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A costly error, and you pay the price

The emergence of the National Registry of Certified Medical Examiners has brought about far more problems for truckers than solutions.

One of the chief problems involves sleep apnea.

Far too many people in the regulatory realm believe apnea is a major safety issue, that it leads to accidents involving a truck. So far, not one single study makes that link. In fact, the FMCSA’s own research found no link between apnea and crashes. However, it’s become one of those issues where people regard it as true because everyone says it is.

Well, in journalism, we are taught to check out everything. Any person I know who has attended any journalism school anywhere has heard some version of this statement: If your mother says she loves you, check it out.

Of course, we’re not going to go make our mothers prove they love us. It’s just a little expression intended to remind you that any fact going into a story must be checked and double checked. You can truly trust no one.

Many of my colleagues here at OOIDA share that attitude.

Shortly after the medical registry went into effect, OOIDA started to hear from truckers. Many of them, a growing number over time, were being told they had to be tested for sleep apnea in order to get their medical card.

The truth: The creation of the registry did not change the fundamental requirements to get a medical card. No specific requirement for apnea testing was on the books.

What’s more, along the way, Congress passed a law saying that if the Federal Motor Carrier Safety Administration wanted to require those tests, it had to go through the full regulatory process.

Notably, they are just starting that process, and it is far from done.

So how did this happen?

Again, some of the folks here at OOIDA checked it out. They discovered that the training materials – the classes doctors took to qualify for inclusion on the register – led those doctors to think that apnea screening was required, and treatment for the condition was also required if it was found.

Again, to date, no such regulation outlining specific testing and treatment requirements exists anywhere.

Those training materials were produced by third parties – businesses the government contracted with, rather than producing the materials themselves. Either the business creating the materials didn’t read the regulation, the FMCSA did not review those materials, or they ignored a blatant error.

They did put out a memo attempting to clarify the situation. I’ve seen Missouri River water that was more clear.

That error has cost truckers millions of dollars. That’s an estimate, but a conservative one.

A recent survey by the American Transportation Research Institute showed that more than 50 percent of truckers subjected to the tests paid the cost out of their own wallet. Add in the lost wages from missing work – because as you all know all too well, you don’t run, you don’t get paid – and the cost of a CPAP, and you’re talking real money.

So let me do my own bit of calculation, based in part on ATRI’s findings, part on my own experience as a person with apnea.

ATRI said the average out-of-pocket expense of those truckers who had to pay all or part of their test was $1,220. My test took two days. Based on ATRI’s estimate that the average driver in their survey makes $805 a week – and I’m assuming here that’s a calendar week – that means about $322 in lost wages. Other surveys, including one by OOIDA, place that number far higher. But once again, I’m going to stay as conservative as possible in figuring this.

Now let’s talk equipment.

The CPAP mask I use, if bought on the open market, is $176. The very cheapest reliable CPAPs – the machines used to treat apnea – I found at around $200. Most were significantly more, but I went with the most conservative estimate. I won’t include the cost of other equipment involved.

At that point, for a trucker without medical coverage for apnea, which is a lot of truckers, we’re talking $1,918.

Even if we’re only talking 10,000 truckers – and while we don’t have exact figures, everything we’re seeing indicates we passed 10,000 on this long ago – that’s $19 million.

If we eventually see a half million truckers get hit with just this one test – a test not required under regulations, the result of inaccurate training and an insufficient effort to correct the error – we are talking just under 1 billion dollars, virtually all covered by individuals out of their own pockets.

The upshot of this is that many truckers who have no sleep apnea or mild sleep apnea face a big cost and an unnecessary medical treatment. So many truckers will do all they can to avoid the test.

And there’s yet one more problem. If someone does have this condition, they should get treated – not for some imaginary regulation, but because apnea can lead to other, far more serious conditions. They should do it for their own health.

If your personal doctor thinks you are at risk, I’d urge you to get tested and, if you have apnea, to get treated. But that’s not the same thing as having a sleep test as part of your DOT physical.

That’s the most insidious after-effect of this whole bundle of nonsense. I think it’s actually discouraging people from tending to their own health.

And that, my friends, is a damn shame.

 

Editor’s note: Truckers have until July 8 to comment on the FMCSA’s Advanced Notice of Proposed Rulemaking on sleep apnea screening, testing and treatment. You can make your comments here.

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