Cardiovascular and Respiratory Disease Standards and Procedures

(1) Cardiovascular Disease Standards. (a) Any licensee or applicant who is medically determined to be an AHA functional Class IV heart patient is not eligible for a learner’s permit or license. Any licensee who is an AHA functional Class IV heart patient shall voluntarily surrender his or her driver’s license, or the Registry shall suspend or revoke the license. (b) Individuals who are determined to be AHA functional Class I, II, or III are presumed safe to operate a motor vehicle and will continue to be eligible to receive or hold a learner’s permit or license until the Registry has cause to believe such individuals are unsafe to operate a motor vehicle. In instances where the Registry has cause to believe that an AHA functional Class I, II, or III heart patient is unsafe to operate a motor vehicle, the Registry may restrict, suspend, or revoke driving privileges. The Registry may, in its discretion, request the information specified in 540 CMR 24.06(2) in determining whether an AHA functional Class I, II, or III heart patient is safe to operate a motor vehicle. (2) Change of Cardiovascular Disease Functional Status. Individuals who were formerly determined to be AHA functional Class IV heart patients and have since been re-evaluated by a physician and are now classified as an AHA functional Class I, II, or III heart patient must submit the following documentation from the physician to the Registry in order to become eligible for licensing or reinstatement of operating privileges: (a) status of the individual’s heart condition, including AHA functional class, and accompanying symptomatology; and (b) a certification, to a reasonable degree of medical certainty, that the individual is medically qualified to operate a motor vehicle safely. (3) Implantable Cardiac Defibrillators. (a) Any individual who has an implanted cardiac defibrillator (AICD) as the result of a sudden death event is not eligible for a learner's permit, license, or renewal until six months has elapsed after such device has been implanted and submission of the certification described in 540 CMR 24.06(3)(c). Such individuals shall voluntarily surrender their license or the Registry shall suspend or revoke the license. (b) If at any time after implantation of an AICD for either a sudden death event or for prophylactic reasons the AICD has been appropriately triggered, whether during the initial six month period or at any time thereafter, the individual shall voluntarily surrender his or her license or the Registry shall suspend or revoke the license until such time as the individual can provide the information listed in 540 CMR 24.06(3)(c). (c) Upon completion of the six month "trigger free" period, the individual is eligible to apply for reinstatement of his or her license privileges or for initial licensure, provided he or she can submit the following information from his or her physician: 1. a description of the individual’s current heart condition, including AHA functional class and accompanying symptomatology, if any; and 2. status of the implantable cardiac defibrillator including whether the device has triggered and if so, the exact date of the last trigger; and 3. a certification from the physician that, to a reasonable degree of medical certainty, the physician has determined that the individual is asymptomatic; the device has not been triggered for at least six months; and the individual is medically qualified to operate a motor vehicle safely, with specific reasons provided for that determination. (4) Respiratory Disease Standards- O Saturation Level. 2 (a) Any licensee or applicant for a learner’s permit or license whose O saturation level is 2 greater than 88% at rest or with minimal exertion, with or without supplemental oxygen, is presumed safe to operate a motor vehicle until such time as there is cause to believe that the person is unsafe to operate. (b) Any licensee or applicant whose O2 saturation level is 88% or less at rest or with minimal exertion, even with supplemental oxygen, is not eligible to receive or hold a learner’s permit or license. Licensees whose O saturation rate is 88% or less at rest or with 2 minimal exertion, even with supplemental oxygen, shall voluntarily surrender their license or the Registry shall suspend or revoke the license. (5) Change of O Saturation Level. Applicants or licensees whose O saturation level was 88% 2 2 or less at rest or with minimal exertion, even with supplemental oxygen, and whose saturation level has changed to greater than 88% at rest or with minimal exertion, with or without supplemental oxygen, may be eligible to regain or obtain their licensing privileges by providing the following information from the physician to the Registry: (a) medical documentation that individual’s O2 saturation level is greater than 88% at rest or with minimal exertion; and (b) a certification that, to a reasonable degree of medical certainty, the individual is medically qualified to operate a motor vehicle safely. (6) Respiratory Disease Standards- FEV-1 Levels (in Liters). Applicants or licensees whose FEV-1 level is 1.2 liters or less will be required to submit an O saturation level in order to be 2 eligible to receive or hold a learner’s permit or license. Upon receipt of the O2 saturation level, the Registry shall use the O2 saturation level criteria set forth in 540 CMR 24.06(4) and (5) in determining license eligibility. qualification criteria as he deems appropriate, or may modify these standards as an individual case may require.