For nearly 22 years, Wisconsin has let chiropractors and Christian Science practitioners, along with doctors, issue exemptions to the state’s mandatory seat belt law for people with medical or physical conditions that prevent them from being adequately restrained in a vehicle.

But with a chance at capturing $15 million or more in federal road safety grants, the state Department of Transportation last week enacted an emergency rule allowing only doctors to order the exemptions, which complies with federal guidelines.
It went into effect immediately.

“It’s very clear that an occupant wearing a seat belt in an automobile is far safer than one without,” said John Sobotik, a lawyer for the state Department of Transportation. “So a person with a medical exemption is putting himself at greater risk.”

Russ Leonard, executive director of the Wisconsin Chiropractic Association, did not return repeated calls seeking comment last week.
Joe Farkas, Wisconsin legislative and media liaison for the First Church of Christ, Scientist, said the church would not contest the DOT rule. Farkas and Sobotik said they didn’t know why the previous rule authorized Christian Scientist practitioners, who treat illnesses in church members through prayer, to write seat belt exemptions. The practitioners were able to provide exemptions to anyone, not just church members, Sobotik said.

A National Conference of State Legislatures spokeswoman said the group doesn’t keep track of which states allow chiropractors or Christian Scientists to write exemptions to mandatory seat belt laws. Michigan, Minnesota and Illinois only allow doctors to write seat belt exemptions, while Iowa allows doctors and chiropractors to do so, according to the state DOT.

Sobotik said the state has asked the National Highway Traffic Safety Administration to allow chiropractors to issue exemptions and is awaiting the agency’s response. If allowed, the state could again give chiropractors permission to issue exemptions.

Even though the new rule went into effect Thursday, Sobotik said the department must write a permanent rule governing seat belt exemptions. It has scheduled a public hearing for Sept. 8.

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The rule change is part of a two-pronged strategy by the state to qualify for $15 million or more in federal funding, Sobotik said.

The first part is to enact a law that gives law enforcement the right to stop drivers for the sole reason that they are not wearing seat belts. State lawmakers passed a 2009-11 spending plan that includes that provision. The budget now goes to Gov. Jim Doyle for review.

The second was to amend state rules on exemptions to conform with federal law.

Adopting the two changes by Sept. 30 qualifies the state for $15 million to be used for safety initiatives. If put into effect by Tuesday, the state would get additional funding, about $1 million or more, Sobotik said.

Federal safety money has been available in previous years but Wisconsin has never applied for it because the state didn’t meet the criteria, he said.

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Drivers and passengers might be physically unable to wear seat belts because the belts cause them such severe pain that it distracts them from driving, they have anatomical abnormalities or they have certain conditions such as shoulder cancer, said Dr. Tim Bartholow, a former Sauk Prairie family doctor and a senior vice president for the Wisconsin Medical Society.

But Bartholow said in 17 years as a doctor he had never written an exemption and he considers them rare. He recalled discussing the issue with some patients who had debilitating physical conditions, but they still wanted to wear belts, he said. Assisstive devices are also available for people who need them, such as those who have lost a limb.

The DOT doesn’t establish guidelines for the medical conditions that might make it difficult to wear a seat belt, and Sobotik said that judgment is left to doctors.

There is no special form for the exemption; rather, drivers and passengers who qualify need a letter from a doctor, he said. And right now, people seeking exemptions don’t need to be seen by a doctor in person, he said.

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State DOT data show drivers and passengers are more likely to be killed in a crash if they are not wearing seat belts.

In 2007, of all car and light truck drivers not wearing seat belts who were killed or injured in crashes, 5 percent were killed, according to the DOT. By comparison, of drivers wearing belts who were killed or injured in crashes, less than 1 percent were killed.

Overall, 75.3 percent of drivers and passengers wore seat belts in Wisconsin in 2007, according to the DOT.

It’s unclear how many exemptions to the state’s seat belt law are currently in effect because the state doesn’t keep track.

The state also doesn’t enforce the rule or require drivers carrying exemption letters to provide a copy to the DOT.

“That would be a law enforcement issue,” Sobotik said. “The police would decide whether the (exemption) letters are legitimate or not legitimate.”