A driver was diagnosed with acute deep vein thrombosis (DVT) and has undergone treatment for the past 6 months. The doctors recommend a few more months of treatment to rid the driver of any residual. Assuming otherwise medically fit, the medical examiner should:

A driver presents with multiple medical conditions: well-controlled type 2 diabetes (not on insulin), Stage 1 hypertension (BP 146/92), a history of resolved traumatic pneumothorax, and mild hearing loss corrected with hearing aids to meet the standard. The ME determines all conditions are stable. What is the appropriate certification?

A 48-year-old CDL driver with Type 1 diabetes treated with insulin presents for a physical qualification examination. He provides an Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870) signed by his treating clinician 30 days ago. His A1c is 7.2%, and he reports no episodes of severe hypoglycemia in the past 12 months. However, he only has 2 months of electronic blood glucose self-monitoring records available. What is the most appropriate certification decision?

An ME is examining a driver who operates in a state with physical qualification standards that differ from Federal requirements. The driver operates only in intrastate commerce. The ME is familiar with the Federal standards but uncertain about the state standards. A colleague suggests simply applying Federal standards since most states have adopted them. Which of the following best describes the ME’s obligation?

A driver’s audiometric testing was performed by an outside audiologist. The report shows: Right ear: 500 Hz = 35 dB, 1,000 Hz = 42 dB, 2,000 Hz = 44 dB (ANSI). Left ear: 500 Hz = 30 dB, 1,000 Hz = 38 dB, 2,000 Hz = 50 dB (ANSI). The driver does not use a hearing aid. The audiologist’s report includes name, phone number, email, license number, state of licensure, and is signed and dated. What should the ME conclude?

A commercial driver with a history of stroke presents for recertification with blood pressure of 144/92 mmHg. How should the medical examiner approach this case?

During the health history review, a driver discloses taking a medication but cannot remember the name or dosage. What should the examiner do?

A 52-year-old CMV driver presents with bilateral carpal tunnel syndrome. Which finding would be most concerning for safe vehicle operation?

A driver discloses taking topiramate for migraine prevention. The driver has never had a seizure. What is the ME’s primary obligation regarding this medication?

A 62-year-old CDL driver is being evaluated after a recent diagnosis of chronic lymphocytic leukemia (CLL). He is currently in an early stage, has not started treatment, and reports no symptoms such as fatigue, bruising, or infections. His blood counts show mild lymphocytosis but normal hemoglobin and platelet levels. He has no other disqualifying conditions. How should the medical examiner approach this case?

A 36-year-old CMV driver with PTSD presents reporting a flashback while driving 6 weeks ago during which she momentarily lost awareness of her surroundings. She has since started EMDR therapy and reports no further episodes. Should the examiner certify this driver?

During a CMV certification exam, a driver with interstitial lung disease demonstrates oxygen desaturation to 86% during a supervised walk test after pulmonary rehabilitation. The driver states he only drives short routes and rarely exits the cab. What is the appropriate FMCSA determination?

What minimum follow-up testing frequency must the SAP prescribe in the first 12 months after a driver returns to safety-sensitive duties?

A 38-year-old CDL driver has a prosthetic left eye following enucleation for ocular melanoma 3 years ago. His right eye has distant visual acuity of 20/20, field of vision of 90 degrees in the horizontal meridian, and normal color perception. He presents with a completed MCSA-5871 from his ophthalmologist signed 20 days ago. The ophthalmologist states the vision deficiency is stable and the driver has adapted to monocular vision. The driver was previously certified under the old vision exemption program. What determination should the ME make regarding the vision exemption?