FMCSA Requires Use of New Health Form Detailing More Thorough Medical Histories
This story appears in the April 25 print edition of Transport Topics.
A new version of the commercial vehicle driver medical examination report form requires truckers to provide more thorough medical histories and answer more questions.
Examiners say the new form, required as of April 20, could generate more exemption requests to the Federal Motor Carrier Safety Administration from drivers who have disqualifying conditions.
“There really are a lot of changes to the form, and there are underlying changes that are game changers that drivers don’t even know about,” said Michael Megehee, an FMCSA-certified medical examiner and president of TeamCME, a nationwide network of medical examiners.
For example, Megehee said one of the changes is that the form makes clear drivers must list their complete medical histories, rather than just illnesses or injuries the past five years.
In addition, several questions probe more deeply for signs of obstructive sleep apnea, a focus of FMCSA due to its potential relationship with fatigue, said Brian Morris, associate medical director for AllOne Health.
“There are pros and cons to the new form,” said Morris, also a member of FMCSA’s medical review board. “The intent of the form, based on what I see, is to get a more thorough medical history from the drivers than ever before.”
Morris added, “It’s a way of keeping people honest. The history is more important than the actual exam, in my opinion.”
FMCSA spokesman Duane DeBruyne said that there have been no changes to medical regulations, and the revised form is simpler and more efficient than the old form.
The revised medical examination report form “reflects current medical terminology and examination components and is an encompassing, ‘self-contained’ document” that will be electronically transmitted to state agencies and provide cost savings to motor carriers, drivers, medical examiners, the states and to FMCSA,” DeBruyne told Transport Topics.
The form seeks answers to 32 questions about medical conditions or problems, compared with 26 on the now-defunct form, adding such questions as whether drivers have, or ever have had, cancer, broken bones or high cholesterol.
Many questions are asked in a more open-ended manner, intended to encourage discussion with the examiner.
For example, the form asks if a driver has eye problems or ear and/or hearing problems. The old form is more specific, asking if a driver has eye disorders or impaired vision or ear disorders, loss of hearing or balance.
The new form also adds such questions as, “Have you ever spent a night in the hospital? Have you ever had a sleep test? Do you currently drink alcohol?”
It also requires that examiners take drivers’ blood pressure in a sitting position, not allowing it to be taken lying down. Blood pressure readings tend to register lower when taken from a reclining position.
Morris said some of the common complaints he’s heard about the form from fellow medical examiners are over the new “not sure” response, a lack of spec-?ific numbers on what constitutes high blood pressure, no requirement to calculate a body mass index number and not enough room on the form for a driver’s medical history.
Megehee said one of the major changes that drivers might not appreciate is a requirement for a follow-up exam if there is a 90-day medical certificate due to high blood pressure — the most common problem that examiners diagnose.
“If he comes back the next day and his blood pressure is now acceptable and you issue a new card, you have to perform a full, complete new exam on that day,” MeGehee said. “That means two exams, and I’m going to guess that drivers aren’t going to get that second exam for free.”
However, the new form allows physicians to issue a “determination pending” exam report if they are uncertain whether to disqualify a driver. In that case, the driver would be allowed to drive until his current medical card expires.
“This allows the medical examiner to delay, by up to 45 days, the decision on whether to issue a card,” Megehee said.
Morris said he has been using the new form for a few months, but has received few, if any, complaints from drivers that it is too burdensome.
