Notice2026-03527
Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillator (ICD)
Primary source
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Published
February 23, 2026
Issuing agencies
Transportation DepartmentFederal Motor Carrier Safety Administration
Abstract
FMCSA announces its decision to deny the application of one individual treated with an Implantable Cardioverter Defibrillator (ICD) who requested an exemption from the Federal Motor Carrier Safety Regulations (FMCSRs) prohibiting operation of a commercial motor vehicle (CMV) in interstate commerce by persons with a current clinical diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope (transient loss of consciousness), dyspnea (shortness of breath), collapse, or congestive heart failure.
Full Text
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<title>Federal Register, Volume 91 Issue 35 (Monday, February 23, 2026)</title>
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[Federal Register Volume 91, Number 35 (Monday, February 23, 2026)]
[Notices]
[Pages 8570-8571]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-03527]
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DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
[Docket No. FMCSA-2025-0038]
Qualification of Drivers; Exemption Applications; Implantable
Cardioverter Defibrillator (ICD)
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), Department
of Transportation (DOT).
ACTION: Notice of denial.
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SUMMARY: FMCSA announces its decision to deny the application of one
individual treated with an Implantable Cardioverter Defibrillator (ICD)
who requested an exemption from the Federal Motor Carrier Safety
Regulations (FMCSRs) prohibiting operation of a commercial motor
vehicle (CMV) in interstate commerce by persons with a current clinical
diagnosis of myocardial infarction, angina pectoris, coronary
insufficiency, thrombosis, or any other cardiovascular disease of a
variety known to be accompanied by syncope (transient loss of
consciousness), dyspnea (shortness of breath), collapse, or congestive
heart failure.
FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief,
Medical Programs Division, FMCSA, DOT, 1200 New Jersey Avenue SE,
Washington, DC 20590-0001; (202) 366-4001; <a href="/cdn-cgi/l/email-protection#385e555b4b59555d5c515b5954785c574c165f574e"><span class="__cf_email__" data-cfemail="97f1faf4e4f6faf2f3fef4f6fbd7f3f8e3b9f0f8e1">[email protected]</span></a>. Office
hours are from 8:30 a.m. to 5 p.m. ET Monday through Friday, except
Federal holidays. If you have questions regarding viewing or submitting
material to the docket, contact Dockets Operations, (202) 366-9826.
SUPPLEMENTARY INFORMATION:
I. Public Participation
A. Viewing Comments
To view comments, go to <a href="http://www.regulations.gov">www.regulations.gov</a>. Insert the docket
number, (FMCSA-2025-0038) in the keyword box and click ``Search.''
Next, choose the only notice listed, and click ``Browse Comments.'' If
you do not have access to the internet, you may view the docket online
by visiting Dockets Operations on the ground floor of the DOT West
Building, 1200 New Jersey Avenue SE, Washington, DC 20590-0001, between
9 a.m. and 5 p.m. ET Monday through Friday, except Federal holidays. To
be sure someone is there to help you, please call (202) 366-9317 or
(202) 366-9826 before visiting Dockets Operations.
B. Privacy Act
In accordance with 49 U.S.C. 31315(b)(6), DOT solicits comments
from the public on exemption requests. DOT posts these comments,
including any personal information the commenter provides, to
<a href="http://www.regulations.gov">www.regulations.gov</a>, as described in the system of records notice DOT/
ALL-14 FDMS (Federal Docket Management System), which can be reviewed
under the ``Department Wide System of Records Notices'' link at <a href="https://www.transportation.gov/individuals/privacy/privacy-act-system-records-notices">https://www.transportation.gov/individuals/privacy/privacy-act-system-records-notices</a>. The comments are posted without edit and are searchable by the
name of the submitter.
II. Legal Basis
FMCSA has authority under 49 U.S.C. 31136(e) and 31315(b) to grant
exemptions from the FMCSRs. FMCSA must publish a notice of each
exemption request in the Federal Register (49 CFR 381.315(a)). The
Agency must provide the public an opportunity to inspect the
information relevant to the application, including the applicant's
safety analysis. The Agency must provide an opportunity for public
comment on the request.
The Agency reviews the application, safety analyses, and public
comments submitted and determines whether granting the exemption would
likely achieve a level of safety equivalent to, or greater than, the
level that would be achieved absent the exemption, pursuant to the
standard set forth in 49 U.S.C. 31315(b)(1). The Agency must publish
its decision in the Federal Register (49 CFR 381.315(b)). If granted,
the notice will identify the regulatory provision from which the
applicant will be exempt, the effective period, and all terms and
conditions of the exemption (49 CFR 381.315(c)(1)). If the exemption is
denied, the notice will explain the reason for the denial (49 CFR
381.315(c)(2)). The exemption may be renewed (49 CFR 381.300(b)).
III. Background
The physical qualification standard for drivers regarding
cardiovascular diseases and loss of consciousness provides that for a
person to be physically qualified to drive a CMV, he or she must have
``no current clinical diagnosis of myocardial infarction, angina
pectoris, coronary insufficiency, thrombosis, or any other
cardiovascular disease of a variety known to be accompanied by syncope,
dyspnea, collapse, or congestive cardiac failure'' (49 CFR
391.41(b)(4)). To assist in applying this standard, FMCSA
[[Page 8571]]
publishes guidance for medical examiners (ME) in the form of medical
advisory criteria in Appendix A to 49 CFR part 391.\1\ The advisory
criteria for 49 CFR 391.41(b)(4) indicates that ICDs are installed to
address an ongoing underlying cardiovascular condition and that syncope
or collapse is likely to occur as a result of both the underlying
cardiovascular condition as well as when the ICDs discharge. Therefore,
ICDs are medically disqualifying. In April 2007, FMCSA published an
evidence report titled, ``Cardiovascular Disease and Commercial Motor
Vehicle Driver Safety,'' presenting findings regarding cardiovascular
disease and CMV driver safety.\2\ In December 2014, FMCSA published a
research report titled, ``Implantable Cardio Defibrillators and the
Impact of a Shock to the Patient when Deployed,'' that provided
evidence regarding the potential impact of ICD deployment and how it
may interfere with the safe operation of a CMV.\3\
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\1\ 49 CFR part 391, App.A.II.C, available at <a href="https://www.ecfr.gov/current/title-49/subtitle-B/chapter-III/subchapter-B/part-391/appendix-Appendix%20A%20to%20Part%20391">https://www.ecfr.gov/current/title-49/subtitle-B/chapter-III/subchapter-B/part-391/appendix-Appendix%20A%20to%20Part%20391</a>.
\2\ ``Evidence Report: Cardiovascular Disease'' (Apr. 27, 2007),
available at <a href="https://doi.org/10.21949/1502991">https://doi.org/10.21949/1502991</a>.
\3\ ``Implantable Cardio Defibrillators and the Impact of a
Shock to the Patient when Deployed Research White Paper'' (Dec. 17,
2014), available at <a href="https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2021-06/Cardio%20Defibrillators%20White%20Paper_Final_508C.pdf">https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2021-06/Cardio%20Defibrillators%20White%20Paper_Final_508C.pdf</a>.
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The Agency considered the medical advisory criteria, the April 2007
evidence report, the December 2014 research report, the application,
and the applicant's medical information in deciding whether to grant
the exemption.
On July 24, 2025, FMCSA published a notice announcing receipt of an
application from Charles Pereira requesting an exemption from 49 CFR
391.41(b)(4) and requested comments from the public (90 FR 34967). The
public comment period ended on August 25, 2025.
IV. Discussion of Comments
FMCSA received 43 comments in this proceeding. All commenters were
in support of Charles Pereira receiving an exemption from 49 CFR
391.41(b)(4).
V. Basis for Exemption Determination
The Agency conducted an individualized assessment of the
applicant's medical information, available medical and scientific data
concerning ICDs, and all relevant public comments received.
In the case of persons with ICDs, the underlying condition for
which the ICD was implanted places the individual at high risk for
syncope or other unpredictable events known to result in gradual or
sudden incapacitation. ICDs may discharge, which could result in loss
of ability to safely control a CMV. The December 2014 focused research
report referenced previously upholds the findings of the April 2007
report and indicates that the available scientific data on persons with
ICDs and CMV driving does not support the conclusion that persons with
ICDs are able to meet an equivalent or greater level of safety in
operating a CMV as persons without those devices. Furthermore, while
FMCSA received 43 comments in support of this exemption, none of the
comments provided medical evidence to support the conclusion that
persons with ICDs are able to meet an equivalent or greater level of
safety in operating a CMV as persons without those devices.
VI. Conclusion
FMCSA has determined that the available medical and scientific
literature and research provides insufficient data to enable the Agency
to conclude that granting this exemption would likely achieve a level
of safety equivalent to, or greater than, the level of safety
maintained without the exemption. Therefore, Charles Pereira (CA) has
been denied an exemption from the physical qualification standards in
49 CFR 391.41(b)(4).
Mr. Pereira, prior to this notice, received a letter of final
disposition regarding his exemption request. The decision letter fully
outlined the basis for the denial and constitutes final action by the
Agency. This notice summarizes the Agency's recent denial as required
under 49 U.S.C. 31315(b)(6)(C) by publishing the reason for this
denial.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2026-03527 Filed 2-20-26; 8:45 am]
BILLING CODE 4910-EX-P
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