Only one set of lawsuits has directly tied Concentra to a sleep apnea claim: a pair of federal discrimination suits filed by truck driver Ernest A. Southall, both of which were dismissed. Broader driver complaints about Concentra’s sleep apnea screening during Department of Transportation physicals have not translated into successful court challenges, and related case law involving other employers has generally sided with the companies requiring testing or CPAP use. There is no federal regulation requiring commercial drivers to be screened for obstructive sleep apnea, which is a large part of why the fight over Concentra’s practices plays out in physical exam rooms rather than courtrooms.
The Southall Cases
Ernest A. Southall drove for freight carrier USF Holland. In November 2015 he sued the carrier and Occupational Health Centers of the Southeast, P.A., a Concentra entity, alleging that between 2013 and 2015 he had been disqualified from driving, denied alternate work, and subjected to harassment and retaliation because of his sleep apnea, in violation of the Americans with Disabilities Act.
The court dismissed that first case in December 2018. Southall’s own deposition testimony had cut against him: he described his sleep apnea as mild, said it did not affect major life activities, and acknowledged that on earlier medical forms he had denied having any sleep disorders.{1Landline Media. Judge Tosses Lawsuit Claiming Driver Was Discriminated Against Due to Sleep Apnea}
He tried again in November 2019, filing a second suit in the U.S. District Court for the Middle District of Tennessee. This time he added Teamsters Local 480 as a defendant and alleged a conspiracy among USF Holland, Concentra, and the union around his June 2017 termination, together with a failure to provide reasonable accommodations.{2GovInfo. Southall v. USF Holland, LLC Et Al} On February 3, 2021, the court granted the defendants’ motions to dismiss, holding that the second suit was an impermissible attempt to relitigate the first. The judge wrote that Southall’s allegations “were either raised or could and should have been raised” in the original case, and that both issue preclusion and claim preclusion barred the new filing.{1Landline Media. Judge Tosses Lawsuit Claiming Driver Was Discriminated Against Due to Sleep Apnea}
No court has since ruled directly on whether Concentra’s screening criteria are lawful.
Why There Is No Federal Sleep Apnea Rule
The reason clinics like Concentra have so much room to set their own policies is that federal regulations do not address the question. The Federal Motor Carrier Safety Administration has no rule requiring commercial drivers to be screened or tested for obstructive sleep apnea, and its regulations do not mention the condition by name.{3FMCSA. Driving When You Have Sleep Apnea}{4Overdrive Online. No New Sleep Apnea Guidance in FMCSA Handbook for DOT Docs}
What exists instead is a general pulmonary standard at 49 CFR 391.41(b)(5), which says a driver cannot be certified if a respiratory condition is likely to interfere with safe operation of a commercial vehicle. Medical examiners apply their own clinical judgment to decide whether a driver’s risk factors warrant a sleep study referral.{5NADME. OSA Guidance for MEs From FMCSA}
Efforts to tighten that framework have gone nowhere. In 2012, the FMCSA’s Motor Carrier Safety Advisory Committee and Medical Review Board recommended routine testing of drivers with a Body Mass Index of 35 or greater. In October 2013, Congress passed legislation barring the Department of Transportation from requiring sleep disorder screening except through a full formal rulemaking.{6Congress.gov. Congressional Research Service Report on Sleep Apnea Screening} The FMCSA and Federal Railroad Administration published an Advance Notice of Proposed Rulemaking in March 2016, then withdrew it in August 2017, saying existing safety programs were the appropriate way to address the issue.{7Federal Register. Evaluation of Safety Sensitive Personnel for Moderate-to-Severe Obstructive Sleep Apnea} Nothing new has been proposed since.
The FMCSA’s January 2024 Medical Examiner’s Handbook makes the point explicitly, stating that federal regulations “do not include requirements for MEs to screen individuals for OSA or to recommend that an individual be referred for OSA testing.” The handbook itself is non-binding guidance.{4Overdrive Online. No New Sleep Apnea Guidance in FMCSA Handbook for DOT Docs}
Concentra’s Screening Criteria and Driver Complaints
Concentra’s published materials describe a self-check derived from National Heart, Lung, and Blood Institute criteria. Drivers who answer “yes” to more than two risk-factor questions may be referred to a sleep specialist. The factors include heavy snoring, breathing stoppages during sleep, and daytime drowsiness, along with age 40 or older, a BMI of 25 or above, and a neck circumference of 17 inches or more for men.{} Concentra says it does not endorse any specific sleep medicine provider and does not require drivers to use a particular clinic.{8Concentra. Do I Really Need a Sleep Apnea Test} The company frames the process as a safety measure, and acknowledges that because there is no federal mandate, some drivers view it with suspicion.{9Concentra. Why Some Truck Drivers Are Asked to Take a Sleep Apnea Test}
Drivers who have gone through the physicals report a stricter internal policy at some locations, requiring a sleep study for any male driver over 50 with a neck circumference above 17 inches and a BMI above 33. Rather than issuing a conditional certification while the sleep study is completed, some examiners reportedly fail the DOT physical outright, which immediately keeps the driver off the road. Drivers describe the financial hit as severe: roughly $400 out of pocket for the sleep study, about $800 for a CPAP machine, and $150 per follow-up exam.{10The Truckers Report. You Should Avoid Concentra at All Costs – The CPAP Diagnosis}
A recurring accusation is that the referrals are aimed at generating revenue rather than protecting safety. Some drivers have called the process a “money grab,” noting that many people who match the demographic profile never test positive. One driver cited a sleep specialist who estimated only about 30% of those meeting the four-factor screening criteria would actually have the condition.{10The Truckers Report. You Should Avoid Concentra at All Costs – The CPAP Diagnosis}
One reported wrinkle: whether a sleep study is required may depend on the carrier, not on Concentra’s own policy. According to one account, when a trucking company sets up a contract with Concentra, the carrier can choose whether to include sleep apnea screening, and drivers report no issues at locations where the carrier declines. The practice appears not to be uniform across all 549 Concentra occupational health centers.{10The Truckers Report. You Should Avoid Concentra at All Costs – The CPAP Diagnosis}
How Courts Have Treated Driver Sleep Apnea Claims
The odds for a driver suing over sleep apnea screening or CPAP requirements are not good, based on how related cases have come out. No decision has been issued against Concentra on the merits, and rulings involving other employers have consistently treated sleep apnea requirements as safety-related business decisions rather than disability discrimination.
In Allman v. Walmart Inc., decided by the Sixth Circuit in July 2020, a truck driver challenged Walmart’s requirement that he use a CPAP machine. He had conflicting results from multiple sleep studies, none of which involved Concentra, and argued that the requirement was disability discrimination. The court disagreed, ruling that Walmart “honestly believed” the driver had sleep apnea and had a “legitimate, nondiscriminatory reason” to require CPAP use for safety. The opinion held that when safety regulations govern employee medical conditions, an employer’s regulatory compliance can defeat a discrimination claim.{11SHRM. Driver Diagnosed With Sleep Apnea Loses Claims}{12FindLaw. Allman v. Walmart Inc.}
In Alamillo v. BNSF Railway Co., the Ninth Circuit ruled in August 2017 that an employer could terminate an employee with obstructive sleep apnea for attendance problems, provided the disciplinary policy was applied neutrally and the employee had a chance to request an accommodation.{13Vigilant. Ninth Circuit Okays Termination of Employee With Sleep Apnea}
Between the Southall dismissals and these related rulings, the pattern is consistent. A driver challenging a sleep apnea referral, a failed DOT physical tied to sleep apnea, or a CPAP mandate faces a court environment that has treated such decisions as safety judgments the employer or examiner is entitled to make, and the driver’s own medical history and prior statements can quickly become the deciding evidence.