Question Re: DOT Physical & Sleep Apnea

This is one of the most confusing things since the FMCSA started the examiner registry and tied the CDLs to the physicals. The FMCSA also has not put out a lot of guidance either. A driver is 100% free to GO ANYWHERE at any time to get a 2nd opinion. The FMCSA has NO ISSUE with a person doing this. Getting a 2nd opinion means you tell the 2nd ME about the first physical. Otherwise, it's not a real 2nd opinion according to the FMCSA.

Here is the problem as of my last conversation with the FMCSA Southern Office. The FMCSA has or is about to program algorithms into the physical database that will find these physicals with close dates that the 2nd physical is a better outcome than the 1st. They can then pull both physicals and look at them. If they can't find on the 2nd physical information about the 1st physical they are going to nullify the physical. Then the problem becomes much worse because almost all MEs won't mess with another ME's findings without direct support.

This is why the word needs to get out to avoid Concentra AT ALL COSTS. Maybe one day this dang insanity will get stopped. Until then stay OUT of Concentra if you are overweight. Even if it means you have to decline a job.

 

Isn't there a class action about Concentra and sleep apnea testing?

Sounds like they would want to speak with the OP.

 

I think now would be a great time to write how I stand on this OSA issue as well as driver health in general. I think most reading this know I am now retired. I have been retired for 10 years. Since my retirement, I lost ALL my driving privileges because I have epilepsy. When I retired I was overweight and fighting high blood pressure and was taking Metformin to control blood sugar. I have networked in this business and over the last few years noticed a lot of drivers still active and retired have died in most cases from heart conditions aggravated by diabetes. One guy I used to work with doing truck repos is legally blind now because the retinas in his eyes have leaked blood another condition linked to out-of-control diabetes. I spoke to the Veterans Affairs Doctor that placed all 4 of my stents last year during my last exam. He no longer is a VA doctor. What he told me was the medical research is clear one of the factors that cause diabetes to develop is being overweight. Now, to avoid the reply well Moose I am overweight and I don't have Diabetes. I know and understand this is not something that is 100%. A person's chances of developing diabetes while being overweight are enhanced.
FROM THE CDC!

Diabetes Complications Are Related
Diabetes complications often share the same risk factors, and one complication can make other complications worse. For example, many people with diabetes also have high blood pressure, which in turn worsens eye and kidney diseases. Diabetes tends to lower HDL (“good”) cholesterol and raise triglycerides (a kind of blood fat) and LDL (“bad”) cholesterol. These changes can increase the risk for heart disease and stroke. Smoking doubles the risk of heart disease in people with diabetes.

Take a closer look at these major diabetes complications:

• Heart disease and stroke: People with diabetes are two times more likely to have heart disease or a stroke as people without diabetes.
• Blindness and other eye problems:
  • Damage to blood vessels in the retina (diabetic retinopathy)
  • Clouding of the lens (cataract)
  • Increase in fluid pressure in the eye (glaucoma)
• Kidney disease: High blood sugar levels can damage the kidneys and cause chronic kidney disease (CKD). If not treated, CKD can lead to kidney failure. A person with kidney failure needs regular dialysis (a treatment that filters the blood) or a kidney transplant to survive. About 1 in 3 adults with diabetes has CKD. You won’t know if you have CKD unless your doctor tests you for it.
• Nerve damage (neuropathy): One of the most common diabetes complications, nerve damage can cause numbness and pain. Nerve damage most often affects the feet and legs but can also affect your digestion, blood vessels, and heart.
• Amputations: Diabetes-related damage to blood vessels and nerves, especially in the feet, can lead to serious, hard-to-treat infections. Amputation can be necessary to stop the spread of infection.
• And more:
  • Gum disease can lead to tooth loss and increased blood sugar, making diabetes harder to manage. Gum disease can also increase the risk of type 2 diabetes.
  • Diabetes increases the risk of depression, and that risk grows as more diabetes-related health problems develop.
  • Gestational diabetes, diagnosed during pregnancy, can cause serious complications for mothers or their babies, such as preeclampsia (high blood pressure caused by pregnancy), injury from giving birth, and birth defects.

Complications usually develop over a long time without any symptoms. That’s why it’s so important to make and keep doctor and dentist appointments even if you feel fine. Early treatment can help prevent or delay diabetes-related health conditions and improve your overall health.



My basic point being I want everybody reading this to have a long career as a trucker and have a nice life after they retire. It really bothers me when I get these bad reports hearing that a friend has died.

The next point is about this OSA idiocy. If you have OSA and it is affecting your quality of sleep of course get this situation fixed ASAP. My basic contention is during a physical the ME should simply ask the driver how are you sleeping. If that answer is I am sleeping OK why then do you basically want to call that driver a liar and say I want verification by a sleep study? I will tell you something else. Not all sleep labs are created equal. I know of two cases where a driver was cleared by a sleep study but his carrier would not accept the sleep study. In both cases, the driver took another one and was determined to have OSA. I can't remember the year, but the US Congress told the FMCSA to drop these dang OSA guidelines. This was after all these MEs had invested in sleep labs and in some cases made deals with CPAP makers. If you are overweight I would estimate at least 75% of all MEs see $$$$$$$ when they look at you! This OSA BS is not going to get better either. Still, when I say lose weight, eat healthily, and get plenty of exercise I am not saying this to avoid these crooks. I am saying it because I honestly want all of you to live good LONG lives!

 

FYI, in @Moose1958 very good post, OSA means Obstructive Sleep Apnea a severe form of snoring that routinely causes you to stop breathing.

 

The problem why this crap is forced on many driver is because many don't understand or even know what a good night's rest is, they have been for much of their adult lives been dealing with serious obstructions and got use to having a marginal nights rest.

 

When I was an active driver the CDL was not married to the physicals as they are today. Toward the end, I did have to use a medical examiner that was on the registry. For most of the last 20 or so years I was driving my personal physician did my physicals. In fact, the last time I looked he was still an ME. He would check my throat and ask me how was I sleeping. Then tell me my A1C was too high. He was the one that prescribed my Metformin and my high blood pressure meds. I knew him and he knew me. If I were still active and healthy I am 100% positive I could get a 1-year card from him.

I have said this many times. I DO NOT want dangerous drivers on the highways. I don't want drivers so dang sleepy they are a hazard. I don't want drivers driving 50,000 feet they are so high on something. No sane person wants any of that crap. Sadly more and more primary care physicians are not getting into the registry. It is a lot of what I call "other" types. Then you have the walk-in clinics like Concentra doing a huge amount of driver physicals. I was asked not long ago where would I go to get a physical these days. I said most likely I would go to the CVS clinic in Newport news. I have heard most of the time they don't hassle drivers much.

 

Ni one passes the sleep test,no one.
It's a complete scan

 

This situation can be fixed. Remember the term "follow the money"? Well in this case follow the money. First, no FMCSA registered Medical Examiner should be allowed to hold interest or have a relative that is invested in a sleep lab OR CPAP sales. There should be standardized testing standards. I know for a fact not all sleep labs are the same. Part 391 needs to be changed to FORCE ALL carriers to accept a Medical examiner's opinion with respect to OSA. Carriers should NOT be allowed to have sleep labs or sell CPAP machines. The physical exam paperwork should have on all pages that NO medical examiner can require a Sleep Study. If said ME does not want to certify said driver, they are free to stop the physical at that point and refund the patient's money, and NO report made later to the FMCSA. What I would like to see simply is for a driver to be sent to their personal physician for their determination with regard to OSA. If that doc is OK then so be it, keep on trucking. If this doc after speaking to the driver feels they might have an issue with OSA just go on ahead and get them fitted with a CPAP machine and have them come back later and see if it made a difference. This current system is full of crooked fraudsters. I for one do not like the near-dictatorial attitude these people have. In the end, for most the only safety they seek is to safely get as much money as possible into their bank accounts.

Anybody that is using CPAP and is sleeping better I say great! The system is working well for you.

 

Thank you for the update. This is a good ending to a bad situation, and perfectly legal. You did the right thing in getting a valid second opinion. Sounds like you found a good medical examiner that understands things.