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Who Can Perform Commercial Motor Vehicle (CMV) Driver Examinations?

Who Can Perform Commercial Motor Vehicle (CMV) Driver Examinations?

There is a tension between federal Department of Transportation (DOT) and Federal Motor Carrier Safety Administration (FMCSA) regulations that outline who can perform CMV driver examinations and state regulations related to the performance of physical examinations for medical purposes – state regulations that govern the medical practice of physicians (both allopathic and osteopathic), physician assistants, nurse practitioners, chiropractors, and, in some cases, naturopathic and other allied professionals. Although FMCSA guidelines explicitly indicate that physicians, physician assistants, nurse practitioners, and chiropractors may perform DOT examinations, the guidelines also indicate that deference must be given to state regulations that may specify the...

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Regulation vs. Guidance

Regulation vs. Guidance

There is a great deal of confusion about what constitutes regulation, or law, and what is guidance. This distinction can be critical: medical examiners are required to follow regulation, while medical examiners are encouraged, but not required, to follow guidance recommendations. First, the consequences. If a medical examiners fails to follow a regulation, there is inherent liability risk should adverse consequences ensue.  If an insulin dependent driver has an accident due to an episode of hypoglycemia, the medical examiner that certified the driver without requiring a waiver or exemption will be liable. The other risk is regulatory: if an FMCSA...

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Diabetes and the Commercial Motor Vehicle (CMV) Driver

Diabetes and the Commercial Motor Vehicle (CMV) Driver

Hypoglycemia.  Hypoglycemia.  Hypoglycemia. That may be (just about) all you need to know about diabetes and FMCSA safety concerns. While it is true that hyperglycemia can be associated with mental status changes and effects on physical functioning that increase driver safety risk, such concerns are unlikely to manifest suddenly and with immediate concern. Hypoglycemic reactions, on the other hand, often occur quickly and are often associated with immediate effects on cognition, alertness, and even consciousness. It is for this reason that insulin dependent diabetes mellitus (IDDM) is the diabetic condition of greatest concern for driver safety, since insulin use is...

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