CDME Module 6: Epilepsy, Seizures or Loss of Consciousness (2025)-Opinions of Expert Panel Traumatic Brain Injury and Commercial Motor Vehicle Driver Safety. October 30, 2009.

Opinions of Expert Panel Traumatic Brain Injury and Commercial Motor Vehicle Driver Safety. October 30, 2009.

Pdf Summary

The document summarizes the opinions and recommendations of a Medical Expert Panel (MEP) regarding the impact of Traumatic Brain Injury (TBI) on commercial motor vehicle (CMV) driver safety. The report provides guidelines for the certification of CMV drivers with varying severity of TBI.<br /><br />The MEP consists of four experts: Natalie Hartenbaum, MD; John Hastings, MD; Margit Bleecker, MD, PhD; and Steven Mandel, MD. Their methodology involved a systematic review of existing literature provided by ECRI Institute and MANILA Consulting Group, alongside a one-day meeting to formulate opinions.<br /><br />The panel provided several opinions:<br /><br />1. **Severe TBI:** Individuals with severe TBI (loss of consciousness >24 hours) should be permanently disqualified from driving CMVs due to potential impairments and increased seizure risk.<br /><br />2. **Moderate TBI:** Those with moderate TBI (loss of consciousness between 1-24 hours) should wait three years before certification. Post this period, they must be symptom-free, cleared by a healthcare provider, and evaluated by a neurologist.<br /><br />3. **Mild TBI:** Drivers with mild TBI (loss of consciousness <1 hour) can be certified once symptom-free, with a recommendation to wait 30-90 days post-injury depending on the presence of loss of consciousness.<br /><br />4. **Anti-Seizure Medication:** Individuals on anti-seizure medication should comply with existing FMCSA guidelines related to epilepsy and seizures before certification.<br /><br />5. **Extremity Impairment:** Individuals with TBI-related extremity impairments can apply for a skill performance evaluation certificate.<br /><br />6. **Examiner Qualifications:** Only MDs or DOs should conduct medical examinations for drivers with TBI due to complexities involving cognitive dysfunctions and seizure risks.<br /><br />The report also discusses the likelihood of seizures post-TBI, noting individuals who haven't seized in the first week post-injury still have a significant seizure risk over several years. Rehabilitation program impacts on driving performance remain inconclusive due to insufficient evidence. Overall, the panel's opinions aim to better align safety standards with current medical understanding, addressing both cognitive and physical implications of TBI on CMV drivers.

Keywords

Traumatic Brain Injury

CMV driver safety

Medical Expert Panel

TBI certification guidelines

severe TBI disqualification

moderate TBI waiting period

mild TBI certification

anti-seizure medication

extremity impairment evaluation

examiner qualifications