Serious Medical Conditions and Commercial Driver Licenses

Commercial drivers with serious medical conditions can still meet DOT  medical fitness requirements to safely operate a commercial vehicle and  thus hold CDLs. However, there is general agreement that careful medical  evaluations are necessary to ensure that serious medical conditions do not  preclude the safe operation of a commercial vehicle. Our analysis of DOT data and disability data from the four selected federal  agencies, SSA, VA, OPM, and DOL, found that about 563,000 individuals  had been issued CDLs and were receiving full medical disability benefits. This represented over 4 percent of all CDLs in the DOT database. About 114,000 of these  135,000 individuals, or about 85 percent, had an active CDL according to  CDL data provided by the 12 selected states. Further, our analysis of the state CDL data indicates that most of the  licenses were issued after the commercial driver was found to be eligible  for full disability benefits. As  such our analysis provides a starting point for exploring the effectiveness  of the current CDL medical certification process. Examples of Commercial Drivers with Serious Medical Conditions

Our investigations detail examples of 15 cases where careful medical  evaluations did not occur on commercial drivers who were receiving full  medical disability benefits. In general, a medical diagnosis alone is not adequate to determine  medical fitness to operate a commercial vehicle safely. Further, our  report acknowledged that because medical determinations rely in large  part on subjective factors that are not captured in databases, it is  impossible to determine from data mining and matching the extent to  which commercial drivers have a medical condition that precludes them  from safely driving a commercial vehicle and therefore if the certification  process is effective. Appendix I: Scope and Methodology

To determine to the extent possible the number of individuals holding a  current commercial driver license (CDL) who have serious medical  conditions, we presumed that individuals receiving full federal disability  benefits were eligible for these benefits because of the seriousness of their  medical conditions. For the Social Security Administration  (SSA) and the Department of Veterans Affairs (VA) we provided the CDLIS  commercial driver information to those agencies. The 12  states were selected primarily based on the size of the CDL population. To provide case-study examples of commercial drivers who hold active  CDLs while also receiving federal disability payments for a disqualifying  medical condition, we focused on four states—Florida, Maryland,  Minnesota, and Virginia. For each case, we interviewed, as appropriate, the  commercial driver, the driver’s employer, and the driver’s physician to  determine whether the medical condition should have precluded the driver  from holding a valid CDL. Table 3  below provides details by each selected state on the number of   (1) commercial drivers with active CDLs, (2) commercial drivers with an  active CDL even though they had a medical condition from which they  received full federal disability benefits, and (3) commercial drivers that  were issued a CDL after the driver was approved for full federal disability  benefit payments.
Why GAO Did This Study

Millions of drivers hold commercial driver licenses (CDL), allowing them to operate commercial vehicles. The Department of Transportation (DOT) established regulations requiring medical examiners to certify that these drivers are medically fit to operate their vehicles and provides oversight of their implementation. Little is known on the extent to which individuals with serious medical conditions hold CDLs. GAO was asked to (1) examine the extent to which individuals holding a current CDL have serious medical conditions and (2) provide examples of commercial drivers with medical conditions that should disqualify them from receiving a CDL. To examine the extent to which individuals holding CDLs have serious medical conditions, GAO identified those who were in both DOT's CDL database and selected federal disability databases of the Social Security Administration, Office of Personnel Management, and Departments of Veterans Affairs and Labor and have been identified as 100 percent disabled according to the program's criteria. Because DOT's data also include inactive licenses, GAO obtained current CDL data from 12 selected states based primarily on the size of CDL population. To provide case study examples, GAO focused on four states--Florida, Maryland, Minnesota, and Virginia. For 15 drivers identified from data mining, GAO interviewed, as appropriate, the driver, driver's employer, and driver's physician. GAO is not making any recommendations.

What GAO Found

Commercial drivers with serious medical conditions can still meet DOT medical fitness requirements to safely operate a commercial vehicle and thus hold CDLs. However, there is general agreement that careful medical evaluations are necessary to ensure that serious medical conditions do not preclude the safe operation of a commercial vehicle. Because medical determinations rely in large part on subjective factors that are not captured in databases, it is impossible to determine from data matching and mining alone the extent to which commercial drivers have medical conditions that preclude them from safely driving a commercial vehicle and therefore if the certification process is effective. GAO's analysis provides a starting point for exploring the effectiveness of the current CDL medical certification process. Our analysis of commercial license data from DOT and medical disability data from the Social Security Administration, Office of Personnel Management, and Departments of Veterans Affairs and Labor found that about 563,000 of such individuals had commercial driver licenses and were determined by the federal government to be eligible for full disability benefits. This represented over 4 percent of all commercial driver licenses in the DOT database. Our analysis of 12 selected states indicates that most of these commercial drivers still have active licenses. Specifically, for these 12 selected states, about 85 percent had a current CDL even though they had a medical condition from which they received full federal disability benefits. The majority of these drivers were issued a CDL after the driver was approved for full federal disability benefit. Our investigations detail examples of 15 cases where careful medical evaluations did not occur on commercial drivers who were receiving full disability benefits for serious medical conditions.