From the Guidelines
Commercial driver's license applicants must undergo a comprehensive medical examination that includes a thorough review of their medical history, focusing on conditions that could impair driving ability, such as cardiovascular disease, respiratory disorders, neurological conditions, diabetes, sleep apnea, and substance use disorders, as outlined in the guidelines 1. The medical history review should include information on cardiovascular disease, such as myocardial infarction, arrhythmia, angioplasty, stent, coronary artery bypass graft, or valvular surgery, as well as cerebrovascular disease, including stroke, transient ischemic attack, and endarterectomy 1. Additionally, the review should cover other medical conditions, including hypertension, hyperlipidemia, diabetes mellitus, sleep disorders, sickle-cell anemia, hypercoagulable states, chronic infections, autoimmune diseases, depression, substance abuse, and environmental exposures 1. The examination must be performed by a medical examiner listed on the Federal Motor Carrier Safety Administration's National Registry, resulting in a Medical Examiner's Certificate that may be valid for up to 2 years, though shorter certification periods are common for drivers with controlled medical conditions 1. Key aspects of the medical examination include:
- Vision acuity of at least 20/40 in each eye with or without correction
- Ability to hear a forced whisper at 5 feet
- Blood pressure below 140/90 mmHg for unconditional certification
- Disclosure of all prescription medications, particularly those causing drowsiness or affecting alertness
- Assessment of the applicant's ability to safely operate a commercial vehicle, taking into account their medical history and any potential risks associated with their condition 1. The medical examiner must use their professional judgment to determine whether the applicant's medical condition poses a risk to public safety, and certification should only be granted if the applicant can safely operate a commercial vehicle 1.
From the Research
Medical History Requirements
The medical history and assessments required for commercial driver's license applicants include:
- A review of the applicant's medical history to identify any pre-existing medical conditions that may impact their ability to drive safely 2
- An assessment of the applicant's risk of sudden death or injury while driving, including a review of their cardiac history 3
- An evaluation of the applicant's diabetes management, including their ability to measure glycaemia before driving and prevent and treat hypoglycemia 4
- An assessment of the applicant's other medical conditions, including obesity, hypertension, musculoskeletal conditions, seizures, stroke, neurological and vascular conditions 5
Medical Conditions that May Limit or Disqualify Commercial Drivers
The following medical conditions may limit or disqualify commercial drivers:
- Obesity > 35 kg/m2
- Hypertension
- Diabetes mellitus requiring medication
- Opioid or benzodiazepine use
- Heart disease
- Musculoskeletal conditions
- Seizures
- Stroke
- Neurological and vascular conditions 5
- Sleep disorders and obesity, which are linked to increased risk of crashes 6
Prevalence of Medical Conditions in Commercial Drivers
The prevalence of medical conditions in commercial drivers is high, with:
- 19% of commercial drivers having sleep disorders
- 33% having diabetes
- 23% having hypertension
- 45% having obesity 6