80 FR 16497 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 59 (March 27, 2015)

Page Range		16497-16500
FR Document		2015-07051

FMCSA announces its decision to grant requests from 8 individuals for exemptions from the regulatory requirement 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 regulation and the associated advisory criteria published in the Code of Federal Regulations as the ``Instructions for Performing and Recording Physical Examinations'' have resulted in numerous drivers being prohibited from operating CMVs in interstate commerce based on the fact that they have had one or more seizures and are taking anti-seizure medication, rather than an individual analysis of their circumstances by a qualified medical examiner. The Agency concluded that granting exemptions for these CMV drivers will provide a level of safety that is equivalent to or greater than the level of safety maintained without the exemptions. FMCSA grants exemptions that will allow these 8 individuals to operate CMVs in interstate commerce for a 2-year period. The exemptions preempt State laws and regulations and may be renewed.

Federal Register, Volume 80 Issue 59 (Friday, March 27, 2015)

[Federal Register Volume 80, Number 59 (Friday, March 27, 2015)]
[Notices]
[Pages 16497-16500]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-07051]


-----------------------------------------------------------------------

DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2014-0215]


Qualification of Drivers; Exemption Applications; Epilepsy and 
Seizure Disorders

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of final disposition.

-----------------------------------------------------------------------

SUMMARY: FMCSA announces its decision to grant requests from 8 
individuals for exemptions from the regulatory requirement 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 regulation and the associated advisory 
criteria published in the Code of Federal Regulations as the 
``Instructions for Performing and Recording Physical Examinations'' 
have resulted in numerous drivers being prohibited from operating CMVs 
in interstate commerce based on the fact that they have had one or more 
seizures and are taking anti-seizure medication, rather than an 
individual analysis of their circumstances by a qualified medical 
examiner. The Agency concluded that granting exemptions for these CMV 
drivers will provide a level of safety that is equivalent to or greater 
than the level of safety maintained without the exemptions. FMCSA 
grants exemptions that will allow these 8 individuals to operate CMVs 
in interstate commerce for a 2-year period. The exemptions preempt 
State laws and regulations and may be renewed.

DATES: The exemptions are effective March 27, 2015. The exemptions 
expire on March 27, 2017.

FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director, 
Office of Carrier, Driver and Vehicle Safety, (202) 366-4001, 
[email protected],

[[Page 16498]]

FMCSA, Department of Transportation, 1200 New Jersey Avenue SE., Room 
W64-224, Washington, DC 20590-0001. Office hours are 8:30 a.m. to 5 
p.m., E.T., Monday through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION:

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

B. Background

    Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an exemption 
from the safety regulations for a 2-year period if it finds ``such 
exemption would likely achieve a level of safety that is equivalent to 
or greater than the level that would be achieved absent such 
exemption.'' The statute also allows the Agency to renew exemptions at 
the end of the 2-year period.
    FMCSA grants 8 individuals an exemption from the regulatory 
requirement in Sec.  391.41(b)(8), to allow these individuals who take 
anti-seizure medication to operate CMVs in interstate commerce for a 2-
year period. The Agency's decision on these exemption applications is 
based on an individualized assessment of each applicant's medical 
information, including the root cause of the respective seizure(s), the 
length of time elapsed since the individual's last seizure, and each 
individual's treatment regimen. In addition, the Agency reviewed each 
applicant's driving record found in the Commercial Driver's License 
Information System (CDLIS) \1\ for commercial driver's license (CDL) 
holders, and interstate and intrastate inspections recorded in Motor 
Carrier Management Information System (MCMIS).\2\ For non-CDL holders, 
the Agency reviewed the driving records from the State licensing 
agency. The Agency acknowledges the potential consequences of a driver 
experiencing a seizure while operating a CMV. However, the Agency 
believes the drivers covered by the exemptions granted here have 
demonstrated that they are unlikely to have a seizure and their medical 
condition does not pose a risk to public safety.
---------------------------------------------------------------------------

    \1\ Commercial Driver's License Information System (CDLIS) is an 
information system that allows the exchange of commercial driver 
licensing information among all the States. CDLIS includes the 
databases of fifty-one licensing jurisdictions and the CDLIS Central 
Site, all connected by a telecommunications network.
    \2\ Motor Carrier Management Information System (MCMIS) is an 
information system that captures data from field offices through 
SAFETYNET, CAPRI, and other sources. It is a source for FMCSA 
inspection, crash, compliance review, safety audit, and registration 
data.
---------------------------------------------------------------------------

    In reaching the decision to grant these exemption requests, the 
Agency considered both current medical literature and information and 
the 2007 recommendations of the Agency's Medical Expert Panel (MEP). 
The Agency previously gathered evidence for potential changes to the 
regulation at 49 CFR 391.41(b)(8) by conducting a comprehensive review 
of scientific literature that was compiled into the ``Evidence Report 
on Seizure Disorders and Commercial Vehicle Driving'' (Evidence Report) 
[CD-ROM HD TL230.3 .E95 2007]. The Agency then convened a panel of 
medical experts in the field of neurology (the MEP) on May 14-15, 2007, 
to review 49 CFR 391.41(b)(8) and the advisory criteria regarding 
individuals who have experienced a seizure, and the 2007 Evidence 
Report. The Evidence Report and the MEP recommendations are published 
on-line at http://www.fmcsa.dot.gov/rules-regulations/topics/mep/mep-reports.htm, under Seizure Disorders, and are in the docket for this 
notice.

MEP Criteria for Evaluation

    On October 15, 2007, the MEP issued the following recommended 
criteria for evaluating whether an individual with epilepsy or a 
seizure disorder should be allowed to operate a CMV.\3\ The MEP 
recommendations are included in previously published dockets.
---------------------------------------------------------------------------

    \3\ Engel, J., Fisher, R.S., Krauss, G.L., Krumholz, A., and 
Quigg, M.S., ``Expert Panel Recommendations: Seizure Disorders and 
Commercial Motor Vehicle Driver Safety,'' FMCSA, October 15, 2007.
---------------------------------------------------------------------------

    Epilepsy diagnosis. If there is an epilepsy diagnosis, the 
applicant should be seizure-free for 8 years, on or off medication. If 
the individual is taking anti-seizure medication(s), the plan for 
medication should be stable for 2 years. Stable means no changes in 
medication, dosage, or frequency of medication administration. 
Recertification for drivers with an epilepsy diagnosis should be 
performed every year.
    Single unprovoked seizure. If there is a single unprovoked seizure 
(i.e., there is no known trigger for the seizure), the individual 
should be seizure-free for 4 years, on or off medication. If the 
individual is taking anti-seizure medication(s), the plan for 
medication should be stable for 2 years. Stable means no changes in 
medication, dosage, or frequency of medication administration. 
Recertification for drivers with a single unprovoked seizure should be 
performed every 2 years.
    Single provoked seizure. If there is a single provoked seizure 
(i.e., there is a known reason for the seizure), the Agency should 
consider specific criteria that fall into the following two categories: 
Low-risk factors for recurrence and moderate-to-high risk factors for 
recurrence.
     Examples of low-risk factors for recurrence include 
seizures that were caused by a medication; by non-penetrating head 
injury with loss of consciousness less than or equal to 30 minutes; by 
a brief loss of consciousness not likely to recur while driving; by 
metabolic derangement not likely to recur; and by alcohol or illicit 
drug withdrawal.
     Examples of moderate-to-high-risk factors for recurrence 
include seizures caused by non-penetrating head injury with loss of 
consciousness or amnesia greater than 30 minutes, or penetrating head 
injury; intracerebral hemorrhage associated with a stroke or trauma; 
infections; intracranial hemorrhage; post-operative complications from 
brain surgery with significant brain hemorrhage; brain tumor; or 
stroke.
    The MEP report indicates individuals with moderate to high-risk 
conditions should not be certified. Drivers with a history of a single 
provoked seizure with low risk factors for recurrence should be 
recertified every year.

Medical Review Board Recommendations and Agency Decision

    FMCSA presented the MEP's findings and the Evidence Report to the 
Medical Review Board (MRB) for consideration. The MRB reviewed and 
considered the 2007 ``Seizure Disorders and Commercial Driver Safety'' 
evidence report and the 2007 MEP recommendations. The MRB recommended 
maintaining the current advisory criteria, which provide that

[[Page 16499]]

``drivers with a history of epilepsy/seizures off anti-seizure 
medication and seizure-free for 10 years may be qualified to drive a 
CMV in interstate commerce. Interstate drivers with a history of a 
single unprovoked seizure may be qualified to drive a CMV in interstate 
commerce if seizure-free and off anti-seizure medication for a 5 year 
period or more'' [Advisory criteria to 49 CFR 391.43(f)].
    The Agency acknowledges the MRB's position on the issue but 
believes relevant current medical evidence supports a less conservative 
approach. The medical advisory criteria for epilepsy and other seizure 
or loss of consciousness episodes was based on the 1988 ``Conference on 
Neurological Disorders and Commercial Drivers'' (NITS Accession No. 
PB89-158950/AS). A copy of the report can be found in the docket 
referenced in this notice.
    The MRB's recommendation treats all drivers who have experienced a 
seizure the same, regardless of individual medical conditions and 
circumstances. In addition, the recommendation to continue prohibiting 
drivers who are taking anti-seizure medication from operating a CMV in 
interstate commerce does not consider a driver's actual seizure history 
and time since the last seizure. The Agency has decided to use the 2007 
MEP recommendations as the basis for evaluating applications for an 
exemption from the seizure regulation on an individual, case-by-case 
basis.

C. Exemptions

    Following individualized assessments of the exemption applications, 
including a review of detailed follow-up information requested from 
each applicant, FMCSA is granting exemptions from 49 CFR 391.41(b)(8) 
to 8 individuals. Under current FMCSA regulations, all of the 8 drivers 
receiving exemptions from 49 CFR 391.41(b)(8) would have been 
considered physically qualified to drive a CMV in interstate commerce 
except that they presently take or have recently stopped taking anti-
seizure medication. For these 8 drivers, the primary obstacle to 
medical qualification was the FMCSA Advisory Criteria for Medical 
Examiners, based on the 1988 ``Conference on Neurological Disorders and 
Commercial Drivers,'' stating that a driver should be off anti-seizure 
medication in order to drive in interstate commerce. In fact, the 
Advisory Criteria have little if anything to do with the actual risk of 
a seizure and more to do with assumptions about individuals who are 
taking anti-seizure medication.
    In addition to evaluating the medical status of each applicant, 
FMCSA evaluated the crash and violation data for the 8 drivers, some of 
whom currently drive a CMV in intrastate commerce. The CDLIS and MCMIS 
were searched for crash and violation data on the 8 applicants. For 
non-CDL holders, the Agency reviewed the driving records from the State 
licensing agency.
    These exemptions are contingent on the driver maintaining a stable 
treatment regimen and remaining seizure-free during the 2-year 
exemption period. The exempted drivers must submit annual reports from 
their treating physicians attesting to the stability of treatment and 
that the driver has remained seizure-free. The driver must undergo an 
annual medical examination by a medical examiner, as defined by 49 CFR 
390.5, following the FCMSA's regulations for the physical 
qualifications for CMV drivers.
    FMCSA published a notice of receipt of application and requested 
public comment during a 30-day public comment period in a Federal 
Register notice for each of the applicants. A short summary of the 
applicants' qualifications and a discussion of the comments received, 
if any, follows this section. For applicants who were denied an 
exemption, a notice will be published at a later date.

D. Comments

Docket # FMCSA-2014-0215

    On September 9, 2014, FMCSA published a notice of receipt of 
exemption applications and requested public comment on 12 individuals 
(79 FR 53512; Docket number FMCSA-2014-21421). The comment period ended 
on October 9, 2014. No commenters responded to this Federal Register 
notice. Of the 12 applicants, four were denied. The Agency has 
determined that the following eight applicants should be granted an 
exemption.
Thomas Avery, Jr.
    Mr. Avery is a 45 year-old class B CDL holder in New York. He has a 
history of seizure and has remained seizure free since 1998. He takes 
anti-seizure medication with the dosage and frequency remaining the 
same since that time. If granted an exemption, he would like to drive a 
CMV. His physician states he is supportive of Mr. Avery receiving an 
exemption.
Michael G. Berthiaume
    Mr. Berthiaume is a 54 year-old driver in Minnesota. He has a 
history of seizure and has remained seizure free since 2006. He takes 
anti-seizure medication with the dosage and frequency remaining the 
same since November 2013. If granted an exemption, he would like to 
drive a CMV. His physician states he is supportive of Mr. Berthiaume 
receiving an exemption.
Leo Kurt Clemens
    Mr. Clemens is a 59 year-old class B CDL holder in Pennsylvania. He 
has a history of seizure and has remained seizure free for more than 25 
years. He takes anti-seizure medication with the dosage and frequency 
remaining the same for 3 years. If granted the exemption, he would like 
to drive a CMV. His physician states that he is supportive of Mr. 
Clemens receiving an exemption.
Danny Lee Crafton
    Mr. Crafton is a 65 year-old class A CDL holder in Idaho. He has a 
history of seizure and has remained seizure free since 1974. He takes 
anti-seizure medication with the dosage and frequency remaining the 
same since 2001. If granted the exemption, he would like to drive a 
CMV. His physician states that he is supportive of Mr. Crafton 
receiving an exemption.
Kenneth D. Peachey
    Mr. Peachey is a 72 year-old class A CDL holder in Pennsylvania. He 
has a history of seizure and has remained seizure free since 1984. He 
takes anti-seizure medication with the dosage and frequency remaining 
the same since that time. If granted the exemption, he would like to 
drive a CMV. His physician states that he is supportive of Mr. Peachey 
receiving an exemption.
Philip Neil Stewart
    Mr. Stewart is a 43 year-old class A CDL holder in California. He 
has a history of a seizure disorder and has remained seizure free for 
30 years. He takes anti-seizure medication with the dosage and 
frequency remaining the same for 15 years. If granted the exemption, he 
would like to drive a CMV. His physician states that he is supportive 
of Mr. Stewart receiving an exemption.
Keith T. White
    Mr. White is a 59 year-old class A CDL holder in Pennsylvania. He 
has a history of seizure and has remained seizure free since 1994. He 
takes anti-seizure medication with the dosage and frequency remaining 
the same since 2004. If granted the exemption, he would like to drive a 
CMV. His physician states that he is supportive of Mr. White receiving 
an exemption.

[[Page 16500]]

Alan T. Von Lintel
    Mr. Von Lintel is a 60 year-old driver in Kansas. He has a history 
of a seizure disorder and has remained seizure free since 2004. He 
takes anti-seizure medication with the dosage and frequency remaining 
the same since July 2012. If granted the exemption, he would like to 
drive a CMV. His physician states that he is supportive of Mr. Von 
Lintel receiving an exemption.

E. Basis for Exemption

    Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an exemption 
from the epilepsy/seizure standard 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. Without the exemption, 
applicants will continue to be restricted to intrastate driving. With 
the exemption, applicants can drive in interstate commerce. Thus, the 
Agency's analysis focuses on whether an equal or greater level of 
safety is likely to be achieved by permitting each of these drivers to 
drive in interstate commerce as opposed to restricting the driver to 
driving in intrastate commerce.

Conclusion

    The Agency is granting exemptions from the epilepsy standard, 49 
CFR 391.41(b)(8), to 8 individuals based on a thorough evaluation of 
each driver's safety experience, and medical condition. Safety analysis 
of information relating to these 8 applicants meets the burden of 
showing that granting the exemptions would achieve a level of safety 
that is equivalent to or greater than the level that would be achieved 
without the exemption. By granting the exemptions, the interstate CMV 
industry will gain 8 highly trained and experienced drivers. In 
accordance with 49 U.S.C. 31315(b)(1), each exemption will be valid for 
2 years, with annual recertification required 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.
    FMCSA exempts the following 8 drivers for a period of 2 years with 
annual medical certification required: Thomas Avery (NY); Michael 
Berthiaume (MN); Leo Clemens (PA); Danny Grafton (ID); Kenneth Peachey 
(PA); Philip Stewart (CA); Keith White (PA); and Alan Von Lintel (KS) 
from the prohibition of CMV operations by persons with a clinical 
diagnosis of epilepsy or seizures. If the exemption is still in effect 
at the end of the 2-year period, the person may apply to FMCSA for a 
renewal under procedures in effect at that time.

    Issued on: March 19, 2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015-07051 Filed 3-26-15; 8:45 am]
 BILLING CODE 4910-EX-P

Federal Register / Vol. 80, No. 59 / Friday, March 27, 2015 / Notices 16497

has remained seizure-free. The driver Robert Thomas, Jr. CMV operations by persons with a
must undergo an annual medical Mr. Thomas is a 47 year-old driver in clinical diagnosis of epilepsy or
examination by a medical examiner, as North Carolina. He has a history of seizures. If the exemption is still in
defined by 49 CFR 390.5, following the seizures and has remained seizure free effect at the end of the 2-year period, the
FCMSA’s regulations for the physical since 1999. He takes anti-seizure person may apply to FMCSA for a
qualifications for CMV drivers. medication with the dosage and renewal under procedures in effect at
FMCSA published a notice of receipt that time.
frequency remaining the same since that
of application and requested public Issued on: March 20, 2015.
time. If granted the exemption, he
comment during a 30-day public
comment period in a Federal Register would like to drive a CMV. His Larry W. Minor,
notice for each of the applicants. A short physician states that he is supportive of Associate Administrator for Policy.
summary of the applicants’ Mr. Thomas receiving an exemption. [FR Doc. 2015–07053 Filed 3–26–15; 8:45 am]
qualifications and a discussion of the E. Basis for Exemption BILLING CODE 4910–EX–P
comments received, if any, follows this
Under 49 U.S.C. 31136(e) and
section. For applicants who were denied
31315(b), FMCSA may grant an DEPARTMENT OF TRANSPORTATION
an exemption, a notice will be
exemption from the epilepsy/seizure
published at a later date.
standard in 49 CFR 391.41(b)(8) if the Federal Motor Carrier Safety
D. Comments exemption is likely to achieve an Administration
Docket # FMCSA–2014–0213 equivalent or greater level of safety than
[Docket No. FMCSA–2014–0215]
would be achieved without the
On August 12, 2014, FMCSA exemption. Without the exemption, Qualification of Drivers; Exemption
published a notice of receipt of applicants will continue to be restricted Applications; Epilepsy and Seizure
exemption applications and requested to intrastate driving. With the
public comment on six individuals (79 Disorders
exemption, applicants can drive in
FR 47174; Docket number FMCSA– interstate commerce. Thus, the Agency’s AGENCY: Federal Motor Carrier Safety
2014–19076). The comment period analysis focuses on whether an equal or Administration (FMCSA), DOT.
ended on September 11, 2014. No greater level of safety is likely to be ACTION: Notice of final disposition.
commenters responded to this Federal achieved by permitting each of these
Register notice. Of the six applicants, drivers to drive in interstate commerce SUMMARY: FMCSA announces its
two were denied. The Agency has as opposed to restricting the driver to decision to grant requests from 8
determined that the following four driving in intrastate commerce. individuals for exemptions from the
applicants should be granted an regulatory requirement that interstate
exemption. Conclusion commercial motor vehicle (CMV)
The Agency is granting exemptions drivers have ‘‘no established medical
Lee H. Anderson
from the epilepsy standard, 49 CFR history or clinical diagnosis of epilepsy
Mr. Anderson is a 41 year-old driver or any other condition which is likely
391.41(b)(8), to 4 individuals based on
in Massachusetts. He has a history of to cause loss of consciousness or any
a thorough evaluation of each driver’s
seizures and has remained seizure free loss of ability to control a CMV.’’ The
safety experience, and medical
since 2002. He takes anti-seizure regulation and the associated advisory
condition. Safety analysis of
medication with the dosage and criteria published in the Code of Federal
information relating to these 4
frequency remaining the same since that Regulations as the ‘‘Instructions for
applicants meets the burden of showing
time. If granted an exemption, he would Performing and Recording Physical
that granting the exemptions would
like to drive a CMV. His physician states Examinations’’ have resulted in
achieve a level of safety that is
he is supportive of Mr. Anderson numerous drivers being prohibited from
receiving an exemption. equivalent to or greater than the level
that would be achieved without the operating CMVs in interstate commerce
Gary A. Combs, Jr. exemption. By granting the exemptions, based on the fact that they have had one
the interstate CMV industry will gain 4 or more seizures and are taking anti-
Mr. Combs is a 38 year-old driver in
highly trained and experienced drivers. seizure medication, rather than an
Kentucky. He has a history of one
In accordance with 49 U.S.C. individual analysis of their
seizure in 2006 due to a brain tumor
31315(b)(1), each exemption will be circumstances by a qualified medical
which was removed in 2006 and has
valid for 2 years, with annual examiner. The Agency concluded that
remained seizure free since that time.
recertification required unless revoked granting exemptions for these CMV
He does not take anti-seizure
earlier by FMCSA. The exemption will drivers will provide a level of safety that
medication. If granted an exemption, he
be revoked if the following occurs: (1) is equivalent to or greater than the level
would like to drive a CMV. His
The person fails to comply with the of safety maintained without the
physician states he is supportive of Mr.
terms and conditions of the exemption; exemptions. FMCSA grants exemptions
Combs receiving an exemption.
(2) the exemption has resulted in a that will allow these 8 individuals to
Roland K. Mezger lower level of safety than was operate CMVs in interstate commerce
Mr. Mezger is a 41 year-old driver in maintained prior to being granted; or (3) for a 2-year period. The exemptions
Pennsylvania. He has a history of continuation of the exemption would preempt State laws and regulations and
may be renewed.
mstockstill on DSK4VPTVN1PROD with NOTICES

juvenile epilepsy and has remained not be consistent with the goals and
seizure free since 1997. He takes anti- objectives of 49 U.S.C. 31136 and 31315. DATES: The exemptions are effective
seizure medication with the dosage and FMCSA exempts the following 4 March 27, 2015. The exemptions expire
frequency remaining the same since that drivers for a period of 2 years with on March 27, 2017.
time. If granted the exemption, he annual medical certification required: FOR FURTHER INFORMATION CONTACT:
would like to drive a CMV. His Lee Anderson (MA); Gary Combs, Jr. Charles A. Horan, III, Director, Office of
physician states he is supportive of Mr. (KY); Roland Mezger (PA); and Robert Carrier, Driver and Vehicle Safety, (202)
Mezger receiving an exemption. Thomas, Jr. (NC) from the prohibition of 366–4001, fmcsamedical@dot.gov,

VerDate Sep<11>2014 20:59 Mar 26, 2015 Jkt 235001 PO 00000 Frm 00139 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1

16498 Federal Register / Vol. 80, No. 59 / Friday, March 27, 2015 / Notices

FMCSA, Department of Transportation, for commercial driver’s license (CDL) anti-seizure medication(s), the plan for
1200 New Jersey Avenue SE., Room holders, and interstate and intrastate medication should be stable for 2 years.
W64–224, Washington, DC 20590–0001. inspections recorded in Motor Carrier Stable means no changes in medication,
Office hours are 8:30 a.m. to 5 p.m., Management Information System dosage, or frequency of medication
E.T., Monday through Friday, except (MCMIS).2 For non-CDL holders, the administration. Recertification for
Federal holidays. Agency reviewed the driving records drivers with an epilepsy diagnosis
SUPPLEMENTARY INFORMATION: from the State licensing agency. The should be performed every year.
Agency acknowledges the potential Single unprovoked seizure. If there is
A. Electronic Access consequences of a driver experiencing a a single unprovoked seizure (i.e., there
You may see all the comments online seizure while operating a CMV. is no known trigger for the seizure), the
through the Federal Document However, the Agency believes the individual should be seizure-free for 4
Management System (FDMS) at: http:// drivers covered by the exemptions years, on or off medication. If the
www.regulations.gov. granted here have demonstrated that individual is taking anti-seizure
Docket: For access to the docket to they are unlikely to have a seizure and medication(s), the plan for medication
read background documents or their medical condition does not pose a should be stable for 2 years. Stable
comments, go to http:// risk to public safety. means no changes in medication,
www.regulations.gov and/or Room In reaching the decision to grant these dosage, or frequency of medication
W12–140 on the ground level of the exemption requests, the Agency administration. Recertification for
West Building, 1200 New Jersey Avenue considered both current medical drivers with a single unprovoked
SE., Washington, DC, between 9 a.m. literature and information and the 2007 seizure should be performed every 2
and 5 p.m., e.t., Monday through Friday, recommendations of the Agency’s years.
Medical Expert Panel (MEP). The Single provoked seizure. If there is a
except Federal holidays.
Agency previously gathered evidence single provoked seizure (i.e., there is a
Privacy Act: In accordance with 5
for potential changes to the regulation at known reason for the seizure), the
U.S.C. 553(c), DOT solicits comments
49 CFR 391.41(b)(8) by conducting a Agency should consider specific criteria
from the public to better inform its
comprehensive review of scientific that fall into the following two
rulemaking process. DOT posts these
literature that was compiled into the categories: Low-risk factors for
comments, without edit, including any
‘‘Evidence Report on Seizure Disorders recurrence and moderate-to-high risk
personal information the commenter
and Commercial Vehicle Driving’’ factors for recurrence.
provides, to www.regulations.gov, as • Examples of low-risk factors for
described in the system of records (Evidence Report) [CD–ROM HD
TL230.3 .E95 2007]. The Agency then recurrence include seizures that were
notice (DOT/ALL–14 FDMS), which can caused by a medication; by non-
be reviewed at www.dot.gov/privacy. convened a panel of medical experts in
the field of neurology (the MEP) on May penetrating head injury with loss of
B. Background 14–15, 2007, to review 49 CFR consciousness less than or equal to 30
391.41(b)(8) and the advisory criteria minutes; by a brief loss of consciousness
Under 49 U.S.C. 31136(e) and
regarding individuals who have not likely to recur while driving; by
31315(b), FMCSA may grant an
experienced a seizure, and the 2007 metabolic derangement not likely to
exemption from the safety regulations
Evidence Report. The Evidence Report recur; and by alcohol or illicit drug
for a 2-year period if it finds ‘‘such
and the MEP recommendations are withdrawal.
exemption would likely achieve a level • Examples of moderate-to-high-risk
of safety that is equivalent to or greater published on-line at http://
www.fmcsa.dot.gov/rules-regulations/ factors for recurrence include seizures
than the level that would be achieved caused by non-penetrating head injury
absent such exemption.’’ The statute topics/mep/mep-reports.htm, under
Seizure Disorders, and are in the docket with loss of consciousness or amnesia
also allows the Agency to renew greater than 30 minutes, or penetrating
exemptions at the end of the 2-year for this notice.
head injury; intracerebral hemorrhage
period. MEP Criteria for Evaluation associated with a stroke or trauma;
FMCSA grants 8 individuals an On October 15, 2007, the MEP issued infections; intracranial hemorrhage;
exemption from the regulatory the following recommended criteria for post-operative complications from brain
requirement in § 391.41(b)(8), to allow evaluating whether an individual with surgery with significant brain
these individuals who take anti-seizure epilepsy or a seizure disorder should be hemorrhage; brain tumor; or stroke.
medication to operate CMVs in allowed to operate a CMV.3 The MEP The MEP report indicates individuals
interstate commerce for a 2-year period. recommendations are included in with moderate to high-risk conditions
The Agency’s decision on these previously published dockets. should not be certified. Drivers with a
exemption applications is based on an Epilepsy diagnosis. If there is an history of a single provoked seizure
individualized assessment of each epilepsy diagnosis, the applicant should with low risk factors for recurrence
applicant’s medical information, be seizure-free for 8 years, on or off should be recertified every year.
including the root cause of the medication. If the individual is taking
respective seizure(s), the length of time Medical Review Board
elapsed since the individual’s last Recommendations and Agency Decision
the CDLIS Central Site, all connected by a
seizure, and each individual’s treatment telecommunications network. FMCSA presented the MEP’s findings
regimen. In addition, the Agency 2 Motor Carrier Management Information System
and the Evidence Report to the Medical
reviewed each applicant’s driving (MCMIS) is an information system that captures
mstockstill on DSK4VPTVN1PROD with NOTICES

Review Board (MRB) for consideration.
data from field offices through SAFETYNET,
record found in the Commercial Driver’s CAPRI, and other sources. It is a source for FMCSA The MRB reviewed and considered the
License Information System (CDLIS) 1 inspection, crash, compliance review, safety audit, 2007 ‘‘Seizure Disorders and
and registration data. Commercial Driver Safety’’ evidence
1 Commercial Driver’s License Information 3 Engel, J., Fisher, R.S., Krauss, G.L., Krumholz,
report and the 2007 MEP
System (CDLIS) is an information system that A., and Quigg, M.S., ‘‘Expert Panel
allows the exchange of commercial driver licensing Recommendations: Seizure Disorders and
recommendations. The MRB
information among all the States. CDLIS includes Commercial Motor Vehicle Driver Safety,’’ FMCSA, recommended maintaining the current
the databases of fifty-one licensing jurisdictions and October 15, 2007. advisory criteria, which provide that

VerDate Sep<11>2014 20:59 Mar 26, 2015 Jkt 235001 PO 00000 Frm 00140 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1

Federal Register / Vol. 80, No. 59 / Friday, March 27, 2015 / Notices 16499

‘‘drivers with a history of epilepsy/ evaluated the crash and violation data frequency remaining the same since
seizures off anti-seizure medication and for the 8 drivers, some of whom November 2013. If granted an
seizure-free for 10 years may be currently drive a CMV in intrastate exemption, he would like to drive a
qualified to drive a CMV in interstate commerce. The CDLIS and MCMIS were CMV. His physician states he is
commerce. Interstate drivers with a searched for crash and violation data on supportive of Mr. Berthiaume receiving
history of a single unprovoked seizure the 8 applicants. For non-CDL holders, an exemption.
may be qualified to drive a CMV in the Agency reviewed the driving records
interstate commerce if seizure-free and Leo Kurt Clemens
from the State licensing agency.
off anti-seizure medication for a 5 year These exemptions are contingent on Mr. Clemens is a 59 year-old class B
period or more’’ [Advisory criteria to 49 the driver maintaining a stable CDL holder in Pennsylvania. He has a
CFR 391.43(f)]. treatment regimen and remaining history of seizure and has remained
The Agency acknowledges the MRB’s seizure-free during the 2-year exemption seizure free for more than 25 years. He
position on the issue but believes period. The exempted drivers must takes anti-seizure medication with the
relevant current medical evidence submit annual reports from their dosage and frequency remaining the
supports a less conservative approach. treating physicians attesting to the same for 3 years. If granted the
The medical advisory criteria for stability of treatment and that the driver exemption, he would like to drive a
epilepsy and other seizure or loss of has remained seizure-free. The driver CMV. His physician states that he is
consciousness episodes was based on must undergo an annual medical supportive of Mr. Clemens receiving an
the 1988 ‘‘Conference on Neurological examination by a medical examiner, as exemption.
Disorders and Commercial Drivers’’ defined by 49 CFR 390.5, following the
(NITS Accession No. PB89–158950/AS). Danny Lee Crafton
FCMSA’s regulations for the physical
A copy of the report can be found in the qualifications for CMV drivers. Mr. Crafton is a 65 year-old class A
docket referenced in this notice. FMCSA published a notice of receipt CDL holder in Idaho. He has a history
The MRB’s recommendation treats all of application and requested public of seizure and has remained seizure free
drivers who have experienced a seizure comment during a 30-day public since 1974. He takes anti-seizure
the same, regardless of individual comment period in a Federal Register medication with the dosage and
medical conditions and circumstances. notice for each of the applicants. A short frequency remaining the same since
In addition, the recommendation to summary of the applicants’ 2001. If granted the exemption, he
continue prohibiting drivers who are qualifications and a discussion of the would like to drive a CMV. His
taking anti-seizure medication from comments received, if any, follows this physician states that he is supportive of
operating a CMV in interstate commerce section. For applicants who were denied Mr. Crafton receiving an exemption.
does not consider a driver’s actual an exemption, a notice will be
seizure history and time since the last Kenneth D. Peachey
published at a later date.
seizure. The Agency has decided to use
the 2007 MEP recommendations as the D. Comments Mr. Peachey is a 72 year-old class A
basis for evaluating applications for an CDL holder in Pennsylvania. He has a
Docket # FMCSA–2014–0215 history of seizure and has remained
exemption from the seizure regulation
on an individual, case-by-case basis. On September 9, 2014, FMCSA seizure free since 1984. He takes anti-
published a notice of receipt of seizure medication with the dosage and
C. Exemptions exemption applications and requested frequency remaining the same since that
Following individualized assessments public comment on 12 individuals (79 time. If granted the exemption, he
of the exemption applications, FR 53512; Docket number FMCSA– would like to drive a CMV. His
including a review of detailed follow-up 2014–21421). The comment period physician states that he is supportive of
information requested from each ended on October 9, 2014. No Mr. Peachey receiving an exemption.
applicant, FMCSA is granting commenters responded to this Federal Philip Neil Stewart
exemptions from 49 CFR 391.41(b)(8) to Register notice. Of the 12 applicants,
8 individuals. Under current FMCSA four were denied. The Agency has Mr. Stewart is a 43 year-old class A
regulations, all of the 8 drivers receiving determined that the following eight CDL holder in California. He has a
exemptions from 49 CFR 391.41(b)(8) applicants should be granted an history of a seizure disorder and has
would have been considered physically exemption. remained seizure free for 30 years. He
qualified to drive a CMV in interstate takes anti-seizure medication with the
commerce except that they presently Thomas Avery, Jr. dosage and frequency remaining the
take or have recently stopped taking Mr. Avery is a 45 year-old class B CDL same for 15 years. If granted the
anti-seizure medication. For these 8 holder in New York. He has a history of exemption, he would like to drive a
drivers, the primary obstacle to medical seizure and has remained seizure free CMV. His physician states that he is
qualification was the FMCSA Advisory since 1998. He takes anti-seizure supportive of Mr. Stewart receiving an
Criteria for Medical Examiners, based medication with the dosage and exemption.
on the 1988 ‘‘Conference on frequency remaining the same since that Keith T. White
Neurological Disorders and Commercial time. If granted an exemption, he would
Drivers,’’ stating that a driver should be like to drive a CMV. His physician states Mr. White is a 59 year-old class A
off anti-seizure medication in order to he is supportive of Mr. Avery receiving CDL holder in Pennsylvania. He has a
mstockstill on DSK4VPTVN1PROD with NOTICES

drive in interstate commerce. In fact, the an exemption. history of seizure and has remained
Advisory Criteria have little if anything seizure free since 1994. He takes anti-
Michael G. Berthiaume seizure medication with the dosage and
to do with the actual risk of a seizure
and more to do with assumptions about Mr. Berthiaume is a 54 year-old driver frequency remaining the same since
individuals who are taking anti-seizure in Minnesota. He has a history of 2004. If granted the exemption, he
medication. seizure and has remained seizure free would like to drive a CMV. His
In addition to evaluating the medical since 2006. He takes anti-seizure physician states that he is supportive of
status of each applicant, FMCSA medication with the dosage and Mr. White receiving an exemption.

VerDate Sep<11>2014 20:59 Mar 26, 2015 Jkt 235001 PO 00000 Frm 00141 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1

16500 Federal Register / Vol. 80, No. 59 / Friday, March 27, 2015 / Notices

Alan T. Von Lintel (PA); Philip Stewart (CA); Keith White • Federal eRulemaking Portal: Go to
Mr. Von Lintel is a 60 year-old driver (PA); and Alan Von Lintel (KS) from the http://www.regulations.gov. Follow the
in Kansas. He has a history of a seizure prohibition of CMV operations by on-line instructions for submitting
disorder and has remained seizure free persons with a clinical diagnosis of comments.
since 2004. He takes anti-seizure epilepsy or seizures. If the exemption is • Mail: Docket Management Facility;
medication with the dosage and still in effect at the end of the 2-year U.S. Department of Transportation, 1200
frequency remaining the same since July period, the person may apply to FMCSA New Jersey Avenue SE., West Building
2012. If granted the exemption, he for a renewal under procedures in effect Ground Floor, Room W12–140,
would like to drive a CMV. His at that time. Washington, DC 20590–0001.
physician states that he is supportive of Issued on: March 19, 2015. • Hand Delivery or Courier: West
Mr. Von Lintel receiving an exemption. Larry W. Minor,
Building Ground Floor, Room W12–140,
1200 New Jersey Avenue SE.,
E. Basis for Exemption Associate Administrator for Policy.
Washington, DC, between 9 a.m. and
[FR Doc. 2015–07051 Filed 3–26–15; 8:45 am]
Under 49 U.S.C. 31136(e) and 5 p.m., Monday through Friday, except
BILLING CODE 4910–EX–P Federal Holidays.
31315(b), FMCSA may grant an
exemption from the epilepsy/seizure • Fax: 1–202–493–2251.
standard in 49 CFR 391.41(b)(8) if the Instructions: Each submission must
DEPARTMENT OF TRANSPORTATION include the Agency name and the
exemption is likely to achieve an
equivalent or greater level of safety than Federal Motor Carrier Safety docket number for this notice. Note that
would be achieved without the Administration DOT posts all comments received
exemption. Without the exemption, without change to http://
applicants will continue to be restricted [Docket No. FMCSA–2000–7006; FMCSA– www.regulations.gov, including any
2000–7918; FMCSA–2002–12844; FMCSA– personal information included in a
to intrastate driving. With the 2003–14223; FMCSA–2005–20027; FMCSA–
exemption, applicants can drive in comment. Please see the Privacy Act
2006–25246; FMCSA–2006–26066; FMCSA– heading below.
interstate commerce. Thus, the Agency’s 2008–0398; FMCSA–2010–0187; FMCSA–
analysis focuses on whether an equal or 2010–0287; FMCSA–2010–0372; FMCSA–
Docket: For access to the docket to
greater level of safety is likely to be 2011–0010; FMCSA–2013–0022] read background documents or
achieved by permitting each of these comments, go to http://
drivers to drive in interstate commerce Qualification of Drivers; Exemption www.regulations.gov at any time or
as opposed to restricting the driver to Applications; Vision Room W12–140 on the ground level of
driving in intrastate commerce. the West Building, 1200 New Jersey
AGENCY: Federal Motor Carrier Safety Avenue SE., Washington, DC, between
Conclusion Administration (FMCSA), DOT. 9 a.m. and 5 p.m., Monday through
The Agency is granting exemptions ACTION: Notice of renewal of Friday, except Federal holidays. The
from the epilepsy standard, 49 CFR exemptions; request for comments. Federal Docket Management System
391.41(b)(8), to 8 individuals based on (FDMS) is available 24 hours each day,
SUMMARY: FMCSA announces its 365 days each year. If you want
a thorough evaluation of each driver’s decision to renew the exemptions from
safety experience, and medical acknowledgment that we received your
the vision requirement in the Federal comments, please include a self-
condition. Safety analysis of Motor Carrier Safety Regulations for 22
information relating to these 8 addressed, stamped envelope or
individuals. FMCSA has statutory postcard or print the acknowledgement
applicants meets the burden of showing authority to exempt individuals from
that granting the exemptions would page that appears after submitting
the vision requirement if the comments on-line.
achieve a level of safety that is exemptions granted will not
equivalent to or greater than the level Privacy Act: In accordance with 5
compromise safety. The Agency has U.S.C. 553(c), DOT solicits comments
that would be achieved without the concluded that granting these
exemption. By granting the exemptions, from the public to better inform its
exemption renewals will provide a level rulemaking process. DOT posts these
the interstate CMV industry will gain 8 of safety that is equivalent to or greater
highly trained and experienced drivers. comments, without edit, including any
than the level of safety maintained personal information the commenter
In accordance with 49 U.S.C. without the exemptions for these
31315(b)(1), each exemption will be provides, to www.regulations.gov, as
commercial motor vehicle (CMV) described in the system of records
valid for 2 years, with annual drivers.
recertification required unless revoked notice (DOT/ALL–14 FDMS), which can
earlier by FMCSA. The exemption will DATES: This decision is effective April be reviewed at www.dot.gov/privacy.
be revoked if the following occurs: (1) 21, 2015. Comments must be received FOR FURTHER INFORMATION CONTACT:
The person fails to comply with the on or before April 27, 2015. Charles A. Horan, III, Director, Carrier,
terms and conditions of the exemption; ADDRESSES: You may submit comments Driver and Vehicle Safety Standards,
(2) the exemption has resulted in a bearing the Federal Docket Management 202–366–4001, fmcsamedical@dot.gov,
lower level of safety than was System (FDMS) numbers: Docket No. FMCSA, Department of Transportation,
maintained prior to being granted; or (3) [Docket No. FMCSA–2000–7006; 1200 New Jersey Avenue SE., Room
continuation of the exemption would FMCSA–2000–7918; FMCSA–2002– W64–224, Washington, DC 20590–0001.
Office hours are from 8:30 a.m. to 5 p.m.
mstockstill on DSK4VPTVN1PROD with NOTICES

not be consistent with the goals and 12844; FMCSA–2003–14223; FMCSA–
objectives of 49 U.S.C. 31136 and 31315. 2005–20027; FMCSA–2006–25246; Monday through Friday, except Federal
FMCSA exempts the following 8 FMCSA–2006–26066; FMCSA–2008– holidays.
drivers for a period of 2 years with 0398; FMCSA–2010–0187; FMCSA– SUPPLEMENTARY INFORMATION:
annual medical certification required: 2010–0287; FMCSA–2010–0372;
Thomas Avery (NY); Michael FMCSA–2011–0010; FMCSA–2013– I. Background
Berthiaume (MN); Leo Clemens (PA); 0022], using any of the following Under 49 U.S.C. 31136(e) and 31315,
Danny Grafton (ID); Kenneth Peachey methods: FMCSA may renew an exemption from

VerDate Sep<11>2014 20:59 Mar 26, 2015 Jkt 235001 PO 00000 Frm 00142 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1

Document Created: 2015-12-18 11:36:47
Document Modified: 2015-12-18 11:36:47

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice of final disposition.
Dates		The exemptions are effective March 27, 2015. The exemptions expire on March 27, 2017.
Contact		Charles A. Horan, III, Director, Office of Carrier, Driver and Vehicle Safety, (202) 366-4001, [email protected], FMCSA, Department of Transportation, 1200 New Jersey Avenue SE., Room W64-224, Washington, DC 20590-0001. Office hours are 8:30 a.m. to 5 p.m., E.T., Monday through Friday, except Federal holidays.
FR Citation		80 FR 16497

80 FR 16497 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 59 (March 27, 2015)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration