Osteoporosis Lifting Restrictions

Last updated Apr 10, 2021 at 5:19PM | Published on Aug 18, 2015 | DOT Exams

Commercial driving is considered a heavy duty job.  In addition to driving, CMV driver duties include such rigorous activity as coupling and uncoupling trailers, loading and unloading trailers, inspecting the vehicle, lifting, installing tire chains, climbing ladders, getting in and out of the cab, etc. Musculoskeletal diseases may adversely impact the CMV driver’s muscle strength and agility needed to perform these nondriving tasks.

Quick question about dot clearance for a patient who had L1 compression fracture 4/10/15 from a fall and subsequently found to have severe osteoporosis. He was released to return to work on August 17th however was given a 15 to 20 pound lifting restriction until evaluated by the bone mineral health team in December I am unable to find any specific lifting restrictions corresponding to clearance.  In his current job he would be able to function in this capacity. Is he cleared to drive thank you.

According to the Medical Examiner Handbook:

Driver should be able to:

  • Exercise to a workload capacity greater than 6 Metabolic Equivalents (METs) (through Bruce protocol stage II or equivalent).
  • Attain a heart rate greater than or equal to 85% of predicted maximum (unless on beta blockers).
  • Have a rise in systolic blood pressure greater than or equal to 20 mm Hg without angina.
  • Have no significant ST segment depression.

NOTE: METs — Extensive literature exists on the energy requirements for many physical tasks.

  • Sedentary activity requires fewer than 2 METs. These activities include sitting, slow walking, and lifting light objects of no more than 10 pounds.
  • Light work requires 2 to 4 METs and includes carrying lightweight objects of no more than 20 pounds.
  • Medium work requires 4 to 6 METs and includes carrying moderate weight objects of up to 50 pounds.
  • Heavy and very heavy work requires greater than 6 METs and includes carrying heavy objects and climbing stairs rapidly.

Your driver with a lifting restriction of only 15-20 pounds and with osteoporosis still under evaluation would be in the 2-4 METS light duty range and would not be qualified according to these guidelines.

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2 Comments

  1. Bruce
    Bruce on August 18, 2015 at 10:53 am

    Should the 20 pound lifting restriction be used alone to determine this patients exercise energy expenditure? If the patient is able to do activities exceeding 4 mets ( ie walk on ground level for 15 minutes, climb a flight of stairs, or biking), then that patient would meet the DOT examiner handbook criteria for exercise capacity. If that is correct, then this driver would be able to be cleared provided their lifting requirements do not impede on their ability to load, unload or couple the trailer, tie down straps etc? Thank you.

    • Lawrence Earl, MD
      Lawrence Earl, MD on August 18, 2015 at 11:21 am

      The guidance criteria is the driver should be able to perform at 6 METS. You have to look at the whole picture and make a judgement call on total exercise/lifting capacity. In the example given, this is a vertebral fracture with underlying osteoporosis that is still under evaluation, e.g. not stable. IMHO, this driver would not be qualified.