16546 Federal Register / Vol. 87, No. 56 / Wednesday, March 23, 2022 / Notices 

1The report is available on the internet at https:// 

rosap.ntl.bts.gov/view/dot/16462. 

2These criteria may be found in 49 CFR part 391, 

APPENDIX A TO PART 391—MEDICAL 

ADVISORY CRITERIA, section D. Cardiovascular: 

§ 391.41(b)(4), paragraph 4, which is available on 

the internet at https://www.gpo.gov/fdsys/pkg/CFR2015-title49-vol5/pdf/CFR-2015-title49-vol5- 

part391-appA.pdf. 

DEPARTMENT OF TRANSPORTATION 

Federal Motor Carrier Safety 

Administration 

[Docket No. FMCSA–2021–0159] 

Qualification of Drivers; Exemption 

Applications; Implantable Cardioverter 

Defibrillator (ICD) 

AGENCY: Federal Motor Carrier Safety 

Administration (FMCSA), Department 

of Transportation (DOT). 

ACTION: Notice of denials. 

SUMMARY: FMCSA announces its 

decision to deny the applications from 

five individuals treated with an ICD 

who requested an exemption from the 

Federal Motor Carrier Safety 

Regulations (FMCSRs) prohibiting 

operation of a commercial motor vehicle 

(CMV) in interstate commerce by 

persons with a 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 (transient loss 

of consciousness), dyspnea (shortness of 

breath), collapse, or congestive heart 

failure. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Christine A. Hydock, Chief, Medical 

Programs Division, (202) 366–4001, 

fmcsamedical@dot.gov, FMCSA, DOT, 

1200 New Jersey Avenue SE, Room 

W64–224, Washington, DC 20590–0001. 

Office hours are from 8:30 a.m. to 5 

p.m., ET, Monday through Friday, 

except Federal holidays. If you have 

questions regarding viewing materials in 

the docket, contact Dockets Operations, 

(202) 366–9826. 

SUPPLEMENTARY INFORMATION: 

I. Public Participation 

A. Viewing Comments 

To view comments go to 

www.regulations.gov. Insert the docket 

number, FMCSA–2021–0159, in the 

keyword box, and click ‘‘Search.’’ Next, 

sort the results by ‘‘Posted (NewerOlder),’’ choose the first notice listed, 

and click ‘‘Browse Comments.’’ If you 

do not have access to the internet, you 

may view the docket online by visiting 

Dockets Operations in Room W12–140 

on the ground floor of the DOT West 

Building, 1200 New Jersey Avenue SE, 

Washington, DC 20590–0001, between 9 

a.m. and 5 p.m., ET, Monday through 

Friday, except Federal holidays. To be 

sure someone is there to help you, 

please call (202) 366–9317 or (202) 366– 

9826 before visiting Dockets Operations. 

B. Privacy Act 

In accordance with 49 U.S.C. 

31315(b)(6), DOT solicits comments 

from the public on the exemption 

request. DOT posts these comments, 

without edit, including any personal 

information the commenter provides, to 

www.regulations.gov, as described in 

the system of records notice (DOT/ALL– 

14 FDMS), which can be reviewed at 

www.dot.gov/privacy. 

II. Background 

On November 12, 2021, FMCSA 

published a Federal Register notice (86 

FR 62868) announcing receipt of 

applications from five individuals 

treated with ICDs and requested 

comments from the public. The 

individuals requested an exemption 

from 49 CFR 391.41(b)(4) which 

prohibits operation of a CMV in 

interstate commerce by persons with a 

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 heart 

failure. The public comment period 

closed on December 13, 2021, and one 

comment was received. 

FMCSA has evaluated the eligibility 

of the applicants and concluded that 

granting an exemption would not 

provide a level of safety that would be 

equivalent to, or greater than, the level 

of safety that would be obtained by 

complying with § 391.41(b)(4). A 

summary of each applicant’s medical 

history related to their ICD exemption 

request was discussed in the November 

12, 2021, Federal Register notice and 

will not be repeated here. 

The Agency’s decision regarding this 

exemption application is based on 

information from the Cardiovascular 

Medical Advisory Criteria, an April 

2007 evidence report titled 

‘‘Cardiovascular Disease and 

Commercial Motor Vehicle Driver 

Safety,’’ 1 and a December 2014 focused 

research report titled ‘‘Implantable 

Cardioverter Defibrillators and the 

Impact of a Shock in a Patient When 

Deployed.’’ Copies of these reports are 

included in the docket. 

FMCSA has published advisory 

criteria to assist medical examiners in 

determining whether drivers with 

certain medical conditions are qualified 

to operate a CMV in interstate 

commerce.2 The advisory criteria for 

§ 391.41(b)(4) indicates that coronary 

artery bypass surgery and pacemaker 

implantation are remedial procedures 

and thus, not medically disqualifying. 

ICDs are disqualifying due to risk of 

syncope. 

III. Discussion of Comments 

FMCSA received one comment in this 

proceeding. The commenter supported 

granting exemptions to the applicants 

stipulating a 6-month cardiology review 

and a 6-month medical certification 

period as safety assurances. 

FMCSA acknowledges that while a 

more frequent cardiology review and 

physical qualification period may be 

feasible for some of the applicants, 

others may find a more frequent medical 

review period burdensome and costly. 

In addition, there continues to be a risk 

for arrhythmias, and inherent 

complications such as inappropriate 

discharges, and ICD malfunction which 

could pose a risk to the individual and 

the public while driving a CMV. 

IV. Basis for Exemption Determination 

Under 49 U.S.C. 31136(e) and 

31315(b), FMCSA may grant an 

exemption from the FMCSRs for no 

longer than a 5-year period if it finds 

such exemption would likely achieve a 

level of safety that is equivalent to, or 

greater than, the level that would be 

achieved absent such exemption. 

The Agency’s decision regarding these 

exemption applications is based on an 

individualized assessment of the 

applicants’ medical information, 

available medical and scientific data 

concerning ICDs, and any relevant 

public comments received. 

In the case of persons with ICDs, the 

underlying condition for which the ICD 

was implanted places the individual at 

high risk for syncope or other 

unpredictable events known to result in 

gradual or sudden incapacitation. ICDs 

may discharge, which could result in 

loss of ability to safely control a CMV. 

The December 2014 focused research 

report referenced previously upholds 

the findings of the April 2007 report and 

indicates that the available scientific 

data on persons with ICDs and CMV 

driving does not support that persons 

with ICDs who operate CMVs are able 

to meet an equal or greater level of 

safety. 

V. Conclusion 

The Agency has determined that the 

available medical and scientific 

literature and research provides 


jspears on DSK121TN23PROD with NOTICES1
Federal Register / Vol. 87, No. 56 / Wednesday, March 23, 2022 / Notices 16547 

1These criteria may be found in APPENDIX A TO 

PART 391—MEDICAL ADVISORY CRITERIA, 

section H. Epilepsy: § 391.41(b)(8), paragraphs 3, 4, 

and 5, which is available on the internet at https:// 

www.gpo.gov/fdsys/pkg/CFR-2015-title49-vol5/pdf/ 

CFR-2015-title49-vol5-part391-appA.pdf. 

insufficient data to enable the Agency to 

conclude that granting these exemptions 

would achieve a level of safety 

equivalent to, or greater than, the level 

of safety maintained without the 

exemption. Therefore, the following 

applicants have been denied an 

exemption from the physical 

qualification standards in § 391.41(b)(4): 

Rosie A. Byrd (TX) 

Thomas Jacobs (NY) 

Lee Latin (NC) 

Wayne Pimpare (ME) 

Bradley Plunket (IL) 

The applicants have, prior to this 

notice, received a letter of final 

disposition regarding their exemption 

request. The decision letter fully 

outlined the basis for the denial and 

constitute final action by the Agency. 

The names of these individuals 

published today summarizes the 

Agency’s recent denials as required 

under 49 U.S.C. 31315(b)(4). 

Larry W. Minor, 

Associate Administrator for Policy. 

[FR Doc. 2022–06120 Filed 3–22–22; 8:45 am] 

BILLING CODE 4910–EX–P 

DEPARTMENT OF TRANSPORTATION 

Federal Motor Carrier Safety 

Administration 

[FMCSA Docket No. FMCSA–2021–0026] 

Qualification of Drivers; Exemption 

Applications; Epilepsy and Seizure 

Disorders 

AGENCY: Federal Motor Carrier Safety 

Administration (FMCSA), Department 

of Transportation (DOT). 

ACTION: Notice of final disposition. 

SUMMARY: FMCSA announces its 

decision to exempt 32 individuals from 

the requirement in the Federal Motor 

Carrier Safety Regulations (FMCSRs) 

that interstate commercial motor vehicle 

(CMV) drivers have ‘‘no established 

medical history or clinical diagnosis of 

epilepsy or any other condition which 

is likely to cause loss of consciousness 

or any loss of ability to control a CMV.’’ 

The exemptions enable these 

individuals who have had one or more 

seizures and are taking anti-seizure 

medication to operate CMVs in 

interstate commerce. 

DATES: The exemptions were applicable 

on March 15, 2022. The exemptions 

expire on March 15, 2024. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Christine A. Hydock, Chief, Medical 

Programs Division, (202) 366–4001, 

fmcsamedical@dot.gov, FMCSA, DOT, 

1200 New Jersey Avenue SE, Room 

W64–224, Washington, DC 20590–0001. 

Office hours are from 8:30 a.m. to 5 

p.m., ET, Monday through Friday, 

except Federal holidays. If you have 

questions regarding viewing or 

submitting material to the docket, 

contact Dockets Operations, (202) 366– 

9826. 

SUPPLEMENTARY INFORMATION: 

I. Public Participation 

A. Viewing Comments 

To view comments go to 

www.regulations.gov. Insert the docket 

number, FMCSA–2021–0026, in the 

keyword box, and click ‘‘Search.’’ Next, 

sort the results by ‘‘Posted (NewerOlder),’’ choose the first notice listed, 

and click ‘‘Browse Comments.’’ If you 

do not have access to the internet, you 

may view the docket online by visiting 

Dockets Operations in Room W12–140 

on the ground floor of the DOT West 

Building, 1200 New Jersey Avenue SE, 

Washington, DC 20590–0001, between 9 

a.m. and 5 p.m., ET, Monday through 

Friday, except Federal holidays. To be 

sure someone is there to help you, 

please call (202) 366–9317 or (202) 366– 

9826 before visiting Dockets Operations. 

B. Privacy Act 

In accordance with 49 U.S.C. 

31315(b)(6), DOT solicits comments 

from the public on the exemption 

request. DOT posts these comments, 

without edit, including any personal 

information the commenter provides, to 

www.regulations.gov, as described in 

the system of records notice (DOT/ALL– 

14 FDMS), which can be reviewed at 

www.dot.gov/privacy. 

II. Background 

On February 3, 2022, FMCSA 

published a notice announcing receipt 

of applications from 32 individuals 

requesting an exemption from the 

epilepsy and seizure disorders 

prohibition in 49 CFR 391.41(b)(8) and 

requested comments from the public (87 

FR 6231). The public comment period 

ended on March 7, 2022, and four 

comments were received. 

FMCSA has evaluated the eligibility 

of these applicants and determined that 

granting exemptions to these 

individuals would achieve a level of 

safety equivalent to, or greater than, the 

level that would be achieved by 

complying with § 391.41(b)(8). 

The physical qualification standard 

for drivers regarding epilepsy found in 

§ 391.41(b)(8) states that a person is 

physically qualified to drive a CMV if 

that person has no established medical 

history or clinical diagnosis of epilepsy 

or any other condition which is likely 

to cause the loss of consciousness or any 

loss of ability to control a CMV. 

In addition to the regulations, FMCSA 

has published advisory criteria 1 to 

assist medical examiners (MEs) in 

determining whether drivers with 

certain medical conditions are qualified 

to operate a CMV in interstate 

commerce. 

III. Discussion of Comments 

FMCSA received four comments in 

this proceeding. Of the four comments 

received, three were in support of 

Callon Hegman’s seizure exemption 

application and one was in support of 

Shaen Smith’s seizure exemption 

application. 

IV. Basis for Exemption Determination 

Under 49 U.S.C. 31136(e) and 

31315(b), FMCSA may grant an 

exemption from the FMCSRs for no 

longer than a 5-year period if it finds 

such exemption would likely achieve a 

level of safety that is equivalent to, or 

greater than, the level that would be 

achieved absent such exemption. The 

statute also allows the Agency to renew 

exemptions at the end of the 5-year 

period. FMCSA grants medical 

exemptions from the FMCSRs for a 2- 

year period to align with the maximum 

duration of a driver’s medical 

certification. 

The Agency’s decision regarding these 

exemption applications is based on the 

2007 recommendations of the Agency’s 

Medical Expert Panel. The Agency 

conducted an individualized assessment 

of each applicant’s medical information, 

including the root cause of the 

respective seizure(s) and medical 

information about the applicant’s 

seizure history, the length of time that 

has elapsed since the individual’s last 

seizure, the stability of each individual’s 

treatment regimen and the duration of 

time on or off of anti-seizure 

medication. In addition, the Agency 

reviewed the treating clinician’s 

medical opinion related to the ability of 

the driver to safely operate a CMV with 

a history of seizure and each applicant’s 

driving record found in the commercial 

driver’s license Information System for 

commercial driver’s license (CDL) 

holders, and interstate and intrastate 

inspections recorded in the Motor 

Carrier Management Information 

System. For non-CDL holders, the 

Agency reviewed the driving records 


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