Speaker 1: A stroke occurs when the blood supply to part of your brain is reduced, depriving brain tissue of oxygen and nutrients. A sudden, severe headache is among several possible indications that you’re having a stroke, which may also be accompanied by vomiting, dizziness or confusion.
There are many degrees of severity with any stroke, however, and when it comes to commercial truckers’ medical certifications, neurological conditions in general can present some of the most complex medical issues.
For this installment of Overdrive’s long-running Trucking Law series, Dr. Alexander E. Underwood, certified medical examiner at the KT Health Clinic near Springfield, Missouri, outlined what owner-operators and drivers can expect after a stroke or a seizure.
As Underwood noted, certified Medical Examiners often have to reach out to the Federal Motor Carrier Safety Administration for guidance on certifying drivers who’ve had a stroke, a ministroke or a seizure.
Obviously, the most important issue is assessing the likelihood a driver might have a sudden loss of consciousness or the ability to control the truck. While most circumstances require a cautious approach that in many cases involve lengthy waiting periods, the U.S. DOT has agreed with medical advisory boards that not all neurological conditions preclude an operator from a safe driving career.
Diabetes and high blood pressure are significant contributing factors to the development of strokes, or ministrokes, the latter known as transient ischemic attacks. According to various studies, commercial drivers have an above-average incidence of those TIAs and strokes, likewise hypertension and diabetes.
If you suffer a stroke or TIA and are left with permanent disabling effects like paralysis, severe weakness or vision loss, you will not be medically certifiable as a commercial driver. Otherwise, in the majority of cases, you will be able to resume your driving career if you’re willing to wait.
After initial recovery from a stroke or TIA, you must wait at least a year before being eligible for a medical certificate. If you have a more severe stroke or brain bleed that involves a middle cerebral or anterior cerebral artery, guidance to medical examiners suggests waiting five years.
After the applicable waiting period, you’ll need a few things before you take the medical exam, including clearance from a neurologist, the requisite paperwork, and, in some cases, another on-road evaluation.
If you ultimately do pass the medical exam, you will only be able to be certified for up to one year at a time.
It used to be that anyone taking anti-seizure medication for a seizure disorder was automatically medically disqualified. More recently, FMCSA has been able to grant a waiver for those taking long-term antiseizure medication. To qualify, you must be seizure-free with or without medication for a long time, though — eight consecutive years. If currently taking medication, you must be on the same stable medication regimen for at least two years.
Further, a driver with a history of epilepsy may be qualified without a waiver if seizure-free and medication-free for 10 years. However, many seizures are not the result of epilepsy or another seizure disorder. If you have a single episode of a non-epileptic seizure or a loss of consciousness from an unknown cause, and the incident did not require anti-seizure medication, the rules are much less stringent.
The decision to certify you will be left up to the individual medical examiner, though official guidance is to wait at least six months. You may be qualified if there are no further seizures, no antiseizure medication is required, and clearance is provided by a neurologist.
Yet another circumstance involves suffering a single seizure due to a known cause, such as a high fever, a drug reaction or an infection. In such a case, you may be certified with no specific waiting period if there are no residual symptoms and neurology clearance is provided.
Find this report’s author, Dr. Alexander E. Underwood, via the website for the KT Health Clinic, its physical location just a mile from I-44’s Exit 80 near Springfield, Missouri. Find more reports around medical rules and regulations for CDL drivers in Overdrive’s Trucking Law series, too.
