You do not use any other frequencies other than 500, 1000, and 2000 Hz for calculating average hearing loss. The hearing standard using audiometry is that at least one ear must have an average hearing loss no greater than 40db.

A breast exam should not be confused with examination/auscultation of the chest or lungs.  A breast exam is not part of the medical exam.

Hypertension is contained in the FMCSA Advisory Criteria and is discretionary. The medical examiner must follow the seizure/epilepsy and hearing non-discretionary standards and disqualify the driver if they do not meet the standards.  There are Federal exemptions available for each of the two non-discretionary standards that if applied for and approved by FMCSA, will allow the driver to drive a commercial vehicle. For drivers who want to apply for a federal exemption the medical examiner can qualify the driver for up to one year if they are otherwise medically qualified to drive a CMV and the medical examiner checks the box "Accompanied by a _______ exemption and writes the name of the exemption in the space such as "Federal Hearing".

Measuring height/weight is not considered a “test” for the purpose of the exam.  In addition to the other answers listed, the other required test not listed is measuring blood pressure.

To convert to ANSI you must subtract 8.5 from the 2000 Hz reading, 10 from the 1000 Hz reading and 14 from the 500 Hz reading before adding and averaging the amount of hearing loss.

Scarring of the tympanic membrane (tympanosclerosis) develops hearing loss which can be mild, moderate, or severe. This driver does have hearing loss in the ear with the scarring, but they do pass the whisper test in the right ear and therefore pass the hearing standard which allows them to be certified for 2 years. If the driver is not reporting any other symptoms other than hearing loss, there is no need to refer to an ENT for tympanosclerosis. There are many causes of post-nasal drainage, and it is not a risk for safe driving unless there is the possibility of cough syncope or a severe infection.

On recertification, drivers with a history of hypertension and taking medications, with a blood pressure reading below 140/90, should be certified for one year.  If a driver is removed from their antihypertensive medication by their treating provider, and the driver's blood pressure is stable at 140/90 or less, the medical examiner can consider issuing a 2-year certificate.

The first and second measurements have either the systolic value greater than 140, or diastolic values greater than 90. This is considered stage 1 hypertension. As the driver does not have a history of hypertension, they can be given a one-time 1-year certificate.

In the past, Methadone use was always disqualifying.  In August 2017, FMCSA stated that Methadone was no longer an absolute disqualifier, and that the ME should consult with the prescribing provider in determining driving status.  If considered safe taking the medication as prescribed by the prescribing provider, the ME can qualify the driver. If the driver is taking methadone for maintaining their absence of drug abuse, the medical examiner should verify that the driver has completed a drug abuse program and is in "remission".

The abbreviation for right eye is OD, the abbreviation for left eye is OS, and the abbreviation for both eyes is OU. The driver does not meet the vision standard in either eye. When a driver does not meet the vision standard, they must be disqualified. If it is likely that they will meet the vision standard once they have obtained corrective lenses, this should be the next course of action. They can then return with their corrective lenses and be certified for up to 2 years. As this driver does not meet the standard in either eye, they are not eligible to have a Vision Evaluation Report completed for monocular vision.

Humulin is a form of insulin. Commercial drivers taking insulin must have their treating provider fill out and sign the Insulin Treated Diabetes Evaluation form (MCSA 5870), stating that they are safe to drive. This must be completed before they are certified. The DOT physical exam must be performed within 45 days of the completion of form MCSA 5870. The medical examiner determines whether to issue a medical examiner's certificate.  If the driver only drives within the State (intrastate driving only), medical examiners may refer to State CMV driver insulin regulations.

The driver is qualified to drive without restriction if he can perceive a whispered voice at 5 feet in at least one ear. Because the driver passed the first hearing test administered, the medical examiner is not required to perform audiometric testing.

FMCSA announced in August of 2017 that Chantix was no longer an absolute disqualifying medication, and that MEs should consult with the prescribing provider to determine driving status.  Keep in mind that side effects may intensify for 2 weeks as individuals taper off the medication. There is no FMCSA guidance on whether the driver should be limited to a one-year certificate.

“Current opinion among clinicians is that post-MI individuals may safely return to any occupational task, provided there is no exercise-induced myocardial ischemia or left ventricular dysfunction. Cardiologists recommend that an ETT be performed 4 to 6 weeks after an MI and be repeated at least every 2 years.”

Dizziness is a serious condition that can cause temporary incapacitation. An ENT is best suited to diagnose and treat conditions resulting in dizziness. A neurologist would be a viable alternative. There are multiple otic diseases causing dizziness.

The driver is taking Antabuse which is used to treat alcohol addiction. This is a strong indication that the driver suffers from a CURRENT clinical diagnosis of alcoholism.  If the driver has successfully completed an alcohol addiction treatment program, and Antabuse is being used only to help the driver maintain their disuse of alcohol, the ME can consider issuing a medical certificate if the treating provider’s opinion is that the driver is safe to drive a commercial vehicle.

Headache is not a typical symptom of congestive heart failure.  Additional symptoms include wheezing, enlargement or prominent neck and facial veins, raised jugular venous pulse, bluish discoloration of face, presence of abnormal heart sounds, fatigue, weight gain and more.

Only one eye meets the vision standard. As it is unlikely that corrective lenses will allow this driver to meet the vision standard, the driver should be counseled regarding the need for a Vision Evaluation Report. Once the vision evaluation report is completed, a new exam can be performed and if everything appears satisfactory to the ME, the driver can be given a one-year certificate.

The driver appears to exhibit a “Flat affect” which is seen in schizophrenia and in severe depression.  The driver should be evaluated by a mental health expert for evaluation prior to certification.  MMSE questionnaire is used for evaluation of cognitive status, not necessarily mental disorders.  If the driver does not have a current medical certificate, the ME could consider using determination pending exam status.

Pancreatitis can cause severe, incapacitating pain. Chronic hepatitis B can develop into a serious disease resulting in long-term health problems, including liver damage, liver failure, liver cancer, and even death. However, this driver’s Hep B is asymptomatic. Symptoms of IBS include constipation, diarrhea, bloating, and gas. These symptoms are not of great concern with safe driving. None of the symptoms associated with Barrett’s esophagus are a significant risk to safe driving. They include heartburn, difficulty swallowing, blood in stool, and vomiting.

Use of marijuana is prohibited without exception by Federal law to drive a CMV and takes precedence over state marijuana laws.

It is important to know what is considered normal ROM to aide in determining whether a shoulder is stable, unstable, mobile, or immobile. Answer B would be considered a very immobile shoulder while answer C would be considered a very hypermobile shoulder. Instability is generally a result of injury or absence of stabilizing ligaments, muscles, and an ineffective glenoid arch.

Even though the driver reports exceeding the 10-year waiting period, it was not under medical supervision and the driver discontinued medication use and treatment outside of medical oversight and management.  Because the driver would not be able to provide a medical history this driver does not meet the non-discretionary epilepsy standard until the driver is 10 years seizure free while off anti-seizure medication.  However, if taking medication the driver can apply for the Federal seizure exemption, after being 8 years seizure free while taking anti-seizure medication.

The driver who is diagnosed with moderate (AHI equal to or greater than 15) should have a record showing effective treatment.  Since the driver’s current certificate does not expire for two months, the exam is WNL, and the driver indicates compliance, the exam could be put into the determination category. This allows 45 days to obtain the required documentation and the driver can continue driving for up to 45 days on their previous unexpired medical certificate.

To demonstrate compliance, the driver should produce a report of the period of time since their last exam (generally one year) that shows that they have been using the CPAP at least 70% of nights for at least 4 hours per night.

Medical clearance is recommended for all mental health disorders to help determine if treatment is adequate, effective, safe, and stable, and if the nature and severity of the condition likely to interfere with the ability to drive a CMV safely. With any medication, it’s important to determine if the individual is experiencing side effects that would preclude them from driving.

Ischemic changes on ECG is not part of the guidance for atrial fibrillation. A driver taking Coumadin should have monthly monitoring of their INR with results between 2-3 to be in therapeutic range. Also, the ME should obtain clearance from the cardiologist or treating provider to verify that treatment is adequate and effective, and the driver does not have sustained ventricular tachycardia.

This driver is an immediate risk to the public when behind the wheel of any motor vehicle. Narcolepsy is disqualifying although cataplexy can sometimes be managed with medication and modification of potential triggers.

The minimal required percentage of predicted value for FEV1/FVC ratio is > 65%. Answer A exceeds this value so it passes, but answer B is below, which would indicate a failed test. The minimal required percentage of predicted value for FEV1 is also > 65%. Answer D exceeds this minimum value to pass. The minimal required percentage of predicted value for FVC is > 60%. The value of 63% in answer C is passing.

Topamax is an anticonvulsant medication used for seizure control but can also be prescribed for migraines. When used to treat migraines or pain, the dosage is much lower than the amount used for seizures, and with fewer side effects.  The examiner should confirm with the prescribing provider that the driver does not take it to control seizures, and that treatment has shown to be adequate/effective, safe, and stable prior to certification.

A driver with monocular vision must always have a Vision Evaluation Report completed yearly by an eye specialist to be eligible to drive a CMV in interstate commerce. This report MUST be completed prior to being medically qualified by a ME.

This driver should not have been driving without an SPE certificate. This does require the ME to first certify the driver and then have them complete the SPE process. It is up to FMCSA to determine whether a driver with a missing hand, foot, leg, or arm qualifies for a skill performance certificate which is valid for 2 years.

Like many questions, there is more than one correct answer but you must select the most correct answer. When a driver fails either of the hearing tests, the other test must be performed, which in this case would be an audiometric test. However, the ME must also be able to view the tympanic membranes. Otherwise, the ME cannot determine if there is a more concerning issue than loss of hearing. Also, once the ear wax is removed, there is a good chance that the driver will pass the whisper test. The hearing exemption would only be an option if the tympanic membranes could be viewed and the driver fails both the whisper and audiometric tests (in both ears).

Because the driver has a history of hypertension (he is taking medication), and he has Stage 2 hypertension during his exam, he would be provided a one-time, 3-month certificate.

"The FMCSA does not establish laboratory reference ranges including clinical threshold levels for blood glucose and HbA1C. The Treating Clinician establishes individualized, clinically based parameters for blood glucose and HgbA1C levels and determines stable treatment regimen and properly controlled diabetes mellitus for their patients." MEs may consider the American Diabetes Association (ADA) guidelines as "best practices". They consider any A1c above 9% to be uncontrolled. Generally, an ME will certify a driver with uncontrolled diabetes for 3 months. A driver with Type 2 diabetes can be certified for up to two years if well-controlled, which according to the ADA is an A1c level of 6.5% or lower.

A positive Babinski reflex is indicative of abnormalities in the motor control pathways widely used as a diagnostic aid in disorders of the central nervous system. The examiner should obtain clearance from a neurologist prior to certification.

Although the driver’s condition appears well controlled, for drivers with a history of lung disease the ME is required to determine that the driver meets the pulmonary standards before certification via spirometry, air blood gases (ABG), or pulse oximetry. Once determined to meet the pulmonary standard there is no advisory criteria limiting certification time and the driver may be certified for 2 years.

Ophthalmoscopic examination is not required but may be done if deemed necessary.

Afrezza is an inhaled form of insulin.  It does not matter if insulin is injected or inhaled, the driver is required to have their medical provider complete the ITDM evaluation form and provide it to the ME prior to being certified.

The Federal Insulin Use Exemption program and the FMCSA Insulin Use Waiver program have both been discontinued. As of November 19, 2019, all interstate drivers taking insulin (with the following exception) will be required to obtain a signed ITDM evaluation form. Only the Intra-city Zone Exemption program is still in effect for drivers who use insulin or who do not meet the vision standard.

Prior to certifying the driver, the ME should obtain UA results from the treating provider. Areas of concern with dialysis would be the severity of kidney disfunction and whether the dialysis treatment schedule interferes with the driver’s driving schedule.  In most instances, if the driving schedule does not interfere with treatment, drivers with Stage 1 through 5 can be certified to drive.

The most likely time for complications following a Coronary Artery Bypass Grafting (CABG) is withing the first 3 months. Also, the sternum takes approximately 3 months to heal. Therefore, this driver should be disqualified and wait at least 3 months post-CABG. ECHO results demonstrating an ejection fraction of 40% or greater are adequate.

Monovision is not an eye condition.  It is the use of one contact for near vision and one for distance vision or was purposely done during Lasik surgery.  Monovision is disqualifying but does not require a specialist evaluation.  Drivers that had Lasix or other eye procedures resulting in monovision in distance vision correction in one eye could be certified if they can use lenses to correct the close vision eye to 20/40 distance vision.  If this were the case, the MEC for these drivers would indicate that they must wear lenses. Monocular vision is the term used to indicate that one eye does not meet the vision standard. If the monovision is corrected, the ME would not mark the monovision box.

Page 4 of the medical examiner report form contains that following fields that must be completed by the ME: The ME’s signature and date, their name, address, and telephone number. They must also designate their professional degree and enter their state license, certificate, or registration number and the issuing state. Finally, the ME must enter their National Registry number and their medical examiner’s certificate expiration date.

If during a subsequent exam the driver has stage 1 or 2 hypertension, they cannot be certified until they get their BP below 140/90. If the driver's blood pressure on a subsequent exam is below 140/90, they would get a 6-month certificate.

Sinemet is used to treat Parkinson’s disease. MEs may consider certifying a driver with a confirmed diagnosis of Parkinson’s if they have only mild symptoms on one side of the body. No rigidity should exist. It is a good idea to obtain clearance from the treating provider who is likely a neurologist, but the driver should not be certified in the meantime. It is not recommended to certify a driver with Parkinson’s Disease for more than 1 year.

Drivers can use a hearing aid to pass the hearing standard.  A driver must only meet the hearing standard in 1 ear to be qualified to drive. If the driver's hearing using hearing aids did not pass the standard, the medical examiner should order "open field" audiometric testing.

The driver should be counseled to carry an extra hearing aid battery or if the hearing aids are rechargeable, carry an extra fully charged hearing aid. They should also be counseled to always wear a hearing aid while driving. The driver does not need a hearing exemption.

The minimum acceptable values are FEV1 65%, FVC 60% and FEV1/FVC Ratio of 65%.

The abnormality in the UA is the result of the driver’s menstrual cycle.  Without any other identified abnormality, the driver would be certified for 2 years.

A change in medication response is an indication of unstable angina. The driver is disqualified until stable angina is reached and the waiting period completed.

Although you might be able to auscultate a bruit relating to renal artery stenosis, it would not be heard inferior to the sternal angle. A palpable pulsation and/or a bruit may indicate an AAA.

The driver with a history of Stage 3 hypertension may only be certified for a maximum of 6 months.

The driver is not being treated for a mental condition such as anxiety or depression and has no side effect risks for safe driving. If he had a psychological condition, the ME could consider limiting the driver to a one-year certificate.  In this instance, he can be certified for 2 years.

Gabapentin (Neurontin) is an anti-convulsant medication, but when taken for a reason other than seizure prevention, the driver may be qualified with clearance from the treating provider.

The key to answering this question is that the driver has synovitis. Although the question does not specify whether the synovitis is related to the tendons or joints, it is evident that the driver has an inflammatory process in their hands. From the options provided, the best specialist to diagnose and treat musculoskeletal inflammatory processes is a rheumatologist.

The driver had a single acute provoked seizure from a known cause, without the need for treatment with an anticonvulsant. There is no recommended waiting period, and the examiner may certify him for 2 years.

The best decision would be to obtain clearance from the treating provider to verify that the individual has been symptom free and for how long, and that treatment is adequate and effective. Disqualifying the driver is not a wrong answer, just not the MOST correct. If the driver presents the clearance letter at the time of the exam, there would be no reason to disqualify. But if not, the best thing would be to disqualify the driver until more information could be obtained.

The driver’s hypothyroidism is well managed and asymptomatic. The driver may be certified for 2 years.

The driver suffers a chronic pain condition that may inhibit his ability to perform all essential functions associated with driving a CMV and is taking a narcotic medication which requires clearance from the prescribing physician. Along with the medication, the CME should inquire if the driver has any work limitations that would interfere with performing the duties of commercial driving.

According to recommendations, this driver should not be certified until the medical examiner has verified that the recovery is complete, with X- rays, and the driver has an FVC greater than 60% of predicted value.

Increased specific gravity and sugar spilled into the urine are traits of Diabetes Mellitus.  When a driver is believed to have undiagnosed diabetes, or uncontrolled diabetes, the ME may consider a temporary qualification for up to 3 months. Drivers with over 500mg/dl of sugar in the urine should have a blood glucose test and/or an A1c test to help in the decision process.

Despite admitting to having up to 14 beers a week, with less than a score of 2 on the CAGE questionnaire and showing no other clinical evidence to indicate a current active diagnosis of alcoholism, the driver would be certified for up to 2 years.  Drinking 14 beers a week is the trigger for the ME to take further steps, such as administrating a CAGE or other alcohol questionnaires, or to refer the driver for an evaluation.  In this case, the ME elected to administer the CAGE questionnaire.

A driver with a history of TB is disqualified until they have medical clearance, and have provided results of a chest X-ray, and pulmonary function test that meets or exceeds minimum requirements to drive. It is not required to have a yearly follow-up evaluation unless recommended by the treating physician or due to the clinical course of the condition.

WPW Syndrome is an atrial arrhythmia that is often asymptomatic, but when symptomatic may be treated successfully with medication or in some cases with an ablation.  A successful ablation is assumed to “cure” the condition. If post-electrocardiography demonstrates a normal heart rate and rhythm and the driver has the required medical clearance, they can be certified.

A signed ITDM Evaluation form from his treating provider must be completed within 45 days prior to the CDL exam.  Drivers taking insulin can only be certified for one year.  The Federal Insulin Treated Diabetes exemption program has been discontinued.

The driver shows signs of clubbing of the fingers which is associated with lung disease or heart disease.  Referral to a pulmonary specialist is the most correct answer for diagnosis and condition severity.

This driver with no current diagnosis of OSA but has a BMI equal to or more than 33 with 3 or more risk factors.  Drivers with suspected undiagnosed OSA should be given a 3-month certificate to obtain a sleep study and become compliant if treatment is required. Also, glucovance is for the treatment of diabetes and the ME should verify that the diabetes is controlled.

Even though this driver’s seizure was due to a known cause, they are taking the anticonvulsant medication Trileptal. Because she has been seizure-free for 4 years, she has the option to be certified for one year and apply for the Federal Seizure Exemption.

The recommendation for a driver with a history of severe brain trauma is permanently disqualifying due to the risk of subsequent unprovoked seizures that does not diminish with time.

FMCSA indicates that due to the high re-occlusion rate after 5 years, this may indicate the necessity of an ETT. The ME should verify that the driver is asymptomatic, treatment is adequate and effective, and the driver is compliant with the treatment program. This is most easily done by obtaining clearance from the treating provider, likely a cardiovascular specialist.

Drivers with a history of COPD should be evaluated prior to certification to see if they meet pulmonary standards.  The pulmonary standard can be met using spirometry, pulse oximetry or air blood gasses (ABG).

To pass the color vision standard, drivers are only required to differentiate traffic signal green, red, and amber.  It does not matter what color they actually report seeing.

The classic symptom of glaucoma is limited peripheral vision.

A driver with chronic tuberculosis taking streptomycin is disqualified until treatment is successfully completed due to possible streptomycin damage to the 8^th cranial nerve that could affect hearing and balance.

There is no light duty option for driving and every exam must be treated as if they will be driving and 18-wheeler weighing 110,000 pounds from coast to coast.

There is no specific strength or ROM requirement other than they must be able to perform the duties and demands of a commercial driver. If the ME determines they have the necessary functional capacity, no further evaluation is necessary, and they may certify the driver for up to 2 years. Answer D would be a valid way to proceed if the ME is unsure of the driver’s abilities and to obtain a second opinion. If it is determined that the driver has a “fixed deficit” that may interfere with safe operation, they can be certified but with the exam form and certificate marked that they must have an SPE certificate to drive.

A slightly lower heart rate and blood pressure in an extremely athletic adult is not abnormal.

Protein in the urine (proteinuria) means that the kidneys are not working properly and are allowing too much protein to escape in the urine. A nephrologist is a kidney specialist. Malnutrition would not manifest with a urinalysis but with blood work demonstrating decreased levels of total protein and albumin. Urine protein levels are not affected by the liver or the central nervous system.

Certification for a period of 2 years. Had there been signs of alcoholism, an evaluation would have been required.  Voluntary attendance at self-help meetings is not disqualifying. If the driver had a DOT drug test violation (a positive test on a DOT alcohol test) the driver would have been required to successfully complete an alcohol treatment program if recommended by a DOT accredited SAP before being returned to driving.

Aricept is a medication that is used in the treatment of Alzheimer’s disease.  Any form of dementia, including Alzheimer’s, is disqualifying.

The FMCSA guidelines and recommendations do not have any specifications on the required amount of motion of cervical spine or any other portion of the spine. What is required is that the driver can view both side view mirrors.

The UA is used to determine kidney function and diabetes.

Creatinine is not part of the UA. Protein is the missing fourth test in the exam’s UA.

They all meet the FMCSA definition of epilepsy. Provoked seizures due to a known cause are not part of the FMCSA definition of epilepsy.

A driver may be certified if he was diagnosed with epilepsy and has not had a seizure and has not needed medication for 10 years. In this case, the driver has not had a follow-up with his neurologist and therefore there is no way of confirming that this condition has been under control without the use of medication.

Drivers cannot be provided with two consecutive 3-month certificates for hypertension. The driver is disqualified until his blood pressure is at or below 140/90.

The driver suffers from Stage 1 hypertension. There is no previous history of hypertension. The driver may be certified for 1 year.

The returning driver has Stage 2 hypertension and should be given a 3-month certificate and referred for treatment. The same determination would apply if the driver instead has Stage 1 hypertension.

In order to issue another certificate, the ME must perform a new examination, the ME would issue a 1-year certificate from the date the new certificate was signed and issued.

Drivers with a history of a mental disorder (depression) treated with an antidepressant, even though it appears to be well managed safe and stable, should not be certified until the mental disorder and medication has been shown to be adequate/effective, safe, and stable.  In this case where the driver appears to be safe and stable, the ME can use determination pending to allow 45 days to obtain the necessary clearance.

For NRCME testing purposes, the best answer is to temporarily disqualify the driver as it is “best practice” for the driver to wait a year following a stroke. The reasoning is that the risk of having another stroke or other complications is greatest in the first year.

Open field testing is used to perform audiometric testing on a driver wearing hearing aids.  In this way, the driver wearing hearing aids may meet the audiometric standard and not need a hearing exemption. If the driver is unable to obtain the open field audiometric test at that time, they must be disqualified and a new exam must be performed once they have the audiometric test results.

1 refers to General Appearance, 3 refers to Ears, 6 refers to Heart, and 8 refers to Abdomen.

Those that use contacts to pass the eye standard must carry a spare pair of glasses when driving.

Drivers who have not been compliant can be issued a 1-month certificate.  If compliant for 30 days when they return to the CME, the driver can be certified for 60 days.  When the driver returns again and has been compliant for the last 60 days, the CME can issue a 90-day certificate.  When the driver returns in 90 days and is compliant, the CME can issue a one-year medical certificate.

Long-term use of an NSAID such as naproxen or ibuprofen, especially at high doses, should raise concerns for many potential medical conditions. NSAIDS can cause kidney damage which is monitored by creatinine. However, what is most concerning in this instance is the likelihood that the naproxen is causing orthostatic hypotension, resulting in syncope. The ME should obtain clearance from a mental health specialist, but this is a minor concern in this case. As the driver does not have a history of a respiratory condition and is not demonstrating any sign of respiratory distress, a pulmonary function test (PFT) is not necessary.

The recommended certification time for a driver with OSA is 1 year. If the driver has mild OSA which does not require treatment, the driver still gets only a 1-year medical certificate.

Seborrheic keratoses are benign skin lesions that are usually brown, black or light tan and look waxy or scaly and slightly raised. Excoriation is another term for a scratch and an acrochordon is another term for a skin tag.  Ecchymosis (bruising) could be from a recent injury but ecchymosis from minor bumps may indicate a serious underlying condition, such as a blood-clotting problem or a blood disease. Ecchymosis that seems to last a long time in an otherwise healthy individual is concerning for leukemia.

The driver may not have greater than 40db of hearing loss in the better ear using the ANSI standard measured at 500 Hz, 1000 Hz and 2000 Hz.

An SPE is not available for this driver because CTS is not a “Fixed Deficit”.   If the driver can meet the functions involving hand strength, they should be certified to drive but may be required to have more frequent monitoring of this potentially progressive disease.

Zyprexa is used to treat schizophrenia which is a permanent psychiatric disorder and is in nearly all cases a disqualifying condition.

Pain at rest, also known as rest pain, is disqualifying. A driver who suffers intermittent claudication should receive a clearance from their treating provider.

Some individuals with this condition have a benign and stable clinic course. If the cardiomyopathy has a benign and stable clinical course, the driver can be certified for up to one year but the overall recommendation at this time is that all drivers with hypertrophic cardiomyopathy be disqualified.

The driver’s pulse ox was below the required amount of 92% but the driver passes both the spirometry and ABG pulmonary function tests. Based solely off these results, he could be certified for up to 1 year. However, the driver suffers from COPD with cough syncope, and should automatically be disqualified.

Intraocular pressure causes progressive atrophy of nerve cells. Symptoms include redirection of visual attention, and decreased peripheral, night vision, and color discrimination for certain colors.

Individuals can have symptoms that would preclude them from driving for 3-4 months following ECT. Maintenance or ongoing ECT for depression is not certifiable.

This driver has nothing that would limit him or be unsafe to driving. He has a completely normal exam other than the resting tremor when not holding on to a firm object. There are no other findings that would suggest the possibility of Parkinson’s disease. Therefore, further evaluation is not necessary.

Driver is violating the HOS regulations and should not be certified to drive.

Drivers prescribed Provigil may be considered for driving after the prescribing physician can confirm that the treatment is safe and effective. Drivers are re-certified annually.

The medical exam form is considered medical information protected by HIPPA.

Driving a vehicle for compensation that carries between 9-15 passengers in interstate commerce requires a current medical certificate, but driving a vehicle for compensation that carries less than 9 passengers does not require a medical certificate. For all other instances listed, the driver is required to have a current medical certificate.

A medical examiner can perform the DOT physical exam on nearly any individual. There is no age limit, and each person should be held to the same standards, including certification interval. Drivers with a foreign license or with an international driver’s permit can also receive a medical card. Their country or origin can be written into the State/Province field and enter their license number in the appropriate field. If there is no license or no license number, simply write “none” in the space provided. Only drivers who have a US-issued CDL, or who will be applying for a CDL, should have their exams reported to FMCSA.

The federal requirement is 3 years, however if a doctor/patient relationship is established according to your state regulations, federal (HIPPA) and state medical record retention requirements may be longer.

In the past, there were two providers that could perform part of the physical exam and sign in a specific place on the exam form.  They were an Optometrist or Ophthalmologist.  However, with the new medical exam report form, only the medical examiner can sign the MER 5875.

A soft protrusion in the inguinal area is most likely a hernia. Because this hernia is easily palpable and is causing the driver pain, the driver should be referred to a general surgeon for further evaluation.

Classic findings of macular degeneration.

Drivers with sustain ventricular tachycardia should be disqualified from driving.

The primary mission of the FMCSA is to reduce crashes, injuries and fatalities involving large trucks and buses.

A driver taking over-the-counter antihistamines and antitussive should be counseled not to take the medication for 12 hours prior to driving. These medications both cause drowsiness and should not be taken while driving.