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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+ The slides and recording will be posted within 7 days at: http://www.jjkeller.com/nptcinfo
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: [email protected]
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.
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
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
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
PowerPoint slides and recording up in 1 week
Gary Petty National Private Truck Council