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What medical conditions disqualify a commercial truck driver?


Trucking companies are required to obtain a medical examination by licensed medical examiner of each truck driver. Here are the physical conditions that disqualify a truck driver from obtaining a CDL (commercial drivers license) and operating a commercial motor vehicle.

1. Loss of use of extremity. Loss of use of a foot, leg or arm, subject to a Skill Performance Evaluation of ability to safety control and operate a commercial motor vehicle even with a prosthetic limb.

2. Diabetes. Medical history of clinical diagnosis of diabetes currently requiring insulin. Diabetics whose condition is controlled with oral medication and diet may qualify.

3. Cardiovascular. Current clinical diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope, dyspnea, collapse, or congestive cardiac failure. Coronary artery bypasses are not disqualifying, but implanted pacemakers are disqualifying.

4. Respiratory. Established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely. Examples of disqualifying respiratory conditions are emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea.

5. Hyptertension. Any detection of hypertension requires frequent rechecks. A blood pressure of 180 (systolic) and 110 (diastolic) or higher is considered Stage 3, at high risk for an acute event such as a stroke. The driver with Stage 3 hypertension may not be qualified, even temporarily, until reduced to equal to or less than 140/90 and treatment is well tolerated, and thereafter rechecked every six months.

6. Other physical limitations. Clinical diagnosis of rheumatic, arthritic, orthopedic or vascular disease which interferes with ability to control and operate a motor vehicle. This would include, for example, known to have acute episodes of transient muscle weakness, poor muscular coordination (ataxia), abnormal sensations (paresthesia), decreased muscle tone (hypotonia), visual disturbances and pain which may be suddenly incapacitating. Medical examiners must evaluate the severity and the likelihood of impairment affecting safe operation.

7. Epilepsy. Established medical history or clinical diagnosis of epilepsy or other condition known to cause loss of consciousness. Single episodes of non-epileptic seizure or loss of consciousness are evaluated regarding likelihood of recurrence, with a six month waiting period highly recommended. Drivers with a history of epilepsy/seizures off antiseizure medication and seizure-free for 10 years may be qualified to operate a CMV in interstate commerce. Interstate drivers with a history of a single unprovoked seizure may be qualified to drive a CMV in interstate commerce if seizure-free and off antiseizure medication for a 5-year period or more.

8. Psychiatric. Mental, nervous or functional disease or psychiatric disorder. This is often a subjective evaluation and easily overlooked by medical examiners.

9. Vision. Must have corrected vision of at least 20/40 in both eyes. One who is blind in one eye cannot qualify. My wife, who is functionally blind in one eye, would not qualify.

10. Hearing. Must be able to perceives a forced whispered voice in the better ear at not less than five feet with or without the use of a hearing aid. If tested by use of an audiometric device, must have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz and 2,000 Hz with or without a hearing aid. I wonder whether my daughter, who is deaf but has an Auditory Brainstem Implant that enables her to hear environmental sounds and understand some speech would qualify.

11. Uses a Schedule I drug or other narcotic, with a narrow exception for prescribed medications.

12. Current diagnosis of alcoholism.

While the Federal Motor Carrier Safety Administration has taken steps to tighten up on medical examinations and certifications, there is still likely to be a problem with drivers avoiding going to doctors and avoid reporting dangerous symptoms to medical examiners. I have taken depositions of truckers who fell asleep while driving, looked like medical textbook illustrations of likely candidates for obstructive sleep apnea, and who had great knowledge of sleep apnea, but who denied ever having consulted a physician regarding any sleep related ailment.

There is also a problem with drivers who do get treatment for their disqualifying conditions but neither comply with their doctors directions nor reported their conditions. In one case, I took the deposition of a truck driver’s personal physician who testified that the driver had confirmed obstructive pulmonary obstructive disorder (COPD), required use of an oxyen tank 24/7, and was unfit to operate a large truck. However, the trucker had never told the medical examiner or his employer of this condition.

The next step in reforming the medical qualification process may be to adjust the incentives. Right now the incentive for truck drivers to to avoid seeking treatment for problems that could be disqualifying, and to conceal insofar as possible any medical problems they may have. How can the rules be modified to to encourage drivers who have problems to seek the medical care they need?

And how can truck stop chains be encouraged to provide better access to healthy food and exercise facilities in order to help truck drivers maintain healthier lifestyles?
