The ABCs of DOT Physicals
Posted 5/29/2017 by UHBlog
While commercial trucks are vital to the nation’s economy, they also pose a huge risk to public safety. That’s why the Federal Motor Carrier Safety Administration (FMCSA) was established in 2000. FMCSA’s rules and regulations have driven down the number of accidents between large trucks and passenger vehicles, resulting in fewer injuries and lives lost.
Still, there are more improvements needed, especially when you consider the contributing factors – unsafe trucks and tired truckers – that persist, according to decades-long research by the Insurance Institute for Highway Safety (IIHS).
Many health issues can cause tiredness, which in turn leads to inattention to safe vehicle handling. To address this, the FMCSA – which is part of the Department of Transportation (DOT) – established stricter physical exam requirements in May 2014. These DOT physicals ensure drivers have the ability and qualifications to operate a commercial vehicle safely.
“The new medical exam rules did away with (drivers) using their family doctors, who may have only done one or two of the DOT physicals each year,” says occupational medicine specialist Paul Miotto, MD, who is a certified medical examiner on FMCSA’s National Registry. “Now the physicals can only be done by a certified medical examiner who is listed on the National Registry website.”
Medical examiners perform approximately 3 million exams on commercial truck and bus drivers each year, according to the FMCSA. In addition to being licensed by their state, certified medical examiners such as Dr. Miotto undergo training and testing prior to certification so they know the specific physical qualifications needed by a driver to operate a commercial vehicle safely. Medical examiners report driver exam results monthly via the National Registry system, and are subject to periodic monitoring and/or auditing, as well as continuing education and training. Finally, they must be re-certified every 10 years.
“Not every driver who has a commercial driver’s license is required to get a DOT physical,” Dr. Miotto says. “For drivers who operate a commercial vehicle with a gross weight of between 10,001 and 26,001 pounds or transport a certain number of individuals – such as nursing home van drivers – they need this type of physical. For companies that aren’t certain, the best thing to do is a quick phone call to the Ohio Bureau of Motor Vehicles.”
If your organization’s drivers are required to have the DOT medical exam, it will cover a range of conditions to determine their medical fitness, including cardiovascular disease, respiratory and muscular functions, vision and hearing. Commercial vehicle drivers must have the DOT physical once every two years, which is the maximum period they can be medically certified. Drivers with certain medical conditions may have to go more often for the DOT physical exam. Also, depending on the drivers’ health status, their certification may be short-term, covering only a six-month period.
“Drivers should schedule their DOT physicals several weeks prior to the medical examiner’s certificate expiration date, which is printed on their cards,” he says. “This will allow them the time necessary to correct any underlying medical conditions that may result in not medically qualifying for a card.”
For instance, if the driver’s blood pressure or diabetes isn’t under control, only a temporary card is given. The same goes for a driver who needs to wear hearing aids but may need them adjusted. Similarly, drivers with sleep apnea have to present a full year’s report showing their results from a continuous positive airway pressure (CPAP) therapy machine, which treats the condition. Otherwise, they only get a temporary card.
“We’re doing a complete exam like their family physician does, but with a number of extras,” Dr. Miotto says. "If they’re healthy and pass the physical exam, they’ll be given a two-year medical examiner’s certificate. But if they fail certain parts – such as vision, hearing or blood pressure – they may only be given a card that certifies them for three or six months, or one year. They’ll have to address the health issue, then come back again. While the driver might not be pleased, they understand the underlying reasons: It helps keep the drivers safe on the road, as well as the people they encounter while driving.”
Often, there is confusion about the process and in what order tasks should be completed. For instance, some people obtain their commercial driver’s licenses first and then go in for the DOT physical. If, during the exam, it’s learned they have certain conditions – such as a seizure disorder or uncorrectable vision in one eye – they can’t be issued a medical examiner’s certificate.
“With these big commercial vehicles, you can almost think of them as a weapon on the road,” he says. “They can do a lot of damage to a lot of people if the driver is incapacitated. By ensuring the drivers of these large trucks are healthy, that helps to protect the passengers who are being transported by that driver or are traveling in smaller vehicles along the same roads.”
To learn more about University Hospitals’ occupational health and safety services, connect with University Hospitals Employer Solutions for more information.
Paul Miotto, MD is an occupational medicine specialist and medical director for University Hospitals Occupational Health at University Hospitals Elyria Medical Center Occupational Medicine. You can request an appointment with Dr. Miotto or any other doctor online.