I don't see it. Now I got it. Okay. Okay. So, um, what drug is immediately disqualifying for duty drivers? Methadone. Exactly. Um, the driver has a triple a three centimeters and reporting insidious onset of low back pain, how long should they be certified. Well, there are some, I guess, so, so right now this person is symptomatic. So that right, I would say, I think most people got this right the correct answer right now is not currently eligible, but it depends. Huh. Because they're currently symptomatic. And so, they need to be evaluated. Now if it turns out that that low back pain, the back pain was something else. Then that's fine. Then we can certify them with three centimeters. Drivers take initial certification with a BP of 158 over 94 is otherwise certified otherwise qualified maybe certified for. Yeah, three months is probably the most correct answer to go because their initial so this is their first time in the system. And that'll give them three months to get the blood pressure treated. Okay, even though it's because it's initial. Depending which chart you're following right. This person with a 158 over 94. Mike, you might certify them for a year, you, you could do that would that would be another answer that would not be completely wrong. They're not disqualified. Okay. So the DMV driver C3 certification with blood pressure 164 so they're a research with otherwise normal and I can certify this person for. And it's interesting, these answers are all over the place. So, initial recertification is 164 over 94, we will presume. I realize that's a bad word. We will presume that he hasn't been diagnosed in the past with stage three hypertension so he's never over 180 over 110. So, he could get a one year card or a three month card. They're both okay answers, he would not be disqualified. Okay. When checking your analysis during the physical exam, which the following requires additional information before they can be certified. Yeah, the glucose Syria is a real problem. Because, as of right now if this guy doesn't know he has any diseases until proven otherwise he's an uncontrolled diabetic. And then you can't certify them. The specific traits protein area. Just at least in my part of the country just means it's summer. A lot of people don't drink enough in the summer, a little dehydrated or they went for a run yesterday, or, you know, so that's I see that all the time, and that's that's not a disease questions. I'm just going to say, I've had a number of patients come in. I'm like, wow, they're serious like black did it. And they're like, Oh, well I'm on. Some people, this is too close to two plus glucose Syria. There are now medicines that will intentionally make you spill glucose new urine, and so glucose Syria, by itself is not disqualifying. If it's explained unexplained glucose Syria is disqualifying. And that's why I recommend you have a new commenter in your clinic. And when I had helpers. If they have glucose new urine, just do a finger stick, because I want both those pieces of data to come to me. And the ma's or the nurses could do all that. Now that I'm by myself I went and bought one on Amazon, there, they are dirt cheap. And because they come, they figure they're going to sell you're going to sell you a lifetime supply of little finger six things. You get like 100 so my guess is that they'll, they'll. I will never use 100 in the three years until I need to throw them out. Yeah, but there's a, there's a Walmart. Yeah. So anyway, so the glucose area is is a disqualifying one. The glucose area. The unexplained glucose area. Yeah, the person who's in their diabetic in their own treatment will talk. But if they're if they if they don't they say I'm not diabetic never been diabetic and you've got glucose Syria, we have a problem. So, somebody fails the whisper test you throw them in your audio audiogram, your audiometer booth. Is this person qualified or not. Okay, so the way you do this math we haven't done this part yet but they care about five one and 500 1000 and 2000. So you add them together. And if it's less than 120, they pass. So this guy's right ear. It's, I can't do this math 45, the one on the left here is too much. The right here though, is 3025 which is 55. So that's 40 and 30 that's 7070 is less than 120, they pass. Okay, that's the easy way to do the math. The key thing you have to be able to do is to pick out. Remember it's 500 1000 and 2000 what they care about, and they give you everything, and they're going to give you the whole year. Yeah, that's one year. It has to be have to pass in one year to be okay. Or the whisper test or the whisper test. 120 if you add them together. It's an average of 40. So if you really want to add them up and divide you can do that, but if you don't want to do the division. I can do three times 40 120 I can do that that makes the math simpler it's just adding. Okay, so person with blood pressure, and a new driver 140 over 92 otherwise normal certified for you guys are all over the place which is just fine, because I don't know what the right answer is right answer is not two years. Probably because they would be, I would consider them hypertensive, but maybe they're under 150 I don't know. I don't know what the right answer for this question is three months and one year will be the most defensible. The, even under the very actually three months is not defensible. Even under the very old system. This person would be eligible for a one year card if this their first time ever. They could have a one year card. So, the probably the most correct answer would be a one year card. You could argue for a two year card if you really wanted to, but it would be a one year card definitely. Actually that's not too yeah it would be a one year card is the correct answer for this one. Somebody had an MI how long do you have to wait. No, they know. They'd never mind. Yes, this is the two month one for actually having an MI, and, and there's a cardiologist, and you've had a stress test to at least six months. Okay, hitching and unhitching trailers requires. I'm sorry, you have to stress test. If it's an MI. I need something that tells me about their exercise capacity. I need something, I need some imaging. I stress test would be what you really want to at least, and all I want six months is fine. An echo might be okay if it's what I call perfectly normal. I wouldn't want no testing, that would that would make me very worried. And they may have the, you know, they may have done a cat, I mean today they're going to have gotten a cat. And if the cast is or EF is 50%. We're good. But if they haven't had anything done they just, you know, what I call the 1970s treatment of an MI would put you into the hallway a little nitro a little morphine, some oxygen and send the priest down to see you. If that's what they're, if that's the way they were treated which sometimes happens. Then I worried. They left the hospital the next morning, because they felt better and they just got up and left. I've had, I've seen several of those patients homeowners are tough. Okay so hatching and hatching on hitching preemption and power grass. Absolutely. And drivers weight is unimportant for these two tasks, because you have to fit under the trailer, but if they can fit under the trailer they're good. The driver taking insulin diabetes company by treating doctors note on their prescription pad, saying he's fine to be a commercial vehicle driver. And what does he get cannot certify this absolutely correct. It has to be on their FMCSA form, there's no, no choice that no options. I would want to know the question I would want to know is, was what, when do they need the nitro. If they only need it with what I would consider to be actual exertion, then I'm probably okay with this. And then we have to talk about what they do, if they're, you know, how they protect themselves if they have to use a nitro while they're driving, like, get off the road don't pop a nitro while you're driving at 80 miles an hour. But that person probably could be certified, which the following is an exam finding covered by specific regulation from FMCSA with no examiner discretion is vision, right, there's a certain standard you got to meet the standard you got me the standard not there this way this is the one of the areas where it's not his best medical judgment. This one actually has rules. During the exam a driver for recertification has a blood pressure of 148 over 94, taking blood pressure measurement for two years recommendation is. And this one is you're going to follow the old recommendation. You're going to give them a three month card to get their blood pressure fixed going to follow the new recommendation might give them one year card until I get the blood pressure fixed. At all cases you're hitting your health based recommendation is their blood pressures too hot. You could pen this and send back to the treatment physician if you're, if you're not comfortable with this level of blood pressure, you could pen this and send it back there treating physician that's also okay. Not a two year car. I'm not. Okay, so the waiting period for someone who has had a moderate TBI without early seizures is yeah it's a two year waiting period. Because the key words is without early seizures. I this is my area that drives me nuts I really wish they, I wish we had a better way to deal with people with mild TBI is because, unfortunately, the research doesn't care. And these are the people that I think are getting stuck in jail for too long. Two years. Yeah, we're back to agree with this stuff that doesn't agree with itself. I think, I think that came from their book, because there's a chart, which is, which is really long waiting periods. And then there's the book and then there was some stuff in the hand in the research retraining. I forgot where that came where the one year came from. And again, this is where this is the part that's super frustrating so I the test worries. A driver's implantable defibrillator put in place eight months ago, got a note from his cardiologist said he said no activations, and he's ready to go back to truck driving. Yeah, that's a not, that's a not eligible. I agree. I like going through questions because these are, but but we're service. Yeah, we're moving. Okay, so drive with pacemaker certified for how long. When you're just got to make sure we go back to his cardiologist exercise stress test is often done how often as directed by the cardiologist the correct answer. Cabbage is three months to let everything heal. Correct. Certain master heal, and they have to have what I do is have the people, hold their arms out and bring their arms in and if they can do that without screaming, probably okay. Resist it I'm saying yeah I'm there. I put my I keep the I hold, hold their arms out and they try to bring them in this way, because that that that's what makes them move their sternum, and if they, if they wince, they're not ready. They'll just do it we're okay. Are you assuming that the projection fractions. Well this is a bare minimum. Right. Yes, this is where the F over 40% because nobody can drive with the F less than 40, which the following impact driver safety, and would be. That's a medical one would be the mental conditions I can't adjust the other ones non discretionary disqualification for the vision standard, or is is color vision, have to be able to do red, green and amber. The missing the right foot back to certification period with SP. One year, two years. That's the recipe is the only thing wrong is that it's up to them to have the SP, not me, because SP separate assist it's a separate process from their medical certification. If everything else is fine. They never to your card. The guy with the artificial left foot that's not going to change right. What is the next step in a driver with greater than 40 decibel hearing loss in one year but normally other year, give him a card.

driver medical evaluation

disqualification conditions

hypertension certification

hearing assessment

visual acuity regulations