Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders |
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Larry W. Minor
Federal Motor Carrier Safety Administration
13 June 2016
[Federal Register Volume 81, Number 113 (Monday, June 13, 2016)]
[Notices]
[Pages 38262-38264]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-13867]
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DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
[FMCSA Docket No. FMCSA-2015-0117]
Qualification of Drivers; Exemption Applications; Epilepsy and
Seizure Disorders
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.
ACTION: Notice of final disposition.
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SUMMARY: FMCSA announces its decision to exempt five individuals from
the regulatory requirement that interstate commercial motor vehicle
(CMV) drivers have ``no established medical history or clinical
diagnosis of epilepsy or any other condition which is likely to cause
loss of consciousness or any loss of ability to control a CMV.'' The
exemptions enable these individuals to operate CMVs in interstate
commerce.
DATES: The exemptions were effective on September 12, 2015. The
exemptions expire on September 12, 2017.
FOR FURTHER INFORMATION CONTACT: Christine A. Hydock, Chief, Medical
Programs Division, (202) 366-4001, fmcsamedical@dot.gov, FMCSA,
Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113,
Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m.
e.t., Monday through Friday, except Federal holidays.
SUPPLEMENTARY INFORMATION:
I. Electronic Access
You may see all the comments online through the Federal Document
Management System (FDMS) at: http://www.regulations.gov.
Docket: For access to the docket to read background documents or
comments, go to http://www.regulations.gov and/or Room W12-140 on the
ground level of the West Building, 1200 New Jersey Avenue SE.,
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday,
except Federal holidays.
Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits
comments from the public to better inform its rulemaking process. DOT
posts these comments, without edit, including any personal information
the commenter provides, to www.regulations.gov, as described in the
system of records notice (DOT/ALL-14 FDMS), which can be reviewed at
www.dot.gov/privacy.
II. Background
On August 12, 2015, FMCSA published a notice announcing receipt of
applications from 12 individuals requesting an exemption from the
prohibition against persons with a clinical diagnosis of epilepsy or
any other condition that is likely to cause a loss of consciousness or
any loss of ability to operate a CMV in interstate commerce and
requested comments from the public (80 FR 48406). The public comment
period closed on September 11, 2015, and one comment was received.
FMCSA has evaluated the eligibility of these applicants and
determined that granting the exemptions to five individuals would
achieve a level of safety equivalent to or greater than the
[[Page 38263]]
level that would be achieved by complying with the current regulation
49 CFR 391.41(b)(8).
The physical qualification standard for drivers regarding epilepsy
found in 49 CFR 391.41(b)(8) states that a person is physically
qualified to drive a CMV if that person:
Has no established medical history or clinical diagnosis of
epilepsy or any other condition which is likely to cause the loss of
consciousness or any loss of ability to control a CMV.
In addition to the regulations, FMCSA has published advisory
criteria \1\ to assist medical examiners in determining whether drivers
with certain medical conditions are qualified to operate a CMV in
interstate commerce. [49 CFR part 391, APPENDIX A TO PART 391--MEDICAL
ADVISORY CRITERIA, section H. Epilepsy: Sec. 391.41(b)(8), paragraphs
3, 4, and 5.]
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\1\ See http://www.ecfr.gov/cgi-bin/text-idx?SID=e47b48a9ea42dd67d999246e23d97970&mc=true&node=pt49.5.391&rgn=div5#ap49.5.391_171.a and https://www.gpo.gov/fdsys/pkg/CFR-2015-title49-vol5/pdf/CFR-2015-title49-vol5-part391-appA.pdf.
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The advisory criteria states that if an individual has had a sudden
episode of a non-epileptic seizure or loss of consciousness of unknown
cause that did not require anti-seizure medication, the decision
whether that person's condition is likely to cause the loss of
consciousness or loss of ability to control a CMV should be made on an
individual basis by the medical examiner in consultation with the
treating physician. Before certification is considered, it is suggested
that a 6-month waiting period elapse from the time of the episode.
Following the waiting period, it is suggested that the individual have
a complete neurological examination. If the results of the examination
are negative and anti-seizure medication is not required, then the
driver may be qualified.
In those individual cases where a driver had a seizure or an
episode of loss of consciousness that resulted from a known medical
condition (e.g., drug reaction, high temperature, acute infectious
disease, dehydration, or acute metabolic disturbance), certification
should be deferred until the driver has recovered fully from that
condition, has no existing residual complications, and is not taking
anti-seizure medication.
As a result of medical examiners misinterpreting advisory criteria
as regulation, numerous drivers have been prohibited from operating a
CMV in interstate commerce based on the fact that they have had one or
more seizures and are taking anti-seizure medication, rather than an
individual analysis of their circumstances by a qualified medical
examiner based on the physical qualification standards and medical best
practices.
In reaching the decision to grant these exemption requests, the
Agency considered the 2007 recommendations of the Agency's Medical
Expert Panel (MEP). The January 15, 2013 (78 FR 3069) Federal Register
notice provides the current MEP recommendations which is the criteria
the Agency uses to grant seizure exemptions.
Five of the twelve applicants have been seizure-free over a range
of 11 to 26 years while taking anti-seizure medication and maintained a
stable medication treatment regimen for the last two years. In each of
these cases, the applicant's treating physician verified his or her
seizure history and supports the ability to drive commercially. A
summary of each applicant's seizure history was discussed in the August
12, 2015 Federal Register notice and will not be repeated in this
notice.
III. Discussion of Comments
One anonymous commenter opposes granting exemptions to 49 CFR
391.41(b)(8) because of the unpredictability of seizure disorders and
the risk this presents to commercial driving. The commenter believes
that the physical qualification standards are in place to provide the
minimum physical standard to drive commercially and granting these
exemptions would ``increase the likelihood of a terrible accident due
to an unexpected seizure''.
The Agency acknowledges this commenter's concerns regarding the
safety of individuals with a history of seizure driving commercially.
The Agency's decision to grant seizure exemptions is based on the 2007
Evidence Report, the 2007 MEP Recommendations, and an individual
evaluation of the driver's medical history and driving record to ensure
an acceptable level of safety for drivers who have been seizure-free
for an extended period of time.
IV. Basis for Exemption Determination
The Agency has determined that five applicants should be granted an
exemption. Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an
exemption from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) if
the exemption is likely to achieve an equivalent or greater level of
safety than would be achieved without the exemption. The exemption
allows the applicants to operate CMVs in interstate commerce.
The Agency's decision regarding these exemption applications is
based on an individualized assessment of each applicant's medical
information, including the root cause of the respective seizure(s) and
medical information about the applicant's seizure history, the length
of time that has elapsed since the individual's last seizure, the
stability of each individual's treatment regimen and the duration of
time on or off of anti-seizure medication. In addition, the Agency
reviewed the treating clinician's medical opinion related to the
ability of the driver to safely operate a CMV with a history of seizure
and each applicant's driving record found in the Commercial Driver's
License Information System (CDLIS) for commercial driver's license
(CDL) holders, and interstate and intrastate inspections recorded in
the Motor Carrier Management Information System (MCMIS). For non-CDL
holders, the Agency reviewed the driving records from the State
Driver's Licensing Agency (SDLA). The Agency acknowledges the potential
consequences of a driver experiencing a seizure while operating a CMV.
However, the Agency believes the drivers granted this exemption have
demonstrated that they are unlikely to have a seizure and their medical
condition does not pose a risk to public safety.
Consequently, FMCSA finds that in each case exempting these five
applicants from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) is
likely to achieve a level of safety equal to that existing without the
exemption. A decision will be made on the other seven applicants on a
later date.
V. Conditions and Requirements
The terms and conditions of the exemption will be provided to the
applicants in the exemption document and includes the following: (1)
Each individual must remain seizure-free and maintain a stable
treatment during the 2-year exemption period; (2) each individual must
submit annual reports from their treating physicians attesting to the
stability of treatment and that the driver has remained seizure-free;
(3) each individual must undergo an annual medical examination by a
certified Medical Examiner, as defined by 49 CFR 390.5; and (4) each
individual must provide a copy of the annual medical certification to
the employer for retention in the driver's qualification file, or keep
a copy of his/her driver's qualification file if he/she is self-
employed. The driver must also have a copy of the exemption when
driving, for presentation to a duly authorized Federal, State, or local
enforcement official.
[[Page 38264]]
VI. Conclusion
Based upon its evaluation of the five exemption applications, FMCSA
exempts the following drivers from the epilepsy/seizure standard in 49
CFR 391.41(b)(8), subject to the requirements cited above: Eric Joseph
Barnwell (MI); Jason S. Coleman (NJ); Charles A. McCarthy III (MA);
Randy P. Schuelke (WI); and Cory R. Wagner (IL).
In accordance with 49 U.S.C. 31315(b)(1), each exemption is valid
for 2 years, unless revoked earlier by FMCSA. The exemption will be
revoked if the following occurs: (1) The individual fails to comply
with the terms and conditions of the exemption; (2) the exemption has
resulted in a lower level of safety than was maintained prior to being
granted; or (3) continuation of the exemption would not be consistent
with the goals and objectives of 49 U.S.C. 31136 and 31315. If the
exemption is still effective at the end of the 2-year period, the
individual may apply to FMCSA for a renewal under procedures in effect
at that time.
Issued on: June 3, 2016.
Larry W. Minor,
Associate Administrator for Policyal.
[FR Doc. 2016-13867 Filed 6-10-16; 8:45 am]
BILLING CODE 4910-EX-P