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FMCSA's Medical Review Board: Five Years of Progress in Commercial Driver Medical Examinations

Hegmann, Kurt T. MD, MPH; Andersson, Gunnar B. J. MD, PhD; Greenberg, Michael I. MD, MPH; Phillips, Barbara MD, MSPH; Rizzo, Matthew MD

Journal of Occupational and Environmental Medicine: April 2012 - Volume 54 - Issue 4 - p 424–430
doi: 10.1097/JOM.0b013e3182480535
Original Articles

Objective: To revise and update guidance recommendations to the Federal Motor Carrier Safety Administration for evaluating commercial drivers.

Methods: The Federal Motor Carrier Safety Administration's medical review board has addressed guidance for commercial drivers for the past 5 years. The processes for most topics involve comprehensive literature searches, evidence reports, medical expert panel reports, critique of the literature, testimony, and decision making.

Results: No quality literature evaluating risk of crash among commercial motor vehicle drivers was found for most medical conditions. Little literature was available for crash risk among all drivers. For select conditions, such as seizure disorders, obstructive sleep apnea, and narcolepsy, there is evidence of increased crash risk among the general driving population and evidence-based guidance is now available.

Conclusions: Detailed guidance from the Medical Review Board is available for assessing commercial drivers with various disorders. Many challenges remain.

Supplemental Digital Content is available in the text.

From the Rocky Mountain Center for Occupational and Environmental Health (Dr Hegmann), University of Utah, Salt Lake City, Utah; Department of Orthopedic Surgery (Dr Andersson), Rush University Medical Center, Chicago, Ill; Department of Emergency Medicine (Dr Greenberg), Drexel University College of Medicine, Philadelphia, Pa; Division of Pulmonary, Critical Care and Sleep Medicine (Dr Phillips), Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Ky; and College of Medicine (Dr Rizzo), Department of Neurology, University of Iowa, Iowa.

Address correspondence to: Kurt T. Hegmann, MD, MPH, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, 391 Chipeta Way, Ste C, Salt Lake City, UT 84108 (

Disclosure: Dr Hegmann served as chair of the FMCSA's Medical Review Board from 2006 to 2010. Dr Greenberg served as co-chair and board member of the FMCSA's Medical Review Board from 2006 to 2009 and Dr Rizzo served as board member from 2006 to 2009. Drs Andersson and Phillips served as board members from 2006 to 2010.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

©2012The American College of Occupational and Environmental Medicine