Dr. John McElligott noticed a trend among the patients he’d see walk into his Memphis, TN, medical office.

“These drivers work hard; it’s not an easy life,” said McElligott, who is an OOIDA Member.

More than 10,000 truck driving patients have gone through McElligott’s Professional Drivers Medical Depot clinics – a chain of truck stop-based medical clinics for truckers with offices mostly in the southern U.S.

He said it’s not difficult to encounter drivers who have one or two borderline health issues – maybe a slight case of asthma, a borderline blood pressure, or a “heart gallop” noticed during one visit.

So McElligott views slight increases in blood pressure or other health measures with a skeptical eye. Sometimes he’ll tell the driver to go home and get a good night’s sleep before coming back, and to avoid coffee the next morning. He sometimes works with the driver to develop dietary and exercise changes to improve blood pressure numbers naturally over a few weeks.

McElligott’s view of treating driver health practically appears to fly in the face of a recently proposed fitness for duty matrix system recommended by the FMCSA Medical Review Board.

Under the take-no-prisoners approach, the Medical Review Board’s matrix would require a driver with a hint of asthma and a higher than normal blood pressure to be tested annually by DOT-certified medical exams. A third health issue would require two exams a year, and four would park a driver indefinitely.

The board formally adopted the recommendation in January. It has not been advanced for a proposed rulemaking by FMCSA, and if many in transportation industry had a say in the matter it would never see the light of day.

Fitness for duty matrix
The rule would require drivers who have either a condition or meet one of a long list of medical criteria to increase their DOT physicals or be barred from driving altogether.

The matrix would punish drivers who exhibit more than one of the following conditions:

• diabetes (medicinally treated),
• cardiovascular disease,
• hypertension,
• disrhythmias,
• obstructive sleep apnea,
• a Body Mass Index of 35 or greater (A 5-foot-8 inch tall male weighing 230 pounds has a BMI of 35),
• opioid or benzodiazepine use,
• renal disease,
• pulmonary disease,
• epilepsy,
• musculoskeletal disease requiring medical surgical or prosthetic treatment,
• requirement for visual exemption (vision not meeting 20-40 after corrective lenses),
• major psychiatric illness, and
• “other conditions as identified by FMCSA.”

If there’s good news on the topic, it’s that truckers don’t have to comply with the recommendation – at least not yet. Because, right now, it is just a recommendation.

The Medical Review Board cannot unilaterally begin regulating truck drivers. The board makes recommendations, which could be proposed for rulemakings by FMCSA. The agency has not acted on the board’s fitness for duty matrix recommendation.

“The Medical Review Board is bound by the provisions of the Federal Advisory Committee Act, which requires that its deliberations are open and accessible to the public,” FMCSA Spokesman Duane DeBruyne told Land Line. “We appreciate the work of the board, and we obviously value the expertise of its members. As a federal government agency, however, FMCSA is not bound by the recommendations of the board. The agency has all the prerogative to act upon any recommendation, aspects of it, or not at all.”

News of any action on the board’s recommendation won’t necessarily come anytime soon, the spokesman added.

“There are no timetable requirements imposed upon the agency,” DeBruyne said.

Even so, the influence of accomplished medical experts recommending wholesale changes for CDL certification can’t be overlooked.

McElligott agrees.

In early January, McElligott attended a meeting during which the Medical Review Board adopted the matrix recommendation. After the meeting ended, he shared his thoughts with board members.

“I don’t think medical review board members have ever been in the domain of the trucker,” McElligott later told Land Line.

He said that if a Medical Review Board member actually tried to keep up with a hard-working trucker, the board member would be exhausted in a couple of weeks.

Since founding the chain of clinics in 2006 McElligott has learned the rigors the trucking industry places on a driver’s body and on a trucker’s personal schedule.

Long-haul truckers pushed by work schedules and inefficient loading systems often squeeze DOT physicals and other appointments in where they can, which can result in high blood pressure or other symptoms.

McElligott said he’s continually amazed at the increasingly vigorous campaign to regulate driver health, particularly in the last few years.

Federal regulators don’t understand the stresses truck drivers are under, McElligott said, or the consequences of heaping on misguided regulations would have on small trucking companies.

“If we’ve got a driver with a health problem, let’s educate him, get him treated but not let him lose his home, house and everything else because of a couple of doctor visits,” McElligott said. “I think they need to understand the consequences of these actions.”

– By Charlie Morasch, staff writer
charlie_morasch@landlinemag.com

Visit Land Line Magazine’s Web site at www.landlinemag.com this week for part two of “Fitness for duty.”