When is it appropriate to request additional tests or consultations?

Requesting additional tests or consultations on a case-by-case basis is appropriate because it allows the medical examiner to assess each candidate's unique medical conditions and needs. This approach ensures that the decision to conduct further evaluations is guided by specific findings that may arise during the physical examination or through the candidate's medical history.

By evaluating each situation individually, the examiner can determine whether there are legitimate concerns regarding a candidate's health that warrant additional tests or consultations. This method is essential in maintaining the safety and health standards required for commercial drivers, as it takes into account the varying factors that can affect an individual's fitness for duty.

While requests from the candidate or discretionary decisions by the examiner may play a role in the process, they do not necessarily encompass the comprehensive assessment that a case-by-case evaluation provides, which is critical in ensuring appropriate and justified medical decisions. Additionally, federal regulations may set guidelines but do not encompass the nuanced evaluation that's often required in individual cases.