OPAM Workshop: DOT FMCSA NRCME Course-263074

263074 - Article 6

Pdf Summary

The American Osteopathic College of Occupational and Preventive Medicine provides guidelines for certifying commercial motor vehicle (CMV) drivers regarding neurological conditions, such as epilepsy, seizures following brain insults, traumatic brain injuries (TBI), and vertigo. The certification process for these health issues is guided by the Department of Transportation's (DOT) Federal Motor Carrier Safety Administration (FMCSA) regulations.

<strong>Epilepsy and Seizures</strong>: 
A person diagnosed with epilepsy or with a medical history featuring two unprovoked seizures is considered unqualified to drive a CMV as per FMCSA criteria outlined in 49 CFR 391.41(b)(8). A seizure-free period of at least 10 years, alongside being off antiseizure medications, is required for potential qualification, though a waiver is possible after 8 years. A single unprovoked seizure requires the driver to be seizure-free and off medications for 5 years for differentiation from epilepsy.

<strong>Traumatic Brain Injury (TBI)</strong>: 
Certification is influenced by the severity of the injury – mild, moderate, or severe – and whether early seizures occurred. For moderate TBI without early seizures, a 2-year seizure-free period without anticonvulsants is required, while moderate TBI with early seizures necessitates a 5-year seizure-free period. Severe TBI, regardless of seizures, largely results in non-certification.

<strong>Stroke</strong>: 
Drivers post-stroke must wait a minimum of 1 year if at no risk for seizures, or 5 years if there is seizure risk, before certification. Certification relies on neurologist evaluation ensuring no residual deficits affecting driving ability. Annual examinations are a key follow-up measure. 

<strong>Vertigo and Dizziness</strong>: 
Certification depends on diagnosis and treatment status. Individuals experiencing benign positional vertigo or acute/chronic peripheral vestibulopathy must complete a symptom-free waiting period before consideration. Drivers must be assessed for potential medication side effects, especially sedatives.

The guidelines emphasize careful evaluation and consultation with neurologists to ensure medical fitness without jeopardizing driving safety.

Keywords

American Osteopathic College

Occupational Medicine

Preventive Medicine

CMV certification

neurological conditions

epilepsy

traumatic brain injury

stroke

vertigo

FMCSA regulations