FMCSA may propose a rule to adopt the entire “Fitness for Duty” matrix recommendation of the Medical Review Board, adopt part of the recommendation, or not address it at all, FMCSA spokesman Duane DeBruyne has stated several times.

As Land Line has noted, the good news for truckers is that FMCSA hasn’t acted to draft a rulemaking on any part of the Medical Review Board’s fitness for duty matrix, nor has the agency begun rulemaking procedures for last year’s recommendation for drivers with a BMI of 30 or greater to obtain sleep apnea exams.

Under the take-no-prisoners matrix approach, a driver with two health issues would be required to undergo annual DOT exams. A third health issue would require two exams a year, and four would park a driver indefinitely.

Besides likely parking millions of drivers, the approach would prove expensive for drivers – many of whom would be making at least two to four more doctor visits per medical certification.

Dr. John McElligott, who helped found a chain of truck stop medical clinics, said the matrix combined with medical certification changes would have another unintended consequence: clogging medical office waiting rooms.

Because DOT physicals can be performed only by those physicians certified or registered with FMCSA, truckers are limited as to whom they can see for the government-mandated exams.

“They’re going to create a logjam,” McElligott said in a telephone interview. “There aren’t that many doctors out there doing DOT physics when you have to be certified anyway. Here’s the problem: They don’t even know how many drivers are out there. At the meeting they said 8 million. We’ve heard between 2 million and 3 million are over the road. Nobody really knows.”

In recent interviews with Land Line, Medical Review Board Members Kurt Hegmann, M.D., and Barbara Phillips, M.D., each said the board is concerned about drivers who die or are hurt because of medical issues.

McElligott said commercial drivers need to stay ahead of the DOT and FMCSA to ensure they aren’t removed from their trucks for iffy or borderline heath issues that often may be improved with minimal lifestyle changes.

“If truckers are going to die, it will probably be quicker as a result of heart disease, diabetes or stroke,” McElligott said.

To guard against those ailments and others, McElligott suggests drivers work more fruits and vegetables into diets, lay off heavily salted foods and exercise when possible, starting slowly.

He also urges his patients to schedule their visit ahead of their DOT physical. McElligott’s office and many other doctors offer wellness programs that test for a variety of health indicators, including blood pressure and blood sugar.

“If you have some medical problems, and you know you’re borderline, get a wellness exam. They’re between $45 and $100,” McElligott said, adding that some doctors’ offices may charge as much as $300 for in-depth wellness exams.

Getting that wellness exam early can help a driver recognize an issue that often can be improved within a few weeks.

“If you just came off the road after 600 miles, you don’t want to do a DOT physical,” McElligott said. “Then they come in on the fly, they have 10 cups of coffee, two packs of cigarettes, and a buffet meal. Man, that’s going to jack up your blood pressure and blood sugar and do all kinds of things.”

McElligott said taking a few extra measures can improve a driver’s medical testing figures, and also the doctor’s ability to correctly gauge the driver’s health.

“After drivers get home from a few days on the road, you want to wait and relax,” McElligott said. “Get a shower, stay off cigarettes and energy drinks; they drive your blood pressure way up. You want to come in when you’re relaxed, and that’s the best time to do it.”

Standing up for truckers
OOIDA, which has attended medical review board meetings for years, is watching the board and any potential rulemaking, said Joe Rajkovacz, OOIDA regulatory affairs specialist.

“As this all unfolds, the association will be keeping a very watchful eye on how these recommendations may be used by FMCSA as the basis of any proposed rulemakings,” Rajkovacz told Land Line.

In 2008, OOIDA President and CEO Jim Johnston and satellite radio broadcaster Dave Nemo nominated McElligott to serve on the Medical Review Board.

McElligott said he’s been told he stands a better chance of being approved for the board in 2009 or later because a new presidential administration is in office. Regardless, McElligott plans to attend most of the board’s quarterly meetings to ensure that medical perspectives from truck drivers are heard.

“There’s a chance,” McElligott said. “I’m not going to hold my breath. I may be too pro-trucker. But we need to educate these folks. I don’t think they understand the life of a trucker or the consequences of their recommendations. I don’t know of any other profession, including doctors, where workers are as regulated as truck drivers are.”

Approved or not, the “Fitness for Duty” matrix could inspire similarly expensive and unnecessary regulations. Employers could adopt the standards touted by the FMCSA Medical Review Board in programs termed “voluntary.”

Before ending the phone call, McElligott urged truckers to work at improving their health – even if they consider themselves relatively healthy.

“They’ve got to be proactive with their health because things are changing,” McElligott said. “Get ahead of the system or the system will consume you.”

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