80 FR 17139 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 61 (March 31, 2015)

Page Range		17139-17141
FR Document		2015-07332

FMCSA announces its decision to grant requests from 3 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 3 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 61 (Tuesday, March 31, 2015)

[Federal Register Volume 80, Number 61 (Tuesday, March 31, 2015)]
[Notices]
[Pages 17139-17141]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-07332]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2014-0378]


Qualification of Drivers; Exemption Applications; Epilepsy and 
Seizure Disorders

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

ACTION: Notice of final disposition.

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SUMMARY: FMCSA announces its decision to grant requests from 3 
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 3 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 31, 2015. The exemptions 
expire on March 31, 2017.

FOR FURTHER INFORMATION 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.

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 3 individuals an exemption from the regulatory 
requirement in section 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 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

[[Page 17140]]

``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.
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    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 ``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 3 individuals. Under current FMCSA regulations, all of the 3 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 3 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 3 drivers, some of 
whom currently drive a CMV in intrastate commerce. The CDLIS and MCMIS 
were searched for crash and violation data on the 3 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 
follows this section. For applicants who were denied an exemption, a 
notice will be published at a later date.

[[Page 17141]]

D. Comments

Docket # FMCSA-2014-0378

    On October 27, 2014, FMCSA published a notice of receipt of 
exemption applications and requested public comment on six individuals 
(79 FR 64003; Docket number FMCSA-2014-25450). The comment period ended 
on November 26, 2014. Three commenters responded to this notice. Bobby 
Shane Walker, an applicant in this notice, expressed support for his 
health status and driving safety. He provided details about his most 
recent driving accident. An anonymous commenter submitted details 
involving Bobby Shane Walker's recent driving accident and provided the 
driving accident report. Bob Johnson expressed support for the Epilepsy 
standard because it will save lives and benefit our citizens. Of the 
six applicants, three were denied. The Agency has determined that the 
following three applicants should be granted an exemption.

James Connelly

    Mr. Connelly is a 60 year-old class B CDL holder in New Jersey. He 
has a history of seizures and has remained seizure free since 2000. 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. Connelly 
receiving an exemption.

Timothy C. Marrill

    Mr. Marrill is a 48 year-old class A CDL holder in Missouri. He has 
a history of epilepsy and has remained seizure free since 1995. He 
takes anti-seizure medication with the dosage and frequency remaining 
the same for over two years. If granted an exemption, he would like to 
drive a CMV. His physician states he is supportive of Mr. Marrill 
receiving an exemption.

John Rinkema

    Mr. Rinkema is a 64 year-old driver in Illinois. He has a history 
of seizures and has remained seizure free since 1968. He takes anti-
seizure medication with the dosage and frequency remaining the same 
since that time since 2004. If granted the exemption, he would like to 
drive a CMV. His physician states that he is supportive of Mr. Rinkema 
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 3 individuals based on a thorough evaluation of 
each driver's safety experience, and medical condition. Safety analysis 
of information relating to these 3 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 3 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 3 drivers for a period of 2 years with 
annual medical certification required: James Connelly (NJ); Timothy 
Merrill (MO); and John Rinkema (IL) 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 20, 2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015-07332 Filed 3-30-15; 8:45 am]
BILLING CODE 4910-EX-P

Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices 17139

individual sending the comment (or commercial motor vehicle (CMV) B. Background
signing the comment for an association, drivers have ‘‘no established medical Under 49 U.S.C. 31136(e) and
business, labor union, etc.). You may history or clinical diagnosis of epilepsy 31315(b), FMCSA may grant an
review DOT’s complete Privacy Act or any other condition which is likely exemption from the safety regulations
Statement in the Federal Register to cause loss of consciousness or any for a 2-year period if it finds ‘‘such
published on April 11, 2000 (65 FR loss of ability to control a CMV.’’ The exemption would likely achieve a level
19477–78). regulation and the associated advisory of safety that is equivalent to or greater
Docket: To read background criteria published in the Code of Federal than the level that would be achieved
documents or comments received, go to Regulations as the ‘‘Instructions for absent such exemption.’’ The statute
http://www.regulations.gov at any time Performing and Recording Physical also allows the Agency to renew
or to the Docket Management Facility in Examinations’’ have resulted in exemptions at the end of the 2-year
Room W12–140 of the West Building numerous drivers being prohibited from period.
Ground Floor at 1200 New Jersey operating CMVs in interstate commerce FMCSA grants 3 individuals an
Avenue SE., Washington, DC, between 9 based on the fact that they have had one exemption from the regulatory
a.m. and 5 p.m., Monday through or more seizures and are taking anti- requirement in section 391.41(b)(8), to
Friday, except Federal holidays. seizure medication, rather than an allow these individuals who take anti-
FOR FURTHER INFORMATION CONTACT: individual analysis of their seizure medication to operate CMVs in
Timoleon Mouzakis, Federal Aviation circumstances by a qualified medical interstate commerce for a 2-year period.
Administration, Engine and Propeller examiner. The Agency concluded that The Agency’s decision on these
Directorate, Standards Staff, ANE–111, granting exemptions for these CMV exemption applications is based on an
12 New England Executive Park, drivers will provide a level of safety that individualized assessment of each
Burlington, Massachusetts 01803–5229; is equivalent to or greater than the level applicant’s medical information,
(781) 238–7114; facsimile: (781) 238– of safety maintained without the including the root cause of the
7199; email: timoleon.mouzakis@ exemptions. FMCSA grants exemptions respective seizure(s), the length of time
faa.gov. that will allow these 3 individuals to elapsed since the individual’s last
This notice is published pursuant to operate CMVs in interstate commerce seizure, and each individual’s treatment
14 CFR 11.85. for a 2-year period. The exemptions regimen. In addition, the Agency
preempt State laws and regulations and reviewed each applicant’s driving
Issued in Washington, DC, on March 24,
2015.
may be renewed. record found in the Commercial Driver’s
DATES: The exemptions are effective License Information System (CDLIS) 1
Dale Bouffiou,
March 31, 2015. The exemptions expire for commercial driver’s license (CDL)
Acting, Director, Office of Rulemaking. holders, and interstate and intrastate
on March 31, 2017.
Petition for Exemption FOR FURTHER INFORMATION CONTACT: inspections recorded in Motor Carrier
Charles A. Horan, III, Director, Office of Management Information System
Docket No.: FAA–2015–0156. (MCMIS).2 For non-CDL holders, the
Petitioner: Rolls-Royce plc. Carrier, Driver and Vehicle Safety, (202)
366–4001, fmcsamedical@dot.gov, Agency reviewed the driving records
Section of 14 CFR Affected: Section from the State licensing agency. The
33.27 (f)(6). FMCSA, Department of Transportation,
1200 New Jersey Avenue SE., Room Agency acknowledges the potential
Description of Relief Sought: The consequences of a driver experiencing a
petitioner seeks relief from § 33.27 (f)(6) W64–224, Washington, DC 20590–0001.
Office hours are 8:30 a.m. to 5 p.m., e.t., seizure while operating a CMV.
for the Rolls-Royce Trent 1000–AE, –CE, However, the Agency believes the
–AE2, and –CE2 engine models, to Monday through Friday, except Federal
holidays. drivers covered by the exemptions
exclude the entire high-pressure shaft granted here have demonstrated that
system from consideration in SUPPLEMENTARY INFORMATION:
they are unlikely to have a seizure and
determining the highest overspeed that their medical condition does not pose a
A. Electronic Access
would result from a complete loss of risk to public safety.
load on a turbine rotor. You may see all the comments online In reaching the decision to grant these
[FR Doc. 2015–07383 Filed 3–30–15; 8:45 am]
through the Federal Document exemption requests, the Agency
Management System (FDMS) at: http:// considered both current medical
BILLING CODE 4910–13–P
www.regulations.gov. literature and information and the 2007
Docket: For access to the docket to recommendations of the Agency’s
DEPARTMENT OF TRANSPORTATION read background documents or Medical Expert Panel (MEP). The
comments, go to http:// Agency previously gathered evidence
Federal Motor Carrier Safety www.regulations.gov and/or Room for potential changes to the regulation at
Administration W12–140 on the ground level of the 49 CFR 391.41(b)(8) by conducting a
West Building, 1200 New Jersey Avenue comprehensive review of scientific
[Docket No. FMCSA–2014–0378] SE., Washington, DC, between 9 a.m. literature that was compiled into the
Qualification of Drivers; Exemption and 5 p.m., e.t., Monday through Friday,
Applications; Epilepsy and Seizure except Federal holidays. 1 Commercial Driver License Information System
Privacy Act: In accordance with 5 (CDLIS) is an information system that allows the
Disorders
U.S.C. 553(c), DOT solicits comments
asabaliauskas on DSK5VPTVN1PROD with NOTICES

exchange of commercial driver licensing
AGENCY: Federal Motor Carrier Safety from the public to better inform its information among all the States. CDLIS includes
the databases of fifty-one licensing jurisdictions and
Administration (FMCSA), DOT. rulemaking process. DOT posts these the CDLIS Central Site, all connected by a
ACTION: Notice of final disposition. comments, without edit, including any telecommunications network.
personal information the commenter 2 Motor Carrier Management Information System

SUMMARY: FMCSA announces its provides, to www.regulations.gov, as (MCMIS) is an information system that captures
data from field offices through SAFETYNET,
decision to grant requests from 3 described in the system of records CAPRI, and other sources. It is a source for FMCSA
individuals for exemptions from the notice (DOT/ALL–14 FDMS), which can inspection, crash, compliance review, safety audit,
regulatory requirement that interstate be reviewed at www.dot.gov/privacy. and registration data.

VerDate Sep<11>2014 18:32 Mar 30, 2015 Jkt 235001 PO 00000 Frm 00115 Fmt 4703 Sfmt 4703 E:\FR\FM\31MRN1.SGM 31MRN1

17140 Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices

‘‘Evidence Report on Seizure Disorders minutes; by a brief loss of consciousness the 2007 MEP recommendations as the
and Commercial Vehicle Driving’’ not likely to recur while driving; by basis for evaluating applications for an
(Evidence Report) [CD–ROM HD metabolic derangement not likely to exemption from the seizure regulation
TL230.3 .E95 2007]. The Agency then recur; and by alcohol or illicit drug on an individual, case-by-case basis.
convened a panel of medical experts in withdrawal.
• Examples of moderate-to-high-risk C. Exemptions
the field of neurology (the MEP) on May
14–15, 2007, to review 49 CFR factors for recurrence include seizures Following individualized assessments
391.41(b)(8) and the advisory criteria caused by non-penetrating head injury of the exemption applications,
regarding individuals who have with loss of consciousness or amnesia including a review of detailed follow-up
experienced a seizure, and the 2007 greater than 30 minutes, or penetrating information requested from each
Evidence Report. The Evidence Report head injury; intracerebral hemorrhage applicant, FMCSA is granting
and the MEP recommendations are associated with a stroke or trauma; exemptions from 49 CFR 391.41(b)(8) to
published on-line at http:// infections; intracranial hemorrhage; 3 individuals. Under current FMCSA
www.fmcsa.dot.gov/rules-regulations/ post-operative complications from brain regulations, all of the 3 drivers receiving
topics/mep/mep-reports.htm, under surgery with significant brain exemptions from 49 CFR 391.41(b)(8)
Seizure Disorders, and are in the docket hemorrhage; brain tumor; or stroke. would have been considered physically
for this notice. The MEP report indicates individuals qualified to drive a CMV in interstate
with moderate to high-risk conditions commerce except that they presently
MEP Criteria for Evaluation should not be certified. Drivers with a take or have recently stopped taking
On October 15, 2007, the MEP issued history of a single provoked seizure anti-seizure medication. For these 3
the following recommended criteria for with low risk factors for recurrence drivers, the primary obstacle to medical
evaluating whether an individual with should be recertified every year. qualification was the FMCSA Advisory
epilepsy or a seizure disorder should be Criteria for Medical Examiners, based
Medical Review Board
allowed to operate a CMV.3 The MEP on the 1988 ‘‘Conference on
Recommendations and Agency Decision
recommendations are included in Neurological Disorders and Commercial
previously published dockets. FMCSA presented the MEP’s findings
Drivers,’’ stating that a driver should be
Epilepsy diagnosis. If there is an and the Evidence Report to the Medical
Review Board (MRB) for consideration. off anti-seizure medication in order to
epilepsy diagnosis, the applicant should
The MRB reviewed and considered the drive in interstate commerce. In fact, the
be seizure-free for 8 years, on or off
2007 ‘‘Seizure Disorders and Advisory Criteria have little if anything
medication. If the individual is taking
Commercial Driver Safety’’ evidence to do with the actual risk of a seizure
anti-seizure medication(s), the plan for
report and the 2007 MEP and more to do with assumptions about
medication should be stable for 2 years.
recommendations. The MRB individuals who are taking anti-seizure
Stable means no changes in medication,
recommended maintaining the current medication.
dosage, or frequency of medication
administration. Recertification for advisory criteria, which provide that In addition to evaluating the medical
drivers with an epilepsy diagnosis ‘‘drivers with a history of epilepsy/ status of each applicant, FMCSA
should be performed every year. seizures off anti-seizure medication and evaluated the crash and violation data
Single unprovoked seizure. If there is seizure-free for 10 years may be for the 3 drivers, some of whom
a single unprovoked seizure (i.e., there qualified to drive a CMV in interstate currently drive a CMV in intrastate
is no known trigger for the seizure), the commerce. Interstate drivers with a commerce. The CDLIS and MCMIS were
individual should be seizure-free for 4 history of a single unprovoked seizure searched for crash and violation data on
years, on or off medication. If the may be qualified to drive a CMV in the 3 applicants. For non-CDL holders,
individual is taking anti-seizure interstate commerce if seizure-free and the Agency reviewed the driving records
medication(s), the plan for medication off anti-seizure medication for a 5 year from the State licensing agency.
should be stable for 2 years. Stable period or more’’ [Advisory criteria to 49 These exemptions are contingent on
means no changes in medication, CFR 391.43(f)]. the driver maintaining a stable
dosage, or frequency of medication The Agency acknowledges the MRB’s treatment regimen and remaining
administration. Recertification for position on the issue but believes seizure-free during the 2-year exemption
drivers with a single unprovoked relevant current medical evidence period. The exempted drivers must
seizure should be performed every 2 supports a less conservative approach. submit annual reports from their
years. The medical advisory criteria for treating physicians attesting to the
Single provoked seizure. If there is a epilepsy and other seizure or loss of stability of treatment and that the driver
single provoked seizure (i.e., there is a consciousness episodes was based on has remained seizure-free. The driver
known reason for the seizure), the the 1988 ‘‘Conference on Neurological must undergo an annual medical
Agency should consider specific criteria Disorders and Commercial Drivers’’ examination by a medical examiner, as
that fall into the following two (NITS Accession No. PB89–158950/AS). defined by 49 CFR 390.5, following the
categories: low-risk factors for A copy of the report can be found in the FCMSA’s regulations for the physical
recurrence and moderate-to-high risk docket referenced in this notice. qualifications for CMV drivers.
factors for recurrence. The MRB’s recommendation treats all FMCSA published a notice of receipt
• Examples of low-risk factors for drivers who have experienced a seizure of application and requested public
recurrence include seizures that were the same, regardless of individual comment during a 30-day public
asabaliauskas on DSK5VPTVN1PROD with NOTICES

caused by a medication; by non- medical conditions and circumstances. comment period in a Federal Register
penetrating head injury with loss of In addition, the recommendation to notice for each of the applicants. A short
consciousness less than or equal to 30 continue prohibiting drivers who are summary of the applicants’
taking anti-seizure medication from qualifications and a discussion of the
3 Engel, J., Fisher, R.S., Krauss, G.L., Krumholz,
operating a CMV in interstate commerce comments received follows this section.
A., and Quigg, M.S., ‘‘Expert Panel
Recommendations: Seizure Disorders and
does not consider a driver’s actual For applicants who were denied an
Commercial Motor Vehicle Driver Safety,’’ FMCSA, seizure history and time since the last exemption, a notice will be published at
October 15, 2007. seizure. The Agency has decided to use a later date.

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Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices 17141

D. Comments exemption is likely to achieve an DEPARTMENT OF TRANSPORTATION
Docket # FMCSA–2014–0378 equivalent or greater level of safety than
would be achieved without the Surface Transportation Board
On October 27, 2014, FMCSA exemption. Without the exemption, [Docket No. AB 303 (Sub-No. 46X)]
published a notice of receipt of applicants will continue to be restricted
exemption applications and requested to intrastate driving. With the Wisconsin Central Ltd.—Abandonment
public comment on six individuals (79 Exemption—in Lake County, Ill.
exemption, applicants can drive in
FR 64003; Docket number FMCSA–
interstate commerce. Thus, the Agency’s On March 11, 2015, Wisconsin
2014–25450). The comment period
ended on November 26, 2014. Three analysis focuses on whether an equal or Central Ltd. (WCL) filed with the
commenters responded to this notice. greater level of safety is likely to be Surface Transportation Board (Board) a
Bobby Shane Walker, an applicant in achieved by permitting each of these petition under 49 U.S.C. 10502 for
this notice, expressed support for his drivers to drive in interstate commerce exemption from the provisions of 49
health status and driving safety. He as opposed to restricting the driver to U.S.C. 10903 to abandon 3.6 miles of
provided details about his most recent driving in intrastate commerce. rail line extending between milepost
driving accident. An anonymous 71.0 in North Chicago, Lake County, Ill.,
Conclusion
commenter submitted details involving and milepost 74.6 in Waukegan, Lake
Bobby Shane Walker’s recent driving The Agency is granting exemptions County, Ill. (the Line). The Line
accident and provided the driving from the epilepsy standard, 49 CFR traverses United States Postal Service
accident report. Bob Johnson expressed 391.41(b)(8), to 3 individuals based on Zip Codes 60064, 60085, and 60087.
support for the Epilepsy standard a thorough evaluation of each driver’s According to WCL, there is one
because it will save lives and benefit our shipper, International Precision
safety experience, and medical
citizens. Of the six applicants, three Components Corporation (IPCC), located
condition. Safety analysis of
were denied. The Agency has on the Line. WCL states that IPCC has
information relating to these 3
determined that the following three entered into a terminable agreement
applicants meets the burden of showing with WCL to lease a side track
applicants should be granted an that granting the exemptions would
exemption. connecting to the Line. From WCL’s
achieve a level of safety that is side track, IPCC transloads shipments to
James Connelly equivalent to or greater than the level truck for final delivery at IPCC’s off-Line
Mr. Connelly is a 60 year-old class B that would be achieved without the manufacturing facility. WCL notes that
CDL holder in New Jersey. He has a exemption. By granting the exemptions, it is exploring the relocation of IPCC’s
history of seizures and has remained the interstate CMV industry will gain 3 transloading operations to another rail-
seizure free since 2000. He takes anti- highly trained and experienced drivers. served location. After receiving Board
seizure medication with the dosage and In accordance with 49 U.S.C. authority to abandon the Line, WCL
frequency remaining the same since that 31315(b)(1), each exemption will be states that it intends to salvage the rails,
time. If granted an exemption, he would valid for 2 years, with annual ties, and other track material and then
like to drive a CMV. His physician states recertification required unless revoked to negotiate a sale of the right-of-way to
he is supportive of Mr. Connelly earlier by FMCSA. The exemption will the City of Waukegan (City). According
receiving an exemption. be revoked if the following occurs: (1) to WCL, the sale of the right-of-way will
The person fails to comply with the allow the City to implement an urban
Timothy C. Marrill redevelopment project.
terms and conditions of the exemption;
Mr. Marrill is a 48 year-old class A (2) the exemption has resulted in a In addition to an exemption from the
CDL holder in Missouri. He has a lower level of safety than was provisions of 49 U.S.C. 10903, WCL
history of epilepsy and has remained maintained prior to being granted; or (3) seeks an exemption from 49 U.S.C.
seizure free since 1995. He takes anti- continuation of the exemption would 10904 (offer of financial assistance
seizure medication with the dosage and (OFA) procedures). In support, WCL
not be consistent with the goals and
frequency remaining the same for over states that the right-of-way is needed for
objectives of 49 U.S.C. 31136 and 31315.
two years. If granted an exemption, he a valid public purpose as it is an
would like to drive a CMV. His FMCSA exempts the following 3 essential component of the City’s multi-
physician states he is supportive of Mr. drivers for a period of 2 years with faceted lakefront revitalization and
Marrill receiving an exemption. annual medical certification required: redevelopment effort. WCL further
James Connelly (NJ); Timothy Merrill asserts that there is no overriding public
John Rinkema
(MO); and John Rinkema (IL) from the need for continued freight rail service.
Mr. Rinkema is a 64 year-old driver in prohibition of CMV operations by This request will be addressed in the
Illinois. He has a history of seizures and persons with a clinical diagnosis of final decision.
has remained seizure free since 1968. epilepsy or seizures. If the exemption is According to WCL, the Line does not
He takes anti-seizure medication with still in effect at the end of the 2-year contain federally granted rights-of-way.
the dosage and frequency remaining the period, the person may apply to FMCSA Any documentation in WCL’s
same since that time since 2004. If for a renewal under procedures in effect possession will be made available
granted the exemption, he would like to at that time. promptly to those requesting it.
The interest of railroad employees
asabaliauskas on DSK5VPTVN1PROD with NOTICES

drive a CMV. His physician states that
he is supportive of Mr. Rinkema Issued on: March 20, 2015. will be protected by the conditions set
receiving an exemption. Larry W. Minor, forth in Oregon Short Line Railroad—
Associate Administrator for Policy. Abandonment Portion Goshen Branch
E. Basis for Exemption Between Firth & Ammon, In Bingham &
[FR Doc. 2015–07332 Filed 3–30–15; 8:45 am]
Under 49 U.S.C. 31136(e) and Bonneville Counties, Idaho, 360 I.C.C.
BILLING CODE 4910–EX–P
31315(b), FMCSA may grant an 91 (1979).
exemption from the epilepsy/seizure By issuing this notice, the Board is
standard in 49 CFR 391.41(b)(8) if the instituting an exemption proceeding

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Document Created: 2015-12-18 11:47:53
Document Modified: 2015-12-18 11:47:53

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 31, 2015. The exemptions expire on March 31, 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 17139

80 FR 17139 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 61 (March 31, 2015)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration