The Medical Review Board of the Federal Motor Carrier Safety Administration (FMCSA) outlined its official recommendations to the agency on screening and disqualification criteria for truck drivers who are suspected of having moderate to severe obstructive sleep apnea. Here we will cover the Code of Regulations and an explanation of the program phases. For additional information on the boards preliminary recommendations, read Part 1 of this series here.
Code of Federal Regulations:
CFR Section 391.41(a)(1)(i)states physical qualifications for drivers now require that a commercial driver may .... not operate a commercial motor vehicle unless he or she is medically certified as physically qualified to do so....
CFR Section 391.41(b)(5)further states that a person is qualified to drive a commercial motor vehicle provided that person: Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with ability to control and drive a commercial motor vehicle safely.
Sleep apnea is specifically included as a respiratory dysfunction that is likely to interfere with ability to control and drive a commercial motor vehicle. Simply put, screening for a respiratory dysfunction (sleep apnea) is now mandated and automatically included in the drivers medical card exam.
If the certified medical examiner (CME) suspects that the driver might suffer from sleep apnea, the CME must refer the driver to a sleep specialist for testing; and if tested positive, for treatment.
The medical examiner cannot sign off on the medical exam unless this portion of the exam is completed and done so in a timely fashion. If the exam is not completed in timely fashion, the commercial drivers license will either be suspended or simply not renewed. In either event, the driver will not be permitted to drive unless an extension is obtained for purposes of completing the exam. There are NO EXCEPTIONS. Most clinics will grant a 90-day extension for purposes of obtaining a sleep apnea test and, when indicated, participation in a treatment program.
While some clinics will grant additional extensions, those are becoming fewer and fewer due to the mounting risk of accidents and concurrent liability for both the driver and employer. When treatment is indicated, the driver will be permitted to continue driving provided he/she participates in an approved treatment program traditionally, a Continuous Positive Airway Pressure (CPAP) device.
In-lab testing usually requires more than one session at a cost of between $1,500 and $5,000. To reduce the overall costs and anxiety occasioned toour driversas a result of these new Regulations, we have made special arrangements with the nations leading sleep apnea screening, testing and treatment company,SleepMaster SolutionsTM (SMS), specializing in the transportation industry and, in particular, commercial drivers. SMS will conduct an initial, no-cost screening of all of our clients, and our clients drivers. This screening can be conducted at the drivers convenience, electronically through SMS telemedicine network, or, if preferred, at one of SMS clinic facilities located in all 50 states.
Screening can be done at a time well before the drivers required medical exam without impacting or otherwise shortening the time for the required medical exam. By doing so, the driver knows well beforehand whether or not he/she has sleep apnea, and if so, can access the appropriate regulatory compliant treatment program before the required medical exam. SMS will absorb the full cost of this screening process. If the driver tests positive, he/she MUST BECOME FULLY COMPLIANT with the DOT Regulations in order to continue driving commercially.
Helpe Inc.has an agreement that may be used to refer drivers for free sleep apnea evaluations, which may result in a negative finding for sleep apnea. This would result in the driver receiving a sleep apnea evaluation certificate, which could then be taken to his/her DOT physician to be used in conjunction with the DOT physical.
If a driver were in need of further sleep apnea studies, the company provides an in-home evaluation, which can be accomplished without waiting months for an appointment and done at a discounted price.
Phase 1 of the program involves the screening process.All drivers can be screened for sleep apnea symptoms, or lack of, before their required medical exam. Screening is conducted electronically, at the drivers convenience, by the SleepMaster Solutions team of telemedicine physicians. In the event the driver does not have any indications of sleep apnea, a medical report and a Certificate of Compliance will be issued to this effect.
Phase 2 occurs only if driver has indications of sleep apnea. SleepMaster will provide the driver with appropriate home sleep test (HST) machine for their use. If the driver tests negative for sleep apnea, a medical report and Certificate of Compliance will be issued. If the driver tests positive for sleep apnea, he enters Phase III of the program. Pricing for Phase 2 of the Program includes shipping and handling to the driver, medical review of the test results, and a medical report provided to the driver and his/her physician. The fee for the complete HST and medical report is $495, and payment plans are available.
Phase 3 is the treatment portion of the Program.In Phase 3, a network physician will provide a prescription for the driver to receive a DeVilbiss IntelliPAP Auto Adjust System with heated humidifier, or comparable CPAP unit. To obtain the physical, a driver diagnosed with sleep apnea must present evidence of participating in a treatment program for at least 30 days prior to the physical. SleepMaster provides the driver with evidence of such participation in the form of a Certificate of Compliance. Pricing includes choice of mask with headgear (nasal or full face), travel case, tubing and filters, and DOT compliance report reviews. The fee for the Phase 3 treatment plan, including the Certificate of Compliance is $1,400. Payment plans are available.
We believe this is a hassle free, lower cost alternative to the pressing sleep apnea recommendations being brought forward by the Medical Review Board.
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Combined Express, Inc. and Delaware Valley Shippers, Inc. provide over the road and intermodal LTL and Truckload transportation services throughout the United States. Customized packages are available to satisfy your transportation needs.