The Louisiana Department of Public Safety & Corrections Office of Motor Vehicles CDL Physical Examination Form is an essential document for commercial drivers in Louisiana, ensuring that they meet the Department of Transportation's health standards. On a specific examination date, drivers can apply for new certifications, re-certifications, or follow-ups depending on their situation. Initially, the driver provides personal and health history information, which is crucial for the medical examiner to understand any past illnesses or injuries that could affect driving ability. The form extensively covers a variety of health aspects, including vision and hearing standards, blood pressure and pulse rate measurements, and a thorough physical examination checking for conditions that could impede safe driving. Specific tests, like urinalysis, are required to unearth any underlying medical issues. Moreover, the form takes a holistic look at the driver's ability to perform under various physical conditions and does not solely focus on current health status but considers the impact of potential side effects from medications, both prescribed and over-the-counter. The comprehensive review aims at ensuring public safety by allowing only those meeting stringent health criteria to operate commercial vehicles, with the medical examiner's certification confirming the driver's fitness for duty. This process underscores the importance of health in maintaining high standards of road safety and professionalism within the commercial driving sector.
Question | Answer |
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Form Name | Louisiana Form Cdl Physical |
Form Length | 8 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 2 min |
Other names | louisiana dot physical form, louisiana physical examination, la cdl physical, louisiana cdl medical card renewal |
Louisiana Department of Public Safety & Corrections
Office of Motor Vehicles
CDL PHYSICAL EXAMINATION FORM
(Meets Department of Transportation Requirements)
Date of Examination: _____________ |
New Certification |
Follow up
1. DRIVER’S INFORMATION: Driver completes this section.
Driver’s Name: ______________________________________________________________________________________________________
Address: ___________________________________________________________________________________________________________
Soc. Sec. No. ___________________________________ Date of Birth _____________________ Age ___________ Race/Sex ____________
Driver’s License No. _______________________ Class ______ State ______ Telephone: ___________________________________________
2. HEALTH HISTORY: Driver completes this section, but medical examiner is encouraged to discuss with driver.
Yes No |
Yes No |
Any illness or injury in last 5 years? |
Diabetes or elevated blood sugar controlled by: |
Head/Brain injuries, disorders or illnesses |
diet |
Seizures, epilepsy |
pills |
If yes, specify medication ____________________________ |
insulin |
Eye disorders or impaired vision (except corrective lenses) |
Nervous or psychiatric disorders, severe depression |
Ear disorders, loss of hearing or balance |
If yes, specify medication _____________________________ |
Heart disease or heart attack; other cardiovascular condition |
Loss of or altered consciousness |
If yes, specify medication ____________________________ |
Fainting, dizziness |
Heart surgery (valve replacement/bypass, angioplasty, |
Sleep disorders, pauses in breathing while asleep, |
pacemaker) |
daytime sleepiness, loud snoring |
High blood pressure |
Stroke or paralysis |
If yes, specify medication ___________________________ |
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Muscular disease |
Missing or impaired hand, arm, foot, leg, finger or toe |
Shortness of breath |
Spinal injury or disease |
Lung disease, emphysema, asthma, chronic bronchitis |
Chronic low back pain |
Kidney disease, dialysis |
Regular, frequent alcohol use |
Liver disease |
Narcotic or habit forming drug use |
Digestive problems |
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For any YES answer, indicate onset date, diagnosis, treating physician’s name and address, and any current limitations. List all medications (including over the counter medications) used regularly or recently.
I certify that the above information is complete and true. I understand that inaccurate, false or missing information may invalidate the examination and my Medical Examiner’s Certificate.
Driver’s Signature |
Date |
Medical Examiners’s Comments on Health History (The medical examiner must review and discuss with the driver any YES answers and potential hazards of medications including
Is the condition(s) likely to hamper the driver’s ability to control and/or safely operate a commercial motor vehicle? Yes
No
Does treatment/medication utilized cause any side affects that are likely to hamper the ability to control and/or safely operate a commercial motor
vehicle? Yes No
NAME: __________________________________________________
TESTING Medical examiner completes Section 3 through 7
3.VISION: Standard: At least 20/40 distance acuity (Snellen) in each eye with or without correction. At least 70 degree peripheral in horizontal meridian measured in each eye. The use of corrective lenses should be noted on the Medical Examiner’s Certification.
INSTRUCTIONS: When other than the Snellen chart is used, give test results in
Numerical reading must be provided:
ACUITY (Distance) |
UNCORRECTED |
CORRECTED |
HORIZONTAL FIELD OF VISION |
Can applicant recognize and distinguish |
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Right Eye |
20/______ |
20/______ |
Right Eye |
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degrees |
among traffic control signals and devices |
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Left Eye |
20/______ |
20/______ |
Left Eye |
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degrees |
showing standard red, green and amber |
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Both Eyes |
20/______ |
20/______ |
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colors? Yes |
No |
Applicant meets visual acuity requirement only when wearing:______ Corrective lenses
Monocular Vision?: Yes
No
Complete next line only if vision testing is done by an ophthalmologist or optometrist:
Date of Exam |
Printed Name of Ophthalmologist/Optometrist |
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Signature |
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Telephone Number |
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License No/State of Issue |
4.HEARING: Standard: a) Must first perceive forced whispered voice > 5 ft., with or without hearing aid, or b) average hearing loss in better ear < 40 dB.
Check if hearing aid used for tests. |
Check if hearing aid required to meet standard |
INSTRUCTIONS: To convert audiometric test results from ISO to ANSI,
Numerical readings must be recorded. |
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A) Record distance from individual at which forced whispered voice can first be heard. |
Right Ear _______ ft. |
Left Ear _______ ft. |
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B) If audiometer is used, record hearing loss in decibels. |
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500 Hz |
1000 Hz |
2000 Hz |
Average |
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(Acc. To ANSI |
Right Ear |
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______ |
______ |
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Left Ear |
______ |
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______ |
______ |
5.BLOOD PRESSURE/PULSE RATE - Numerical readings must be recorded. Medical Examiner should take at least two readings to confirm BP.
Blood |
Systolic |
Diastolic |
Pressure
Driver qualified if <140/90.
Pulse Rate: Regular Irregular
Record Pulse Rate:
Reading |
Category |
Expiration Date |
Recertification |
Stage 1 |
1 year |
1 year if <140/90. |
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months if |
Stage 2 |
1 year from date of exam if |
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< 140/90 |
>180/110 |
Stage 3 |
6 months from date of exam if <140/90 |
6 months if <140/90 |
NOTE: Medical Examiner should take at least 2 readings to confirm blood pressure prior to posting reading on this form.
NAME: ___________________________________________________
6. LABORATORY AND OTHER TEST FINDINGS Numerical readings must be recorded.
Urinalysis is required. Protein, blood or sugar in the urine may be an indication for further testing to rule out any underlying medical problems.
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Sp. Gr. |
Protein |
Blood |
Sugar |
URINE SPECIMEN: |
_______________ |
_______________ |
_______________ |
_______________ |
Other Tests (Describe and record) ______________________________________________________________________________________
7. PHYSICAL EXAMINATION Height: ____________ (inches) Weight: ____________ (lbs)
The presence of a certain condition may not necessarily disqualify a driver, particularly if the condition is controlled adequately and is not likely to worsen or is readily amendable to treatment. Even if a condition does not disqualify a driver, the medical examiner may consider deferring the driver temporarily. Also, the driver should be advised to take the necessary steps to correct the condition as soon as possible particularly if the condition, if neglected, could result in more serious illness that might affect driving.
Check YES if there are any abnormalities. Check NO if the body system is normal. Discuss any YES answers in detail in the space below and indicate whether it would affect the driver’s ability to operate a commercial motor vehicle safely. Enter applicable item number before each comment. If organic disease is present, note that it has been compensated for. See Instructions to the Medical Examiner for guidance.
BODY SYSTEM |
CHECK FOR: |
YES* |
NO |
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1. |
General appearance |
Marked overweight, tremor, signs of alcoholism, problem drinking, |
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or drug abuse. |
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2. |
Eyes |
Pupillary equality, reaction to light, accommodation, ocular motility, |
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ocular muscle imbalance, extraocular movement, nystagmus, |
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exophthalmos, strabismus uncorrected by corrective lenses, retinopathy, |
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cataracts, aphakia, glaucoma, macular degeneration. Refer to a |
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specialist if appropriate. |
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3. |
Ears |
Scarring of the tympanic membrane, occlusion of external canal, |
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perforated eardrums. |
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4. |
Mouth and Throat |
Irremediable deformities likely to interfere with breathing or swallowing. |
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5. |
Heart |
Murmurs, extra sounds, enlarged heart, pacemaker, implantable |
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defibrillator. |
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6. |
Lungs and chest, |
Abnormal chest wall expansion, abnormal respiratory rate, abnormal |
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not including breast |
breath sounds including wheezes or alveolar rates, impaired respiratory |
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examination |
function, cyanosis. Abnormal findings on physical exam may require |
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further testing such as pulmonary tests and/or |
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7. |
Abdomen and Viscera |
Enlarged liver, enlarged spleen, masses, bruits, hernia, significant |
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abdominal wall muscle weakness. |
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8. |
Vascular system |
Abnormal pulse and amplitude, carotid or arterial bruits, varicose veins. |
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9. |
Hernias. |
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10. |
Extremities - Limbs |
Loss or impairment of leg, foot, toe, arm, hand, finger. Perceptible limp, |
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impaired. Driver may |
deformities, atrophy, weakness, paralysis, clubbing, edema, hypotonia. |
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be subject to SPE |
Insufficient mobility and strength in lower limb to operate pedals properly. |
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certificate if otherwise |
Insufficient grasp and prehension in upper limb to maintain steering |
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qualified. |
wheel grip. |
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11. |
Spine, other |
Previous surgery, deformities, limitation of motion, tenderness |
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musculoskeletal |
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12. |
Neurological |
Impaired equilibrium, coordination or speech pattern; paresthesia, |
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asymmetric deep tendon reflexes, sensory or positional abnormalities, |
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abnormal patellar and Babinski’s reflexes, ataxia. |
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*Comments
NAME: ______________________________________________________
Note certification status here. See Instructions to the Medical Examiner for guidance.
I certify that ________________________________________________________________________________________________________
Name of Driver
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Meets standards in 49 CRF |
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Wearing corrective lenses |
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Wearing hearing aid |
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Does not meet standards |
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Accompanied by a______waiver/exemption |
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Skill Performance Evaluation (SPE) Certificate |
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Meets standards, but periodic evaluation required. |
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Driving within an exempt |
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Qualified by operation of 49 CFR 391.64 |
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(vision or insulin dependent waiver program) |
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Due to ___________________________driver qualified only for: |
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3 months |
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1 year |
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6 months |
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Other |
Temporarily disqualified due to (condition or medication): _____________________________________________________________
Return to medical examiner’s office for follow up on: ________________________________________________________________________
Name of medical examiner (print) |
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Signature of medical examiner |
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Address of medical examiner |
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Telephone number of medical examiner |
If meets standards, complete a Medical Examiner’s Certificate (at the back of
this form) as stated in 49 CFR 391.43(h).
TO BE COMPLETED BY PATIENT
I hereby authorize and request the physician who has examined and whose signature appears above to release all information and findings contained herein to the Louisiana Department of Public Safety and Corrections. The Louisiana Department of Public Safety and Corrections can release this information to such individuals or groups as may be considered necessary and appropriate to determine my ability to safely operate a commercial motor vehicle.
Date |
Signature of Patient |
OMV COMPLETES THIS SECTION
REVIEWED BY
DATE
FIELD OFFICE
APP. DATE
HEADQUARTER’S REVIEW
49 CFR 391.41
Physical Qualifications for Drivers
THE DRIVER’S ROLE
Responsibilities, work schedules, physical and emotional demands, and lifestyles among commercial drivers vary by the type of driving that they do. Some of the main types of drivers include the following: turn around or short
relay (drivers return to |
their home base each |
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evening); long relay |
(drivers drive |
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then have at least a |
10 |
hour |
straight through haul |
(cross country drivers); and |
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team drivers (drivers |
share the driving by |
alternating their
The following factors may be involved in a driver’s performance of duties: abrupt schedule changes and rotating work schedules, which may result in irregular sleep patterns and a driver beginning a trip in a fatigued condition; long hours; extended time away from family and friends, which may result in lack of social support; tight pickup and delivery schedules, with irregularity in work, rest, and eating patterns, adverse road , weather and traffic conditions, which may cause delays and lead to hurriedly loading or unloading cargo in order to compensate for the lost time; and environmental conditions such as excessive vibration, noise, and extremes in temperatures. Transporting passengers or hazardous materials may add to the demands on the commercial driver.
There may be duties in addition to the driving task for which a driver is responsible and needs to be fit. Some of these responsibilities are: coupling and uncoupling trailer(s) from the tractor; loading and unloading trailer(s) (sometimes a driver may lift a heavy load or unload as much as 50,000 pounds of freight after sitting for a long period of time without any stretching period); inspecting the operating condition of tractor and trailer(s) before, during, and after delivery of cargo; lifting, installing and removing heavy tire chains; and lifting heavy tarpaulins to cover open top trailers. The above tasks demand agility, the ability to bend and stoop, the ability to maintain a crouching position to inspect the underside of the vehicle, frequent entering and exiting of the cab, and the ability to climb ladders on the tractor and/or trailer(s).
In addition, a driver must have the perceptual skill to monitor a sometimes complex driving situation, the judgment skills to make quick decisions, when necessary, and the manipulative skills to control an oversize steering wheel, shift gears using a manual transmission, and maneuver a vehicle in crowded areas.
391.41PHYSICAL QUALIFICATION FOR DRIVERS
a)A person shall not drive a commercial motor vehicle unless he is physically qualified to do so
and, except as provided in 391.67, has on his person the original, or a photographic copy, of a medical examiner’s certificate that he is physically qualified to drive a commercial motor vehicle.
b)A person is physically qualified to drive a motor vehicle if that person:
1)Has no loss of a foot, a leg, a hand, or an arm, or has been granted a Skill Performance Evaluation (SPE) Certificate (formerly Limb Waiver Program) pursuant to 391.49.
2) Has no impairment of; (i) A hand or finger which interferes with prehension or power grasping; or (ii) An arm, foot, or leg which interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; or any other significant limb defect or limitation which interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; or has been granted a SPE Certificate pursuant to 391.49.
3) Has no established medical history or clinical
diagnosis of diabetes mellitus currently requiring insulin for control;
4)Has no 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 cardiac failure.
5)Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with his ability to control and drive a commercial motor vehicle safely.
6)Has no current clinical diagnosis of high blood pressure likely to interfere with his ability to operate a commercial motor vehicle safely.
7)Has no established medical history or clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease which interferes with his ability to control and operate a commercial motor vehicle safely.
8)Has 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 commercial motor vehicle.
9)Has no mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with his ability to drive a commercial motor vehicle safely.
10)Has distant visual acuity of at least 20/40 (Snellen) in each eye without corrective lenses or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses, distant binocular acuity of at least 20/40 (Snellen) in both eyes with or without corrective lenses, field of vision of at least 70 degrees in the horizontal meridian in each eye, and the ability to recognize the colors of traffic signals and devices showing standard red, green and amber.
11) First perceives a forced whispered voice in the better ear not less than 5 feet with or without the use of a hearing aid, or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to American National Standard (formerly ASA Standards)
12)(i) Does not use a controlled substance identified in 21 CFR 1308.11 Schedule I, an amphetamine, a narcotic, or any other
(A)Is familiar with the driver’s medical history and assigned duties; and (B) has advised the driver that the prescribed substance or drug will not adversely affect the driver’s ability to safely operate a commercial motor vehicle.
13) Has no current clinical diagnosis of alcoholism. For further information, see INSTRUCTIONS TO MEDICAL EXAMINER included in this form.
INSTRUCTIONS TO THE MEDICAL EXAMINER
General Information
The purpose of this examination is to determine a driver’s physical qualification to operate a commercial motor vehicle (CMV) in interstate commerce according to the requirements in 49 CFR
In addition to reviewing the Health History section with the driver and conducting the physical examination, the medical examiner should discuss common prescriptions and
examiner in light of the driver’s job responsibilities, work schedule and potential for the condition to render the driver unsafe.
Medical conditions should be recorded even if they are not cause for denial, and they should be discussed with the driver to encourage
appropriate remedial care. This advice is especially needed when a condition, if neglected, could develop into a serious illness that could affect driving.
If the medical examiner determines that the driver is fit to drive and is also able to perform
Interpretation of Medical Standards
Since the issuance of the regulations for physical qualifications for commercial drivers, the Federal Motor Carrier Safety Administration (FMCSA) has published recommendations called Advisory Criteria to help medical examiners in determining whether a driver meets the physical qualifications for commercial driving. These recommendations have been condensed to
provide information to medical examiners that (1) is directly relevant to the physical examination and
(2)is not already included in the medical examination form. The specific regulation is printed in italics and its reference by section is highlighted.
Federal Motor Carrier Safety Regulations
Loss of Limb: 391.41(b)(1)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no loss of a foot, leg, hand or an arm, or has been granted a Skill Performance Evaluation (SPE) Certificate pursuant to Section 391.49.
Limb Impairment: 391.41(b)(2)
A person is physically qualified to drive a commercial motor vehicle if that person: Has no i m p a i r m e n t o f . , ( i ) A h a n d o r f i n g e r w h i c h interferes with prehension or power grasping; or
(ii)An arm, foot, or leg which interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; or (iii) Any other significant limb defect or limitation which interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; Perform normal tasks associated with operating a commercial motor vehicle; or (iv) Has been granted a Skill Performance Evaluation Certificate pursuant to Section 391.49.
A person who suffers loss of a foot, leg, hand or arm or whose limb impairment in any way interferes with the safe performance of normal tasks associated with operating a commercial motor vehicle is subject to the Skill Performance Evaluation (SPE) Certification Program pursuant to Section 391 . 49, assuming the person is otherwise qualified.
With the advancement of technology, medical aids and equipment modifications have b e e n d e v e l o p e d t o c o m p e n s a t e f o r c e r t a i n
disabilities . The SPE Certification Program (formerly the Limb Waiver Program) was designed to allow persons with the loss of a foot or limb or with functionai impairment to qualify under the Federal Motor Carrier Safety Regulations (FMCSRs) by use of prosthetic devices or equipment modifications which enable them to safely operate a commercial motor vehicle. Since there are no medical aids equivalent to the original body or limb, certain risks are still present, and thus restrictions may be included on individual SPE certificates when a State Director for the FMCSA determines they are necessary to be consistent with safety and public interest.
If the driver is found otherwise medically qualified (391.41(b)(3) through (13)), the medical examiner must check on the medical certificate that the driver is qualified only if accompanied by a SPE certificate. The driver and the employing motor carrier are subject to appropriate penalty if the driver operates a commercial motor vehicle in interstate or foreign commerce without a current SPE certificate for his/her physical disability.
Diabetes: 391.41(b)(3)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis for diabetes mellitus currently requiring insulin for control.
Diabetes mellitus is a disease which, on occasion, can result in a loss of consciousness or disorientation in time and space. Individuals who require insulin for control have conditions which can get out of control by the use of too much or too little insulin, or food intake not consistent with the insulin dosage. Incapacitation may occur from symptoms of hyperglycemic or hypoglycemic reactions (drowsiness, semiconsciousness, diabetic coma or insulin shock).
The administration of insulin is, within itself, a complicated process requiring insulin, syringe, needle, alcohol sponge and a sterile technique. Factors related to
Hypoglycemic drugs, taken orally, are sometimes prescribed for diabetic individuals to help stimulate natural body production of insulin. If the condition can be controlled by the use of oral medication and diet, then an individual may be qualified under the present rule. CMV drivers who do not meet the Federal diabetes standard may call
(202)
NOTE: See Conference Report on Diabetic Disorders and Commercial Drivers and Insulin - U sing Commercial Motor Vehicle Drivers at: http:// www.fmcsa.dot.gov/rulesregs/medreports.htm
Cardiovascular Condition: 391.41(b)(4)
A person is physically qualified to drive a commercial motor vehicle if that person: Has no 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 cardiac failure.
The term “has no current clinical diagnosis of” is specifically designed to encompass: “a clinical diagnosis of” (1) a current cardiovascular condition, or (2) a cardiovascular condition which has not fully stabilized regardless of the time limit. The term “known to be accompanied by” is defined to include: a clinical diagnosis of a cardiovascular disease (1) which is accompanied by symptoms of syncope, dyspnea, collapse or congestive cardiac failure; and/or (2) which is likely to cause syncope,
dyspnea, collapse or congestive cardiac failure. It is the intent of the FMCSRs to render unqualified a driver who has a current cardiovascular
disease which is accompanied by and/or likely to cause symptoms of syncope, dyspnea, collapse, or congestive cardiac failure. However, the subjective decision of whether the nature and severity of an individual’s condition will likely cause symptoms of cardiovascular insufficiency is on an individual basis and qualification rests with the medical examiner and the motor carrier. In those cases where there is an occurrence of cardiovascular insufficiency (myocardial infarction, thrombosis, etc.) it is suggested before a driver is certified that he/she have a normal resting and stress electrocardiogram (ECG), no residual complications and no physical limitations, and is taking no medication likely to interfere with safe driving.
Coronary artery bypass surgery and pacemaker implantation are remedial procedures and thus, not unqualifying. Implantable cardioverter defibrillators are disqualifying due to risk of syncope. Coumadin is a medical treatment which can improve the health and safety of the driver and should not, by its use, medically disqualify the commercial driver. The emphasis should be on the underlying medical condition(s) which require treatment and the general health of the driver. The FMCSA should be contacted at (202)
NOTE: See Conference on Cardiac Disorders and
CommercialDriversat http://www.fmcsa.dot.gov/rulesregs/medreports.htm.
Respiratory Dysfunction: 391.41(b)(5)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with ability to control and drive a commercial motor vehicle safely.
Since a driver must be alert at all times, any change in his/her mental state is in direct conflict with highway safety. Even the lightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. If the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy. Anticoagulation therapy for deep vein thrombosis and/or pulmonary thromboembolism is not unqualifying once optimum dose is achieved, provided lower extremity venous examinations remain normal and the treating physician gives a favorable recommendation.
NOTE: See conference on pulmonary/respiratory
disorders and commercial drivers at: http://www.fmcsa.dot.gov/rulesregs/medreports.htm.
Hypertension: 391.41(b)(6)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no current clinical diagnosis of high blood pressure likely to interfere with ability to operate a commercial motor vehicle.
Hypertension alone is unlikely to cause sudden collapse; however, the likelihood increases when target organ damage, particularly cerebral vascular disease, is present. This regulatory criteria is based on FMCSA’s Cardiovascular Advisory Guidelines for the Examination of CMV Drivers, which used the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (1997).
Stage 1 hypertension corresponds to a systolic BP of
Certification examinations should be done annually thereafter and should be at or less than 140/90. If less than 160/100, certification may be extended one time for 3 months.
Ablood pressure of
A blood pressure at or greater than 180 (systolic) and 110 (diastolic) is considered Stage 3, high risk for an acute
Annual recertification is recommended if the medical examiner does not know the severity of hypertension prior to treatment.
An elevated blood pressure finding should be confirmed by at least two subsequent measurements on different days.
Treatment includes nonpharmacologic and pharmacologic modalities as well as counseling to reduce other risk factors. Most antihypertensive medications also have side effects, the importance of which must be judged on an individual basis. Individuals must be alerted to
the hazards of these medications while driving. Side effects of somnolence or syncope are particularly undesirable in commercial drivers.
Secondary hypertension is based on the above stages. Evaluation is warranted if patient is persistently hypertensive on maximal or near- maximal doses of
NOTE: See Cardiovascular Advisory Panel Guidelines for the Medical Examination of
Commercial Motor Vehicle Drivers at:
http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Rheumatic, Arthritic, Orthopedic, Muscular, Neuromuscular or Vascular Disease: 391.41(b)(7)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscular or vascular disease which interferes with ability to control and operate a commercial motor vehicle safely
Certain diseases are known to have acute episodes of transient muscle weakness, poor
muscular coordination (ataxia), abnormal sensations (paresthesia), decreased muscular tone (hypotonia), visual disturbances and pain which may be suddenly incapacitating. With each recurring episode, these symptoms may become more pronounced and remain for longer periods of time. Other diseases have more insidious onsets and display symptoms of muscle wasting (atrophy), swelling and paresthesia which may not suddenly incapacitate a person but may restrict his/her movements and eventually interfere with the ability to safely operate a motor vehicle. In many instances these diseases are degenerative in nature or may result in deterioration of the involved area.
Once the individual has been diagnosed as having rheumatic, arthritic, orthopedic, muscular, neuromuscular or vascular disease, then he/she has an established history of that disease . The physician, when examining an individual, should consider the following: (1) the nature and severity of the individual’s condition (such as sensory loss or loss of strength); (2) the degree of limitation present (such as range of motion); (3) the likelihood of progressive limitation (not always present initially but may manifest itself over time); and (4) the likelihood of sudden incapacitation. If severe functional impairment exists, the driver does not qualify. In cases where more frequent monitoring is required, a certificate for a shorter time period may be issued.
NOTE: See Conference on Neurological Disorders
andCommercial Driversat: http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Epilepsy: 391.41(b)(8)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has 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 motor vehicle.
Epilepsy is a chronic functional disease characterized by seizures or episodes that occur without warning, resulting in loss of voluntary control which may lead to loss of consciousness and/or seizures. Therefore, the following drivers cannot be qualified: (1) a driver who has a medical history of epilepsy; (2) a driver who has a current clinical diagnosis of epilepsy; or (3) a driver who is taking
If an individual has had a sudden episode of a
In those individual cases where a driver has a seizure or an episode of loss of consciousness that resulted from a known medical condition (e.g. drug reaction, high temperature, acute infectious disease, dehydration or acute metabolic disturbance), certification should be deferred until the driver has fully recovered from that condition and has no existing residual complications, and not taking
D r i v e r s w i t h a h i s t o r y o f e p i l e p s y / seizures off
NOTE: See Conference on Neurological Disorders
andCommercialDrivers at: http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Mental Disorders: 391.41(b)(9)
A person is physically qualified to drive a commercial motor vehicle if the person:
Has no mental, nervous, organic or functional disease or psychiatric disorder likely to interfere with the ability to drive a motor vehicle safely.
Emotional or adjustment problems contribute directly to an individual’s level of memory, reasoning, attention and judgment. These problems
often underlie physical disorders. A variety of functional disorders can cause drowsiness, dizziness, confusion, weakness or paralysis that may lead to incoordination, inattention, loss of functional control and susceptibility to accidents while driving. Physical fatigue, headache, impaired coordination, recurring physical, ailments and chronic “nagging” pain may be present to such a degree that certification for commercial driving is inadvisable. Somatic and psychosomatic complaints should be thoroughly examined when determining an individual’s overall fitness to drive. Disorders of a periodically incapacitating nature, even in the early stages of development, may warrant disqualification.
Many bus and truck drivers have documented that “nervous trouble” related to neurotic, personality, emotional or adjustment problems is responsible for a significant fraction of their preventable accidents. The degree to which an individual is able to appreciate, evaluate and adequately respond to environmental strain and emotional stress is critical when assessing an individual’s mental alertness and flexibility to cope with the stresses of commercial motor vehicle driving.
When examining the driver, it should be kept in mind that individuals who live under chronic emotional upsets may have deeply ingrained maladaptive or erratic behavior patterns. Excessively antagonistic, instinctive, impulsive, openly aggressive, paranoid or severely depressed behavior greatly interfere with the driver’s ability to drive safely. Those individuals who are highly susceptible to frequent states of emotional instability (schizophrenia, affective psychoses, paranoia, anxiety or depressive neuroses) may warrant disqualification. Careful consideration should be given to the side effects and interactions of medications in the overall qualification determination. See Psychiatric Conference Report for specific recommendations on the use of these medications and potential hazards for driving.
NOTE: See Conference on Psychiatric Disorders and
CommercialDriversat: http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Vision: 391.41(b)(10)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has distant visual acuity of at least 20/40 (Snellen) in each eye with or without corrective lenses or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses, distance binocular acuity of at least 20/40 (Snellen) in both eyes with or without corrective lenses, field of vision of at least 70 degrees in the horizontal meridian in each eye, and the ability to recognize the colors of traffic signals and devices showing standard red, green and amber.
The term “ability to recognize the colors of” is interpreted to mean if a person can recognize and distinguish among traffic control signals and devices showing standard red, green and amber, he or she meets the minimum standards, even though he or she may have some type of color perception deficiency. If certain color perception tests are administered, (such as Ishihara, Pseudoisochromatic, Yarn) and doubtful findings are discovered, a controlled test using signal red, green and amber may be employed to determine the driver’s ability to recognize these colors.
Contact lenses are permissible if there is sufficient evidence to indicate that the driver has good tolerance and is well adapted to their use. Use of a contact lens in one eye for distance visual acuity and another lens in the other eye for near vision is not acceptable, nor are telescopic lenses acceptable for the driving of commercial motor vehicles.
If an individual meets the criteria by the use of glasses or contact lenses, the following statement shall appear on the Medical Examiner’s Certificate: “Qualified only if wearing corrective lenses”.
CMV drivers who do not meet the Federal vision standard may call (202)
NOTE: See Visual Disorders and Commercial Drivers at: http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Hearing: 391.41(b)(11)
A person is physically qualified to drive a commercial motor vehicle if that person:
First perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid, or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to American National Standard (formerly ASA Standard)
Since the prescribed standard under the FMCSRs is the American Standards Association (ANSI), it may be necessary to convert the audiometric results from the ISO standard to the ANSI standard. Instructions are included on the Medical Examination report form.
If an individual meets the criteria by using a hearing aid, the driver must wear that hearing aid and have it in operation at all times w h i l e d r i v i n g . A l s o , t h e d r i v e r m u s t b e i n possession of a space power source for the hearing aid.
For the whispered voice test, the individual should be stationed at least 5 feet from the examiner with the ear being tested turned toward the examiner. The other ear is covered. Using the breath which remains after a normal expiration, the examiner whispers words or random numbers such as 66, 18, 23, etc. The examiner should not use only sibilants
If an individual meets the criteria by the use of a hearing aid, the following statement must appear on the Medical Examiner’s Certification “ Qualified only when wearing a hearing aid”.
NOTE: See Hearing Disorders and Commercial
M o t o rVe h i c l e D r i v e r s a t : http://www.fmcsa.dot.gov/rulesregs/medreports.htm
Drug Use 391.41(b)(12)
A person is physically qualified to drive a commercial motor vehicle if that person:
Does not use a controlled substance identified in 21 CFR 1308.11. Schedule 1, an amphetamine, a n a r c o t i c , o r a n y o t h e r h a b i t - f o r m i n g d r u g . Exception: A driver may use such a substance or drug, if the substance or drug is prescribed by a licensed medical practitioner who is familiar with the driver’s medical history and assigned duties; and has advised the driver that the prescribed substance or drug will not adversely affect the driver’s ability to safely operate a commercial motor vehicle.
This exception does not apply to methadone. The intent of the medical certification process is to medically evaluate a driver to ensure that the driver has no medical condition which interferes with the safe performance of driving tasks on a public road. If a driver uses a Schedule I drug or other substance, an amphetamine, a narcotic, or any other
A test for controlled substances is not required as part of this biennial certification process. The FMCSA or the driver’s employer should be contacted directly for information on controlled substances and alcohol testing under Part 382 of the FMCSRs.
The term “uses” is designed to encompass instances of prohibited drug use determined by a physician through established
medical means. This may or may not involve body fluid testing. If body fluid testing takes place, posi- tive test results should be confirmed by a second test of greater specificity. The term
The driver is medically unqualified for the duration of the prohibited drug(s) use and until a second examination shows the driver is free from the prohibited drug(s) use.
NOTE: See Conference on Neurological Disorders and Commercial Drivers Conference on Psychiatric Disorders and Commercial Drivers at: http://fmcsa.dot.gov/rulesregs/medreport.htm
Alcoholism: 391.41(b)(13)
A person is physically
qualified to drive a commercial motor vehicle if that person:
Has no current clinical diagnosis of alcoholism.
The term “current clinical diagnosis of” is specifically designed to encompass a current alcoholic illness or those instances where the individual’s physical condition has not fully stabilized, regardless of the time element. If an individual shows signs of having an
MEDICALEXAMINER’S CERTIFICATE
IcertifythatIhaveexamined____________________________________inaccordancewiththeFederalMotorCarrierSafetyRegulations(49CFR391.41-
391.49)andwithknowledgeofthedrivingduties,Ifindthispersonisqualified;and,ifapplicable,onlywhen:
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qualifiedbyoperationof49CFR391.64(visionorinsulindependent |
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TheinformationIhaveprovidedregardingthisphysicalexaminationistrueandcomplete. Acompleteexaminationformwithanyattachmentembodiesmy findingscompletelyandcorrectlyandisonfileinmyoffice.
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NOTE: DRIVERMUSTCARRYACOPYOFTHISCERTIFICATEWHENOPERATINGACOMMERCIAL VEHICLE.
DPSMV 2219 (R/12/03)