Source: http://www.dotmedicalexam.com/blog.html
Timestamp: 2017-12-13 10:58:52
Document Index: 333589608

Matched Legal Cases: ['§ 391', '§ 391', '§ 384', 'art 382', 'art 383', 'art 387', 'art 387', 'art 390', 'art 391', 'art 391', 'art 392', 'art 392', 'art 392', 'art 395', 'art 396', 'art:385', '§391', 'art 391', 'art 391', 'art 40', 'art 381', 'art 391', 'art 391', 'art 391', 'art 391']

Posted on Thursday, April 06, 2017 8:29 AM
Why do Occupational medical service coffee in their waiting
Yet when it comes to coffee, the worst thing you can do
is to offer a cup to a truck driver. Especially if they are there for a DOT exam:
Studies – such as the one by the FMCSA - have prove
without a doubt that High Blood pressure is one of the most common
problem that Commercial drivers have. They have caused many injuries and deaths to innocent motorists and passengers do to strokes.
Medical Examiners have an obligation to not only help the patient,
but to also protect public safety.
Should a commercial driver with undiagnosed – and more importantly
untreated – High Blood pressure do to drinking a cup of coffee, it could mask the underlying effects of the disease.
As the blood levels of caffeine and its metabolites increase, the
driver may feel more alert. And the symptoms of High pressure –
such as increase of rate rate – can emerge. Caffeine also gives a “kick” to our blood pressure, and is actually a well-documented pressor (substance that elevates blood pressure). Increases tend to be mild, in the range of 5 to 10 mmHg. That’s regardless of how often you drink coffee or your caffeine tolerance, although there are always rare exceptions.
Posted on Friday, March 24, 2017 2:37 AM
Role of Medical Examiners’ Clinical Judgment in the Medical Certification Process of Sleep Apnea
“The current regulations and advisory criteria do not include guidelines concerning OSA screening, diagnosis, and treatment,” the bulletin states. “Medical examiners should rely upon their medical training and expertise in determining whether a driver exhibits symptoms and/or multiple risk factors for OSA, and they should explain to the driver the basis for their decision if the examiner decides to issue a medical certificate for a period of less than two years to allow for further evaluation, or to deny a driver the medical certificate.”
Posted on Wednesday, October 12, 2016 10:07 AM
The U.S. Department of Transportation’s Federal Motor Carrier Safety Administration (FMCSA) issued a final rule amending its commercial driver’s license (CDL) regulations to ease the transition of military personnel into civilian careers driving commercial motor vehicles (CMVs) by simplifying the process of obtaining a commercial learner’s permit (CLP) or CDL.
This final rule extends the period of time for applying for a skills test waiver from 90 days to one year after leaving a military position requiring the operation of a CMV.
This final rule also allows a state to accept applications from active duty military personnel who are stationed in that state and to administer the written and skills tests for a CLP or CDL.
The state of domicile may issue the CLP or CDL on the basis of those
Posted on Wednesday, June 01, 2016 6:21 AM
Posted on Friday, May 06, 2016 7:26 PM
The primary safety goal regarding OSA is to identify drivers with moderate-to severe
OSA to ensure these drivers are managing their condition to reduce to the
greatest extent practical the risk of drowsy driving. Moderate-to-severe OSA is
defined by an apnea-hypopnea index (AHI)1 of greater than or equal to 15.
• The Agency does not require that these drivers be considered unfit to continue them
driving careers; only that the medical examiner makes a determination whether they
need to be evaluated and, if warranted, demonstrate they are managing their OSA to
reduce the risk of drowsy driving.
• Screening: With regard to identifying drivers with undiagnosed OSA, FMCSA’s
regulations and advisory criteria do not include screening guidelines. Medical
examiners should consider common OSA symptoms such as loud snoring, witnessed
apneas, or sleepiness during the major wake periods, as well as risk factors, and
consider multiple risk factors such as body mass index (BMI), neck size,
involvement in a single-vehicle crash, etc.
• Diagnosis: Methods of diagnosis include in-laboratory polysomnography, at-home
polysomnography, or other limited channel ambulatory testing devices which
ensure chain of custody.
• Treatment: OSA is a treatable condition, and drivers with moderate-to-severe OSA
can manage the condition effectively to reduce the risk of drowsy driving.
Treatment options range from weight loss to dental appliances to Continuous
Positive Airway Pressure (CPAP) therapy, and combinations of these treatments.
The Agency’s regulations and advisory criteria do not include recommendations for
treatments for OSA and FMCSA believes the issue of treatment is best left to the
treating healthcare professional and the driver.
Posted on Tuesday, May 03, 2016 8:34 PM
Posted on Thursday, March 17, 2016 8:40 AM
(FMCSA), along with the Department of Transportation (DOT), requires that persons subject to the commercial driver’s license (CDL) requirements and their employers follow alcohol and drug testing rules. These rules include procedures for testing, frequency of tests, and substances tested for.
Las Vegas NV 702.266.6802 TA Truck Stop
Posted on Sunday, February 21, 2016 6:54 PM
Dear Truck Diver,
Hypertension can almost always be prevented, so these steps are very important even if you do not have high blood pressure. • Maintain a healthy weight. • Be physically active. • Follow a healthy eating plan. • Eat foods with less sodium (salt). • Drink alcohol only in moderation. • Take prescribed drugs as directed
For an overall eating plan, consider DASH, which stands for “Dietary Approaches to Stop Hypertension.” You can reduce your blood pressure by eating foods that are low in saturated fat, total fat, and cholesterol, and high in fruits, vegetables, and low fat dairy foods. The DASH eating plan includes whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages. It is also high in potassium, calcium, and magnesium, as well as protein and fiber. Eating foods lower in salt and sodium also can reduce blood pressure
Posted on Friday, February 19, 2016 5:55 AM
Dear Transportation Company,
The Medical Examiner's Certification Integration final rule requires certified MEs to continue using the current driver examination forms found on the FMCSA website until December 22, 2015 and to use the newly revised driver examination forms discussed in the final rule beginning December 22, 2015. However, as a result of the unexpected delays in posting the final versions of the newly revised driver examination forms and recognizing that MEs need to have access to the forms prior to the effective date for a number of reasons, FMCSA published a Federal Register notice on December 21, 2015 allowing MEs to use both the current and newly revised versions of the MER Form, MCSA-5875 and MEC, Form MCSA-5876 from December 22, 2015 until April 20, 2016 (80 FR 79273).
Lower Hypertension for Truck Drivers
Posted on Saturday, February 13, 2016 10:20 AM
For an overall eating plan, consider DASH, which stands for “Dietary Approaches to Stop Hypertension.” You can reduce your blood pressure by eating foods that are low in saturated fat, total fat, and cholesterol, and high in fruits, vegetables, and lowfat dairy foods. The DASH eating plan includes whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages. It is also high in potassium, calcium, and magnesium, as well as protein and fiber. Eating foods lower in salt and sodium also can reduce blood pressure
New Medical Exam
Posted on Saturday, February 06, 2016 6:01 PM
Just a reminder from Trucker Exam Inc that after April 16, 2016, the new Medical Exam form 5875 and Medical Certificate 5876 will be mandatory. They may be used after December 22, 2015, for all DOT CDL Physicals and replaces the old forms
Please visit the link below for free printing and downloading, PDF format. Includes Instructions to Physicians, Minimum Requirements, Physical Qualifications and CDL Medical Certificate for Commercial Drivers.
FMSCA web site
Posted on Sunday, December 20, 2015 4:57 PM
Deadline Confirmed
FMCSA has confirmed that sometime after Monday, December 21st, they will inform CMEs and interested parties regarding the deadline delay. The new deadline is April 20, 2016 (note: I was 2 days off in my last newsletter).
Scheduled to be published on 12/21 in the Federal Register is the announcement that the FMCSA will provide a 120-day grace period during which Medical Examiners may use either the current or the newly revised versions of the Medical Examination Report Form and Medical Examiner’s Certificate, beginning December 22, 2015, and until April 20, 2016. On April 20, 2016 use of the new forms will be required.
Pre-Employment Sceening
Posted on Friday, December 04, 2015 6:39 AM
The Pre-Employment Screening Program (PSP) allows carriers, individual drivers, and industry service providers access to commercial drivers' safety records from the Federal Motor Carrier Safety Administration's (FMCSA) Motor Carrier Management Information System (MCMIS). Records are available 24 hours a day via the PSP web site.
PURPOSE The Federal Motor Carrier Safety Administration (FMCSA) established the Pre-Employment Screening Program (PSP) to comply with Federal legislation requiring the Agency to provide information on driver safety performance to persons conducting preemployment screening for the motor carrier industry. The PSP was launched on May 11, 2010, and is a voluntary program. Motor carriers can use the information provided through the PSP—comprised of 5 years of crash data and 3 years of inspection data on the driver—to assist in determining if a driver applicant should be hired. FMCSA embarked on this analysis to determine if using the PSP has a positive impact on CMV safety.
FMCSA New driver examination forms
Trucker Exam Inc: Posted on Friday, December 04, 2015 4:29 AM
FYI: FCMSA has posted PDF samples of the new driver examination forms on the National Registry website which can be accessed by clicking the links below. Please note that these forms are samples only and are prohibited from being used prior to the December 22, 2015 compliance date.
FMCSA to Delay Dec 22nd Deadline
FMCSA has decided to delay the Dec 22nd deadline. However, the date of the new deadline has not be determined, and all other details are not available at this time. FMCSA should make an announcement soon, and we will sent all available information when we receive it.
Look for the new DOT Exam Form in December 2015.
Posted on Monday, June 01, 2015 8:48 AM
The U.S. Department of Transportation’s Office of Drug and Alcohol Policy and Compliance (ODAPC) has updated the “What Employers Need to Know About DOT Drug and Alcohol Testing” guidelines, also known as the “Employer Handbook.” Last revised in October 2010, this new version can be viewed at http://www.dot.gov/odapc/employer_handbook. A summary of changes made to the “Employer Handbook” can be found on the last page of the booklet.
Posted on Tuesday, October 21, 2014 2:37 AM
Lon Edwards would like to connect on LinkedIn. How would you like to respond? Lon Edwards Director Trucker Exam Inc Confirm you know Lon You received an invitation to connect. LinkedIn will use your email address to make suggestions to our members in features like People You May Know. Unsubscribe If you need assistance or have questions, please contact LinkedIn Customer Service. © 2014, LinkedIn Corporation. 2029 Stierlin Ct. Mountain View, CA 94043, USA
Posted on Wednesday, October 15, 2014 4:13 AM
Posted on Monday, October 06, 2014 11:48 AM
Lon Edwards would like to stay in touch on LinkedIn. Lon Edwards Director Trucker Exam Inc Fresno, California Area Hi fc8ee4ba-aab1-4972-9 Tei, I'd like to add you to my professional network on LinkedIn. - Lon Confirm that you know Lon Other people you may know on LinkedIn Lon Edwards Director Trucker Exam Inc Michael McPhillips Experienced Telecom Executive Al Malone Customer Retail Manager at Kraft Foods You received an invitation to connect. LinkedIn will use your email address to make suggestions to our members in features like People You May Know. Unsubscribe This email was intended for fc8ee4ba-aab1-4972-9 Tei Blg. Learn why we included this. If you need assistance or have questions, please contact LinkedIn Customer Service. © 2014, LinkedIn Corporation. 2029 Stierlin Ct. Mountain View, CA 94043, USA
Trucker Exam Inc. works with companies to design execute and manage your drug testing program. We offer complete and professional drug and alcohol screening services including:
- Drug Testing (i.e. Pre-employment, Random, Post Accident, Reasonable Suspicion, etc.) by Hair, Urine, or Saliva with results for DOT in less than 24 hours and administrative in less than 15 minutes
- Private on line storage of: Chain of custody forms, Results, Quarterly Random selections and results, Annual MIS forms, Consortia contract, D/A Policy and Reasonable suspicion certificates for each company
- Free Drug and Alcohol Policy Development for US DOT and administrative companies
- Free employee awareness training and supervisor training
- US DOT Consortia random selection services
Access to a total of 2,500 collection sites across the United States .
- On line assistance in identifying a Substance Abuse Professional (SAP)
- On-site drug and alcohol screening services
- After-hour drug and alcohol screening services
- On line US DOT drug and alcohol compliance forms
- Results can be reported on line, fax, or e-mail
- Non-DOT Pre-employment Instant Drug Test exams are reported within 25 minutes or less
Drug Testing US DOT and NON -DOT, Alcohol Testing US DOT (BAT, STT) and Corporate, Hair Drug Testing.
http://www.dotmedicalexam.com
Posted on Tuesday, August 05, 2014 1:35 AM
http://portal-workshop.de/living.php?kektn2874dtrsvhb
truckerexam@yahoo.com
Trucker Exam Inc. Promises Drivers No Wait Time
Fresno, CA—sitting at a truck stop waiting for a license or DOT- medical exam might just be one of life’s top-ranked annoyances, right up there with sitting in traffic and sitting at warehouse all day.
That’s why Truck Exam Inc., a provider of workplace DOT medical testing, opened the first transportation clinic in 1993 at the E-Z TRIP TRUCK STOP in Fresno California, exclusively for drivers. Trucker Exam Inc. promises no wait time for DOT and Non DOT- medical exams and drug testing.
“This mobile office was designed specifically for truck drivers at the truck stop drivers are able to park their truck, there no waiting, in out less than 30 minutes.
The driver can get their DOT physical exam completed, use the Internet to, or get their truck fill up with diesel says Dr. Lon Edwards , the company’s CEO.
Dr Edwards is an is a DOT doctor who helped develop four DOT clinics in California and Nevada, three of them in are in the Central Valley of California and one in Las Vegas Nevada, but never before one to give quick and easy access to driver medical exams in Fresno Ca.
“The clinic is staffed by Doctor’s and RN’s who understand that drivers work very hard, that their time is valuable, and time is money,” Dr Edwards says. “Our exams are administered by DOT doctors who specialize in DOT Exam’s, who are familiar with provincial driver’s certified licensing exams, and who know the requirements. Plus, truck drivers don’t have to wait several hours to see their DOT doctor.”
The Trucker Exam Inc. mobile clinic, which also offers other DOT services like DOT EXAM, AND DRUG TESTING is located at
6522 N GOLD STATE FRESNO CA. 93722 559 431-2648
FYI: From FMCSA 04/22/14
Driver/Carrier:
Thank you for your commitment to safer roadways!
This page created March 7, 2014
The Board will consider amendments to the Truck and Bus Regulation at its April 24-25, 2014 meeting. The staff proposal is intended to help ensure that the air quality benefits originally envisioned by the regulation will be achieved, by providing some additional compliance flexibility to vehicle owners. The proposed amendments are subject to change at the Board hearing and are currently not in effect.
Regulation Update and Benefits
More time for rural areas with cleaner air (area map)
Additional time for 2nd and 3rd truck in small fleets
Additional time for owners that cannot finance compliance
Adjusted compliance timelines for low-use or vocational trucks
Work truck extension (up to 20,000 total miles/year)
Low-use vehicle exemption (up to 5,000 total miles/year)
Low mileage agricultural vehicles
Recognizing early actions already taken by fleets to comply
Extending use of existing PM filter retrofits
Extending use of phase-in option credits
You can get more information, including the Staff Report, at the Rulemaking Document page. You can make a commenton the proposed changes if interested. Additional supporting documentation and analyses for the proposed amendments are available at the AB1085Compliance page.
Motor Carriers would need to run a new MVR within 15 days ofa driver
getting a new DOT physical and certifying their card with their SDLA. 49 CFR 391.51. This rule will discuss the MVRand the 15 day requirement.
§ 391.51 General requirements for driver
The medicalexaminer’s certificate as required by § 391.43(g) or
a legible copy of the certificate.
· (ii) Exception. For CDL drivers
beginning January 30,2012, if the CDLIS motor vehicle record contains medical certification status information, the motor carrier employer must meet this
requirement by obtaining the CDLIS motor vehicle record defined at
§ 384.105 of this chapter. That record must be obtained from the current
licensing State and placed in the driver qualification file. After January 30,
2014, a non-excepted,interstate CDL driver without medical certification
status information Anthe CDLIS motor vehicle record is designated ‘‘not certified’’
to operate a CMV in interstate commerce. For up to 15 days from the
date stamped on the receipt of the medical examiner’s certificate, provided
to the driver by testate driver licensing agency, a motor carrier may use that receipt as proof of the driver’s medical certification.
Trucker Exam Inc. (TEI) on-site services recently added certified medical examiners to their Fresno, Ca. Madera Ca. and Las Vegas NV. Offices, to accommodate the increase of DOT exams and drug tests by local employers. With seven examiners, TEI maintains the largest network of certified medical examiners on the FMCSA National Registry in California and Nevada. TEI DOT examiners are also available for on-site and remote examinations and drug testing
TEI works to meet a FMCSA deadline of 5/21/14 when all DOT exams must be performed by a certified medical examiner. Previously, any private doctor was able to perform the exam without any prior specific training or certification. As part of this new regulation, a National Registry will maintain a database of all certified medical examiners.
To set appointment you can:
Call 1-800-542-2225
Go to the TEI portal also allows for scheduling appointments and retrieving results all through one website. www.dotmedicalexam.com
www.dot.gov/affairs/index.html
To maintain high standards of safety and professionalism,commercial drivers are subject to federal regulations outlined by the FederalMotor Carrier Safety Administration (FMCSA), which is a part of the U.S. Departmentof Transportation (DOT).
One component of maintaining your Commercial Driver’sLicense (CDL), is complying with the FMCSA’s drug testing regulations via yourcarrier or employer. Below is an overview of how and why carriers in thetrucking industry may use drug and alcohol screening to ensure safety.
Dear Motor Carrier,
You are subscribed to Federal Motor Carrier Safety Administration email updates.Subscriber Services: Manage Preferences
Questions for Federal Motor Carrier Safety Administration please Contact Us STAY CONNECTED
This email was sent to truckerexam@yahoo.com using GovDelivery, on behalf of:
Federal Motor Carrier Safety Administration · 1200 New Jersey Avenue SE · Washington, DC 20590
Posted on Friday, January 03, 2014 8:34 PM
The best gift you can give your transportation company is to have your drivers complete you’rea Certify medical examiner. Doing so will ensure that your drivers will be ableto drive after the May 21, 2014 compliance date. After this date, drivers can only see a certified medical examiner that is listed on the National Registryfor their DOT exam. Make sure that your all driver in 2014 are medically certified
Part 382 D & A = 10% random alcohol/50% drug + pre-employment drug test before the driver drives + post accident drug & alcohol tests when required
Part 383 CDL = Make sure drivers have a current CDL
Part 387 = Have a copy of MCS Form 90 on site and ensure the MCS Form 90 reflects the level of insurance required. It annoys me the insurance industry will only issue a MCS Form 90 for what a carrier list on their application for authority; if a carrier has $1,000,000 policy and their authority indicates the carrier is a non-HM requiring $750,000 that's what the MCS 90 will reflect. If a carrier transports ANY amount of HM they must have $1,000,000 insurance. It's a violation of Part 387 to not have:
1. Inadequate levels of insurance
2. Insufficent insurance on file for the commodity transported, i.e. HM
3. No MCS Form 90
4. MCS Form 90 doesn't reflect the level of insurance required
Part 390 General Record Keeping = Records available when asked for; many carriers are under the assumption they have 48 hours to produce the records... The 48 hour rule applies to carriers with multiple terminals that allows the terminals to store records at the terminal.
Part 391 DQ = See Part 391.51 for a list of all files REQUIRED in the DQ file. Make sure your company has a tracking tool to keep track of DOT medical renewals; Outlook or other calendar programs work wonders in providing pops ups to remind the user tasks are due. Pick one month a year and pull all of your drivers' MVR; if you use June then do ALL drivers in June including those hired in the 11 months preceeding the annual pull. Make sure you do the employment inquires required.
Part 392 Driving a CMV = Thou shall not speed Part 392.2; if a driver logs a trip at 70 mph in a state with a 65 mph speed limit your company can be cited and prosecuted for Part 392.2.
Part 395 HOS = Driver's record of duty status (RODS)... No flase RODS; no missing RODS; RODS turned in on time; RODS complete with all required information
Part 396 Maintenance = Annual inspections, DVIRs, scheduled maintenance program with a record maintenance is being performed on time and road side inspections, proof repairs were completed
FMCSA - MRB/MCSA Joint Committee Recommendations
Full language of the recommendations as I best followed their drafting/revision follows. (Note: there may be further revision as yet before they are sent formally to FMCSA, though their intention as outlined here should largely remain. Italics represent committee annotations about intentions.)
RECOMMENDATION LANGUAGE:
Recommendation 1 — General
Obstructive sleep apnea (OSA) diagnosis precludes unconditional certification.
A driver with OSA diagnosis can be certified if:
The driver has untreated OSA with apnea-hypopnea index (AHI) < 20 (i.e., mild-to-moderate OSA) AND
The driver does not admit to experiencing sleepiness during the major wake period OR
OSA is being effectively treated.
A driver with an OSA diagnosis may be recertified annually, based on demonstrating compliance with therapy.
Minimally acceptable compliance with PAP means at least 4 hours/day of use 70 percent of days.
§ Drivers should be encouraged that more hours of PAP use is preferable.
§ Optimal treatment efficacy occurs with 7 hours or more of daily use during sleep.
The intent behind the AHI threshold is to prioritize those drivers with OSA that need immediate treatment.
Drivers with mild OSA (AHI levels as low as 5) may benefit from OSA treatment, and should be encouraged to explore treatment options.
Drivers with an AHI between 5 and 20 should be encouraged to seek treatment, if they have a history involving a fatigue-related crash or a DOT-defined single vehicle crash [footnote reference: crash involving a CMV that results in a fatality or injury treatable away from the scene or disabling damage requiring tow away], or if they report sleepiness while operating a motor vehicle.
Why set the AHI threshold at 20?
Crash risk in the moderate-to-severe OSA range is statistically higher than for drivers with mild OSA.
From a practical perspective, setting the AHI limit at 15 or above makes it more difficult to get a patient under treatment to that AHI level. Although AHI of 15 is likely a safer threshold, there is not data to show this.
RECOMMENDATION 2 — Drivers with any of the following should be disqualified immediately or denied certification:
Report excessive sleepiness during the major wake period while driving, OR
Experienced a crash associated with falling asleep, OR
Have been found non-compliant in treatment per Recommendation 1.
RECOMMENDATION 3 — Drivers with any of the following may be granted conditional certification per Recommendation 4:
Have AHI > 20 until compliant with PAP, OR
Have undergone surgery and are pending post-op findings per Recommendations 10-12, OR
Have a BMI > or equal to 35 kg/m (pending sleep study).
BMI cutoff of 33 is supported by studies (MRB).
BMI cutoff should be objectively related to crash risk (Conway).
RECOMMENDATION 4 — Conditional certification
Driver with BMI > or equal to 35 kg/m may be certified for 60 days pending sleep study and treatment (if diagnosed with OSA).
Within 60 days, if a driver being treated with OSA is compliant with treatment (per Recommendations 8-12), the driver may receive additional 90 day conditional certification.
After 90 days, if the driver is still compliant with treatment, the driver may be certified for no more than 1 year. Future certification dependent on continued compliance.
Refer to Recommendation 1 for definition of minimal compliance. [Insert clinical evaluation educational footnote]
[CLINICAL EVALUATION EDUCATION FOOTNOTE]
Medical examiners should screen all drivers for OSA.
The driver is judged at-risk for OSA based on:
The driver’s answers to a validated questionnaire (e.g., Berlin), OR *Some other validated screening tool.
Symptoms: loud snoring, witnessed apneas, sleepiness during major wake period.
Risk factors may include the following. A single risk factor alone may not infer risk. Need to look at multiple factors.
Factors contributing to high risk
Neck size > 17” male, 15.5” female (strongly correlated with obesity, which is associated with sleep apnea)
Age 42 and aove
BMI > 28 kg/m
Small airway (Mallampati Scale score of Class 3 or 4)
Experienced a single-vehicle crash
Conditions associated with high risk:
RECOMMENDATION 5 — Method of diagnosis and severity
Methods of diagnosis include in-laboratory polysomnography, at-home polysomnography OR a FDA-approved limited channel ambulatory testing device which ensures chain of custody.
In-laboratory polysomnography, which is more comprehensive, should be considered when the clinician suspects a sleep disorder in addition to sleep apnea.
Note that new technologies will likely emerge that will be able to screen for OSA.
Driver should be tested while on usual chronic medications.
Note that the joint medical committee did not consider AHI levels from unattended studies, but only in-lab sleep studies, which detect the arousal component of hypopneas (not just saturation).
An in-home sleep study may underestimate AHI when compared to an in-lab sleep study.
An AHI detected on an in-home sleep study may be less than an in-lab study because the in-home study likely does not consider total sleep time.
Therefore, the medical examiner should use clinical judgment when interpreting results of an unattended sleep study.
If the clinician believes the level of apnea is greater than the level reported by the in-home study, the clinician should consider recommending an in-laboratory sleep study.
RECOMMENDATION 6 — Treatment, PAP
All individuals with OSA should be referred to a clinician with relevant expertise.
PAP is the preferred OSA therapy.
Adequate PAP pressure should be established through one of the following:
Titration study with polysomnography
Auto-titration system
A driver who has been disqualified may be conditionally certified (per Recommendation 4) if successfully treated for 1 week AND
The driver can demonstrate at least minimal compliance (4 hrs/use 70% of nights) AND
The driver does not report excessive sleepiness during major wake period.
RECOMMENDATION 7 — Treatment alternatives
There are limited data regarding compliance with and the long-term efficacy of dental appliances cannot be demonstrated currently, so these technologies are unapproved alternatives at this time.
Surgical treatment is acceptable (see Recommendations 10, 11 and 12).
RECOMMENDATION 8 — Bariatric surgery
After bariatric surgery, a driver may be certified if:
Compliant with PAP, OR 6 months have passed since surgery (for weight loss), AND
Cleared by treating physician, AND
No reported excessive sleepiness during major wake period.
After six months have passed since surgery, a repeat sleep study may be considered to evaluate for the presence of ongoing sleep apnea.
If clinically indicated, repeat sleep study.
RECOMMENDATION 9 — Oropharyngeal surgery, facial bone surgery
After oropharyngeal or facial bone surgery, a driver may be certified if:
1 month has passed since surgery, AND
After 1 month has passed since surgery, if the apnea appears to have resolved, a repeat sleep study should be considered to test for the presence of ongoing sleep apnea.
RECOMMENDATION 10 — Tracheostomy
After tracheostomy, a driver may be certified if:
Transportation Companies May Be Affected by PPACA-Related
Health Insurance Marketplace Changes
Under the Patient Protection and Affordable Care Act(PPACA), employers covered by the Fair Labor Standards Act (FSLA) must providenotification to their employees about other aspects of the new health insurancemarketplace. This generally includes offices that have at least one employeeand conduct a minimum of $500,000 in annual business. Eligible employers--thismay include chiropractic offices--are required to provide this notice to allcurrent employees by Oct. 1 and to each new employee at the time of hirebeginning Oct. 1.
Your office may fall under the FLSA even if the gross salesor volume of business does not meet the requisite dollar volume of $500,000annually. Employees may still be covered if they individually engage ininterstate commerce, the production of goods for interstate commerce or in anoccupation closely related and directly essential to such production.Interstate commerce includes such activities as transacting business viainterstate telephone calls or the U. S. Mail (such as handling insuranceclaims), ordering or receiving goods from an out-of-state supplier, or handlingthe accounting or bookkeeping for such activities. It would also include thehandling of credit card transactions since that involves the interstate bankingand finance systems.
The U.S. Department of Labor (DOL) has providedemployers with two sample notices they may use to comply with this rule, onefor employers who do NOT offer a health plan and another for employers who DOoffer a health plan for some or all employees. For more information on whetheryour office falls under this requirement, please click here or refer to DOL'sTechnical Guidance or contact your attorney
Hours-of-ServiceLog book
Posted on Thursday, September 05, 2013 9:12 AM
· Limits themaximum average work week for truck drivers to 70 hours, a decrease from thecurrent maximum of 82 hours;
· Allows truckdrivers who reach the maximum 70 hours of driving within a week to resume ifthey rest for 34 consecutive hours, including at least two nights when theirbody clock demands sleep the most - from 1-5 a.m., and;
· Requirestruck drivers to take a 30-minute break during the first eight hours of ashift.
The final rule retains the current 11-hour daily drivinglimit and 14-hour work day.
Companies and drivers that commit egregious violations ofthe rule could face the maximum penalties for each offense. Trucking companiesand passenger carriers that allow drivers to exceed driving limits by more thanthree hours could be fined $11,000 per offense, and the drivers themselvescould face civil penalties of up to $2,750 for each offense.
Further information, including "Hours-of-ServiceLogbook Examples," is available on FMCSA's web site at www.fmcsa.dot.gov/HOS.
The staff at Trucker Exam Inc. believes that buildingcollaborative relationships with Transportation industry for the lasts nineteenyears. Our Certified DOT Doctor here to help achieve the best outcomes with truckdriver.
One call to our staff at 1.800.542.2225 will tell youeverything you need to know to refer a truck driver to Trucker Exam Inc. and,you can download DOT Medical order form you need right here.
Referral / Consult Form Process
Test and procedure referral forms are required Trucker Exam Inc.to schedule procedures. These forms must be completed and faxed to Trucker ExamInc. at 1.800.542.2225 Scheduling Center as indicated on each form.
Download Order and Referral / Consult Forms
All referral / consult forms are provided in .pdf format.
Fresno Ca , Las Vegas NV, Madera Ca
Posted on Saturday, August 10, 2013 3:03 PM
RIN: 2126–AB26 Docket #: FMCSA–2004-19608 49 CFR Part:385, 386, 390, 395
Publication Date:12/27/2011 Effective Date:2/27/2012 Compliance Date: 7/1/2013
Action :Final Rule
FMCSA revises the hours of service (HOS) regulations to limit the use of the 34-hour restart provision to once every 168 hours and to require that anyone using the 34-hour restart provision have as part of the restart two periods that include 1 a.m. to 5 a.m.
It also includes a provision that allows truckers to drive if they have had a break of at least 30 minutes, at a time of their choosing, sometime within the previous 8 hours.
This rule does not include a change to the daily driving limit because the Agency is unable to definitively demonstrate that a 10-hour limit—which it favored in the notice of proposed rulemaking (NPRM)—would have higher net benefits than an 11-hour limit.
The current 11-hour limit is therefore unchanged at this time. The 60- and 70-hour limits are also unchanged.
The purpose of the rule is to limit the ability of drivers to work the maximum number of hours currently allowed, or close to the maximum, on a continuing basis to reduce the possibility of driver fatigue.
Long daily and weekly hours are associated with an increased risk of crashes and with the chronic health conditions associated with lack of sleep. These changes will affect only the small minority of drivers who regularly work the longer hours.
The Federal Motor Carrier Safety Administration announced that during “enforcement activities‿ such as roadside inspections it will start validating drivers’ medical cards by contacting the certifying medical examiner to verify a driver’s name and date of birth and the card’s date of issuance and any restrictions it indicates. The FMCSR requires the th DOT medical card to be kept in the DQ file not the long form at present.
The FMCSR has a requirement for the long form and explains to physicians how it must be completed; however, the FMCSR does not address how the long form will be stored once it's filled We are waiting to see how the National Board of Physicians pans out as I know that doctors spend less than five minutes with a patient that most work is done by staff.
FRAUD WARNING from FMCSA...
Posted on Monday, June 24, 2013 6:01 PM
"There has been another round of fraudulent letters issued to U.S. Department of Transportation (DOT) contractors and potential contractors purporting to be issued by DOT. These fraudulent letters request that current or potential contractors register by submitting their company's financial information on a release form entitled, "Authorization to release financial information. Please DO NOT". Please be aware that DOT does not require any financial information to be submitted in order to be eligible for procurement. All letters were signed as the Senior Procurement Officer. Please Do Not complete the release form which is attached to the letter and DO NOT release any information to the facsimile number cited in the letter.
The point of contact concerning these fraudulent letters is the Department of Transportation Office of the Inspector General Hotline at 1-800-424-9071."
Asthma is a common disease. Individuals with asthma generally exhibit reversible airway obstruction that can be treated effectively with pharmaceutical agents such as bronchodilators and corticosteroids; however, asthma ranges in severity from essentially asymptomatic to potentially fatal.
In some drivers, complications of asthma and/or side effects of therapy may interfere with safe driving. You are responsible on a case-by-case basis for ensuring that the driver is medically fit for duty.
MEDICAL QUALIFICATIONS FOR COMMERCIAL DRIVERS LICENSE (CDL).
A person shall not drive a commercial motor vehicle unless he/she is physically qualified to do so and, except as provided in §391.67, must have on his/her person
the original, or a photographic copy, of a medical examiner's certificate to show that he/she is physically qualified to drive a commercial motor vehicle.
Physical Qualifications (49 CFR Part 391.41)
Medical Certificate Instructions New
Medical Examination Form (PDF)
General Qualifications (49 CFR Part 391.11)
DOT Procedures for Drug and Alcohol Testing (49 CFR Part 40)
Waivers/Exemptions/Pilot Programs (49 CFR Part 381)
Alternative Physical Qualifications for Loss/Impairment of Limbs (49 CFR Part 391.49)
Medical Evaluation Conflict Resolution (49 CFR Part 391.47)
Intra-City Zone Driver Limited Exemptions (49 CFR Part 391.62)
Vision & Diabetes Waiver Grand fathering Study (49 CFR Part 391.64)
CMV drivers are prohibited from testing while driving. So what qualifies as testing? Texting means manually entering alphanumeric text into, or reading text from, an electronic device. This includes, but is not limited to, short message service, e-mailing, instant messaging, a command or request to access a Web page, or pressing more than a single button to initiator terminate a voice communication using a mobile phone.
Use of mobile phones is restricted for CVM drivers
This ruling restricts a CVM driver from reaching for or holding a mobile phone to conduct a voice communication, as well as dialing by pressing more than a single button. CVM drivers who use a mobile phone while driving can only operate a hands-free phone located in close proximity. Inshore, the rule prohibits unsafely reaching for a device, holding a mobile phone, or pressing multiple buttons.
The rules impose sanctions for driver offenses, including civil penalties up to $2,750 and disqualification for multiple offenses. Motor carriers are also prohibited from requiring or allowing their drivers to text or use a hand-held mobile phone while driving and may be subject to civil penalties up to $11,000. Violations will impact ISMS results. Texting and calling on a hand-held phone carry the worst possible violation severity weights against a driver’s results!
For the rest of the story:cal 800.542.2225
NRCME News:
Posted on Sunday, April 21, 2013 7:07 PM
NRCME announces that there is a new Hearing Exemption that has been added to the insulin, vision, and Epilepsy/Seizure exemption programs. Certain drivers that do not meet the hearing standard in either ear may apply for the hearing exemption. The phone number for criteria used for those who may apply to either the hearing or seizure exemptions is thru the Medical Programs phone number at 202-366-4001. The insulin and vision exemption program contact number is still 703-448-3094.
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