Physical Qualification of DriversThis webcast will cover ...• Physical qualification requirements• Best practices related to physical

qualifications• Functional capacity screening• Question & Answer

ModeratorDr. Gary Petty, President & CEO, NPTC

PanelistsTom Bray, Sr. Editor – Transportation Management,

J. J. Keller & Associates, Inc. Tom Moore, CTP, Senior Vice President, NPTCMike Walker, Director of Transportation, Metal Sales

Manufacturing Corporation.

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October 2nd, 2013

Physical Qualification of Drivers

Dr. Gary PettyPresident & CEO

National Private Truck Council

Introduction• Regulations – Tom Bray• Policy and Procedure Best Practices –Tom Moore

• Metal Sales Manufacturing Program – Mike Walker• Housekeeping issues:

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Gary Petty National Private Truck Council

Driver Physical Qualification Requirements

Thomas BrayEditor, Transportation Management

J. J. Keller & Associates, Inc.

Tom BrayJ. J. Keller &

Associates, Inc.

Who needs an exam?• Anyone operating a CMV as defined in §390.5• Commercial motor vehicle (CMV)

includes vehicles: 10,001 lbs. or more (rating or actual); or designed or used to transport more than 8 passengers

(including the driver) for compensation; or designed or used to transport more than 15 passengers,

including the driver, not for compensation; or used to transport a placardable amount of hazmat

Tom BrayJ. J. Keller &

Associates, Inc.

Who needs an exam?

• Anyone who has not had an exam within the past 2 years, (could be sooner depending on the expiration date of the current med card) For new hires, you may:

Accept a current medical certificate; orRequire a new exam

• Drivers whose ability to perform his/her normal job duties has been impaired by a physical or mental injury or disease (this is a carrier decision)

• Reference: §391.45

Tom BrayJ. J. Keller &

Associates, Inc.

Medical standards• Section 391.41(b) covers 13 medical areas • When in doubt: Use a medical advisor Consult FMCSA: fmcsamedical@dot.gov

Tom BrayJ. J. Keller &

Associates, Inc.

Medical standards: guidelines

§391.41(b) Guidelines for medical disqualification: 1. Loss of foot, leg, hand, or arm2. Impairment of hand, finger, arm, foot, or leg3. Cardiac disease4. Respiratory dysfunction (including untreated sleep

apnea)5. High blood pressure 6. Rheumatic, arthritic, orthopedic, muscular,

neuromuscular, or vascular disease7. Mental, nervous, organic, or functional disease or

psychiatric disorder likely to interfere with operating a CMV

8. Use of a 21 CFR 1308.11 Schedule I substance, an amphetamine, a narcotic, or any other habit-forming drug

9. Current clinical diagnosis of alcoholism

Tom BrayJ. J. Keller &

Associates, Inc.

Medical standards: Absolutes

• §391.41(b) Absolutes (i.e., no judgment calls by the examiner): Insulin-dependent diabetesEpilepsyVisionHearing

Tom BrayJ. J. Keller &

Associates, Inc.

Exam procedures• Medical Advisory Criteria, FAQs, and MRB

Recommendations:“Fills in the blanks”Published by FMCSAUsed as a reference by examinersOffers more details than exam formRefers examiners to detailed studies

Tom BrayJ. J. Keller &

Associates, Inc.

Exam procedures• Medical examiner’s discretion includes: Issuing a card based on findings Issuing a card for entire 2 years despite guidance Requesting additional tests or information

Such as sleep study or medical release from specialist

Issuing a card for lesser time frame than guidance Not certifying the driver

Tom BrayJ. J. Keller &

Associates, Inc.

Certification• Driver given medical examiner’s certification

(“med card”), carrier must place copy in DQ file

• Original long-form physical is kept at the medical examiner’s office Must be requested within confines of HIPAA Maintained separately from DQ and personnel files Medical examiner’s certificate does not fall under these

privacy laws

Tom BrayJ. J. Keller &

Associates, Inc.

Medical examiners: now• Currently, a medical examiner must:

Be a licensed, certified, and/or registered doctor of medicine, doctor of osteopathy, physician assistant, advanced practice nurse, or doctor of chiropractic

Understand the demands of being a driver Know the regulations and reference materials

• Reference: §391.43, §390.5

Tom BrayJ. J. Keller &

Associates, Inc.

Medical examiners: near future

• National Registry of Certified Medical Examiners: Examiners must receive approved trained,

pass a test (certified), be placed on an official list, Drivers/carriers must use an examiner from the list beginning May 21,

2014

• New boxes on the forms include (required in 2014): Medical examiner’s National Registry number Identification of type of commerce in which the driver is engaged

• See: http://nrcme.fmcsa.dot.gov

Tom BrayJ. J. Keller &

Associates, Inc.

CDL/med card merger rule• Only applies to CDL holders• Once fully implemented:

A CDL driver’s driving record will show medical status (driver does not have to carry card)

Carriers must have MVR showing medical status in DQ file rather than the med card

• States: Started collecting medical data as of Jan. 30, 2012 Are collecting data as existing CDLs expire, or any other

contact they have with the drivers States must have data on all CDL drivers by Jan. 30, 2014

Tom BrayJ. J. Keller &

Associates, Inc.

Tom Moore, CTPSenior Vice President

National Private Truck Council

Looming Driver Shortage

Tom Moore National Private

Truck Council

Source: FTR Associates

How FleetsAre Raising the Bar

Tom Moore National Private

Truck Council• Working with the medical examiner• Maintaining medical files• Education and training of the driver workforce• Improving driver wellness programs• Enhancing the qualification standards

Hiring Qualifications

Minimum Age = 22.6

Minimum Experience = 2.3 yrs.

Hair Follicle

Personality Profile

Functional Capacity

0% 10% 20% 30% 40%

Tom Moore National Private

Truck Council

Working With the Medical Examiner

Tom Moore National Private

Truck Council

• Physicals Nationwide provider versus local facility Physical conductor -- doctor, nurse practitioner,

physicians assistant, chiropractor Verify knowledge of the regulations

• Review physical post-offer

Tom Moore National Private

Truck Council

• Secure and limit access to files• Conduct annual review twice per year• Audit physicals forms• Verify licenses for equipment being used

Maintaining Medical Files

Education and Training

Tom Moore National Private

Truck Council

• FMCSA provides excellent resource http://www.fmcsa.dot.gov/rules-regulations/administration/fmcsr/fmcsrruletext.aspx?reg=391.43

• Beyond the regs, drivers need to know that you care about their welfare

• Drivers need to take responsibility• Consider incorporating as part of the hiring &

screening process

Fleets Offering Driver Wellness Programs

Yes; 71%

No; 26%

No Answer; 3%Tom Moore

National Private Truck Council

Driver Wellness Components

Sleep Apnea

Nutritional Counseling

Exercise Program

Weight Management

Smoking Cessation

0% 10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Tom Moore National Private

Truck Council

Enhanced DOT Physicals• Problem – Driver workers’ comp claims review found

that: 10% of the claims accounted for 70% of the cost Over 50% of the claims involved musculoskeletal

injuries Large number of high dollar claims occurred within 90

days of hiring date

Solution – • Improve the company portion of the medical exam and

identify those individuals that are not physically fit to perform the job by: Establish a customized testing program to identify

significant musculoskeletal problems. Improving cardio and overall fitness screening. Early health risk identification.

Tom Moore National Private

Truck Council

Michael WalkerDirector of Transportation

Metal Sales Manufacturing Corporation

FPO

For more than 50 years, Metal Sales Manufacturing Corporation has earned a reputation as the premier provider of innovative metal roofing, metal siding, building components and accessories. We’ve backed this reputation with the steel roofing industry’s largest professional sales & service team, supported by 21 branches located throughout the United States.We offer a full line of exceptional quality metal roofing systems, siding and metal wall panels for agricultural, commercial, architectural, industrial, and residential projects of every shape and size – new construction or retro-fit.

Metal Sales Manufacturing Corporation

Equipment118 Power Units224 Trailers50 Booms/All Terrain Forklifts

Operations Figures7,410,000 Miles105,612 Stops

Mike WalkerMetal Sales

Functional Screen Purpose• Utilized to safely match driver candidates

to the physical demands of a truck driving position at Metal Sales Manufacturing Corporation (MSMC) conducted in unison with pre-employment Medical Examination for Commercial Driver Fitness Determination and re-certifications as required by the Federal Motor Carrier Safety Regulations (§391.43).

Mike WalkerMetal Sales

Scope

A standardized and precise measure of an individual’s current capacity that accurately tests each candidate to ensure they can accomplish the specific physical demands of the truck driving job.

Mike WalkerMetal Sales

Scope Highlights• Requires a detailed “job analysis” which was

developed with Physical Therapist (PT) on site with MSMC representatives outlining the responsibilities of the job.

• Minimizes the risk of injuries to the employee by identifying potential musculoskeletal and medical conditions that may increase the risk of workplace injury.

• Minimizes MSMC exposure to on-the-job injuries and the resulting expenses related to worker’s compensation claims, in addition to operational costs, i.e. common carrier expenses, equipment retrieval costs, etc.

• Helps to maximize customer service by minimizing interruptions in the workforce that can result from on-the-job injuries.

• Reduces insurance premiums by minimizing claims.

Mike WalkerMetal Sales

Legal IssuesADA allows Pre-Employment Functional Assessments. Tests/standards/programs cannot discriminate against protected classes (females, minorities, disabled or older adults) as defined by the Civil Rights Acts of 1964 and 1991, the Americans with Disabilities Act (ADA) and the Age Discrimination in Employment Act (ADEA), however

Mike WalkerMetal Sales

Legal Issuesif job relatedness is established and documented, then the fitness tests, standards and programs can distinguish who can and cannot perform the essential functions of the job. It is important to implement tests that distinguish between those who can and cannot do the essential functions of the job.

Mike WalkerMetal Sales

Legal Issues• Additionally the test must be required of everyone

in the position and everyone in the post offer/pre-employment stage of the process. It cannot be selectively applied.

• Under ADA, there is a provision called “reasonable accommodation”. A person with a disability who is unable to perform the essential functions of the job; has the right to request an accommodation. The employer must determine the nature of the accommodation and whether or not the accommodation is “reasonable” or would cause an “undue hardship”.

Mike WalkerMetal Sales

History/Physical Screen and Musculoskeletal Evaluation

1. Neck ROM

5. Balance (10 sec.)

2. Back/Trunk ROM 3. Shoulder/UE ROM

4. Lower Ext ROM 7. Grip Strength6. Squats (10 reps)

• Previous / Current Health Issues / Restrictions

• Heart Rate Pre/Post • Projected 80% HR• Blood Pressure• Comments/Signed and

dated by Physical Therapist

Commercial Driver Functional ScreenCRITICAL DEMAND

TEST DESIGN PASS SCORE OVERALL TEST MET

Floor to Waist Lift

FCE Equipment. Client is to lift the weight from the Floor to Waist level and back following FCE protocol. 60# x 1 rep _____

Pass Score: 60#Score: _____

YESNO

Front Carry(25 feet)

FCE Equipment. Client will lift from Waist level and carry/transfer weight a total of 25 feet following FCE protocol. 60# x 1 rep ____

Pass Score: 60#Score: _____

YESNO

Chest to Floor Lift (52”)

FCE Equipment. Client will lift from Chest (52”) level down to Floor and back to Chest level using either 2 hands on handles or over/under hand technique. 60# x 1 rep ________

Pass Score: 60#Score: _____

YESNO

Stair/Step Climbing

FCE Equipment (ladder), ensuring 3 points of contact are maintained at all times during the activity. Clients will ascend/descend a 15” step 3 times .Steps: ____

Pass Score: 3 Steps (15”)Score: _____

YESNO

Horizontal Pushing

FCE Equipment. Generate 75# of horizontal push force at self-selected height in at least 1 of 3 attempts, standing, using a force gauge or wall mount pulley. Trial 1: Trial 2: Trial 3:

Pass Score: 75#Score: ______

YES NO

Horizontal Pulling

FCE Equipment . Generate 75# of horizontal pull force at self-selected height in at least 1 of 3 attempts, standing, using a force gauge or wall mount pulley.Trial 1: ___ Trial 2: ___ Trial 3: __

Pass Score: 75#Score: ______

YESNO

Reason for Failure: Physical Status (BP, HR, Medical contraindication, restriction) Functional Status (unsafe body mechanics/physically incapable;applicant stops test) Signed & dated by Physical Therapist

Lifts – Floor to Waist & Chest to Floor

Mike WalkerMetal Sales

Horizontal Pushing & Pulling

Mike WalkerMetal Sales

Stair/Step Climbing & Front Carry

Mike WalkerMetal Sales

Considerations / Suggestions

• Test extreme/rare occurrences (100+ pounds) or normal, every day occurrences (60 pounds)?

• Is test standardized across the company (variations with driver and product mix at 21 MSMC locations)?

• At inception what do you do with existing (long term) employees that might not meet these restrictions?

• What can be done, if anything, to lower Critical Demand functions (i.e. lower weight requirements) and/or get drivers to work more safely?

o Involve all employees (drivers, supervisors and corporate staff) to help develop testing.

o Trailer ladders.o Accordion style tarping systems.o Minimize climbing on the deck with “strap bar”.o Doors in the head board of trailer.o Trim tubs under trailer deck.

Mike WalkerMetal Sales

Considerations / Suggestions

• Quarterly and Annual Driver Incentive Programs - AIM – Accident Free Injury Free Moving Violation Free

• Decals on driver side doors on all trucks

• Physical Therapist annual participation in driver meetings at each branch

• Develop functional screening DVD in unison with Atlas Ergonomics based on the MSMC job function requirements

MSMC On the Job Injuries vs. Number of Drivers

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 201302468

101214161820 19

8

18

13

7

11

5 57

34

5

11

1

Injuries

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

20

40

60

80

100

120

5562

7076 79

85 89 90 89 84 8490

96 100

# drivers

MSMC Driver Injury Decline

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

1

2

3

4

5

6

7

8

9

10

Back Fractures/Dislocations Lacerations/Contusions Strains Cardiac / Heat

ACKNOWLEDGEMENTS• David Wright, Physical Therapist, Occupational Medicine

Physicians, New Albany, Indiana

• Dave Moore, LPN, MSMC Transportation Coordinator, Sellersburg, Indiana

• Larry Gardner, MSMC Transportation Manager, Sellersburg, Indiana

• Sacha Powers, MSMC Director of Human Resources

• Drew Bossen, PT, MBA, Atlas Ergonomics, www.atlasergo.com

• Brian Brennenstuhl, B & B Signs, Clarksville, Indiana, 812/282-5366

• Pat Lanning, MSMC Marketing Manager

• Denise Hall, MSMC Corporate Transportation Assistant

Mike WalkerMetal Sales

Question & Answer Session

Please continue to submit your questions.

Tom MooreNational Private Truck Council

Tom BrayJ. J. Keller &

Associates, Inc.

Gary Petty National Private Truck Council

Mike WalkerMetal Sales

Closing Remarks

• Checkout the archive of past topics at: http://www.jjkeller.com/nptcinfo

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Gary Petty National Private Truck Council

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