DOT MEDICAL EXAMINER STUDY RESOURCE Courtesy of NRCME Public Records

DQ = Disqualify Driver (until conditions met for return.)

The 4 Non-Discretionary Standards: 58lbs is normal grasp and pre­hension.

SPE = Skilled Performance Eval. Drivers get 2 years with a fixed

• Epilepsy �:::::::::::::::::::::::.-' 1, ___________ .... • Hearing• Vision• Insulin Dependent Diabetes Mellitus

J DQ= Untreated Sleep Apnea

Urine Dipstick tests for: • Blood• Specific Gravity• Sugar/glucose• Protein

.-----------------,

: DQ= Narcolepsy ___ :

: Active Tuberculosis=DQ

Obstructive Sleep Apnea: 1 year qualification after 3 months with no symptoms post surgery or one month no symptoms from C-pap machine use.

02 Equipment to assist in breathing = DQ.

Hypoxemia at Rest =

DQ EDS- Excessive Daytime Sleepiness.

RLS- Restless Leg Syn­drome

OSA- Obstructive Sleep Ap­nea

IS IT Incapacitating?

•

CZl

Ul •

•

Static-DQ Progressive­

DQ Episodic-DQ

Examiner Must Decide!

Blood Gasses

• �f'meas11re111e111 reveals a

PaO2 of less than 65111111

Hg at less than 5,000 Ji.

• Or /es.\· than 60mm Hg

ahtll'e 5000 Ji.

.-111(//or

• Carho11 dioxide greater

1'11111 45111111 (at 1111y altitude)

DISQUALIFY DR/I ER

•

•

•

•

•

•

If Untreated = DQ

Severe cough Poor Meds Tolerance Frequent and Severe episodes FCV<65% PaO2 <65mm DISQUALIFY

Alcohol Abuse is Disqualifying. If an examiner

suspects alcohol abuse, the Designated

Employer Represelllative should be informed

alld the driver IMMEDIDIATELY

Disqualified The DER is responsible for

referral to a Substance Abuse Professio11al

DQ:

• Primary AlveolarHypoventilationSyn.

• Idiopathic Hy-persomnolence

• RLS with EDS

Severe TBI = DQ Moderate TBI= Do not DQ on its own. Case by case basis, but must be seizure free for 2-5 years after injury. (See "Wait Times and Limits" Guide in Resource Library)

Epilepsy: 2 or more unprovoked seizures. DQ. To re-qualify must have I 0 years no meds and no unprovoked seizures.

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Study Guide3

Un.Hable Angina: DQ Framingham 4-- is a Risk Scoring System for Heart. Based on correctable vs. non-correctable conditions. • Pain at rest.

• Poor response to medications.

3

Non Sustained VT Defini­

tion

> 40% and less than <50%.

Myocardial Infarction

2 Month Wait

Ejection Fraction> 40%

Exercise Tolerance Test Normal.

Tolerates Medications

Passes CMV Physical

Exercise 1'01- 0

erance Test,. ing is clone in:

• Ml 0

• Angio-plasty

• StaticAnginaPectoris

• CABG

0

0

0

0

Coronary Bypass Grafting (CABG) also known as "Cabbage"

1. Return to Work 3 months post procedure.2. Must be asymptomatic3. Ejection Fraction of>40%.4. Yearly Recertification5. Tolerance of Medications

0

0

Heart Failure

Idiopathic Dilated

Cardio-

1nyopathy .... Most Common

form of heart

failure.

Pacemaker:

Return to Driving • One month post im­

plant.• One year routine

check.

6. Must have a 5 year Exercise Tolerance Test due to likelihood of re-occlusion. Then,ETT yearly.

Significant Pulmonary Hyperten­sion Disqualify.

Atrial Fibrillation Risk: Embolus- Stroke

I year if rate control led via mcds.

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Certi y Period

Item Wait Period (needs new exam-

Other/Exemption Period (no symptoms) if otherwise

aualified)

10 Years seizure free no Epilepsy definition: 2 or more

Epilepsy anticon

1 Year unprovoked seizures with no time limit in between

Headaches adeauate RX 2 years Single unprovoked seizure 5 yea rs, no meds, no seizure 1 year

Acute/Chronic benign 2 mo, no sx 2 Years

vestibulooathv CNS Infections

Bad. Meningitis, viral encephalitis No seizure: 1 year 2 Years Bact. Meniaitis with earlv seizure 5 year 2 Years

Viral Encohalitis with seizure 10 years 1 Year Neu romuscu la r /Periphera I

DQ may have appeal after specialist

Nueropathv eval

Autonomic Neuropathy adequate RX 2 Year Diabetic Autonomic Neuropathy- 1

Year unless cardiac sx lntrcranial Hemm./subarrachnoid 1 year no seizure or risk of

1 cerebellum/brainstem low seizure

bid. seizure year

risk areas lntrcranial Hemm./subarrachnoid

5 year with risk of seizure 1 Year cortical/subcortical high seizure risk

bid. areas

Stroke 1 year no seizure risk 1 Year cerebellum/brainstem low seizure

risk areas

5 year with risk of seizure 1 year cortical/subcortical high seizure risk

areas TIA 1 year 1 Year no seizures no seizure meds

Traumatic Brain Injury (severe) DQ LOC for more than 24 hours and/or dural penetration.

Traumatic Brain Injury (moderate) 2 year without seizure 1 Year LOC > 30 min but < 24 hrs, no dural

penetration

5 year with seizure 1 Year LOC greater than 30 min but less

than 24 hours.no dural oenetration Traumatic Brain Injury (mild) 1 Year no seizure 2 Years

2 years with seizure 1 year Hernia adeauate RX 2 Years

Benian Tumors 1 year 2 years Benign Supratentorial Tumors 2 years 2 Years

Nephrooathv adequate RX 2 Years Dialvsis DQ

Oxvaen use DQ lnolantable Cardio-defibrillator DQ

Electro convulsive therapy 6 mos symptom free after

1 year treatment

Bipolar 6 mos symptom free: non-

1 year Severe depressive, manic, suicidal: 1

osvchotic year wait.

Severe depression adequate RX 1 year Severe depressive mode with suicide:

1 year wait. Schizoohrenia DQ

Alcoholism Successfully complete RX 2 year Chantix for smokina cessation DQ

Peripheral Neuropathy DQ

Monocular vision DQ

Pick's Dss DQ Non-fundionina labvrinth DQ

Anticoaaulants for CVA DQ

NEURO WAIT TIMES NO SEIZURES AND OFF ANTI-CONVULSANTS

1 Year

Mild TBI without seizure Stroke

without seizure Hemmorage

without seizure Transient

lschemia Attack

All tumors

Bacterial Meningitis no seizure

Viral Meningitis no seizure

2 years

Mild TBI with early seizure

Moderate TBI without seizure

Supratentorial tumors

5 Years

Moderate TBI with seizures

Stroke with risk of seizure

Hemmorage with risk of seizure One unprovoked seizure Bacterial Meningitis with early seizure 10 Years Epilepsy Viral Encephalitis

If diagnosis of restrictive impairment with an FVC less than 60% of the predicted value

OR

If diagnosis of obstructive airway disease with FEV

1

<65%. of predicted value and FEV/FVC ratio less than 65%

Obtain pulse oximetry. ,. I If Sp02 is <92°/o ..-

• ObtainABG.

If the Pa02

on the ABG is less than 65 mmHg(altitude < 5,000 feet) or 60 mmHg

(altitude above 5,000 feet) or PaC02

greater than 45 mmHg (any altitude)

�

Disqualify the driver.

7 Copyright 2013 NRCME Training Systems, LLC

8 Copyright 2013 NRCME Training Systems, LLC