Our goal is to complete your exam on the visit day and issue your certification the same day. FMCSA does have various rules and regulations which we must follow before we can give a certificate. In situations where we need letters from your Primary Care Provider (PCP) or specialist, with your permission, we will try and get these faxed over before your visit. Most commonly, we need a short letter if you are on controlled meds or a machine for sleep apnea. If your blood pressure is over 140/90, you may need to see your PCP to get it controlled and bring us a short letter stating they are seeing you for this and that your blood pressure is under control. Aside from these cases, same-day certification is usually issued. We will never charge you anything until we can give you your certification. We will try to get letters faxed to us the same day, but this may depend on your PCP.
Questions about marijuana are not uncommon since it is legal in Oregon. However, as you know or will soon learn, it is not allowed for commercial driving because it is not legal federally. It is a common issue for a person preparing to attend a trucking school who has legally used marijuana in the past month or two to wonder if it will be positive on their drug test. THC stores in fat, so your body composition significantly affects this answer. In general, we have seen THC be positive at 1-2 months and three months or more in some cases. If this is a concern for you, Rogue Medical offers a rapid drug screen with laboratory confirmation for a nominal fee. No test is 100 percent, so this is not a guarantee, but your chances of a positive are minimal if you first test positive on our rapid.
If you test positive for marijuana on a federal test, you will generally be required to attend a drug rehab program (at your expense) with a Substance Abuse Professional (SAP) before you are allowed to retest. The retest will be a “return to duty” and mandatory observed collection.
High blood pressure is the most common complication. Home BP cuffs are widely available and relatively inexpensive. Since this is about your ability to work and your safety, we suggest getting one and checking your BP on a routine basis. Automatic cuffs are conveinent, but always get the upper arm cuff – not the wrist cuff. The accuracy of wrist cuffs varies depending on where your wrist is positioned relative to your heart when taking the measurement. Alternately, you can check your BP at many pharmacies. If you have no previous diagnosis or treatment for high blood pressure, but your blood pressure is too high at the visit, we can usually issue a 3-month certification. You will need to see your Primary Care Provider (PCP) get your blood pressure under control. We will provide them a letter from us with instructions and our Fax number. When your BP is controlled, they will fax us their chart note showing the meds you are on and your blood pressure reading in their office. We will add this to your file and issue a certification for the remainder of the year from your exam date.
If your PCP treats you for high blood pressure, we suggest you have your own BP cuff and regularly check your blood pressure. Your blood pressure can vary at different times and under other conditions. Your PCP cannot be the provider that does your CMV exam – that is just an FMCSA rule, and yes, it is a change from the previous. Your PCP will want to see you at least once a year. We suggest you visit your PCP a month or two before the site visit so meds can be adjusted if needed. Otherwise, if your BP is too high, we will have to hold the certification until your meds are changed, which is not our preference. FMCSA only allows a three-month certificate with the initial dx of hypertension.
If you have diabetes, we will need clearance and a statement (or chart note) from your PCP, which must be within the past year.
· We will also need a record of your last A1C lab, and again this must be within the past year, but six months is recommended. We can do an A1C test in our office for a fee if you choose.
· You must see your ophthalmologist at least once a year if you have diabetes and drive commercially. We will need a letter from your ophthalmologist, clearing you to drive CMV and stating that you do not have “diabetic retinopathy.”
· If you see an endocrinologist (diabetic specialist), we will also need a letter or chart note.
· If you have “peripheral neuropathy,” which is damage to your nerves from your diabetes or any vascular or sensation problems in your legs or feet, you should be seeing a podiatrist, and we will need a letter from them.
If you have a sleep apnea diagnosis, we will need a letter or chart note from your PCP or sleep specialist. The specialist is usually a Neurologist or Pulmonologist at the sleep center where you are seen, and your CPAP machine use is monitored.
You must be able to hear a forced whisper in at least one ear from no less than 5 feet. If you can’t do this, you probably know it. See an audiologist and get hearing aids. We can arrange for hearing screening in our office through Rogue Hearing who can also sell, fit and repair hearing aids for you if needed.
You must have distance vision in each eye of 20/40 or better with or without correction. If you need correction, you must bring it with you. Contacts are acceptable, but you must also have glasses since you are required to have them in your possession for backup while driving, or you will be in violation. Recent changes allow for meeting the 20/40 criteria in only one eye in some cases, but this will need specific paperwork from an ophthalmologist.
Controlled or Sedating Medication
If you are prescribed controlled or sedating medications, we will need a letter from the prescriber. Stating they feel you are safe to “drive commercially” while using the controlled medications they prescribe. Not all PCPs are willing to do this, so we recommend that you discuss this with the prescriber in advance. Note: it needs to specify “commercial driving.”
NOTE: The use of Marijuana or Methadone is disqualifying under FMCSA even if it is legal in the state. If you use either of these, you cannot be certified even if you have a letter.
If you see any specialist for a medical condition, you should get a clearance letter from them stating your need is managed, and they feel you are safe to drive commercially. If you are not sure – please call – text, or E-mail us, and we will be glad to clarify.