Qualification of Drivers; Exemption Requests; Epilepsy and Seizure Disorders, 60606-60607 [E6-17032]

Agencies

• Federal Motor Carrier Safety Administration
• DEPARTMENT OF TRANSPORTATION

[Federal Register Volume 71, Number 198 (Friday, October 13, 2006)]
[Notices]
[Pages 60606-60607]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-17032]


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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.

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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 
docket.

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: https://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 https://
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 https://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 https://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 
comments on-line.
    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 https://dms.dot.gov.

FOR FURTHER INFORMATION CONTACT: Dr. Mary D. Gunnels, Chief, Physical 
Qualifications Division, (202) 366-4001, maggi.gunnels@dot.gov, 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.

SUPPLEMENTARY INFORMATION: 

Background

    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-
seizure medication.
    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,
Administrator.
[FR Doc. E6-17032 Filed 10-12-06; 8:45 am]
BILLING CODE 4910-EX-P