Is there a database of DOT Physicals available to doctors?

I am not 100% positive if this is particularly concerning the physical part (referring to this comment I quoted in your reply to @Ridgeline ), but it definitely is true of drug and alcohol testing. HIPAA Statement | US Department of Transportation

 

I'd like to hear the explanation for that, please.

 

First off, I did Google and it looped me back to here with posters saying there is such a database but without any links.

Secondly, in your 2 links above, the first is for medical examiners to register as certified to conduct examinaitons and for carriers and drivers to verify that medical examiners are on said registry.

Finally, the second link is for a private organization. Not the Federal government. It's also from 2014 and it does tell medical examiners how to report examination results but nowhere does it say they are required to report them.

 

IF you go to a concerta they have your previous one file if it was done at a concerta. I forgot to mark something once and they pulled it up. I don't use concertas anymore lol Not for that specific reason but they just all around suck.

 

There were 2 things debated in this thread. Let me address the database. The first point is the FMCSA maintains a medical database because this is how the FMCSA maintains the CDLIS where the states can see medical information. I'm not going to get too deep into the rule-making history of 391.43 but I am going to link to 391.43(g)(5)(i) that clearly states the ME is to transmit to the FMCSA a finished physical to them. If there was no database what in the Sam Hill are the MEs sending finished exams to? That rule is specific about the form it is sent in. The ME uses the MSCA-5850 form. This form is a bit different than the MSCA-5875.

On that HIPAA thing, it applies in some respects, and in others, it does not. Medical information is PRIVATE per Federal LAW! Unless you sign a waiver to release this information it is to stay private. This topic always reminds me of the Federal Privacy Act of 1974. I remember having these forms handed to me during my enlistment process to enter the USAF back in 1975. On the form I signed, it clearly stated I had the right to not release any of my information, but if I did not sign the form I could not enlist in the USAF. This dynamic is very close to what happens with the MSCA-5875. If you want a medical card you must fill out this form and sign it.

 

I was sipping on some good (I'm lying decaf coffee stinks) coffee thinking about this medical privacy issue. I remember speaking to a driver who has diabetes and now takes pills for control. He did not want to disclose this because it left him with only a 1-year card. Then as luck would have it he was stuck out on the road and was told he needed to get a physical ASAP because his was about to expire. When they did that dip test in his urine it came back that protein was spilling into his urine. The ME did a stick test and his glucose came back over 200. The ME would not certify him and this left both he and the carrier in a jam. He said once he got home he fasted and went and got a 1 year card. He also went to see his family doctor and started taking metformin. Because of the situation that happened his safety dept would not allow him to operate any of their trucks until they saw his long form and got a medical report from his family doctor that he was OK to drive. In this situation, HIPAA was useless to him because being allowed to operate their trucks was contingent on him releasing the information. This is why there is such confusion when it comes to HIPAA. If you want an insurance company to pay for services you have to allow them access to your records. There are other examples that I won't list. So any statement that says HIPAA does not apply is false. The problem is while HIPAA applies you must give up some aspects of that medical privacy when it comes to satisfying Federal and State regulatory requirements.

Does anybody remember this?



This is a good example of how confusing medical privacy can get. I'm not going to get into who was right or wrong. I just think both thought they were right. The cop thought he was right because of the implied consent laws. The Nurse thought she was right based on hospital policy. If a nurse and a cop are at odds like this then you know that HIPAA is very confusing across the board. This is why I call HIPAA a pay to play situation. If you want to get something that is contingent on allowing the release, well it is up to you to decide going forward!

 

The HIPAA law is a joke. There are plenty of ways around it and anyone who thinks his medical information is confidential is deluding himself.
There is no such thing as total confidentiality anymore, not in medicine and not in most other things. If somebody wants information on you they'll get it.

 

After my daughter got married she became eligible for Tricare and because of this elected to drop her health insurance through American Airlines. About a month after she got married either American or the insurance carrier released some of her health information. I agree, in practice, HIPAA is a joke, but in theory, is is supposed to keep health information private.

 

Sure, start with 45 CFR 164.508, there are a whole lot of others that explain what the exemptions are for different occupations and situations. The DOT exemption comes from the Transportation Act of 1991 (I think that's what it is called) and the Secure Transportation act of 2002.

The former codifies a moratorium on any restrictions to access medical records to determine if a transportation worker is fit to operate a vehicle, be it a truck, a plane or a locomotive. The latter reinforces the first law and it even states the first law and why it is reinforced.

The DOT has a statement, well several to do with physicals and medical privacy, which is on their website, Metalicious mentioned in the quote below.

The thing that is missed is this fact - the medical professional is only covered under HIPAA and HIPAA is not always understood by the medical professional. For example, one thing that is against HIPAA is the sign-in sheet at the doctor's office, It doesn't matter what doctor it is, it is illegal to have that signup sheet because it is an exposure to the person's medical condition.

They all have been legally advised to just have everyone sign releases to cover their *****.

Circling back to the reason for the exemption is a legal issue - revoking HIPAA.

One of the legal aspects of HIPAA is revoking permission, the DOT recognized this as a problem back in the early 90s when people were making the claim that medical records are private. When there was a discussion with the US DOT advisors on the HIPAA committee, this was brought up with many examples of a driver being "caught" not fit to drive and then claiming the DOT and company have no right to the medical records because he revoked HIPAA.

SO this is one a very few reasons for the exemption.

Yes drug testing is between MRO/Collection and the company, so HIPAA limitily applies but we are not talking about drug testing.

NO privacy isn't protected by federal law as you think. There have been many cases where medical records, even after HIPAA was passed where the medical practice just dumped all of them in a dumpster or worse just left them in the building. There were two cases here, one in federal court and one in state court, both cases were tossed because there was no law that said that the practice was liable for those records and the federal case negated the FPA of 74.

It actually is a joke, 90% of what it was to do was not even realized, it like other BS laws changed a lot in the medical industry. It is the most misconstrued law that exists today.

Many are clueless as to what it really is about.


OK NOW THAT SAID ... hope that satisfies a few ... I stated DOT physicals are not protected under the HIPAA law, and that is very true. I can allow any employee to look at any physical they want in the driver's jacket. I can question a condition that I think may be harmful to the public's safety - ALL BECAUSE IT DOES NOT FALL UNDER HIPAA.

HOWEVER, what laws do I and others have to follow when it comes to physicals?


The Americans with Disabilities act - another BS law that is gutless.