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Guidance/Advisory Criteria — Conditions

Vertigo and Dizziness

The normal ability to maintain balance and orientation while operating a commercial motor vehicle (CMV) depends upon peripheral nervous system (PNS) sensory input from three major systems and the appropriate motor integration in the central nervous system (CNS). The three PNS sensory systems are vestibular, visual, and proprioception. Inappropriate interactions of these systems or interactions within the CNS may produce an unsafe degree of vertigo or dizziness that endangers the health and safety of the driver and the public.

The most common medications used to treat vertigo are antihistamines, benzodiazepines, and phenothiazines. Use of either benzodiazepines or phenothiazines for the treatment of vertigo would render the driver medically unqualified. Special consideration should be given to the possible sedative side effects of antihistamines. The medical examiner should determine if these drugs produce sedation in the individual driver.

Certification/Recertification — Vertigo and Dizziness

Waiting period

Minimum — 2 months asymptomatic with diagnosis of:

  • Benign positional vertigo.
  • Acute and chronic peripheral vestibulopathy.

NOTE: If more than one waiting period applies (because of multiple conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification — 2 years

NOTE: Any driver with a deficit that requires special evaluation and screening should be recertified annually.

Recommend to certify if:

The driver has a diagnosis of:

  • Benign positional vertigo and has completed the appropriate symptom-free waiting period.
  • Acute and chronic peripheral vestibulopathy and has completed the appropriate symptom-free waiting period.
  • A medical condition of a nature and severity that does not endanger the health and safety of the driver and the public.

Recommend not to certify if:

The driver has a diagnosis of:

  • Benign positional vertigo and has been symptomatic within the past 2 months.
  • Acute and chronic peripheral vestibulopathy and has been symptomatic within the past 2 months.
  • Meniere's disease.
  • Labyrinthine fistula.
  • Nonfunctioning labyrinths.

Monitoring/Testing

You may on a case-by-case basis obtain additional tests and/or consultation to adequately assess driver medical fitness for duty.

Follow-up

The driver should have at least biennial medical examinations.

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