Hidden Conditions
I know some examiners that have high volume practices and don’t require commercial drivers to disrobe for a DOT physical.
Here’s an interstate driver who popped into a truck stop restaurant to wolf down a burger and fries.
Some would argue that this condition is not likely to be the immediate cause of an accident.
Until the development of an acute deep vein thrombosis or a pulmonary embolus.
But it might prompt an examiner to consider other cardiovascular conditions, and consider risk factors of obesity, possible diabetes, sleep apnea, etc.
How would you certify such a driver?
If multiple conditions are uncovered during the DOT physical “teetering on the edge” one might submit a “determination pending” to allow a complete work up with the primary doctor. Or you could go anywhere from a few months to a year to monitor progression and see if any other conditions rear up. I doubt I’d feel comfortable giving a full 2 year certificate at any rate.
Similarly, many a chest or abdominal surgical scar is missed by not making a simple observation. Joint swelling, bruising, petechiae and rashes can all be missed. I’ve even heard of an examiner not knowing a driver had a prosthetic leg because he never looked!
Make the driver disrobe for their DOT physical. Unfortunately, they’re not all going to be completely forthcoming regarding recent or past surgery and so many other conditions you can pick up with simple observation.
How would you handle the driver above? Let us know in the comments section below!
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I direct your attention to page 41 of the FMCSA Medical Examiner Handbook.
9. Genitourinary System
“You must check for hernias.”
Women are not checked in the genitourinary area for hernias, so I refuse to have that done. I agree to take my shirt off and that is it.
Refusal to have a complete exam performed is grounds for disqualification.
Oh well who cares really?
Its not grounds for disqualification. I refer you to page 51 of the medical handbook by the fmcsa.
It refer to the law which does not require it and only states to note hernia and examine it there is discomfort. Do your homework.
It is up to the medical examiner to decide regarding disqualification. The overall concept here is that many medical conditions may be missed if a driver is fully clothed during the exam. A diligent exam and best accepted medical practice is to have the driver disrobe and don a standard medical gown.
Sounds like grounds to file a discrimination lawsuit. If its indeed an optional test stated by the fmcsa on page 51, and your doc just deciding to dq you with no substantial evidence that the test is needed. I would contact an attorney right away. And if a doctor is worried about any blow back, the exam form citing page 51 of the fmcsa along with a signature from the patient stating no discomfort and opting out of the hernia exam would cover it. Dont use you medical license to bully patients into submission. You must respect the individuals comfort level. If they sign off on said paperwork you would net be held liable.