New Federal DOT Forms

[Guest UVAPAC]

Has anyone had an opportunity to review the new federal DOT forms?  Sometime in the next 2 months they are going to be mandatory.  Essentially there are more screening questions, and some major changes to the types of cards that may be issue.  (Such as a new 45 day pending category.)

 

One of the most interesting aspects is there is actually an area to document "neck circumference" and BMI.  There is actually an asterisk which suggests than any female with a neck circumference greater than 16 inches in a female or 17 inches in a male, or BMI greater than 33 are at high risk for Sleep Apnea.

 

Is this to suggest that all overweight patients or patients with a larger build should be mandated to have sleep studies prior to receiving a card.

 

This would effect a large percentage of my patient population who wish to obtain medical cards.

[cc56]

I just saw the form last week for 1 patient.  I like that they have to reveal everything.  The last form was easy to "forget" stuff.  This new one asks everything, and at the end asks if there is anything else not mentioned in the form.  Last interesting thing is on the back.  It specifically says to not evaluate language skills for the medical card.  There was a discussion once about some one not speaking English and if you could have a translator.  If you can't speak English though, how are you able to fill out the form correctly?  

 

Funny story on the new form.  The guy marked NO for everything.  In the column for diabetes it states control with Diet, meds, insulin and has a little box by each.  The guy checked NO and then all 3 little boxes.  It was for a trucking school, I suspect they tell them to mark NO on everything so they can get their card.  

[Reality Check 2]

I didn't see the part about language skills but there is a HUGE DOT internet page that stresses that the driver must read, write and understand English sufficient to converse w law enforcement and answer questions and fill out forms.

 

https://www.fmcsa.dot.gov/regulations/title49/section/391.11

 

We NEVER offer translation services for DOT. Fill out the form on your own and don't ask for help. If that isn't possible - you don't qualify for DOT.

 

One local Drive Thru kind of DOT factory will fail ANYONE w BMI over 33 or big neck and send them to the PCP they often do not have requiring a sleep apnea study the patient often doesn't need or can't afford. The patients are peaved and often unemployed temporarily without really having asked the patient for info. Even if a PCP writes a clinical document stating sleep apnea is not clinically suspected -- they disregard it and will not issue a card.

 

Proof of NOT sleep apnea is not required but the DOT examiner has no obligation to issue a card.

 

http://www.sleepreviewmag.com/2015/02/analysis-fmcsa-bulletin/

 

Very messed up system.

 

I truly want drivers to be safe but value actual medical practice over charging fees and rubber stamping people out to cover my butt and "follow the rules"

[Reality Check 2]

https://www.oregon.gov/ODOT/MCT/docs/mustspeakenglish.pdf

 

I printed this and hung it in our clinic.

 

How can someone not speak English for medical and "pass" but HAVE TO speak English to drive?

 

If I can't get medical history in English - how can I judge medical fitness?

 

Govt mismatch oxymoron at its finest.....

[Reality Check 2]

http://nadme.org/

 

Has anyone heard of this site or used any of its services?

 

There is a $149 CME on OSA.

 

I am curious and have the budget to use it and ignore it if useless.

 

A bunch of "expert educational" organizations seem to have sprung to life since we were required to be certified as DOT examiners.

 

Kind of like roofers after a hurricane.....

 

Anyone worked with this site?

[Guest UVAPAC]

http://www.cbsnews.com/news/how-medically-unfit-commercial-drivers-end-up-behind-the-wheel-greyhound-bus-crash/

 

It is news articles like this that have me very worried about OSA in particular.

 

The new forms set forth very clear (yet optional) guidelines on risk factors for OSA.  (Neck Circumference and BMI).  If you choose to not do measure BMI and Neck Circumference, or measure them, and don't mandate a sleep study if criteria not met... and the driver you clear gets into a fatal accident... I think you would have a lot of very difficult questions to answer.

 

I have even suggested something as simple as having all patients fill out an Epworth Sleepiness Scale with their DOT Paperwork, but the physicians I work with are against this practice.