stress tests, worksheets, and original tracings, as needed, to adequately assess medical fitness for
duty.
NOTE: If a
driver gives a "Yes" answer to the question regarding heart surgery, obtain documentation
fr
om the cardiologist before certifying. Also, FMCSA medical guidelines recommend not to certify the
driver who has an ICD, due to risk of syncope and gradual or sudden incapacitation while driving a
CMV. This includes a dual pacemaker/ICD, even if the ICD has not been activated.
High blood pressure
Ask about the history, diagnosis, and treatment of hypertension. In addition, talk with the driver about
his/her response to prescribed medications.
Hypertension alone is unlikely to cause sudden collapse. The likelihood inc
reases, however, when
there is target organ damage, particularly cerebral vascular disease. Recommending specific therapy
is beyond the scope of the physical examination. As a medical examiner, though, you are concerned
with the blood pressure response to treatment, and whether the driver is free of any effects or side
effects that could impair job performance.
Muscular disease
Ask the driver about history, diagnosis, and treatment of musculoskeletal conditions, such as
rhe
umatic, arthritic, orthopedic, and neuromuscular diseases. Does the diagnosis indicate that the
driver is at risk for sudden, incapacitating episodes of muscle weakness, ataxia, paresthesia,
hypotonia, or pain? Does the diagnosis indicate a degenerative process that over time will restrict
movements and eventually interfere with the ability to safely operate a CMV?
NOTE: In addition to driving, CMV driver duties include such rigorous activity as coupling and
unc
oupling trailers, loading and unloading trailers, inspecting the vehicle, lifting, installing tire chains,
climbing ladders, getting in and out of the cab, etc. Musculoskeletal diseases may adversely impact
the CMV driver’s muscle strength and agility needed to perform these nondriving tasks.
Shortness of breath (SOB)
Ask what acti
vities precipitate the episodes, nature, and characteristics of SOB. Does the driver
experience SOB only with exertion or also when at rest?
NOTE: Ac
cording to guidelines, many drivers may experience SOB while performing the nondriving
as
pects of their work (e.g., loading and unloading, etc.). However, most commercial drivers are not
short of breath while driving their vehicles. SOB while driving should trigger a more detailed
evaluation of the driver that can include consulting with an appropriate medical specialist.
L"0/&; L$(&'*M)R3'/.+% UT K FA"*A$"E
In addition to the guidance provided in the section above, directions specific to each category in Column 2
are listed below for each "Yes" answer. Feel free to ask other questions to help you gather sufficient
information to make your qualification/disqualification decision.
Lung disease, emphysema, asthma, chronic bronchitis
Ask about emergency room visits, hospitalizations, supplemental use of oxygen, use of inhalers and
other medications, risk of exposure to allergens, etc.
NOTE: Si
nce a driver must be alert at all times, any change in mental state is in direct conflict with
hi
ghway safety. Even the slightest impairment in respiratory function under emergency conditions
(when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
Page 30 of 260