Manifold

I'm doing it on purpose. Because I know they won't go there for DE. That would decimate PCA DE, and they know it. There are lots of organizations that run DEs at every track, and none of them require medical forms.

peterp

Exactly. The issue and solution is as simple as that. What should be added, though, to address PCA's potential concerns, rather than just asking for blind trust, is a simple checkbox on the form that says "I confirm that I use a CPAP daily to treat my OSA condition". It's still a trust system, but the applicant has effectively signed an affidavit that they will use the machine daily, so liability for failure to do so has been transferred to the applicant.

If there is a "slippery slope" of other issues like diabetes, it's just another line item checkbox having the applicant formally acknowledge that they will treat it.

Problem solved :
1) It's a trust system (solving THE problem)
2) Liability unambiguously lies with the person responsible for managing the condition
3) Applicants will be even more diligent because checking that box means they have legally committed to continually treating the condition (which has more permanence than the one-time data snapshot PCA is currently asking for that doesn't guarantee continued use)

Done! Go racing.

Manifold

Yes, that solves it. Everyone should be good with that solution.

PCA, please update the form ASAP. Luigi will sign the updated form and return to PCA racing, and the rest of us can get back to our day jobs.

LuigiVampa

I offered to provide PCA with a notarized affidavit saying I was in compliance over two and a half months ago. The medical committee and general counsel both rejected this compromise proposal without explanation.

They can't even show me the rule yet they reject every compromise offer. You tell me I'm not being retaliated against!

Mahler9th

I don't recall ever hearing about any "rule," and it does not seem that any type of "rule" is part of this situation.

PCA CR has stated that they want the type of OSA compliance information that may be required for commercial truck drivers.

They may have their reasons for this, but what has been reported here regarding their rationale makes little or no sense.

Meanwhile we know that ADA advocates for CDL/truck driver candidates with diabetes treated via insulin, and there are related requirements for physicals in the CFR.

They do so to try to ensure the "rules...are fair and do not discriminate against people with diabetes."

https://diabetes.org/tools-resources...rivers-license

We all know that hypoglycemia can be a very dangerous result of poor glycemic management and can have severely untoward consequences for drivers on streets and on tracks and in races.

Likely there are studies which (attempt to?) compare the prevalence of trucking accidents caused by poorly managed OSA to those caused by poor management of blood glucose. Accidents from either cause are unfortunate.

If PCA CR insists upon collecting data for OSA rx based on trucking "guidelines" or "requirements," then it seems natural for them to do so for folks that disclose diabetes treatment with insulin. I do not know if they do.

If they do not, their policies might be considered discriminatory against people with OSA.

And if so... discrimination based upon a medical condition may result in untoward liabilities for the PCA.

NOT GOOD.

The prevalence of therapeutic medical devices that can store data related to compliance has grown over time as appropriate technology has become available at costs that enable profitable business.

From a clinical standpoint, this has created opportunities and challenges. From a risk management standpoint, the same is true.

It would seem "unbalanced" for PCA CR to insist upon CPAP data compliant with the trucking industry when a candidate discloses CPAP therapy, if they don't insist on similar steps compliant with trucking industry when a candidate discloses diabetes with insulin treatment for glycemic control.

What is going on here may discourage some folks from being truthful in their disclosures on medical forms.

NOT GOOD.

Unintended consequences?

sbelles

It might not be good and Individual states may have laws governing private clubs but as far as I know they are mostly exempt from ADA compliance unless events are open to the general public.

Manifold

Now that PCA has taken a beating publicly, maybe they'll realize that agreeing to this compromise is reasonable and in PCA's best interest.

I don't think this is about 'rules'. PCA leaders generally have latitude to ask for information on a case by case basis in matters related to safety.

LuigiVampa

You need to stop saying that because it is absolutely untrue. It is all about the rules.

PCA can't ask for whatever they want, regardless of the rules, because that would mean there are no rules.

If they want to require something which is not a rule they need to make it a rule.

Manifold

Is there a rule explicitly or implicitly prohibiting them from asking for CPAP compliance data in this case?

LuigiVampa

YES!

It's called the minimum standard.

Imagine if whoever is in charge of PCA at the moment just gets to make up whatever rules they want. How would that work out?

PCA is governed by rules, and in my case, there is no rule requiring that I provide the CPAP data. None. If there was don't you think they would have shown it to me by now?

Manifold

Minimum standard is minimum, not maximum. Someone can ask for more than the minimum, and asking for more in a particular case doesn't mean that new 'rule' was created.

That said, if they are asking you for CPAP compliance data, they should now ask everyone for CPAP compliance data, and they should put that on the form.

But the better solution, as discussed, is that the form should be revised to say that the applicant attests that they are using the CPAP (or other treatment for OSA), and no compliance data should need to be provided.

LuigiVampa

You guys have to stop. That is not what minimum standard means.

peterp

I could not possibly agree more with @Manifold. If you are going to succeed, it’s critical to pick only battles that are justified and winnable. This is neither.

No simple medical form will ever be perfect as a pass/fail screening. They can ask for more info if they feel it is warranted, and they should always have that right.

Manifold

It's 100% what that means in professional engineering practice. Engineers can and should always do more than the minimum, if they judge that to be necessary.

Same applies to safety in general - one can and should do more than the minimum when necessary.

Who decides when more should be done than the minimum? The person responsible for making the decision.

peterp

There is a very pragmatic solution for your issue that is likely achievable as it solves the issues on all sides. You can probably get that agreed to if you focus on that.

To bring up this other stuff about minimum standard and to dissect the corporate structure of the medical committee and to attack the doctor (who, at worst, is only overreaching by requiring that he needs to see the data) just sends PCA the message that you are more interested in the fight than the solution.

The "olive branch" compromise approach would seem to be to give PCA the data now as a one-time event to get you racing ASAP, and to take time pressure off of something that will take some time to resolve, while working with them to add the "I confirm that I use a CPAP daily to treat my OSA condition" checkbox to the form for next year. You should be able to make that happen because it is better than what they have now -- the checkbox transfers potential liability from the PCA to the racer who checked the box, the racer is far more likely to manage the condition at all times because they are signing themselves up for liability by checking that box, and it is better than the current one-time data share (which does not do much to ensure they continue using it).

.