This webcast will cover ...
•
Physical qualification requirements
•
Best practices related to physical qualifications
•
Functional capacity screening
•
Question & Answer
Moderator
Dr. Gary Petty , President & CEO, NPTC
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Panelists
Tom Bray , Sr. Editor – Transportation Management,
J. J. Keller & Associates, Inc.
Tom Moore, CTP , Senior Vice President, NPTC
Mike Walker, Director of Transportation, Metal Sales
Manufacturing Corporation.

October 2 nd , 2013

Dr. Gary Petty
President & CEO
National Private Truck Council

• Regulations – Tom Bray
• Policy and Procedure Best Practices –
Gary Petty
Tom Moore National Private
Truck Council
• Metal Sales Manufacturing Program – Mike Walker
• Housekeeping issues:
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Driver Physical Qualification
Requirements
Thomas Bray
Editor, Transportation Management
J. J. Keller & Associates, Inc.
Tom Bray
J. J. Keller &
Associates, Inc.

•
• Anyone operating a CMV as defined in §390.5
Commercial motor vehicle (CMV) includes vehicles:
 10,001 lbs. or more (rating or actual); or
 designed or used to transport more than 8 passengers
(including the driver) for compensation; or
 designed or used to transport more than 15 passengers, including the driver, not for compensation; or
 used to transport a placardable amount of hazmat
Tom Bray
J. J. Keller &
Associates, Inc.

• Anyone who has not had an exam within the past 2 years, (could be sooner depending on the expiration date of the current med card)
 For new hires, you may:
 Accept a current medical certificate; or
 Require a new exam
• Drivers whose ability to perform his/her normal job duties has been impaired by a physical or mental injury or disease (this is a carrier decision)
• Reference: §391.45
Tom Bray
J. J. Keller &
Associates, Inc.

• Section 391.41(b) covers 13 medical areas
• When in doubt:
 Use a medical advisor
 Consult FMCSA: fmcsamedical@dot.gov
Tom Bray
J. J. Keller &
Associates, Inc.

§391.41(b) Guidelines for medical disqualification:
1.
Loss of foot, leg, hand, or arm
2.
Impairment of hand, finger, arm, foot, or leg
3.
Cardiac disease
4.
Respiratory dysfunction (including untreated sleep apnea)
5.
High blood pressure
6.
Rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular disease
7.
Mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with operating a CMV
8.
Use of a 21 CFR 1308.11 Schedule I substance, an amphetamine, a narcotic, or any other habit-forming drug
9.
Current clinical diagnosis of alcoholism
Tom Bray
J. J. Keller &
Associates, Inc.

• §391.41(b) Absolutes (i.e., no judgment calls by the examiner):
 Insulin-dependent diabetes
 Epilepsy
 Vision
 Hearing
Tom Bray
J. J. Keller &
Associates, Inc.

• Medical Advisory Criteria, FAQs, and MRB
Recommendations:
 “Fills in the blanks”
 Published by FMCSA
 Used as a reference by examiners
 Offers more details than exam form
 Refers examiners to detailed studies
Tom Bray
J. J. Keller &
Associates, Inc.

• Medical examiner’s discretion includes:
 Issuing a card based on findings
 Issuing a card for entire 2 years despite guidance
 Requesting additional tests or information
 Such as sleep study or medical release from specialist
 Issuing a card for lesser time frame than guidance
 Not certifying the driver
Tom Bray
J. J. Keller &
Associates, Inc.

• Driver given medical examiner’s certification
(“med card”), carrier must place copy in DQ file
• Original long-form physical is kept at the medical examiner’s office
 Must be requested within confines of HIPAA
 Maintained separately from DQ and personnel files
 Medical examiner’s certificate does not fall under these privacy laws
Tom Bray
J. J. Keller &
Associates, Inc.

• Currently, a medical examiner must:
 Be a licensed, certified, and/or registered doctor of medicine, doctor of osteopathy, physician assistant, advanced practice nurse, or doctor of chiropractic
 Understand the demands of being a driver
 Know the regulations and reference materials
• Reference: §391.43, §390.5
Tom Bray
J. J. Keller &
Associates, Inc.

• National Registry of Certified
Medical Examiners:
 Examiners must receive approved trained, pass a test (certified), be placed on an official list,
Tom Bray
J. J. Keller &
Associates, Inc.
 Drivers/carriers must use an examiner from the list beginning May 21,
2014
• New boxes on the forms include (required in 2014):
 Medical examiner’s National Registry number
 Identification of type of commerce in which the driver is engaged
• See: http://nrcme.fmcsa.dot.gov

• Only applies to CDL holders
• Once fully implemented:
 A CDL driver’s driving record will show medical status
(driver does not have to carry card)
 Carriers must have MVR showing medical status in DQ file rather than the med card
• States:
 Started collecting medical data as of Jan. 30, 2012
 Are collecting data as existing CDLs expire, or any other contact they have with the drivers
 States must have data on all CDL drivers by Jan. 30, 2014
Tom Bray
J. J. Keller &
Associates, Inc.

Tom Moore, CTP
Senior Vice President
National Private Truck Council

Tom Moore
National Private
Truck Council
Source: FTR Associates

• Working with the medical examiner
• Maintaining medical files
• Education and training of the driver workforce
• Improving driver wellness programs
• Enhancing the qualification standards
Tom Moore
National Private
Truck Council

Hiring Qualifications
Functional
Capacity
Minimum
Age = 22.6
Minimum
Experience = 2.3 yrs.
Personality
Profile
Hair Follicle
0% 10% 20% 30% 40%
Tom Moore
National Private
Truck Council

• Physicals
 Nationwide provider versus local facility
Tom Moore
National Private
Truck Council
 Physical conductor -- doctor, nurse practitioner, physicians assistant, chiropractor
 Verify knowledge of the regulations
• Review physical post-offer

• Secure and limit access to files
• Conduct annual review twice per year
• Audit physicals forms
• Verify licenses for equipment being used
Tom Moore
National Private
Truck Council

• FMCSA provides excellent resource http://www.fmcsa.dot.gov/rulesregulations/administration/fmcsr/fmcsrruletex t.aspx?reg=391.43
• Beyond the regs, drivers need to know that you care about their welfare
• Drivers need to take responsibility
• Consider incorporating as part of the hiring & screening process
Tom Moore
National Private
Truck Council

No; 26%
No Answer; 3%
Tom Moore
National Private
Truck Council
Yes; 71%

Smoking Cessation
Weight Management
Exercise Program
Nutritional Counseling
Sleep Apnea
0% 20% 40% 60% 80% 100%
Tom Moore
National Private
Truck Council

• Problem – Driver workers’ comp claims review found that:
 10% of the claims accounted for 70% of the cost
 Over 50% of the claims involved musculoskeletal injuries
 Large number of high dollar claims occurred within 90 days of hiring date
Solution –
• Improve the company portion of the medical exam and identify those individuals that are not physically fit to perform the job by:
 Establish a customized testing program to identify significant musculoskeletal problems.


Improving cardio and overall fitness screening.
Early health risk identification.
Tom Moore
National Private
Truck Council

Michael Walker
Director of Transportation
Metal Sales Manufacturing Corporation
FPO

For more than 50 years, Metal Sales Manufacturing Corporation has earned a reputation as the premier provider of innovative metal roofing, metal siding, building components and accessories.
We’ve backed this reputation with the steel roofing industry’s largest professional sales & service team, supported by 21 branches located throughout the United States.
We offer a full line of exceptional quality metal roofing systems, siding and metal wall panels for agricultural, commercial, architectural, industrial, and residential projects of every shape and size
– new construction or retro-fit.

Equipment
118 Power Units
224 Trailers
50 Booms/All Terrain Forklifts
Mike Walker
Metal Sales
Operations Figures
7,410,000 Miles
105,612 Stops

• Utilized to safely match driver candidates to the physical demands of a truck driving position at Metal Sales Manufacturing
Corporation (MSMC) conducted in unison with pre-employment Medical Examination for Commercial Driver Fitness
Determination and re-certifications as required by the Federal Motor Carrier Safety
Regulations ( § 391.43).
Mike Walker
Metal Sales

A standardized and precise measure of an individual’s current capacity that accurately tests each candidate to ensure they can accomplish the specific physical demands of the truck driving job.
Mike Walker
Metal Sales

• Requires a detailed “job analysis” which was developed with Physical Therapist (PT) on site with
MSMC representatives outlining the responsibilities of the job.
• Minimizes the risk of injuries to the employee by identifying potential musculoskeletal and medical conditions that may increase the risk of workplace injury.
• Minimizes MSMC exposure to on-the-job injuries and the resulting expenses related to worker’s compensation claims, in addition to operational costs, i.e. common carrier expenses, equipment retrieval costs, etc.
• Helps to maximize customer service by minimizing interruptions in the workforce that can result from onthe-job injuries.
•
Reduces insurance premiums by minimizing claims.
Mike Walker
Metal Sales

ADA allows Pre-Employment Functional
Assessments. Tests/standards/programs cannot discriminate against protected classes
(females, minorities, disabled or older adults) as defined by the Civil Rights Acts of 1964 and
1991, the Americans with Disabilities Act
(ADA) and the Age Discrimination in
Employment Act (ADEA), however
Mike Walker
Metal Sales

if job relatedness is established and documented, then the fitness tests, standards and programs can distinguish who can and cannot perform the essential functions of the job. It is important to implement tests that distinguish between those who can and cannot do the essential functions of the job.
Mike Walker
Metal Sales

• Additionally the test must be required of everyone in the position and everyone in the post offer/preemployment stage of the process. It cannot be selectively applied.
Mike Walker
Metal Sales
• Under ADA, there is a provision called “reasonable accommodation”. A person with a disability who is unable to perform the essential functions of the job; has the right to request an accommodation. The employer must determine the nature of the accommodation and whether or not the accommodation is “reasonable” or would cause an “undue hardship”.

History/Physical Screen and Musculoskeletal Evaluation
•Previous / Current Health
Issues / Restrictions
•Heart Rate Pre/Post
•Projected 80% HR
•Blood Pressure
•Comments/Signed and dated by Physical
Therapist
1. Neck ROM 2. Back/Trunk ROM 3. Shoulder/UE ROM
4. Lower Ext ROM 5. Balance (10 sec.) 6. Squats (10 reps) 7. Grip Strength

TEST DESIGN CRITICAL
DEMAND
PASS SCORE OVERALL TEST
MET
Floor to Waist
Lift
FCE Equipment. Client is to lift the weight from the Floor to Waist level and back following FCE protocol. 60# x 1 rep _____
Pass Score: 60#
Score: _____
YES
NO
Front Carry
(25 feet)
FCE Equipment. Client will lift from Waist level and carry/transfer weight a total of 25 feet following FCE protocol. 60# x 1 rep ____
Pass Score: 60#
Score: _____
Chest to Floor
Lift (52”)
FCE Equipment. Client will lift from Chest (52”) level down to
Floor and back to Chest level using either 2 hands on handles or over/under hand technique. 60# x 1 rep ________
Pass Score: 60#
Score: _____
Stair/Step
Climbing
Horizontal
Pushing
FCE Equipment (ladder), ensuring 3 points of contact are maintained at all times during the activity. Clients will ascend/descend a 15” step 3 times .Steps: ____
Pass Score: 3
Steps (15”)
Score: _____
FCE Equipment. Generate 75# of horizontal push force at selfselected height in at least 1 of 3 attempts, standing, using a force gauge or wall mount pulley. Trial 1: Trial 2: Trial 3:
Pass Score:
75#
Score: ______
Horizontal
Pulling
FCE Equipment . Generate 75# of horizontal pull force at selfselected height in at least 1 of 3 attempts, standing, using a force gauge or wall mount pulley.Trial 1: ___ Trial 2: ___ Trial 3: __
Pass Score:
75#
Score: ______
Reason for Failure:

Physical Status (BP, HR, Medical contraindication, restriction)

Functional Status (unsafe body mechanics/physically incapable;applicant stops test) Signed & dated by Physical Therapist
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO

Mike Walker
Metal Sales

Mike Walker
Metal Sales

Mike Walker
Metal Sales

•
Test extreme/rare occurrences (100+ pounds) or normal, every day occurrences (60 pounds)?
• Is test standardized across the company (variations with driver and product mix at 21 MSMC locations)?
• At inception what do you do with existing (long term) employees that might not meet these restrictions?
Mike Walker
Metal Sales
•
What can be done, if anything, to lower Critical Demand functions (i.e. lower weight requirements) and/or get drivers to work more safely?
o Involve all employees (drivers, supervisors and corporate staff) to help develop testing.
o Trailer ladders.
o Accordion style tarping systems.
o
Minimize climbing on the deck with “strap bar”.
o Doors in the head board of trailer.
o Trim tubs under trailer deck.

• Quarterly and Annual Driver Incentive Programs -
 AIM –
A ccident Free I njury Free M oving Violation Free
• Decals on driver side doors on all trucks
• Physical Therapist annual participation in driver meetings at each branch
• Develop functional screening DVD in unison with Atlas Ergonomics based on the MSMC job function requirements

120
100
80
60
40
20
0
MSMC On the Job Injuries vs. Number of Drivers
Injuries
19
20
18
15
13
11 11
10
8
7 7
5 5 5
5
4
3
0
1
2013 2000 2001 2002 2003 2004 2005 2006 2007
# drivers
2008 2009 2010 2011 2012
55
62
70
76
79
85
89 90 89
84 84
90
96
100
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Back Fractures/Dislocations
8
7
6
10
9
5
4
3
2
1
0
2000 2001 2002 2003 2004
Lacerations/Contusions Strains
2005 2006 2007 2008 2009 2010
Cardiac / Heat
2011 2012 2013

• David Wright, Physical Therapist, Occupational Medicine
Physicians, New Albany, Indiana
• Dave Moore, LPN, MSMC Transportation Coordinator,
Sellersburg, Indiana
• Larry Gardner, MSMC Transportation Manager, Sellersburg,
Indiana
• Sacha Powers, MSMC Director of Human Resources
• Drew Bossen, PT, MBA, Atlas Ergonomics, www.atlasergo.com
• Brian Brennenstuhl, B & B Signs, Clarksville, Indiana, 812/282-
5366
• Pat Lanning, MSMC Marketing Manager
• Denise Hall, MSMC Corporate Transportation Assistant
Mike Walker
Metal Sales

Gary Petty
National Private
Truck Council
Tom Moore
National Private
Truck Council
Tom Bray
J. J. Keller &
Associates, Inc.
Please continue to submit your questions.
Mike Walker
Metal Sales


Gary Petty
National Private
Truck Council

Visit: www.jjkeller.com/nptcinfo
For today’s presentation and learn more about future NPTC and J. J. Keller webcasts.