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History of the FMCSA Seizure Standard
Eileen Gregory-Nolan, R.N.Medical Programs DivisionSeptember 27, 2017
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49 CFR 391.41(b)(8)“no established medical history or clinical diagnosis of epilepsy or any other condition that is likely to cause the loss of consciousness, or any loss of control of a CMV.”49 CFR 381.300temporary relief from one or more FMCSRs…provides the person or class with relief from the regulation…exemptions may be granted from certain sections of the FMCSRs…notice and comment publication period may take up to 120 days
Applicable Regulations
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Exemption History
Medical Expert Panel (MEP) Evidence ReportComprehensive scientific literature reviewKey questions addressedGuidelines based on scientific evidence
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Exemption History
2007 MEP RecommendationsCriteria for EvaluationEpilepsy diagnosis – seizure-free 8 years on or off anti-seizure medication, if on anti-seizure medication stable 2 yearsSingle unprovoked seizure - seizure-free 4 years on or off anti-seizure medication, if on anti-seizure medication stable 2 yearsSinge provoked seizure - consider risk for recurrenceLow-risk factors – may be certified for 1 yearModerate-to-high risk factors – should not be certified
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Exemption History
Medical Review Board (MRB)Considered MEP’s Findings and Evidence ReportRecommended Maintain Current Advisory CriteriaEpilepsy/seizures - off anti-seizure medication and seizure free for 10 yearsSingle unprovoked seizure - off anti-seizure medication and seizure free 5 years
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Decision to use 2007 MEP RecommendationsRelevant current medical evidenceIndividual, case-by-case determinationCriteria for EvaluationEpilepsy diagnosis – seizure-free 8 years on or off anti-seizure medication, if on anti-seizure medication stable 2 yearsSingle unprovoked seizure - seizure-free 4 years on or off anti-seizure medication, if on anti-seizure medication stable 2 yearsSinge provoked seizure - consider risk for recurrenceLow-risk factors – may be certified for 1 yearModerate-to-high risk factors – should not be certified
Exemption History
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Exemption Review
Review process considers and includesCase-by-case medical history reviewMEP recommendationsMEP Evidence ReportMedical Advisory CriteriaPhysician Statement (submitted by treating physician)Motor Vehicle RecordRecommendations to the Associate Administrator
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