Three, track all medical certificate applications. “In the absence of a mechanism to track all medical certification examinations, a commercial driver with a serious medical condition who is denied a medical certificate by one examiner may be able to obtain a medical certificate from another examiner, thus subverting the purpose of the medical certification process”. So if these medical examiners find out that a trucker has seizures from blinking lights (I would call that an occupational reality when driving at night), then the trucker just tries his luck elsewhere. Or, he goes to Texas.