A number of truck drivers have reported being terminated from their jobs due to having sleep apnea. There is still some confusion about the FMCSA regulations concerning this medical condition and the ability to still operate a commercial motor vehicle. The confusion exists somewhere amid understanding the difference between "regulations" and "guidelines."
As of this date, the FMCSA has no regulation that specifically addresses sleep apnea as a disqualifying condition. There is however, the established federal regulation, Section 391.41(b)(5) which states that a person is physically qualified to drive a commercial motor vehicle if they have "no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with his/her ability to control and drive a commercial motor vehicle safely."
In addition, the FMCSA has published a Medical Advisory Criteria as a guideline for the medical examiner to determine a driver's medical qualifications pursuant to Section 391.41 of the FMCSRs. It is within this advisory recommendation that these certain conditions are described as those which interfere with "oxygen exchange."
Furthermore, on another FMCSA advisory entitled, Sleep Apnea and Commercial Drivers, it states the following: "The disqualifying level of sleep apnea is moderate to severe, which interferes with safe driving. The medical examiner must qualify and determine a driver’s medical fitness for duty."
So at this point, we have a specific federal regulation that disqualifies a driver from operating a CMV if they have a respiratory dysfunction that will cause an unsafe operation and two advisory and recommendation guidelines which specifically mention "sleep apnea" within the context. If there is no regulation that distinctively relates to sleep apnea as being a disqualifying condition, then how is it possible drivers are being disqualified?
Each state sets its own medical standards for driving a commercial motor vehicle and many states have determined that sleep apnea is a disqualifying condition based on the textual content under Section 391.41(b)(5).
Each state has its own authority to suspend or deny a person a CDL license. On the same advisory page of Sleep Apnea and Commercial Drivers, the FMCSA "advises" that: "A motor carrier may not require or permit a driver to operate a CMV if the driver has a condition, including sleep apnea, that would affect his or her ability to safely operate the vehicle."
Although the FMCSA clearly states that a person with sleep apnea, once successfully treated, can still drive a CMV, it is the mixing of the federal regulation under Section 391.41 and the two above listed advisory guidelines causing much of the confusion among drivers.
Even though they are only recommendations and guidance offered by the FMCSA, these guidelines still provide the medical examiners, state and motor carriers the self-authority to deny or remove an applicant or driver from the CMV position; even without them technically being "regulations."