Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Timothy Prince

Committee Member

Dr. Kathi Harp

Committee Member

Dr. David Mannino


Commercial Driver’s License (CDL) examinees report their medical history during their Federal Motors Carriers Safety Administration (FMCSA) medical certification exams ≤2 years. When the examinees report diagnoses which may impact the control and operation of commercial motor vehicles (CMV), they face scrutiny with decreased medical certification or may be Adam PascoePascoe Page 2 7/18/2018 considered unfit to control and operate a CMV. Medical examiners may have access to the examinees’ electric medical records (EMRs) to generate a deeper appreciation, independent from the examinees’ self-report, of their risk for sudden and/or gradual incapacitation. We do not know how often diagnoses are omitted from the history given to medical examiners and how competent medical examiners can determine diagnoses not reported by the examinee.

We reviewed the EMRs for 210 examinees, whom presented to an Occupational-Medicine clinic in the Northeast (USA), specifically for any diagnoses that may potentially affect the routine control and operation of a CMV. We recorded their demographic information (including employment type), specific diagnoses, and the certification outcome. We also noted which diagnoses were reported to the medical examiner and which diagnoses were elucidated either by review of the medical records or during physical exam.

The 210 examinees in our sample had a mean age of 44.74 yrs [95% CI: 42.97-46.52 yrs], were 5.24% [2.91-9.25%] female, and 19.05% [14.26-24.98%] presented for a new medical certification. There was no statistical significance between the correlation between employment type (i.e., fleet-employee vs. independent owner-operator) and misreport on the examinee (n = 201)- or the diagnosis (n = 630)-level. The examinees failed to report 53% of their diagnosis, and medical examiners were only aware of 17% of additional diagnoses (i.e., those diagnoses not reported by the examinee).

The medical examiner is often making the decision to certify an examinee with an incomplete appreciation of the examinee’s medical history.

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