DOT MEDICAL EXAMINER STUDY RESOURCE Courtesy of NRCME Public Records
DQ = Disqualify Driver (until conditions met for return.)
The 4 Non-Discretionary Standards: 58lbs is normal grasp and prehension.
SPE = Skilled Performance Eval. Drivers get 2 years with a fixed
• Epilepsy �:::::::::::::::::::::::.-' 1, ___________ .... • Hearing• Vision• Insulin Dependent Diabetes Mellitus
J DQ= Untreated Sleep Apnea
Urine Dipstick tests for: • Blood• Specific Gravity• Sugar/glucose• Protein
.-----------------,
: DQ= Narcolepsy ___ :
: Active Tuberculosis=DQ
Obstructive Sleep Apnea: 1 year qualification after 3 months with no symptoms post surgery or one month no symptoms from C-pap machine use.
02 Equipment to assist in breathing = DQ.
Hypoxemia at Rest =
DQ EDS- Excessive Daytime Sleepiness.
RLS- Restless Leg Syndrome
OSA- Obstructive Sleep Apnea
IS IT Incapacitating?
•
CZl
Ul •
•
Static-DQ Progressive
DQ Episodic-DQ
Examiner Must Decide!
Blood Gasses
• �f'meas11re111e111 reveals a
PaO2 of less than 65111111
Hg at less than 5,000 Ji.
• Or /es.\· than 60mm Hg
ahtll'e 5000 Ji.
.-111(//or
• Carho11 dioxide greater
1'11111 45111111 (at 1111y altitude)
DISQUALIFY DR/I ER
•
•
•
•
•
•
If Untreated = DQ
Severe cough Poor Meds Tolerance Frequent and Severe episodes FCV<65% PaO2 <65mm DISQUALIFY
Alcohol Abuse is Disqualifying. If an examiner
suspects alcohol abuse, the Designated
Employer Represelllative should be informed
alld the driver IMMEDIDIATELY
Disqualified The DER is responsible for
referral to a Substance Abuse Professio11al
DQ:
• Primary AlveolarHypoventilationSyn.
• Idiopathic Hy-persomnolence
• RLS with EDS
Severe TBI = DQ Moderate TBI= Do not DQ on its own. Case by case basis, but must be seizure free for 2-5 years after injury. (See "Wait Times and Limits" Guide in Resource Library)
Epilepsy: 2 or more unprovoked seizures. DQ. To re-qualify must have I 0 years no meds and no unprovoked seizures.
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Study Guide3
Un.Hable Angina: DQ Framingham 4-- is a Risk Scoring System for Heart. Based on correctable vs. non-correctable conditions. • Pain at rest.
• Poor response to medications.
3
Non Sustained VT Defini
tion
> 40% and less than <50%.
Myocardial Infarction
2 Month Wait
Ejection Fraction> 40%
Exercise Tolerance Test Normal.
Tolerates Medications
Passes CMV Physical
Exercise 1'01- 0
erance Test,. ing is clone in:
• Ml 0
• Angio-plasty
• StaticAnginaPectoris
• CABG
0
0
0
0
Coronary Bypass Grafting (CABG) also known as "Cabbage"
1. Return to Work 3 months post procedure.2. Must be asymptomatic3. Ejection Fraction of>40%.4. Yearly Recertification5. Tolerance of Medications
0
0
Heart Failure
Idiopathic Dilated
Cardio-
1nyopathy .... Most Common
form of heart
failure.
Pacemaker:
Return to Driving • One month post im
plant.• One year routine
check.
6. Must have a 5 year Exercise Tolerance Test due to likelihood of re-occlusion. Then,ETT yearly.
Significant Pulmonary Hypertension Disqualify.
Atrial Fibrillation Risk: Embolus- Stroke
I year if rate control led via mcds.
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Certi y Period
Item Wait Period (needs new exam-
Other/Exemption Period (no symptoms) if otherwise
aualified)
10 Years seizure free no Epilepsy definition: 2 or more
Epilepsy anticon
1 Year unprovoked seizures with no time limit in between
Headaches adeauate RX 2 years Single unprovoked seizure 5 yea rs, no meds, no seizure 1 year
Acute/Chronic benign 2 mo, no sx 2 Years
vestibulooathv CNS Infections
Bad. Meningitis, viral encephalitis No seizure: 1 year 2 Years Bact. Meniaitis with earlv seizure 5 year 2 Years
Viral Encohalitis with seizure 10 years 1 Year Neu romuscu la r /Periphera I
DQ may have appeal after specialist
Nueropathv eval
Autonomic Neuropathy adequate RX 2 Year Diabetic Autonomic Neuropathy- 1
Year unless cardiac sx lntrcranial Hemm./subarrachnoid 1 year no seizure or risk of
1 cerebellum/brainstem low seizure
bid. seizure year
risk areas lntrcranial Hemm./subarrachnoid
5 year with risk of seizure 1 Year cortical/subcortical high seizure risk
bid. areas
Stroke 1 year no seizure risk 1 Year cerebellum/brainstem low seizure
risk areas
5 year with risk of seizure 1 year cortical/subcortical high seizure risk
areas TIA 1 year 1 Year no seizures no seizure meds
Traumatic Brain Injury (severe) DQ LOC for more than 24 hours and/or dural penetration.
Traumatic Brain Injury (moderate) 2 year without seizure 1 Year LOC > 30 min but < 24 hrs, no dural
penetration
5 year with seizure 1 Year LOC greater than 30 min but less
than 24 hours.no dural oenetration Traumatic Brain Injury (mild) 1 Year no seizure 2 Years
2 years with seizure 1 year Hernia adeauate RX 2 Years
Benian Tumors 1 year 2 years Benign Supratentorial Tumors 2 years 2 Years
Nephrooathv adequate RX 2 Years Dialvsis DQ
Oxvaen use DQ lnolantable Cardio-defibrillator DQ
Electro convulsive therapy 6 mos symptom free after
1 year treatment
Bipolar 6 mos symptom free: non-
1 year Severe depressive, manic, suicidal: 1
osvchotic year wait.
Severe depression adequate RX 1 year Severe depressive mode with suicide:
1 year wait. Schizoohrenia DQ
Alcoholism Successfully complete RX 2 year Chantix for smokina cessation DQ
Peripheral Neuropathy DQ
Monocular vision DQ
Pick's Dss DQ Non-fundionina labvrinth DQ
Anticoaaulants for CVA DQ
NEURO WAIT TIMES NO SEIZURES AND OFF ANTI-CONVULSANTS
1 Year
Mild TBI without seizure Stroke
without seizure Hemmorage
without seizure Transient
lschemia Attack
All tumors
Bacterial Meningitis no seizure
Viral Meningitis no seizure
2 years
Mild TBI with early seizure
Moderate TBI without seizure
Supratentorial tumors
5 Years
Moderate TBI with seizures
Stroke with risk of seizure
Hemmorage with risk of seizure One unprovoked seizure Bacterial Meningitis with early seizure 10 Years Epilepsy Viral Encephalitis
If diagnosis of restrictive impairment with an FVC less than 60% of the predicted value
OR
If diagnosis of obstructive airway disease with FEV
1
<65%. of predicted value and FEV/FVC ratio less than 65%
Obtain pulse oximetry. ,. I If Sp02 is <92°/o ..-
• ObtainABG.
If the Pa02
on the ABG is less than 65 mmHg(altitude < 5,000 feet) or 60 mmHg
(altitude above 5,000 feet) or PaC02
greater than 45 mmHg (any altitude)
�
Disqualify the driver.
7 Copyright 2013 NRCME Training Systems, LLC
8 Copyright 2013 NRCME Training Systems, LLC