The original Medical Examiner’s Handbook – published prior to 2015 – listed many conditions as disqualifying. Examples include hypertrophic cardiomyopathy, peripheral neuropathy, use of methadone, and many others. Since then, the FMCSA has clarified that there are only 2 conditions that are disqualifying by regulation – hearing loss and seizures/epilepsy – and also clarified that all other conditions must be assessed on a case-by-case basis. Despite this updated guidance, the FMCSA does still indicate that drivers with a current diagnosis of alcoholism should be disqualified, as should drivers who use a Schedule I substance, although the FMCSA never states that these are disqualifying “by regulation”.
The direction the FMCSA is taking is clear: the FMCSA is tasking Medical Examiners to make individualized assessments of drivers’ medical conditions and not to rely on a cookbook approach. This trend is also reflected in the elimination of the vision and diabetes regulations, which previously required the FMCSA to make driver certification assessments for exemptions/waivers, but now require the use of the alternative qualification process for drivers with monocular vision and insulin-treated diabetes mellitus.
For more information regarding regulations and guidance, please contact FMCSA Medical directly at FMCSAMedical@dot.gov or by telephone at (202) 366-4001.