Physicals

DOT Physicals

Citran’s goal is to keep our roads safe by ensuring the commercial motor vehicle (CMV) driver is healthy enough to perform the demanding job of driving across our nation’s roadways. The DOT medical exam and commercial motor vehicle certification is required to determine the drivers are physically qualified to operate a CMV. Following the guidelines set forth by the Federal Motor Carrier Safety Administration (FMCSA), Citran performs DOT medical exams with providers that are certified medical examiners listed on the National Registry to ensure the high standards are met during each medical exam. Employees do not need an appointment for a DOT physical, simply walk-in to Citran to receive your medical card.

About the Exam

Each driver will be evaluated by Citran’s FMCSA certified medical examiner (MD, DO, APN, PA)
Exams are valid for 24 months, but may also be issued for lesser amount of times in order to monitor certain health conditions
Our FMCSA medical examiner’s goal is to keep your drivers safe and healthy, while keeping them on the road
Additional information may be requested to help with this cause

Recordkeeping

The driver will be given a copy of their long form and medical card
Citran is able to email, fax, or mail designated employee representatives the drivers medical long form and card for convenient and fast results

T8 Physicals

Bus drivers are entrusted with our most precious cargo…..our children! The state of Ohio has specific certification and requirements that must be met to ensure a bus driver is healthy and safe to drive.

Citran Occupational Health providers understand the specific standards set by the Ohio administrative code 3301-83-07 and the T-8 physical form. Our providers understand the ohio exam is different than the federal DOT exam and evaluate your bus drivers accordingly. They may still use the federal motor carrier safety regulation as guidance when evaluating bus drivers to exercise caution when clearing your drivers.

Drivers are assessed to ensure they are able to safely perform their job requirements as stated by the state of Ohio:

Operate a school vehicle in normal and adverse driving conditions
Operate a school vehicle for prolonged periods of time
Engage in repetitive physical activities using arms and legs
Conduct extensive pre-trip inspections of the school vehicle
Assist with loading and unloading of passengers
Lift and manage special needs and pre-school children
Manage and secure wheelchairs and other adaptive equipment
Evacuate passengers in emergency situations

Pre-Employment Physicals

Citran will assist you in hiring the right candidate for the job! From your basic physical to a comprehensive physical. Let us help you secure the candidate with our same day appointments and typical 24-hour turnaround results.

Our pre-employment physicals are designed to eliminate hiring an employee with prior or current physical ailments that may inhibit them from successfully performing the job functions required by an employer.

A basic pre-employment physical includes these components: Health history, physical exam, vision screen, blood pressure, pulse, height and weight.

A comprehensive pre-employment physical consists of the same components in a basic physical plus more in-depth screenings such as: lab tests, audiogram, chest x-ray, EKG, pulmonary function test, vaccinations and more. These evaluations are conducted to determine if the employee is capable of performing the work activities with minimal risk of injury. Employers rely on pre-employment exams to help reduce workers’ compensation claims and frequent injuries.

Before a visit to Citran for a pre-employment physical, candidates should gather important medical information to bring so our providers can get a better understanding of their medical history:

Citran authorization form
Valid driver’s license or picture ID
List of current medications
List of past surgeries or hospitalizations
List of medical conditions
List of allergies

Police & Fire Pension Exams

The expert in Clark County conducting the required medical exam for the Ohio Police & Fire Pension Fund for new hires. Candidates are scheduled within the same week to undergo tests to determine physical requirements. Results are typically received within a week of the exam.

According to Ohio law, prospective OP&F members must undergo a comprehensive pre-employment physical prior to becoming a member. The reason that this medical testing is required is because under Ohio law, an in-service disability that results from heart, cardiovascular, or respiratory disease is presumed to be duty-related (presumptive clause). OP&F can more effectively evaluate a disability case under these circumstances if the member has undergone a pre-employment health baseline that measures the presence or absence of these specified medical conditions. However, more flexibility has been added to the PEP requirements. The OP&F Board of Trustees may waive the requirement that the absence of the specified conditions must be evidenced by a pre-employment physical. The requirement can only be waived if there is competent medical evidence, as determined by the Board and/or medical advisor that a member’s heart disease, cardiovascular, disease, or respiratory disease is the result of a member’s duties as a police officer or firefighter.
The physician certification must be in the form prescribed by OP&F or a form substantially similar, as determined by OP&F in its sole and absolute discretion, which must include the physician’s diagnosis and evaluation of the existence of any heart disease, cardiovascular disease, or respiratory disease identified in the medical testing and diagnostic procedures established. The physician certification must be fully completed and signed by a licensed physician who is licensed to practice medicine in the state in which the examination was conducted; and The physician certification must state the date of the examination and the report cannot be signed more than nine months before the potential employee’s membership with OP&F; The member’s medical questionnaire completed by the member must be in the form prescribed by OP&F or a form substantially similar, as determined by OP&F in its sole and absolute discretion, but this questionnaire cannot be signed more than nine months before the potential employee’s membership with OP&F; and From and after the effective date of this rule, copies of the medical tests and procedures and medical questionnaire outlined in this rule must be included as part of the physician’s report.
The minimum medical testing and diagnostic procedures to be incorporated into a member’s physical examination administered by physicians to prospective members of OP&F shall include the following: 1. A Spirometry that represents at least a valid and reproducible forced expiratory volume at one second (FEV1), forced vital capacity (FVC), and forced expiratory volume at one second/forced vital capacity (FEV1/FVC) that meets the criteria of the American thoracic society; 2. A chest x-ray that is at least a P.A. 72” (i.e. front to back); 3. A Lipid profile that includes the total cholesterol (including both LDL and HDL); and 4. A cardiac stress test performed consistent with standard Bruce protocol and must include the electrocardiogram (EKG).

Respirator Physicals/Fit Testing

Our goal is to help keep employees safe while wearing a respirator on the job. As part of the medical clearance process, Citran medical examiners can review respirator questionnaires to determine if employees are physically fit wear a respirator. The medical clearance exam complies with OSHA standards to determine if employees can safely wear a respirator by completing the OSHA respirator questionnaire, medical examination by a licensed healthcare professional and administering a spirometry test to measure the air flow in the lungs. As part of a respiratory protection program Citran also offers a qualitative fit testing for your employee’s respirators to ensure they fit properly.

OSHA’s revised Respiratory Protection Standard (29 CFR 1910.134 and 29 CFR 1926.103) went into effect April 8, 1998.Respirators in the work place keep millions of workers safe while completing their job duties and are required in various workplaces country wide. These safety precautions protect workers against harmful fumes, fogs, dust, smokes, mists, gases, vapors and sprays as well as preventing lack of oxygen in some settings. By protecting the worker from these hazards the employer is decreasing the risk of their employees developing life altering conditions such as cancer, lung impairment and disease, or death. OSHA has developed the respiratory protection standard to prevent unnecessary deaths and illnesses from happening on the job.

Respirators offer protection by either removing the contaminants from the air or by supplying clean respirable air. The first type includes particulate respirators which work by filtering out airborne particles as well as air-purifying respirators with cartridges/canisters which filter out chemicals and gases. The second type is including self-contained breathing apparatus (SCBA) that includes their own air supply as well as airline respirators, which use compressed air from a remote source. The OSHA guidelines and website provides helpful tools for companies to select the most appropriate type of respirator for their employees.

Citran can help by ensuring the employee is healthy and safe to wear a respirator and by properly fitting the selected respirator to each employee. Citran’s respirator physical includes the mandatory OSHA respirator questionnaire that we keep on file to compare year to year. The physical also includes vital signs, and a pulmonary function test. The pulmonary function test assesses lung function. By obtaining a baseline assessment of the lung function, Citran’s providers are able to compare test year to year or after accidental exposure to better treat your employees.

After there has been an initial respirator physical, following years, the company can save time and cost, while still ensuring high quality care, by having their employees complete the OSHA respiratory questionnaire and providing the completed questionnaire to Citran’s providers to complete a respirator review. Any employee with red flags, will be contacted to come into the office for a complete physical. Any employee without any changes from the previous year will be cleared to continue to wear their respirator and maintain a healthy and productive workforce.

Once your employee is deemed medically able to wear the respirator, Citran Occupational Health offers fit testing to ensure that the respirator will protect your employee with the proper fit. If the respirator does not fit properly contaminated air can leak into the facepiece allowing the employees to breath in dangerous substances.

The “fit test” tests the seal between the respirator facepiece and the face. It takes about 20 minutes to complete and should be completed at least annually. Fit test should be performed by wearing the same make, model, and size of respirator that the employee will be using on the job to ensure that the respirator fits the employee to protect them on the job. There are two types of respirator fit testing: quantitative and qualitative.

Quantitative fit testing uses a machine to measure the actual amount of leakage into the facepiece. The respirators will have a probe attached to the facepiece that will be connected to the machine by a hose. It can be used for any type of tight-fitting respirator, and must be used to fit a SCBA. At the time, Citran Occupational Health does not offer quantitative fit testing.

Citran Occupational Health does offer Qualitative fit testing. Qualitative fit testing determines pass/fail using the employee’s sense of taste, smell, and their reaction to an irritant in order to detect a leakage into the respirator facepiece. If the employee is unable to detect the substance this is considered a “passed” test and an appropriately fitting respirator. A “failed” test is one in which the employee is able to detect the substance and would require a retest after assessing the fit of the respirator and if a different make, model, or size would be necessary.

OSHA currently accepts four qualitative fit test methods:

Isoamyl acetate: smells like bananas;
Saccharin: which leaves a sweet taste in your mouth
Bitrex: leaves a bitter taste in your mouth
Irritant smoke: can cause coughing

Citran uses bitrex, as most people are sensitive to this substance. If the employee is not sensitive to the substance, then an alternative fit test must be used.

Qualitative fit testing is most appropriate for half mask respirators and can not be used to assess full face respirators.

Factors that can affect the testing process would include glasses, personal protective equipment, and facial hair. It is important to bring all additional items that will be worn while wearing the respirator to the fit testing to ensure the respirator fits with the additional equipment. If the employee has facial hair that will interfere with the seal of the respirator, they should make sure to shave prior to fit testing, and should be required to obtain a clear seal when wearing the respirator.

Fit test should be retested every 12 months with the specific make, model, style and size of respirator the employee will be using. You must be fit tested before you use a respirator in the workplace, and you must be retested at least every 12 months to make sure that the respirator you use still fits you. Fit testing should also be completed before 12 months if there has been a change in the employee’s physical condition that would affect the fit including: Large weight gain or loss, major dental work (dentures), facial surgery altering face shape, or significant scarring in the area of the seal.  

Return-To-Work Exam

These exams are done only when an employee is currently off work and returning to work for their employer; to their job or a modified job. Most often the employee will have been released to work by their private physician. It is strongly suggested that the employer provide us with a job description for that job to which the employee will be returning, so we can compare the employee’s current physical capabilities to what is required for the job. These examinations can be basic or comprehensive.

A basic exam will focus on an uncomplicated single problem for which the employee was off work. In a basic examination, the employee has minimal to no impairment from returning to work. The physical may recommend minor restrictions that are in concert with those of the Attending Physician and there is no conflict. The employer should expect the employee to return at full duty or within the restrictions written by the Attending Physician.

A comprehensive return-to-work exam occurs when the problem for which the employee is off work is more complex, there are multiple problems or further contact and research is required with private physicians or supervisors regarding limitations, etc. A return-to-work exam also becomes comprehensive when there arises any discrepancy or conflict between the recommendations of the Citran Physician and the Attending Physician. A dictated report will always accompany a return-to-work exam.

Fitness-For-Duty Exam

Basically a general medical examination similar to a pre-placement exam looking for medical problems which may be contributing or causing impairment. These exams can be either basic or comprehensive. A comprehensive fit-for-duty exam would be done under the following circumstances: if complications arise during the exam; if other investigation or evaluation is needed; or if some type of intervention is required, such as a referral to the emergency department, EAP, private physician, etc.

It is strongly suggested that the employer provide a job description for the job so that we can compare the employee’s current physical capabilities to what is required in the job. If a drug or alcohol test is requested by the company, a written authorization form or verbal authorization must be presented by the employer representative. The physician will always have discretion to perform whatever reasonable testing is required to assist in his/her determination, drug or alcohol testing & laboratory work included. 