Commercial Driver Medical Examination| Rules and Regulations

2015 NRCME: Review of Important Bulletins.

Important bulletins FMCSA sent to medical examiners in 2015.

 

1/20/15

OSA Bulletin to MEs and Training Organizations-01122015

To remind healthcare professionals on FMCSA’s National Registry of Certified Medical Examiners (the National Registry) of the current physical qualifications standard and advisory criteria concerning the respiratory system, specifically how the requirements apply to drivers that may have obstructive sleep apnea (OSA).

 

1/21/15 to 3/18/15

Issuing Medical Certificates and Instructions for Reporting Driver Exam results:

  • The FMCSA requests that all medical examiners continue providing drivers with a paper copy of the medical certificate so that Commercial Driver’s License (CDL) holders can provide a copy to the State licensing agency, and the non-CDL drivers can provide the documentation to their employers and Federal and State enforcement officials.

  • The Agency is currently completing efforts to put into place an electronic system to enable us to transmit the medical certificate information from the National Registry system to the State licensing agencies. However, until that system is completed, we need medical examiners to continue issuing paper copies of the medical certificates to drivers who pass the medical exam.

Instructions on how to enter driver exam results on the online MCSA- 5850 was provided, as well how to submit and upload updated or corrected information.  MEs were also instructed to mark CDL “YES” on the MEC if the driver is a CDL holder or applicant for a commercial driver’s license (CDL) or a commercial learner’s permit (CLP).

 

4/20/2015

Driver communication, Knowing Difference between Regulations and Best Practices, and Avoiding Appearances of Conflicts of interest:

FMCSA wants MEs to communicate clearly to drivers regarding the medical determinations made during the medical certification process.

Distinguish Between Regulations and Best Practices

  • Of the thirteen physical qualification standards in the Federal Motor Carrier Safety Regulations (49 CFR 391.41(b)(1) – (b)(13)) , four standards (hearing, vision, diabetes and seizures) have specific requirements, and nine standards require the Medical Examiner to rely on medical judgment using medical best practices and relevant standards of care.
  • FMCSA urges Medical Examiners to explain clearly to drivers whether they are relying on best practices and standards of care rather than a regulation as the basis for their certification decision.
  • Training providers should teach the regulations and offer advice on how best to weave in best practices and standards of care.

 

Avoid Appearances of Conflicts of Interest

FMCSA reminds Medical Examiners, who are listed on the National Registry of Certified Medical Examiners, that the perception of a conflict of interest is possible if drivers are referred for costly testing at laboratories where the Medical Examiner has a financial interest.

 

5/5/2015

Intrastate vs Interstate

Important Information about the Medical Examiner’s Certificate

When Do I Mark “Intrastate Only” No?

You mark the Medical Examiner’s Certificate “No” when a driver operates or intends to operate a commercial motor vehicle (CMV) in interstate commerce, even if the driver operates a vehicle that weighs less than 26,001 pounds and does not require a commercial driver’s license.

A driver operates in interstate commerce if he or she:

  1. Drives across a State line; or

  2. Carries freight that is originating or terminating outside the State.

When do I mark “Intrastate Only” Yes?

You mark it “Yes” if the driver does not operate or intend to operate a CMV in interstate commerce.

A driver operates only in intrastate commerce if he or she:

  1. Drives only in his or her State; and

  2. Carries freight that is originating and terminating inside the State.

 

6/17/15

Medical Examination Report Form (MERF); Certification period of Grandfathered drivers:

The Federal Motor Carrier Safety Administration (FMCSA) has heard from many of you recently asking about submitting CMV driver exams. A few recently asked questions are:

1. What Forms Do I Use for the DOT Driver Exams?

Certified Medical Examiners (MEs) must continue to use the Medical Examination Report and Medical Examiner’s Certificate as found on the FMCSA website athttp://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-applications-and-forms until December 22, 2015.

On April 23, FMCSA published a final rule, Medical Examiner’s Certification Integration, which will require MEs to use the new Medical Examination Report Form, MCSA-5875 and Medical Examiner’s Certificate (MEC) Form, MCSA-5876 beginning December 22, 2015. FMCSA will publish the new forms on the FMCSA website soon.

 

What is the Maximum Certification Period for a Federally Grandfathered Driver?

For a driver who is grandfathered under 49 CFR 391.64, the maximum certification period is one year.

These drivers participated in a Vision Waiver Study Program or a Diabetes Waiver Study Program in the early 1990s. In 1996, FMCSA grandfathered these drivers and sent them a letter. They may continue to drive if they meet the requirements in 49 CFR 391.64, including having an annual DOT medical examinaton.

 

10/15/15 to 11/02/15

New MER Form and New MEC:

The new forms were to be used by December 22, 2015.  Samples of the forms were published  and question and answer sessions were held on November 10, 2015 and November 19, 2015 to address any questions that may arise from stakeholder’s review of the new driver examination forms.  The FMCSA also promised fillable PDF versions of the Medical Examination Report (MER) Form, MCSA-5875 and Medical Examiner’s Certificate (MEC) Form, MCSA-5876 to be made available for download from the National Registry  (https://nationalregistry.fmcsa.dot.gov) and FMCSA (www.fmcsa.dot.gov) websites at a later date.

The use of these forms prior to December 22, 2015 was PROHIBITED and the FMCSA issued a stern statement to MEs regarding that.

 Use of these fillable medical forms for examination purposes are prohibited prior to December 22, 2015 and will mean that you are not in compliance with FMCSA regulations. If use is discovered during future audits, FMCSA will require examinations to be updated on the proper forms. Please also note that the National Registry will NOT support the new forms prior to December 22, 2015. If fillable PDF versions of the forms are required for programming electronic systems prior to November 9, 2015, please email your request to FMCSA at fmcsamedical@dot.gov.

USE OF THESE FORMS PRIOR TO DECEMBER 22, 2015 IS PROHIBITED

 

12/4/15

The date to use the new forms was of course delayed an in December FMCSA issued this update citing technical difficulties as a reason:

Update Regarding Posting of Revised Driver Examination Forms

The Medical Examiner’s Certification Integration final rule requires certified Medical Examiners (MEs) to continue using the current driver examination forms found on the FMCSA website until December 22, 2015 and to use the newly revised driver examination forms discussed in the final rule beginning December 22, 2015.

FMCSA planned to post the final PDF versions of the Medical Examination Report (MER) Form, MCSA-5875 and Medical Examiner’s Certificate (MEC) Form, MCSA-5876 on the FMCSA and National Registry websites on November 9, 2015. However, due to some challenging technical difficulties, the forms have not been posted.

As a result of the unexpected delays in posting the final versions of the driver examination forms and recognizing that MEs need to have access to the forms prior to the effective date for a number of reasons, the Agency is planning to postpone the effective date for use of the newly revised MER and MEC. FMCSA will be publishing a Federal Register notice announcing this change and providing a revised effective date.

As soon as we have a specific date that the forms will be posted on the FMCSA and National Registry websites, MEs will be notified through email and the National Registry listserv.

 

12/18/15

A final Update Regarding Posting and Use of Driver Examination Forms was published allowing MEs to use both the current and newly revised versions of the Medical Examination Report Form and Medical Examiner’s Certificate from December 22, 2015 until April 20, 2016

As a result of the unexpected delays in posting the final versions of the newly revised driver examination forms and recognizing that MEs need to have access to the forms prior to the effective date for a number of reasons, FMCSA will allow MEs to use both the current and newly revised versions of the Medical Examination Report Form and Medical Examiner’s Certificate from December 22, 2015 until April 20, 2016. The Agency has published a Federal Register notice announcing this guidance which is accessible by clicking the link below.

Federal Register Notice Use of Driver Examination Forms:     federal register notice use of driver examination forms

Both the current and newly revised versions of the driver examination forms are available on the FMCSA website. In addition, the final versions of the newly revised driver examination forms have been posted in the Resource Center of the National Registry website and are accessible by clicking on the links below.

Medical Examination Report (MER) Form, MCSA-5875:       MCSA-5875 final 508

Medical Examiner’s Certificate (MEC), Form MCSA-5876:  MCSA-5876 final 508

A sample CMV Driver Medical Examination Results Form, MCSA-5850 has been posted in the Resource Center of the National Registry website and is accessible by clicking on the link below. Because the CMV Driver Medical Examination Results Form, MCSA-5850 is an electronic form and only available through the ME’s National Registry account, the sample is a representation of what MEs will see when entering CMV driver examination results into the National Registry system. MEs are required to continue to report CMV driver medical examination results by accessing their National Registry accounts and completing the MCSA-5850 online.

CMV Driver Medical Examination Results Form, MCSA-5850 (Sample):  NRII and 5850 (1)

 

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