Certification Process for Drivers with Serious Medical Conditions
GAO-08-1030T, Jul 24, 2008
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. Because the effectiveness of the medical certification process is not known, this testimony, and the accompanying report (GAO-08-826) that GAO is releasing today focuses on (1) GAO's analyses of the magnitude of commercial drivers with serious medical conditions, and (2) examples of cases where careful medical examinations did not occur on commercial drivers with serious medical conditions. To examine the extent individuals holding CDLs have significant disabilities, GAO identified those who were in both DOT's CDL database and selected disability databases of 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. GAO obtained current CDL data from 12 selected states. To provide case studies, GAO focused on 4 states--Florida, Maryland, Minnesota, and Virginia. For 15 drivers identified from data mining, GAO interviewed, as appropriate, the driver, the driver's employer and the driver's physician.
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. GAO's 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 individuals had commercial driver licenses and were determined by the federal government to be eligible for full disability benefits. This represented about 4 percent of all commercial drivers in the DOT database. The 12 selected states we analyzed represent about 135,000 of these commercial drivers. For these 12 selected states, our analysis indicates that about 85 percent of these commercial drivers still have active licenses. The majority of these drivers were issued a CDL after being approved for full federal disability benefits. GAO's 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.