For employees performing safety-sensitive job duties including Operating (Transportation, Engineering, and Mechanical), Supply, and Telecom field personnel and Train Dispatchers
A Serious Health Condition or Event is defined as a new diagnosis, recent event, or change in previously stable medical condition that could impact an individual’s ability to safely perform their job duties – physically or mentally. This includes conditions or events that impair an individual’s ability to immediately control equipment being operated, interfere with assessing potential risks within the work environment, or otherwise compromise safe job performance.
Examples of Serious Health Conditions and Events, include but are not limited to:
Cardiovascular Conditions including:
- Heart attack (myocardial infarction) that is confirmed or was suspected (including any Emergency Room or hospital care for chest pain or other symptoms of possible heart disease).
- Cardiac arrest, requiring cardio-pulmonary resuscitation (CPR) or use of a defibrillator.
- Serious cardiac arrhythmias (abnormal heart rhythm) requiring medical treatment.
- Stroke or Transient Ischemic Attack (TIA).
- Bleeding inside the skull (intracranial) or bleeding inside the brain (intracerebral)
- Heart surgery or invasive cardiovascular procedures (including coronary bypass graft, cardiac catheterization or angioplasty; or placement of a pacemaker, stent, internal cardiac defibrillator, heart valve or aortic artery graft).
Seizure or Loss of Consciousness including:
- A seizure of any kind.
- Diagnosis of epilepsy (a condition with risk for recurrent seizures).
- Treatment with anti-seizure medication to prevent seizures.
- Loss of consciousness (of any duration including episode caused by insulin reaction).
Significant Vision or Hearing Change including:
- Significant vision change in one or both eyes affecting visual acuity (if not correctable to 20/40), color vision or peripheral vision (including visual field loss from retinal disease or treatment).
- Eye surgery (including for glaucoma, cataracts, or laser treatment of the cornea or retina).
- Significant hearing loss or surgery on the inner ear.
- New use of hearing aids.
Diabetes Treated with Insulin:
- Including Type I and Type II Diabetes Mellitus if insulin is used.
- Severe hypoglycemic event (defined as a hypoglycemic event with: (a) loss of consciousness, (b) substantial mental confusion, drowsiness, or weakness, or (c) requiring the assistance of another person).
Severe Sleep Apnea:
- Diagnosis or treatment of severe obstructive sleep apnea (using CPAP or other treatments).
Serious Mental Health Conditions including:
- Psychotic disorder
- Bipolar disorder
- Panic disorder
- Suicidal or homicidal ideations/attempt
- Psychosis
- Active substance use disorder
Last Updated: October 1, 2025