Driver Medicals: A Bitter Pill

Brett Weibe has a vision problem. “My peripheral sight in my left eye-it isn’t good,” the Winnipeg-based owner-operator says hesitantly. “What I want to know is would a medical waiver from Manitoba be accepted by the U.S. so I could drive down there?” Marianne Sweeten wonders about her boyfriend, a company driver who runs a regular route between Regina and Omaha, Neb. If the U.S. Federal Highway Administration says it won’t honor the medical fitness qualifications of drivers from Saskatchewan because the province hasn’t adopted the medical standards outlined by Canada’s National Safety Code, she asks, “Does that mean drivers from Saskatchewan are going to be stopped at the border?”

Indeed, the reciprocity accord between the United States and Canada on medical fitness requirements for commercial drivers is generating as many questions as answers. The agreement, contained in letters exchanged between Transport Canada and the FHWA Dec. 30, means the countries will recognize each other’s rules governing medical qualifications for truck and bus drivers starting March 31, the end of a 90-day transition period. On that date, Canadian drivers will no longer be required to carry a medical fitness certificate to operate in the U.S.-their provincial driver’s licence will serve as proof of medical fitness. The two countries agreed to develop a set of identifier codes that can be displayed on the driver’s licence to reflect whether or not he is medically qualified to operate outside the borders of his country.

The agreement caps nearly three years of negotiation between the two countries, the pace of which picked up last fall when the Canadian Medical Protective Association, a legal defence group representing 56,000 doctors in Canada, warned its members that completing the paperwork required by the FHWA to verify medical fitness would increase their liability exposure. FHWA medical forms constitute U.S. legal documents, the group reasoned, opening the door for a person injured in the U.S. by a Canadian driver to sue the doctor should the driver’s medical condition at the time be called into question. The CMPA doesn’t protect members for work performed on behalf of jurisdictions outside Canada. As a result, drivers who have needed to renew their medical certification have been left scrambling for alternatives.

“We really were looking forward to a resolution to this issue that would allow Canadian doctors to get back to performing exams right away,” says Graham Cooper, vice-president of the Canadian Trucking Alliance in Ottawa. “While that hasn’t happened, we fought hard and I think earned a real victory on behalf of truck drivers. I say ‘I think’ because we’re still waiting to see how some of the loose ends get tied up before March 31.”

For that matter, so are transport officials on both sides of the border. “We have a number of issues related to this agreement that need to be refined,” concedes Brian Orrbine, senior advisor, road safety programs, at Transport Canada. “Right now, it’s premature to say exactly what all those issues are, let alone what the solutions will be. But the fact remains that there are details to be smoothed out and we’re starting the process of doing just that.”

No doubt atop the agenda is how Transport Canada and the FHWA plan to reconcile differences among the provinces on specific medical qualifications. FHWA authorities approved the deal on the presumption that medical fitness criteria outlined by Standard 6 of the National Safety Code are “equivalent” to fitness requirements in the U.S. Federal Motor Carrier Safety Regulations.

Furthermore, in the U.S. letter of agreement dated Dec. 24, FHWA associate administrator George L. Reagle writes, “It is . our understanding, based on the assurance of Transport Canada, that all Canadian provinces and territories, with the exception of Saskatchewan, have now implemented the NSC Medical Standards for Drivers.”

Most jurisdictions do in fact have some sort of requirements for vision, color perception, hearing, physical or mental disabilities, conditions requiring medication, drug or alcohol problems, and when a driver has to undergo a medical exam. But despite the guiding presence of the NSC, minimum standards for medical fitness vary from place to place. For example, some provinces require drivers to be able to distinguish between the colors red and green, while others don’t address color perception at all. Rules concerning the frequency of examinations differ as well. British Columbia, for instance, requires a physical exam at the time of the initial licence application, at ages 40, 50, 55, 60, and every two years thereafter. Alberta requires an exam only at the initial licence application and with each renewal.

Nor do the letters indicate how U.S. authorities plan to treat drivers licensed by Saskatchewan, which has not adopted National Safety Code medical standards at all. “I haven’t heard what kind of policy will be in place to address the situation,” says Peter Hurst of the transport compliance branch at Saskatchewan Highways and Transportation. “I’m aware that SGI (Saskatchewan Government Insurance, which oversees medical qualifications for drivers) is looking at making policy changes, but certainly those sorts of decisions won’t come before March 31. On the other hand, it’s hard to fathom that truck drivers from Saskatchewan will be barred from operating in the U.S. The fact is, I don’t have any answers on that.”

The letters do seem clear on a number of medical conditions that would prohibit operation of a commercial motor vehicle across the border even if a driver has been granted grandfather rights or a waiver from his home province or state. These include drivers who are insulin-using diabetics, fail to meet minimum hearing or vision requirements, or have an established medical history or clinical diagnosis of epilepsy. Wherever regulations differed on either side of the border, the two countries appeared to take the harder line.

“I would say that any driver who might doubt his or her status should wait until they are notified of the changes by Transport Canada or FHWA before jumping to conclusions,” says Hurst. “These agreements do take time to sort out in terms of policy and enforcement.”

Meanwhile, Canadian Trucking Alliance chief executive David Bradley says his association has been trying to broker an interim measure that would give doctors some assurance that they would not risk medical liability were they to resume conducting medical exams for commercial drivers without further delay. “We’re leaving no stone unturned,” Bradley says. “We’re hopeful that we, along with Transport Canada, can reach a solution. It’s proving difficult-a challenge-but we’re not going to give up.”

The CMPA says the agreement does not sufficiently reduce the risk of medical liability for Canadian doctors during the 90-day waiting period following the official exchange of letters. “It’s unfortunate for drivers, who are caught in the middle of this,” says CMPA spokesperson Françoise Parent. “But until March 31, the situation is unchanged as far as we’re concerned. . Doctors still have to sign the U.S. forms. Our advice to our members is as valid today as it was in September: don’t sign the U.S. paperwork. Hold off until the 31st of March.”

Without question, it’s one of the most definitive policy statements heard in months.