Cleared by psychiatry

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Cleared by psychiatry

Post by Mmpeterso » Fri May 17, 2019 12:09 pm

I had a DOT that was cleared by psychiatry after an inpatient admit and stated they were stable. I cleared the patient as well, as I felt after reviewing records the patient did not pose a danger and was stable and being closely monitored. The psychiatrist checked the box that they did not feel the patient was in danger and that the could drive. The patient was on no new medications and was under "addiction treatment" for the past 6 months without relapse for alcohol. They also had MDD. The admit was just a psych hold and release within past 6mo. I also discussed the case with my supervising physician.

So, a few weeks later the employer medical director calls and says they want me to reconsider and disqualify the applicant for renewal. They also asked me for a "Fit for Duty" statement, which I declined to provide as the client only presented for DOT recertification.

Thoughts? I did end up changing the card as requested by employer to disqualify and requested the patient be re-examined by my supervising provider and he agreed to see the patient for an eval.

Robert Swotinsky MD
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Re: Cleared by psychiatry

Post by Robert Swotinsky MD » Sat May 18, 2019 4:35 pm

was under "addiction treatment" for the past 6 months without relapse for alcohol
When your supervising provider evaluates this driver's fitness for duty, the supervising provider should consider obtaining and reviewing the records of addiction treatment. Understand that the DOT Physical Qualification standards state that a "current clinical diagnosis of alcholism" is disqualifying. The DSM-V defines alcohol-related disorders as "in early remission" if sobriety is maintained for at least 3 months and "in sustained remission" if sobriety is maintained for at least 12 months.

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