[Federal Register: October 13, 2006 (Volume 71, Number 198)]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
[Docket No. FMCSA-2006-24278]
Qualification of Drivers; Exemption Requests; Epilepsy and Seizure Disorders
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.
ACTION: Notice of applications for exemptions, request for comments.
SUMMARY: FMCSA announces receipt of applications from four individuals
for exemptions from the prohibition against persons with a clinical
diagnosis of epilepsy (or any other condition which is likely to cause
a loss of consciousness or any loss of ability to control a commercial
motor vehicle (CMV)), operating trucks and buses in interstate
commerce. If granted, the exemptions would enable these individuals
with seizure disorders to operate CMVs in interstate commerce. All
records associated with these requests are available in the public
DATES: Comments must be received on or before November 13, 2006.
ADDRESSES: You may submit comments identified by Department of
Transportation (DOT) Docket Management System (DMS) Docket Number
FMCSA-2006-24278 using any of the following methods:
- Web site: http://dmses.dot.gov. Follow the instructions
for submitting comments on the DOT electronic docket site.
- Fax: 1-202-493-2251.
- Mail: Docket Management Facility; U.S. Department of
Transportation, 400 Seventh Street, SW., Nassif Building, Room PL-401,
Washington, DC 20590-0001.
- Hand Delivery: Room PL-401 on the plaza level of the
Nassif Building, 400 Seventh Street, SW., Washington, DC, between 9
a.m. and 5 p.m., Monday through Friday, except Federal Holidays.
- Federal eRulemaking Portal: Go to http://www.regulations.gov.
Follow the on-line instructions for submitting comments.
Instructions: All submissions must include the Agency name and
docket number for this notice. Note that all comments received will be
posted without change to http://dms.dot.gov, including any personal
information provided. Please see the Privacy Act heading below.
Docket: For access to the docket to read background documents or
comments received, go to http://dms.dot.gov at any time or Room PL-401
on the plaza level of the Nassif Building, 400 Seventh Street, SW.,
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday,
except Federal holidays. The DMS is available 24 hours each day, 365
days each year. If you want acknowledgment that we received your
comments, please include a self-addressed, stamped envelope or postcard
or print the acknowledgement page that appears after submitting
Privacy Act: Anyone may search the electronic form of all comments
received into any of our dockets by the name of the individual
submitting the comment (or of the person signing the comment, if
submitted on behalf of an association, business, labor union, etc.).
You may review the DOT's complete Privacy Act Statement in the Federal
Register published on April 11, 2000 (65 FR 19477; Apr. 11, 2000). This
information is also available at http://dms.dot.gov.
FOR FURTHER INFORMATION CONTACT: Dr. Mary D. Gunnels, Chief, Physical
Qualifications Division, (202) 366-4001, firstname.lastname@example.org, FMCSA,
Department of Transportation, 400 Seventh Street, SW., Washington, DC
20590-0001. Office hours are from 8:30 a.m. to 5 p.m., Monday through
Friday, except Federal holidays.
Under 49 U.S.C. 31315 and 31136(e), FMCSA may grant an exemption
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 statute also allows the
agency to renew exemptions at the end of the 2-year period. The
individuals listed in this notice have recently requested an exemption
from the epilepsy prohibition in 49 CFR 391.41(b)(8), which applies to
drivers of CMVs in interstate commerce. Section 391.41(b)(8) states
that a person is physically qualified to drive a commercial motor
vehicle if that person has no established medical history or clinical
diagnosis of epilepsy or any other condition which is likely to cause
the loss of consciousness, or any loss of ability to control a
commercial motor vehicle.
FMCSA provides medical advisory criteria for use by medical
examiners in determining whether drivers with certain medical
conditions should be certified to operate CMVs in interstate commerce.
Currently, FMCSA's medical advisory criteria includes a recommendation
that individuals diagnosed with epilepsy and taking anticonvulsant
medication to reduce the likelihood of seizures are at high risk for
further episodes and should not be considered for medical
certification. Drivers diagnosed with epilepsy and taking
anticonvulsant medication which helps them control their seizures may
be at low risk, however, these individuals are exposed to conditions
which place them at increased risk for loss of consciousness and
therefore increased risk for seizure occurrence, and the acquisition of
replacement anti-seizure medication if drugs are lost or forgotten,
place such individuals at some increase in risk. These individuals
should not be authorized to drive commercial vehicles. Drivers
diagnosed with epilepsy, seizure free and off medication for 10 years
may be medically certified to operate CMVs.
FMCSA further notes that individuals who experience a single
unprovoked seizure, but do not have epilepsy, per se, are clearly at a
higher risk than the general population to have further seizures.
Individuals with a single unprovoked seizure, seizure-free for a 5-year
period and off medications, should not be restricted from obtaining a
license to operate a CMV. The history of the occurrence of febrile
seizures in childhood should not be a restriction to licensing to
operate a CMV. Seizures, in the context of a systemic metabolic
dysfunction, should not be a primary reason for restriction from
medical certification to operate a CMV. Any restriction should be based
upon the risk of recurrence of the primary condition. There are several
conditions in which the risk for unprovoked seizures is sufficiently
high, even in the absence of the occurrence of acute [[Page 60607]]
seizures, that medical certification should be restricted for variable
periods following these incidents (head injury, surgical procedures
involving dural penetration, cerebrovascular disease and infections of
the nervous system).
Summary of Applications
Anthony P. Besch
Mr. Besch has a history of epilepsy since childhood, and he
currently uses anti-seizure medications to prevent seizures. Mr. Besch
does not currently operate a CMV on public roads. Mr. Besch has stated
in his application that "there would be no negative impacts on safety
as I am seizure free, have excellent vision, and reflexes." Mr.
Besch's physician further states that, "he does have a history of
seizures only in sleep and none during the day; therefore, Tony is
legally able to drive due to his seizures being in good control." Mr.
Besch holds a Class A CDL from Illinois.
Charles D. Gant
Mr. Gant is a hazardous material (HM) CMV driver who experienced
slurred speech, drooling and numbness in his left upper extremity for
approximately 15 minutes on August 20, 1999. On August 23, 1999, he was
examined at a hospital emergency room, and subsequently referred to a
neurologist who diagnosed him as having a stroke (cerebrovascular
accident). He was prescribed Coumadin which he stopped taking against
medical advice of the prescribing physician. On October 1, 2002, his
physician reported that Mr. Gant had a left temporal headache with a
reduction in left visual field, but no abnormal sensation, numbness,
weakness or loss of speech. On June 27, 2004, "he awakened with
involuntary movements of his left upper extremity followed by spastic
movements of his left lower extremity lasting for about 20 minutes."
His family physician stated that this represented his third minor
cerebral vascular accident (CVA) or "quite probably a seizure". The
physician performed Magnetic Resonance Imaging (MRI) on June 30, 2004
which revealed a subacute CVA in the right frontoparietal junction. Mr.
Gant was examined by his physician on February 25, 2005 who diagnosed
him as follows: controlled hypertension; history of at least three (3)
previous CVAs. He was prescribed Coumadin, Dilantin (an anti-seizure
medication) and Diovan/Hydrochlorothiazide to prevent seizures.
John W. Morris, Jr.
Mr. Morris is a CMV driver who lost consciousness while driving on
March 20, 2004, and was then hospitalized for three days. Mr. Morris
was examined by a neurologist while he was hospitalized. The
neurologist determined that he had experienced a seizure. Mr. Morris
was placed on Carbatrol (an anti-seizure medication) and subsequently,
in August 2004, a medical examiner refused to certify him as meeting
FMCSA's requirements. On September 23, 2004, Mr. Morris consulted
another neurologist and his test results (Electroencephalography and
MRI) were normal, and he was told to gradually discontinue the
Carbatrol. Mr. Morris states he has had no additional seizures after
March 20, 2004, and has not taken Carbatrol since November 1, 2004. Mr.
Morris states that two neurologists have concluded that his seizures
were likely induced by alcohol. He states that his medical test results
are normal and he has been seizure free for one year and three months.
Wayne C. Sorenson
Mr. Sorenson is a CMV driver who completed a commercial driving
course to ensure safe operation of a semi tractor-trailer and was
awarded a certificate in May 2004. He states that he had seizures 11
years ago while sleeping which was the result of an adverse reaction to
medication. He has remained on Tegretol (an anti-seizure medication)
for the last 11 years, and has maintained therapeutic levels of the
medication and, subsequently, reports that he has had no seizures. Mr.
Sorenson states that he has no other diagnosed conditions, physical or
psychological impairment, no history of strength, sensory or
coordination impairment that would interfere with safe driving. Mr.
Sorenson indicated that a medical examiner refused to certify him as
meeting FMCSA's physical qualifications requirements because of the
seizures he experienced in 1994 and because he continues to take anti-
These four drivers were not granted medical certification based on
49 CFR 391.41(b)(8) which states: "A person has no established medical
history or clinical diagnosis of epilepsy or other condition which is
likely to cause loss of consciousness or any loss of ability to control
a commercial vehicle."
Request for Comments
In accordance with 49 U.S.C. 31315 and 31136(e), FMCSA requests
public comment from all interested persons on the exemption
applications described in this Notice. We will consider all comments
received before the close of business on the closing date indicated
earlier in the Notice.
Issued on: October 3, 2006.
John H. Hill,
[FR Doc. E6-17032 Filed 10-12-06; 8:45 am]
BILLING CODE 4910-EX-P