[Federal Register Volume 80, Number 119 (Monday, June 22, 2015)]
[Rules and Regulations]
[Pages 35577-35596]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-15161]
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DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
49 CFR Parts 383, 384 and 391
[Docket No. FMCSA-2012-0178]
RIN 2126-AB40
Medical Examiner's Certification Integration; Correction
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.
ACTION: Final rule; correction.
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SUMMARY: FMCSA makes corrections to a rule that appeared in the Federal
Register on April 23, 2015 (80 FR 22790). In that rule, FMCSA amended
the Federal Motor Carrier Safety Regulations (FMCSRs) to require
certified medical examiners (MEs) performing physical examinations of
commercial motor vehicle (CMV) drivers to use a newly developed Medical
Examination Report (MER) Form, MCSA-5875, in place of the current MER
Form and to use Form MCSA-5876 for the Medical Examiner's Certificate
(MEC); and report results of all CMV drivers' physical examinations
performed (including the results of examinations where the driver was
found not to be qualified) to FMCSA by midnight (local time) of the
next calendar day following the examination. That final rule was a
follow-on rule to the Medical Certification Requirements as Part of the
CDL rule final rule, published on December 1, 2008, and the National
Registry of Certified Medical Examiners final rule, published on April
20, 2012.
DATES: Effective June 22, 2015.
FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director,
Carrier, Driver, & Vehicle Safety Standards, Federal Motor Carrier
Safety Administration, 1200 New Jersey Avenue SE., Washington, DC
20590-0001, by telephone at (202) 366-4001 or via email at
[email protected].
SUPPLEMENTARY INFORMATION: In FR Doc. 2015-09053, published on
Thursday, April 23, 2015 80 FR (22790) the following corrections are
made.
Corrections to the Preamble
1. On page 22798, in the third column, in FMCSA's response to
comment number 8. Voiding the MEC, the first sentence under the heading
``FMCSA Response'' is corrected to read as follows:
As explained in both the National Registry final rule (77 FR at
24108) and in the NPRM in this rulemaking (78 FR at 27348), under
the authority granted by 49 U.S.C. 31149(c)(2), FMCSA may void an
MEC issued to a CMV driver if it finds either that a Medical
Examiner has issued a certificate to a driver ``who fails to meet
the applicable standards at the time of the examination'' or ``that
a Medical Examiner has falsely claimed to have completed training in
physical and medical examination standards.''
2. Beginning on page 22810, in the third column, and continuing on
page 22811, in the first column, in Sec. 383.73, paragraphs
(a)(2)(vii), (b)(5), (o)(1)(i)(A), and (o)(1)(ii)(A) are corrected to
read as follows:
Sec. 383.73 State procedures
(a) * * *
(2) * * *
(vii)(A) Before June 22, 2018, for drivers who certified their type
of driving according to Sec. 383.71(b)(1)(i) (non-excepted interstate)
and, if the CLP applicant submits a current medical examiner's
certificate, date-stamp the medical examiner's certificate, and post
all required information from the medical examiner's certificate to the
CDLIS driver record in accordance with paragraph (o) of this section.
(B) On or after June 22, 2018, for drivers who certified their type
of driving according to Sec. 383.71(b)(1)(i) (non-excepted interstate)
and, if FMCSA provides current medical examiner's
[[Page 35578]]
certificate information electronically, post all required information
matching the medical examiner's certificate to the CDLIS driver record
in accordance with paragraph (o) of this section.
(b) * * *
(5)(i) Before June 22, 2018, for drivers who certified their type
of driving according to Sec. 383.71(b)(1)(i) (non-excepted interstate)
and, if the CDL holder submits a current medical examiner's
certificate, date-stamp the medical examiner's certificate and post all
required information from the medical examiner's certificate to the
CDLIS driver record in accordance with paragraph (o) of this section.
(ii) On or after June 22, 2018, for drivers who certified their
type of driving according to Sec. 383.71(b)(1)(i) (non-excepted
interstate) and, if FMCSA provides current medical examiner's
certificate information electronically, post all required information
matching the medical examiner's certificate to the CDLIS driver record
in accordance with paragraph (o) of this section.
* * * * *
(o) * * *
(1) * * *
(i) * * *
(A) Post the driver's self-certification of type of driving under
Sec. 383.71(b)(1) to the CDLIS driver record;
* * * * *
(ii) * * *
(A) Post the driver's self-certification of type of driving under
Sec. 383.71(b)(1) to the CDLIS driver record;
* * * * *
Part 391 Authority [Corrected]
3. On page 22812, in the first column, the authority citation for
part 391 is corrected to read as follows:
Authority: 49 U.S.C. 504, 508, 31133, 31136, 31149 and 31502;
sec. 4007(b), Pub. L. 102-240, 105 Stat, 1914, 2152; sec. 114, Pub.
L. 103-311, 108 Stat. 1673, 1677; sec. 215, Pub. L. 106-159, 113
Stat. 1748, 1767; and 49 CFR 1.87.
4. On page 22812, beginning at the top of the second column and
continuing at the top of the third column, in Sec. 391.23, paragraphs
(m)(2)(i) and (m)(3) are corrected to read as follows:
Sec. 391.23 Investigation and inquiries.
* * * * *
(m) * * *
(2) Exception. For drivers required to have a commercial driver's
license under part 383 of this chapter:
(i) Beginning January 30, 2015, using the CDLIS motor vehicle
record obtained from the current licensing State, the motor carrier
must verify and document in the driver qualification file the following
information before allowing the driver to operate a CMV:
(A) The type of operation the driver self-certified that he or she
will perform in accordance with Sec. 383.71(b)(1) of this chapter.
(B)(1) Beginning on May 21, 2014, and ending on June 22, 2018, that
the driver was certified by a medical examiner listed on the National
Registry of Certified Medical Examiners as of the date of medical
examiner's certificate issuance.
(2) If the driver has certified under paragraph (m)(2)(i)(A) of
this section that he or she expects to operate in interstate commerce,
that the driver has a valid medical examiner's certificate and any
required medical variances.
(C) Exception. Beginning on January 30, 2015 and until June 22,
2018, if the driver provided the motor carrier with a copy of the
current medical examiner's certificate that was submitted to the State
in accordance with Sec. 383.73(b)(5) of this chapter, the motor
carrier may use a copy of that medical examiner's certificate as proof
of the driver's medical certification for up to 15 days after the date
it was issued.
* * * * *
(3) Exception. For drivers required to have a commercial learner's
permit under part 383 of this chapter:
(i) Beginning July 8, 2015, using the CDLIS motor vehicle record
obtained from the current licensing State, the motor carrier must
verify and document in the driver qualification file the following
information before allowing the driver to operate a CMV:
(A) The type of operation the driver self-certified that he or she
will perform in accordance with Sec. 383.71(b)(1) and (g) of this
chapter.
(B)(1) Until June 22, 2018, that the driver was certified by a
medical examiner listed on the National Registry of Certified Medical
Examiners as of the date of medical examiner's certificate issuance.
(2) If the driver has a commercial learner's permit and has
certified under paragraph (m)(3)(i)(A) of this section that he or she
expects to operate in interstate commerce, that the driver has a valid
medical examiner's certificate and any required medical variances.
(C) Until June 22, 2018, if the driver provided the motor carrier
with a copy of the current medical examiner's certificate that was
submitted to the State in accordance with Sec. 383.73(a)(5) of this
chapter, the motor carrier may use a copy of that medical examiner's
certificate as proof of the driver's medical certification for up to 15
days after the date it was issued.
(ii) Until July 8, 2015, if a driver operating in non-excepted,
interstate commerce has no medical certification status information on
the CDLIS MVR obtained from the current State driver licensing agency,
the employing motor carrier may accept a medical examiner's certificate
issued to that driver, and place a copy of it in the driver
qualification file before allowing the driver to operate a CMV in
interstate commerce.
5. Beginning on page 22812, in the third column, and continuing to
page 22821, in the third column, in Sec. 391.43, paragraphs (f),
(g)(5)(ii), and (h) are corrected to read as follows:
Sec. 391.43 Medical examination; certificate of physical examination.
* * * * *
(f)(1) Until December 22, 2015, the medical examination shall be
performed, and its results shall be recorded, substantially in
accordance with the following instructions and examination form.
Instructions for Performing and Recording Physical Examinations
The medical examiner must be familiar with 49 CFR 391.41, Physical
qualifications for drivers, and should review these instructions before
performing the physical examination. Answer each question ``yes'' or
``no'' and record numerical readings where indicated on the physical
examination form.
The medical examiner must be aware of the rigorous physical,
mental, and emotional demands placed on the driver of a commercial
motor vehicle. In the interest of public safety, the medical examiner
is required to certify that the driver does not have any physical,
mental, or organic condition that might affect the driver's ability to
operate a commercial motor vehicle safely.
General information. The purpose of this history and physical
examination is to detect the presence of physical, mental, or organic
conditions of such a character and extent as to affect the driver's
ability to operate a commercial motor vehicle safely. The examination
should be conducted carefully and should at least include all of the
information requested in the following form. History of certain
conditions may be cause for rejection. Indicate the need for further
testing and/or require evaluation by a specialist. Conditions may be
recorded which do not, because of their character or degree, indicate
that certification of physical fitness should be denied. However, these
conditions should be discussed with the driver and he/she should be
advised to take the
[[Page 35579]]
necessary steps to insure correction, particularly of those conditions
which, if neglected, might affect the driver's ability to drive safely.
General appearance and development. Note marked overweight. Note
any postural defect, perceptible limp, tremor, or other conditions that
might be caused by alcoholism, thyroid intoxication or other illnesses.
Head-eyes. When other than the Snellen chart is used, the results
of such test must be expressed in values comparable to the standard
Snellen test. If the driver wears corrective lenses for driving, these
should be worn while driver's visual acuity is being tested. If contact
lenses are worn, there should be sufficient evidence of good tolerance
of and adaptation to their use. Indicate the driver's need to wear
corrective lenses to meet the vision standard on the Medical Examiner's
Certificate by checking the box, ``Qualified only when wearing
corrective lenses.'' In recording distance vision use 20 feet as
normal. Report all vision as a fraction with 20 as the numerator and
the smallest type read at 20 feet as the denominator. Monocular drivers
are not qualified to operate commercial motor vehicles in interstate
commerce.
Ears. Note evidence of any ear disease, symptoms of aural vertigo,
or Meniere's Syndrome. When recording hearing, record distance from
patient at which a forced whispered voice can first be heard. For the
whispered voice test, the individual should be stationed at least 5
feet from the examiner with the ear being tested turned toward the
examiner. The other ear is covered. Using the breath which remains
after a normal expiration, the examiner whispers words or random
numbers such as 66, 18, 23, etc. The examiner should not use only
sibilants (s-sounding test materials). The opposite ear should be
tested in the same manner. If the individual fails the whispered voice
test, the audiometric test should be administered. For the audiometric
test, record decibel loss at 500 Hz, 1,000 Hz, and 2,000 Hz. Average
the decibel loss at 500 Hz, 1,000 Hz and 2,000 Hz and record as
described on the form. If the individual fails the audiometric test and
the whispered voice test has not been administered, the whispered voice
test should be performed to determine if the standard applicable to
that test can be met.
Throat. Note any irremediable deformities likely to interfere with
breathing or swallowing.
Heart. Note murmurs and arrhythmias, and any history of an enlarged
heart, congestive heart failure, or cardiovascular disease that is
accompanied by syncope, dyspnea, or collapse. Indicate onset date,
diagnosis, medication, and any current limitation. An electrocardiogram
is required when findings so indicate.
Blood pressure (BP). If a driver has hypertension and/or is being
medicated for hypertension, he or she should be recertified more
frequently. An individual diagnosed with Stage 1 hypertension (BP is
140/90-159/99) may be certified for one year. At recertification, an
individual with a BP equal to or less than 140/90 may be certified for
one year; however, if his or her BP is greater than 140/90 but less
than 160/100, a one-time certificate for 3 months can be issued. An
individual diagnosed with Stage 2 (BP is 160/100-179/109) should be
treated and a one-time certificate for 3-month certification can be
issued. Once the driver has reduced his or her BP to equal to or less
than 140/90, he or she may be recertified annually thereafter. An
individual diagnosed with Stage 3 hypertension (BP equal to or greater
than 180/110) should not be certified until his or her BP is reduced to
140/90 or less, and may be recertified every 6 months.
Lungs. Note abnormal chest wall expansion, respiratory rate, breath
sounds including wheezes or alveolar rales, impaired respiratory
function, dyspnea, or cyanosis. Abnormal finds on physical exam may
require further testing such as pulmonary tests and/or x-ray of chest.
Abdomen and Viscera. Note enlarged liver, enlarged spleen, abnormal
masses, bruits, hernia, and significant abdominal wall muscle weakness
and tenderness. If the diagnosis suggests that the condition might
interfere with the control and safe operation of a commercial motor
vehicle, further testing and evaluation is required.
Genital-urinary and rectal examination. A urinalysis is required.
Protein, blood or sugar in the urine may be an indication for further
testing to rule out any underlying medical problems. Note hernias. A
condition causing discomfort should be evaluated to determine the
extent to which the condition might interfere with the control and safe
operation of a commercial motor vehicle.
Neurological. Note impaired equilibrium, coordination, or speech
pattern; paresthesia; asymmetric deep tendon reflexes; sensory or
positional abnormalities; abnormal patellar and Babinski's reflexes;
ataxia. Abnormal neurological responses may be an indication for
further testing to rule out an underlying medical condition. Any
neurological condition should be evaluated for the nature and severity
of the condition, the degree of limitation present, the likelihood of
progressive limitation, and the potential for sudden incapacitation. In
instances where the medical examiner has determined that more frequent
monitoring of a condition is appropriate, a certificate for a shorter
period should be issued.
Spine, musculoskeletal. Previous surgery, deformities, limitation
of motion, and tenderness should be noted. Findings may indicate
additional testing and evaluation should be conducted.
Extremities. Carefully examine upper and lower extremities and note
any loss or impairment of leg, foot, toe, arm, hand, or finger. Note
any deformities, atrophy, paralysis, partial paralysis, clubbing,
edema, or hypotonia. If a hand or finger deformity exists, determine
whether prehension and power grasp are sufficient to enable the driver
to maintain steering wheel grip and to control other vehicle equipment
during routine and emergency driving operations. If a foot or leg
deformity exists, determine whether sufficient mobility and strength
exist to enable the driver to operate pedals properly. In the case of
any loss or impairment to an extremity which may interfere with the
driver's ability to operate a commercial motor vehicle safely, the
medical examiner should state on the medical certificate ``medically
unqualified unless accompanied by a Skill Performance Evaluation
Certificate.'' The driver must then apply to the Field Service Center
of the FMCSA, for the State in which the driver has legal residence,
for a Skill Performance Evaluation Certificate under Sec. 391.49.
Laboratory and other testing. Other test(s) may be indicated based
upon the medical history or findings of the physical examination.
Diabetes. If insulin is necessary to control a diabetic driver's
condition, the driver is not qualified to operate a commercial motor
vehicle in interstate commerce. If mild diabetes is present and it is
controlled by use of an oral hypoglycemic drug and/or diet and
exercise, it should not be considered disqualifying. However, the
driver must remain under adequate medical supervision.
Upon completion of the examination, the medical examiner must date
and sign the form, provide his/her full name, office address and
telephone number. The completed medical examination form shall be
retained on file at the office of the medical examiner.
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(2) On and after December 22, 2015, the medical examination shall
be performed, and its results shall be recorded on the Medical
Examination Report Form, MCSA-5875, set out below:
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[GRAPHIC] [TIFF OMITTED] TR22JN15.015
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(g) * * *
(4) Beginning December 22, 2015, if the medical examiner finds that
the determination of whether the person examined is physically
qualified to operate a commercial motor vehicle in accordance with
Sec. 391.41(b) should be delayed pending the receipt of additional
information or the conduct of further examination in order for the
medical examiner to make such determination, he or she must inform the
person examined that the additional information must be provided or the
further examination completed within 45 days, and that the pending
status of the examination will be reported to FMCSA.
(5) * * *
(ii) Beginning on June 22, 2015, if the medical examiner does not
perform a medical examination of any driver who is required to be
examined by a medical examiner listed on the National Registry of
Certified Medical Examiners during any calendar month, the medical
examiner must report that fact to FMCSA, via a secure FMCSA-designated
Web site, by the close of business on the last day of such month.
(h)(1) Until December 22, 2015, the medical examiner's certificate
shall be substantially in accordance with the following form.
[GRAPHIC] [TIFF OMITTED] TR22JN15.016
[[Page 35596]]
(2) On and after December 22, 2015, the medical examiner's
certificate shall be completed in accordance with the following Form
MCSA-5876, Medical Examiner's Certificate.
[GRAPHIC] [TIFF OMITTED] TR22JN15.017
* * * * *
Issued under the authority delegated in 49 CFR 1.87 on: June 12,
2015.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2015-15161 Filed 6-19-15; 8:45 am]
BILLING CODE 4910-EX-P