Skill Performance Evaluation Certificate Application Form (Page 10 of 25) in pdf

MEDICAL EVALUATION SUMMARY

Date______________________

FROM:____________________________________________________________

(Motor Carrier's Name)

TO: ____________________________________________________________

(Doctor's Name) Must be Board Qualified or Board Certified Orthopedic Surgeon or Physiatrist

SPE Applicant Name:___________________________________________

PART I

The above driver is being referred to you for a medical evaluation summary as required by Section 391.49 of the

Federal Motor Carrier Safety Regulations (FMCSR). The FMCSR states that the motor carrier shall furnish the

examining physiatrist or orthopedic surgeon with a description of the job tasks which are contained herein. The

FMCSR further states that the medical evaluation summary shall be completed, dependent upon the driver's

physical disability in accordance with the following objectives:

1. IN CASES INVOLVING AMPUTATION - The summary shall include an assessment of the driver's physical

capabilities as they relate to the driver's ability to perform the tasks as specified in the accompanying job task

description.

2. IN CASES INVOLVING LIMB IMPAIRMENT - The summary shall include an explanation as to how and why

the impaired area interferes with the driver's ability to perform the tasks as specified in the accompanying job

task description. The summary shall also contain an assessment of whether the condition will likely

remain medically stable over the driver applicant's lifetime.

3. IN CASES INVOLVING EITHER AN UPPER LIMB AMPUTATION OR UPPER LIMB IMPAIRMENT, the

summary shall include a statement by the examiner that the applicant is capable of demonstrating precision

prehension (manipulating knobs and switches) and power grasp prehension (holding and maneuvering the

steering wheel) with each upper limb separately.

Few people outside of the motor carrier industry fully appreciate the mental and physical demands placed on

commercial drivers. Medical examiners should not apply automobile driving experience to evaluate fitness of

commercial driver applicants.

The physical demands of commercial driving and related tasks vary considerably with type of vehicles and duties

involved. To effectively match job demands with an applicant's abilities to meet these demands, the physiatrist or

orthopedic surgeon must know the type of vehicle to be driven, the job demands, and environment involved. For

their own, as well as the safety of others, drivers minimally must have adequate:

A. Strength - of the skeletal muscles to turn large diameter steering wheels (20-24 inches) rapidly and maintain a

grip on them when confronted with tire failures and/or striking potholes or obstructions on the roadway.

B. Mobility - of the joints to reach various controls that must be pushed, pulled, or twisted; and to climb, bend,

crawl, lift, twist, and turn to position for visual inspection; and to perform various related other associated tasks

such as coupling and uncoupling trailers and vehicle inspections.

C. Stability - of joints and of the torso to maintain alert driving postures to smoothly modulate foot and hand

controls, to climb into and out of the vehicle cab and cargo compartments.

D. Power Grasp and Prehension - of hands and fingers to control the steering wheel, operate the transmission

(gear shift lever), air brake controls, and various other tasks such as operating light switches, directional

signals, horns.

Skill Performance Evaluation Certificate Application Form Page 10