Consider this look at systematic problems and scams associated with DOT medical examinations to be the case study supporting yesterday’s post identifying the compliance problems associated with DOT medical examiner’s certificates and reports.
I recently had a case in which my truck driver client had been issued a Medical Examiner’s Certificate after having submitted to DOT medical examinations. The medical examiner was a nurse practitioner. She appeared to have performed a thorough and comprehensive physical of my truck driver. But there were a few problems.
- The nurse practitioner had re-certified the driver when his heart condition and blood pressure results should have only permitted him to receive a re-certification for one year, pursuant to 49 C.F.R. § 391.41.
- My truck driver failed to disclose that he had previously been diagnosed and treated for obstructive sleep apnea. When asked about it later, he thought that since he regularly used his sleep apnea wasn’t a problem any more. Fair enough, maybe. At the time of his examination, the portion of the Medical Examination Report that the driver filled out didn’t ask about sleep apnea specifically, but rather instructed the driver to check yes or no for “Sleep disorders, pauses in breathing while asleep, daytime sleepiness, loud snoring.” While using his CPAP, my driver wasn’t experiencing any of those symptoms. Or maybe it’s an example of a purposely withholding information from his medical examiner so that he can get back out on the roadway to earn a living.
- But he was also taking a number of medications that should have given the medical examiner pause about re-certifying the driver. In addition to taking blood pressure medication, my truck driver had active prescriptions for anti-seizure/nerve pain medication; Alzheimer’s/memory loss medication; and medication for his COPD diagnosis. While none of these medications standing alone would have prevented my client from being re-certified, taken in the aggregate and alongside his other medical concerns, it should have given the medical examiner greater pause.
In same ways this was a problem with a medical examiner who either wasn’t properly trained on the criteria affecting re-certification periods. And in other ways it reflects problems in which the system relies on drivers (who are trying to get back out on the roads and earn a living) to relay health information that could negatively affect their ability to work.
But those examples pale in comparison to what has recently been uncovered in Georgia, where Dr. Anthony Lefteris issued bogus medical certificates to more than 6,600 truck drivers while operating out of an Atlanta-area Petro truck stop. He issued the re-certifications without submitting the drivers to the necessary DOT medical examinations. Lefteris was on the FMCSA’s list of certified medical examiners, but has since been removed. Each of the 6,600 drivers, who are sprawled over 48 states, are being compelled to undergo re-certification.
The FMCSA continues to implement new regulations to make the roadways safer and to ensure that driver’s are medically qualified to be operating commercial motor vehicles, but there is still a ways to go. As identified in yesterday’s post, there are no measures in place to require, or even permit, motor carriers to obtain a driver’s Medical Examination Report or other corroborate that he/she is legitimately medically qualified to operate a vehicle. Which is particularly troublesome when there are medical professionals handing out medical certificates like they’re counterfeit hall passes in a middle school.
Photo by British Columbia Emergency Photography.
