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Federal Register / Vol. 86, No. 119 / Thursday, June 24, 2021 / Notices New Jersey Avenue SE, Washington, DC, between 9 a.m. and 5 p.m., ET, Monday through Friday, except Federal Holidays.
Fax: 202 4932251.
To avoid duplication, please use only one of these four methods. See the Public Participation portion of the SUPPLEMENTARY INFORMATION section for instructions on submitting comments.
Ms.
Christine A. Hydock, Chief, Medical Programs Division, 202 3664001, fmcsamedical@dot.gov, FMCSA, DOT, 1200 New Jersey Avenue SE, Room W64224, Washington, DC 205900001.
Office hours are 8:30 a.m. to 5 p.m., ET, Monday through Friday, except Federal holidays. If you have questions regarding viewing or submitting material to the docket, contact Dockets Operations, 202 3669826.

FOR FURTHER INFORMATION CONTACT:

SUPPLEMENTARY INFORMATION:

I. Public Participation
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A. Submitting Comments If you submit a comment, please include the docket number for this notice Docket No. FMCSA20210025, indicate the specific section of this document to which each comment applies, and provide a reason for each suggestion or recommendation. You may submit your comments and material online or by fax, mail, or hand delivery, but please use only one of these means. FMCSA recommends that you include your name and a mailing address, an email address, or a phone number in the body of your document so that FMCSA can contact you if there are questions regarding your submission.
To submit your comment online, go to www.regulations.gov/docket?D=FMCSA20210025. Next, sort the results by Posted Newer-Older, choose the first notice listed, click the Comment button, and type your comment into the text box on the following screen. Choose whether you are submitting your comment as an individual or on behalf of a third party and then submit.
If you submit your comments by mail or hand delivery, submit them in an unbound format, no larger than 812 by 11 inches, suitable for copying and electronic filing. If you submit comments by mail and would like to know that they reached the facility, please enclose a stamped, self-addressed postcard or envelope.
FMCSA will consider all comments and material received during the comment period.

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B. Viewing Comments To view comments go to www.regulations.gov. Insert the docket number, FMCSA20210025, in the keyword box, and click Search. Next, sort the results by Posted NewerOlder, choose the first notice listed, and click Browse Comments. If you do not have access to the internet, you may view the docket online by visiting Dockets Operations in Room W12140
on the ground floor of the DOT West Building, 1200 New Jersey Avenue SE, Washington, DC 205900001, between 9
a.m. and 5 p.m., ET, Monday through Friday, except Federal holidays. To be sure someone is there to help you, please call 202 3669317 or 202 366
9826 before visiting Dockets Operations.
C. Privacy Act In accordance with 5 U.S.C. 553c, DOT solicits comments from the public to better inform its rulemaking process.
DOT posts these comments, without edit, including any personal information the commenter provides, to www.regulations.gov, as described in the system of records notice DOT/ALL
14 FDMS, which can be reviewed at www.transportation.gov/privacy.
II. Background Under 49 U.S.C. 31136e and 31315b, FMCSA may grant an exemption from the FMCSRs for no longer than a 5-year period if it finds such exemption would likely achieve a level of safety that is equivalent to, or greater than, the level that would be achieved absent such exemption. The statute also allows the Agency to renew exemptions at the end of the 5-year period. FMCSA grants medical exemptions from the FMCSRs for a 2year period to align with the maximum duration of a drivers medical certification.
The four individuals listed in this notice have requested an exemption from the epilepsy and seizure disorders prohibition in 49 CFR 391.41b8.
Accordingly, the Agency will evaluate the qualifications of each applicant to determine whether granting the exemption will achieve the required level of safety mandated by statute.
The physical qualification standard for drivers regarding epilepsy found in 391.41b8 states that a person is physically qualified to drive a CMV if that person has no established medical history or clinical diagnosis of epilepsy or any other condition which is likely to cause the loss of consciousness or any loss of ability to control a CMV.

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In addition to the regulations, FMCSA
has published advisory criteria 1 to assist medical examiners MEs in determining whether drivers with certain medical conditions are qualified to operate a CMV in interstate commerce.
The criteria states that if an individual has had a sudden episode of a nonepileptic seizure or loss of consciousness of unknown cause that did not require anti-seizure medication, the decision whether that persons condition is likely to cause the loss of consciousness or loss of ability to control a CMV should be made on an individual basis by the ME in consultation with the treating physician.
Before certification is considered, it is suggested that a 6-month waiting period elapse from the time of the episode.
Following the waiting period, it is suggested that the individual have a complete neurological examination. If the results of the examination are negative and anti-seizure medication is not required, then the driver may be qualified.
In those individual cases where a driver has had a seizure or an episode of loss of consciousness that resulted from a known medical condition e.g., drug reaction, high temperature, acute infectious disease, dehydration, or acute metabolic disturbance, certification should be deferred until the driver has recovered fully from that condition, has no existing residual complications, and is not taking anti-seizure medication.
Drivers who have a history of epilepsy/seizures, off anti-seizure medication, and seizure-free for 10
years, may be qualified to operate a CMV in interstate commerce. Interstate drivers with a history of a single unprovoked seizure may be qualified to drive a CMV in interstate commerce if seizure-free and off anti-seizure medication for a 5-year period or more.
As a result of MEs misinterpreting advisory criteria as regulation, numerous drivers have been prohibited from operating a CMV in interstate commerce based on the fact that they have had one or more seizures and are taking anti-seizure medication, rather than an individual analysis of their circumstances by a qualified ME based on the physical qualification standards and medical best practices.
On January 15, 2013, FMCSA
announced in a Notice of Final Disposition titled, Qualification of 1 These criteria may be found in APPENDIX A TO
PART 391MEDICAL ADVISORY CRITERIA, section H. Epilepsy: 391.41b8, paragraphs 3, 4, and 5, which is available on the internet at https
www.gpo.gov/fdsys/pkg/CFR-2015-title49-vol5/pdf/
CFR-2015-title49-vol5-part391-appA.pdf.

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