A new report has raised concerns about the costs and quality of medical care for commercial drivers nearly three years after the implementation of a federal mandate aimed at improving the process.

Released on April 17 by the American Transportation Research Institute (ATRI) and Mayo Clinic, the report focused on a May 2014 final rule that required commercial driver’s license (CDL) holders to obtain medical clearance every two years only from professionals listed on the National Registry of Certified Medical Examiners.

The survey – based on interviews with over 900 truck drivers, 300 motor carriers and 1,200 medical examiners – found that more than 63% of drivers reported higher costs for their exams since the rule was implemented, with 40% facing out-of-pocket costs between $75 and $124.

For many, the higher costs did not seem to correlate into greater care, ATRI said, with just 6.2% of drivers indicating improved exam quality since the rule was implemented.

[For more insight into how fleets can better manage the driver medical exam process, click here.]

More than one-quarter of drivers spent 20 minutes or less with examiners, with an alarming 6.5% of those drivers spending 10 minutes or fewer, which is “an insufficient time to complete all required processes of a DOT physical,” the report noted.

The disparity in exam time resulted in many drivers expressing concerns that fitness determinations were too subjective and dependent on the examiner, ATRI pointed out.
Similarly, only 18 of the more than 300 carriers polled by the group stated they have no significant concerns with the overall medical certification process.

“The inconsistency in quality of exams provided our drivers create real challenges for us as a fleet,” noted Victor Hart, director of safety for DOT Transportation, in ATRI’s report.

Another issue raised by drivers and carriers: certification delays, mainly caused by paperwork confusion.

Some 60.4% of truck drivers polled by ATRI who were not issued medical certificates on the same day as their exam pointed to the need to provide additional records as the culprit.

As a result, drivers expressed a desire for better “clarity of standards,” while motor carriers listed certification delays and driver confusion among its greatest concerns with the rule.

Drivers also face lost wages, which can average $835 a week, if they are temporarily forced off the road until a new medical certificate is obtained, ATRI noted.

Meanwhile, most of the medical examiners interviewed said they “appreciated training opportunities but bemoaned the fact that there was little guidance from the Federal Motor Carrier Safety Administration (FMCSA) in adjudicating complex medical situations,” ATRI said in its report.

As a result, about 14% of medical examiners say they have either discontinued or will stop doing the exams in the next year.

The result, ATRI stressed, is that some drivers could find it difficult to locate a certified examiner for their physicals in the future.

The report also provided some insight into some of the medical issues truck drivers face, with the two most commonly cited reasons for not receiving a certificate being high blood pressure (90%) and diabetes (6.1%).

“The study is under review,” said FMCSA Spokesman Duane DeBruyne, pointing out that the National Registry of Certified Medical Examiners was required by federal law and addressed four National Transportation Safety Board recommendations.