Commercial Drivers
Certification Process for Drivers with Serious Medical Conditions Gao ID: GAO-08-826 June 30, 2008Millions of drivers hold commercial driver licenses (CDL), allowing them to operate commercial vehicles. The Department of Transportation (DOT) established regulations requiring medical examiners to certify that these drivers are medically fit to operate their vehicles and provides oversight of their implementation. Little is known on the extent to which individuals with serious medical conditions hold CDLs. GAO was asked to (1) examine the extent to which individuals holding a current CDL have serious medical conditions and (2) provide examples of commercial drivers with medical conditions that should disqualify them from receiving a CDL. To examine the extent to which individuals holding CDLs have serious medical conditions, GAO identified those who were in both DOT's CDL database and selected federal disability databases of the Social Security Administration, Office of Personnel Management, and Departments of Veterans Affairs and Labor and have been identified as 100 percent disabled according to the program's criteria. Because DOT's data also include inactive licenses, GAO obtained current CDL data from 12 selected states based primarily on the size of CDL population. To provide case study examples, GAO focused on four states--Florida, Maryland, Minnesota, and Virginia. For 15 drivers identified from data mining, GAO interviewed, as appropriate, the driver, driver's employer, and driver's physician. GAO is not making any recommendations.
Commercial drivers with serious medical conditions can still meet DOT medical fitness requirements to safely operate a commercial vehicle and thus hold CDLs. However, there is general agreement that careful medical evaluations are necessary to ensure that serious medical conditions do not preclude the safe operation of a commercial vehicle. Because medical determinations rely in large part on subjective factors that are not captured in databases, it is impossible to determine from data matching and mining alone the extent to which commercial drivers have medical conditions that preclude them from safely driving a commercial vehicle and therefore if the certification process is effective. GAO's analysis provides a starting point for exploring the effectiveness of the current CDL medical certification process. Our analysis of commercial license data from DOT and medical disability data from the Social Security Administration, Office of Personnel Management, and Departments of Veterans Affairs and Labor found that about 563,000 of such individuals had commercial driver licenses and were determined by the federal government to be eligible for full disability benefits. This represented over 4 percent of all commercial driver licenses in the DOT database. Our analysis of 12 selected states indicates that most of these commercial drivers still have active licenses. Specifically, for these 12 selected states, about 85 percent had a current CDL even though they had a medical condition from which they received full federal disability benefits. The majority of these drivers were issued a CDL after the driver was approved for full federal disability benefit. Our investigations detail examples of 15 cases where careful medical evaluations did not occur on commercial drivers who were receiving full disability benefits for serious medical conditions.
GAO-08-826, Commercial Drivers: Certification Process for Drivers with Serious Medical Conditions
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Report to Congressional Requesters:
United States Government Accountability Office:
GAO:
June 2008:
Commercial Drivers:
Certification Process for Drivers with Serious Medical Conditions:
GAO-08-826:
GAO Highlights:
Highlights of GAO-08-826, a report to congressional requesters.
Why GAO Did This Study:
Millions of drivers hold commercial driver licenses (CDL), allowing
them to operate commercial vehicles. The Department of Transportation
(DOT) established regulations requiring medical examiners to certify
that these drivers are medically fit to operate their vehicles and
provides oversight of their implementation. Little is known on the
extent to which individuals with serious medical conditions hold CDLs.
GAO was asked to (1) examine the extent to which individuals holding a
current CDL have serious medical conditions and (2) provide examples of
commercial drivers with medical conditions that should disqualify them
from receiving a CDL.
To examine the extent to which individuals holding CDLs have serious
medical conditions, GAO identified those who were in both DOT‘s CDL
database and selected federal disability databases of the Social
Security Administration, Office of Personnel Management, and
Departments of Veterans Affairs and Labor and have been identified as
100 percent disabled according to the program‘s criteria. Because DOT‘s
data also include inactive licenses, GAO obtained current CDL data from
12 selected states based primarily on the size of CDL population. To
provide case study examples, GAO focused on four states”Florida,
Maryland, Minnesota, and Virginia. For 15 drivers identified from data
mining, GAO interviewed, as appropriate, the driver, driver‘s employer,
and driver‘s physician. GAO is not making any recommendations.
What GAO Found:
Commercial drivers with serious medical conditions can still meet DOT
medical fitness requirements to safely operate a commercial vehicle and
thus hold CDLs. However, there is general agreement that careful
medical evaluations are necessary to ensure that serious medical
conditions do not preclude the safe operation of a commercial vehicle.
Because medical determinations rely in large part on subjective factors
that are not captured in databases, it is impossible to determine from
data matching and mining alone the extent to which commercial drivers
have medical conditions that preclude them from safely driving a
commercial vehicle and therefore if the certification process is
effective. GAO‘s analysis provides a starting point for exploring the
effectiveness of the current CDL medical certification process.
Our analysis of commercial license data from DOT and medical disability
data from the Social Security Administration, Office of Personnel
Management, and Departments of Veterans Affairs and Labor found that
about 563,000 of such individuals had commercial driver licenses and
were determined by the federal government to be eligible for full
disability benefits. This represented over 4 percent of all commercial
driver licenses in the DOT database. Our analysis of 12 selected states
indicates that most of these commercial drivers still have active
licenses. Specifically, for these 12 selected states, about 85 percent
had a current CDL even though they had a medical condition from which
they received full federal disability benefits. The majority of these
drivers were issued a CDL after the driver was approved for full
federal disability benefit.
Our investigations detail examples of 15 cases where careful medical
evaluations did not occur on commercial drivers who were receiving full
disability benefits for serious medical conditions. The following table
details some of the more egregious examples from our investigation.
Table: Examples of Commercial Drivers with Serious Medical Conditions:
Type of driver: Bus;
State: Florida;
Medical condition: Driver receives disability benefits due to breathing
insufficiency, for which he uses three daily inhalers. He stated that
he ’occasionally blacks out and forgets things,“ but continues to hold
a CDL and be hired as a substitute bus driver, despite not having the
required medical certificate.
Type of driver: Bus;
State: Minnesota;
Medical condition: Driver receives disability benefits due to epilepsy.
He also suffers from headaches, sleep apnea, asthma, and high blood
pressure. Driver and medical examiner agreed that if the driver felt
’loopy“ he would not drive a commercial vehicle.
Type of driver: Truck;
State: Florida;
Medical condition: Driver receives disability benefits for multiple
sclerosis, which causes fatigue. Driver hauls circus equipment to
various shows, despite not having the required medical certificate.
Type of driver: Truck;
State: Maryland;
Medical condition: Driver receives disability benefits for complete
deafness. Medical examiner acknowledged error in certifying medical
fitness of driver.
Source: GAO.
[End of table]
To view the full product, including the scope and methodology, click on
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-826]. For more
information, contact Greg Kutz at (202) 512-6722 or kutzg@gao.gov.
[End of section]
Contents:
Letter:
Results in Brief:
Background:
Serious Medical Conditions and Commercial Driver Licenses:
Examples of Commercial Drivers with Serious Medical Conditions:
Agency Comments and Our Evaluation:
Appendix I: Scope and Methodology:
Appendix II: Medical Certificate Requirements:
Appendix III: Information on Commercial Drivers for the 12 Selected
States:
Appendix IV: Methods Used by States to Verify Commercial Driver Medical
Certification:
Appendix V: Commercial Drivers with Serious Medical Conditions:
Appendix VI: Staff Acknowledgments:
Tables:
Table 1: NTSB's Recommendations to FMCSA for Preventing Unqualified
Drivers from Operating Commercial Vehicles:
Table 2: Summary Information on Five Commercial Drivers with Active
Licenses despite Serious Medical Conditions:
Table 3: Detail Information on Commercial Drivers for 12 Selected
States:
Table 4: Summary Information on Remaining 10 Commercial Drivers with
Serious Medical Conditions:
Figures:
Figure 1: CDL Drivers Receiving Full Federal Disability Benefits for 12
Selected States:
Figure 2: State Methods to Verify Medical Certification:
Abbreviations:
CDL: Commercial Driver License:
CDLIS: Commercial Driver License Information System:
COPD: Chronic Obstructive Pulmonary Disorder:
DOL: Department of Labor:
DOT: Department of Transportation:
FMCSA: Federal Motor Carrier Safety Administration:
NTSB: National Transportation Safety Board:
OPM: Office of Personnel Management:
SPE: Skills Performance Evaluation:
SSA: Social Security Administration:
VA: Department of Veterans Affairs:
[End of section]
United States Government Accountability Office:
Washington, DC 20548:
June 30, 2008:
The Honorable James L. Oberstar:
Chairman:
Committee on Transportation and Infrastructure:
House of Representatives:
The Honorable Peter A. DeFazio:
Chairman:
Subcommittee on Highways and Transit:
Committee on Transportation and Infrastructure:
House of Representatives:
Millions of American drivers hold commercial driver licenses (CDL),
allowing them to operate a variety of commercial vehicles such as
school buses, cargo vans, and tractor trailers. To help prevent
accidents resulting from commercial drivers with medical conditions,
federal law requires medical examiners to certify that commercial
drivers are medically fit to operate their vehicles. Specifically, the
Department of Transportation (DOT) requires commercial drivers to
undergo a medical physical examination at least every 2 years. As part
of this medical physical, DOT regulations establish standards that the
medical examiner must follow to determine a driver's fitness including
reviewing the driver's medical history, performing key medical tests
(such as vision and hearing tests), and conducting a physical
examination of the commercial driver. Notwithstanding these written
regulations, medical examiners must still exercise judgment in
determining whether individuals are medically fit to drive commercial
vehicles, such as people whose serious medical conditions make them
eligible for federal disability benefits.
Not all serious medical conditions interfere with the safe operation of
a commercial vehicle. However, some serious medical conditions can and
should disqualify a driver from being medically certified according to
DOT regulations.
It is unknown to what extent individuals with serious medical
conditions hold CDLs and whether there are situations of medically
unfit individuals who hold a CDL. In this context, you asked us to (1)
determine to the extent possible the number of individuals holding a
current CDL who have serious medical conditions, and (2) provide case-
study examples of commercial drivers who hold an active CDL despite
having a medical condition that should disqualify them from obtaining a
CDL.
To explore the overlap between CDL holders and people with serious
medical conditions, we identified individuals who were in both DOT's
Commercial Driver License Information System (CDLIS) database and
selected federal disability databases. We presumed that individuals
receiving full federal disability benefits were eligible for these
benefits because of the seriousness of their medical conditions. DOT's
CDLIS database contains an archive of all CDLs reported to DOT by the
states. We obtained this database and compared the CDL holders from
CDLIS with the disability recipients of selected federal programs
administered by the Social Security Administration (SSA), Department of
Veterans Affairs (VA), Office of Personnel Management (OPM), and
Department of Labor (DOL). Specifically, we identified CDL holders that
are both currently receiving disability benefits and have been
identified as 100 percent disabled according to the program's criteria.
We further analyzed the recipient files to extract those medical
conditions that would likely disqualify a driver from a CDL, such as
deafness and epilepsy. Because CDLIS contains inactive CDLs in its
population, we obtained data of active CDLs from a nonrepresentative
selection of 12 states to identify those CDL holders in CDLIS that have
an active CDL.[Footnote 1] Further, because commercial drivers may
contract a serious medical condition after the issuance of the CDL, we
determined the number of individuals that received their CDL subsequent
to the federal agencies determination that the individual is eligible
for full benefits due to their medical condition. In addition, our
estimate does not include drivers with severe medical conditions that
are not in the selected federal programs we analyzed.
To provide case-study examples of commercial drivers who hold active
CDLs and also receive full federal benefits due to a CDL disqualifying
medical condition, we focused on four states as agreed to with your
staff--Florida, Maryland, Minnesota, and Virginia. From these four
states, we selected, for detailed investigation, 15 commercial drivers
that we identified based on our data analysis and mining. For each
case, we interviewed, as appropriate, the commercial driver, the
driver's employer, and the driver's physician to determine whether,
under current DOT regulations and guidelines, the medical condition
should have precluded the driver from holding a valid CDL. For these 15
cases, we also reviewed relevant state department of motor vehicle
reports, police reports, and other public records.
We performed our investigative work from May 2007 to June 2008 in
accordance with standards prescribed by the President's Council on
Integrity and Efficiency. A detailed discussion of our scope and
methodology is presented in appendix I.
Results in Brief:
Commercial drivers with serious medical conditions, even those whose
conditions qualify them for full federal disability benefits, can still
meet DOT medical fitness requirements to safely operate a commercial
vehicle and thus hold CDLs. However, there is general agreement that
careful medical evaluations are necessary to ensure that serious
medical conditions do not preclude the safe operation of a commercial
vehicle. Because medical determinations rely in large part on
subjective factors that are not captured in databases, it is impossible
to determine from data mining and matching the extent to which
commercial drivers have medical conditions that preclude them from
safely driving a commercial vehicle and therefore if the certification
process is effective. As such our analysis provides a starting point
for exploring the effectiveness of the current CDL medical
certification process.
Our analysis of commercial license data from DOT and medical disability
data from SSA, VA, OPM, and DOL found that about 563,000 individuals
had CDLs and were determined by the federal government to be eligible
for full federal benefits due to their medical condition.[Footnote 2]
This represented over 4 percent of all CDLs in the DOT database.
Further, our analysis also showed that over 1,000 of these drivers were
diagnosed with vision, hearing, or seizure disorders, which are medical
conditions that would generally deny the granting of a CDL.
While some of the 563,000 commercial drivers may have inactive
licenses, our analysis of 12 selected states indicates that most of
these commercial drivers still have active licenses. Specifically, of
the 563,000 CDL holders receiving full disability benefits, about
135,000 were from our 12 selected states. Of these 135,000 commercial
drivers, about 114,000, or approximately 85 percent, had a current CDL
while also receiving full federal disability benefits. Further,
approximately 85,000, or about 63 percent of the active commercial
drivers from the 12 selected states, were issued a CDL after the driver
was approved for full federal benefits.
Our investigations detail examples of 15 cases where careful medical
evaluations did not occur on commercial drivers with serious medical
conditions. Some of the more egregious examples of our investigations
include the following:
* A bus driver in Maryland has been receiving Social Security
disability benefits since March 2006 due to his heart conditions. In
June 2006, approximately 3 months after Social Security determined the
driver was fully disabled, the Maryland driver license agency renewed
his CDL. The bus driver provided our investigator a forged medical
certificate. Specifically, we found that (1) the medical certificate
did not have the required medical license number; (2) the physician did
not have any record that the bus driver underwent a medical examination
for a CDL; and (3) the physician denied conducting a CDL medical exam
or signing the medical certificate.
* A truck driver has received SSA disability benefits for over 10 years
for several medical conditions, including complications due to an
amputation. The truck driver stated he has a prosthetic right leg due
to a farm accident in 1985. Drivers with amputations are disqualified
unless they obtain a Skills Performance Evaluation (SPE) from DOT. To
test his prosthetic leg, the truck driver stated that he was required
to push the doctor across the room in a rolling chair. The doctor
signed the medical certificate without indicating that an SPE must be
obtained from DOT.
We provided a draft of our report to DOT for review and comment. In
response to our draft, DOT commented that our first objective
incorrectly implied that individuals who are fully disabled with severe
medical conditions cannot safely drive commercial vehicles. In
addition, DOT stated that our report did not accurately characterize
the 15 cases where careful medical evaluations did not occur because 9
drivers were not evaluated by a medical examiner. We believe our report
clearly acknowledges that it is impossible to determine the extent to
which these commercial drivers have a medical condition that would
preclude them from safely driving a commercial vehicle and that our
analysis simply provides a starting point for exploring the
effectiveness of the current CDL medical certification process. We also
believe that we fairly characterize that all 15 cases did not have a
careful medical evaluation because for all 15 cases the medical
evaluation was inadequate or did not occur. DOT also provided us a
technical comment which we incorporated in the report. See the "Agency
Comments and Our Evaluation" section of this report for a more detailed
discussion of agency comments from DOT.
Background:
The loss of lives and property resulting from commercial motor vehicle
accidents has been a focus of public concern for several years. In
2006, about 5,300 people died as a result of crashes involving large
commercial trucks or buses, and about 126,000 more were injured.
[Footnote 3] A recent study performed by DOT showed that a significant
number of commercial driver crashes were due to a physical impairment
of the driver. Specifically, DOT found that about 12 percent of the
crashes where the crash cause could be identified were due to drivers
falling asleep, being disabled by a heart attack or seizure, or other
physical impairments.[Footnote 4]
The Federal Motor Carrier Safety Administration (FMCSA) within DOT
shoulders the primary federal responsibility for reducing crashes,
injuries, and fatalities involving large trucks and buses. FMCSA's
primary means of preventing these crashes is to develop and enforce
regulations to help ensure that drivers and motor carriers are
operating in a safe manner. FMCSA's regulations, among other things,
require that drivers of commercial motor vehicles are 21 years old, can
read and speak the English language, have a current and valid
commercial motor vehicle operator's license, have successfully
completed a driver's road test, and are physically qualified to drive.
[Footnote 5] As part of these regulations, FMCSA established standards
for the physical qualifications of commercial drivers, including the
requirement of a medical certification from a medical examiner stating
that the commercial driver is physically qualified to operate a
commercial motor vehicle.[Footnote 6] See appendix II for a description
of the federal medical requirements.[Footnote 7]
The National Transportation Safety Board (NTSB),[Footnote 8] an
independent federal agency that investigates transportation accidents,
considers the medical fitness of commercial drivers a major concern.
Over the past several years, NTSB has reported on serious flaws in the
medical certification process of commercial drivers. NTSB stated that
these flaws can lead to increased highway fatalities and injuries for
commercial vehicle drivers, their passengers, and the motoring public.
In 2001 NTSB recommended eight safety actions to improve the oversight
of the medical certification process, in response to a bus crash that
killed 22 people in Louisiana. According to NTSB, currently all eight
of the recommendations remain open. In response to FMCSA's failure to
adequately address NTSB's recommendations, NTSB placed the oversight of
medical fitness on its "Most Wanted" list in 2003. Table 1 details each
of NTSB's recommendations.
Table 1: NTSB's Recommendations to FMCSA for Preventing Unqualified
Drivers from Operating Commercial Vehicles:
Description of NTSB recommendations:
1. Individuals performing medical examinations for drivers are
qualified to do so and are educated about occupational issues for
drivers.
2. Every prior application by an individual for medical certification
is recorded and reviewed.
3. Medical certification regulations are updated periodically to permit
trained examiners to clearly determine whether drivers with common
medical conditions should be issued a medical certificate.
4. Individuals performing examinations have specific guidance and a
readily identifiable source of information for questions on such
examinations.
5. The review process prevents, or identifies and corrects, the
inappropriate issuance of medical certification.
6. Enforcement authorities can identify invalid medical certification
during safety inspections and routine stops.
7. Enforcement authorities can prevent an uncertified driver from
driving until an appropriate medical examination takes place.
8. Mechanisms for reporting medical conditions to the medical
certification and reviewing authority and for evaluating these
conditions between medical certification exams are in place, and that
individuals, health care providers, and employers are aware of these
mechanisms.
Source: NTSB.
[End of table]
Several fatality crashes highlight the need for and the importance of
having an effective medical certificate process. For example,
* In July 2000, a truck collided with a Tennessee Highway Patrol
vehicle protecting a highway work zone. The patrol car exploded at
impact, killing the state trooper. The driver of the truck had
previously been diagnosed with sleep apnea and hypothyroidism, and had
a similar crash in 1997, when he struck the rear of a patrol car in
Utah. NTSB stated that it believes that if a comprehensive medical
oversight program been in place at the time of the accident, this
driver, with known and potentially incapacitating medical conditions,
would have been less likely to have been operating a commercial
vehicle. This accident, the NTSB said, "demonstrates how easily unfit
drivers are able to take advantage of the inadequacies of the current
medical system, resulting in potentially fatal consequences."
* In May 2005, a truck collided with a sports utility vehicle in Kansas
killing a mother and her 10-month-old baby. Prior to the accident, a
physician diagnosed the truck driver with a severe form of sleep apnea.
The truck driver subsequently went to another physician who issued the
medical certificate because the driver did not disclose this illness.
The truck driver was found guilty of two counts of vehicular
manslaughter.
* In August 2005 in New York, a truck collided with a motor vehicle,
killing the occupants. The truck driver admitted to forging a medical
certificate required to get his CDL license because he had been
diagnosed with a seizure disorder. The truck driver recently pled
guilty of two counts of manslaughter.
Serious Medical Conditions and Commercial Driver Licenses:
Commercial drivers with serious medical conditions can still meet DOT
medical fitness requirements to safely operate a commercial vehicle and
thus hold CDLs. However, there is general agreement that careful
medical evaluations are necessary to ensure that serious medical
conditions do not preclude the safe operation of a commercial vehicle.
It is impossible to determine from data analysis which commercial
drivers receiving disability benefits have a medical condition that
precludes them from safely driving a commercial vehicle because medical
determinations are largely based on subjective factors that are not
captured in databases. As such our analysis provides a starting point
for exploring the effectiveness of the current CDL medical
certification process.
Our analysis of DOT data and disability data from the four selected
federal agencies, SSA, VA, OPM, and DOL, found that about 563,000
individuals had been issued CDLs and were receiving full medical
disability benefits.[Footnote 9] This represented over 4 percent of all
CDLs in the DOT database. However, because DOT's database does include
drivers that had suspended, revoked, or lapsed licenses,[Footnote 10]
the actual number of active commercial drivers that receive full
federal disability benefits cannot be determined. Also, our analysis
does not include drivers with severe medical conditions that are not in
the specific disability programs we selected.
The majority of the individuals with serious medical conditions from
our 12 selected states had an active CDL. Specifically, as shown in
figure 1, of the 563,000 CDL holders receiving full disability
benefits, about 135,000 of those individuals were from our 12 selected
states. About 114,000 of these 135,000 individuals, or about 85
percent, had an active CDL according to CDL data provided by the 12
selected states.
Further, our analysis of the state CDL data indicates that most of the
licenses were issued after the commercial driver was found to be
eligible for full disability benefits. Specifically, about 85,000 of
the 135,000 individuals, or about 63 percent, had their CDL issued
after the federal agency determined that the individual met the federal
requirements for full disability benefits according to data from our
four selected federal agencies. See appendix III for details for each
selected state for the number of (1) commercial drivers with active
CDLs, (2) commercial drivers with an active CDL even though they had a
medical condition from which they received full federal disability
benefits, and (3) commercial drivers that were issued a CDL after the
driver was approved for full federal disability benefit payments.
Figure 1: CDL Drivers Receiving Full Federal Disability Benefits for 12
Selected States:
[See PDF for image]
This figure is an illustration of CDL drivers receiving full federal
disability benefits for 12 selected states, as follows:
Data match:
DOT CDL data are matched against data from four federal agencies
administering disability programs.
50-state population:
Total 50-state population of CDL holders receiving medical disability
is 563,000.
12-state analysis (135,000):
12 states are selected for analysis: CA, FL, IL, KY, MD, MI, MN, MT,
TN, TX, VA, WI.
85% of licenses are active:
114,000 licenses (85%) are still active despite conditions including
vision, hearing, and seizure disorders.
63% are active and issued after disability:
85,000 licenses (63%) have an issue date after disability benefit start
date.
Source: GAO (data), Art Explosion (graphics).
[End of figure]
Because much of the determination of the medical fitness of commercial
drivers relies on subjective factors, and because there are ways to
circumvent the process (as shown below), it is impossible to determine
the extent to which these commercial drivers have a medical condition
that would preclude them from safely driving a commercial
vehicle.[Footnote 11] As such our analysis provides a starting point
for exploring the effectiveness of the current CDL medical
certification process. However, because these individuals are receiving
full disability benefits, it is likely that these medical conditions
are severe. Further, our analysis also showed that over 1,000 of these
drivers are diagnosed with vision, hearing, or seizure disorders, which
are medical conditions that would routinely deny the granting of a CDL.
Examples of Commercial Drivers with Serious Medical Conditions:
Our investigations detail examples of 15 cases where careful medical
evaluations did not occur on commercial drivers who were receiving full
medical disability benefits. The case studies were selected from
approximately 30,000 individuals from Florida, Maryland, Minnesota, and
Virginia that had their CDL issued after the federal agency determined
that the individual met the federal requirements for full medical
disability benefits. For all 15 cases, we found that the states renewed
the drivers' CDLs after the drivers were found by the federal
government to be eligible for full disability benefits. For more
detailed information on criteria for selection of the 15 cases, see
appendix I.
On the basis of our investigation of these 15 cases, we identified
instances where careful medical examinations did not occur. Most states
do not require commercial drivers to provide medical certifications to
be issued a CDL. Instead, many states only require individuals to self-
certify that a medical examiner granted them a medical certification
allowing them to operate commercial vehicles, thus meeting the minimum
federal requirements.[Footnote 12] As a result, we found several
commercial drivers who made false assertions on their self-
certification that they received a medical certification when in fact
no certification was made. For more information on state requirements
for medical certifications, see appendix IV.
In addition, our investigations found that commercial drivers produced
fraudulent documentation regarding their medical certification.
Specifically, we found instances where commercial drivers forged a
medical examiner's signature on a medical certification form. In
addition, we also found a driver who failed to disclose to the medical
examiner that another doctor had prescribed him morphine for his back
pain.
Finally, our investigations found certain medical examiners did not
follow the federal requirements in the determination of medical fitness
of commercial drivers. For example, one medical examiner represented to
GAO that she did not know that a driver's deafness would disqualify the
individual from receiving a medical certification.
Table 2 highlights 5 of the 15 drivers we investigated. For all cases
we investigated, the CDL was issued after the driver's disability
benefits started. Appendix V provides details on the other 10 cases we
examined. We are referring all 15 cases to the respective state driver
license agency for further investigation.
Table 2: Summary Information on Five Commercial Drivers with Active
Licenses despite Serious Medical Conditions:
Case: 1;
State: Maryland;
Details:
* Bus driver receives Social Security disability benefits since March
2006 due to an aneurysm of the aorta and valvular heart disease;
* Three months after disability determination, the state renewed bus
driver's CDL for 5 years;
* The bus driver provided our investigator a forged medical
certificate, without the required medical license number. Medical
examiner denied conducting CDL medical exam or signing the medical
certificate.
Case: 2;
State: Virginia;
Details:
* Truck driver receives Social Security disability benefits since 1995
for leg amputation, among other medical conditions;
* Medical examiner did not require truck driver to obtain the mandatory
Skills Performance Evaluation (SPE);
* In 2007, the state driver license agency renewed driver's CDL for 5
years with a "Tanker" endorsement.
Case: 3;
State: Florida;
Details:
* Bus driver receives Social Security disability benefits since 1994
for chronic obstructive pulmonary disorder (COPD)[A];
* Bus driver currently uses three daily inhalers to control breathing,
and stated that he "occasionally blacks out and forgets things;"
* Driver continues to be hired as a substitute bus driver, despite not
having a medical certificate;
* Bus driver's CDL expires in 2010.
Case: 4;
State: Minnesota;
Details:
* Bus driver receives Social Security disability benefits since 2004
for epilepsy, among other medical conditions;
* Medical examiner certified the driver in 2007 despite previously
prescribing him daily antiseizure medication. DOT guidance states that
this disqualifies the driver;
* The driver and medical examiner agreed that if the driver felt
"loopy" he would not drive a commercial vehicle;
* Driver stated that he also suffers from headaches, sleep apnea,
asthma, and high blood pressure;
* The state driver license agency renewed the CDL for 4 years in 2007.
Case: 5;
State: Florida;
Details:
* Truck driver receives Veteran Affairs disability benefits since 1990
for multiple sclerosis;
* Driver stated that the medical condition causes fatigue;
* Driver stated that the last medical certificate received was in the
late 1990s;
* The driver's relative occasionally employs the driver to haul circus
equipment to various shows, despite not having a current medical
certificate;
* The state driver license agency renewed the CDL for about 4 years in
2007.
Source: GAO.
[A] Chronic obstructive pulmonary disease (COPD) is a term referring to
two lung diseases, chronic bronchitis and emphysema.
[End of table]
The following provides illustrative detailed information on three of
the cases we examined.
Case 1: A bus driver in Maryland has been receiving Social Security
disability benefits since March 2006 due to his heart conditions.
Specifically, the driver had open heart surgery in 2003 to repair a
ruptured aorta, had a stroke in 2005, and shortly thereafter had
another surgery to replace a heart valve. In June 2006, approximately 3
months after Social Security determined the driver was fully disabled;
the Maryland driver license agency renewed his CDL for 5 years with a
"Passenger" endorsement. The bus driver provided our investigator a
forged medical certificate. Specifically, we found that:
* the medical certificate did not have the required medical license
number;
* the physician did not have any record that the bus driver underwent a
medical examination for a CDL, and:
* the physician denied conducting a CDL medical exam or signing the
medical certificate.
Surprisingly, the medical practice also had a copy of the forged
medical certificate in its files. The medical practice's staff stated,
however, that it is not uncommon for a patient to bring documents to
the office and ask that they be stored in their medical records. The
driver's CDL does not expire until 2011.
Case 2: A Virginia truck driver has received SSA disability benefits
for over 10 years. The driver's disability records indicate that that
driver had multiple medical conditions, including complications due to
an amputation, and that the driver is "also essentially illiterate."
[Footnote 13] The truck driver has a prosthetic right leg resulting
from a farm accident. Although the driver possesses a current medical
certificate, the medical examiner did not specify on the medical
certificate that it is only valid when accompanied with a Skills
Performance Evaluation (SPE) certificate.[Footnote 14] To test his
prosthetic leg, the truck driver stated that he was asked to push the
medical examiner across the room in a rolling chair with the prosthetic
leg. In our investigation, we attempted to contact the medical examiner
but discovered that he is no longer employed by that clinic. The state
revoked his medical license due to illegally distributing controlled
substances.
In 2006, the truck driver was involved in a single vehicle accident
when the load in his truck shifted when making a turn and the truck
overturned. Prior to October 2007, the truck driver had a CDL with both
"Tanker" and "Hazmat" endorsements. In October 2007, the state driver
license agency renewed his CDL with a "Tanker" endorsement, which will
not expire until 2012.
Case 3: A bus driver has been receiving Social Security disability
benefits since 1994 for chronic obstructive pulmonary disorder (COPD).
The bus driver currently uses three daily inhalers to control his
breathing and has a breathing test conducted every 6 months. The bus
driver stated that he "gets winded" when he walks to his mailbox and he
"occasionally blacks out and forgets things." However, the driver
stated that he has no problem driving a bus, however, he cannot handle
luggage or perform any other strenuous duties.
Despite not possessing a valid medical certificate, companies continue
to hire him as a bus driver on an ad hoc basis. For example, the driver
drove a passenger bus as recently as 1 month prior to the time of our
interview. The driver stated that the companies have not asked to see
his medical certificate. He further stated that because most companies
are "hurting for drivers," they "don't ask a lot of questions" and pay
many of their drivers in cash. The driver's CDL expires in 2010.
Agency Comments and Our Evaluation:
We provided a draft of our report to DOT for review and comment. We
received e-mail comments on the draft on June 16, 2008, from FMCSA's
Office of Medical Programs. In FMCSA's response, FMCSA stated that our
first objective implies that individuals who are fully disabled have
severe medical conditions that may also prevent safe driving. FMCSA
stated the following:
* Disability, even full disability associated with a diagnosis, does
not necessarily mean that an individual is medically unfit to operate a
commercial vehicle.
* Disability is not related necessarily to when a medical condition
occurred or recurs. The onset of a disease or disabling medical
condition is more relevant to medical fitness than when the disability
benefits and payments began. As an example, a fully disabled individual
may have accommodated to the disability and may improve with treatment
while receiving lifelong disability payments.
* In general, a medical diagnosis alone is not adequate to determine
medical fitness to operate a commercial vehicle safely. As an example,
multiple sclerosis, while disabling, has several progressive phases,
and is not necessarily disqualifying.
In addition, FMCSA did not believe that we accurately characterized the
15 cases where careful medical evaluations did not occur. FMCSA stated
that this implies these drivers were evaluated by someone for medical
fitness for duty, but in 9 cases, the driver was not certified or not
evaluated by a medical examiner.
We believe our report clearly acknowledges that it is impossible to
determine the extent to which these commercial drivers have medical
conditions that would preclude them from safely driving a commercial
vehicle. In the report, we state that commercial drivers with serious
medical conditions can still meet DOT medical fitness requirements to
safely operate a commercial vehicle and thus hold CDLs. Further, our
report acknowledged that because medical determinations rely in large
part on subjective factors that are not captured in databases, it is
impossible to determine from data mining and matching the extent to
which commercial drivers have a medical condition that precludes them
from safely driving a commercial vehicle and therefore if the
certification process is effective. Thus, our analysis provides a
starting point for exploring the effectiveness of the current CDL
medical certification process.
We also believe that we fairly characterize that all 15 cases did not
have a careful medical evaluation. For all 15 cases that we reviewed,
we found that the medical evaluation was not adequate or did not occur.
Thus, we conclude that a careful medical evaluation did not occur for
all 15 drivers in our case studies.
FMCSA also provided us a technical comment which we incorporated in the
report.
As agreed with your offices, unless you publicly release its contents
earlier we plan no further distribution of this report until 30 days
from its date. At that time, we will send copies of this report to the
Secretary of Transportation. We will make copies available to others
upon request. In addition, the report will be available at no charge on
the GAO Web site at [hyperlink, http://www.gao.gov].
Please contact me at (202) 512-6722 or kutzg@gao.gov if you have any
questions concerning this report. Contact points for our Offices of
Congressional Relations and Public Affairs may be found on the last
page of this report. GAO staff who made key contributions to this
report are listed in appendix VI.
Signed by:
Gregory D. Kutz:
Managing Director:
Forensic Audits and Special Investigations:
[End of section]
Appendix I: Scope and Methodology:
To determine to the extent possible the number of individuals holding a
current commercial driver license (CDL) who have serious medical
conditions, we presumed that individuals receiving full federal
disability benefits were eligible for these benefits because of the
seriousness of their medical conditions. As such, we obtained and
analyzed the Department of Transportation's (DOT) Commercial Driver
License Information System (CDLIS) database as of May 2007. For the
Social Security Administration (SSA) and the Department of Veterans
Affairs (VA) we provided the CDLIS commercial driver information to
those agencies. SSA and VA then matched the commercial drivers to the
individuals receiving benefits for their disability programs and
provided us those results. We also obtained and analyzed the recipient
files for four additional federal disability programs. These include
the Office of Personnel Management's (OPM) civil service retirement
program and the three programs administered by the Department of Labor:
Black Lung, Federal Employee Compensation Act, and the Energy Employees
Occupational Illness Compensation Program. We matched the CDL holders
from CDLIS to the four federal disability recipient files based on
social security number, name, and date of birth. We further analyzed
the CDL and disability data to ensure that the commercial drivers met
the following criteria:
* the individual must be currently receiving disability benefits, and:
* the individual must be identified as 100 percent disabled[Footnote
15] according to the program's criteria.
Because CDLIS is an archival database, the CDLIS data contain
information on expired CDLs. To identify the active drivers within
CDLIS, we obtained CDL data from a nonrepresentative selection of 12
states. The 12 selected states, representing about 42 percent of all
CDLs contained in CDLIS, are: California, Florida, Illinois, Kentucky,
Maryland, Michigan, Minnesota, Montana, Tennessee, Texas, Virginia, and
Wisconsin. The 12 states were selected primarily based on the size of
the CDL population. Because commercial drivers may contract a serious
medical condition after the issuance of the CDL, we also determined the
number of individuals that received their CDL subsequent to when the
federal agencies determined the individual to be eligible for full
disability benefits. Our estimate does not include drivers with severe
medical conditions that are not in the selected programs we analyzed.
We matched the 12 state CDL files to the six CDLIS-disability match
files based on driver license number, and identified those CDLs that
were current based on license status.
To provide case-study examples of commercial drivers who hold active
CDLs while also receiving federal disability payments for a
disqualifying medical condition, we focused on four states--Florida,
Maryland, Minnesota, and Virginia. From these four states, we selected,
in a nonrepresentative fashion, 15 commercial drivers for detailed
investigation. We identified these driver cases based on our data
analysis and mining. For each case, we interviewed, as appropriate, the
commercial driver, the driver's employer, and the driver's physician to
determine whether the medical condition should have precluded the
driver from holding a valid CDL. For these 15 cases, we also reviewed
state department of motor vehicle reports, police reports, and other
public records.
Data Reliability:
To determine the reliability of DOT's CDLIS data, we used SSA's
Enumeration and Verification System to verify key data elements in the
database that were used to perform our work.
For the federal disability databases, we assessed the reliability of
the data from SSA and VA, which comprise 99 percent of the CDLIS-
disability matches. To verify its reliability, we reviewed program
logic used by the agencies to match the CDLIS data with their federal
disability recipients. We also reviewed the current Performance and
Accountability Reports for the agencies to verify that their systems
had successfully undergone the required stewardship reviews.
For the 12 selected states' CDL databases, we performed electronic
testing of the specific data elements in the database that were used to
perform our work. In addition, for 5 of the 12 states we verified the
query logic used to create the CDL extract files. For the other 7
states we were unable to obtain the query logic.
We performed our investigative work from May 2007 to June 2008 in
accordance with standards prescribed by the President's Council on
Integrity and Efficiency.
[End of section]
Appendix II: Medical Certificate Requirements:
Federal regulations require that commercial drivers be examined and
certified by a licensed medical examiner, such as licensed physician,
physician's assistant, and nurse practitioner, to ensure they meet
minimum physical qualifications prior to driving. It is the
responsibility of both drivers and motor carriers employing drivers to
ensure that drivers' medical certificates are current. According to
federal regulations, the medical examiner must be knowledgeable about
the regulatory physical qualifications and guidelines as well as the
driver's responsibilities and work environment. In general, the medical
certification procedures include the following steps:
* The driver completes and certifies a medical certification form that
includes information about the driver's health history. The form is
provided to the medical examiner as part of the examination.
* The medical examiner discusses the driver's health history and the
side effects of prescribed medication and common over-the-counter
medications.
* The medical examiner tests the driver's vision, hearing, blood
pressure, pulse rate, and urine specimen (for testing sugar and protein
levels).
* The medical examiner conducts a physical examination and makes a
determination on driver fitness.
* If the medical examiner determines the driver is fit to drive, he/she
signs the medical certificate, which the driver must carry with his/her
license. The certificate must be dated. The medical examiner keeps a
copy in his/her records, and provides a copy to the driver's employer.
* When the medical examiner finds medical conditions that prevent
certification of the physical condition of the driver and this finding
is in conflict with the findings of another medical examiner or the
driver's personal physician, the driver can apply to the Federal Motor
Carrier Safety Administration (FMCSA) for a determination.
Federal regulations and the accompanying medical guidance provide
criteria to the medical examiners for determining the physical
condition of commercial drivers. Although the medical examiner makes
the determination as to whether the driver is medically fit to operate
a commercial vehicle, the following provides a general overview of the
nature of the physical qualifications:
* no loss of physical limbs, including a foot, a leg, a hand, or an
arm;
* no impairment of limbs that would interfere with grasping or their
ability to perform normal tasks;[Footnote 16]
* no established medical history or clinical diagnosis of diabetes
currently requiring insulin for control, respiratory dysfunction, or
high blood pressure that would affect their ability to control or drive
a commercial motor vehicle;
* no current diagnosis of a variety of coronary conditions and
cardiovascular disease including congestive heart failure;
* no mental disease or psychiatric disorder that would interfere with
their ability to drive a commercial vehicle safely;
* has distant visual acuity and hearing ability that meets stated
standards;
* does not use a controlled substance or habit-forming drug; and:
* has no current clinical diagnosis of alcoholism.
When operating a commercial motor vehicle, drivers must have a copy of
the medical examiner's certificate in their possession.[Footnote 17]
Motor carriers, in turn, are required to maintain a copy of the
certificate in their files. When drivers are stopped for a roadside
inspection, state inspectors can review the medical examiner's
certificate. During compliance reviews of motor carriers, FMCSA
investigators may also verify the validity of medical certifications on
file with the motor carrier.
[End of section]
Appendix III: Information on Commercial Drivers for the 12 Selected
States:
In the main portion of the report, we state that from the 12 selected
states 114,000 commercial drivers had a current commercial driver
license (CDL) even though they had a medical condition from which they
received full federal disability benefits. Further, approximately
85,000, or about 63 percent of the active commercial drivers, were
issued a CDL after the driver was approved for full federal disability
benefit payments. Table 3 below provides details by each selected state
on the number of (1) commercial drivers with active CDLs, (2)
commercial drivers with an active CDL even though they had a medical
condition from which they received full federal disability benefits,
and (3) commercial drivers that were issued a CDL after the driver was
approved for full federal disability benefit payments.
Table 3: Detail Information on Commercial Drivers for 12 Selected
States:
State: California;
Drivers with active CDLs: 683,300;
Drivers with active CDLs receiving full federal disability payments:
11,600;
Drivers where CDL issued after full federal disability was approved:
6,600.
State: Florida;
Drivers with active CDLs: 603,700;
Drivers with active CDLs receiving full federal disability payments:
22,500;
Drivers where CDL issued after full federal disability was approved:
19,000.
State: Illinois;
Drivers with active CDLs: 377,800;
Drivers with active CDLs receiving full federal disability payments:
7,800;
Drivers where CDL issued after full federal disability was approved:
6,500.
State: Kentucky;
Drivers with active CDLs: 142,100;
Drivers with active CDLs receiving full federal disability payments:
4,800;
Drivers where CDL issued after full federal disability was approved:
3,500.
State: Maryland;
Drivers with active CDLs: 129,300;
Drivers with active CDLs receiving full federal disability payments:
2,400;
Drivers where CDL issued after full federal disability was approved:
1,600.
State: Michigan;
Drivers with active CDLs: 377,300;
Drivers with active CDLs receiving full federal disability payments:
14,900;
Drivers where CDL issued after full federal disability was approved:
12,500.
State: Minnesota;
Drivers with active CDLs: 240,100;
Drivers with active CDLs receiving full federal disability payments:
5,500;
Drivers where CDL issued after full federal disability was approved:
4,400.
State: Montana;
Drivers with active CDLs: 51,100;
Drivers with active CDLs receiving full federal disability payments:
1,000;
Drivers where CDL issued after full federal disability was approved:
600.
State: Tennessee;
Drivers with active CDLs: 206,600;
Drivers with active CDLs receiving full federal disability payments:
6,200;
Drivers where CDL issued after full federal disability was approved:
4,100.
State: Texas;
Drivers with active CDLs: 819,300;
Drivers with active CDLs receiving full federal disability payments:
22,600;
Drivers where CDL issued after full federal disability was approved:
16,100.
State: Virginia;
Drivers with active CDLs: 215,500;
Drivers with active CDLs receiving full federal disability payments:
7,800;
Drivers where CDL issued after full federal disability was approved:
5,200.
State: Wisconsin;
Drivers with active CDLs: 297,900;
Drivers with active CDLs receiving full federal disability payments:
8,200;
Drivers where CDL issued after full federal disability was approved:
5,900.
Source: GAO.
Note: Numbers are rounded to the nearest hundred.
[End of table]
[End of section]
Appendix IV: Methods Used by States to Verify Commercial Driver Medical
Certification:
The states have adopted different levels of control to verify that
commercial driver license applicants meet the Department of
Transportation (DOT) medical certification requirements. As shown in
figure 2, 25 states, or 50 percent, allow drivers to self-certify that
they meet the requirements. The self-certification is often simply a
check-box on the application. Eighteen states, or 36 percent, require
that the commercial driver show the DOT medical certificate to the
driver licensing agency at the time of application. Further, 6 states,
or 12 percent, not only require that the driver show the DOT medical
certificate at the time of application but also maintain a copy of the
certificate in the driving records of the applicant. Finally, 1 state
did not respond to the inquiries.
Figure 2: State Methods to Verify Medical Certification:
[See PDF for image]
This figure contains a map of the United States with shading indicating
methods used by state to verify medical certification, as well as the
following number of states per category:
Allow driver to self-certify: 25 (50%);
Driver shows certificate: 18 (36%);
Driver's license agency retains copy of certificate: 6 (12%);
No answer: 1 (2%).
States in each category:
Allow driver to self-certify:
Alaska;
Arkansas;
Delaware;
Idaho;
Illinois;
Iowa;
Kansas;
Maine;
Michigan;
Minnesota;
Missouri;
Nebraska;
New Hampshire;
New Jersey;
New York;
North Dakota;
Ohio;
Oklahoma;
Oregon;
Pennsylvania;
Rhode Island;
South Dakota;
Texas;
Virginia;
Washington.
Driver shows certificate:
Colorado;
Connecticut;
Florida;
Georgia;
Hawaii;
Kentucky;
Nevada;
Massachusetts;
Mississippi;
Montana;
North Carolina;
South Carolina;
Tennessee;
Utah;
Vermont;
West Virginia;
Wisconsin;
Wyoming;
Driver's license agency retains copy of certificate:
Arizona;
California;
Indiana;
Louisiana;
Maryland;
New Mexico.
No answer:
Alabama.
[End of figure]
[End of section]
Appendix V: Commercial Drivers with Serious Medical Conditions:
Table 2 in the main portion of the report provides information on five
detailed case studies. Table 4 shows the remaining case studies that we
investigated. As with the five cases discussed in the body of this
testimony, we found drivers with a valid commercial driver license
(CDL) who also had serious medical conditions.
Table 4: Summary Information on Remaining 10 Commercial Drivers with
Serious Medical Conditions:
Case: 6;
State: Maryland;
Details:
* Truck driver receiving Federal Employee's Compensation Act benefits
since 2000 due to back injury;
* Truck driver prescribed morphine for pain since at least 2004.
Medical examiner stated that he was not aware of the prescription and
would not have certified the driver under that condition;
* Truck driver is currently bedridden and on bottled oxygen for lung
disease;
* The state driver license agency last renewed the CDL in 2002.
Case: 7;
State: Maryland;
Details:
* Truck driver receiving Social Security disability benefits since 2001
due to asbestosis;
* The driver provided Maryland a medical certificate in 2007;
* Medical examiner denied signing the medical certificate form and has
not performed any medical examination of truck driver for over 5 years.
Medical examiner stated that the examiner's phone number and
certificate number on the medical certificate were erroneous;
* Medical examiner stated that the driver was not medically fit to
drive because of the medical conditions;
* The state driver license agency last renewed the CDL in 2007.
Case: 8; State:
Virginia; Details:
* Bus driver receiving Social Security disability benefits since 1998
for multiple sclerosis;
* Bus driver never had CDL medical examination performed. Bus driver
stated employer did not require medical certification;
* Bus driver drove school bus for several years in early 2000s while
receiving Social Security disability benefits;
* Police officer cited bus driver as responsible for three-vehicle
accident in 2006. The accident caused injuries to 16 people;
* The state driver license agency last renewed the CDL in 2006.
Case: 9;
State: Virginia; Details:
* Truck driver receiving Veterans Affairs (VA) disability benefits
since 1998 for multiple conditions including emphysema, spinal
arthritis, and limited arm motion;
* Truck driver drove dump truck and snow plow;
* Truck driver did not obtain a medical certificate. Truck driver
stated that at times he had difficulty breathing and likely would not
pass the medical examination for a CDL;
* The state driver license agency last renewed the CDL in 2005.
Case: 10;
State: Florida;
Details:
* Truck driver receiving Social Security disability benefits since 2002
due to an amputation;
* Driver stated that he also has had two surgeries on his back and
cannot sit or stand for extended periods of time;
* Driver does not have current medical certificate, and stated that he
"does not think he would pass" the medical examination;
* Driver denied driving a commercial vehicle in the past year. When
told that DOT records indicate he had a roadside inspection in 2007 he
became evasive and terminated the interview;
* The state driver license agency last renewed the CDL in 2003.
Case: 11;
State: Minnesota;
Details:
* Truck driver receiving Social Security disability benefits since 2001
for multiple medical conditions, including leg amputation;
* Medical examiner did not indicate on medical certificate that a
Skills Performance Evaluation (SPE) is required. The truck driver
stated that he did not have an SPE or a waiver;
* The state driver license agency last renewed the CDL in 2005.
Case: 12;
State: Minnesota; Details:
* Bus driver receiving VA disability since 2001 for multiple sclerosis;
* The driver could not provide a copy of the CDL medical certificate.
Driver stated that he did not know when he last took a medical
certification examination;
* The state driver license agency last renewed the CDL in 2004.
Case: 13;
State: Minnesota;
Details:
* Commercial driver receiving VA disability since 2004 for epilepsy,
schizophrenia, posttraumatic stress disorder, and depression;
* The driver could not provide a copy of the CDL medical certificate.
Driver stated he had not taken a medical certification examination
since early 2000s;
* Driver stated that he is taking several medications to control his
mental illnesses;
* The state driver license agency last renewed the CDL in 2004.
Case: 14;
State: Virginia;
Details:
* Truck driver receiving Social Security disability benefits since 2001
for chronic obstructive pulmonary disorder (COPD) and heart failure;
* Truck driver never had medical certification examination performed.
Driver stated that he would probably not pass the CDL medical
examination;
* Truck driver stated he occasionally drove a dump truck;
* The state driver license agency last renewed the CDL in 2007.
Case: 15;
State: Maryland;
Details:
* Truck driver receiving Social Security disability benefits since 2001
due to complete deafness;
* Truck driver operates a dump truck as part of an excavating business;
* Medical examiner admitted error in certifying medical fitness of
driver;
* The state driver license agency last renewed the CDL in 2006.
Source: GAO.
[End of table]
[End of section]
Appendix VI: Staff Acknowledgments:
GAO staff who made major contributions to this report include Matthew
Valenta, Assistant Director; Sunny Chang; Paul DeSaulniers; Craig
Fischer; John V. Kelly; Jeffrey McDermott; Andrew McIntosh; Andrew
O'Connell; Philip Reiff; Nathaniel Taylor; and Lindsay Welter.
[End of section]
Footnotes:
[1] The 12 selected states were California, Florida, Illinois,
Kentucky, Maryland, Michigan, Minnesota, Montana, Tennessee, Texas,
Virginia, and Wisconsin. The 12 states were selected primarily based on
the size of the CDL population. These 12 selected states represented
about 42 percent of all CDLs contained in CDLIS.
[2] A certain number of commercial drivers may also not be legally
entitled to federal disability payments because they do not have a
qualifying disability. For example, our review did not make a
determination as to whether commercial drivers committed fraud in their
application for disability benefits.
[3] These figures are from 2006, the most recent year for which data
are available.
[4] DOT, Federal Motor Carrier Safety Administration, Large Truck Crash
Causation Study, Publication No.: FMCSA-RRA-07-017 (July 2007).
[5] The FMCSA develops requirements for operating commercial vehicles,
while states issue CDLs. Along with verifying identity, residency, and
driving skills, states must also verify that the commercial driver
applicant is medically qualified for the license prior to issuance of
the CDL.
[6] Federal regulations require that commercial drivers provide
evidence of their medical certifications to employers (e.g., motor
carrier companies). In addition, commercial drivers are required to
carry their medical certifications when operating a commercial vehicle,
and as such, may be required to show such certifications to inspectors
(e.g., roadside check) or law enforcement, if requested.
[7] Although federal regulations apply specifically to interstate
drivers, at least 47 of the 50 states have adopted the federal medical
requirements for their intrastate commercial drivers.
[8] NTSB is an independent U.S. federal agency that investigates every
civil aviation accident in the United States and significant accidents
in the other modes of transportation.
[9] SSA and VA accounted for 99 percent of the identified drivers.
[10] CDLIS is used to ensure that drivers do not obtain CDLs from
multiple states. As such, it is an archival system and includes
licenses that are expired or suspended. CDLIS does not contain an
identifier to indicate whether the license is currently active.
[11] Federal disability programs such as the SSA's "Ticket to Work" do
allow certain fully disabled recipients to work and still receive their
disability benefits.
[12] DOT is finalizing a proposed rule to merge information from the
medical examiner's certificate into the commercial driver license
process as required by the Motor Carrier Safety Improvement Act of
1999. The new rule would require drivers to provide a copy of their
current medical examiner's certificate to their state driver license
agency. This new rule would make the state driver license agencies
responsible for ensuring that holders of commercial driver licenses
have current medical certificates.
[13] To be qualified for a CDL, DOT regulations require that a driver
"can read and speak the English language sufficiently to converse with
the general public, to understand highway traffic signs and signals in
the English language, to respond to official inquiries, and to make
entries on reports and records." 49 C.F.R. §391.11(b)(2).
[14] Drivers with amputations are disqualified from receiving a medical
certificate unless they obtain an SPE from DOT.
[15] OPM's disability criteria do not allow for precise identification
of 100 percent disabled. Its definition of disabled is becoming
"disabled because of a medical condition, resulting in a deficiency in
performance, conduct, or attendance, or if there is no such deficiency,
the disabling medical condition must be incompatible with either useful
and efficient service or retention in the position." 5 C.F.R §844.103.
Of the 563,000 CDLIS-disability matches, about 1,500 (0.26 percent)
came from OPM.
[16] If one of these first two conditions exists, the commercial driver
is required to obtain a Skills Performance Evaluation (SPE)
certificate.
[17] The Department of Transportation is finalizing a proposed rule to
merge information from the medical examiner's certificate into the
commercial driver license process as required by the Motor Carrier
Safety Improvement Act of 1999. The new rule would require drivers to
provide a copy of their current medical examiner's certificate to their
state driver license agency. This new rule would make the state driver
license agencies responsible for ensuring that holders of commercial
driver licenses have current medical certificates.
[End of section]
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