81 FR 28134 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 89 (May 9, 2016)

Page Range		28134-28135
FR Document		2016-10794

FMCSA announces its decision to exempt eight individuals 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 exemptions enable these individuals to operate CMVs in interstate commerce.

Federal Register, Volume 81 Issue 89 (Monday, May 9, 2016)

[Federal Register Volume 81, Number 89 (Monday, May 9, 2016)]
[Notices]
[Pages 28134-28135]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-10794]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[FMCSA Docket No. FMCSA-2015-0320]


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 exempt eight individuals 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 
exemptions enable these individuals to operate CMVs in interstate 
commerce.

DATES: The exemptions were effective on January 21, 2016. The 
exemptions expire on January 21, 2018.

FOR FURTHER INFORMATION CONTACT: Christine A. Hydock, Chief, Medical 
Programs Division, (202) 366-4001, [email protected], FMCSA, 
Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113, 
Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. 
e.t., Monday through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION: 

I. 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., 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.

II. Background

    On December 21, 2015, FMCSA published a notice announcing receipt 
of applications from 17 individuals requesting an exemption from the 
prohibition against persons with a clinical diagnosis of epilepsy or 
any other condition that is likely to cause a loss of consciousness or 
any loss of ability to operate a CMV in interstate commerce and 
requested comments from the public (80 FR 70065). The public comment 
period closed on January 20, 2016, and no comments were received.
    FMCSA has evaluated the eligibility of these applicants and 
determined that granting the exemptions to eight individuals would 
achieve a level of safety equivalent to or greater than the level that 
would be achieved by complying with the current regulation 49 CFR 
391.41(b)(8).
    The physical qualification standard for drivers regarding epilepsy 
found in 49 CFR 391.41(b)(8) states that a person is physically 
qualified to drive a CMV if that person


[[Page 28135]]


    Has no established medical history or clinical diagnosis of 
epilepsy or any other condition which is likely to cause the loss of 
consciousness or any loss of ability to control a CMV.

    In addition to the regulations, FMCSA has published advisory 
criteria to assist medical examiners in determining whether drivers 
with certain medical conditions are qualified to operate a CMV in 
interstate commerce. The advisory criteria found in Appendix A to 49 
CFR 391.41, states that:

    If an individual has had a sudden episode of a non-epileptic 
seizure or loss of consciousness of unknown cause that did not 
require anti-seizure medication, the decision whether that person's 
condition is likely to cause the loss of consciousness or loss of 
ability to control a CMV should be made on an individual basis by 
the medical examiner in consultation with the treating physician. 
Before certification is considered, it is suggested that a 6-month 
waiting period elapse from the time of the episode. Following the 
waiting period, it is suggested that the individual have a complete 
neurological examination. If the results of the examination are 
negative and anti-seizure medication is not required, then the 
driver may be qualified.
    In those individual cases where a driver had a seizure or an 
episode of loss of consciousness that resulted from a known medical 
condition (e.g., drug reaction, high temperature, acute infectious 
disease, dehydration, or acute metabolic disturbance), certification 
should be deferred until the driver has recovered fully from that 
condition, has no existing residual complications, and is not taking 
anti-seizure medication.
    Drivers who have a history of epilepsy/seizures, off anti-
seizure medication and seizure-free for 10 years, may be qualified 
to operate 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.

    As a result of medical examiners misinterpreting advisory criteria 
as regulation, numerous drivers have been prohibited from operating a 
CMV 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 based on the physical qualification standards and medical best 
practices.
    In reaching the decision to grant these exemption requests, the 
Agency considered the 2007 recommendations of the Agency's Medical 
Expert Panel (MEP). The January 15, 2013 (78 FR 3069) Federal Register 
notice provides the current MEP recommendations which is the criteria 
the Agency uses to grant seizure exemptions.
    These eight applicants have been seizure-free over a range of 13 to 
43 years while taking anti-seizure medication and maintained a stable 
medication treatment regimen for the last two years. In each case, the 
applicant's treating physician verified his or her seizure history and 
supports the ability to drive commercially. A summary of each 
applicant's seizure history was discussed in the December 21, 2015 
Federal Register notice and will not be repeated in this notice.

III. Discussion of Comments

    There were no comments in response to this notice. The Agency has 
determined that eight applicants should be granted an exemption.

IV. Basis for Exemption Determination

    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. The exemption allows the 
applicants to operate CMVs in interstate commerce.
    The Agency's decision regarding these exemption applications is 
based on an individualized assessment of each applicant's medical 
information, including the root cause of the respective seizure(s) and 
medical information about the applicant's seizure history, the length 
of time that has elapsed since the individual's last seizure, the 
stability of each individual's treatment regimen and the duration of 
time on or off of anti-seizure medication. In addition, the Agency 
reviewed the treating clinician's medical opinion related to the 
ability of the driver to safely operate a CMV with a history of seizure 
and each applicant's driving record found in the Commercial Driver's 
License Information System (CDLIS) for commercial driver's license 
(CDL) holders, and interstate and intrastate inspections recorded in 
the Motor Carrier Management Information System (MCMIS). For non-CDL 
holders, the Agency reviewed the driving records from the State 
Driver's Licensing Agency (SDLA). The Agency acknowledges the potential 
consequences of a driver experiencing a seizure while operating a CMV. 
However, the Agency believes the drivers granted this exemption have 
demonstrated that they are unlikely to have a seizure and their medical 
condition does not pose a risk to public safety.
    Consequently, FMCSA finds that in each case exempting these 
applicants from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) is 
likely to achieve a level of safety equal to that existing without the 
exemption.

V. Conditions and Requirements

    The terms and conditions of the exemption will be provided to the 
applicants in the exemption document and includes the following: (1) 
Each individual must remain seizure-free and maintain a stable 
treatment during the 2-year exemption period; (2) each individual must 
submit annual reports from their treating physicians attesting to the 
stability of treatment and that the driver has remained seizure-free; 
(3) each individual must undergo an annual medical examination by a 
certified Medical Examiner, as defined by 49 CFR 390.5; and (4) each 
individual must provide a copy of the annual medical certification to 
the employer for retention in the driver's qualification file, or keep 
a copy of his/her driver's qualification file if he/she is self-
employed. The driver must also have a copy of the exemption when 
driving, for presentation to a duly authorized Federal, State, or local 
enforcement official.

VI. Conclusion

    Based upon its evaluation of the eight exemption applications, 
FMCSA exempts the following drivers from the epilepsy/seizure standard 
in 49 CFR 391.41(b)(8), subject to the requirements cited above: James 
E. Allen (ME); Thomas A DeAngelo (IL); Nathan Dermer (AK); Daniel Lloyd 
Halstead (NV); Kevin Mathis (NJ); Toriano T. Mitchell (OH); Thomas A. 
Mitman (NY) and Tyler W. Schaefor (ME).
    In accordance with 49 U.S.C. 31315(b)(1), each exemption is valid 
for 2 years, unless revoked earlier by FMCSA. The exemption will be 
revoked if the following occurs: (1) The individual 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. If the 
exemption is still effective at the end of the 2-year period, the 
individual may apply to FMCSA for a renewal under procedures in effect 
at that time.

    Issued on: April 29, 2016.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2016-10794 Filed 5-6-16; 8:45 am]
 BILLING CODE 4910-EX-P

Federal Register / Vol. 81, No. 89 / Monday, May 9, 2016 / Notices 28135

Has no established medical history or These eight applicants have been from the epilepsy/seizure standard in 49
clinical diagnosis of epilepsy or any other seizure-free over a range of 13 to 43 CFR 391.41(b)(8) is likely to achieve a
condition which is likely to cause the loss of years while taking anti-seizure level of safety equal to that existing
consciousness or any loss of ability to control
medication and maintained a stable without the exemption.
a CMV.
medication treatment regimen for the
In addition to the regulations, FMCSA last two years. In each case, the V. Conditions and Requirements
has published advisory criteria to assist applicant’s treating physician verified
medical examiners in determining The terms and conditions of the
his or her seizure history and supports exemption will be provided to the
whether drivers with certain medical the ability to drive commercially. A
conditions are qualified to operate a applicants in the exemption document
summary of each applicant’s seizure and includes the following: (1) Each
CMV in interstate commerce. The history was discussed in the December
advisory criteria found in Appendix A individual must remain seizure-free and
21, 2015 Federal Register notice and
to 49 CFR 391.41, states that: maintain a stable treatment during the
will not be repeated in this notice.
2-year exemption period; (2) each
If an individual has had a sudden episode III. Discussion of Comments individual must submit annual reports
of a non-epileptic seizure or loss of
consciousness of unknown cause that did not There were no comments in response from their treating physicians attesting
require anti-seizure medication, the decision to this notice. The Agency has to the stability of treatment and that the
whether that person’s condition is likely to determined that eight applicants should driver has remained seizure-free; (3)
cause the loss of consciousness or loss of be granted an exemption. each individual must undergo an annual
ability to control a CMV should be made on medical examination by a certified
an individual basis by the medical examiner IV. Basis for Exemption Determination Medical Examiner, as defined by 49 CFR
in consultation with the treating physician. Under 49 U.S.C. 31136(e) and 390.5; and (4) each individual must
Before certification is considered, it is
31315(b), FMCSA may grant an provide a copy of the annual medical
suggested that a 6-month waiting period
elapse from the time of the episode. exemption from the epilepsy/seizure certification to the employer for
Following the waiting period, it is suggested standard in 49 CFR 391.41(b)(8) if the retention in the driver’s qualification
that the individual have a complete exemption is likely to achieve an file, or keep a copy of his/her driver’s
neurological examination. If the results of the equivalent or greater level of safety than qualification file if he/she is self-
examination are negative and anti-seizure would be achieved without the employed. The driver must also have a
medication is not required, then the driver exemption. The exemption allows the copy of the exemption when driving, for
may be qualified. applicants to operate CMVs in interstate presentation to a duly authorized
In those individual cases where a driver commerce.
had a seizure or an episode of loss of Federal, State, or local enforcement
The Agency’s decision regarding these official.
consciousness that resulted from a known
medical condition (e.g., drug reaction, high
exemption applications is based on an
individualized assessment of each VI. Conclusion
temperature, acute infectious disease,
dehydration, or acute metabolic disturbance), applicant’s medical information,
including the root cause of the Based upon its evaluation of the eight
certification should be deferred until the
driver has recovered fully from that respective seizure(s) and medical exemption applications, FMCSA
condition, has no existing residual information about the applicant’s exempts the following drivers from the
complications, and is not taking anti-seizure seizure history, the length of time that epilepsy/seizure standard in 49 CFR
medication. has elapsed since the individual’s last 391.41(b)(8), subject to the requirements
Drivers who have a history of epilepsy/
seizure, the stability of each individual’s cited above: James E. Allen (ME);
seizures, off anti-seizure medication and Thomas A DeAngelo (IL); Nathan
seizure-free for 10 years, may be qualified to treatment regimen and the duration of
time on or off of anti-seizure Dermer (AK); Daniel Lloyd Halstead
operate a CMV in interstate commerce. (NV); Kevin Mathis (NJ); Toriano T.
Interstate drivers with a history of a single medication. In addition, the Agency
unprovoked seizure may be qualified to drive reviewed the treating clinician’s Mitchell (OH); Thomas A. Mitman (NY)
a CMV in interstate commerce if seizure-free medical opinion related to the ability of and Tyler W. Schaefor (ME).
and off anti-seizure medication for a 5-year the driver to safely operate a CMV with In accordance with 49 U.S.C.
period or more. a history of seizure and each applicant’s 31315(b)(1), each exemption is valid for
As a result of medical examiners driving record found in the Commercial 2 years, unless revoked earlier by
misinterpreting advisory criteria as Driver’s License Information System FMCSA. The exemption will be revoked
regulation, numerous drivers have been (CDLIS) for commercial driver’s license if the following occurs: (1) The
prohibited from operating a CMV in (CDL) holders, and interstate and individual fails to comply with the
interstate commerce based on the fact intrastate inspections recorded in the terms and conditions of the exemption;
that they have had one or more seizures Motor Carrier Management Information (2) the exemption has resulted in a
and are taking anti-seizure medication, System (MCMIS). For non-CDL holders, lower level of safety than was
rather than an individual analysis of the Agency reviewed the driving records maintained prior to being granted; or (3)
their circumstances by a qualified from the State Driver’s Licensing continuation of the exemption would
medical examiner based on the physical Agency (SDLA). The Agency not be consistent with the goals and
qualification standards and medical best acknowledges the potential objectives of 49 U.S.C. 31136 and 31315.
practices. consequences of a driver experiencing a If the exemption is still effective at the
In reaching the decision to grant these seizure while operating a CMV. end of the 2-year period, the individual
exemption requests, the Agency However, the Agency believes the may apply to FMCSA for a renewal
mstockstill on DSK3G9T082PROD with NOTICES

considered the 2007 recommendations drivers granted this exemption have under procedures in effect at that time.
of the Agency’s Medical Expert Panel demonstrated that they are unlikely to Issued on: April 29, 2016.
(MEP). The January 15, 2013 (78 FR have a seizure and their medical
Larry W. Minor,
3069) Federal Register notice provides condition does not pose a risk to public
the current MEP recommendations safety. Associate Administrator for Policy.
which is the criteria the Agency uses to Consequently, FMCSA finds that in [FR Doc. 2016–10794 Filed 5–6–16; 8:45 am]
grant seizure exemptions. each case exempting these applicants BILLING CODE 4910–EX–P

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Document Created: 2018-02-07 14:49:53
Document Modified: 2018-02-07 14:49:53

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 were effective on January 21, 2016. The exemptions expire on January 21, 2018.
Contact		Christine A. Hydock, Chief, Medical Programs Division, (202) 366-4001, [email protected], FMCSA, Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113, Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. e.t., Monday through Friday, except Federal holidays.
FR Citation		81 FR 28134

81 FR 28134 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 89 (May 9, 2016)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration