Physician Reporting Responsibilities to the New Jersey Motor Vehicle Commission
More than likely a day does not pass in which you have concerns about a patient whose visual functions appear compromised or impaired as it may relate to safe driving. And surely your next thought is what are my responsibilities, moral, societal, and legal. Do we have mandatory or permissive reporting laws in NJ? What are the New Jersey vision requirements? Are there other medical conditions that a physician may encounter that would require mandatory reporting? How does HIPAA play into physician reporting responsibilities? Am I personally at risk when reporting PHI, if patients do not wish me to do so?
Driving licenses are divided in Basic and Commercial classes. The provisions within the New Jersey Administrative Code that govern vision standards are premised on the statutory authority of the Motor Vehicle Commission to regulate driver safety, and the Code establishes vision standards for basic license holders. Federal regulations establish vision standards for commercial drivers. N.J.A.C. 13:21-8.10: Visual Acuity Test standards for Basic License Holders.
A.) A minimum of 20/50 in each eye, with or without corrective lenses as measured be Snellen Chart.
B.) When the vision in either eye is less than 20/50 and cannot be improved by means of corrective lenses, a certificate adequately explaining the deficiency signed by a physician, ophthalmologist of an optometrist must be presented.
C.) When the vision in either eye is less than 20/50 and corrective lenses will improve the vision, the corrective lenses will be required to be worn while driving; except where corrective lenses show an improvement but wearing lenses would be detrimental to the applicants well being a statement to this effect signed by a physician, Ophthalmologist, or Optometrist must be presented.
D.) When there is no vision in one eye, the good eye must meet the minimum standard of 20/50 with or without corrective lenses.
E.) In the event that any special device or equipment is used or needed to meet the minimum requirements outlined in this section, the matter may be referred to the Safety Standards Driver Testing for final determination.
Commercial Driver License Vision Standard
CFR 391.41(b) A person is physically qualified to drive a commercial motor vehicle that person-
CFR 391.41(b)(10) Has distant visual acuity of at least 20/40(Snellen) in each eye without corrective lenses or visual acuity separately corrected to 20/40 or better with corrective lenses, distant binocular acuity of at least 20/40 in both eyes with or without corrective lenses, field of vision of at least 70* in the horizontal meridian in each eye and the ability to recognize the colors of traffic signals and devices showing standard red, green, or amber.
Regarding Physician Reporting Requirements
NJ Law (N.J.S.A. 39:3-10.4) requires all physicians to report patients to the Motor Vehicle Commission within 24 hours after determining that a patient experiences any of the following: Recurrent convulsive seizures, recurrent period of unconsciousness or impairment, or loss of motor coordination due to conditions such as, but not limited to epilepsy in any of its forms which persist or recur despite medical treatment.
The Motor Vehicle Commission website advises that if you believe that one of your patient’s is no longer fit to drive, please fill out MVC’s FORM MR-4 Medical Emergency Report. This can include a driver that does not meet previously noted vision standards. The form can be accessed at http://www.state.nj.us/mvc/pdf/licenses/mvc-form_MR-4.pdf. If you are unable to download the form or have any questions about its contents, please call (609)292-7500 ext. 5032.
Current New Jersey law and regulations establish an elective reporting system for driver vision deficiencies and a mandatory process for reporting specific neurologic dysfunctions. As to the issue of immunity as it pertains to PHI and HIPAA laws, if a physician in good faith believes that the reporting will serve the public welfare and protect the public best interest, New Jersey Law provides immunity from Civil Liability per N.J.S.A. 39:2-16 (even in light of HIPPA). It should be so noted that there is no statutory protection from liability for a physician who has failed to report a patient that may cause injuries to a third party due to a condition know to the physician, and the physician can in fact be held liable for damages. As always, with any questions relating to potential civil liability, it is best to confer with an attorney.