What type of impairment requires an SPE?
The loss of a hand, foot, leg, or arm or a fixed impairment to an extremity
- only fixed not progressive diseases
How long can you certify a driver with an SPE?
If otherwise qualified, certify up to 2 years with an SPE.
When does SPE not apply
impairment affect the torso or progressive disease.
Driver with an SPE must always what?
Have their SPE on them at all times.
How long can you certify a patient with nephropathy?
Up to two years.
- may need further monitoring or additional testing or more freq eval than every 2 years. case by case basis.
When is a creatinine with a GFR required?
- Risks for CKD
- Known medical or family hx of kidney disease
- > 65 years
- DM, HTN, Proteinuria.
Do not certify what patients with real disease?
- Driver on dialysis/renal replacement therapy
- Stage 5 with no renal replacement
- Renal transplant can get certified with certain waiting periods
How long can you certify Stage 1 and Stage 2 CKD drivers
2 years
How long can you certify stage 3 CKD drivers
1 years
How long can you certify stage 4 CKD drivesr
6 month if nml EKG and bp <140/90
3 months if nml EKG and bp 140-180/90-110
When do you not certify a stage 4 CKD driver
Abnormal ECG or echo with LVH
b/p >180/110
Can you certify a driver on anticonvulsant?
Yes if
- they are not being taken for seizures
- Enough time to stabilized on the medication and no side effects that would effect driving.
When a patient is on anticonvulsants, you must always know
Why they are taking them.
DQ if taking them for seizures
When are unprovoked seizures greatest after a structural brain injury?
2 years
What is the minimum waiting period for a structural brain injury with mild insult without early seizures, stroke without seizure risk, and intracerebral or subarachnoid hemorrhage without risk for seizure
1 year seizure free and anticonvulsants
Structural brain injury with moderate insult without early seizures or a mild insult with early seizures, waiting periods is what
2 years seizure free and off anticonvulsants
Structural brain injury moderate insult with early seizures, stroke with risk of seizure, or intracerebral or subarachnoid hemorrhage with risk of seizures
5 years seizure free and off anticonvulsants
What is max cert for structural brain injury
1 year
What is needed to certify for a structural brain injury
- Appropriate amount of waiting period
- Normal PE, neuro exam
- Neuro-ophthalamological eval and neuropsychological test
- Clearance from a neurologist
What automatically DQ’s a structural brain injury
- Severe brain insult
2. Do not meet required critieria
Can you certify seizures due to from systemic metabolic illness?
Max - 2 years if
- Only certify if they have a known etiology
- Tx was effective and has been corrected
- minimal risk of reoccurrence of primary condition
Can someone with epilepsy be certified
- Generally No.
However. if
- 8 years seizure free off medication (some say 10 years)
- On medication stable, with no change in dosages or frequency for minim 2 years.
Annual certification
Does one seizure constitute epilepsy?
No.
2 unprovoked seizures constitutes epilepsy.
Can you certify a single unprovoked seizure?
Yes.
- 5 year seizure free and off anticonvulsants
- Clearance from a neurologist
Max cert - 1 year
After 4 years can seek an exemption
