Medical standards for school bus and school pupil (7D) driver's licenses

To operate vehicles that transport school pupils, there are certain medical requirements that must be met.

Overview

To be eligible to operate a school bus, 7D, or 7D½ school pupil transport vehicle, you must:

• have the ability to hear normal conversational sounds
• not have a loss of foot, leg, hand, or arm, or other physical defect or limitation likely to interfere with safe driving
• be free from any mental, nervous, heart, organic, or functional disease likely to interfere with safe driving
• be free from addiction to use of narcotics, or habit forming drugs, alcoholic beverages or liquors
• not have a “G” restriction (limit to daylight only) on your driver's license

To qualify for a 7D or 7D½ certificate, you must provide to the RMV a completed 7D school pupil transport certificate application, which should:

• be fully completed by you and the physician
• be 1 year old or less from the date of the vision screening
• contain the original signatures of you and the certifying physician. No photocopies will be accepted

Additional Resources

Application for a School Pupil Transportation (7D) Certificate

Vision

You must meet all of the following visual standards to be eligible for a school bus, 7D, or 7D½ certificate:

Visual acuity and horizontal peripheral field of vision standard:

• At least 20/40 distant visual acuity in each eye, with or without corrective lenses, and not less than 120 degrees combined horizontal peripheral field of vision
• A “B” restriction (corrective lenses) must be put on the learner's permit/ or driver's license when corrective lenses are used to meet this standard
• A customer who uses bioptic telescopic lenses is not eligible to receive a school bus, 7D, or 7D½ certificate

Color vision standard:

• Must be able to distinguish the colors red, green and amber 

Vision impairment standard:

• Must not have unresolvable diplopia (double vision which cannot be resolved by wearing an eye patch or other suppressive device) 

Diabetic condition

If you have diabetes, you are eligible to receive a school bus, 7D, or 7D½ school pupil transport vehicle certificate if:

• You've never had a hypoglycemic episode or spell (as certified by the health care provider)
• You do not use insulin to control their diabetes

If you use insulin to control your diabetes or have had a serious hypoglycemic event, you are eligible to receive a school bus, 7D or 7D½ school pupil transport vehicle certificate upon meeting all of the following conditions:

• You possess a currently valid operator's certificate
• Are not diagnosed with hypoglycemic unawareness
• Have not had a serious hypoglycemic event as certified by a Massachusetts board certified or board eligible endocrinologist within the last 3 years
• Provide a Massachusetts board certified or board eligible endocrinologist with a complete written medical history including, but not limited to:
  • the date insulin use began
  • all hospitalization reports
  • consultation notes for diagnostic examinations
  • all results of studies conducted for diabetes
  • follow-up reports and reports of any hypoglycemic insulin reactions within the last 3 years
• Are examined by a Massachusetts board certified or board eligible endocrinologist every 6 months and submits a complete school pupil transport diabetes medical evaluation form, issued by the Registry of Motor Vehicles

If you use insulin to control your diabetes you must adhere to the following conditions in order to receive a school bus, 7D, or 7D½ certificate:

• Carry, use, and record the readings from a portable, self-monitoring blood-glucose device that is equipped with a computerized memory including date and time of test
  • Readings can be recorded in a log or in paper tapes generated by self-monitoring blood-glucose devices having a printing capability
• Monitor blood glucose immediately prior to driving and every four hours thereafter while on duty
• Have log records of blood glucose values (with time and date) available to law enforcement or authorized RMV personnel upon request
• Submit log records to the certifying endocrinologist for each renewal application
• Carry on your person at all times and use, as necessary, a source of rapidly absorbable glucose
• Not operate a school bus or a school pupil transport vehicle unless blood glucose measures within the target parameters of 80 and 350
  • If blood glucose measures between 60 and 79 you cannot drive school children until blood glucose measure is within the target parameters defined above
  • If blood glucose measures below 60, you cannot drive school children until certified as “safe to operate” by a Massachusetts board certified or board eligible endocrinologist
  • If blood glucose measures 350 or more, you cannot operate a school bus or school pupil transport vehicle until certified as “safe to operate” by a Massachusetts board certified or board eligible endocrinologist
• Report and surrender your school bus, 7D, or 7D½ certificate immediately to the RMV if a serious hypoglycemic event should occur
• Submit a glucose log within fifteen days of a serious hypoglycemic event to the treating endocrinologist
• Acknowledge every 6 months through signature and in the presence of your treating endocrinologist that you understand and will adhere to the special conditions of your school bus, 7D, or 7D½ school pupil transport vehicle certificate

To ensure that you meet this diabetic condition standard, you must provide to the RMV a completed school pupil transport diabetes medical evaluation form. 

The school pupil transport diabetes medical evaluation form must be:

• Certified by the examining endocrinologist
• Signed by the license applicant
• Submitted to the RMV every 6 months

Additional Resources

School Bus and School Pupil Transport (7D) Operator Diabetes Medical Evaluation Form

Cardiovascular condition

You're not qualified to receive a school bus, 7D, or 7D½ school pupil transport vehicle certificate if you are:

• Classified according to the American Heart Association (AHA) functional classification system as an American Heart Association functional Class III or IV heart patient OR
• Have had an implanted cardiac defibrillator placed for a "sudden death event" in which case you will not be eligible for an active school bus, 7D, or 7D½ school pupil transport vehicle certificate until a 6 month period during which there is documentation of no episodes of appropriate device firing

If you were formerly deemed ineligible for a school bus, 7D, or 7D½ school pupil transport vehicle certificate due to your automated implantable cardiac defibrillator or classification as a Class III or IV heart patient, and are now eligible, you must submit a written statement from your health care provider to the RMV which indicates that:

• An automated implantable cardiac defibrillator implanted for a "sudden death event" has not fired in a 6 month period or that the automated implantable cardiac defibrillator was implanted for prophylactic reasons and has not fired in a 6 month period
• You are classified as either American Heart Association functional Class I, Class II, or does not have heart disease
• To a reasonable degree of medical certainty, you are medically qualified to operate a commercial vehicle

A health care provider may use the school bus and school pupil transport (7D) operator cardiovascular medical evaluation form  to deliver this evaluation.

Additional Resources

School Bus and School Pupil Transport (7D) Operator Cardiovascular Medical Evaluation Form

Pulmonary/respiratory condition

Minimum O2 saturation levels

If your oxygen (O2) saturation level is greater than 88% at rest or with minimal exertion, with or without supplemental oxygen, you are eligible for a School Bus, 7D or 7D½ school pupil transport vehicle certificate.

If your O2 saturation level is 88% or less at rest or with minimal exertion, even with supplemental oxygen, you're not eligible for a School Bus, 7D or 7D½ school pupil transport vehicle certificate, and are required to voluntarily surrender your School Bus, 7D or 7D½ school pupil transport vehicle certificate, or be subject to suspension or revocation. 

If your O2 saturation level was 88% or less at rest or with minimal exertion, even with supplemental oxygen, and your saturation level has changed to greater than 88% at rest or with minimal exertion, with or without supplemental oxygen, you may be able to get your licensing privileges by providing the following information from a health care provider to the RMV:

• Medical documentation that your O2 saturation level is greater than 88% at rest or with minimal exertion
• A letter from a health care provider certifying that you are medically qualified to operate a school bus or school pupil transport vehicle and perform the added duties and responsibilities associated with the transportation of school children. A health care provider may use the RMV's medical evaluation form to deliver this information.

Minimum respiratory function

If your forced expiratory (respiratory) volume in one second (FEV-1) level is 1.2 liters or less you will be required to submit an O2 saturation test result in order to be eligible for a school bus, 7D, or 7D½ school pupil transport vehicle certificate.

Additional Resources

Medical Evaluation Form

Epilepsy

If you have a current diagnosis of epilepsy, you are not eligible to receive or retain a school bus, 7D, or 7D½ school pupil transport vehicle certificate.

Additional Resources

School Bus, 7D, and 7D1/2 Certificates Issued Prior to June 16, 1998