A diagnosis of MS does not result in an immediate mandatory revocation
of a commercial driver's license in Texas. However, a commercial
driver's license holder with possible or diagnosed MS is certainly
subject to review and possible revocation or ongoing testing
requirements.
Texas Statutes require that driver's licenses be revoked if a person
is incapable of safely operate a motor vehicle or fails to provide
medical records or fails to undergo medical or other examinations
required by the Texas medical advisory board.
"Transportation Code-Chapter 643"
http://www.capitol.state.tx.us/cgi-bin/cqcgi?CQ_SESSION_KEY=QMNHGISMSOBS&CQ_QUERY_HANDLE=124219&CQ_CUR_DOCUMENT=5&CQ_TLO_DOC_TEXT=YES
The Texas medical advisory board is described here:
"The Medical Advisory Board [HSC Subch. H]
A panel of thirty-five physicians that are appointed by the Texas
Department of Health governs the Medical Advisory Board (MAB). Three
physicians from the panel convene to review possible medical
conditions as they relate to the driving ability of reported Texas
drivers. This panel reviews medical documentation submitted by the
subject?s personal doctor regarding the condition in question.
The Department of Public Safety acts in accordance with the medical
findings of the Medical Advisory Board by enforcing the decisions of
medically incapable or medically approved to drive. A person who is
found medically incapable of safely operating a motor vehicle is
subject to license revocation. [TRC 521.294 (1)]
A Texas driver may be reported to the Medical Advisory Board by
physicians, family, friends, acquaintances, driver license field
personnel, anonymously or by admission of a possible health condition
that may interfere with the safe operation of a motor vehicle upon
application or renewal for a Texas driver license. All reports are
kept confidential and are not included in public records.
If you wish to report a possible medical condition of a Texas driver,
you must be able to identify the Texas driver with full name and date
of birth or Texas driver license number. Please send your written
concern to the Texas Department of Public Safety, PO Box 4087, Austin,
TX 78773-0320, Attention: Driver Improvement Bureau. Note: Verbal
notification is not sufficient information for the Department to take
action."
"Driver Improvement Bureau" Texas Department of Public Safety
http://www.txdps.state.tx.us/administration/driver_licensing_control/dic.htm
"The Texas Department of Public Safety has adopted by reference the
Federal Motor Carrier Safety Regulations...."
"Texas Commercial Motor Vehicle Drivers Handbook" section 13.8, Page
141 http://www.txdps.state.tx.us/ftp/forms/CDLhandbook.pdf
The applicable Federal Regulations are maintained by the Federal Motor
Carrier Safety Administration. The ones applicable to MS state that:
"A person is physically qualified to drive a commercial motor vehicle
if that person:
Has no established medical history or clinical diagnosis of a
rheumatic, arthritic, orthopedic, muscular, neuromuscular or vascular
disease which interferes with the ability to control and operate a
commercial motor vehicle.
Certain diseases are known to have acute episodes of transient muscle
weakness, poor muscular coordination (ataxia), abnormal sensations
(paresthesia), decreased muscle tone (hypotonia), visual disturbances
and pain which may be suddenly incapacitating. With each recurring
episode, these symptoms may become more pronounced and remain for
longer periods of time. Other diseases have more insidious onsets and
display symptoms of muscle wasting (atrophy), swelling and paresthesia
which may not suddenly incapacitate a person but may restrict his/her
movements and eventually interfere with the ability to safely operate
a motor vehicle. In many instances these diseases are degenerative in
nature or may result in deterioration of the involved area.
Once the individual has been diagnosed as having a rheumatic,
arthritic, orthopedic, muscular, neuromuscular or vascular disease,
then he/she has an established history of that disease. The physician,
when examining an individual, should consider the following:
(1) The nature and severity of the individual's condition (such as
sensory loss or loss of strength;
(2) The degree of limitation present (such as range of motion;
(3) The likelihood of progressive limitation (not always present
initially but manifest itself over time;
(4) The likelihood of sudden incapacitation.
If severe functional impairment exists, the driver does not qualify.
In cases where more frequent monitoring is required, a certificate for
a shorter period of time may be issued."
"Medical Advisory Criteria for Evaluation Under 49 CFR Part 391.41"
http://www.fmcsa.dot.gov/rulesregs/fmcsr/medical.htm
Suggested rules specifically relating to Multiple Sclerosis are found
at "CONFERENCE ON NEUROLOGICAL DISORDERS and COMMERCIAL DRIVERS"
Federal Highway Administration (July 1988) pages 28-29
http://www.fmcsa.dot.gov/Pdfs/neuro.pdf. Specifically:
"MULTIPLE SCLEROSIS
Patients with acute, chronic, or relapsing progressive multiple
sclerosis (MS) often accumulate incremental neurologic dysfunction
involving multiple functional subsystems of the central nervous system
at multiple levels. The multiplicity of neurological dysfunction
causes complex disorders of integrated sensory-motor and, in some
cases, cognitive function
which exceeds the simple sum of individual neurological deficits. In
addition, there is a
potential for unpredictable relapses at any time and patients with progressive MS
characteristically suffer from excessive fatiguability and daily
fluctuations in motor
performance. Prolonged physical activity, emotional stress, warm
ambient climate and minor
viral infections are common conditions which are known to transiently
worsen neurological
function in these patients.
Disposition
The complex disorder of integrated sensory-motor function Seen in
acute, chronic, or
relapsing progressive MS is not compatible with the level of motor
skill required for
operation of commercial vehicles, and these patients should not be
approved for licensure.
Some patients with clinically definite MS may have a benign course with minimal
neurologic dysfunction being present even 10 to 15 years after the
onset of the disease.
Patients with clinically benign MS for a duration of at least 5 years
after diagnosis, and
patients with possible or probable MS, may be considered candidates
for licensure to operate
a commercial vehicle if the following conditions apply:
* There are no signs of relapse or progression.
* There are no or only functionally insignificant neurologic signs and symptoms as
determined by a neurologist.
o An MRI and triple evoked potential studies are normal or do not
reveal new lesions
compared to prior evaluations made at least one year apart.
* There is no history of excessive fatiguability or periodic fluctuations of motor
performance especially in relation to heat, physical and emotional
stress and infections.
The disqualification may be appealed to a neurologist or physiatrist
who may recommend
a simulated driving skills test or equivalent functional test (see
Appendix A). If an
applicant wins an appeal, then an on-the-road driving test is required before final
certification. In order. to detect subsequent signs of progression,
the candidate will be
reevaluated annually by a neurologist*, who may again recommend
functional testing (see
Appendix A), and will require a repeat on-the-road driving test."
Sincerely,
Wonko |
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