OOIDA: Medical Examiner Handbook draft unfit for publication

October 28, 2022

Mark Schremmer

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The latest draft of the Medical Examiner Handbook has “critical shortcomings” that make it unfit for publication, the Owner-Operator Independent Drivers Association told FMCSA in recent comments.

Responding to FMCSA’s recent notice regarding the handbook’s latest draft, OOIDA outlined ways to provide clarity and consistency so that all qualified truckers can receive medical certifications.

“The handbook should acknowledge that certified medical examiners should not overrule personal medical physicians,” OOIDA wrote in comments signed by President Todd Spencer. “The Medical Examiner Handbook should stress the importance of CMEs accepting the medical judgment of a driver’s personal physician. Too often, CMEs ignore personal physician’s judgments and deny medical cards to drivers.”

OOIDA says another way to improve the handbook is by making it clear that drivers can seek a second opinion.

“The handbook should specifically state that a driver is entitled to a second opinion and that the CME must acknowledge that fact if asked by the driver. From conversations with our members, we understand many examiners believe it’s against regulation for a driver to get a second opinion.”

Another common issue, OOIDA says, is when certified medical examiners treat guidance as regulation.

“Most importantly, the updated Medical Examiner Handbook must differentiate between actual regulation and guidance,” the Association wrote. “While the updated handbook attempts to better distinguish between regulations and guidance, there are many sections, such as obstructive sleep apnea, that remain overly reliant on recommendations instead of approved regulatory standards.”

OOIDA also suggested several revisions to the 122-page handbook. Several of the suggested revisions involve the obstructive sleep apnea section.

“The Medical Examiner Handbook should not link to the 2016 Medical Review Board guidance on the certification of drivers with moderate-to-severe obstructive sleep apnea,” OOIDA wrote. “The inclusion of this guidance will only empower medical examiners to continue forcing needless screenings upon experienced drivers. Additionally, publishing the Medical Review Board guidance in the handbook would circumvent both legislative and regulatory policy implemented by Congress and FMCSA.”

The notice

In August, FMCSA published a notice regarding the draft of the latest handbook. The agency gave the public until Sept. 30 to comment and then extended the deadline another month following a request from OOIDA and others.

The goal of the updated Medical Examiner Handbook is to provide information about regulatory requirements and guidance for medical examiners to consider.

FMCSA’s latest draft covers such topics as driver examination forms, physical qualifications for commercial drivers, the medical certification process, recording the examination and medical variances.

Comments on the notice will be accepted through Oct. 31. To do so, go to the Regulations.gov website and enter Docket No. FMCSA-2022-0111.

OOIDA’s full comments can be found here. LL