80 FR 57034 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 182 (September 21, 2015)

Page Range		57034-57036
FR Document		2015-23595

FMCSA announces its decision to grant requests from 9 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 9 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 182 (Monday, September 21, 2015)

[Federal Register Volume 80, Number 182 (Monday, September 21, 2015)]
[Notices]
[Pages 57034-57036]
From the Federal Register Online [www.thefederalregister.org]
[FR Doc No: 2015-23595]

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2014-0381]

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 9
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 9 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 September 21, 2015. The exemptions
expire on September 21, 2017.

FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director,
Office of Carrier, Driver and Vehicle Safety, (202) 366-4001, or via
email at fmcsamedical@dot.gov, or by letter to 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., 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 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., 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 9 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
conditions do not pose a risk to public safety.
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\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.
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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 gathered evidence for potential changes to the regulation
previously 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/regulations/medical/reports-how-medical-conditions-impact-driving, 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.
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\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

[[Page 57035]]

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 9 individuals. Under current FMCSA regulations, all of the 9 drivers
receiving exemptions from 49 CFR 391.41(b)(8) would have been
considered qualified physically to drive a CMV in interstate commerce
except that they presently take or have recently stopped taking anti-
seizure medication. For these 9 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 9 drivers, some of
whom currently drive a CMV in intrastate commerce. The CDLIS and MCMIS
were searched for crash and violation data on the 9 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 was published previously.

Docket #FMCSA-2014-0381

On February 4, 2015, FMCSA published a notice of receipt of
exemption applications and requested public comment on 12 individuals
(80 FR 6166; Docket number FMCSA-2015-02135). The comment period ended
on March 6, 2015. Four commenters responded to this notice. Of the 12
applicants, three were denied. The Agency has determined that the
following nine applicants should be granted an exemption:
Robert Elmer Atkins
Mr. Atkins is a 54 year-old driver in Oregon. He has a history of
epilepsy and has remained seizure free since 1980. 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. Atkins receiving
an exemption.
Ronald Boogay
Mr. Boogay is a 57 year-old class C CDL holder in New Jersey. He
has a history of a seizure disorder and has remained seizure free since
1989. He takes anti-seizure medication with the dosage and frequency
remaining the

[[Page 57036]]

same since 2004. If granted the exemption, he would like to drive a
CMV. His physician states that he is supportive of Mr. Boogay receiving
an exemption.
Ronald Francis Bohr
Mr. Bohr is a 59 year-old class A CDL holder in Iowa. He has a
history of a seizure disorder and has remained seizure free since 1996.
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.
Bohr receiving an exemption.
Earl Bernard Bomgaars
Mr. Bomgaars is a 66 year-old class A CDL holder in Iowa. He has a
history of epilepsy and has remained seizure free since 1963. 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. Bomgaars
receiving an exemption.
Teddy Hugh Dixon
Mr. Dixon is a 54 year-old class A CDL holder in Georgia. He has a
history of a seizure disorder 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 the exemption, he would
like to drive a CMV. His physician states that he is supportive of Mr.
Dixon receiving an exemption.
John Griffith
Mr. Griffith is a 43 year-old class A CDL holder in North Dakota.
He has a history of a seizure disorder and has remained seizure free
since 1980. 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. Griffith receiving an exemption.
William Rainer, III
Mr. Rainer is a 41 year-old driver in Texas. He has a history of
epilepsy and has remained seizure free since 2006. 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. Rainer receiving
an exemption.
Michael R. Weymouth
Mr. Weymouth is a 48 year-old class A CDL holder in New Hampshire.
He has a history of a seizure disorder and has remained seizure free
since 1986. He takes anti-seizure medication with the dosage and
frequency remaining the same since 2010. If granted an exemption, he
would like to drive a CMV. His physician states that he is supportive
of Mr. Weymouth receiving an exemption.
Everet Thomas Wright
Mr. Wright is a 67 year-old driver in Kentucky. He has a history of
a seizure disorder and has remained seizure free since 2002. He takes
anti-seizure medication with the dosage and frequency remaining the
same since 2013. If granted an exemption, he would like to drive a CMV.
His physician states that he is supportive of Mr. Wright receiving an
exemption.

D. Comments

In response to this notice, FMCSA received 4 comments. All
commenters were in support of commercial driving for individuals with a
history of seizure, who have been seizure free for over four or five
years.

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 9 individuals based on a thorough evaluation of
each driver's safety experience and medical condition. Safety analysis
of information relating to these 9 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 9 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 9 drivers for a period of 2 years with
annual medical certification required: Robert Elmer Atkins (OR); Ronald
Boogay (NJ); Ronald Francis Bohr (IA); Earl Bernard Bomgaars (IA);
Teddy Hugh Dixon (GA); John Griffith (ND); William Rainer, III (TX);
Michael R. Weymouth (NH); and Everet Thomas Wright (KY) 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: September 8, 2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015-23595 Filed 9-18-15; 8:45 am]
BILLING CODE 4910-EX-P

57034 Federal Register / Vol. 80, No. 182 / Monday, September 21, 2015 / Notices

concerning hearing: Kevin S. Beacham 366–4001, or via email at for commercial driver’s license (CDL)
(MD); Tyler R. Carter (LA); Stephen K. fmcsamedical@dot.gov, or by letter to holders, and interstate and intrastate
Gensmer (MN); Nathaniel W. Godfrey FMCSA, Department of Transportation, inspections recorded in Motor Carrier
(KY); Jared Y. Katakurd (HI); Ervin E. 1200 New Jersey Avenue SE., Room Management Information System
Mitchell (AL); Robert L. Parrish, Jr. W64–224, Washington, DC 20590–0001. (MCMIS).2 For non-CDL holders, the
(CA); Matthew B. Skelton (TX); Charles Office hours are 8:30 a.m. to 5 p.m., Agency reviewed the driving records
A. Whitworth (LA); and Jesse W. Monday through Friday, except Federal from the State licensing agency. The
Shelander (TX) holidays. Agency acknowledges the potential
Issued on: September 8, 2015. SUPPLEMENTARY INFORMATION: consequences of a driver experiencing a
Larry W. Minor,
seizure while operating a CMV.
A. Electronic Access However, the Agency believes the
Associate Administrator for Policy.
You may see all the comments online drivers covered by the exemptions
[FR Doc. 2015–23594 Filed 9–18–15; 8:45 am]
through the Federal Document granted here have demonstrated that
BILLING CODE 4910–EX–P they are unlikely to have a seizure and
Management System (FDMS) at: http://
www.regulations.gov. their medical conditions do not pose a
Docket: For access to the docket to risk to public safety.
DEPARTMENT OF TRANSPORTATION In reaching the decision to grant these
read background documents or
Federal Motor Carrier Safety comments, go to www.regulations.gov exemption requests, the Agency
Administration and/or Room W12–140 on the ground considered both current medical
level of the West Building, 1200 New literature and information and the 2007
[Docket No. FMCSA–2014–0381] Jersey Avenue SE., Washington, DC, recommendations of the Agency’s
between 9 a.m. and 5 p.m., Monday Medical Expert Panel (MEP). The
Qualification of Drivers; Exemption Agency gathered evidence for potential
through Friday, except Federal holidays.
Applications; Epilepsy and Seizure Privacy Act: In accordance with 5 changes to the regulation previously at
Disorders U.S.C. 553(c), DOT solicits comments 49 CFR 391.41(b)(8) by conducting a
AGENCY: Federal Motor Carrier Safety from the public to better inform its comprehensive review of scientific
Administration (FMCSA), DOT. rulemaking process. DOT posts these literature that was compiled into the
ACTION: Notice of final disposition. comments, without edit, including any ‘‘Evidence Report on Seizure Disorders
personal information the commenter and Commercial Vehicle Driving’’
SUMMARY: FMCSA announces its provides, to www.regulations.gov, as (Evidence Report) [CD–ROM HD
decision to grant requests from 9 described in the system of records TL230.3 .E95 2007]. The Agency then
individuals for exemptions from the notice (DOT/ALL–14 FDMS), which can convened a panel of medical experts in
regulatory requirement that interstate be reviewed at www.dot.gov/privacy. the field of neurology (the MEP) on May
commercial motor vehicle (CMV) 14–15, 2007, to review 49 CFR
drivers have ‘‘no established medical B. Background 391.41(b)(8) and the advisory criteria
history or clinical diagnosis of epilepsy Under 49 U.S.C. 31136(e) and regarding individuals who have
or any other condition which is likely 31315(b), FMCSA may grant an experienced a seizure and the 2007
to cause loss of consciousness or any exemption from the safety regulations Evidence Report. The Evidence Report
loss of ability to control a CMV.’’ The for a 2-year period if it finds ‘‘such and the MEP recommendations are
regulation and the associated advisory exemption would likely achieve a level published on-line at http://
criteria published in the Code of Federal of safety that is equivalent to or greater www.fmcsa.dot.gov/regulations/
Regulations as the ‘‘Instructions for than the level that would be achieved medical/reports-how-medical-
Performing and Recording Physical absent such exemption.’’ The statute conditions-impact-driving, under
Examinations’’ have resulted in also allows the Agency to renew Seizure Disorders, and are in the docket
numerous drivers being prohibited from exemptions at the end of the 2-year for this notice.
operating CMVs in interstate commerce period.
MEP Criteria for Evaluation
based on the fact that they have had one FMCSA grants 9 individuals an
or more seizures and are taking anti- exemption from the regulatory On October 15, 2007, the MEP issued
seizure medication, rather than an requirement in § 391.41(b)(8), to allow the following recommended criteria for
individual analysis of their these individuals who take anti-seizure evaluating whether an individual with
circumstances by a qualified medical medication to operate CMVs in epilepsy or a seizure disorder should be
examiner. The Agency concluded that interstate commerce for a 2-year period. allowed to operate a CMV.3 The MEP
granting exemptions for these CMV The Agency’s decision on these recommendations are included in
drivers will provide a level of safety that exemption applications is based on an previously published dockets.
is equivalent to or greater than the level individualized assessment of each Epilepsy diagnosis. If there is an
of safety maintained without the applicant’s medical information, epilepsy diagnosis, the applicant should
exemptions. FMCSA grants exemptions including the root cause of the
that will allow these 9 individuals to respective seizure(s), the length of time the databases of fifty-one licensing jurisdictions and
the CDLIS Central Site, all connected by a
operate CMVs in interstate commerce elapsed since the individual’s last telecommunications network.
for a 2-year period. The exemptions seizure, and each individual’s treatment 2 Motor Carrier Management Information System

preempt State laws and regulations and regimen. In addition, the Agency (MCMIS) is an information system that captures
rmajette on DSK7SPTVN1PROD with NOTICES

may be renewed. reviewed each applicant’s driving data from field offices through SAFETYNET,
CAPRI, and other sources. It is a source for FMCSA
DATES: The exemptions are effective record found in the Commercial Driver’s inspection, crash, compliance review, safety audit,
September 21, 2015. The exemptions License Information System (CDLIS) 1 and registration data.
expire on September 21, 2017. 3 Engel, J., Fisher, R.S., Krauss, G.L., Krumholz,
1 Commercial Driver License Information System A., and Quigg, M.S., ‘‘Expert Panel
FOR FURTHER INFORMATION CONTACT:
(CDLIS) is an information system that allows the Recommendations: Seizure Disorders and
Charles A. Horan, III, Director, Office of exchange of commercial driver licensing Commercial Motor Vehicle Driver Safety,’’ FMCSA,
Carrier, Driver and Vehicle Safety, (202) information among all the States. CDLIS includes October 15, 2007.

VerDate Sep<11>2014 15:14 Sep 18, 2015 Jkt 235001 PO 00000 Frm 00075 Fmt 4703 Sfmt 4703 E:\FR\FM\21SEN1.SGM 21SEN1

Federal Register / Vol. 80, No. 182 / Monday, September 21, 2015 / Notices 57035

be seizure-free for 8 years, on or off recommended maintaining the current In addition to evaluating the medical
medication. If the individual is taking advisory criteria, which provide that status of each applicant, FMCSA
anti-seizure medication(s), the plan for ‘‘drivers with a history of epilepsy/ evaluated the crash and violation data
medication should be stable for 2 years. seizures off anti-seizure medication and for the 9 drivers, some of whom
Stable means no changes in medication, seizure-free for 10 years may be currently drive a CMV in intrastate
dosage, or frequency of medication qualified to drive a CMV in interstate commerce. The CDLIS and MCMIS were
administration. Recertification for commerce. Interstate drivers with a searched for crash and violation data on
drivers with an epilepsy diagnosis history of a single unprovoked seizure the 9 applicants. For non-CDL holders,
should be performed every year. may be qualified to drive a CMV in the Agency reviewed the driving records
Single unprovoked seizure. If there is interstate commerce if seizure-free and from the State licensing agency.
a single unprovoked seizure (i.e., there off anti-seizure medication for a 5 year These exemptions are contingent on
is no known trigger for the seizure), the period or more’’ [Advisory criteria to 49 the driver maintaining a stable
individual should be seizure-free for 4 CFR 391.43(f)]. treatment regimen and remaining
years, on or off medication. If the The Agency acknowledges the MRB’s seizure-free during the 2-year exemption
individual is taking anti-seizure position on the issue but believes period. The exempted drivers must
medication(s), the plan for medication relevant current medical evidence submit annual reports from their
should be stable for 2 years. Stable supports a less conservative approach. treating physicians attesting to the
means no changes in medication, The medical advisory criteria for stability of treatment and that the driver
dosage, or frequency of medication epilepsy and other seizure or loss of has remained seizure-free. The driver
administration. Recertification for consciousness episodes was based on must undergo an annual medical
drivers with a single unprovoked the 1988 ‘‘Conference on Neurological examination by a medical examiner, as
seizure should be performed every 2 Disorders and Commercial Drivers’’ defined by 49 CFR 390.5, following the
years. (NITS Accession No. PB89–158950/AS). FCMSA’s regulations for the physical
Single provoked seizure. If there is a A copy of the report can be found in the qualifications for CMV drivers.
single provoked seizure (i.e., there is a docket referenced in this notice. FMCSA published a notice of receipt
known reason for the seizure), the The MRB’s recommendation treats all of application and requested public
Agency should consider specific criteria drivers who have experienced a seizure comment during a 30-day public
that fall into the following two the same, regardless of individual comment period in a Federal Register
categories: low-risk factors for medical conditions and circumstances. notice for each of the applicants. A short
recurrence and moderate-to-high risk In addition, the recommendation to summary of the applicants’
factors for recurrence. continue prohibiting drivers who are qualifications and a discussion of the
• Examples of low-risk factors for taking anti-seizure medication from comments received follows this section.
recurrence include seizures that were operating a CMV in interstate commerce For applicants who were denied an
caused by a medication; by non- does not consider a driver’s actual exemption, a notice was published
penetrating head injury with loss of seizure history and time since the last previously.
consciousness less than or equal to 30 seizure. The Agency has decided to use
minutes; by a brief loss of consciousness the 2007 MEP recommendations as the Docket #FMCSA–2014–0381
not likely to recur while driving; by basis for evaluating applications for an On February 4, 2015, FMCSA
metabolic derangement not likely to exemption from the seizure regulation published a notice of receipt of
recur; and by alcohol or illicit drug on an individual, case-by-case basis. exemption applications and requested
withdrawal. public comment on 12 individuals (80
• Examples of moderate-to-high-risk C. Exemptions
FR 6166; Docket number FMCSA–2015–
factors for recurrence include seizures Following individualized assessments 02135). The comment period ended on
caused by non-penetrating head injury of the exemption applications, March 6, 2015. Four commenters
with loss of consciousness or amnesia including a review of detailed follow-up responded to this notice. Of the 12
greater than 30 minutes, or penetrating information requested from each applicants, three were denied. The
head injury; intracerebral hemorrhage applicant, FMCSA is granting Agency has determined that the
associated with a stroke or trauma; exemptions from 49 CFR 391.41(b)(8) to following nine applicants should be
infections; intracranial hemorrhage; 9 individuals. Under current FMCSA granted an exemption:
post-operative complications from brain regulations, all of the 9 drivers receiving
surgery with significant brain exemptions from 49 CFR 391.41(b)(8) Robert Elmer Atkins
hemorrhage; brain tumor; or stroke. would have been considered qualified Mr. Atkins is a 54 year-old driver in
The MEP report indicates individuals physically to drive a CMV in interstate Oregon. He has a history of epilepsy and
with moderate to high-risk conditions commerce except that they presently has remained seizure free since 1980.
should not be certified. Drivers with a take or have recently stopped taking He takes anti-seizure medication with
history of a single provoked seizure anti-seizure medication. For these 9 the dosage and frequency remaining the
with low risk factors for recurrence drivers, the primary obstacle to medical same since that time. If granted the
should be recertified every year. qualification was the FMCSA Advisory exemption, he would like to drive a
Criteria for Medical Examiners, based CMV. His physician states that he is
Medical Review Board on the 1988 ‘‘Conference on supportive of Mr. Atkins receiving an
Recommendations and Agency Decision Neurological Disorders and Commercial exemption.
FMCSA presented the MEP’s findings Drivers,’’ stating that a driver should be
rmajette on DSK7SPTVN1PROD with NOTICES

and the Evidence Report to the Medical off anti-seizure medication in order to Ronald Boogay
Review Board (MRB) for consideration. drive in interstate commerce. In fact, the Mr. Boogay is a 57 year-old class C
The MRB reviewed and considered the Advisory Criteria have little if anything CDL holder in New Jersey. He has a
2007 ‘‘Seizure Disorders and to do with the actual risk of a seizure history of a seizure disorder and has
Commercial Driver Safety’’ evidence and more to do with assumptions about remained seizure free since 1989. He
report and the 2007 MEP individuals who are taking anti-seizure takes anti-seizure medication with the
recommendations. The MRB medication. dosage and frequency remaining the

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57036 Federal Register / Vol. 80, No. 182 / Monday, September 21, 2015 / Notices

same since 2004. If granted the Michael R. Weymouth In accordance with 49 U.S.C.
exemption, he would like to drive a Mr. Weymouth is a 48 year-old class 31315(b)(1), each exemption will be
CMV. His physician states that he is A CDL holder in New Hampshire. He valid for 2 years, with annual
supportive of Mr. Boogay receiving an has a history of a seizure disorder and recertification required unless revoked
exemption. has remained seizure free since 1986. earlier by FMCSA. The exemption will
He takes anti-seizure medication with be revoked if the following occurs: (1)
Ronald Francis Bohr The person fails to comply with the
the dosage and frequency remaining the
Mr. Bohr is a 59 year-old class A CDL same since 2010. If granted an terms and conditions of the exemption;
holder in Iowa. He has a history of a exemption, he would like to drive a (2) the exemption has resulted in a
seizure disorder and has remained CMV. His physician states that he is lower level of safety than was
supportive of Mr. Weymouth receiving maintained prior to being granted; or (3)
seizure free since 1996. He takes anti-
an exemption. continuation of the exemption would
seizure medication with the dosage and
not be consistent with the goals and
frequency remaining the same since that Everet Thomas Wright objectives of 49 U.S.C. 31136 and 31315.
time. If granted the exemption, he
Mr. Wright is a 67 year-old driver in FMCSA exempts the following 9
would like to drive a CMV. His
Kentucky. He has a history of a seizure drivers for a period of 2 years with
physician states that he is supportive of annual medical certification required:
disorder and has remained seizure free
Mr. Bohr receiving an exemption. since 2002. He takes anti-seizure Robert Elmer Atkins (OR); Ronald
Earl Bernard Bomgaars medication with the dosage and Boogay (NJ); Ronald Francis Bohr (IA);
frequency remaining the same since Earl Bernard Bomgaars (IA); Teddy
Mr. Bomgaars is a 66 year-old class A 2013. If granted an exemption, he would Hugh Dixon (GA); John Griffith (ND);
CDL holder in Iowa. He has a history of like to drive a CMV. His physician states William Rainer, III (TX); Michael R.
epilepsy and has remained seizure free that he is supportive of Mr. Wright Weymouth (NH); and Everet Thomas
since 1963. He takes anti-seizure receiving an exemption. Wright (KY) from the prohibition of
medication with the dosage and CMV operations by persons with a
D. Comments
frequency remaining the same since that clinical diagnosis of epilepsy or
time. If granted the exemption, he In response to this notice, FMCSA seizures. If the exemption is still in
would like to drive a CMV. His received 4 comments. All commenters effect at the end of the 2-year period, the
physician states that he is supportive of were in support of commercial driving person may apply to FMCSA for a
Mr. Bomgaars receiving an exemption. for individuals with a history of seizure, renewal under procedures in effect at
who have been seizure free for over four that time.
Teddy Hugh Dixon or five years.
Issued on: September 8, 2015.
Mr. Dixon is a 54 year-old class A E. Basis for Exemption Larry W. Minor,
CDL holder in Georgia. He has a history Under 49 U.S.C. 31136(e) and Associate Administrator for Policy.
of a seizure disorder and has remained 31315(b), FMCSA may grant an [FR Doc. 2015–23595 Filed 9–18–15; 8:45 am]
seizure free since 2000. He takes anti- exemption from the epilepsy/seizure BILLING CODE 4910–EX–P
seizure medication with the dosage and standard in 49 CFR 391.41(b)(8) if the
frequency remaining the same since that exemption is likely to achieve an
time. If granted the exemption, he equivalent or greater level of safety than DEPARTMENT OF TRANSPORTATION
would like to drive a CMV. His would be achieved without the
physician states that he is supportive of exemption. Without the exemption, Federal Motor Carrier Safety
Mr. Dixon receiving an exemption. applicants will continue to be restricted Administration
to intrastate driving. With the
John Griffith [Docket No. FMCSA–2015–0118]
exemption, applicants can drive in
Mr. Griffith is a 43 year-old class A interstate commerce. Thus, the Agency’s Qualification of Drivers; Exemption
CDL holder in North Dakota. He has a analysis focuses on whether an equal or Applications; Epilepsy and Seizure
history of a seizure disorder and has greater level of safety is likely to be Disorders
remained seizure free since 1980. He achieved by permitting each of these
drivers to drive in interstate commerce AGENCY: Federal Motor Carrier Safety
takes anti-seizure medication with the
as opposed to restricting the driver to Administration (FMCSA), DOT.
dosage and frequency remaining the
same since that time. If granted the driving in intrastate commerce. ACTION: Notice of applications for
exemption, he would like to drive a Conclusion exemptions; request for comments.
CMV. His physician states that he is The Agency is granting exemptions SUMMARY: FMCSA announces receipt of
supportive of Mr. Griffith receiving an from the epilepsy standard, 49 CFR applications from 8 individuals for an
exemption. 391.41(b)(8), to 9 individuals based on exemption from the prohibition against
William Rainer, III a thorough evaluation of each driver’s persons with a clinical diagnosis of
safety experience and medical epilepsy or any other condition that is
Mr. Rainer is a 41 year-old driver in condition. Safety analysis of likely to cause a loss of consciousness
Texas. He has a history of epilepsy and information relating to these 9 or any loss of ability to operate a
has remained seizure free since 2006. applicants meets the burden of showing commercial motor vehicle (CMV) in
rmajette on DSK7SPTVN1PROD with NOTICES

He takes anti-seizure medication with that granting the exemptions would interstate commerce. The regulation and
the dosage and frequency remaining the achieve a level of safety that is the associated advisory criteria
same since that time. If granted the equivalent to or greater than the level published in the Code of Federal
exemption, he would like to drive a that would be achieved without the Regulations as the ‘‘Instructions for
CMV. His physician states that he is exemption. By granting the exemptions, Performing and Recording Physical
supportive of Mr. Rainer receiving an the interstate CMV industry will gain 9 Examinations’’ have resulted in
exemption. highly trained and experienced drivers. numerous drivers being prohibited from

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Document Created: 2015-12-15 09:38:28
Document Modified: 2015-12-15 09:38:28

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 September 21, 2015. The exemptions expire on September 21, 2017.
Contact		Charles A. Horan, III, Director, Office of Carrier, Driver and Vehicle Safety, (202) 366-4001, or via email at [email protected], or by letter to 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., Monday through Friday, except Federal holidays.
FR Citation		80 FR 57034

80 FR 57034 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 80, Issue 182 (September 21, 2015)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration