Complete text: Medical reciprocity letter of understanding

[ Following is the complete text of a letter from George Reagle, associate administrator for motor carriers at the U.S. Federal Highway Administration in Washington, D.C., to Nicole Pageot, director general, road safety and motor vehicle regulation, at Transport Canada in Ottawa, outlining terms of a medical reciprocity agreement between the two countries. Pageot responded with a letter confirming these terms on Dec. 30. ]

December 24, 1998

Ms. Nicole Pageot

Director General, Road Safety and Motor Vehicle Regulation

Transport Canada

Ontario, Canada K1A0N5

Dear Ms. Pageot:

This letter constitutes the official position of the United States, pursuant to the provisions of the North American Free Trade Agreement (NAFTA) to agree on a work plan to achieve reciprocity between the two nations on medical fitness requirements for operators of commercial motor vehicles (CMV). The Federal Highway Administration (FHWA) is delegated authority to establish medical fitness requirements for CMV operators in the United States (U.S.) through the Federal Motor Carrier Safety Regulations (FMCSRs). Representatives of Transport Canada and the Dept. of Transportation are coordinating this issue under the auspices of the Land Transportation Standards Subcommittee (LTSS).

The FHWA has reviewed the medical provisions of the Canadian National Safety Code for Motor Carriers (NSC) and has determined they are equivalent to the medical fitness regulations in the FMCSRs. It is also out 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.” Transport Canada has indicated that Saskatchewan is currently reviewing its medical standard for CMV drivers. Conversely, Transport Canada has reviewed the medical fitness regulations in the FMCSRs and has determined they are equivalent to the medical provisions in the NSC.

The absolute prohibition from driving by an individual who does not meet the minimum standard for vision in the FMCSRs is equivalent to the provisions of the NSC. Although the FMCSRs contain an absolute prohibition against qualifying insulin-using diabetics to operate CMVs in the U.S., the NSC allows for individual assessment of insulin-using diabetics and allows some insulin-using diabetics to operate CMVs in Canada. The U.S. has granted grandfather rights to approximately 100 insulin-using diabetics that participated in a terminated waiver program to operate in interstate commerce. To maintain the equivalency of the FMCSRs and the NSC in the qualification of diabetic driver, the FHWA and Transport Canada agree that insulin-using diabetics from either country will not be qualified to operate in the other country. The U.S. and Canada agree to notify affected drivers by letter that they will not be able to drive a CMV in trans-border operations.

The FMCSRs prohibit from driving an individual who can not hear a forced whispered voice in the better ear at not less than five feet with or without a hearing aid, or who has an average hearing loss in the better ear greater than 40 decibels at 500, 1,000, 2,000 hertz. Moreover, recent FHWA research to evaluate its hearing requirement and the role of driver hearing in CMV operations concluded that the FHWA hearing requirement is necessary. Although the NSC has an equivalent hearing requirement for drivers operating passenger and emergency vehicles or transporting dangerous goods, it has no hearing requirements for straight or articulated trucks. To ensure equivalency of medical fitness for operators of CMVs between the U.S. and Canada, the FHWA and Transport Canada agree that hearing-impaired drivers from Canada who do not meet the hearing requirements in the FMCSRs will not be qualified to operate a CMV in the U.S. Canada agrees to notify affected drivers by letter. U.S. drivers who do not meet the hearing requirements in the FMCSRs are not qualified to operate CMVs in interstate commerce and therefore are not authorized to operate CMVs in Canada.

The FMCSRs prohibit from driving an individual who has an established medical history or clinical diagnosis of epilepsy. The NSC, however, allows driver who have epilepsy and who have been seizure free for 10 years, on or off medication, to operate CMVs in Canada. To ensure equivalency of medical fitness for operating CMVs between the U.S. and Canada, the FHWA and Transport Canada agree that Canadian drivers who have a diagnosis of epilepsy will not be qualified to operate CMVs in the U.S. Canada agrees to notify affected drivers by letter. U.S. drivers who have an established medical history or clinical diagnosis of epilepsy are not qualified to operate CMVs in interstate commerce and therefore are not authorized to operate CMVs in Canada.

The FHWA and Transport Canada further agree that Canadian driver who do no meet the medical provisions in the NSC but may have a waiver issued by one of the Canadian Provinces or Territories would not be qualified to operate a CMV in the U.S. Similarly, drivers in the U.S. who do not meet [requirements of the] FMCSRs but have been waived or granted grandfather rights by the FHWA or a state would not be qualified to operate a CMV in Canada. Canada and the U.S. agree to notify affected parties.

Both countries agree to adopt an identifier code to be displayed on the licence and the driving record to identify a commercial driver who is not qualified or disqualified from operating outside the borders of his or her country. This identifier is to be mutually agreed upon within 12 months of the effective date of this agreement, and will be implemented in both countries within 24 months thereafter.

By this grant of reciprocal status, Canadian drivers who meet the medical provisions in the NSC and who operate a commercial vehicle in the U.S. will no longer be required to carry a medical fitness card as of the effective date of this agreement. If at any time in the future, the U.S. shall take steps to merge its medical fitness determination into its commercial driverÕs licence (CDL) process, Canada agrees to accept the U.S. CDL as proof of medical fitness without further negotiation between the countries.

Both countries agree to provide to the other country timely notification of any changes to its medical standards for the purpose of reviewing and ensuring the continued equivalency of the standards. This agreement may be amended at any time by the agreement of both countries, which will be effected upon the exchange of letters. The provisions of this letter are severable and subsequent exchanges shall not constitute an abrogation of the entire agreement.

Either party to this agreement may, at any time, give notice in writing to the other party of its decision to terminate the agreement. Such termination shall take effect one hundred and eighty (180) days after such notice.

I propose that if the foregoing is acceptable to the Government of Canada, this letter and your confirmatory reply constitute an understanding between our Governments. This agreement will be effective 90 days after exchanging letters of agreement. This will allow time for notification to necessary parties.

I look forward to continued cooperation between the U.S. and Canada concerning the compatibility of commercial driver systems, as well as all other aspects of CMV safety.

Sincerely yours,

George L. Reagle

Associate Administrator for Motor Carriers


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