FMCSA denies 16 seizure-disorder exemption requests: every applicant fell short on seizure-free time

The Federal Motor Carrier Safety Administration has turned down 16 drivers who asked to be exempted from the federal rule on epilepsy and seizures. The agency gave the same reason for all 16: they did not meet the minimum time requirement for being seizure-free, either on or off anti-seizure medication.

The notice runs in the Federal Register on Nov. 9 under docket FMCSA-2026-0036. Last week, FMCSA published separate notices granting exemptions to 39 other drivers.

The rule behind it

Under 49 CFR 391.41(b)(8), a person is physically qualified to drive a commercial motor vehicle in interstate commerce only if they have no established medical history or clinical diagnosis of epilepsy or any other condition likely to cause loss of consciousness or loss of ability to control a CMV.

Since January 2013, FMCSA has granted case-by-case exemptions from that standard. An exemption is granted only if the agency finds it would likely achieve a level of safety equal to or greater than following the rule.

How the applications were judged

FMCSA published the 17 applications for comment on March 17, 2026. The comment period closed April 16 with five comments. Two supported one applicant and one supported another; FMCSA said the comments did not change its review of the medical evidence.

For each applicant, the agency said it looked at:

• the root cause of the seizures and the applicant's seizure history;
• how long it has been since the last seizure;
• how stable the treatment regimen is, and how long the person has been on or off anti-seizure medication;
• the treating clinician's opinion on whether the person can safely drive a CMV;
• the certified driving record from the state licensing agency, including police reports for any crash.

The agency also uses the medical advisory criteria in Appendix A to Part 391 and the recommendations of its 2007 Medical Expert Panel on seizure disorders.

What the denial means

The notice covers 16 of the 17 applications. Each of the 16 drivers had already received a final decision letter before the notice ran; FMCSA said those letters explain the basis for each denial and are the agency's final action. The Federal Register notice is the public summary the law requires, listing names and the reason for denial.

The federal standard and its exemptions apply to interstate commerce; states set their own medical rules for drivers who stay within their borders. For interstate work, a driver who is denied remains medically disqualified under 391.41(b)(8) unless they later qualify.

Questions go to FMCSA's Medical Programs Division at (202) 366-4001.