Recommendation for a psychiatrist/psychologist evaluation

Post Reply
dschrauben

Recommendation for a psychiatrist/psychologist evaluation

Post by dschrauben » Thu May 29, 2014 2:56 pm

The medical handbook recommends an evaluation by a psychiatrist/psychologist every 2 years for a driver being treated for depression.Since the majority of depression is treated by FMPs is it the opinion that this is necessary or that a note from the FMP that the driver's depression is stable and the medications won't affect the ability to drive safely would be sufficient.



markrainey

Re: Recommendation for a psychiatrist/psychologist evaluatio

Post by markrainey » Thu May 29, 2014 4:45 pm

The DOT Medical Examination by Hartenbaum has Table 9-4 on page 262 ( 5th edition ). This is just a recommendation: For mild depression, a letter from a healthcare or mental health professional is recommended. The family doctor is fine. If they are doing well with mild depression, keep them on the road. Freud says man needs work and love. Keep 'em working.

dschrauben

Re: Recommendation for a psychiatrist/psychologist evaluatio

Post by dschrauben » Fri May 30, 2014 10:14 am

I typically have had the FMP give me a note.I saw a driver recently who described his depression as a "deep" depression. the FMCSA Medical Examiner's handbook recommends a driver with major depression be examined at least every 2 years by a psychologist/psychiatrist. It's too bad we can't get more definitive guidance on many issues. Just like OSA, there are several recommendations you can use and because the Feds don't give us more definitive screening guidelines drivers can still "shop" around for the most lenient examiners.

jmaslanko

Re: Recommendation for a psychiatrist/psychologist evaluatio

Post by jmaslanko » Fri May 30, 2014 11:51 am

Just this week at my group's monthly staff meeting, one of my partners presented a case with a similar issue. The driver was taking an SSRI for an "anger" problem. He had a letter from his PCP (an FP) stating he was able to drive a CMV. But he'd never seen a psychiatrist, and my partner couldn't determine a more specific diagnosis. This exam was a re-cert for him, and he told her he'd never had problems while driving. But she'd never seen him before, and was uncomfortable. She actually decided to DQ him until he was cleared by a psychiatrist. Our group was divided on what they would have done. Some thought the FP clearance was adequate. I suggested contacting the carrier for information on his driving history. But that might take time. She needed to make a decision, and she can't be faulted for being conservative.

Post Reply