Interstate commercial drivers with epilepsy or another condition likely to cause loss of consciousness can apply to FMCSA for an exemption from 49 CFR 391.41(b)(8). There is no fill-in form: the application letter lists what the treating physician's statement must say, and FMCSA publishes each application in the Federal Register for 30 days of public comment before deciding.
The driver's treating physician writes a statement on letterhead dated within 3 months of submission and supplies recent visit notes. The driver adds a license copy, a 3-year driving record, an applicant statement and a signed medical release form.
Download the current version from the source each time; forms change without notice.
Federal Seizure Exemption Application - treating physician statement
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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On letterhead and dated within 3 months: the diagnosis, the date of the last seizure (month and year, or year), current anti-seizure medications with dose and frequency, the date of the last change to each, and a sentence stating the physician supports the applicant driving a CMV in interstate commerce.
FMCSA's criteria call for recertification every year for drivers with an epilepsy diagnosis and every 2 years for drivers with a single unprovoked seizure. FMCSA posts a separate renewal application that asks for the same treating physician letter.
Yes. FMCSA weighs low-risk causes, such as a medication, head injury with loss of consciousness of 30 minutes or less, or alcohol withdrawal, against moderate-to-high-risk causes such as penetrating head injury, brain tumor or stroke. Drivers with moderate-to-high-risk factors should be seizure-free for 8 years.