How does the FMCSA makes decisions on medical standards for truckers, CMV drivers?

Medical expert panels make recommendations through Medical Expert Panels (MEPs) program, yet truckers with serious medical conditions are still behind the wheel

The Federal Motor Carrier Safety Administration (FMCSA) has certain medical requirements which any person must satisfy before he or she may be eligible to operate a commercial  motor vehicle.

For example, as we’ve discussed on our blog before, truck drivers must meet a certain threshold for hearing ability (but it is also noteworthy that the FMCSA has the power to waive certain requirements.

This raises an interesting question: How does an agency that is tasked with regulating  highway safety determine the appropriate medical standards for truck drivers?

To help the FMCSA maintain helpful and relevant medical standards for commercial truck drivers, the agency has created a Medical Expert Panels (MEPs) program. The program allows the FMCSA to establish medical advisory boards to provide valuable input regarding medical fitness requirements. The mission of the MEPs is “to improve highway safety by… expert opinion and advice on medical standards and guidance and research on the medical certification of commercial motor vehicle (CMV) drivers.”

The panels are constantly working with the agency to update and evaluate current medical fitness for duty standards, and the guidelines for commercial drivers who operate large semi-trucks, buses or other commercial vehicles.

MEPs are comprised of a number of experienced researchers and clinicians who have experience dealing with evidence-based medicine. Each individual MEP is comprised of an independent panel of physicians, clinicians and scientists. These panelists are experts in their respective fields. The MEP team then conducts primary research on relevant medical issues, reviews similar research conducted by other bodies, and then performs analyses “using quantitative and qualitative models to develop evidence-based recommendations” for the FMCSA.  The recommendations are submitted to the agency in the form of a report.

For example, recently the FMCSA, at the recommendation of the MEP, changed the medical testing requirements for potential truck drivers who have a BMI above 35.  This is an example of the MEP making medical suggestions in the face of new medical knowledge and advances, as the effects of sleep apnea and dangers such as driver fatigue have become better understood.

MEP reports are available online for review by the general public.  You can take a look at the executive summaries of evidence reports, including the MEP recommendation reports.

Here’s more information about the FMCSA’s Medical Program.

But why are truck drivers with serious medical conditions still driving?

It’s important to note that while the FMSCA sets medical standards for truck drivers, there are many truck drivers or motor carriers who ignore the laws and find ways around them. There are nearly 600,000 commercial truck drivers with dangerous medical conditions and who qualify for full federal disability payments driving on the roads today, according to a U.S. Government Accountability Office study from 2010.  As a lawyer who handles serious truck accident cases around the country, I see how these dangerous medical conditions cause otherwise completely preventable truck wrecks that injure and kill innocent people on our roadways.

Here’s something just as disturbing:  A random analysis of truck drivers by the Government Accountability Office (GAO) found 22 percent were driving while receiving disability benefits for epilepsy, alcohol addiction or drug dependence.

Again, this is consistent with our own experience, and is a reason why so many truckers try to flee the accident scene after they have killed someone – because they know the blood test will show positive. In many instances, the trucking company’s safety director encourages this, because it is better to pay an insignificant fine, than it is to pay a significant punitive damages claim for knowingly letting a drug addicted or alcoholic driver get behind the wheel of a tractor trailer and kill someone.

Shockingly, the biggest reason this still happens is because there is a flaw in how truck drivers are examined. Truck drivers with dangerous medical conditions know which doctors will say they can still drive.  They will  go to certain doctors who they know will write them a clean bill of health, regardless of what their actual health actually is, or how dangerous they might be to others on the road.  Some truck companies exacerbate this problem by failing to be the final safety check in the process, failing to properly screen truckers and failing to enforce mandatory federal safety rules that require drivers to meet  basic health standards.

Here are the  FMCSA basic physical requirements that any trucker must meet to drive a truck, according to 49 CFR: 391.41. Truck drivers are required to not have any of the following conditions that could potentially interfere with operation of a commercial motor vehicle:

• Impairments of the foot, leg, hand, arm or finger.
• Epilepsy.
• Psychiatric conditions.
• High blood pressure.
• Insulin dependent diabetes.
• Specific cardiovascular or respiratory conditions.