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I did a commercial driver medical exam on a 34-year-old pregnant female, G3P1Ab1, EDC 4/29/14 with an otherwise negative history and normal physical, other than a gravid uterus that at this point of her pregnancy does not yet appear to impair her ability to perform the functions of a CMV driver. She is doing very well with no complications during this pregnancy. I am unsure whether to give her a 2 year certification, since her normal pregnancy is progressing and at some point she will have to be at least temporarily disqualified to do all the driving and nondriving functions required by her job. I can’t find this issue addressed in the Medical Examiner’s Handbook from FMCSA. Should I give her a short-term certification and a follow-up to see if her ability to do CMV driver work is affected by her pregnancy? At this time she treadmills 20 minutes per day and still does chores on her farm. She is in better shape right now than most of the other drivers I examine.
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The medical examiner can issue a 3-, 6-, or 12-month certification if the driver is felt to need monitoring of fitness for duty sooner than 2 years. While the pregnant driver will remove herself when she delivers and for some time thereafter, this is not a medical injury or illness that requires the medical examiner to monitor for fitness for duty. I would give her a 2 year card.
Thanks, Dr. Swotinsky. That seems to be the consensus of the replies I have received on the occ-med listserv as well. The fact that the normal, healthy pregnancy is known to be a progressive condition that at some point in the near future (this patient is in her third trimester) will most certainly make her temporarily unqualified to drive doesn’t seem to be considered a factor in deciding the driver's certification status at the time of the exam, by the occ med specialists I have heard from. In fact, some seem baffled by my concern that pregnancy would even be an issue, as if it would never limit a driver’s ability to safely perform their work functions if they pass the driver’s exam. But much like asymptomatic hypertensives, with conditions that are not overtly limiting at the time of exam but are at risk to progress and eventually cause limitations, sometimes (as you point out) a time limited certification and/or follow-up is recommended for such conditions. Since this topic of pregnancy is not addressed by the FMCSA, I just wanted to be sure I am following the standard of practice of the occ med community. Thanks for your message! I feel much better about giving her a 2 year certificate now.
Just for the record, there is a federal law, the Pregnancy Discrimination Act, which prohibits any adverse employment action based solely on pregnancy. Absent any clear-cut evidence of a safety concern, it might be construed as a violation of the law to DQ a driver just because she's pregnant.
Thank for the link to that Act. I'm not a lawyer, but it appears this law applies to employers. I don't see any mention of medical examiners who do fitness-for-duty evaluations, so I don't see that this applies to me. In general, I think we're mandated to place the safety of the driver and the public above personal liberty, quite frankly. The employer better be careful what they do with my certification status determinations, though.