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Posted: 11 years, 1 month ago
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REALLY wanting this career, mental disorder (schizophrenia) may be a problem, help?
I have done some more research and believe that this is going to largely come down to the company you are trying to work for. However, the company probably cannot deny you solely on the basis of your condition as long as you pass the DOT physical due to the Americans with Disabilities Act.
There is a great deal of discretion involved on the part of the medical examiner. Also, the definition for "medical examiner" is very lax.
Definition for Medical Examiner
Thus, it seems that you may choose your own medical examiner as long as they qualify under the definition above.
The medical examiner's form states under Mental disorders:
Careful consideration should be given to the side effects and interactions of medications in the overall qualification determination. See Psychiatric Conference Report for specific recommendations on the use of medications and potential hazards for driving. (See Conference on Psychiatric Disorders and Commercial Drivers at: http://www.fmcsa.dot.gov/rulesregs/medreports.htm)
The Conference on Psychiatric Disorders and Commercial Drivers states:
1. Psychiatric Disorders and CMV Driver Certification It is the opinion of the MEP that all individuals with a history of the following psychiatric disorders should undergo additional medical and psychiatric evaluation to further assess functional ability before being considered qualified to drive a CMV: Psychotic Disorders Bipolar Disorders Major Depressive Disorder with a history of psychosis, suicidal ideation, homicidal ideation or a suicide attempt Obsessive Compulsive Disorder Antisocial Personality Disorder 3 Such individuals must demonstrate that they are likely to be able to perform their normal duties by undergoing a thorough evaluation of physical and mental function by a qualified psychiatrist.
...
Several pages later it states:
4. Differentiation of Acute and Chronic Psychiatric Disorders The MEP believes FMCSA should define acute psychiatric disorders as those that have occurred for less than six months and chronic as those which have lasted more than six months. o Remission is defined as having no or minimal symptoms and no longer meeting the diagnostic criteria for the disorder. Determining whether or not an individual is in remission, however, is often a difficult judgment call as it involves assessment of functioning as well as symptoms. o Anyone who has had a history of a psychiatric disorder of concern, as previously defined, within the past 3 years or a history of a recurrent disorder of concern should be re-evaluated intermittently by a qualified psychologist or psychiatrist upon referral from the medical examiner. Justification: Individuals with a history of a psychiatric disorder of concern within the past 3 years, such as a psychotic disorder not otherwise specified or a major depressive disorder may be asymptomatic at the time of the medical evaluation but at risk for recurrence. Obtaining a mental health assessment by a qualified psychologist or psychiatrist should assist the medical examiner in assessing the likelihood of a recurrence and/or need for treatment to decrease such a likelihood. In addition, the mental health professional should recommend whether future monitoring/assessment of the individual is necessary, from a mental health perspective.
The above indicates to me that you can pass the DOT physical but there must be a specialist confirming that your condition would not interfere with your ability to safely and effectively drive a commercial vehicle. I still think the misdiagnosis scenario is preferable because schizophrenia seems to receive additional scrutiny. Additionally, the situation you described indicates to me that your condition could possibly be in remission. If it is determined that your condition is in remission I believe you it would be considered the equivalent of not having the condition at all as long as you are periodically re-evaluated to ensure that it does not reoccur and come out of remission.
I think there is a lot of hope here for people in the mental health community that would like to pursue this career. Mental health professionals will be able to make this determination without the negative stigma the general public applies to those coping with mental health conditions.
Posted: 11 years, 1 month ago
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REALLY wanting this career, mental disorder (schizophrenia) may be a problem, help?
I have done a lot of thinking about this issue as I suffer from a similar but different condition but am still interested in this career.
My reading of the guidelines indicates that schizophrenia is a disqualifying condition. However, the guidelines indicate that only a confirmed diagnosis is automatically disqualifying. It appears that there would need to be some issue that could call the original diagnoses into question. The word “confirmed” implies that the DOT would use some sort of medical professional to make this determination.
Given my experience in the mental health community, there is a significant chance that you may have been misdiagnosed. Although I do not have schizophrenia, this did occur for me and since getting the proper diagnosis the treatment has been very effective. In other words, the symptoms were better accounted for by another mental health condition meaning I did not have the original condition I was diagnosed for. I suspect that the DOT would need to confirm your diagnosis either way. Also, you would want to visit a psychiatrist that specializes in related disorders or schizophrenia itself. A specialist like this would be able to make an accurate, credible evaluation of whether there is a condition that better fits your symptoms.
If a new diagnosis is received then the following is my thoughts on how a successful exemption for the DOT physical would go.
If it is true that you do not have schizophrenia but another mental condition then the guideline used would essentially be effectiveness and safety. I would expect that you would need to be off disability for what would be the required waiting period. So, if you qualify for an automatic medical benefit through disability, which many do, use this to get the re-valuation as well as a release from disability. I believe you will need to be released from disability in order show that although you have a medical condition you can safely and effectively satisfy job duties with reasonable accommodations. This will help in getting through your physical as it would provide the examiner with direct evidence you meet the effectiveness and safety guideline. My experience with government officials is that you would likely need to be involved in an active treatment program. The presumption being that you would be less likely to exhibit dangerous symptoms later and if there was deterioration in your condition it would be detected early. Further, an active treatment program would give the examiner another piece evidence to support the effectiveness and safety guidelines. You can do anything from regular psychotherapy to medicinal therapy or a combination of both. Be aware that some medications would require additional consideration but the guidelines are pretty lax as they just need to be shown as adequate and effective. You may only need 1 session of psychotherapy every three months or something like that to qualify as having an active treatment plan.
In order for the above to be relevant, the DOT must not confirm diagnosis of schizophrenia. The guideline on this seems pretty clear cut. This situation is a tough one, you could do more than that which is described and still be denied. Just give them every reason you can to receive a certification from the DOT examiner.
I am impressed with the cooperation on the part of your recruiter.
Could you PM me with the company you are working with?
Posted: 11 years, 1 month ago
View Topic:
REALLY wanting this career, mental disorder (schizophrenia) may be a problem, help?
Posted: 11 years, 1 month ago
View Topic:
REALLY wanting this career, mental disorder (schizophrenia) may be a problem, help?
I am happy to help anyway. There are a few quick things I want to add.
This issue has been studied by the DOT with the following conclusion:
Our searches identified four studies with a total of 332 individuals with psychotic disorders, three studies with a total of 377 individuals with mood disorders, one study with anxiety disorders, and three studies with 217 individuals with personality disorders. The median quality assessment for each subgroup analysis was low. Even when pooling of data was possible, none of these analyses found a statistically significant increase in crash risk for any of the four types of disorders compared to patients without psychiatric disorders. However, the possibility of increased crash risk could not be ruled out in any of these subgroup analyses.
There is a scholarship opportunity for some with certain mental health conditions. This scholarship appears to be valid for truck driving school or other educational opportunities to further career goals if the DOT Physical disqualifies a trucking hopeful.