Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders, 17139-17141 [2015-07332]
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Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices
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[FR Doc. 2015–07383 Filed 3–30–15; 8:45 am]
BILLING CODE 4910–13–P
DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety
Administration
asabaliauskas on DSK5VPTVN1PROD with NOTICES
[Docket No. FMCSA–2014–0378]
Qualification of Drivers; Exemption
Applications; Epilepsy and Seizure
Disorders
Federal Motor Carrier Safety
Administration (FMCSA), DOT.
ACTION: Notice of final disposition.
AGENCY:
FMCSA announces its
decision to grant requests from 3
individuals for exemptions from the
regulatory requirement that interstate
SUMMARY:
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Jkt 235001
commercial motor vehicle (CMV)
drivers have ‘‘no established medical
history or clinical diagnosis of epilepsy
or any other condition which is likely
to cause loss of consciousness or any
loss of ability to control a CMV.’’ The
regulation and the associated advisory
criteria published in the Code of Federal
Regulations as the ‘‘Instructions for
Performing and Recording Physical
Examinations’’ have resulted in
numerous drivers being prohibited from
operating CMVs in interstate commerce
based on the fact that they have had one
or more seizures and are taking antiseizure medication, rather than an
individual analysis of their
circumstances by a qualified medical
examiner. The Agency concluded that
granting exemptions for these CMV
drivers will provide a level of safety that
is equivalent to or greater than the level
of safety maintained without the
exemptions. FMCSA grants exemptions
that will allow these 3 individuals to
operate CMVs in interstate commerce
for a 2-year period. The exemptions
preempt State laws and regulations and
may be renewed.
DATES: The exemptions are effective
March 31, 2015. The exemptions expire
on March 31, 2017.
FOR FURTHER INFORMATION CONTACT:
Charles A. Horan, III, Director, Office of
Carrier, Driver and Vehicle Safety, (202)
366–4001, fmcsamedical@dot.gov,
FMCSA, Department of Transportation,
1200 New Jersey Avenue SE., Room
W64–224, Washington, DC 20590–0001.
Office hours are 8:30 a.m. to 5 p.m., e.t.,
Monday through Friday, except Federal
holidays.
SUPPLEMENTARY INFORMATION:
A. Electronic Access
You may see all the comments online
through the Federal Document
Management System (FDMS) at: https://
www.regulations.gov.
Docket: For access to the docket to
read background documents or
comments, go to https://
www.regulations.gov and/or Room
W12–140 on the ground level of the
West Building, 1200 New Jersey Avenue
SE., Washington, DC, between 9 a.m.
and 5 p.m., e.t., Monday through Friday,
except Federal holidays.
Privacy Act: In accordance with 5
U.S.C. 553(c), DOT solicits comments
from the public to better inform its
rulemaking process. DOT posts these
comments, without edit, including any
personal information the commenter
provides, to www.regulations.gov, as
described in the system of records
notice (DOT/ALL–14 FDMS), which can
be reviewed at www.dot.gov/privacy.
PO 00000
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17139
B. Background
Under 49 U.S.C. 31136(e) and
31315(b), FMCSA may grant an
exemption from the 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 statute
also allows the Agency to renew
exemptions at the end of the 2-year
period.
FMCSA grants 3 individuals an
exemption from the regulatory
requirement in section 391.41(b)(8), to
allow these individuals who take antiseizure medication to operate CMVs in
interstate commerce for a 2-year period.
The Agency’s decision on these
exemption applications is based on an
individualized assessment of each
applicant’s medical information,
including the root cause of the
respective seizure(s), the length of time
elapsed since the individual’s last
seizure, and each individual’s treatment
regimen. In addition, the Agency
reviewed each applicant’s driving
record found in the Commercial Driver’s
License Information System (CDLIS) 1
for commercial driver’s license (CDL)
holders, and interstate and intrastate
inspections recorded in Motor Carrier
Management Information System
(MCMIS).2 For non-CDL holders, the
Agency reviewed the driving records
from the State licensing agency. The
Agency acknowledges the potential
consequences of a driver experiencing a
seizure while operating a CMV.
However, the Agency believes the
drivers covered by the exemptions
granted here have demonstrated that
they are unlikely to have a seizure and
their medical condition does not pose a
risk to public safety.
In reaching the decision to grant these
exemption requests, the Agency
considered both current medical
literature and information and the 2007
recommendations of the Agency’s
Medical Expert Panel (MEP). The
Agency previously gathered evidence
for potential changes to the regulation at
49 CFR 391.41(b)(8) by conducting a
comprehensive review of scientific
literature that was compiled into the
1 Commercial Driver License Information System
(CDLIS) is an information system that allows the
exchange of commercial driver licensing
information among all the States. CDLIS includes
the databases of fifty-one licensing jurisdictions and
the CDLIS Central Site, all connected by a
telecommunications network.
2 Motor Carrier Management Information System
(MCMIS) is an information system that captures
data from field offices through SAFETYNET,
CAPRI, and other sources. It is a source for FMCSA
inspection, crash, compliance review, safety audit,
and registration data.
E:\FR\FM\31MRN1.SGM
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17140
Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices
asabaliauskas on DSK5VPTVN1PROD with NOTICES
‘‘Evidence Report on Seizure Disorders
and Commercial Vehicle Driving’’
(Evidence Report) [CD–ROM HD
TL230.3 .E95 2007]. The Agency then
convened a panel of medical experts in
the field of neurology (the MEP) on May
14–15, 2007, to review 49 CFR
391.41(b)(8) and the advisory criteria
regarding individuals who have
experienced a seizure, and the 2007
Evidence Report. The Evidence Report
and the MEP recommendations are
published on-line at https://
www.fmcsa.dot.gov/rules-regulations/
topics/mep/mep-reports.htm, under
Seizure Disorders, and are in the docket
for this notice.
MEP Criteria for Evaluation
On October 15, 2007, the MEP issued
the following recommended criteria for
evaluating whether an individual with
epilepsy or a seizure disorder should be
allowed to operate a CMV.3 The MEP
recommendations are included in
previously published dockets.
Epilepsy diagnosis. If there is an
epilepsy diagnosis, the applicant should
be seizure-free for 8 years, on or off
medication. If the individual is taking
anti-seizure medication(s), the plan for
medication should be stable for 2 years.
Stable means no changes in medication,
dosage, or frequency of medication
administration. Recertification for
drivers with an epilepsy diagnosis
should be performed every year.
Single unprovoked seizure. If there is
a single unprovoked seizure (i.e., there
is no known trigger for the seizure), the
individual should be seizure-free for 4
years, on or off medication. If the
individual is taking anti-seizure
medication(s), the plan for medication
should be stable for 2 years. Stable
means no changes in medication,
dosage, or frequency of medication
administration. Recertification for
drivers with a single unprovoked
seizure should be performed every 2
years.
Single provoked seizure. If there is a
single provoked seizure (i.e., there is a
known reason for the seizure), the
Agency should consider specific criteria
that fall into the following two
categories: low-risk factors for
recurrence and moderate-to-high risk
factors for recurrence.
• Examples of low-risk factors for
recurrence include seizures that were
caused by a medication; by nonpenetrating head injury with loss of
consciousness less than or equal to 30
3 Engel, J., Fisher, R.S., Krauss, G.L., Krumholz,
A., and Quigg, M.S., ‘‘Expert Panel
Recommendations: Seizure Disorders and
Commercial Motor Vehicle Driver Safety,’’ FMCSA,
October 15, 2007.
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minutes; by a brief loss of consciousness
not likely to recur while driving; by
metabolic derangement not likely to
recur; and by alcohol or illicit drug
withdrawal.
• Examples of moderate-to-high-risk
factors for recurrence include seizures
caused by non-penetrating head injury
with loss of consciousness or amnesia
greater than 30 minutes, or penetrating
head injury; intracerebral hemorrhage
associated with a stroke or trauma;
infections; intracranial hemorrhage;
post-operative complications from brain
surgery with significant brain
hemorrhage; brain tumor; or stroke.
The MEP report indicates individuals
with moderate to high-risk conditions
should not be certified. Drivers with a
history of a single provoked seizure
with low risk factors for recurrence
should be recertified every year.
Medical Review Board
Recommendations and Agency Decision
FMCSA presented the MEP’s findings
and the Evidence Report to the Medical
Review Board (MRB) for consideration.
The MRB reviewed and considered the
2007 ‘‘Seizure Disorders and
Commercial Driver Safety’’ evidence
report and the 2007 MEP
recommendations. The MRB
recommended maintaining the current
advisory criteria, which provide that
‘‘drivers with a history of epilepsy/
seizures off anti-seizure medication and
seizure-free for 10 years may be
qualified to drive a CMV in interstate
commerce. Interstate drivers with a
history of a single unprovoked seizure
may be qualified to drive a CMV in
interstate commerce if seizure-free and
off anti-seizure medication for a 5 year
period or more’’ [Advisory criteria to 49
CFR 391.43(f)].
The Agency acknowledges the MRB’s
position on the issue but believes
relevant current medical evidence
supports a less conservative approach.
The medical advisory criteria for
epilepsy and other seizure or loss of
consciousness episodes was based on
the 1988 ‘‘Conference on Neurological
Disorders and Commercial Drivers’’
(NITS Accession No. PB89–158950/AS).
A copy of the report can be found in the
docket referenced in this notice.
The MRB’s recommendation treats all
drivers who have experienced a seizure
the same, regardless of individual
medical conditions and circumstances.
In addition, the recommendation to
continue prohibiting drivers who are
taking anti-seizure medication from
operating a CMV in interstate commerce
does not consider a driver’s actual
seizure history and time since the last
seizure. The Agency has decided to use
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Sfmt 4703
the 2007 MEP recommendations as the
basis for evaluating applications for an
exemption from the seizure regulation
on an individual, case-by-case basis.
C. Exemptions
Following individualized assessments
of the exemption applications,
including a review of detailed follow-up
information requested from each
applicant, FMCSA is granting
exemptions from 49 CFR 391.41(b)(8) to
3 individuals. Under current FMCSA
regulations, all of the 3 drivers receiving
exemptions from 49 CFR 391.41(b)(8)
would have been considered physically
qualified to drive a CMV in interstate
commerce except that they presently
take or have recently stopped taking
anti-seizure medication. For these 3
drivers, the primary obstacle to medical
qualification was the FMCSA Advisory
Criteria for Medical Examiners, based
on the 1988 ‘‘Conference on
Neurological Disorders and Commercial
Drivers,’’ stating that a driver should be
off anti-seizure medication in order to
drive in interstate commerce. In fact, the
Advisory Criteria have little if anything
to do with the actual risk of a seizure
and more to do with assumptions about
individuals who are taking anti-seizure
medication.
In addition to evaluating the medical
status of each applicant, FMCSA
evaluated the crash and violation data
for the 3 drivers, some of whom
currently drive a CMV in intrastate
commerce. The CDLIS and MCMIS were
searched for crash and violation data on
the 3 applicants. For non-CDL holders,
the Agency reviewed the driving records
from the State licensing agency.
These exemptions are contingent on
the driver maintaining a stable
treatment regimen and remaining
seizure-free during the 2-year exemption
period. The exempted drivers must
submit annual reports from their
treating physicians attesting to the
stability of treatment and that the driver
has remained seizure-free. The driver
must undergo an annual medical
examination by a medical examiner, as
defined by 49 CFR 390.5, following the
FCMSA’s regulations for the physical
qualifications for CMV drivers.
FMCSA published a notice of receipt
of application and requested public
comment during a 30-day public
comment period in a Federal Register
notice for each of the applicants. A short
summary of the applicants’
qualifications and a discussion of the
comments received follows this section.
For applicants who were denied an
exemption, a notice will be published at
a later date.
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Federal Register / Vol. 80, No. 61 / Tuesday, March 31, 2015 / Notices
D. Comments
Docket # FMCSA–2014–0378
On October 27, 2014, FMCSA
published a notice of receipt of
exemption applications and requested
public comment on six individuals (79
FR 64003; Docket number FMCSA–
2014–25450). The comment period
ended on November 26, 2014. Three
commenters responded to this notice.
Bobby Shane Walker, an applicant in
this notice, expressed support for his
health status and driving safety. He
provided details about his most recent
driving accident. An anonymous
commenter submitted details involving
Bobby Shane Walker’s recent driving
accident and provided the driving
accident report. Bob Johnson expressed
support for the Epilepsy standard
because it will save lives and benefit our
citizens. Of the six applicants, three
were denied. The Agency has
determined that the following three
applicants should be granted an
exemption.
James Connelly
Mr. Connelly is a 60 year-old class B
CDL holder in New Jersey. He has a
history of seizures and has remained
seizure free since 2000. He takes antiseizure medication with the dosage and
frequency remaining the same since that
time. If granted an exemption, he would
like to drive a CMV. His physician states
he is supportive of Mr. Connelly
receiving an exemption.
Timothy C. Marrill
Mr. Marrill is a 48 year-old class A
CDL holder in Missouri. He has a
history of epilepsy and has remained
seizure free since 1995. He takes antiseizure medication with the dosage and
frequency remaining the same for over
two years. If granted an exemption, he
would like to drive a CMV. His
physician states he is supportive of Mr.
Marrill receiving an exemption.
asabaliauskas on DSK5VPTVN1PROD with NOTICES
John Rinkema
Mr. Rinkema is a 64 year-old driver in
Illinois. He has a history of seizures and
has remained seizure free since 1968.
He takes anti-seizure medication with
the dosage and frequency remaining the
same since that time since 2004. If
granted the exemption, he would like to
drive a CMV. His physician states that
he is supportive of Mr. Rinkema
receiving an exemption.
E. Basis for Exemption
Under 49 U.S.C. 31136(e) and
31315(b), FMCSA may grant an
exemption from the epilepsy/seizure
standard in 49 CFR 391.41(b)(8) if the
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18:32 Mar 30, 2015
Jkt 235001
exemption is likely to achieve an
equivalent or greater level of safety than
would be achieved without the
exemption. Without the exemption,
applicants will continue to be restricted
to intrastate driving. With the
exemption, applicants can drive in
interstate commerce. Thus, the Agency’s
analysis focuses on whether an equal or
greater level of safety is likely to be
achieved by permitting each of these
drivers to drive in interstate commerce
as opposed to restricting the driver to
driving in intrastate commerce.
Conclusion
The Agency is granting exemptions
from the epilepsy standard, 49 CFR
391.41(b)(8), to 3 individuals based on
a thorough evaluation of each driver’s
safety experience, and medical
condition. Safety analysis of
information relating to these 3
applicants meets the burden of showing
that granting the exemptions would
achieve a level of safety that is
equivalent to or greater than the level
that would be achieved without the
exemption. By granting the exemptions,
the interstate CMV industry will gain 3
highly trained and experienced drivers.
In accordance with 49 U.S.C.
31315(b)(1), each exemption will be
valid for 2 years, with annual
recertification required unless revoked
earlier by FMCSA. The exemption will
be revoked if the following occurs: (1)
The person fails to comply with the
terms and conditions of the exemption;
(2) the exemption has resulted in a
lower level of safety than was
maintained prior to being granted; or (3)
continuation of the exemption would
not be consistent with the goals and
objectives of 49 U.S.C. 31136 and 31315.
FMCSA exempts the following 3
drivers for a period of 2 years with
annual medical certification required:
James Connelly (NJ); Timothy Merrill
(MO); and John Rinkema (IL) from the
prohibition of CMV operations by
persons with a clinical diagnosis of
epilepsy or seizures. If the exemption is
still in effect at the end of the 2-year
period, the person may apply to FMCSA
for a renewal under procedures in effect
at that time.
Issued on: March 20, 2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015–07332 Filed 3–30–15; 8:45 am]
BILLING CODE 4910–EX–P
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17141
DEPARTMENT OF TRANSPORTATION
Surface Transportation Board
[Docket No. AB 303 (Sub-No. 46X)]
Wisconsin Central Ltd.—Abandonment
Exemption—in Lake County, Ill.
On March 11, 2015, Wisconsin
Central Ltd. (WCL) filed with the
Surface Transportation Board (Board) a
petition under 49 U.S.C. 10502 for
exemption from the provisions of 49
U.S.C. 10903 to abandon 3.6 miles of
rail line extending between milepost
71.0 in North Chicago, Lake County, Ill.,
and milepost 74.6 in Waukegan, Lake
County, Ill. (the Line). The Line
traverses United States Postal Service
Zip Codes 60064, 60085, and 60087.
According to WCL, there is one
shipper, International Precision
Components Corporation (IPCC), located
on the Line. WCL states that IPCC has
entered into a terminable agreement
with WCL to lease a side track
connecting to the Line. From WCL’s
side track, IPCC transloads shipments to
truck for final delivery at IPCC’s off-Line
manufacturing facility. WCL notes that
it is exploring the relocation of IPCC’s
transloading operations to another railserved location. After receiving Board
authority to abandon the Line, WCL
states that it intends to salvage the rails,
ties, and other track material and then
to negotiate a sale of the right-of-way to
the City of Waukegan (City). According
to WCL, the sale of the right-of-way will
allow the City to implement an urban
redevelopment project.
In addition to an exemption from the
provisions of 49 U.S.C. 10903, WCL
seeks an exemption from 49 U.S.C.
10904 (offer of financial assistance
(OFA) procedures). In support, WCL
states that the right-of-way is needed for
a valid public purpose as it is an
essential component of the City’s multifaceted lakefront revitalization and
redevelopment effort. WCL further
asserts that there is no overriding public
need for continued freight rail service.
This request will be addressed in the
final decision.
According to WCL, the Line does not
contain federally granted rights-of-way.
Any documentation in WCL’s
possession will be made available
promptly to those requesting it.
The interest of railroad employees
will be protected by the conditions set
forth in Oregon Short Line Railroad—
Abandonment Portion Goshen Branch
Between Firth & Ammon, In Bingham &
Bonneville Counties, Idaho, 360 I.C.C.
91 (1979).
By issuing this notice, the Board is
instituting an exemption proceeding
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Agencies
[Federal Register Volume 80, Number 61 (Tuesday, March 31, 2015)]
[Notices]
[Pages 17139-17141]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-07332]
-----------------------------------------------------------------------
DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
[Docket No. FMCSA-2014-0378]
Qualification of Drivers; Exemption Applications; Epilepsy and
Seizure Disorders
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.
ACTION: Notice of final disposition.
-----------------------------------------------------------------------
SUMMARY: FMCSA announces its decision to grant requests from 3
individuals for exemptions from the regulatory requirement that
interstate commercial motor vehicle (CMV) drivers have ``no established
medical history or clinical diagnosis of epilepsy or any other
condition which is likely to cause loss of consciousness or any loss of
ability to control a CMV.'' The regulation and the associated advisory
criteria published in the Code of Federal Regulations as the
``Instructions for Performing and Recording Physical Examinations''
have resulted in numerous drivers being prohibited from operating CMVs
in interstate commerce based on the fact that they have had one or more
seizures and are taking anti-seizure medication, rather than an
individual analysis of their circumstances by a qualified medical
examiner. The Agency concluded that granting exemptions for these CMV
drivers will provide a level of safety that is equivalent to or greater
than the level of safety maintained without the exemptions. FMCSA
grants exemptions that will allow these 3 individuals to operate CMVs
in interstate commerce for a 2-year period. The exemptions preempt
State laws and regulations and may be renewed.
DATES: The exemptions are effective March 31, 2015. The exemptions
expire on March 31, 2017.
FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director,
Office of Carrier, Driver and Vehicle Safety, (202) 366-4001,
fmcsamedical@dot.gov, FMCSA, Department of Transportation, 1200 New
Jersey Avenue SE., Room W64-224, Washington, DC 20590-0001. Office
hours are 8:30 a.m. to 5 p.m., e.t., Monday through Friday, except
Federal holidays.
SUPPLEMENTARY INFORMATION:
A. Electronic Access
You may see all the comments online through the Federal Document
Management System (FDMS) at: https://www.regulations.gov.
Docket: For access to the docket to read background documents or
comments, go to https://www.regulations.gov and/or Room W12-140 on the
ground level of the West Building, 1200 New Jersey Avenue SE.,
Washington, DC, between 9 a.m. and 5 p.m., e.t., Monday through Friday,
except Federal holidays.
Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits
comments from the public to better inform its rulemaking process. DOT
posts these comments, without edit, including any personal information
the commenter provides, to www.regulations.gov, as described in the
system of records notice (DOT/ALL-14 FDMS), which can be reviewed at
www.dot.gov/privacy.
B. Background
Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an exemption
from the 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 statute also allows the Agency to renew exemptions at
the end of the 2-year period.
FMCSA grants 3 individuals an exemption from the regulatory
requirement in section 391.41(b)(8), to allow these individuals who
take anti-seizure medication to operate CMVs in interstate commerce for
a 2-year period. The Agency's decision on these exemption applications
is based on an individualized assessment of each applicant's medical
information, including the root cause of the respective seizure(s), the
length of time elapsed since the individual's last seizure, and each
individual's treatment regimen. In addition, the Agency reviewed each
applicant's driving record found in the Commercial Driver's License
Information System (CDLIS) \1\ for commercial driver's license (CDL)
holders, and interstate and intrastate inspections recorded in Motor
Carrier Management Information System (MCMIS).\2\ For non-CDL holders,
the Agency reviewed the driving records from the State licensing
agency. The Agency acknowledges the potential consequences of a driver
experiencing a seizure while operating a CMV. However, the Agency
believes the drivers covered by the exemptions granted here have
demonstrated that they are unlikely to have a seizure and their medical
condition does not pose a risk to public safety.
---------------------------------------------------------------------------
\1\ Commercial Driver License Information System (CDLIS) is an
information system that allows the exchange of commercial driver
licensing information among all the States. CDLIS includes the
databases of fifty-one licensing jurisdictions and the CDLIS Central
Site, all connected by a telecommunications network.
\2\ Motor Carrier Management Information System (MCMIS) is an
information system that captures data from field offices through
SAFETYNET, CAPRI, and other sources. It is a source for FMCSA
inspection, crash, compliance review, safety audit, and registration
data.
---------------------------------------------------------------------------
In reaching the decision to grant these exemption requests, the
Agency considered both current medical literature and information and
the 2007 recommendations of the Agency's Medical Expert Panel (MEP).
The Agency previously gathered evidence for potential changes to the
regulation at 49 CFR 391.41(b)(8) by conducting a comprehensive review
of scientific literature that was compiled into the
[[Page 17140]]
``Evidence Report on Seizure Disorders and Commercial Vehicle Driving''
(Evidence Report) [CD-ROM HD TL230.3 .E95 2007]. The Agency then
convened a panel of medical experts in the field of neurology (the MEP)
on May 14-15, 2007, to review 49 CFR 391.41(b)(8) and the advisory
criteria regarding individuals who have experienced a seizure, and the
2007 Evidence Report. The Evidence Report and the MEP recommendations
are published on-line at https://www.fmcsa.dot.gov/rules-regulations/topics/mep/mep-reports.htm, under Seizure Disorders, and are in the
docket for this notice.
MEP Criteria for Evaluation
On October 15, 2007, the MEP issued the following recommended
criteria for evaluating whether an individual with epilepsy or a
seizure disorder should be allowed to operate a CMV.\3\ The MEP
recommendations are included in previously published dockets.
---------------------------------------------------------------------------
\3\ Engel, J., Fisher, R.S., Krauss, G.L., Krumholz, A., and
Quigg, M.S., ``Expert Panel Recommendations: Seizure Disorders and
Commercial Motor Vehicle Driver Safety,'' FMCSA, October 15, 2007.
---------------------------------------------------------------------------
Epilepsy diagnosis. If there is an epilepsy diagnosis, the
applicant should be seizure-free for 8 years, on or off medication. If
the individual is taking anti-seizure medication(s), the plan for
medication should be stable for 2 years. Stable means no changes in
medication, dosage, or frequency of medication administration.
Recertification for drivers with an epilepsy diagnosis should be
performed every year.
Single unprovoked seizure. If there is a single unprovoked seizure
(i.e., there is no known trigger for the seizure), the individual
should be seizure-free for 4 years, on or off medication. If the
individual is taking anti-seizure medication(s), the plan for
medication should be stable for 2 years. Stable means no changes in
medication, dosage, or frequency of medication administration.
Recertification for drivers with a single unprovoked seizure should be
performed every 2 years.
Single provoked seizure. If there is a single provoked seizure
(i.e., there is a known reason for the seizure), the Agency should
consider specific criteria that fall into the following two categories:
low-risk factors for recurrence and moderate-to-high risk factors for
recurrence.
Examples of low-risk factors for recurrence include
seizures that were caused by a medication; by non-penetrating head
injury with loss of consciousness less than or equal to 30 minutes; by
a brief loss of consciousness not likely to recur while driving; by
metabolic derangement not likely to recur; and by alcohol or illicit
drug withdrawal.
Examples of moderate-to-high-risk factors for recurrence
include seizures caused by non-penetrating head injury with loss of
consciousness or amnesia greater than 30 minutes, or penetrating head
injury; intracerebral hemorrhage associated with a stroke or trauma;
infections; intracranial hemorrhage; post-operative complications from
brain surgery with significant brain hemorrhage; brain tumor; or
stroke.
The MEP report indicates individuals with moderate to high-risk
conditions should not be certified. Drivers with a history of a single
provoked seizure with low risk factors for recurrence should be
recertified every year.
Medical Review Board Recommendations and Agency Decision
FMCSA presented the MEP's findings and the Evidence Report to the
Medical Review Board (MRB) for consideration. The MRB reviewed and
considered the 2007 ``Seizure Disorders and Commercial Driver Safety''
evidence report and the 2007 MEP recommendations. The MRB recommended
maintaining the current advisory criteria, which provide that ``drivers
with a history of epilepsy/seizures off anti-seizure medication and
seizure-free for 10 years may be qualified to drive a CMV in interstate
commerce. Interstate drivers with a history of a single unprovoked
seizure may be qualified to drive a CMV in interstate commerce if
seizure-free and off anti-seizure medication for a 5 year period or
more'' [Advisory criteria to 49 CFR 391.43(f)].
The Agency acknowledges the MRB's position on the issue but
believes relevant current medical evidence supports a less conservative
approach. The medical advisory criteria for epilepsy and other seizure
or loss of consciousness episodes was based on the 1988 ``Conference on
Neurological Disorders and Commercial Drivers'' (NITS Accession No.
PB89-158950/AS). A copy of the report can be found in the docket
referenced in this notice.
The MRB's recommendation treats all drivers who have experienced a
seizure the same, regardless of individual medical conditions and
circumstances. In addition, the recommendation to continue prohibiting
drivers who are taking anti-seizure medication from operating a CMV in
interstate commerce does not consider a driver's actual seizure history
and time since the last seizure. The Agency has decided to use the 2007
MEP recommendations as the basis for evaluating applications for an
exemption from the seizure regulation on an individual, case-by-case
basis.
C. Exemptions
Following individualized assessments of the exemption applications,
including a review of detailed follow-up information requested from
each applicant, FMCSA is granting exemptions from 49 CFR 391.41(b)(8)
to 3 individuals. Under current FMCSA regulations, all of the 3 drivers
receiving exemptions from 49 CFR 391.41(b)(8) would have been
considered physically qualified to drive a CMV in interstate commerce
except that they presently take or have recently stopped taking anti-
seizure medication. For these 3 drivers, the primary obstacle to
medical qualification was the FMCSA Advisory Criteria for Medical
Examiners, based on the 1988 ``Conference on Neurological Disorders and
Commercial Drivers,'' stating that a driver should be off anti-seizure
medication in order to drive in interstate commerce. In fact, the
Advisory Criteria have little if anything to do with the actual risk of
a seizure and more to do with assumptions about individuals who are
taking anti-seizure medication.
In addition to evaluating the medical status of each applicant,
FMCSA evaluated the crash and violation data for the 3 drivers, some of
whom currently drive a CMV in intrastate commerce. The CDLIS and MCMIS
were searched for crash and violation data on the 3 applicants. For
non-CDL holders, the Agency reviewed the driving records from the State
licensing agency.
These exemptions are contingent on the driver maintaining a stable
treatment regimen and remaining seizure-free during the 2-year
exemption period. The exempted drivers must submit annual reports from
their treating physicians attesting to the stability of treatment and
that the driver has remained seizure-free. The driver must undergo an
annual medical examination by a medical examiner, as defined by 49 CFR
390.5, following the FCMSA's regulations for the physical
qualifications for CMV drivers.
FMCSA published a notice of receipt of application and requested
public comment during a 30-day public comment period in a Federal
Register notice for each of the applicants. A short summary of the
applicants' qualifications and a discussion of the comments received
follows this section. For applicants who were denied an exemption, a
notice will be published at a later date.
[[Page 17141]]
D. Comments
Docket # FMCSA-2014-0378
On October 27, 2014, FMCSA published a notice of receipt of
exemption applications and requested public comment on six individuals
(79 FR 64003; Docket number FMCSA-2014-25450). The comment period ended
on November 26, 2014. Three commenters responded to this notice. Bobby
Shane Walker, an applicant in this notice, expressed support for his
health status and driving safety. He provided details about his most
recent driving accident. An anonymous commenter submitted details
involving Bobby Shane Walker's recent driving accident and provided the
driving accident report. Bob Johnson expressed support for the Epilepsy
standard because it will save lives and benefit our citizens. Of the
six applicants, three were denied. The Agency has determined that the
following three applicants should be granted an exemption.
James Connelly
Mr. Connelly is a 60 year-old class B CDL holder in New Jersey. He
has a history of seizures and has remained seizure free since 2000. He
takes anti-seizure medication with the dosage and frequency remaining
the same since that time. If granted an exemption, he would like to
drive a CMV. His physician states he is supportive of Mr. Connelly
receiving an exemption.
Timothy C. Marrill
Mr. Marrill is a 48 year-old class A CDL holder in Missouri. He has
a history of epilepsy and has remained seizure free since 1995. He
takes anti-seizure medication with the dosage and frequency remaining
the same for over two years. If granted an exemption, he would like to
drive a CMV. His physician states he is supportive of Mr. Marrill
receiving an exemption.
John Rinkema
Mr. Rinkema is a 64 year-old driver in Illinois. He has a history
of seizures and has remained seizure free since 1968. He takes anti-
seizure medication with the dosage and frequency remaining the same
since that time since 2004. If granted the exemption, he would like to
drive a CMV. His physician states that he is supportive of Mr. Rinkema
receiving an exemption.
E. Basis for Exemption
Under 49 U.S.C. 31136(e) and 31315(b), FMCSA may grant an exemption
from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) if the
exemption is likely to achieve an equivalent or greater level of safety
than would be achieved without the exemption. Without the exemption,
applicants will continue to be restricted to intrastate driving. With
the exemption, applicants can drive in interstate commerce. Thus, the
Agency's analysis focuses on whether an equal or greater level of
safety is likely to be achieved by permitting each of these drivers to
drive in interstate commerce as opposed to restricting the driver to
driving in intrastate commerce.
Conclusion
The Agency is granting exemptions from the epilepsy standard, 49
CFR 391.41(b)(8), to 3 individuals based on a thorough evaluation of
each driver's safety experience, and medical condition. Safety analysis
of information relating to these 3 applicants meets the burden of
showing that granting the exemptions would achieve a level of safety
that is equivalent to or greater than the level that would be achieved
without the exemption. By granting the exemptions, the interstate CMV
industry will gain 3 highly trained and experienced drivers. In
accordance with 49 U.S.C. 31315(b)(1), each exemption will be valid for
2 years, with annual recertification required unless revoked earlier by
FMCSA. The exemption will be revoked if the following occurs: (1) The
person fails to comply with the terms and conditions of the exemption;
(2) the exemption has resulted in a lower level of safety than was
maintained prior to being granted; or (3) continuation of the exemption
would not be consistent with the goals and objectives of 49 U.S.C.
31136 and 31315.
FMCSA exempts the following 3 drivers for a period of 2 years with
annual medical certification required: James Connelly (NJ); Timothy
Merrill (MO); and John Rinkema (IL) from the prohibition of CMV
operations by persons with a clinical diagnosis of epilepsy or
seizures. If the exemption is still in effect at the end of the 2-year
period, the person may apply to FMCSA for a renewal under procedures in
effect at that time.
Issued on: March 20, 2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015-07332 Filed 3-30-15; 8:45 am]
BILLING CODE 4910-EX-P