The Federal Motor Carrier Safety Administration has recently rejected two groups of applicants seeking exemptions from federal commercial driving rules related to a history of epilepsy, after nearly two years in which the agency had been approving both new requests and renewals. The exemptions, when granted, allow individuals with a history of epilepsy or seizure disorders who meet specific medical criteria to operate commercial motor vehicles in interstate commerce — a pathway that has enabled hundreds of drivers to work in an industry that has faced persistent workforce shortages.

A FreightWaves review of Federal Register notices from 2024 to the present found that, before the recent actions, the last time FMCSA rejected either a new exemption request or a renewal request was in September 2024. Since then, the agency's actions had consisted of approvals of new applications or renewals of existing exemptions, making the latest denials stand out among a series of authorizations.

The larger of the two recent denials came on June 23, when FMCSA denied applications from 52 people who were included in a December 2025 exemption request. That request had been published in the Federal Register, with the agency seeking public comments.

In its June 23 Federal Register notice announcing that all 52 requests had been denied, FMCSA said it had received no comments on the request.

All FMCSA actions over the last two years reviewed by FreightWaves include the same language, quoting federal law: "The physical qualification standard for drivers regarding seizures and loss of consciousness provides that a person is physically qualified to drive a commercial motor vehicle (CMV) if that person has 'no established medical history or clinical diagnosis of epilepsy or any other condition which is likely to cause the loss of consciousness or any loss of ability to control' a CMV." Under that standard, drivers with a history of epilepsy are generally barred from holding a commercial driver's license unless they obtain an FMCSA exemption, which requires demonstrating through medical documentation that their condition is well-controlled.

In the 52-person action, FMCSA said it had carried out "individualized assessments of each applicant's medical information," including a review of their histories.

Following that review, FMCSA said in the Federal Register announcement: "FMCSA determined that these applicants do not satisfy the eligibility criteria or meet the terms and conditions of the Federal exemption and granting these exemptions would not provide a level of safety that would be equivalent to, or greater than, the level of safety" required under federal law.

Although the 52 applicants were submitted and rejected as part of a single action, the list of names shows they were not concentrated in one geographic area, with applicants coming from a range of home states.

The second recent denial involved applications from 18 individuals. FMCSA denied those exemptions on July 17, using wording almost identical to the June 23 denial.

Similar wording also appeared in a June 2024 denial of 16 applications and a September 2024 denial involving 21 applicants.

FMCSA approved a group of 63 individuals for epilepsy-related exemptions as recently as June 18, five days before denying the group of 52. That timing suggests the recent negative actions do not, by themselves, indicate a clear policy change after nearly two years of approvals.

In the approval notices, much of the background language explaining the basis for exemptions is the same as in the denial notices.

But in the June 18 approval, FMCSA said: "FMCSA has evaluated the eligibility of these applicants and determined that granting exemptions to these individuals would likely achieve a level of safety that is equivalent to, or greater than, the level that would be achieved by complying with" federal policy.

The agency added: "the Agency believes the drivers granted this exemption have demonstrated that they are unlikely to have a seizure and their medical condition does not pose a risk to public safety in the operation of a commercial motor vehicle."

Exemptions are typically granted for two-year periods, after which drivers must seek renewal by submitting updated medical information. Applicants whose requests are denied may submit new applications if their medical circumstances change.

Emails sent to the FMCSA press office and to Larry Minor, listed as FMCSA's associate administrator for policy, asking whether there had been any change in policy had not received responses by publication time.