Commercial Driver Medical Examination| Rules and Regulations

Exemptions: Diabetes, Vision, Seizure, Hearing, and …

Under 49 U.S.C. 31136(e) and 31315, FMCSA may grant an exemption from the Federal Motor Carrier Safety Regulations for a 2-year period if it finds “such exemption would likely achieve a level of safety that is equivalent to or greater than the level that would be achieved absent such exemption.”


The  Hearing Standard 49 CFR 391.41(b)(11) was adopted in 1970, with a revision in 1971 to allow drivers to be qualified under this standard while wearing a hearing aid.  Application for exemption was presented by the National Association of the Deaf (NAD) based on a study performed by FMCSA’s review Board in 2008.  That study “Executive Summary on Hearing,Vestibular Function and Commercial Motor Driving Safety”, came to 2 conclusions basically:    1.  That no studies that examined the relationship between hearing loss and risk of collision in commercial motor vehicle drivers were identified; 2.  Studies done in private vehicle drivers do not show increased crash risk in the hearing impaired.  In addition the FMCSA reviewed the driving records of the applicants in question, as well as their inspection records along with their crash and violation data and granted 40 individuals exemption from the hearing standard regulatory requirement on February 1, 2013.  The majority of the 570 comments received were in support of the hearing exemption, except perhaps most notably the American Bus Association (ABA) who opposed it on the basis that coach bus operators must be able to interact with passengers.   The FMCSA agreed with the ABA , and under the terms of the exemption, hearing impaired drivers would not be allowed to operate a motor coach in interstate commerce.

There are several deadlines in April for comments on more exemption applications from the four non-discretionary standards.  Some are listed as follows.  Both the Federal Diabetes and the Federal Vision Exemption Program have specific requirements and criteria in place for qualification and maintenance of exemption.  The Epilepsy Exemption and the Hearing Exemption do not.

Diabetes and Vision Standards:

  • April 14, 2014:  Deadline for comments on applications from 40 individuals seeking exemption from the regulation against insulin-treated diabetes mellitus (ITDM) and the operation of a commercial motor vehicles.  See previous post How To Apply To The Federal diabetes Program.  This is also the deadline for comments on 75 individuals who were not able to meet the vision requirement in one eye who are applying for exemption from the vision requirement.   On April 21, 2014, comments are due regarding FMCSA’s decision to renew for another 2 years the vision exemptions of 8 individuals.  These 8 applicants reportedly satisfied the requirements to maintain their exemptions.    See  The Federal Vision Exemption Program-New Proposed Changes and Distinction from 49 CFR 391.64

Epilepsy Standard:

  • April 21, 2014:  Deadline for comments on exemptions applications for 13 commercial drivers seeking relief from the epilepsy regulation.  If granted by the FMCSA , the exemptions would allow these individuals who have had one or more seizures and are taking anti-seizure medication to operate CMVs for 2 years in interstate commerce.  In a previous post FMCSA’s Seizure Exemption For Interstate Commercial Driving, it was reviewed that the 2007 Medical Expert’s Panel recommendations was the basis used by the FMCSA to give exemptions to 22 drivers on January 15, 2013.  If granted again this time, the 13 commercial drivers will get relief from the regulation or standard found in 391.41 (b)(8).

And lastly, the FMCSA has also announced that on January 29, 2014 it has received applications for exemptions from the regulation that prohibits drivers with implantable cardioverter defibrillators (ICDs) from operating commercial vehicles in interstate commerce.  The deadline to receive comments was February 28, 2014.  The 3 individuals are seeking exemption from 49 CFR 391.41(b)(4), which states:

 “. . . a person is physically qualified to drive a commercial motor vehicle if that person has no current clinical diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope (temporary loss of consciousness due to a sudden decline in blood flow to the brain), dyspnea (shortness of breath), collapse, or congestive cardiac failure.”

The prohibition on the use of ICDs is in place due to the high risk of gradual or sudden loss of consciousness or incapacitation in such individuals that would affect their ability to operate a commercial vehicle.  One of the three drivers applying for an exemption had his ICD deploy in 2011.  The reason for use of the ICDs included arrhythmias (ventricular tachycardia) with low ejection fraction and for prevention post myocardial infarction.