Draft Medical Examiners Handbook draws clear line between regs and guidance

July 11, 2019

Mark Schremmer


In advance of the Medical Review Board’s meetings on July 15-16, the Federal Motor Carrier Safety Administration has released a draft version of the 2019 Medical Examiners Handbook.

The previous version of the handbook had been pulled down from public view after the Owner-Operator Independent Drivers Association and others complained that the handbook created confusion for certified medical examiners on what was regulation and what was guidance.

The goal of the handbook to help certified medical examiners in their evaluation of commercial motor vehicle drivers for a medical qualification determination.

Jay Grimes, OOIDA’s director of federal affairs, said that after a first look at the draft handbook it appears this version does a better job of distinguishing between regulation and guidance.

“What was recommended in the previous handbook wasn’t necessarily regulation,” Grimes said.

“At first glance, I think this new version does a better job of outlining what the role of the certified medical examiner is. There’s a section that outlines what’s regulation and what’s guidance. It also makes clear that regulation is the law that they have to go by.”

For instance, the section about sleep apnea tells certified medical examiners that the agency has no regulations specifically regarding the condition.

“FMCSA reminds medical examiners that the agency has no rules or regulatory guidance or criteria specifically on obstructive sleep apnea screening, testing, and treatment beyond the existing requirements in 49 CFR 391.41(b)(5) and the 2000 medical advisory criteria, which is not mandatory,” the draft version of the 2019 handbook stated.

The new version of the handbook, which is reduced from about 250 pages to 78, also reminds medical examiners to look for multiple risk factors because “a high BMI by itself may not be sufficient to order a sleep study.”

FMCSA’s Medical Review Board consists of five medical experts who serve two-year terms. The board is tasked with establishing guidelines for certified medical examiners when conducting Department of Transportation physicals.

Dr. Gerald E. Harmon, vice president of medical affairs at Tidelands Health Group in South Carolina, was recently added to the board. He joins Dr. Gina C. Pervall, Dr. Michael T. Kelley, Dr. Brian T. Morris, and Dr. Albert James Osbahr III.

The meetings will be from 9:15 a.m. to 4:30 p.m. EDT on July 15-16 in Arlington, Va.

According to the agenda summary, the board will revisit its July 2018 handbook recommendations and discuss how to best provide educational materials on pharmacology to certified medical examiners.

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Mark Schremmer

Mark Schremmer, senior editor, joined Land Line in 2015. An award-winning journalist and former assistant news editor at The Topeka Capital-Journal, he brings fresh ideas, solid reporting skills, and nearly two decades of journalism experience to our staff.