What Employers Need to Know About DOT

2Sources: American Trucking Association and the FMCSA

$310 billion annual revenue

11 billion tons of cargo

69%freight

tonnage

commercial motor vehicle (CMV) drivers

5.6 million

100,000motor carriers

About the Department of Transportation (DOT)

3https://www.gpo.gov/fdsys/pkg/FR-2015-04-23/pdf/2015-09053.pdf

• Official governing body for commercial transportation

• Safety standards to protect employers, employees, and general public

Introduction

4

Current

45% by 2045

The U.S. Department of Transportation (DOT) expects freight volume to increase

2045

Driver population

Retirement

Disqualified

Demand for qualified commercial drivers

Concentra and DOT

= 1,000 DOT exams performed by Concentra

• Perform more DOT exams than any other provider in the US

• Certify more drivers than any other medical provider

• Created a DOT FMCSA medical examiner training course

• Authored by Dr. Ellison Wittels, a noted expert on commercial driver certification

• Taught by nationally recognized experts

Concentra performs more than

700,000 DOT exams per year

6Source: FMCSA

$25,000 accident

$1.25M

A carrier must generate $1.25M to pay for the cost of a $25,000 accident.

7Source: FMCSA

In 2011

• 100,272 large vehicle crashes

• 3,054 fatal crashes

8Source: FMCSA

$200,000 accident

Assuming a 2% profit margin, a $200,000 accident will require $10M in revenue to make up the cost.

$10Min revenue

The Federal Motor Carrier Safety Administration (FMCSA) has very strict guidelines on what a DOT physical must include:

• Driver health history

• Vision, hearing, blood pressure, pulse rate

• Overall physical ability

• Bring a complete list of current medications (include doses)

• Glasses, contacts, or hearing aids

9

About DOT Physicals

Bring to DOT Exam

Glasses

Contacts

Prescriptions

Hearing Aid

Medical Record

10

DOT Exam Details and Screening Elements

Blood PressureHearing

Physical Exam

UrinalysisVision

• Ears

• Eyes

• Mouth and throat

• Heart

• Lungs

• Brain and nervous system

• Musculoskeletal system

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DOT Exam Details and Screening Elements

Physical Exam

• As an employer you are allowed to have your own drug and alcohol testing program, but it must still comply with the appropriate DOT regulations.

• An employee must complete testing for controlled substances, prior to performing safety-sensitive functions for an employer.

• Employees may be subject to pre-employment and random testing, reasonable suspicion/reasonable cause, post-accident, and return-to-duty, as well for follow-up.

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Drug and Alcohol Testing Regulations - Drivers

Truck Drivers

Subway Contractors

Pilots

Pipeline Controllers

Locomotive Engineers

Airline Mechanics

Ship Captains

Bus DriversSubject

to testing

An FMCSA/TWU health survey of drivers reported high prevalence rates of physician diagnosed:

13

Source: Ferro referenced the CDC statistic on life expectancy of the commercial truck driver at 61 years, or 16 years lower than the national average.

FMCSA/TWU study: https://www.cdc.gov/niosh/programs/twu/pdfs/repeated-cross-sectional-assessment-of-commercial-truck-driver-health.pdf

National life expectancy average

Life expectancy of a commercial driver: X

9.0%

31.1%32.8%

Diabetes Mellitus BMI >35 Hypertension

16 years shorter

77 years

Regulations for Commercial Vehicles

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All non-exempt commercial motor vehicles that cross

state lines and meet specific criteria, including big-rig

trucks, are subject to the federal motor

carrier safety regulations

If operating within one state,

trucks need to abide by

state-equivalent motor carrier safety

regulations

Cover all persons and entities involved in operating commercial vehicles, including:

• Drivers

• Hiring managers

• Trainers

• Supervisors

• Managers

• Dispatchers

• Other people whose action affects drivers and commercial motor vehicles

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National Registry

CMV drivers must use MEs on the National Registry for their examinations

Complete training on FMCSA’s physical

qualification standards

Pass a certification

test

Demonstrate competence

through periodic

training and testing

Medical Examiners (ME)

New rule will require MEs to submit medical certification information daily

• Transmit to states electronically

• Aim to dramatically decrease chance of drivers falsifying medical certificates

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National Registry

40,000 certified MEs

Driver Health Can Impact Productivity

17

Source: From a 2015 study by the ATA (American Trucking Associationhttp://www.trucking.org/ATA%20Docs/News%20and%20Information/Reports%20Trends%20and%20Statistics/10%206%2015%20ATAs%20Driver%20Shortage%20Report%202015.pdf

Average Driver

• 49 years old

• May not have access to healthy food or exercise

• Chronic conditions

• Can delay or disqualify drivers from certification

Time to Stay Up-to-date

Common Issues Employers Face with DOT

18

Because of the new regulations, drivers who want to extend limited certifications now have to take an entirely new exam—and incur a new exam fee.

Time for drivers to access medical examiners

Time to manage scheduling for driver physical so there are no gaps in certification

Time to learn about the frequently updated state and national regulations

Unfit Drivers Cost More

Recent Changes with DOT Regulations

19

Updates to the MER and MEC forms

New health history questions

New statuses for interstate drivers (pending and incomplete)

Extending a limited certification will require an entirely new physical

Employers will no longer be able to add additional healthy history questions or their logo. Doing so will render them invalid.

• Driverless trucks

• Commercial train transportation

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Future of DOT

• Sleep apnea

• Sleeping and driving habits

• Productivity

New ways to transport

Data and metrics

Potential for new regulations on sleep apnea

• Drivers with untreated sleep apnea are five times as likely to get into preventable crashes as drivers without the condition

You can contact an expert to learn more about DOT and other occupational health topics at http://bit.ly/2f8iU8M

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Interested in Learning More?

National Registry of Certified Medical Examiners (NRCME)

Resources for Additional Information and Questions

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• NRCME -https://nationalregistry.fmcsa.dot.gov/NRPublicUI/home.seam

• NRCME Resource Center includes sample forms, exam form FAQs, and National Registry FAQs -https://nationalregistry.fmcsa.dot.gov/ResourceCenter/

• NRCME DOT Physical Forms -https://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-applications-and-forms

Federal Motor Carrier Safety Administration (FMCSA)

Concentra

• FMCSA regulations -https://www.fmcsa.dot.gov/regulations/title49/b/5/3

• FMCSA Rule Making documents including proposed and final rule content - https://www.fmcsa.dot.gov/regulations/rulemaking

• FMCSA Driver Safety and Health FAQs -https://www.fmcsa.dot.gov/faq/Medical-Requirements

• Concentra’s What to Bring to a DOT Physical -http://www.concentra.com/patients/physicals/dot-checklist/

• Download the new DOT Physical Exam forms -http://www.concentra.com/patients/health-library/dot-physicals/