FMCSA Controls for Commercial Drivers Include Medical Exams, Drug and Alcohol Testing, and Roadside Inspections

FMCSA has established a number of key controls that are designed to  prevent CDL holders from operating commercial vehicles while impaired  that generally cover three areas. First, drivers are required to undergo  regular medical exams by a certified medical examiner to determine if a  driver is physically qualified to operate a commercial vehicle. Second,  employers are responsible for drug testing employees at various points of  employment. Third, state and federal  roadside-inspection programs are intended to identify impaired drivers  and perform other safety checks. While our review did not evaluate  whether these controls were working as intended, in prior work we have  found that these controls were vulnerable to abuse or manipulation. DOT is  required to issue implementing regulations by July 2014. In the instance of a driver who fails to renew his medical  certificate on time, the States are required to downgrade the  individual’s CDL so that he must not operate a commercial motor  vehicle until a valid medical certificate has been submitted to the State  licensing agency. When implemented, these requirements could help improve the control  vulnerabilities identified in our prior work by ensuring that proper medical  reviews are conducted and medical certificates are prepared by qualified  medical examiners. Specifically, the law requires DOT to establish, operate,  and maintain a national clearinghouse with records relating to the results  of positive drug and alcohol tests of commercial drivers or instances of  refused tests. By conducting these sweeps, FMCSA has taken positive steps  to help remove drivers that pose a risk to public safety from the road. Examples of Commercial Drivers with Disqualifying Impairments Related to Epilepsy, Drugs, or Alcohol

We identified instances of drivers who operated—and sometimes  crashed—commercial vehicles despite having medical conditions such as  epilepsy. We also found instances of state  licensing agencies issuing or reissuing CDLs to commercial drivers with  epilepsy or drug or alcohol dependence noted in their medical histories. Thirty-one of the 230 individuals we  identified were involved in accidents while driving a commercial vehicle  during this time. However, because DOT’s database of crashes does not  identify whether the driver’s medical condition may have contributed to  the accident, we could not determine the extent to which the epilepsy  impairment actually caused the accident. CDLs Were Issued or Reissued to Drivers with Impairments Related to Epilepsy, Drugs, and Alcohol

From our random selection of 100 CDL holders, we identified 22 CDL  holders who received SSA disability benefits where epilepsy, alcohol  addiction, or drug dependence was a listed medical impairment and had  CDLs issued or renewed after becoming eligible for those benefits. According to SSA documentation, the driver reported suffering from  seizures as recent as 2008. He suffered from  seizures and unconsciousness. States Could Not Provide Medical Examination Certificates

Since most state driver’s licensing agencies do not require a medical  examination report to be presented to them, according to DOT, they were  unable to provide these reports or medical certificates that we requested  for 29 of the 30 individuals who had CDLs issued or renewed after  becoming eligible for SSA benefits. As mentioned earlier,  as of January 30, 2012, FMCSA requires states to electronically store  medical certificates for new and renewing CDL applicants and are  required to electronically post this information for all CDL holders to the  state’s CDLIS driver records. Agency Comments and Our Evaluation

We provided a draft copy of this report to SSA and DOT. SSA did not  have any comments. DOT’s Director of Audit Relations, Office of the  Secretary of Transportation, provided technical comments on the report,  which have been incorporated as appropriate.
Why GAO Did This Study

Commercial vehicles such as tractor trailers and school buses must be operated by skilled drivers who are mentally and physically capable of performing their jobs safely. Prior GAO work has shown weaknesses in DOTs oversight of CDLs, such as inadequate medical certifications for commercial drivers, potentially putting the public at risk.
GAO was asked to update its work on impaired commercial drivers. This report describes (1) key controls designed to prevent medically unfit or impaired commercial drivers from operating commercial vehicles and (2) examples of commercial drivers with potentially disqualifying impairments related to epilepsy, drugs, or alcohol.
To identify key controls, GAO reviewed FMCSA policies and regulations, and interviewed officials. Cases were identified on the basis of FMCSA roadside-inspection data, DOTs Commercial Driver License Information System (CDLIS), a national database of all commercial drivers, and SSA disability insurance files. From this analysis, GAO identified commercial drivers who were driving with an epilepsy diagnosis. GAO also randomly selected 100 individuals to determine whether the driver was receiving SSA disability benefits when the state issued or renewed the drivers CDL. These cases cannot be generalized beyond those presented.
GAO provided a draft of this report to SSA and DOT. SSA did not have any comments. DOT provided technical comments, which have been addressed in the report, as appropriate.

What GAO Found

The Federal Motor Carrier Safety Administration (FMCSA), part of the Department of Transportation (DOT), has established a number of key controls designed to prevent commercial drivers license (CDL) holders from operating commercial vehicles while impaired. First, drivers are required to undergo regular medical exams by a certified medical examiner. Second, employers are responsible for drug testing employees at various points of employment. Third, state and federal roadside-inspection programs are in place to identify impaired drivers and perform other safety checks. If these key controls are operating effectively, they will help identify commercial drivers who are not capable of driving safely. However, GAOs prior work has found that these controls were vulnerable to abuse or manipulation. The Moving Ahead for Progress in the 21st Century Act, enacted in July 2012, will require additional measures to ensure that disqualified drivers do not operate commercial vehicles, and could help address some of these vulnerabilities. For example, the law requires DOT to implement a national clearinghouse of commercial-driver controlled-substance and alcohol test results by July 2014. DOT has also taken some actions, and now requires CDL holders to provide a copy of their medical certificates to the State licensing agency.
Matching CDL holders with Social Security Administration (SSA) disability files produced 204 commercial drivers who drove a commercial vehicle as recently as 2011 despite having epilepsy, a disqualifying medical condition characterized by sudden seizures and unconsciousness. Thirty-one of these drivers were involved in accidents, demonstrating the threat to public safety posed by medically impaired drivers. GAO also identified 23 cases where state licensing agencies issued or renewed CDLs for drivers after they were, according to SSA records, diagnosed with epilepsy or had drug or alcohol dependence noted, which could also disqualify them from driving under DOT regulations.
However, because DOT did not require state licensing agencies to maintain drivers medical certifications at the time of GAOs review, it is unlikely that states knew of the drivers conditions. In fact, they were unable to provide medical certifications for any of the 23 individuals. States are now required to electronically store medical certificates for new and renewing CDL applicants and will be required to electronically maintain this information for all CDL holders by January 2014. Doing so could help prevent ineligible drivers from obtaining or renewing CDLs in the future.