National Registry of Certified Medical Examiners (NRCME) DOT Practice Exam

A driver has a fixed deficit that is less than the whole hand. Which of the following is true regarding certification of this driver?

1. The driver requires a Skill Performance Evaluation (SPE) certificate

2. You determine if the severity of a fixed deficit that is medically disqualifying unless the driver has an SPE certificate

3. The patient requires referral to an orthopedic surgeon

4. NONE of the above are correct

The correct answer is: You determine if the severity of a fixed deficit that is medically disqualifying unless the driver has an SPE certificate

The statement regarding the certification of a driver with a fixed deficit that is less than the whole hand emphasizes the role of medical evaluation in determining the driver's fitness to operate a commercial vehicle. If a driver presents with a fixed deficit, it is essential to assess not just the existence of the deficit but also its severity and potential impact on the driver's ability to perform necessary driving tasks safely. Under DOT regulations, certain medical conditions may not automatically disqualify a driver; instead, the specific circumstances, including the nature of the deficit and whether it impairs driving capabilities, must be carefully evaluated. A fixed deficit that does not completely disable a hand may or may not affect the driver's skills, depending on its characteristics. In this context, the requirement for an SPE certificate becomes crucial. An SPE certificate is an evaluation process used to determine if a driver with a disability can safely operate a commercial vehicle using adaptive techniques or devices. Therefore, unless the driver has undergone an SPE evaluation and has received the necessary certification, the severity of their fixed deficit could be a barrier to certification. This highlights why the determination of the severity of the fixed deficit is medically significant. It allows for a case-by-case evaluation based on the driver’s specific condition and capabilities, hence affirming the necessity