.
@Phillip
Well they can say what they like, but there are no regulations that will support a ‘mandatory’ sleep study. Just take your business elsewhere. Someone is over-reading the guidelines and does not understand what they are doing for a non-cdl driver.
To better understand this subject read our articles on Sleep Apnea Issues Affect Commercial Drivers.
I have driven for same company for 15 years with perfect record. I am 38 . I had to go to company doctor for my physical for CDL renewal. The doctor said because of my neck size I had to have sleep apnea text. He said it is the law. I read this site and knew it wasn’t. I went to my boss and was told I had to have the test if I wanted to keep my job. I had an at home test with wrist bracelet. I failed. I have no high blood pressure .no sugar diabetes, perfect eye site. Do not use any medication ever. I am an active outdoorsman. No sleep problems! I failed the test. I was told I slept 8 1/2 hours and failed. I talked with the guy giving me the results. He said 99%fail. He told me he personally has taken the test and he failed it. I asked him if he wears the mask, he said ,”No, he cant stand anything on his face.” I tried it for a few minutes with him and could not stand it. I have always had a fear of drowning or suffocating . I cannot use it. What options do I have? Now that I was diagnosed with an “at home study”, could I still get another opinion and drive for a different company? Or , since I took the test because I wanted to stay at my present job is it too late to do that.?? I know about the 30 day wait to go to diff doctor from reading your site. I was given 90 days to comply. Do I wait 30 days after being told I have it? Thank you for this site!
@Kathy
The at home test do not stand up in a court of law.
Your best bet, since neck size and bmi is not a law and there are no new regs for sleep apnea, then go to another facility for your next exam. Unless you demonstrate more than 4 or 5 issues regarding excessive daytime sleepiness, you should pass with out any issues. Just wait out the 90 day to about 2 weeks before it expires.
Can’t tell you what to do about the boss.
I just went to another DOT doctor and got my medical card for two years. However, since the at home wrist test does not stand up in a court of law I did not say I had been diagnosed with sleep apnea. I waited until the 2 weeks before my card expired as you suggested. However, I have been reading site and am now worried I will get flagged and accused of doctor shopping. And lose my license. ?
Also, since my company I have worked at since I was 21 wont let me get another opinion I am going to lose my job. However, I didn’t want to lose my job and my trade (CDL) also. Thank you
@Kathy
If you suffer with sleep apnea symptoms and you lied on the federal form, then you could be flagged. If you have no sleep apnea symptoms and you passed with another CME, then you will have no issues.
Just wanted to thank you for your input and all the help provided on this site.
Have a great day!
Hello, I went to an urgent care for DOT approval for pre employment, and was temporarily suspended due to history of mild sleep apnea about 10 years ago. I had a new home sleep study kit done, with the report stating no sleep apnea found, and a letter stating the same from my family physician. The urgent care to approve this DOT, rejects all this and wants a overnight sleep study in a facility done (which my insurance won’t pay for).
Obviously after all this, the possible job I was trying to get into is closed. The question is: Can I just go to another different urgent care/Dot screening facility when a new job offer comes, present the examiner with the evidence and let them make the decision, or do I have to get the original urgent care to approve me?
I understand I am in a database for sleep apnea now, but I have the current reports stating no sleep apnea, I have a clean driving record, no daytime sleepiness, I’m 5’9 and 150 lbs, ect.
Thank you very much for your help.
@Jake
‘Doc in a box’ facilities are not your best bet. Try to find a CME that works independent of the urgent care places.
You may be in the data base as an individual, but FMCSA does not get the reasoning for the disqualification.
There were no new rulings regarding sleep apnea and the CME who disqualified you is overstepping the guideline to protect themselves from possible risk. See our Sleep Apnea Issues articles.
Take your information along with your doctors medical release with you and you should do just fine.
Doc,
I received a 2 yr DOT medical card from my personal doctor who is a DOT examiner. When I went to “blah blah” trucking for orientation I was required to have another DOT physical and that examiner stated that since my neck size was 17″ and I was overweight that I needed a sleep study done to get hired at the company and they sent me home. I don’t have any of the other symptoms; I don’t snore or stop breathing, I don’t have diabetes or High blood pressure nor do I smoke or drink. Also I do not have an enlarged tongue or swollen tonsils. How do I avoid this idiocy in the future? Would a letter from my personal doctor who is a DOT examiner help?
@Martin
Since there are NO NEW REGULATIONS regarding sleep apnea, the first question would be, is this a company policy?
If it is not company policy, then go through the FMCSA website and enter into conflict your opinion. FMCSA is very aware that the whole sleep apnea scam is taking good drivers off the road and they want to follow-up with regular reports that a CME is requesting expensive test when they are unnecessary.
Next time, if the CME starts in with the neck and BMI, get up and walk out, go somewhere else.
For more information on this misunderstood issue read our articles on Sleep Apnea Screening.
Can a trucking company out of Nebraska make me take a sleep study test. I past the physical an was certified for 2 years. There company policy states I have to take one. But I haven’t sign any papers agreeing to do the study.
@ Chadd
If it is a company policy and they are paying for it, then yes they can require it as part of their hiring policy.
How is the rate of compliance on the Cpap machine. I have been using it 4 hours a night the minimum, the clinic tells me i have to be at 70 to 80- percent compliance. What does that mean ?? How do they determine that ???
@John
Your cpap should be able to download a report of usage. In that report there should be a percentage of compliance. That is what the CME is going to be looking for.
See our article Commercial Drivers, Sleep Apnea for the compliance recommendations.
If a doctor suspects a CDL driver should be tested for sleep apnea can they certify the driver anyways? and then tell them they have three months to take the test and return? How many factors do they have to take in consideration to send someone for a test?
@Lisa
It is totally up to the examiner as to what he does and for how long he does it for. If he suspects sleep apnea, then there better be a number of things that have moved him toward that conclusion. You can Google sleep apnea and see how many things the examiner should be looking for.
Also read our series of articles on Sleep Apnea Affecting CDL Medical Certification.
I have an employee whose med card expires on in two days. He is doing the sleep study and taking it in tomorrow to see what the readings show. My question is, as an employer, what is my responsibility when I have an employee with an expired med card? Do I need to take him out of the truck immediately? or is there some grace period? I’m just trying to understand what all the ramifications are of any further delay in submitting his card – for whatever length of time it gets renewed for – or if it does not get renewed. Your help in understanding this is certainly appreciated.
@LaNelle
The medical card expires at midnight of its expiration date. Some states have a little leniency, but most don’t.
Your driver may ask for another short extension, because if he has to go on a CPAP machine he is going to have another waiting period to go through for compliance with the unit.
As an employer, you have to do what is right for you, the company and the driver. But you should not put the driver or the public at large at risk until your driver can and does pass the DOT examination for “medically fit for duty”.
Hello, I checked the box that says snoring, and I have no health insurance or a primary care doctor, I only snore after a long laborious day of work, and since I quit smoking I snore much less. The examiner says I need to get a sleep apnea blood test? can I just get a CPAP machine and go get my med card? im an owner operator and have been working for two years to get this business profitable. I would not be happy if I just wasted all that because I checked “snoring” on a questionnaire.
thank you
@John
Start with this series of articles on Sleep Apnea and the DOT physical to better understand this issue.
There are no new sleep apnea criteria. So unless you have a issue with excessive daytime sleepiness or many other circumstances that would point at the potential for sleep apnea, I would wait out the short medical card that you were given and then go to another CME for your DOT examination. Snoring is not sufficient to warrant a sleep study.
Now if you are on a CPAP unit, all you need is a medical release form from your doctor and a copy of your last compliance check and you should be good to go.
I was recently ordered to go take a sleep study after going in for my dot recert.. Went and done the sleep study which was a split study. But, the sleep tech said she didn’t have to try the mask as was initially planned. But, however they scheduled me for a 2nd study. She said the doctor would reveiw the initial study and may call and cancel the additional study. I’m confused here.. Either I have sleep apnea or don’t. If there was no need to put the mask on in the middle of the night. What are the chances that I don’t have sleep apnea? My insurance and employer do not cover the costs of any of this. I don’t have money for multiple tests..
@Michael
Looks like you have started a process that now needs to run its course. So get back with the sleep study folks and get an answer now for the yes or no of sleep apnea.
There were no new rules or regulations regarding sleep apnea, so you may have been taken for a money ride. But get your answer from the sleep study folks.
If a nurse practitioner performs my DOT Physical says I need to have a sleep study done but my Dr who is also FMCSA certified says different can my Dr do another Physical on me
@Tank
Yes, you may go to another certified medical examiner.
I have a diagnosis of obstructive sleep apnea and have vocal fold paralysis after surgery for thyroid cancer. Because of the vibration of the lax vocal fold in my throat from the CPAP, I am unable to use the machine until “if and when” the nerve damage to my vocal cord/fold recovers. My 12 weeks of FMLA are about to run out. I work intrastate (SC) only as a yard switcher, regular day hours, home every night. Can I get an exemption to not use the machine under these circumstances? If so, who do I contact at the federal and/or state level?
@DirtTracker
Most of the new regulation and guidelines are aimed at the long haul OTR drivers. Since you are intra-state only and work locally, you should not have to meet the interstate guidelines. Have your doctor fill out a medical release form for you and take it into the your state DLD. That should answer any questions. And when you have to go for your medical certificate, the same medical release form should work with the examiner.
Please also keep in mind that “inter-” vs. “intra-” is about more than where the driver drives. If the vehicles you are moving around ever haul anything that has crossed, or will cross, state lines, the feds may consider your work to be involved with interstate commerce. We had this specific question come up with our mechanics, who only take unloaded trucks out for test drives during repair & maintenance. That being said, if you never leave your employer’s property and do not ever otherwise operate a CMV on a public road, your company has complete discretion.
I wanted to keep my card and license current and went for a DOT. Because I marked “snoring” the physician’s assistant said I have to have a sleep test. The PA said my throat had the typical formation of sleep apnea sufferers and she was doing me a favor. After checking with my wife and reading up on sleep apnea, I contacted the office and have told them the sleep test is not needed. I am 5 foot 7 and 153 pounds, healthy, non-smoker, rested after sleeping, etc. My wife said I snore once a month maybe and she was teasing me. The doctor’s office is dragging their feet to get this changed. This is a private pay as currently I am not driving for a living. What are my options, please? Currently residing in Tennessee and thank you for your time.
@Sam
You might try getting a note from your primary doctor stating that you do not have any sleep apnea symptoms and take it back to the DOT examiner. That should help expedite your situation.
I have been driving for ten years and have narcolepsy since I was 15. I got diagnosed with it back in 2010 And have held Bern able to recertify every 2 years up until last year. I have never had an episode and take medicine to control it. Even with medical letters and forms I may still not get it. Exactly why is that?
@Jason
FMCSA has a real hard time with the potential safety issues that narcolepsy presents.
With a medical release form from your primary doctor, explaining you condition and situation, you may be able to continue driving. But you are going to have to explain yourself, with medical support and a medical release, before any CME is going to work with you. It’s a FMCSA safety issue.
hello I’m trying to help my friend. He is a new driver and at his orientation said he had sleep apnea. Didn’t know about the compliance % that was needed. He has not been using his machine correctly for a while. He was wondering if he decided to go to another company will they know about his first orientation. Aren’t his medical records private?
Thanks for your help.
@Georgia Girl
It does not matter if someone knows or not. You / he signs the federal forms stating that all of the information is correct and true. Lie on the form, lose your driving privileges.
Sleep apnea has a set of regulations that must be adhered to, for a reason of safety.
Just tell the truth and use the cpap as prescribed and he’ll do fine.
What if it is found that the driver has been non-compliant in using the CPAP machine? Can he get a 30 day card to come into compliance? Or what can happen?
@Kristine
Try to keep your eye on the whole picture. If the driver is out of compliance and is exhibiting EDS symptoms, then no, you want him in compliance before he gets behind the wheel, because he is unsafe.
If the driver is just under his given compliance levels, but appears to be doing OK with no signs or symptoms, then yes, give him a short card to get his numbers back in line. It’s all about safety and you are the one calling the shots.
How many days can be missed in a 90 day CPAP test before my license will not be renewed. I just got a 90 day temp ME card ( I drive a school bus) and am going on vacation and will be in an airplane one night out and one night back.
@Diane
All that is being looked for is a 70% compliance when you are using the unit. Like most of the drivers that have sleep apnea, “they won’t leave home without it.” But to miss one or two days while you are gone is no big issue as far as the report is concerned.
I went for pre-employment DOT physical, at Concentra, for an employer that I applied to, I was told at the examination that my BMI was 37 and my neck size was 17.5 in, all questions pertaining to sleep apnea we’re answered no. I was recommended to get a sleep study and was only given a 90 day medical card. What should I do?? Can I just go to another doctor? What are my options? Please help!!
@Josh
You can go somewhere else and get it done, just wait 30 days or so before you do that.
Here we go, I do not have OSA…But, the DOT Dr wanted me to do study because i am 6ft1 and 209 pounds. No daytime sleepiness..He says i am overweight and need massive weight weight loss. My neck is 18 inches from lifting weights years ago. I sleep fine, no sorning and if i do it does not bother my wife. My question is…I did the study and Sleep dr signed off because i was 17 AHI and per guidelines..no treatment needed. SO, now when i have renewal I will go to different dot examiner ( this one is CrAzY) but do i need to be tested again for OSA or just go with new DOT doctor and his test. This other DOT doctor says what this office of examiners are doing is over the top! They are OSA people at 19 years old and weight lifters. So yes, the word is out to stay away from this place. Thanks for your help.
All DOT doctors do what they want. Truck drivers are men tall short skinny fat it takes a man to drive truck do not take sleep test walk out then sue them for none existing LAW any trucking company that goes with fake law made up by doctors should have their DOT # taken away CONCENTRA is a big scam go to your on doctor for a DOT physical
I take Ambien in conjunction with my CPAP therapy. Will that disqualify me for a CDL?
@Warren
You are going to need a medical release form from your doctor describing your need and usage of the medications. That will answer some of the CME’s questions. If you have been doing this regiment for some period of time, make sure the prescribing doctor explains that in the release form.
I recently took my cdl med physical. My BMI was over 35. So I was given a 6 month extension on my medical card. The doctor told me I needed to get checked for sleep apnea or I could just lose the weight. Well I have lost the weight and my BMI is under 35 now. I wanted to know if I’m in the clear next time I take my physical or if I still need to take a sleep apnea test. Can you just lose weight and not have to take a sleep apnea test? Thank you.
@Mitch
Considering that there are no new laws or regulations regarding sleep apnea and that the BMI and neck measurements are only one or two steps in a list of 7 or 8 things, you will probably do fine. There must have been other indicators for the CME to request to the test initially. Weight loss is a big help. But if you do not have any day time sleepiness and all that was needed was to lose some weight, then you should be home safe.
How long is the sleep study good for. I have a bmi over 60 and on near perfect health.
@Esther
A BMI of over 60 and on near perfect health? These two things don’t really add up to the picture of near perfect health. Or, I’ll ask, what is “on near perfect health?”
As far as the sleep studies, each time you return to do a DOT medical examination you need to bring a medical release form from your sleep doctor and a readout indicating your levels of compliance with your unit.
Near perfect health:
OK. No high blood pressure (Low at times)
Heart rate normal
Normal vision
Normal Hearing
Able to swim 1 kilometer without a problem
I am able to move around, I drive a Wheel Chair accessible vehicle and have no problem loading/unloading and restraining wheelchairs.
According to my husband, I don’t snore at night or wake up from not being able to breathe.
During my sleep test, I only got three hours of sleep.
Has the law changed that drivers who have been diagnosed with OSA and are under going treatment and exceed the compliance guidelines, Are they required to get a new sleep study done annually for re-certification of their medical card?
@Jim
It’s a gray area generally speaking. The way the FMCSA has written the guidelines, it looks like you have to take multiple sleep studies.
In reality, if you can bring a medical release form in with your readout showing better than 80% compliance, then you should be good to go. All the CME has to do is enter that information, along with his / her findings to support the decision making process and they should be able to get you a one year card. You will need to do this each time you do your DOT examination.
I have 70% usage on my cpap download report is this sufficient to pass D.O.T regulations?
@Rodney
It should be. But you would be better of with an 80% compliance.
I got a call from my boss yesterday that my DOT medical card was no longer valid due to my recent diagnosis of Idiopathic Hypersomnia. I had to keep my boss informed of my medical condition because it was reported to her by a passenger that I was falling asleep behind the wheel. I made the mistake of talking to my coworkers who have decided that I have traditional Narcolepsy despite me telling them that was not the case. Anyways, I guess it got to the administrative level of my company and then I am assuming to the Medical Examiners office. The whole thing is a bit confusing. The point is I am not allowed to return to work until the Medical examiner gets information from my doctor about my condition. My neurologist is off until Monday and I have only seen him once, plus I’ve already had to call to up the medications as they are not effective. With the limited amount if information about CDL and Idiopathic Hypersomnia it is not looking like they will approve me to drive. Before my diagnosis my chief complaint was Excessive Daytime Sleepiness and i have had a history of lightheadedness and vertigo. Do you know of anyone else with Idiopathic Hypersomnia that has a DOT medical card?
@Amber
No, I do not.
Your condition is mostly a safety issue and once you have it under control you should be able to return to driving. But until it’s under control and your primary physician signs off that you are ready to return to work, you are not medically fit to do your job safely.
I just went in for my physical. I’ve been using a CPAP machine for over 10 years. The doc this time said I had to provide a readout to see that I’m in compliance. My machine is too old to provide this information. There is a port in the back where apparently you can plug into a device to get the info, but no one I’ve called and talked to have the equipment. There is no smart card in my machine. I’ve NEVER been asked for this information. This was a different doctor and a different clinic. He gave me a 3 month extension to provide information I am unable to provide. Any thoughts?
And they wonder why there is a driver shortage.
@John
Try getting your doctor to complete your medical release form explaining your compliance levels and if he can get a read out, then do so. If not the doctor’s explanation regarding your machine and your compliance levels should be sufficient.
I was required to take a sleep study and results said I need VPAP (bi-level w/ full face mask). Medical examiner requested 30 day compliance report, which showed 96% compliance, but an AHI reading of 13.6. This is down from about 2-3 times that before treatment. I am feeling better, but examiner says she needs to see 30 days average AHI <5 to re-certify, so she denied my card until that time. Is she within her duties to require the AHI number when I am in compliance for usage?
@Ed
She has the right, but you may want to have your doctor step in and fill out a medical release form stating that you are being compliant and that your numbers are looking good. This will be a big help here.
Did the sleep study in home, came back 17.9,,now the doctor wants me to come in to do lab study and to set the titration…Why? I have read <20 AHI, you are good for one year. Please help..testing is set for Monday in overnight. 1500 more dollars.
Hello, Okay took the sleep study test and the reading was 17.9 ahi. They now say i need to do overnight study to get the titration to get it set. What is up with this…What are the regulations on it. I thought it said 20? Please let me know…are they wanting me to wear that monkey mask? What steps do i take now? Thanks for all you do………..it is a rough world in truck drivers.
my pcp doctor told me i no loner have to use c-pap machine as i get less sleep using it. medical examiner issued a 3 month card and said i needed another sleep study done, what are my options ?
@Tom
Get a medical release form completed by your primary doctor and take that in when you go for the next DOT examination. If he feels that you do not need the sleep study, then have him say so in the release.
I have been using a cpap machine for the last 4 years and have not had a problem with getting my recertification. Went in this week and the Dr’s will not accept the printout from my machine now since it does not show “ahi” . Was there a rule change in the last year? I just bought a new machine just like my old one at the end of last year, if i would have known i needed a machine that tracked that i would have bought one. Now they won’t give me an extension to get enough days on a new machine that tracks the data they wanted.
@Jaydee
You could try having your primary doctor fill out a medical release form for you, stating that you show proper usage and good compliance with your CPAP. The waters a a bit muddy regarding some of the regulations and a lot of the new CME’s are not reading and understanding what their part of this process is.
Hi, need your help.
Went in for med card and they went 120% over the top and request that i have sleep test done.
29.5 bmi, neck>18. 218 weight 6’1. I do not have it and my wife says she does i do not snore. GAVE ME 3 MONTH MED CARD….. Anyway, went in to see Sleep Dr and he said I dont think you have it …But, we have to prove to DOT. So, he issued me to go to get home study test. I go to pick up the home machine and the gal said…500.00 bucks is your cost and since the dr did not code it ..for med we can not run thur insurance. So..i paid half. Then she gets the last only only machine and said to do this and that …and the finger probe was not connected correctly ..and just to wiggle it and put tape around it … Ok..so i go home with machine that night my wife could not get the lights to work correclly per paper. The amber light would not stop blinking and green was blinking never went solid. The next day i drop the machine off and told the gal the machine was junk…she laughs and said i will send it in. 2 days dr office calls and says you need to go in for lab study ..i think you osa.. It has been 40 days since my dot examine..so i just go to anotther dr and tell him and he says it is a money scam..and gives me a 1 year card because of bp pills.. Is this okay? or what do you think i should do? Thanks for your help…Seems to me that this is a mess with fmca and osa.
@Sam
You’re good at this point. Proper for the one year with the bp meds.
The sleep apnea stuff is a money scam, in most cases.
I am currently up for recertification of my medical card. I am only 33 years old but I am overweight. I have perfect blood pressure, no medical problems to speak of and do not snore or have any problems sleeping. All of this was discussed or noted with the physician doing my recert exam. She asked if I snored and I stated I did not. She asked if there was anyone in my home that could prove that, I stated no, not really. (My husband and I have been living apart for 6 months.) She said because my BMI was over 35 I would have to do an at home sleep study and if I failed it I would have to do a formal sleep test, and in the mean time I could not renew my card. I did the at home test. I ripped it off in the middle of the night because I couldn’t sleep with the darn thing on. However, after I returned the test, a man from the hospital called and said that everything checked out and looked fine. Even though I only kept it on for three hours, the data they collected showed no problems. Then today I get a call from the physician’s nurse stating I have to retake the at home test because they only were able to record 1 1/2 hours of sleep and they have to have at least 2 hours of study recorded. I am livid! I didn’t want to take this in the first place but I did. I DO NOT snore or have problems sleepings and feel that I am just being given the run around by this lady. I told the nurse I’m not doing it, that even if I did I couldn’t be sure I’d even keep it on again. She said that the doctor would be willing to give me a sleeping pill. Really? Why? I don’t need help sleeping if not I’m not being forced to wear some sleep testing machine! Was it even necessary for me to be forced to do this test in the first place? This doc is known for jerking people around but I am not able to go to my primary due to my employer. Any help would be appreciated to fight this.
@carrie S
After thirty days from the original test, you have the right to go to anyone you want to to do your DOT medical examination. So go somewhere else.
Do I need to provide a past 90 day printout from my cpap machine’s memory card to the medical examiner for a requirement to get my medical card?
@steve.
It would be helpful and a medical release form from your doctor will be a huge help to the examiner also
CDL requirement is 70% usage for 4 hours per night for a 2 week period. The download will provide the data needed. I hope the CPAP is beneficial to you.
I had a 3mon card on my last dot exam and was told I needed to have a sleep apnea study from Concentra Health Care. I made an appointment with my primary care and and got a referral for sleep study. They asked the list of preliminary questions yes i am overweight, have a large neck and high blood pressure( being treated and well controlled),but I do not ever fall asleep during the day,dont take naps, never fall asleep when I am a passenger in a car, not a big snorer,and do not fall asleep after eating. The sleep study center said that our insurance would probably not approve a in center sleep study which they did not. Well they would approve a home study. Meanwhile the 3mon was up on my card went back to Concetra to renew my card got a different examiner who gave me a one year card. Got called back to the clinic the next day by first examiner who took my DOT card away. Now I cant work. Did the home sleep study and they say I have sleep apnea have to get CPAP machine and be compliant for 30 days before I can go back to work. Can I get and pay for my own DOT exam from a private place if ok with my employer ?
@bob
Well it really looks like they have placed you between a rock and a hard spot. If your information went into the FMCSA data base as temporarily disqualified then you would be considered doctor shopping by the FMCSA and they are not real keen on this type of activity. If you wait thirty days before going else where then you would be OK to go to the doctor of your choice. And by then you are past the wait period for your CPAP. If the second doctor put your information in as a one year, then you are good to go while you are adapting to the CPAP. At this point, until you know where your medical card is in the FMCSA system, you probably will have to wait the thiry days and then go somewhere else if you can.
How can I find out my status. Does this mean I will have to use CPAP. Thanks
@bob
You should be able to check with FMCSA to see what your status is. And if you do have sleep apnea and the unit works for you, then yes you would have to use it. If you don’t then be aware that there are no new laws or regulations regarding sleep apnea.
I have a current medical card valid for another 14 months. My PCP recently ordered a sleep study and diagnosed me with sleep apnea. Do I need to report the change or can I wait until my next physical?
@nicholas
Just wait for your next DOT examination. When you go for your next DOT, make sure you have all the information regarding your compliance and a medical release form completed by your primary doctor.
If a driver is already using a cpap machine and goes in for an updated physical and tells the medical examiner that he/she is using the cpap unit, how does the driver prove to the M.E. that this is really being done?
@Michael
Your CPAP should provide a read out to demonstrate proper compliance, and your primary doctor should fill out your medical release form for you to demonstrate proper usage.
My ahi is 8.8 what is the limit amd how long will my medical card b good for thanks Randy
@Randy
Looks like you will be in the one year range if there is nothing else.
Was diagnosed with COPD/sleep apnea. Currently on cpap, with 1yr med card.Issued by work Dr.
Was just informed that my pulmonary Dr. wants to add oxygen to cpap.
My primary Dr. DOT certified, says that he believes this disqualifies me.?
@Ron
Have him read up on this issue, or check with the FMCSA guidelines and see what they say, but the issue is more of a “physically fit for duty” question rather then an oxygen question.
What about FEV spirometry test? My primary Dr. says i have to have 65%, am at 57%
@Ron
These are indicators for additional testing. Obvious difficulty breathing in a resting position is an indicator for additional pulmonary function tests. If the forced expiratory volume in the first second of expiration (FEV1) is less than 65% of that predicted, arterial blood gas measurements should be evaluated.
So check with your primary physician and also have him complete your medical release form for you before you go for your next DOT examination. This will answer many of the questions that the medical examiner will have.
Hi, mike again, I didn’t make my #s plain on cpap >4hrs night 39%, I wore my machine 86% of the time, but I was just wearing it 3.45 hrs a night so I wasnt getting any credit for the 4 hours, I let taking it off during the night, is this right why I was not meeting the 70%? Thanks
Hi, I work for utility company and drive a bucket truck 4hrs 39%, well I was using it on nights before work and not n weekends, for this truck I’m not required CDL but I do drive interstates and cross state lines, can they denie my card for this type truck with no CDL, my card runs out dec31, went to see sleep dr, he says come back jan 12, my card will be out then, whi should I ask for maybe 30day extension, I’ve worked with this company 37 years, thanks
@Mike
This is a state related question, so check with your state DLD to find out for sure.
You do not fall under Federal FMCSA rules and regulations on this matter.
I have read every post to this point and apparently it is impossible for someone diagnosed with narcolepsy regardless of symptoms/treatment to be approved for a CDL. Further, I was left confused by the three posts dealing with driving jobs that do not require a CDL (smaller non passenger box truck crossing various state lines, no CDL required but has narcolepsy) where the employer indicates you must pass a DOT physical. I have heard you say consistently that DOT physical is not required when a CDL is not required and that you have to contact the state… so will the state (NY, NJ) accept/approve/deem satisfactory a DOT physical for someone diagnosed with narcolepsy?
Or what I am hearing is someone with narcolepsy should not be driving a vehicle for a living regardless of CDL or DOT physical, period?
does this mean someone with narcolepsy can not drive any vehicle for a living under any circumstances?
I can understand not being approved for a CDL but to be eliminated from all driving jobs doesn’t seem American.
Help make this crystal clear for us, thanks.
@sk8trek
Nothings impossible, and some things are more time consuming than others.
First determine what type of driving you are going to be doing. Does that type of driving require a commercial drivers license?
If not then you need to know if the type of driving is going to require a medical card. (fit for duty as a driver).
If you need a medical card to drive whatever you are going to drive, then you will need to take as much information from your treating doctor about your condition and his treatments and a medical release form explaining your situation.
With all this information in hand when you go for the medical certification, the CME now must understand what type of driving you are going to be doing. At this point, if all looks logical and the safety issues have been addressed by both the CME and your medical doctors information, the CME will make his final decision based on all the available input. That’s how it is supposed to work.
And besides you are probably driving some type of vehicle anyway, so you still may want to check with your local drivers license department and see what they have to say about narcolepsy and driving, while under the treatment of your PCP.
Hey, I am impressed that you answered and pretty happy with the scope and clarity too. Yes, I drive my own van delivering car parts, no requirements.
I want to drive something that requires a CDL which offers frequents stops/deliveries as I do now (dump truck would be cool). I would not do well driving day in day out on the open road without taking a break every 100 or 200 miles. Being a UPS, FedEx or box truck driver for example (no cdl but dot physical) is a great fit for me and agree that as you described anything is possible, in fact, highly probable.
Thanks for your time and giving me a bit of hope.
I have very mild case of sleep apnea. My doctor said if I choose to use cpap I could. I tried hard to use. Woke up with it off my face every time. I told him I wasn’t using it . Now he won’t give me a release saying I don’t need it. It was my decision to go on it. Shouldn’t it be the same to drop off if I have mild sleep apnea. Were are the guidelines saying ruling for mild sleep apnea. Ah1 was 7.2 per hour. In rem it was 25.9. Sleep specialist called this very mild case. What is required for cpap ? Diane
@Diane
If you do not have a functional diagnosis of sleep apnea, then go somewhere else and take your DOT examination there.
Otherwise, explain to your doctor that he is mis-reading the federal rules and there is no new rulings about sleep apnea on the books. No diagnosis, then no new laws.
Read our articles on Sleep Apnea Screening to better understand where you fit in to this scenario.
I just received an offer of employment. They said I had to go for a DOT physical even though my current physical hasn’t expired. The doctor said that because I do snore and my BMI is 31.5 vs my neck size of 17, I have to be tested within 30 days.I don’t know what the requirement is but I’m guessing my BMI has to be under 30. I don’t have the money to go for a sleep study and I don’t start work for 2 weeks. Wouldn’t It be better to lose 5 pounds?
@Nick
There is no new FMCSA laws/rules or guidelines (like BMI and neck size) requiring you to do anything regarding sleep apnea. If the doctor cannot show you the law, then get up and leave. Go somewhere else for your DOT examination.
Read our articles on Sleep Apnea Screening to better understand your position on this issue.
Upon trying to return to work following breast cancer surgery and a diabetes diagnosis, My employer had me do a physical. They made me see 3 doctors, one of which was a sleep doctor.
Although I did not answer their questions negatively, as I had no daytime sleepiness, nor was my neck size huge. My BMI was just over requirements The first test showed an AHI of 3, but my RDI was 14.5.
The sleep center told me I did not have sleep apnea, but the doctor insisted I did and put me on a cpap at a 6 setting. I was able to use it to get back to work, but the machine does absolutely nothing for me and in fact causes headaches and dark circles under my eyes. I quit using it.
I had to go back out of work for breast reconstruction and know they will require me to get another physical. How can I prove that I do not need this CPAP any suggestions.
Also, I never saw the doctor that ordered the cpap. I only spoke to him on the phone. I saw his PA, I know they lied to get the insurance to pay for a test that I didn’t need. There was so much trouble with this you would not believe.
Thanks
@Angela
Get your primary doctor to review your sleep study records and have him complete a medical release form for you before you go back for your next DOT examination.
And go somewhere else for your next DOT physical.
I am a bus driver and I seen a dot examiner for renewal who request sleep study because if my BMI and High Blood pressure, was also given 90days which will expire in three weeks. I went to primary Doc she ordered test, my results were moderate. I have absolutely no problem using machine if it helps but, between funds and appointments to get started with machine my expiration day is near, and the DOT require I be on machine for 30days. I’m soo confused what to do, because my card will expire before I’m finished. I don’t want to lose my home,job, etc, I’m a single parent. Can I get Disabilty benefits?..but will the DOT/primary Dr. Give me the time off, until I’m finished?…please help!
I’m caught in this sleep apnea trap. I had an AHI OF LESS THAN 20/ my BMI suggested a sleep study. I took it. The recommendation is AHI<20, DOES NOT have daytime sleepiness.. Can be certified for 1 year. MES are confusing the words AND &OR
It clearly states that AHI less than 20 AND does not have day time sleepiness OR
has OSA and is being effectively treated
should be certified for one year.
I fall into this category. Yet I was still put out of service pending the doctor reviewing this recommendation or (standard). This is what's going to cause major lawsuits, forcing companies to pay drivers for every day they were out of work. I'm losing money every day in spite these recommendations. If it's not a rule, regulation, nor law, then no one should be out of service. It's a recommendation.
are DOT Dr. that work sends us to thought this sleep study on me cant get it done with in the time he gave me know my med card was done today and work said come back when I get it and wont send us to another Dr. can this Dr. how can this guy put me out of work over a sleep study PLZ help
@Cliff
By law, after 30 days you can go to any certified medical examiner you wish to go to.
Now you may have to pay for it yourself, but you do have rights that supersede your employer.
And there is no new rules and regulations regarding sleep apnea testing or the diagnosis there of, so don’t get fooled by someone telling you have to do a sleep test when there are no issues that point at you having sleep apnea.
For more information to understand this issue read our blog articles on sleep apnea.
Can my husband keep his cdls if he was recently diagnosed with narcolepsy and takes medication?
@Jessica
He will need to have the condition completely under control and have his medical doctor complete a medical release form before he goes in for his next DOT examination.
That will help answer many of the questions that the CME will have. Take the medical release form with him to the examination. Also, explore what is the underlying cause of the condition.
If a DOT physician has said you need a test for sleep apnea,is there an appeal process you can go through in the state of Tennessee?
@Melinda
One, there is no policy regarding sleep apnea, unless there are serious health issues.
But if you want to enter into conflict with the examiner, look/hunt through the FMCSA website. There is a place to do so.
Otherwise wait thirty days and go somewhere else, for your physical exam.
Or ask to see the rules from FMCSA. Read our articles on Sleep Apnea to better understand this issue.
My husband had his DOT physical this fall.His DOT physician said he needed to do a home test for sleep apnea,due to “new” federal regulations,and due to my husband’s neck size,weight,and BMI. By federal and/or state laws,does he have to do the test?His physician,while DOT certified,that his company chose,is a chiropractor.My husband was given a 90 day certificate.Can he get a second opinion without being flagged?
@Melinda
A lot of the new CME’s are under the impression that there were new rules regarding sleep apnea. There are no new rules.
So unless there are other serious health issues, either ask to see the law (which does not exist) or go somewhere else just before your medical card expires. There is no flagging procedure with the FMCSA.
Just had study done and will now be tethered to CPAP machine. I have friend who is willing to give me the machine that he will not use, HUGE savings for me. This machine is 4-5 yrs old, and I’m just wondering if it will meet the standards for what is required to satiate the doctors and politicians. I guess I’m looking for memory/download capability information. Would LOVE to not put out the thousands
(why so pricey?) of dollars for new machine if older model will work. I just love having the DOT in my bedroom.
You stated there are no laws just guidlines regarding testing for sleep apnea. If a driver see’s a doctor and the doctor orders a sleep apnea study and issues a 90 day medical card extention for the driver, can the driver get a second opinion prior to the sleep study or is he flagged in the system and committed to this test? Will the driver have issues at DMV if the second physical passes?
@James
FMCSA has a conflict resolution section on their website. I know that it exists, but you will have to dig around on the site to find it.
Just because a CME says he wants a sleep test, it is just his opinion, not a ruling, not a regulation, not a law just an opinion.
A second opinion is a second view of the same thing with a little different observation.
So no, you are not flagged and the DMV does not have anything to do with the FMCSA rules and regulation. So get your second opinion before the sleep study and then use the medical card that he issues or hunt the FMCSA website and enter into conflict with the first doctor.
CME’s are to determine medical fitness for duty to operate a commercial motor vehicle safely, that’s their job, nothing else.
Update: Driver went to Concentra and was ordered to get a sleep apnea test. Driver felt it wasn’t necessary as they only did a visual check of his neck circumference and he didn’t have any symptoms such as loud excessive snoring and waking in the middle of the night gasping for air. Insurance would not cover this test of nearly $700 + $1000 for the C-Pap machine. Driver waited 30 days ( is that necessary?) and had a second opinion completed. Driver passed the 2nd physical and is good for 2 yrs. Driver will follow up with his Primary Doctor to answer possible sleep apnea questions but won’t be restricted and regulated with DOT in the process. I wanted to share this with you and your viewers. Thanks for your input-James
@James
30 days is an FMCSA recommendation, to prevent doctor shopping. Another reason to not leave your renewal to the last minute.
Thank you for sharing your experience, to help others understand this issue.
concentra also owns sleep clinics, it’s a racket, a lot of our drivers were told they needed sleep studies. Our company no longer uses them and very few of our drivers have been sent for a sleep study
I went for a physical for a new job I already had a medical card that was good till December of 2015. When I got to Concentra they gave me a DOT Physical and I passed everything but because my BMI is 36, my neck circumference is 18.5, I’m 50 yrs old and I take medication for High Blood Pressure that I have to have a sleep study done because I am a candidate for sleep apnea. The doctor told me that my current medical card was no longer any good and issued me a 3 month card till I get the sleep study done. I do not have any insurance so I would have to pay around $2000 for this study. I do not have any of the symptoms of sleep apnea. Is this true that he can pull my medical card and do I need to have a sleep study done?