Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

Larry W. Minor
Federal Motor Carrier Safety Administration
10 September 2018

[Federal Register Volume 83, Number 175 (Monday, September 10, 2018)]
[Notices]
[Pages 45723-45724]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-19644]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[FMCSA Docket No. FMCSA-2018-0053]


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 eight individuals from 
the requirement in the Federal Motor Carrier Safety Regulations 
(FMCSRs) 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 who have had one or more seizures and are taking anti-
seizure medication to operate CMVs in interstate commerce.

DATES: The exemptions were applicable on August 1, 2018. The exemptions 
expire on August 1, 2020.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, (202) 366-4001, fmcsamedical@dot.gov, FMCSA, 
Department of Transportation, 1200 New Jersey Avenue SE, Room W64-224, 
Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m., 
e.t., Monday through Friday, except Federal holidays. If you have 
questions regarding viewing or submitting material to the docket, 
contact Docket Services, telephone (202) 366-9826.

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., e.t., 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 http://www.regulations.gov, as described in 
the system of records notice (DOT/ALL-14 FDMS), which can be reviewed 
at http://www.dot.gov/privacy.

II. Background

    On June 21, 2018, FMCSA published a notice announcing receipt of 
applications from eight individuals requesting an exemption from the 
epilepsy and seizure disorders prohibition in 49 CFR 391.41(b)(8) and 
requested comments from the public (83 FR 28896). The public comment 
period ended on July 23, 2018, and six comments were received.
    FMCSA has evaluated the eligibility of these applicants and 
determined that granting exemptions to these individuals would achieve 
a level of safety equivalent to or greater than the 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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III. Discussion of Comments

    FMCSA received six comments in this proceeding. Four of these 
comments supported granted the exemptions. One commenter did not 
support granting these exemptions due to his or her concerns about 
these drivers refilling their medications while they are operating a 
CMVs on an interstate basis. Another commenter suggested that these 
applicants should provide complete medical histories and records and be 
incident free for at least two years. This commenter also stated his or 
her opinion that employers of drivers who have been issued an exemption 
be required to obtain additional accident liability insurance for these 
drivers. In reviewing these applications for exemptions, FMCSA 
evaluated the medical records of all eight applicants, obtained 
documentation of the treating physician's support for granting the 
applicant an exemption, and determined that granting these exemptions 
would achieve an equivalent or greater level of safety than would be 
achieved without the exemption. FMCSA does not require employers to 
obtain additional insurance for drivers with medical exemptions.

IV. Basis for Exemption Determination

    Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an exemption 
from the epilepsy and seizure disorder prohibition 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.
    In reaching the decision to grant these exemption requests, FMCSA 
considered the 2007 recommendations of the Agency's Medical Expert 
Panel (MEP). The January 15, 2013, Federal Register notice (78 FR 3069) 
provides the current MEP recommendations which is the criteria the 
Agency uses to grant seizure exemptions.
    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

[[Page 45724]]

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). A 
summary of each applicant's seizure history was discussed in the June 
21, 2018 Federal Register notice (83 FR 28896) and will not be repeated 
in this notice.
    These eight applicants have been seizure-free over a range of 4 to 
40 years while taking anti-seizure medication and maintained a stable 
medication treatment regimen for the last two years. In each case, the 
applicant's treating physician verified his or her seizure history and 
supports the ability to drive commercially.
    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 
applicants from the epilepsy and seizure disorder prohibition in 49 CFR 
391.41(b)(8) is likely to achieve a level of safety equal to that 
existing without the exemption.

V. Conditions and Requirements

    The terms and conditions of the exemption are provided to the 
applicants in the exemption document and includes the following: (1) 
Each driver must remain seizure-free and maintain a stable treatment 
during the two-year exemption period; (2) each driver must submit 
annual reports from their treating physicians attesting to the 
stability of treatment and that the driver has remained seizure-free; 
(3) each driver must undergo an annual medical examination by a 
certified Medical Examiner, as defined by 49 CFR 390.5; and (4) each 
driver 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.

VI. Preemption

    During the period the exemption is in effect, no State shall 
enforce any law or regulation that conflicts with this exemption with 
respect to a person operating under the exemption.

VII. Conclusion

    Based upon its evaluation of the eight exemption applications, 
FMCSA exempts the following drivers from the epilepsy and seizure 
disorder prohibition, 49 CFR 391.41(b)(8), subject to the requirements 
cited above:

Ricky B. Alegre (NJ)
Stephen M. Christner (PA)
Paul J. Gomez (CA)
Lawrence J. Knox (MA)
Thomas A. Ork (NY)
Constance Seale (DE)
Anne M. Spencer-Brown (WV)
Floyd C. Williams (VA)

    In accordance with 49 U.S.C. 31315(b)(1), each exemption will be 
valid for two years from the effective date unless revoked earlier by 
FMCSA. The exemption will be revoked if the following occurs: (1) The 
person 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.

    Issued on: August 30, 2018.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2018-19644 Filed 9-7-18; 8:45 am]
 BILLING CODE 4910-EX-P