This Week’s Member Questions:
DOT Certification Issues:
I have a DOT driver with a known, unruptured, unrepaired cerebral aneurysm (fusiform enlargement of the supraclinoid right internal carotid artery measuring up to 7 millimeters in diameter), discovered incidentally 16 months ago. I'm having difficulty finding specific guidance for this type of aneurysm.
Here’s the discussion in Occnation - it focuses on outdated data from the old FMCSA handbook, NOT relying solely on the neurosurgeon’s opinion, certification guidelnes and public safety issues.
Looking for guidance on the Inspire Device for sleep apnea. In the past when this device came out, there was no way to see the usage and if the device was working properly to mange OSA. So, we were told years ago by our OHS Director that a DOT driver had to use CPAP to manage OSA and prove it it being used etc. by bringing us the CPAP compliance report. Recently, we had a patient bring us an Inspire compliance report showing usage, etc. Is this an acceptable alternative to CPAP for our DOT drivers as long as they bring us the report and it shows proper use etc? Would this still be a 1 year certification?
Short answers:
Yes, Inspire is acceptable. FMCSA mandates no specific treatment modality or compliance metric. The standard under §391.41(b)(5) and the 2024 Handbook is whether the OSA is adequately, effectively, and stably treated — not how.
But the usage report alone isn't enough. Inspire has no codified DOT threshold like CPAP's "4 hrs/night, 70% of nights," so the brief directs examiners to anchor on both adherence (usage report) and effectiveness
Yes, still a 1-year card. Modality doesn't change the interval; the brief notes the nuance that 1-year for treated OSA is a near-universal best practice rather than a strict regulatory mandate, so members should apply their existing OSA recertification policy consistently across CPAP and Inspire.
There is also a full Practice Brief here in the library:
Other Recent Practice Briefs
(Members only resource - get membership here)
Distinguishing the Respiratory Protection Standard from Substance-Specific Surveillance
Guidance on remote interpreter services, collector qualification, and documentation under 49 CFR Part 40
Clinical reference for occupational health providers on recognition, triage, and pre-hospital cooling of heat-related illness, with risk factor screening guidance for the OHP encounter.
Operational reference for CMEs managing DOT physical workflows under the FMCSA Medical Examiner's Certification Integration Rule (National Registry II), with the October 11, 2026 paper-certificate exemption expiration approaching.
There are more and adding every month!
📚 Member Library
Practice Briefs, surveillance program design, DOT compliance resources, and the full quality measurement framework live in the NAOHP Member Library.
— Larry
🎓 Build the Provider Side of the Stack
The core provider actions, the Dashboard domains, and the clinical decision standards behind them are the curriculum of the OccMed Providers Course — and the working agenda of the twice-monthly Provider Office Hours.
If your providers are the ones making the calls that drive your employer outcomes, this is the program built for them.
New Vendor Member Spotlight: Data Dimensions
Data Dimensions helps healthcare providers reduce administrative burden and streamline document-driven workflows without disrupting patient care.
Trusted by thousands of providers nationwide, our HIPAA-compliant solutions integrate
seamlessly to improve efficiency, accuracy, and visibility across clinical and
administrative operations.
Our offerings include:
Providerflow TM , a secure digital fax and document workflow solution that
streamlines inbound and outbound clinical communication by replacing
paper-based processes with automated, EHR-connected workflowsEDI Clearinghouse, with a robust network of over 4,500 electronic payor
connections and real-time eligibility verification, claims
get submitted quickly and accurately so you get paid fast.
Together, these scalable tools save clinical and administrative teams time
managing documents, accelerate reimbursement, and allow for more time
focused on patient care.
🫂 2026 conference plans
We're gauging interest in a conference this fall (a Thursday evening through Saturday in mid-October to early November, likely in the midwest, possibly Ohio).
Please answer below—this is not a commitment to register, just a read on interest.
Purpose Built Occupational Health EMR
🗓 Upcoming Events
Occ Med Sales and Marketing Office Hours is moving to LinkedIn Live this month
We’re trying a new format to make the monthly sessions easier to access, attend, and share. This month’s session will be on Thursday, June 11 at 1pm ET (10am PT), and the LinkedIn Live event will be the place to watch.
The topic is: Are You Selling Drug Tests or Employer Solutions? Ira Pasternack and David Saslavsky will discuss how Occ Med teams can move from basic service requests to stronger employer relationships using the Four-S Account Growth Framework.
You can register for the LinkedIn Live here: https://www.linkedin.com/events/areyousellingdrugtestsoremploye7466885362905432064/theater/
We’ll also be publishing recordings on YouTube in the coming weeks. Stay tuned for more information.
Prove Your Value: Hardwiring Client Communication & ROI in Occ Med
Client communication is essential to a successful Occ Med program.
How timely and thorough is your communication process?
Does your EMR assist you in that process?
Can you demonstrate a value/ROI to your clients?
Becoming a Safety Leader in Healthcare
The Expanding Role of the Nurse in Health Care Safety
Goal: Master the evolving intersection of occupational health and safety leadership.
Key Topics:
• Shifting expectations of OHNs: from clinical care to system safety oversight.
• Understanding the dual lens of employee and patient safety.
• Introduction to Total Worker Health® principles in hospital settings.
• The business case for nurse-led safety programs (ROI, risk reduction, engagement).
Target Audience:
Registered Nurses, Occupational Health Nurses, and Employee Health professionals transitioning into or expanding safety leadership roles in healthcare systems.
Free Intro Class:
Speaker: Shanna Dunbar
The first cohort for the full course is coming this fall.
Recent Events:
🏭 Occupational Health Industry News & Signals
OSHA's expanded heat enforcement program hits a state-plan deadline this week
OSHA let its 2022 Heat National Emphasis Program expire on April 8 and replaced it two days later with a revised, expanded NEP effective through April 2031. The new version strengthens how OSHA evaluates heat illness prevention and increases enforcement across construction, manufacturing, agriculture, and maritime — and widens the lens to indoor heat, including warehouses, kitchens, manufacturing floors, and boiler rooms. There's a near-term marker for state-plan states: on or before June 9, 2026, each must tell federal OSHA whether it already has an equivalent policy, intends to adopt the revised NEP, or does not intend to adopt it. The federal heat standard itself has stalled, with no finalization date set and the rule not a current administration priority — so the NEP and the General Duty Clause are the live enforcement tools. AlertMedia + 3
What it means for you: Inspectors now assess what's happening on the floor, not just what's in the binder. Indoor sites that never thought of themselves as heat-exposed are in scope. On an inspection the questions are concrete: is there a written plan, acclimatization for new and returning workers, water and shade access, and supervisors trained to spot early heat illness. That's where occupational health earns its seat — building the plan, training the people who recognize symptoms, and handling the medical side when someone goes down.
The Heat Program Design Series brief in the Member Library walks the written plan, acclimatization schedule, and surveillance components end to end. Build your heat program in the Member Library →
Workers' comp claim costs are climbing on severity
A new industry report summarized by Business Insurance finds medical severity — rather than overall claim frequency — is the defining workers' comp trend. Frequency is flat to declining nationally, but allowed medical cost per claimant rose 9.5% from 2022 to 2025, reaching $4,398 in 2025. Analysts also flag a coming pressure: as health-coverage changes under the One Big Beautiful Bill Act take hold, some injuries that would have gone through group health may shift into the comp system, with early signs possible by late 2026 or 2027. Business InsuranceBusiness Insurance
Source: Business Insurance
What it means for you: Severity is a management problem before it's an actuarial one. What a claim costs is driven largely by how it's handled after the worker walks in — early evaluation, accurate modified-duty restrictions, and a clean path back to safe productive work. Restrictions should track the injury's functional limits and nothing else. The clinics that evaluate early, set restrictions to the injury, and confidently manage what belongs in the clinic are the ones that keep their clients' severity in check.
Those are core provider actions, and they're the working curriculum of the OccMed Providers Course and the twice-monthly Provider Office Hours. Build the provider side of the stack →
The HazCom GHS Rev 7 clock is now running for employers
OSHA's updated Hazard Communication Standard aligns with GHS Revision 7. A final rule published January 15, 2026 pushed each compliance date forward four months. The first one has now passed: manufacturers, importers, and distributors had until May 19, 2026 to align labels and Safety Data Sheets for pure substances with the new standard. Updated SDSs for single-ingredient chemicals are reaching workplaces now. The downstream marker is next: employers must update workplace labeling, their written HazCom program, and employee training by November 20, 2026. VensureHR + 2
What it means for you: Any client whose workers handle covered chemicals — most industrial, construction, and manufacturing accounts — has roughly five months to update its program and retrain. The new sheets arriving now are the practical trigger to start. This is a clean, billable surveillance-and-training touchpoint, and a reason to be in front of those clients before the deadline rather than after a citation.
OccNation members are trading written-program language, SDS workflow checklists, and training outlines as the new sheets land. Find the working documents in the Member Library →