What Conditions Require Waiting Periods?

WAITING PERIODS Waiting periods are time frames where the driver may not drive following a medical event, or as a result of the medical treatment associated with a medical condition. They can vary from one week to up to 10 years; most average to approximately 3 months. Medical examiners are required to follow all waiting periods. They exist for:

• Most cardiovascular events and treatment such as heart attacks and heart surgeries.
• All seizure disorders such as epilepsy, seizures caused by head injuries, and unknown causes.
• Most other neurologic disorders such as traumatic brain injuries, following a stroke or TIA (mini stroke), after brain surgeries, and with brain infections, etc.
• Some mental disorders such as severe depression, after a suicide attempt, or if you have had a psychosis.
• The use of Chantix, a medication used to help stop smoking.
• If you are beginning the use of a CPAP or other device used to treat sleep apnea.

Conveniently, you can obtain clearance letters that specifically spells out what is needed for each condition or treatment. Regulations and Guidance – Waiting Periods If more than 1 waiting period is involved, the longer waiting period applies.

1. 1. Seizure disorder
      1. 1. FMCSA definition of epilepsy is 2 or more events or use of anti-seizure-medication to control seizures (see section on DQ for epilepsy of seizure disorders).
         2. If 1 event of unknown cause, and no anti seizure medication is required, the waiting period is 6 months (see section on required clearance).
         3. If from a known cause (medication reaction, high fever for example), no waiting period is required (Best Practice decision, see section on required medical clearance).
      1. If the driver has met or exceeded 10 years with out the use of anti seizure medication (under medical direction) and has not suffered a seizure, they may be considered for medical certification (Best Practice). See also section on exemptions.
   2. Mental Disorders (2-1:10 through 2-1:16)
      1. 1. Severe depression/thoughts of suicide or suicide attempt – 1 year
         2. Non-psychotic major depression, no suicide attempt – 6 months.
      1. Psychosis – symptom free for 1 year
         1. 1. Brief episode of psychosis – 6 months
         1. Treatment involves the use of electroconvulsive therapy – 6 months

1. 1. Cardiovascular disorders
      1. 1. Post MI – 2 months
         2. PCI (angioplasty) – 1 week
         3. Most surgical procedures except heart transplant – 3 months, except
         4. Heart transplant – 1 year
         5. Post-percutaneous balloon mitral valvotomy – 4 weeks.
         6. Surgical commissurotomy (valvular procedure) – 4 weeks.
      1. Post-balloon valvuloplasty – 1 month
   2. Pacemaker for sinus node dysfunction, and AV block is 1 month, all other pacemakers are 3 months.

1. Anticoagulation therapy – 1 month rn
   1. Pulmonary embolism/Deep Vein Thrombosis (DVT) – 3 months
2. Respiratory disorders
   1. 1. Sleep Apnea – 1 month for new CPAP use, 3 months with surgery
      2. Use of Chantix for smoking, after discontinuing use – 2 weeks
   1. Pulmonary Embolism – 3 months.
3. Neurologic disorders (7-1:7 through 7-1:14)
   1. 1. Thromboembolytic stroke – 1 year
      2. Stroke involving medial or anterior cerebral artery – 5 years
      3. Stroke with risk of seizures – 5 years
      4. Transient Ischemic Attack (TIA) – 1 year
      5. Intracerebral or subarachnoid hemorrhage – 5 years
      6. Surgically repaired AV malformation or aneurysm with no seizure risk -1 year
      7. Surgically removed infratentorial meningiomas, acustic neuromas, pituitary adenomas, and benign spinal tumors – 2 years
      8. Surgically removed supratentorial or spinal tumors – 2 years
      9. Infections of the CNS
      10. Viral encephalitis with early seizures – 10 years
      11. Bacterial encephalitis with early seizures – 5 years
      12. Infections of the CNS (bacterial meningitis, viral encephalitis without early seizures) – 1 year
      13. Traumatic Brain Injury (TBI)
      14. Moderate with early seizures – 5 years
      15. Moderate without early seizures – 2 years
      16. Benign Paroxysimal Vertigo and Vestibulopathy – 2 months
4. There are numerous variations in medical certification, waiting periods, required medical clearance, required testing, counseling, disqualifying medications and conditions etc. Please refer to these sections for this information.

Obtain a medical clearance letter specific to your condition or treatment. Go to the Pass My Physical Q&A to find out what is needed before you go. Continue to how to deal with medications.