81 FR 33577 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 102 (May 26, 2016)

Page Range		33577-33579
FR Document		2016-12436

FMCSA announces its decision to exempt five 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 102 (Thursday, May 26, 2016)

[Federal Register Volume 81, Number 102 (Thursday, May 26, 2016)]
[Notices]
[Pages 33577-33579]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-12436]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[FMCSA Docket No. FMCSA-2015-0118]


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 five 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 October 22, 2015. The 
exemptions expire on October 22, 2017.

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 September 21, 2015, FMCSA published a notice announcing receipt 
of applications from eight 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 57036). The public comment 
period closed on October 21, 2015, and 13 comments were received.
    FMCSA has evaluated the eligibility of these applicants and 
determined that granting the exemptions to five 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).

[[Page 33578]]

    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:

    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 \1\ to assist medical examiners in determining whether drivers 
with certain medical conditions are qualified to operate a CMV in 
interstate commerce. [49 CFR part 391, APPENDIX A TO PART 391--MEDICAL 
ADVISORY CRITERIA, section H. Epilepsy: Sec.  391.41(b)(8), paragraphs 
3, 4, and 5.]
---------------------------------------------------------------------------

    \1\ See http://www.ecfr.gov/cgi-bin/text-idx?SID=e47b48a9ea42dd67d999246e23d97970&mc=true&node=pt49.5.391&rgn=div5#ap49.5.391_171.a and https://www.thefederalregister.org/fdsys/pkg/CFR-2015-title49-vol5/pdf/CFR-2015-title49-vol5-part391-appA.pdf.
---------------------------------------------------------------------------

    The advisory criteria 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.
    Five of the eight applicants have been seizure-free over a range of 
10 to 25 years while taking anti-seizure medication and maintained a 
stable medication treatment regimen for the last two years. In each of 
these cases, 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 
September 21, 2015 Federal Register notice and will not be repeated in 
this notice.

III. Discussion of Comments

    Thirteen commenters responded to this notice, 11 of whom 
specifically expressed support for applicant Billy Ray Hunter and two 
in support of granting seizure exemptions in general.

IV. Basis for Exemption Determination

    The Agency has determined that five of the eight applicants should 
be granted an 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. 
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 five 
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. A decision will be made on the other three applicants on a 
later date.

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 five 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: Joshua Alan 
Abel (MD); James E. Blosser, Jr. (VA); Jeremy H. Fryburg (PA); Jonathan 
Robert Jones (WI); and Anthony Edward Martens (SD).

[[Page 33579]]

    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: May 19, 2016.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2016-12436 Filed 5-25-16; 8:45 am]
 BILLING CODE 4910-EX-P

Federal Register / Vol. 81, No. 102 / Thursday, May 26, 2016 / Notices 33577

automatically stay the effectiveness of Frequency of Use: On occasion. is likely to cause loss of consciousness
the exemption. Petitions for stay must Type of Affected Public: Individuals or any loss of ability to control a CMV.’’
be filed no later than June 1, 2016 (at or households, state or local The exemptions enable these
least seven days before the exemption governments, farms, businesses, or other individuals to operate CMVs in
becomes effective). for-profit, Federal agencies or interstate commerce.
An original and ten copies of all employees, non-profit institutions, DATES: The exemptions were effective
pleadings, referring to Docket No. FD small businesses or organizations. on October 22, 2015. The exemptions
36033, must be filed with the Surface Small Businesses or Organizations expire on October 22, 2017.
Transportation Board, 395 E Street SW., Affected: Yes. FOR FURTHER INFORMATION CONTACT:
Washington, DC 20423–0001. In Federal Budget Functional Category Christine A. Hydock, Chief, Medical
addition, a copy of each pleading must Code: 452. Programs Division, (202) 366–4001,
be served on applicant’s representative, Estimated Number of Annual fmcsamedical@dot.gov, FMCSA,
Eric M. Hocky, Clark Hill PLC, One Responses: 1,800. Department of Transportation, 1200
Commerce Square, 2005 Market Street, Estimated Total Annual Burden New Jersey Avenue SE., Room W64–
Suite 1000, Philadelphia, PA 19103. Hours: 3,600. 113, Washington, DC 20590–0001.
According to RBMN, this action is Estimated Average Burden Hours per
Office hours are from 8:30 a.m. to 5 p.m.
categorically excluded from Response: 2.0.
e.t., Monday through Friday, except
environmental review under 49 CFR Need for and Use of Information: TVA
Federal holidays.
1105.6(c). Land Management activities and Section
Board decisions and notices are 26a of the Tennessee Valley Authority SUPPLEMENTARY INFORMATION:
available on our Web site at Act of 1933, as amended, require TVA I. Electronic Access
WWW.STB.DOT.GOV. to collect information relevant to
You may see all the comments online
Decided: May 20, 2016. projects that will impact TVA land and
through the Federal Document
By the Board, Rachel D. Campbell, land rights and review and approve
Management System (FDMS) at: http://
Director, Office of Proceedings. plans for the construction, operation,
www.regulations.gov.
Tia Delano, and maintenance of any dam,
Docket: For access to the docket to
appurtenant works, or other obstruction
Clearance Clerk. read background documents or
affecting navigation, flood control, or
[FR Doc. 2016–12349 Filed 5–24–16; 8:45 am] comments, go to http://
public lands or reservations across,
BILLING CODE P www.regulations.gov and/or Room
along, or in the Tennessee River or any
W12–140 on the ground level of the
of its tributaries. The information is
West Building, 1200 New Jersey Avenue
collected via paper forms and/or
TENNESSEE VALLEY AUTHORITY SE., Washington, DC, between 9 a.m.
electronic submissions and is used to
and 5 p.m., Monday through Friday,
assess the impact of the proposed
Agency Information Collection except Federal holidays.
project on TVA land or land rights and
Activities: Proposed Collection; Privacy Act: In accordance with 5
statutory TVA programs to determine if
Comment Request U.S.C. 553(c), DOT solicits comments
the project can be approved. Rules for
from the public to better inform its
AGENCY: Tennessee Valley Authority. implementation of TVA’s Section 26a
rulemaking process. DOT posts these
ACTION: 60-Day notice of submission of responsibilities are published in 18 CFR
comments, without edit, including any
information collection approval and part 1304.
personal information the commenter
request for comments. Philip D. Propes, provides, to www.regulations.gov, as
Director, Enterprise Information Security and described in the system of records
SUMMARY: The proposed information
Policy. notice (DOT/ALL–14 FDMS), which can
collection described below will be
[FR Doc. 2016–12401 Filed 5–25–16; 8:45 am] be reviewed at www.dot.gov/privacy.
submitted to the Office of Management
and Budget (OMB) for review, as BILLING CODE 8120–08–P II. Background
required by the Paperwork Reduction On September 21, 2015, FMCSA
Act of 1995 (44 U.S.C. chapter 35, as published a notice announcing receipt
amended). The Tennessee Valley DEPARTMENT OF TRANSPORTATION
of applications from eight individuals
Authority is soliciting public comments requesting an exemption from the
on this proposed collection as provided Federal Motor Carrier Safety
Administration prohibition against persons with a
by 5 CFR 1320.8(d)(1). clinical diagnosis of epilepsy or any
ADDRESSES: Requests for information, [FMCSA Docket No. FMCSA–2015–0118] other condition that is likely to cause a
including copies of the information loss of consciousness or any loss of
collection proposed and supporting Qualification of Drivers; Exemption
ability to operate a CMV in interstate
documentation, should be directed to Applications; Epilepsy and Seizure
commerce and requested comments
the Agency Clearance Officer: Philip D. Disorders
from the public (80 FR 57036). The
Propes, Tennessee Valley Authority, AGENCY: Federal Motor Carrier Safety public comment period closed on
1101 Market Street (MP 2C), Administration (FMCSA), DOT October 21, 2015, and 13 comments
Chattanooga, Tennessee 37402–2801; were received.
ACTION: Notice of final disposition.
(423) 751–8593. FMCSA has evaluated the eligibility
sradovich on DSK3TPTVN1PROD with NOTICES

DATES: Comments should be sent to the SUMMARY: FMCSA announces its of these applicants and determined that
Agency Clearance Officer no later than decision to exempt five individuals granting the exemptions to five
July 25, 2016. from the regulatory requirement that individuals would achieve a level of
SUPPLEMENTARY INFORMATION: interstate commercial motor vehicle safety equivalent to or greater than the
Type of Request: Reauthorization. (CMV) drivers have ‘‘no established level that would be achieved by
Title of Information Collection: medical history or clinical diagnosis of complying with the current regulation
Section 26a Permit Application. epilepsy or any other condition which 49 CFR 391.41(b)(8).

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33578 Federal Register / Vol. 81, No. 102 / Thursday, May 26, 2016 / Notices

The physical qualification standard As a result of medical examiners medical opinion related to the ability of
for drivers regarding epilepsy found in misinterpreting advisory criteria as the driver to safely operate a CMV with
49 CFR 391.41(b)(8) states that a person regulation, numerous drivers have been a history of seizure and each applicant’s
is physically qualified to drive a CMV prohibited from operating a CMV in driving record found in the Commercial
if that person: interstate commerce based on the fact Driver’s License Information System
Has no established medical history or that they have had one or more seizures (CDLIS) for commercial driver’s license
clinical diagnosis of epilepsy or any other and are taking anti-seizure medication, (CDL) holders, and interstate and
condition which is likely to cause the loss of rather than an individual analysis of intrastate inspections recorded in the
consciousness or any loss of ability to control their circumstances by a qualified Motor Carrier Management Information
a CMV. medical examiner based on the physical System (MCMIS). For non-CDL holders,
In addition to the regulations, FMCSA qualification standards and medical best the Agency reviewed the driving records
has published advisory criteria 1 to practices. from the State Driver’s Licensing
In reaching the decision to grant these Agency (SDLA). The Agency
assist medical examiners in determining
exemption requests, the Agency acknowledges the potential
whether drivers with certain medical
considered the 2007 recommendations consequences of a driver experiencing a
conditions are qualified to operate a
of the Agency’s Medical Expert Panel seizure while operating a CMV.
CMV in interstate commerce. [49 CFR
(MEP). The January 15, 2013 (78 FR However, the Agency believes the
part 391, APPENDIX A TO PART 391—
3069) Federal Register notice provides drivers granted this exemption have
MEDICAL ADVISORY CRITERIA,
the current MEP recommendations demonstrated that they are unlikely to
section H. Epilepsy: § 391.41(b)(8),
which is the criteria the Agency uses to have a seizure and their medical
paragraphs 3, 4, and 5.]
grant seizure exemptions. condition does not pose a risk to public
The advisory criteria states that if an Five of the eight applicants have been safety.
individual has had a sudden episode of seizure-free over a range of 10 to 25 Consequently, FMCSA finds that in
a non-epileptic seizure or loss of years while taking anti-seizure each case exempting these five
consciousness of unknown cause that medication and maintained a stable applicants from the epilepsy/seizure
did not require anti-seizure medication, medication treatment regimen for the standard in 49 CFR 391.41(b)(8) is likely
the decision whether that person’s last two years. In each of these cases, the to achieve a level of safety equal to that
condition is likely to cause the loss of applicant’s treating physician verified existing without the exemption. A
consciousness or loss of ability to his or her seizure history and supports decision will be made on the other three
control a CMV should be made on an the ability to drive commercially. A applicants on a later date.
individual basis by the medical summary of each applicant’s seizure
examiner in consultation with the V. Conditions and Requirements
history was discussed in the September
treating physician. Before certification is 21, 2015 Federal Register notice and The terms and conditions of the
considered, it is suggested that a 6- will not be repeated in this notice. exemption will be provided to the
month waiting period elapse from the applicants in the exemption document
time of the episode. Following the III. Discussion of Comments and includes the following: (1) Each
waiting period, it is suggested that the Thirteen commenters responded to individual must remain seizure-free and
individual have a complete neurological this notice, 11 of whom specifically maintain a stable treatment during the
examination. If the results of the expressed support for applicant Billy 2-year exemption period; (2) each
examination are negative and anti- Ray Hunter and two in support of individual must submit annual reports
seizure medication is not required, then granting seizure exemptions in general. from their treating physicians attesting
the driver may be qualified. to the stability of treatment and that the
In those individual cases where a IV. Basis for Exemption Determination driver has remained seizure-free; (3)
driver had a seizure or an episode of The Agency has determined that five each individual must undergo an annual
loss of consciousness that resulted from of the eight applicants should be medical examination by a certified
a known medical condition (e.g., drug granted an exemption. Under 49 U.S.C. Medical Examiner, as defined by 49 CFR
reaction, high temperature, acute 31136(e) and 31315(b), FMCSA may 390.5; and (4) each individual must
infectious disease, dehydration, or acute grant an exemption from the epilepsy/ provide a copy of the annual medical
metabolic disturbance), certification seizure standard in 49 CFR 391.41(b)(8) certification to the employer for
should be deferred until the driver has if the exemption is likely to achieve an retention in the driver’s qualification
recovered fully from that condition, has equivalent or greater level of safety than file, or keep a copy of his/her driver’s
no existing residual complications, and would be achieved without the qualification file if he/she is self-
is not taking anti-seizure medication. exemption. The exemption allows the employed. The driver must also have a
Drivers who have a history of applicants to operate CMVs in interstate copy of the exemption when driving, for
epilepsy/seizures, off anti-seizure commerce. presentation to a duly authorized
medication and seizure-free for 10 years, The Agency’s decision regarding these Federal, State, or local enforcement
may be qualified to operate a CMV in exemption applications is based on an official.
interstate commerce. Interstate drivers individualized assessment of each
with a history of a single unprovoked applicant’s medical information, VI. Conclusion
seizure may be qualified to drive a CMV including the root cause of the Based upon its evaluation of the five
in interstate commerce if seizure-free respective seizure(s) and medical exemption applications, FMCSA
and off anti-seizure medication for a 5- information about the applicant’s exempts the following drivers from the
sradovich on DSK3TPTVN1PROD with NOTICES

year period or more. seizure history, the length of time that epilepsy/seizure standard in 49 CFR
has elapsed since the individual’s last 391.41(b)(8), subject to the requirements
1 See http://www.ecfr.gov/cgi-bin/text-idx?SID= seizure, the stability of each individual’s cited above: Joshua Alan Abel (MD);
e47b48a9ea42dd67d999246e23d97970&mc= treatment regimen and the duration of James E. Blosser, Jr. (VA); Jeremy H.
true&node=pt49.5.391&rgn=div5#ap49.5.391_171.a
and https://www.gpo.gov/fdsys/pkg/CFR-2015-
time on or off of anti-seizure Fryburg (PA); Jonathan Robert Jones
title49-vol5/pdf/CFR-2015-title49-vol5-part391- medication. In addition, the Agency (WI); and Anthony Edward Martens
appA.pdf. reviewed the treating clinician’s (SD).

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Document Created: 2016-05-26 01:13:42
Document Modified: 2016-05-26 01:13:42

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 October 22, 2015. The exemptions expire on October 22, 2017.
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 33577

81 FR 33577 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 102 (May 26, 2016)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration