NOTE:
New York State Department of Education requires all elementary and secondary school bus drivers to have an annual medical examination. Drivers must comply with all rules and regulations promulgated by such department.
Except as provided in subdivision (d) of this section, the medical examination shall be performed by a licensed doctor of medicine or osteopathy, physician assistant or nurse practitioner who shall not be acting as the driver's personal physician, physician assistant or nurse practitioner during the course of the physical examination. An advanced practice nurse, who is not a nurse practitioner, may conduct the physical examination if they are acting under the direction and supervision of a physician and, if applicable, in accordance with a written practice or protocol agreement. In addition, when the medical examination is performed by an advanced practice nurse, who is not a nurse practitioner, the supervising or collaborating physician must approve the findings and sign the examination report. Any laboratory examination may be conducted to determine the driver's physical qualification as required in this Part.
INSTRUCTIONS FOR PERFORMING AND RECORDING PHYSICAL EXAMINATIONS
The medical examiner should review these instructions before performing the physical examination. Using the examination form (DS-874) answer each question yes or no where appropriate.
The medical examiner should be aware of the rigorous physical demands and mental and emotional responsibilities placed on the driver of a bus. In the interest of public safety, the medical examiner is required to certify that the driver is medically qualified.
GENERAL INFORMATION. The purpose of this history and physical examination is to certify the applicant's ability to operate a bus safely. The examination should be made carefully and be at least as complete as indicated on form DS-874.
GENERAL APPEARANCE AND DEVELOPMENT. Note marked overweight, or any posture defect, perceptible limp, tremor, or other defects that might be caused by alcoholism, thyroid intoxication, or other illnesses. No driver shall use a narcotic or other habit-forming drug.
HEAD-EYES. When other than the Snellen chart is used, the results of such test must be expressed in value comparable to the standard Snellen test. If the applicant wears corrective lenses, these should be worn while applicant's visual acuity is being tested. If corrective lenses are necessary, indicate on the examination form by checking the box, "Qualified only when wearing corrective lenses." In recording distance vision use 20 feet as normal. Report all vision as a fraction with 20 as numerator and the smallest types read at 20 feet as denominator. The driver must have a distant visual acuity of 20/40 (Snellen) in each eye with a field of vision of at least 70° in the horizontal meridian in each eye. Note ptosis, discharge, visual fields, ocular muscle imbalance, color blindness, corneal scar, exophthalmos, or strabismus, uncorrected by corrective lenses. Monocular drivers are not qualified to operate buses. If the driver habitually wears contact lenses, or intends to do so while driving, there should be sufficient evidence to indicate that he or she has good tolerance and is well adapted to their use. The use of contact lenses should be noted on the record.
EARS. Note evidence of mastoid or middle ear disease, discharge, symptoms of aural vertigo, or Meniere's Syndrome. When recording hearing, record distance from patient at which a forced whispered voice can first be heard. If audiometer is used to test hearing, record decibel loss at 500 Hz, 1,000 Hz and 2,000 Hz. If the driver is qualified only when wearing a hearing aid the following statement must be marked on the examination report: "Qualified only when wearing a hearing aid."
THROAT. Note evidence of disease, irremediable deformities of the throat likely to interfere with eating or breathing, or any laryngeal condition which could interfere with the safe operation of a bus.
THORAX-HEART. Stethoscopic examination is required. Note murmurs and arrhythmias, and any past or present history of cardiovascular disease, of a variety known to be accompanied by syncope, dyspnea, collapse, enlarged heart or congestive heart failures. Electrocardiogram is required when findings so indicate.
BLOOD PRESSURE. Record with either spring or mercury column type of sphygmomanometer. If the blood pressure is consistently above 160/90 mm. Hg., further tests may be necessary to determine whether the driver is qualified to operate a bus.
LUNGS. If any lung disease is detected, state whether active or arrested; if arrested, your opinion as to how long it has been quiescent.
GASTROINTESTINAL SYSTEM. Note any disease of the gastrointestinal system.
ABDOMEN. Note wounds, injuries, scars or weakness of muscles of abdominal walls sufficient to interfere with normal function. Any hernia should be noted if present. State how long and if adequately contained by truss.
ABNORMAL MASSES. If present, note location, if tender, and whether or not applicant knows how long they have been present. If the diagnosis suggests that the condition might interfere with the control and safe operation of a bus, more stringent tests must be made before the applicant can be certified.
TENDERNESS. When noted, state where most pronounced, and suspected cause. If the diagnosis suggests that the condition might interfere with the control and safe operation of a bus, more stringent tests must be made before the applicant can be certified.
GENITO-URINARY. Urinalysis is required. Acute infections of the genito-urinary tract, as defined by local and State public health laws, indications from urinalysis of unstabilized diabetes, symptomatic albumin-urea in the urine, or other findings indicative of health conditions likely to interfere with the control and safe operation of a bus, will disqualify an applicant from operating a bus.
NEUROLOGICAL. If positive Romberg is reported, indicate degrees of impairment. Pupillary reflexes should be reported for both light and accommodation. Knee jerks are to be reported absent only when not obtainable upon reinforcement and as increased when foot is actually lifted from the floor following a light blow on the patella, sensory vibratory and positional abnormalities should be noted.
EXTREMITIES. Carefully examine upper and lower extremities. Record the loss or impairment of a leg, foot, toe, arm, hand or fingers. Note any and all deformities, the presence of atrophy, semiparalysis or paralysis, or varicose veins. Determine whether sufficient grasp is present to enable the driver to secure and maintain a grip on the steering wheel. Determine whether sufficient mobility and strength exist to enable the driver to operate pedals properly. Particular attention should be given to and a record should be made of, any impairment or structural defect which may interfere with the driver's ability to operate a bus safely.
SPINE. Note deformities, limitation of motion, or any history of pain, injuries, or disease, past or presently experienced in the cervical or lumbar spine region. If findings so dictate, radiologic and other examinations should be used to diagnose congenital or acquired defects; or spondylolisthesis and scoliosis.
RECTO-GENITAL STUDIES. Diseases or conditions causing discomfort should be evaluated carefully to determine the extent to which the condition might be handicapping while lifting, pulling, or during periods of prolonged driving that might be necessary as part of the driver's duties.
LABORATORY AND OTHER SPECIAL FINDINGS. Urinalysis is required, as well as such other tests as the medical history or findings upon physical examination may indicate are necessary. A serological test is required if the applicant has a history of luetic infection or present physical findings indicate the possibility of latent syphilis. Other studies deemed advisable may be ordered by the examining physician.
DIABETES. If insulin is necessary to control a diabetic condition, the driver is not qualified to operate a bus if the bus driver has an established medical history or clinical diagnosis of diabetes mellitus which has not been stabilized by insulin therapy to the degree that his or her personal physician can certify that such person has not had an incident of hypoglycemic shock for a period of two years, or since the last physical examination given pursuant to the requirements of this Part, whichever is longer. In a case where diabetes can be stabilized by a diet or hypoglycemic agent and falls within the criteria indicated above, while the driver should not be disqualified, he must be under adequate medical supervision and follow-up. The follow-up shall consist of certification every six months by the employee's personal physician that his or her condition has remained stabilized and that he or she has not had an incident of hypoglycemic shock since the last certification.
N.Y. Comp. Codes R. & Regs. Tit. 15 § 6.10
New York State Department of Education requires all elementary and secondary school bus drivers to have an annual medical examination. Drivers must comply with all rules and regulations promulgated by such department.