FMCSA regulatory guidelines are generally silent regarding who is responsible for the payment of costs associated with DOT medical examinations. This includes the cost of the examinations themselves, although for most drivers it is the costs of possible evaluation and treatment for potentially disqualifying medical conditions that are more significant.
Most motor carriers pay for the costs of the examination itself. Few pay for any costs of medical evaluation and treatment. This leaves the driver responsible for such costs. Costs may be minimal for, say, a driver that simply has hypertension and requires prescription medication management. Costs may be significant for drivers with a possible sleep disorder, which may require an initial sleep study, lease or purchase of CPAP equipment and monitoring, and a follow-up sleep study to establish that treatment is successful. An annual sleep study to demonstrate ongoing effectiveness may also be necessary.
As much as a medical examiner may be sympathetic to a driver without health insurance, or who has insurance with high deductibles or co-pays, the medical examiner must be careful not to allow consideration of such costs to color the examiner’s judgment in terms of following FMCSA requirements and guidelines. The medical examiner is responsible for the safety of the public, and of the driver, and the medical examiner’s role is to evaluate medical risks and minimize these to the extent possible. The medical examiner is not responsible for the driver’s financial welfare, and much as it might be tempting to consider the driver’s financial issues, this is not a role that medical examiners should embrace.
Steven St. Clair, MD, MPH
Dr. St. Clair is a medical consultant to the NRCME Training Institute, LLC. The NRCME Training Institute, LLC provides an affordable 100% online DOT medical examiner training program which meets and exceeds FMCSA requirements.