49 CFR 391.41(b)(11) - Summary of Regulation

"First perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to American National Standard (formerly ASA Standard) Z24.5–1951."

• The required tests screen for hearing loss in the range of normal conversational tones.
• Two tests are used to screen hearing: a forced whisper test AND/OR an audiometric test.
  • Either test may be administered first.
  • Test both ears.
  • Administration of the second test may be omitted when the test results of the initial test meet the hearing requirement for that test.
• Hearing requirements are:
  • First perceive a forced whispered voice, in one ear, at not less than five feet.

  OR

  • Have an average hearing loss, in one ear, less than or equal to 40 decibels (dB).
• When a hearing aid is used to meet the hearing qualification requirement, the hearing aid must be used while driving.
• Disqualify when both the forced whisper test AND the audiometric test are failed.

Hearing plays a role in safe driving. Hearing warning sounds, such as horns, train signals, and sirens may allow the driver to react to a potential hazard before it is visible. An auditory alarm or changes in the usual sound of the engine or vehicle carriage may be the first indication that the vehicle may require maintenance.

Hearing loss can interfere with communication between the driver and other people such as dispatchers, loading dock personnel, passengers, and law enforcement officers.

Balance is required for safe driving and task performance (e.g., vehicle inspections, securing loads) and when getting into, and out of, trucks and buses.

Here are the hearing questions that are asked in the health history. Yes responses require clarification and documentation.

• Ear disorders?
• Loss of hearing?
• Loss of balance?

Here are important questions to ask.

• Symptoms related to or caused by ear disease?
• Use of otic preparations?

Examine the ears for:

• Scarring of the tympanic membranes.
• Occlusion of the external ear canal.
• Perforated eardrums.

Note and discuss abnormal findings, including the impact on driving and certification. Hearing loss can be a symptom of a disease rather than a discrete disorder. In some cases, hearing loss may be treated and reversed.

The forced whisper test and audiometry are used to determine certification. These tests measure hearing loss using the frequencies found in normal conversation. Either test can be administered first. Administration of both tests is required only when the initial test results for both ears fail to meet the hearing requirement.

A hearing aid may be used during forced whisper testing. When a driver who wears a hearing aid is unable to pass a forced whisper test, referral to an audiologist, otolaryngologist, or hearing aid center is required.

The hearing qualification requirement for:

• Forced whisper test:
  • First perceives a forced whispered voice.
  • In one ear.
  • At not less than five feet.
• Audiometric test:
  • Has an average hearing loss (average of test results for 500 Hz, 1,000 Hz, and 2,000 Hz).
  • In one ear.
  • Less than or equal to 40 dB.

Ear trauma and otic disease can adversely impact hearing and/or balance and interfere with safe driving and performance of related tasks. When findings are inconclusive regarding medical fitness for duty, ancillary tests and/or additional evaluation by a specialist, usually an audiologist or otolaryngologist, may be required to obtain sufficient medical information to determine certification status.

The following links are summaries of medical report recommendations for hearing:

• Meniere's disease.
• Vertigo.
• Labyrinthine fistula.
• Nonfunctioning labyrinth.

FMCSA medical reports are available on the FMCSA Web site.

The qualified driver, with or without the use of a hearing aid:

• First perceives a forced whispered voice, in one ear, at not less than five feet.

OR

• Has an average hearing loss, in one ear, less than or equal to 40 dB at 500 Hz, 1,000 Hz, and 2,000 Hz.

The medical examiner may certify the driver for up to 2 years.

The driver who uses a hearing aid to qualify must wear a hearing aid while driving. The medical examiner marks the "wearing hearing aid" checkbox on both the Medical Examination Report Form and the medical examiner's certificate. The examiner should advise the driver to carry a spare power source for the hearing aid.