The Federal Motor Carrier Safety Administration is asking the public to weigh in on four people with seizure histories who want permission to drive commercial motor vehicles in interstate commerce, something the federal medical standard would otherwise bar. The agency published the notice of exemption applications in the Federal Register on Sept. 8, and comments are due Oct. 8.

The requests reflect a real tension. Seizure disorders vary widely, and many people with epilepsy are well controlled on medication. But a seizure behind the wheel of a truck or bus could endanger everyone nearby. By law, FMCSA can grant an exemption only if it would likely achieve a level of safety equivalent to, or greater than, the level achieved without it.

The notice does not change the rule for anyone else, and it concerns only four individuals. It is also part of a steady stream: the Sept. 9 Federal Register carried six more FMCSA notices on epilepsy and seizure disorder exemption applications.

A Standard That Bars Epilepsy Diagnoses

Under federal driver qualification rules, a person is physically qualified to drive a commercial motor vehicle only with "no established medical history or clinical diagnosis of epilepsy" or any other condition likely to cause a loss of consciousness or loss of ability to control the vehicle. The standard governs drivers operating in interstate commerce, which is why these exemption requests are framed around crossing state lines.

FMCSA's medical advisory criteria allow some drivers to qualify without an exemption. Drivers with a history of epilepsy or seizures who are off anti-seizure medication and seizure-free for 10 years may be qualified, and drivers with a single unprovoked seizure may qualify after five years seizure-free and off medication, according to advisory criteria restated in a past FMCSA notice. Drivers who still take anti-seizure medication generally need an individual exemption, however long they have gone without a seizure.

Since Jan. 15, 2013, FMCSA has granted exemptions case by case. It weighs its medical advisory criteria, recommendations from a 2007 Medical Expert Panel that reviewed the evidence available at the time, public comments, and each applicant's medical information and driving record.

Applicants' Seizure-Free Records Vary

Two of the four applicants are Class A commercial driver's license holders, ages 52 and 55, from North Dakota and New Jersey. Both have a history of seizure disorder and take anti-seizure medication. The North Dakota applicant has been seizure-free since March 2020, with the same dosage and frequency since August 2025. The New Jersey applicant has been seizure-free since May 25, 2025, with the same dosage and frequency since Jan. 29, 2026.

The others are a 24-year-old Class C license holder in California with a history of provoked seizures, seizure-free since Oct. 30, 2020, and taking no anti-seizure medication, and a 32-year-old Class D license holder in Alabama with epilepsy who has been seizure-free since October 2024, with a medication regimen unchanged since Jan. 3, 2024. Each applicant's physician supports the request.

FMCSA's instructions for seizure exemption applicants set benchmarks. Applicants with an epilepsy or seizure disorder diagnosis should be seizure-free for eight years, on or off medication, and any medication plan should be stable for two years, meaning no changes in medication, dosage or frequency. A single unprovoked seizure calls for four years seizure-free. For a single provoked seizure, the benchmark depends on the risk of recurrence, with eight years seizure-free expected for moderate-to-high-risk causes.

Several details in the notice fall short of those benchmarks. The three applicants taking medication have all been seizure-free for less than eight years, and two of them have had stable medication regimens for less than two years. FMCSA has not ruled on any of the four, and the notice does not say how it will weigh those gaps.

Recent approvals have involved longer records. In a decision published earlier this year, the agency exempted 11 drivers who had been seizure-free for 8 to 33 years while taking anti-seizure medication and had maintained a stable treatment regimen for the previous two years.

Weighing Seizure Risk Against Road Safety

FMCSA has been direct about the stakes. In that February decision, the agency wrote that it "acknowledges the potential consequences of a driver experiencing a seizure" while operating a commercial vehicle, but said the drivers it approved had shown they were unlikely to have a seizure and did not pose a risk to public safety.

Exemptions are limited. FMCSA grants medical exemptions for two years, matching the maximum length of a driver's medical certificate, and they can be renewed. Terms in the February decision required drivers to remain seizure-free with stable treatment, report any seizure within 24 hours, submit annual reports from their treating physicians, undergo an annual exam by a certified medical examiner, and submit annual certified driving records.

The evidence behind the program has limits worth stating. The expert panel's review dates to 2007, and the notice cites no newer research. Public participation is often thin, too: FMCSA received no comments on the 11 applications it decided in February.

The public notice is also narrow. It lists each applicant's age, license class, state, seizure history, medication status and physician support, but not driving records. FMCSA says it reviews each applicant's certified driving record separately, including any moving violations and crashes. Commenters are working from a partial picture.

Comment Deadline and Decision Ahead

Comments on docket FMCSA-2026-0043 can be filed through the regulations.gov docket for these applications, or by mail, hand delivery, or fax to the Department of Transportation's Dockets Operations office. Comments are posted publicly, including any personal information they contain. FMCSA asks commenters to cite the docket number, identify the section of the notice they are addressing, and give a reason for each suggestion.

The people most affected include drivers with seizure histories who are seeking commercial careers, the carriers that might hire them, and the traveling public that shares highways with heavy vehicles. Drivers with a seizure disorder should talk with their treating physician and a certified medical examiner before assuming they are eligible. FMCSA's application requires a physician's letter dated within three months that lists the diagnosis, the date of the last seizure, and medication history, along with a driving record covering the past three years.

After the comment period closes, FMCSA will review each application and publish its decision in the Federal Register, listing the terms of any exemption granted or explaining any denial. The bottom line: the rule itself is not changing, but four individual requests are open for public scrutiny until Oct. 8.

What Readers Want to Know

What is FMCSA asking the public to comment on?

Applications from four people with seizure histories who want exemptions from the federal rule that bars drivers with epilepsy or similar conditions from operating commercial motor vehicles across state lines. Comments are due Oct. 8, 2026.

Can people with epilepsy drive trucks interstate?

Some can. Under FMCSA's advisory criteria, drivers with a history of epilepsy who are off medication and seizure-free for 10 years may qualify. Drivers still on medication generally need an individual exemption, which FMCSA has granted case by case since 2013.

What does FMCSA look for in an exemption request?

Its instructions call for applicants with epilepsy to be seizure-free for eight years, on or off medication, with any medication plan unchanged for two years. The agency also considers driving records, physician statements, and public comments.

Will all four applicants be approved?

That is not known. FMCSA has not ruled, and several details in the notice fall short of the agency's published benchmarks. Decisions will be published in the Federal Register.

How long does an exemption last?

Two years, matching the maximum length of a medical certificate. Exemptions can be renewed, and recent terms have required annual physician reports and annual medical exams.

How can I submit a comment?

Go to regulations.gov and search docket FMCSA-2026-0043, or send comments by mail, hand delivery or fax to DOT Dockets Operations. Comments, including personal information, are posted publicly.