On August 16, 2022, the Federal Motor Carrier Safety Administration (FMCSA) published a 122-page draft of the new Medical Examiner’s Handbook that could become a guide for certified medical examiners who determine whether a driver meets the physical qualifications for commercial driving. The Agency also proposed changes to the Medical Advisory Criteria now published in the Code of Federal Regulations, 49 CFR part 391, Appendix A.
Under the current regulations, medical examiners make physical qualification determinations of drivers on a case-by-case basis and may refer to the related Medical Advisory Criteria for guidance. See 49 CFR 391.41 through 391.49.
According to the FMCSA, the handbook would provide medical examiners clearer information on specific regulatory requirements relative to a driver’s physical qualifications and offer further guidance to medical providers when making such determinations.
The current draft of the handbook, however, also offers recommendations on identifying drivers at risk for moderate-to-severe obstructive sleep apnea, a condition currently not required for testing by medical examiners under the Federal Motor Carrier Safety Regulations (FMCSRs). Should the handbook be formally adopted by the Agency, this would pose the question as to whether the handbook becomes a catalyst for future regulatory requirements, such as screening commercial drivers for obstructive sleep apnea, under the FMCSRs.
The debate about regulatory requirements for CMV drivers with obstructive sleep apnea is nothing new. In March 2016, the FMCSA published an Advance Notice of Proposed Rulemaking (ANPRM) that would have required CMV drivers who exhibit multiple risk factors for obstructive sleep apnea to undergo evaluations and treatment by a healthcare professional with expertise on sleep disorders. However, this ANPRM was withdrawn in 2017.
FMCSA is now accepting public comments about the proposed regulatory guidance on or before September 30, 2022.