Effective September 30, the Federal Motor Carrier Safety Administration (FMCSA) has revised the wording of the medical forms physicians use to evaluate truck drivers, encouraging them to look at those with high blood pressure more carefully.
In reality, FMCSA's current medical standard for blood pressure remains unchanged: A person may drive a commercial motor vehicle if he/she “has no current clinical diagnosis of high blood pressure likely to interfere with the ability to operate a commercial motor vehicle safely.”
But beginning Sept. 30, 2004, medical forms will include the following instructions:
Individuals diagnosed with Stage 1 hypertension BP (blood pressure 140/90-159/99) may be certified for one year. At recertification, if BP is equal to or less than 140/90, one-year certification can be issued. However, if BP is higher than 140/90 but lower than 160/100, only a one-time, 3-month certificate can be issued.
Individuals diagnosed with Stage 2 hypertension (BP 160/100-179/109) should be treated and a one-time, 3-month certification can be issued. Once BP is down to 140/90 or lower, they may be recertified annually.
Individuals diagnosed with Stage 3 hypertension (BP equal to or greater than 180/110) should not be certified until their BP is reduced to 140/90 or less. Then they must be recertified every six months.
Individual physicians can decide whether or not they want to use the recommended BP thresholds. According to Christina Cullinan, director of workforce & fleet safety for ATA, however, the new wording underscores the threat of malpractice should a physician exercise judgment that goes outside the instructions. “Medical liability issues are almost always going to disqualify the driver if they don't meet these guidelines.”
William MacLeod, FMCSA director of the office of communications, noted that the new BP guidelines have actually been in place since October 2002. “Although the blood pressure guidelines were changed, there has been no change in the regulation,” MacLeod said. “The guidelines are to help the medical examiner make that determination. The guidelines should — not must — be used. If not used, the medical examiner should document other best practice guidelines and/or data to support his or her decision.”