The White Coat Criminals. DOT Med Examiners Behaving Badly

How fraudulent medical certification has put medically unqualified drivers behind the wheels of commercial vehicles, directly causing preventable deaths

DOT medical examiners who sell commercial driver med certs like drive-through prescriptions are putting medically unqualified drivers behind the wheels of CMVs. The barriers to entry like medical and physical fitness, the ability to shift a manual transmission, etc., etc., have largely been hijacked and eliminated over the past 15-20 years. From gas station and fast food "clinics" to airport offices, a network of corrupt medical professionals has transformed commercial driver medical certification from a safety barrier into a profit center with fatal consequences documented by the National Transportation Safety Board.

The scope of medical certification fraud is wild. Over 15,000 commercial drivers received voided medical certificates from just two Houston-area doctors in 2025. A single Alabama chiropractor falsely certified over 2,000 drivers. A New York doctor operating from JFK Airport used unqualified staff to conduct fake exams while selling oxycodone prescriptions for cash. These are evidence of systematic corruption that has turned medical certification into America's deadliest fraud scheme.

National Transportation Safety Board investigations provide evidence of how fraudulent medical certification directly causes preventable deaths. In a 2016 Palm Springs crash that killed 13 people and injured 31, investigators found that the truck driver had untreated obstructive sleep apnea, and the bus driver had untreated diabetes and was fatigued, likely due to acute sleep loss, at the time of the crash.

The truck driver "was most likely asleep at the time of the crash, due to fatigue that, given his extremely high level of obesity, probably resulted from undiagnosed and untreated moderate-to-severe obstructive sleep apnea." The bus driver had untreated diabetes, NTSB says, even though he tested positive in a glucose urine test, meaning he likely had diabetes during his most recent medical certificate examination.

A 2018 fatal multivehicle crash in Illinois that killed one person and injured others revealed similar medical certification failures. All three truckers involved in the deadly pile-up had lied to obtain medical certifications. Based on his medical conditions, the Pioneer truck driver should have been referred for a sleep study. But he wasn't. The screening physician was unaware that the Medical Review Board's recommendations for sleep apnea had been updated by the FMCSA in 2016.

These crashes were preventable tragedies caused by medical examiners who failed to detect disqualifying conditions that federal regulations specifically prohibit in commercial drivers.

The Federal Motor Carrier Safety Administration's April 2025 action against Houston-area doctors Dr. Jenny Le and Dr. Dustin Mai represents the largest medical certification fraud case in DOT history. FMCSA voided over 15,000 unexpired Medical Examiner's Certificates (MECs) issued by Dr. Le and Dr. Mai between March 2023 and March 2025, an action that affected 15,225 commercial motor vehicle drivers.

Two individuals compromised the medical certification of more drivers than some states process in a year, demonstrating how easily bad actors can exploit the system. The investigation found that these examiners "failed to correctly apply required standards for CMV driver qualification," essentially rubber-stamping certifications without conducting proper examinations.

Both doctors were chiropractors, highlighting a concerning trend in medical certification fraud. While chiropractors can be qualified medical examiners when properly trained, the profession's accessibility, combined with inadequate federal oversight, has created opportunities for individuals to obtain examining authority without understanding commercial vehicle medical requirements. When I create policies for fleets are advise on policies for fleets, or when I oversaw large private equity, multi-DOT fleets, I always recommended they have a policy against using chiropractors in general for medical certifications.

The case of Dr. Kenneth Edwards in Phenix City, Alabama provides a detailed blueprint of how medical certification fraud operates. Edwards, a chiropractor, operated an assembly-line system that processed thousands of drivers without conducting legitimate examinations.

Dr. Edwards was charged with crimes including conspiracy, wire fraud, conspiracy to commit wire fraud, making false statements, and falsification of federal records. The investigation initiated by the U.S. Department of Transportation determined that while listed as a Certified Medical Examiner on the National Registry, Dr. Edwards exhibited a pattern whereby examinations were incomplete, required tests were not performed, and information on medical examination forms was falsified.

Edwards employed Joann Bush as a medical assistant and Andrea Daigle as his office manager. Neither Bush nor Daigle was authorized to conduct DOT medical examinations, yet they performed many of the "physicals" while Edwards falsified records claiming he had conducted the examinations personally. Edwards, Bush, and Daigle often failed to examine the applicant's hearing and periodically neglected to fulfill other DOT requirements for physicals, such as urinalysis, vision tests, and health history reviews. In some cases, they wrote false entries on medical examination forms when an accurate report would have disqualified the applicant.

In one documented case, Dr. Edwards reported that an applicant had 20/20 vision in both eyes. In fact, one of the applicant's eyes was prosthetic. This wasn't medical oversight, it was criminal fraud that put a visually impaired driver behind the wheel of a commercial vehicle. Edwards was sentenced to 37 months in federal prison and ordered to pay $10,000 in fines. The judge described his actions as putting "physically unqualified individuals behind the wheels of large commercial vehicles," making "our region's roadways more dangerous as a result of Dr. Edwards's greed."

In another case, Dr. Gerald Surya, who operated from JFK International Airport while simultaneously running drug dealing and medical certification fraud schemes. Surya, a senior aviation medical examiner authorized to examine pilots, used his airport location to conduct fraudulent DOT medical examinations while selling oxycodone prescriptions for cash.

Dr. Gerald Surya was indicted by a Federal grand jury in U.S. District Court, Brooklyn, NY, for fraud in connection with identification documents. Dr. Surya practiced medicine at JFK Medport, Inc. (Medport) located at JFK Airport in Queens, NY. DOT-OIG's investigation determined that Surya had knowledge of and approved the use of unqualified medical assistants and interns in conducting DOT medical examinations at Medport.

The medical assistants and interns forged Dr. Surya's name on medical examination forms and certificates even though Surya was not present for said examinations. This created a parallel fraud scheme where unqualified staff conducted fake medical examinations while Surya sold illegal drug prescriptions from the same location.

Surya's drug-dealing operation provides insight into the criminal mentality behind medical fraud. The investigation revealed that Dr. Surya sold prescriptions for oxycodone, a powerful opioid painkiller, and other controlled substances to a select group of "patients" in exchange for cash. At the outset of the investigation in 2013, Dr. Surya charged $60 cash for each illegal prescription, however, he raised the price to approximately $100 per prescription after agents and investigators conducted a court-authorized search of his office.

Surya was sentenced to 6 months' home confinement, 5 years' probation, a $3,000 fine, a $50,000 criminal forfeiture, and a $100 special court assessment for his DOT medical examination fraud, separate from his drug dealing conviction.

The Sleep Apnea Crisis

NTSB investigations consistently identify untreated sleep apnea as a contributing factor in fatal commercial vehicle crashes, yet the medical certification system continues to fail at detecting this life-threatening condition. A study conducted by the University of Pennsylvania and sponsored by the Federal Motor Carrier Safety Administration (FMCSA) found that almost one-third (28 percent) of commercial truck drivers have mild to severe sleep apnea.

Despite this alarming statistic, FMCSA abandoned proposed regulations that would have required sleep apnea testing for high-risk drivers. The agency cited industry opposition and cost concerns, prioritizing economic interests over public safety. This regulatory retreat has left sleep apnea detection entirely dependent on individual medical examiner competence, a system that fraud cases have proven to be completely unreliable.

The consequences are measurable in body counts. NTSB Chairman Robert L. Sumwalt stated: "In this crash, not one but two commercial vehicle drivers, people who drive for a living were unable to respond appropriately to cues that other motorists acted on. Federal and state regulators, commercial motor carriers and professional drivers can do better."

The Board has classified FMCSA's response to sleep apnea recommendations as "Open – Unacceptable Response," indicating the agency either disagreed with NTSB's recommendation or failed to take action in a timely manner despite mounting evidence of the problem's severity.

Diabetes and Sweet Death

Diabetes is another medical condition that fraudulent examiners routinely overlook or misreport. In the 2016 Palm Springs crash, the bus driver had untreated diabetes, NTSB says, even though he tested positive in a glucose urine test, meaning he likely had diabetes during his most recent medical certificate examination.

The medical examiner either failed to interpret the glucose test results properly or deliberately ignored them to maintain the driver's certification. This wasn't a medical error it was professional malpractice that directly contributed to 13 deaths.

According to the Centers for Disease Control and Prevention, about 23.8 percent of the U.S. population, 7.2 million people, have undiagnosed diabetes. When commercial drivers with undiagnosed diabetes experience blood sugar crashes while operating vehicles, the results can be catastrophic.

Current DOT medical regulations require glucose testing and diabetes management protocols. Still, fraudulent examiners routinely bypass these requirements or falsify results to maintain the assembly-line processing that maximizes their profits.

Medical certification fraud operates as a classic volume business, where examiners prioritize quantity over quality to maximize revenue. Legitimate DOT medical examinations requiring comprehensive testing and evaluation take time, limiting the number of drivers an examiner can process daily. Fraudulent examiners eliminate time-consuming testing to process more drivers at higher profit margins.

Dr. Edwards fraudulently obtained approximately $224,000 through his scheme, according to federal prosecutors. This represents thousands of fake examinations conducted over multiple years, demonstrating the economic incentives that drive medical fraud.

The business model is simple: advertise services at truck stops and driving schools, eliminate time-consuming medical testing, rubber-stamp certifications, and collect cash payments. The fraudulent examiners face minimal oversight, limited enforcement, and high profit potential, creating perfect conditions for systematic corruption.

Too Little, Too Late

FMCSA's response to medical certification fraud has been reactive and inadequate. The agency maintains a National Registry of Certified Medical Examiners containing over 38,000 registered examiners, but oversight is minimal and enforcement is sporadic.

Since August 2014, DOT's criminal investigations have resulted in eight indictments and six convictions for fraud in the medical certification process. While important, these only address the worst cases that come to federal attention, leaving thousands of potentially fraudulent examiners out in the wild.

The agency's 2024 action to remove approximately 15,727 medical examiners who haven't accessed their accounts via login.gov represents an administrative cleanup rather than a fraud prevention measure. Many of these inactive accounts belong to examiners who have simply not updated their registration, rather than fraudulent operators.

The Nuclear Verdict Connection

Medical certification fraud creates significant liability exposure for trucking companies in nuclear verdict litigation. Plaintiff attorneys use evidence of fraudulent medical certification to argue that carriers knew or should have known their drivers were medically unqualified, supporting claims of negligent hiring and supervision.

The Edwards case provides a template for these arguments. Any carrier that used Edwards for medical certification now faces potential liability claims based on his fraudulent practices. The documented fraud creates presumptions of negligence that are difficult to overcome in civil litigation.

Corporate defendants face the challenge of explaining why they selected medical examiners without verifying their legitimacy or investigating their practices. The economics of cheap medical certification, a key factor in choosing fraudulent examiners, becomes evidence of prioritizing cost savings over public safety.

Medical certification fraud intersects with immigration and border security concerns when fraudulent examiners target non-English speaking drivers who may be less likely to report inappropriate practices. These vulnerable populations become victims of fraud while creating additional safety risks on public highways.

California's Assembly Bill 60, which has issued over 1 million driver's licenses to undocumented immigrants since 2015, creates pathways for commercial licensing that fraudulent medical examiners exploit. Language barriers and unfamiliarity with legitimate medical procedures make these drivers easy targets for certification mills.

Every fraudulent medical certificate represents a potential mass casualty event waiting to happen. The families who lost loved ones in the Palm Springs crash, the Illinois multivehicle collision, and countless other preventable tragedies paid the ultimate price for a medical certification system that prioritizes profits over people.

Commercial vehicle medical certification exists for one purpose: ensuring that only medically qualified drivers operate vehicles that can kill entire families in an instant. When medical professionals corrupt this system for financial gain, they transform from healers into killers, white coat criminals whose greed creates widows and orphans.

The technology exists to stop medical certification fraud. The legal framework exists to prosecute it severely. The evidence exists to prove its deadly consequences. What's missing is the regulatory will to prioritize public safety over industry convenience and political considerations.

Until medical certification fraud carries consequences severe enough to deter criminal behavior, American families will continue paying the ultimate price for our failure to keep medically unqualified drivers off the road.