This article is Part I in a three part series looking at the National Registry of Certified Medical Examiners (NRCME). Compliance with the NRCME went into effect on May 21, 2014, and already two examiners have been removed from the Registry. It is a stark reminder that examiners found not in compliance with, but not limited to 49 CFR 391.41 (Physical Qualification for Drivers) or 49 CFR 391.43 (Medical examination; certificate of physical examination), may face similar outcomes. At the very least they may be be censured, or made to undergo error correction training. It is also a reminder that performing DOT physical examinations is serious business and therefore should be done with care. If you don’t have the time or the desire to stay current with requirements and perform proper DOT examinations, then it’s probably better not to do them at all. This is said not to discourage anyone, but to raise awareness. Just as motor carriers (small or large) can be put out of service for non-compliance by the FMCSA, so can and so have medical examiners. It is probably even easier to do so now that every examiner is listed in the Registry and assigned a unique identifier. Whether examiners will also be fined for violations is something else to consider. The Federal codes or statutes used to levy civil and criminal penalties and fines on individuals and companies by the Secretary of Transportation, may very well be applied to medical examiners; But that is a discussion for another time.
Because the certified Medical Examiner has important responsibilities, as is detailed at length in the Complete Guide to Medical Examiner Certification (the Guide for short), every examiner should probably keep a copy on their desktop. In the next series of articles we will review the many responsibilities of the medical examiner and discuss ways an examiner can stay in compliance, by properly documenting examinations, keeping good records, and preventing errors of omission or commission. All that, and at the same time of course perform competent and safe physicals.
Reason the FMCSA created the NRCME
The National Transportation and Safety Board (NTSB) linked improper certification of commercial driver drivers with serious disqualifying medical conditions as a reason for crashes and fatal injuries. This was determined the case in 2001 with the May 1999 Mother’s Day Crash NOLA.com: Bus Crash1 in New Orleans. Congress acted and mandated that the FMCSA create a National Registry to ensure that medical examiners are trained and tested on FMCSA qualification standards and guidelines, and that they issue medical examiner’s certificates only to individuals who meet those standards.
“FMCSA issued the rule in response to the statutory requirements in the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU), the surface transportation reauthorization legislation enacted in 2005.
The Final Rule for the establishment of the NRCME was published in the Federal Register on April 20, 2012 and compliance was required beginning May 21, 2014.
Of note, the Department of Transportation (DOT) recently celebrated it’s 50th anniversary. The FMCSA, one of 12 agencies of the DOT established the NRCME almost 2 years ago now.
In the next topic we will look at what is expected and required of medical examiners, the process for enforcement of non-compliance, and removal from the Registry.
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