Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders, 28134-28135 [2016-10794]

Download as PDF 28134 Federal Register / Vol. 81, No. 89 / Monday, May 9, 2016 / Notices physician states that he is supportive of Mr. Skinner receiving an exemption. Shaen Smith Mr. Smith is a 47 year-old driver in Minnesota. He has a history of epilepsy and has remained seizure free since 1998. He takes anti-seizure medication with the dosage and frequency remaining the same since 2013. His physician states that he is supportive of Mr. Smith receiving an exemption. Kevin Lee Sprinkle Mr. Sprinkle is a 35 year-old class A CDL holder in North Carolina. He has a history of juvenile epilepsy and has remained seizure free since 2005. He takes anti-seizure medication with the dosage and frequency remaining the same since that time. His physician states that he is supportive of Mr. Sprinkle receiving an exemption. Patrick Trimbo search box insert the docket number ‘‘FMCSA–2015–0322’’ and click the search button. When the new screen appears, click on the blue ‘‘Comment Now!’’ button on the right hand side of the page. On the new page, enter information required including the specific section of this document to which each comment applies, and provide a reason for each suggestion or recommendation. If you submit your comments by mail or hand delivery, submit them in an unbound format, no larger than 81⁄2 by 11 inches, suitable for copying and electronic filing. If you submit comments by mail and would like to know that they reached the facility, please enclose a stamped, selfaddressed postcard or envelope. We will consider all comments and materials received during the comment period. FMCSA may issue a final determination any time after the close of the comment period. Mr. Trimbo is a 53 year-old class A CDL holder in Minnesota. He has a history of a seizure disorder and has remained seizure free since 1996. He takes anti-seizure medication with the dosage and frequency remaining the same since 2008. His physician states that he is supportive of Mr. Trimbo receiving an exemption. V. Viewing Comments and Documents Alan Washabaugh Issued on: April 29, 2016. Larry W. Minor, Associate Administrator for Policy. To view comments, as well as any documents mentioned in this preamble, go to https://www.regulations.gov and in the search box insert the docket number FMCSA–2015–0322 and click ‘‘Search.’’ Next, click ‘‘Open Docket Folder’’ and you will find all documents and comments related to this notice. Mr. Washabaugh is a 57 year-old class A CDL holder in Pennsylvania. He has a history of a seizure disorder and has remained seizure free since 1996. He takes anti-seizure medication with the dosage and frequency remaining the same since that time. His physician states that he is supportive of Mr. Washabaugh receiving an exemption. III. Request for Comments In accordance with 49 U.S.C. 31136(e) and 31315, FMCSA requests public comment from all interested persons on the exemption petitions described in this notice. We will consider all comments received before the close of business on the closing date indicated in the date section of the notice. mstockstill on DSK3G9T082PROD with NOTICES IV. Submitting Comments You may submit your comments and material online or by fax, mail, or hand delivery, but please use only one of these means. FMCSA recommends that you include your name and a mailing address, an email address, or a phone number in the body of your document so that FMCSA can contact you if there are questions regarding your submission. To submit your comment online, go to https://www.regulations.gov and in the VerDate Sep<11>2014 17:44 May 06, 2016 Jkt 238001 [FR Doc. 2016–10795 Filed 5–6–16; 8:45 am] BILLING CODE 4910–EX–P The exemptions were effective on January 21, 2016. The exemptions expire on January 21, 2018. FOR FURTHER INFORMATION CONTACT: Christine A. Hydock, Chief, Medical Programs Division, (202) 366–4001, fmcsamedical@dot.gov, FMCSA, Department of Transportation, 1200 New Jersey Avenue SE., Room W64– 113, Washington, DC 20590–0001. Office hours are from 8:30 a.m. to 5 p.m. e.t., Monday through Friday, except Federal holidays. SUPPLEMENTARY INFORMATION: DATES: I. 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., 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. II. Background DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration [FMCSA Docket No. FMCSA–2015–0320] 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 exempt eight individuals 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 exemptions enable these individuals to operate CMVs in interstate commerce. SUMMARY: PO 00000 Frm 00089 Fmt 4703 Sfmt 4703 On December 21, 2015, FMCSA published a notice announcing receipt of applications from 17 individuals requesting an exemption from the prohibition against persons with a clinical diagnosis of epilepsy or any other condition that is likely to cause a loss of consciousness or any loss of ability to operate a CMV in interstate commerce and requested comments from the public (80 FR 70065). The public comment period closed on January 20, 2016, and no comments were received. FMCSA has evaluated the eligibility of these applicants and determined that granting the exemptions to eight individuals would achieve a level of safety equivalent to or greater than the level that would be achieved by complying with the current regulation 49 CFR 391.41(b)(8). The physical qualification standard for drivers regarding epilepsy found in 49 CFR 391.41(b)(8) states that a person is physically qualified to drive a CMV if that person E:\FR\FM\09MYN1.SGM 09MYN1 Federal Register / Vol. 81, No. 89 / Monday, May 9, 2016 / Notices 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 CMV. In addition to the regulations, FMCSA has published advisory criteria to assist medical examiners in determining whether drivers with certain medical conditions are qualified to operate a CMV in interstate commerce. The advisory criteria found in Appendix A to 49 CFR 391.41, states that: mstockstill on DSK3G9T082PROD with NOTICES If an individual has had a sudden episode of a non-epileptic seizure or loss of consciousness of unknown cause that did not require anti-seizure medication, the decision whether that person’s condition is likely to cause the loss of consciousness or loss of ability to control a CMV should be made on an individual basis by the medical examiner in consultation with the treating physician. Before certification is considered, it is suggested that a 6-month waiting period elapse from the time of the episode. Following the waiting period, it is suggested that the individual have a complete neurological examination. If the results of the examination are negative and anti-seizure medication is not required, then the driver may be qualified. In those individual cases where a driver had a seizure or an episode of loss of consciousness that resulted from a known medical condition (e.g., drug reaction, high temperature, acute infectious disease, dehydration, or acute metabolic disturbance), certification should be deferred until the driver has recovered fully from that condition, has no existing residual complications, and is not taking anti-seizure medication. Drivers who have a history of epilepsy/ seizures, off anti-seizure medication and seizure-free for 10 years, may be qualified to operate 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. As a result of medical examiners misinterpreting advisory criteria as regulation, numerous drivers have been prohibited from operating a CMV 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 based on the physical qualification standards and medical best practices. In reaching the decision to grant these exemption requests, the Agency considered the 2007 recommendations of the Agency’s Medical Expert Panel (MEP). The January 15, 2013 (78 FR 3069) Federal Register notice provides the current MEP recommendations which is the criteria the Agency uses to grant seizure exemptions. VerDate Sep<11>2014 17:44 May 06, 2016 Jkt 238001 These eight applicants have been seizure-free over a range of 13 to 43 years while taking anti-seizure medication and maintained a stable medication treatment regimen for the last two years. In each case, the applicant’s treating physician verified his or her seizure history and supports the ability to drive commercially. A summary of each applicant’s seizure history was discussed in the December 21, 2015 Federal Register notice and will not be repeated in this notice. III. Discussion of Comments There were no comments in response to this notice. The Agency has determined that eight applicants should be granted an exemption. IV. Basis for Exemption Determination 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. The exemption allows the applicants to operate CMVs in interstate commerce. The Agency’s decision regarding these exemption applications is based on an individualized assessment of each applicant’s medical information, including the root cause of the respective seizure(s) and medical information about the applicant’s seizure history, the length of time that has elapsed since the individual’s last seizure, the stability of each individual’s treatment regimen and the duration of time on or off of anti-seizure medication. In addition, the Agency reviewed the treating clinician’s medical opinion related to the ability of the driver to safely operate a CMV with a history of seizure and each applicant’s driving record found in the Commercial Driver’s License Information System (CDLIS) for commercial driver’s license (CDL) holders, and interstate and intrastate inspections recorded in the Motor Carrier Management Information System (MCMIS). For non-CDL holders, the Agency reviewed the driving records from the State Driver’s Licensing Agency (SDLA). The Agency acknowledges the potential consequences of a driver experiencing a seizure while operating a CMV. However, the Agency believes the drivers granted this exemption have demonstrated that they are unlikely to have a seizure and their medical condition does not pose a risk to public safety. Consequently, FMCSA finds that in each case exempting these applicants PO 00000 Frm 00090 Fmt 4703 Sfmt 9990 28135 from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) is likely to achieve a level of safety equal to that existing without the exemption. V. Conditions and Requirements The terms and conditions of the exemption will be provided to the applicants in the exemption document and includes the following: (1) Each individual must remain seizure-free and maintain a stable treatment during the 2-year exemption period; (2) each individual must submit annual reports from their treating physicians attesting to the stability of treatment and that the driver has remained seizure-free; (3) each individual must undergo an annual medical examination by a certified Medical Examiner, as defined by 49 CFR 390.5; and (4) each individual must provide a copy of the annual medical certification to the employer for retention in the driver’s qualification file, or keep a copy of his/her driver’s qualification file if he/she is selfemployed. The driver must also have a copy of the exemption when driving, for presentation to a duly authorized Federal, State, or local enforcement official. VI. Conclusion Based upon its evaluation of the eight exemption applications, FMCSA exempts the following drivers from the epilepsy/seizure standard in 49 CFR 391.41(b)(8), subject to the requirements cited above: James E. Allen (ME); Thomas A DeAngelo (IL); Nathan Dermer (AK); Daniel Lloyd Halstead (NV); Kevin Mathis (NJ); Toriano T. Mitchell (OH); Thomas A. Mitman (NY) and Tyler W. Schaefor (ME). In accordance with 49 U.S.C. 31315(b)(1), each exemption is valid for 2 years, unless revoked earlier by FMCSA. The exemption will be revoked if the following occurs: (1) The individual 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. If the exemption is still effective at the end of the 2-year period, the individual may apply to FMCSA for a renewal under procedures in effect at that time. Issued on: April 29, 2016. Larry W. Minor, Associate Administrator for Policy. [FR Doc. 2016–10794 Filed 5–6–16; 8:45 am] BILLING CODE 4910–EX–P E:\FR\FM\09MYN1.SGM 09MYN1

Agencies

[Federal Register Volume 81, Number 89 (Monday, May 9, 2016)]
[Notices]
[Pages 28134-28135]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-10794]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[FMCSA Docket No. FMCSA-2015-0320]


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 exempt eight individuals 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 
exemptions enable these individuals to operate CMVs in interstate 
commerce.

DATES: The exemptions were effective on January 21, 2016. The 
exemptions expire on January 21, 2018.

FOR FURTHER INFORMATION CONTACT: Christine A. Hydock, Chief, Medical 
Programs Division, (202) 366-4001, fmcsamedical@dot.gov, FMCSA, 
Department of Transportation, 1200 New Jersey Avenue SE., Room W64-113, 
Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. 
e.t., Monday through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION: 

I. 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., 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.

II. Background

    On December 21, 2015, FMCSA published a notice announcing receipt 
of applications from 17 individuals requesting an exemption from the 
prohibition against persons with a clinical diagnosis of epilepsy or 
any other condition that is likely to cause a loss of consciousness or 
any loss of ability to operate a CMV in interstate commerce and 
requested comments from the public (80 FR 70065). The public comment 
period closed on January 20, 2016, and no comments were received.
    FMCSA has evaluated the eligibility of these applicants and 
determined that granting the exemptions to eight individuals would 
achieve a level of safety equivalent to or greater than the level that 
would be achieved by complying with the current regulation 49 CFR 
391.41(b)(8).
    The physical qualification standard for drivers regarding epilepsy 
found in 49 CFR 391.41(b)(8) states that a person is physically 
qualified to drive a CMV if that person


[[Page 28135]]


    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 CMV.

    In addition to the regulations, FMCSA has published advisory 
criteria to assist medical examiners in determining whether drivers 
with certain medical conditions are qualified to operate a CMV in 
interstate commerce. The advisory criteria found in Appendix A to 49 
CFR 391.41, states that:

    If an individual has had a sudden episode of a non-epileptic 
seizure or loss of consciousness of unknown cause that did not 
require anti-seizure medication, the decision whether that person's 
condition is likely to cause the loss of consciousness or loss of 
ability to control a CMV should be made on an individual basis by 
the medical examiner in consultation with the treating physician. 
Before certification is considered, it is suggested that a 6-month 
waiting period elapse from the time of the episode. Following the 
waiting period, it is suggested that the individual have a complete 
neurological examination. If the results of the examination are 
negative and anti-seizure medication is not required, then the 
driver may be qualified.
    In those individual cases where a driver had a seizure or an 
episode of loss of consciousness that resulted from a known medical 
condition (e.g., drug reaction, high temperature, acute infectious 
disease, dehydration, or acute metabolic disturbance), certification 
should be deferred until the driver has recovered fully from that 
condition, has no existing residual complications, and is not taking 
anti-seizure medication.
    Drivers who have a history of epilepsy/seizures, off anti-
seizure medication and seizure-free for 10 years, may be qualified 
to operate 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.

    As a result of medical examiners misinterpreting advisory criteria 
as regulation, numerous drivers have been prohibited from operating a 
CMV 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 based on the physical qualification standards and medical best 
practices.
    In reaching the decision to grant these exemption requests, the 
Agency considered the 2007 recommendations of the Agency's Medical 
Expert Panel (MEP). The January 15, 2013 (78 FR 3069) Federal Register 
notice provides the current MEP recommendations which is the criteria 
the Agency uses to grant seizure exemptions.
    These eight applicants have been seizure-free over a range of 13 to 
43 years while taking anti-seizure medication and maintained a stable 
medication treatment regimen for the last two years. In each case, the 
applicant's treating physician verified his or her seizure history and 
supports the ability to drive commercially. A summary of each 
applicant's seizure history was discussed in the December 21, 2015 
Federal Register notice and will not be repeated in this notice.

III. Discussion of Comments

    There were no comments in response to this notice. The Agency has 
determined that eight applicants should be granted an exemption.

IV. Basis for Exemption Determination

    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. The exemption allows the 
applicants to operate CMVs in interstate commerce.
    The Agency's decision regarding these exemption applications is 
based on an individualized assessment of each applicant's medical 
information, including the root cause of the respective seizure(s) and 
medical information about the applicant's seizure history, the length 
of time that has elapsed since the individual's last seizure, the 
stability of each individual's treatment regimen and the duration of 
time on or off of anti-seizure medication. In addition, the Agency 
reviewed the treating clinician's medical opinion related to the 
ability of the driver to safely operate a CMV with a history of seizure 
and each applicant's driving record found in the Commercial Driver's 
License Information System (CDLIS) for commercial driver's license 
(CDL) holders, and interstate and intrastate inspections recorded in 
the Motor Carrier Management Information System (MCMIS). For non-CDL 
holders, the Agency reviewed the driving records from the State 
Driver's Licensing Agency (SDLA). The Agency acknowledges the potential 
consequences of a driver experiencing a seizure while operating a CMV. 
However, the Agency believes the drivers granted this exemption have 
demonstrated that they are unlikely to have a seizure and their medical 
condition does not pose a risk to public safety.
    Consequently, FMCSA finds that in each case exempting these 
applicants from the epilepsy/seizure standard in 49 CFR 391.41(b)(8) is 
likely to achieve a level of safety equal to that existing without the 
exemption.

V. Conditions and Requirements

    The terms and conditions of the exemption will be provided to the 
applicants in the exemption document and includes the following: (1) 
Each individual must remain seizure-free and maintain a stable 
treatment during the 2-year exemption period; (2) each individual must 
submit annual reports from their treating physicians attesting to the 
stability of treatment and that the driver has remained seizure-free; 
(3) each individual must undergo an annual medical examination by a 
certified Medical Examiner, as defined by 49 CFR 390.5; and (4) each 
individual must provide a copy of the annual medical certification to 
the employer for retention in the driver's qualification file, or keep 
a copy of his/her driver's qualification file if he/she is self-
employed. The driver must also have a copy of the exemption when 
driving, for presentation to a duly authorized Federal, State, or local 
enforcement official.

VI. Conclusion

    Based upon its evaluation of the eight exemption applications, 
FMCSA exempts the following drivers from the epilepsy/seizure standard 
in 49 CFR 391.41(b)(8), subject to the requirements cited above: James 
E. Allen (ME); Thomas A DeAngelo (IL); Nathan Dermer (AK); Daniel Lloyd 
Halstead (NV); Kevin Mathis (NJ); Toriano T. Mitchell (OH); Thomas A. 
Mitman (NY) and Tyler W. Schaefor (ME).
    In accordance with 49 U.S.C. 31315(b)(1), each exemption is valid 
for 2 years, unless revoked earlier by FMCSA. The exemption will be 
revoked if the following occurs: (1) The individual 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. If the 
exemption is still effective at the end of the 2-year period, the 
individual may apply to FMCSA for a renewal under procedures in effect 
at that time.

    Issued on: April 29, 2016.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2016-10794 Filed 5-6-16; 8:45 am]
 BILLING CODE 4910-EX-P
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