MEMBERSHIP ALERT!

Medical Certification Changes

 

The Union was recently made aware of the implementation of recommendations from the Federal Motor Carrier Safety Administration (FMCSA) for changes in medical certification regarding the effect of Obstructive Sleep Apnea (OSA) on Commercial Motor Vehicle Driver safety.

 

Since December 2008, individuals who hold a Commercial Drivers License (CDL) are subject to a Body Mass Index (BMI) evaluations as an objective method for identifying individuals at high risk for OSA.  Studies in CDL holders have identified that a BMI, a measure of obesity, of 33kg/m2 is the optimal cut-point to identify, using this information alone (height/weight), who is likely to have OSA.

 

In a study released on January 14, 2008, the FMCSA has determined that there is substantial data that OSA is associated with an increased risk of crashes in passenger cars.  However, there has been little study of Commercial Drivers.  While the generalization of the findings may not be conclusive, the findings allow the opportunity to draw evidence-based conclusions about the relationship between OSA and motor vehicle crash risk in general.

 

If an individual has a BMI index of 33 kg/m2 or greater, they may be conditionally certified for 1 month pending the findings of a sleep study.  The sleep study, usually done in-facility, should be done within a week of diagnosis.  Individuals recently diagnosed with OSA may be conditionally certified for 1 month during which time they will be started on CPAP therapy.  At the end of this month, they can be conditionally certified for 3 months if compliance to CPAP is documented in the two previous weeks.  Compliance should be reassessed at 3 months.  If at the 3-month assessment an individual demonstrates treatment compliance, that individual may be certified for a period of 1 year.   If the individual is not in compliance, their certification may not be renewed or only renewed for a brief period to allow compliance with therapy to be re-established.  The FMCSA also warns that if an individual stops using their CPAP and is involved in a crash (related to the condition), then it is likely that the legal community will consider them liable.

 

The intentions of the change in medical certification appear to be the facilitation of the diagnosis and treatment for OSA to reduce the risk of crashes and other sleep-deprivation incidents and conditions, such as the increased risk of heart damage associated with OSA.

 

We are actively investigating this matter, and will give an in-depth report in the next edition of our Local’s newsletter:  Route 265.

 

Fraternally,

 

LORETTA A. SPRINGER

President and Business Agent

 

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