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Sleep Apnea and the law - zonk - 09-02-2012

[Parts of this thread copied from the old forum]
By BikerEric - May 9 2010
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According to DOT ( Department of Transportation) Rules and regulations
If you are diagnosed with OSA and are left untreated OR not following your treatment regimen , Your DOT driver's certificate can/will be withdrawn. ( Basically you have failed your DOT physical)
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DOT Health and Safety Guidelines

Are your drivers compliant with current medical fitness standards?

The Department of Transportation, Federal Motor Safety Administration (FMCSA) recently proposed updates to existing guidelines regarding compliance with medical fitness standards related directly and indirectly to respiratory dysfunctions, including sleep apnea.

Physical qualifications, related to respiratory dysfunction for drivers, state that "a person is physically qualified to drive a commercial motor vehicle (CMV) if that person has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with his/her ability to control and drive a commercial motor vehicle safely. If the medical examiner detects a respiratory dysfunction, that in anyway is likely to interfere with the driver's ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy."3
http://www.fmcsa.dot.gov/rules-regulations/administration/fmcsr/fmcsrruletext.aspx?reg=391.41
FMCSA Rules and Regulations Section 391.41
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In the State of Maryland 'Sleep Apnea" is one of several medical reasons you can lose your Driver's License entirely!
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Approval by Driver Wellness & Safety and/or the Medical Advisory Board is required if you have any of the conditions listed below. If you have a listed condition and you are applying for a learner's permit, you must have approval prior to the issuance of the permit. If your driver's license has been revoked and you have asked to have it reinstated, you may be referred by the MVA for review by Driver Wellness and Safety and/or the Medical Advisory Board.

1. Cerebral Palsy;
2. Diabetes requiring insulin;
3. Epilepsy;
4. Multiple sclerosis;
5. Muscular dystrophy;
6. Irregular heart rhythm or heart condition;
7. Stroke, ministroke, or transient ischemic attack (TIA);
8. Alcohol dependence or abuse;
9. Drug or substance dependence or abuse;
10. Loss of limb or limbs;
11. Traumatic brain injury;
12. Bipolar disorder;
13. Schizophrenic disorders;
14. Panic attack disorder;
15. Impaired or loss of consciousness, fainting, blackout, or seizure;
16. Disorder which prevents a corrected minimum visual acuity of 20/70 in each eye and a field of vision of at least 110 degrees;
17. Parkinson's disease;
18. Dementia, for example, Alzheimer's disease or multi-infarct dementia;
19. Sleep disorders, for example, narcolepsy or sleep apnea; or
20. Autism.

For a variety of other reasons, your name also may be given to the MVA for possible referral to the Board, by any of the following:

* Law enforcement agencies
* Judges or attorneys
* Private physicians, hospitals or health care providers
* Complaints from private citizens (after investigation by the MVA)

If you are referred, the MVA’s Driver Wellness and Safety Division (DW&S) will send you an information packet indicating additional information needed from you. The DW&S may then decide to refer you for an MAB evaluation.

The MAB does not perform medical examinations. The physician evaluating your situation primarily depends upon reports from your physician or treatment source. However, the physician may ask you to come in for an interview.
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Just an FYI for those of you that didn't know how serious this can be to your ability to make a living or even your freedom to move about.
"It is said , that some suffer from insanity, I, however, Choose to enjoy it"




RE: Sleep Apnea and the law - Podd - 09-02-2012

Ooooo, a big bone of contention here in the UK and one I almost fell foul of.
Sleep Apnoea 'IS' a reportable condition, I was actually told by a Doctor that as I was being treated for Apnoea, I no longer had it, so I didn't have to report it. This is obviously rubbish although at a SATA Convention at the Oxford Radcliffe Hospital a 'Show of Hands' in a audience of 600'ish showed that at least a third had not reported it to the DVLA and three quarters of the audience had not reported it to their car insurance company rendering their insurance invalid!
This was a while ago though.
I 'told' the DVLA and they 'held' my driving licence as I had sent it off to be renewed, this was a big problem as it actually expired and the would not tell me if I had a licence or not for several months after the expiry date, 'Verbally' they said I should continue driving until I heard either way, as it happens they made a decision without checking my Medical Records (My Clinician told me there was no record of this happening).
My licence arrived although it is medically restricted because of my Apnoea and my car insurance was also increased, my travel insurance has also increased dramatically as well.
It's very odd that when driving late at night, all of my family are fast asleep in the car and I am the one left driving as they know I won't fall asleep at the wheel, to be honest I wouldn't drive if I felt tired anyway.
It seems that 50% of drivers with Apnoea can fall asleep while driving, the other 50% it's not as clear cut but we are all penalised the same (This in my opinion is probably the correct decision!)
Rather oddly, the wearing of glasses is not reportable in the UK but not wearing them can get you into big trouble if they are required (I am not saying don't wear glasses if you need them, just that the Law is rather strange?)


RE: Sleep Apnea and the law - Moriarty - 09-03-2012

(09-02-2012, 01:44 AM)zonk Wrote: [Parts of this thread copied from the old forum]
By BikerEric - May 9 2010
__________________________________________________________

Just an FYI for those of you that didn't know how serious this can be to your ability to make a living or even your freedom to move about.
"It is said , that some suffer from insanity, I, however, Choose to enjoy it"

The situation in Queensland (Australia) is that you can be the dopiest doziest driver and if you have never been diagnosed as OSA there is no legal issue with your Drivers licence... although you would of course be a danger to yourself and a menace to others.

If on the other hand you have done the responsible thing and gone to the doctor for investigation into your occasional snoring then as soon as OSA is diagnosed the doctor is expected by the regulations to rule you unfit to drive pending treatment and a demonstration that your OSA is controlled by the prescribed treatment.

The reality for me was that the doctor hastened slowly on that and since the symptoms were snoring and not fatigue he didn't take any action while I was under the specialist. As a result I was able to keep driving. Once the report from the specialist came back my doctor wrote the forms and now I have my licence endorsed to say that I need a new medical compliance certificate every year - which means a trip to the specialist armed with my SD card.

If I had been a 'professional' or 'commercial' driver in Queensland (i.e. Bus, truck, taxi, etc driver) there would have been no ifs or buts - my licence (and thus my livelihood) would have been suspended until evidence of satisfactory treatment is supplied.

I do not have a problem with making sure that OSA sufferers are obliged to have treatment and have their licence endorsed and carry medical certificates if they wish to drive. What I do worry about is the number of UNDIAGNOSED OSA sufferers that are out here making my 900km per week of travel on our highways that much more dangerous for me.

I must say though that, as most here have probably found, the numerous side benefits to better sleeping fixed problems that I didn't realise I had and gives me a better lifestyle than before.




p.s It does seem a little bit nominal though - all I actually need to do is carry the paper saying I was fine when they checked and have it renewed every 12 months... There is no mechanism to ensure that I am compliant with my treatment on an ongoing basis although I think I would be nuts not to be.

p.p.s - no apology for the Australian spelling of 'licence' Smile


RE: Sleep Apnea and the law - archangle - 09-03-2012

Just what we need. Another big brother regulation that makes commercial drivers afraid to seek treatment for a dangerous medical condition and continue to drive half asleep because if they try to solve their problem, they'll lose their livelihood.


RE: Sleep Apnea and the law - SuperSleeper - 09-03-2012

(09-03-2012, 03:40 PM)archangle Wrote: Just what we need. Another big brother regulation that makes commercial drivers afraid to seek treatment for a dangerous medical condition and continue to drive half asleep because if they try to solve their problem, they'll lose their livelihood.

It's called Unintended Consequences. There was a book by that name somewhere if I remember correctly.




RE: Sleep Apnea and the law - Podd - 09-04-2012

The onus is on the driver in every case and it would appear every country as well to report Apnoea, although in the UK there definately is no compliance issue as there isnt any follow up?
That's quite shocking but as I am sure you are all aware some of the earlier machines didn't record data anyway .and a LOT are still in use
I reported my Apnoea and I sleep very soundly at night, in more ways than one.


RE: Sleep Apnea and the law - TorontoCPAPguy - 09-04-2012

In Ontario, Canada, it is the LAW that an MD MUST report anyone suffering from severe sleep apnea to the MOT/DOT and the patient loses their license forthwith. It takes some work to get it back. I have a friend with sleep apnea who had this happen to him. He could fall asleep mid sentence in conversation. Tried a dental device for $3K. No go. Then an APAP as I suggested and PRESTO! Got his license back after a couple of sleep studies. Tough to work out of a truck with no license.

Asides from the doctor taking away your drivers license..... if you catch yourself EVER EVER nodding off at a red light consider it a warning sign and a favour from the Almighty and get thee to a sleep doc and get fixed. You have just used up one of your nine lives.




RE: Sleep Apnea and the law - archangle - 09-04-2012

I agree untreated apneacs should not drive trucks (or cars). I'm pointing out that having the doctors report apneacs could actually make the problem worse because people will quickly learn to NOT tell their doctors about problems that might be apnea because they could lose their driver's license. You could end up with more untreated apneacs on the road rather than less.

Nothing gets people stirred up and ready to lie, cheat, and steal quicker than threatening to take their driver's license away.

You could also end up with more and more drivers unwilling to discuss other medical problems with their doctors. "Don't tell your doc about anything. Joe went to the doctor to get his blood sugar checked and the doctor took his driver's license away."


RE: Sleep Apnea and the law - Podd - 09-04-2012

There was a massive poster campaign here in the UK basically it said "John died in his sleep last night, he was driving at 70mph at the time", It really shocked me, I was contracting at the time and driving 140 miles every day, up a 05:00am and home at 21:00pm. Although I hadn't had any problems, I decided then and there it just wasn't worth the risk.
It did cost me financially (Quite a lot actually) but I don't regret it at all, since then I have taken my Motorcycle driving test and now ride a 1200cc motorcycle and on rainy or cold days drive a car, I do have a medically restricted driving licence which does limit the size of the vehicle I can drive. Whilst this still gives me a lot of freedom even I think it is ridiculous that there is no 'monitoring' of Apnoea here in the UK, I really don't want to think about the risks and consequences others 'may' be taking, not just with their lives but all the other others they 'possibly' put at risk!!!


RE: Sleep Apnea and the law - archangle - 09-04-2012

I agree untreated apneacs should not drive. I'm just pointing out that regulation often has the opposite effect.

More regulation of drivers might make the situation worse, not better. Many drivers are already careful to conceal medical conditions that could cause them to lose their license, and as a consequence, some unnecessarily go untreated.

Prohibition in the US caused alcohol consumption to actually go up.

The war drugs doesn't really seem to be doing a whole lot of good overall.