DOT Physical Issues

That's just plain BAD advice.........or more accurately false information.

 

Only thing is what you and the OP say are BS is the law , period , it makes no difference if " it doesn't matter to me what the regulations are " ( your words ) It DOES make all the difference in the world that if you have a medical condition that could , affect your capability to drive safely , it must be either corrected , or in the case of type 2 diabetes maintained and controlled , you guys and others see this a privacy issue , well heads-up fellas , when you get into your truck , you're gonna be operating that vehicle in a very , very , very public venue , that's why , and where the lines get drawn , both of those PA's where doing exactly what the laws require of them , nothing personal , they're charged with making sure an underlying medical condition doesn't put the motoring public in danger by you operating a semi in it...I would think that you both would want that since you have families that travel to work , to school , and the like , how would you feel if a family member of yours were to be killed or horribly injured by a driver with type 2 diabetes that wasn't maintained and controlled properly , I think you the answer to that question as do the rest of us.

 

It isn't a law, there is no laws involved, it is really two issues, one is misplaced regulations that should have direct oversight by congress and the other is that many things are open to interpretation by the examiner, nothing is uniformed. I have a doctor with 10 years of schooling and ten more years of practice who I see every three months telling me that I am fit to do a lot of things, and then I have a PA telling me I may not be fit to drive? His 5 years of schooling isn't matched with that of a doctor and I think that is one issue, maybe we need doctors be involved or scrap this idea of registering the examiners.

First off I get the safety thing, I understand what the reasoning it but there is something that is along the lines of reasonable exams and unreasonable judgement. The problem is that if I am under doctors care, which many diabetics are, that should be taken in account, not to be explored or as in my case having a PA tell my doctor that there is room for improvement. On the other hand the exam is fitness to operate the vehicle, not to judge a person's ability to operate that safely, there is no psychological exam involved, there are a lot who need it and who are unsafe.

Second this isn't a privacy thing, it is a problem of misjudgement and further a problem with the entire program for the DOT physical. Like the idea of having RNs and PAs give examines but my doc can't? Where is there a special need to know a special or specific skill in order to make a judgement with the criteria that is given for the exam? There isn't any. There isn't a thing on that exam form nor in the exam criteria that prevents a MD internist to give that exam except the need to be qualified by the FMCSA/US DOT. As my doc made it clear, the PA sees me for less than 5 minutes with someone else giving me the 20 minute intake interview, how does that give a clear picture of my health and my ability to operate a vehicle safely?

The operation of a vehicle in a public venue already takes place, I drive a car. There is no judgement on my health to drive a car and if the public would face this BS, there would be a backlash against those dependent on votes. I also have a motor home, a large car hauler which is not a commercial vehicle and weighs as much as my trucks, but not one of them require a DOT exam to qualify to drive. Where is the difference?

I agree with you on them doing their job, but what is their job?

It is to examine a person and determine if they have any detrimental medical condition that prevents them from operating a commercial vehicle safely at that moment. That exam is not done over a period of months or with the knowledge of the person's medical condition over years of interaction but in less than 30 minutes that judgement has to be made. The real issue is that we can't as human predict or even mitigate medical issues that are controlled by one or another treatment.

How this judgement is made?

By disclosure of medical history, medications and a superficial exam.

So explain to me how a PA who is examining someone can make that judgement in a 30 minute exam?

Sorry Tony dude, I've been there with a family member being killed by someone who had a medical condition and it still doesn't matter to me - in that case nothing could be done as in many of the cases that happen every month. It seems that we are trying to prevent things from happening that can't ever be predicted or even reduced.

What does matter to me at least is a clear defined exam process which doesn't change because of political reasons, with further stringent requirement by the examiner not to go beyond the scope of the exam. Further more limits that issues like Sleep Apnea (which I have and has been treated since 2001) and diabetes that what given is accepted by the examiner as accurate and faithful.

Why do I have to prove I use my cpap when there is proof in a form by a third party for what is required?

I give them what they asked for last year but that wasn't good enough this year?

Why do I have to provide proof I am controlling my diet and provide readouts of my glucose meter (which I have three of them)?

When confronted with someone who tells me I can do better and then questions what I've been doing so far, I fell it is beyond their job to judge my fitness for driving at that moment.

Tony, what this comes down to is added stress for me, nothing else. I wouldn't mind the exam or the bs that goes with it but every year I go through something, sometimes the same thing, sometimes it is new and for the past 4 years, I have ended up with one of the 30 or 60 or 90 cards just to go back and deal with the same BS. This time it is two things that this guy needs to see and it is tiring, very tiring. One thing I have to add is I worked in the medical field for years doing IT work but also finances and regulations for practices and hospitals. I know how things work like privacy issues and so on. I also know how arrogant doctors and nurses get and don't tolerate it. My present doc is good, she does the right thing for me, set me up to improve my health but she also thinks this is all a bunch of BS with no foundation for his demands, as she said it is like holding someone hostage. My doc who treats my sleep apnea was on the advisory board with the DOT and she left because of the politics involved. She has fought for every one of her patients who has been faced with BS by examiners because they step beyond the bounds of their job. She has less than kind words for examiners.

 

One question , the Dr. that you see now , why isn't he/she on the approved list to give DOT exams , seems that that one thing would help you with your issues. MY son is an MD . I asked him about your situation , He told me that since the PA wasn't involved in your over-all health care plan , in order for him to make a decision on how good you were controlling your type 2 he would need more info , pretty simple , at least to me. It isn't such a hassle for either one to contact the other , send a record , a care plan /treatment plan , and discuss whats best for you , and your ability to drive a commercial vehicle. I really don't see it as a hindrance , or BS , but , I'm on the outside looking in. I sincerely hope that you and the OP get your issues resolved , and you both keep your type 2 under control and maintained for you both. Thanks for the long response , it cleared up a question or 2 , and made me aware of just how important physicals are to us all.

 

So, while we're all having a pissing contest about what is legal, what isn't, who's right and who isn't. Let me through my $.04 in.

I'm type 2 diabetic, until this time around, my family Dr. did my DOT, they no longer do it because of the hassle. They referred me to a new clinic to get it done. Guess what, because of my diabetes and my blood pressure, I only got a 1 yr card. Initially I was upset with the Dr., and thought he was in the wrong. But I found out yesterday when I went for my diabetic checkup, that the DOT Dr. had requested a copy of my blood work from my family Dr. before I went in. I forgot, when I made the Appt., that they had asked who my primary care was. I look at it this way, it is about safety, it's about preventing a problem, it's about them no being sued, it's about them not losing their license, and it's about you not killing someone. BTW, that Dr. can just as easily call the company, advise them that you refuse to comply with medical directives, and they feel you are not fit to drive. Then what? You going to sue her? I want to be there for that lawsuit, my money is on her wining the suit.

Secondary point to it, if you want to take it further. My wife is epileptic, in Jan. 2014 she has a seizure while driving to work, went off the road, hit a light pole, totaled the car. The hospital yanked her license, told her she couldn't drive until the nuerologist cleared her. It took 3 months, two office visits, two rounds of blood work before he cleared her. In Dec. 2014, she did it again. Lucky for her, there was no hospital visit involved, only a quick check over by an ambulance, I showed up on scene, along with three cops, she hit a guardrail at an angle. While the car wasn't totaled, it did spend a month in the body shop. Since the cops couldn't prove the accident was caused by a medical condition, I'm fairly certain it was, they didn't cite her, and it was a reported as a not at fault accident.

Apparently though, the first accident shows up on our C.L.U.E. report as being caused by a medical condition. We were previously with Esurance, just switched to Allstate 10 days ago for Auto, Motorcycle and Home. Allstate underwriting sent us a demand letter, within 45 days, we have to provide to them a letter from her Nuerologist that she is medically cleared to drive. If we fail to provide it, they will automatically drop coverage for her. When the policy renews in 6 months, they will require this again, and the time after that.

So, not only can DOT require these things, as can insurance companies if they suspect there is something else involved.

 

I wonder what that "no no" medication is, really. There is nothing on that list other than insulin, which you can get a diabetes exemption for anyway. Having a high A1c is NOT a disqualifying factor. Being on medication to treat Type II diabetes means that you can get a 1-year card, provided that all other health issues check out okay. While the PA that did your physical does have the right to request more information from your doctor, she is not your doctor to tell you what you should and shouldn't do. She was disqualifying you for the wrong reasons, according to what you had posted here.