FMCSA updates guidance for truck driver medical examiners

New handbook could be used to launch rulemaking on sleep apnea risks.

For the first time in seven years, physicians have reliable guidance they can use to help determine if commercial truck drivers are physically fit to operate their vehicles.

The Federal Motor Carrier Safety Administration on Tuesday published a draft of its new Medical Examiner’s Handbook (MEH). The handbook provides information on driver health requirements and guidelines used by medical examiners (MEs) listed on FMCSA’s National Registry of Certified Medical Examiners to interpret regulations on physical qualifications for commercial drivers.

An ME is licensed, certified, and/or registered in accordance with state laws and regulations to perform physical examinations and must also be knowledgeable of the physical and mental demands associated with operating a truck.

“Other health care professionals, such as treating providers and specialists, may provide additional medical information or consultation, but the ME ultimately decides whether the driver meets the physical qualification standards of FMCSA,” according to the agency.

FMCSA also emphasized that, unlike regulations, the recommendations and guidance in the handbook “do not have the force and effect of law and are not meant to bind MEs, drivers or the public in any way. Rather, such guidance itself is only advisory and not mandatory.”

FMCSA first posted the MEH on its website in 2008 but had to withdraw it in 2015 because some of the information was “obsolete or was prescriptive in nature,” according to FMCSA, and therefore MEs and training organizations were told not to consider the MEH as guidance to interpret federal regulations.

Potential for sleep apnea rulemaking

While federal regulations do not include specific requirements related to testing drivers for obstructive sleep apnea (OSA), “the big question is whether FMCSA will use [the MEH] as a potential launchpad for a formal rulemaking on OSA,” P. Sean Garney, co-director of Scopelitis Transportation Consulting, told FreightWaves.

To address the issue, FMCSA would have to go through a formal rulemaking process, Garney noted. In 2016, FMCSA and the Federal Railroad Administration (FRA) issued an advanced notice of proposed rulemaking on OSA, but the Trump administration withdrew the proposal in 2017. “The agencies believe that current safety programs and FRA’s rulemaking addressing fatigue risk management are the appropriate avenues to address OSA,” the agencies stated at the time.

Over the last decade, however, “there is a lot more data available on [OSA], and the industry’s take on the issue has evolved as well. The time could be right,” Garney said.

FMCSA addresses OSA in the handbook by providing a link to recommendations made in 2016 by the Medical Review Board, an advisory committee to the agency. It includes suggestions on risk factors, screening, testing and medical certification of drivers with OSA.

Comments on the draft handbook must be received on or before Sept. 30.

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