The Federal Motor Carrier Safety Administration (FMCSA) has learned that some Medical Examiners (MEs) listed on the National Registry of Certified Medical Examiners (National Registry) are completing the driver’s Medical Examiner’s Certificate (MEC) incorrectly. To correct any misunderstandings, FMCSA is providing the examples of completed MECs below.

1) Drivers physically qualified: The MEC for a driver who has no physical conditions that limit hisslashher ability to safely operate a commercial motor vehicle is certified for two years. The MEC must include:

all of the driver’s pertinent information.
all of the ME’s pertinent information.
the date of the examination and the date the MEC expires.
the signature of the certified ME that performed the medical examination and is listed on the National Registry.
the certified ME’s National Registry number must be entered on the MEC in the space provided. See completed example below.

2) Drivers who need an exemption from the regulation (e.g., Diabetes, Vision, hearing or seizure): Some drivers who do not meet the physical qualification standards may qualify for an exemption from the regulation. FMCSA may, on a case by case basis, grant a medical exemption from a physical qualification standard set forth in 49 CFR § 391.41, if the Agency determines the exemption is in the interest of the public and would likely achieve a level of safety that is equivalent to, or greater than, the level that would be achieved by complying with the regulation. MEs are required to complete the entire medical examination. MEs must also complete and issue a MEC to the driver, if upon examination the ME discovers that the driver is otherwise physically qualified but needs an exemption because of:

Insulin use, or
Does not meet the vision requirements in one eye, or
Does not meet the hearing requirements, or
Has a history of a seizure disorder, etc.

The MEC must be completed in the same way as for the physically qualified driver. However, the following must also be completed.

The box that says “accompanied by a ______________ waiverslashexemption” must be checked.
The blank with the type of exemption required (e.g., diabetes, hearing, seizure, or vision) must be filled in. See completed example below.
Please note: The MEC is only valid when accompanied by an exemption issued by FMCSA.
Drivers who need a Skills Performance Evaluation (SPE): The SPE Certificate Program is an alternative regulation for drivers who have limb impairments or amputations. Not all drivers who have limb impairments or amputations need a SPE. For example, a driver who has a couple of digits amputated but has grasp and prehension does not need to be referred for a SPE (see 49 CFR 391.49 for complete information regarding the SPE Certificate Program).

MEs are required to complete the entire medical examination. MEs must also complete and issue a MEC to the driver, if upon examination the ME discovers that the driver is otherwise physically qualified but needs a SPE because the driver wears prostheses or has a limb impairment. Some drivers may already have a SPE Certificate and may bring it to the exam. Others may never have been issued a SPE Certificate. In either case, you must complete the MEC.

The MEC must be completed in the same way as for the physically qualified driver. However, the following must also be completed.

Check the box that says “accompanied by a ______________ SPE Certificate.”
FMCSA cannot conduct a SPE without the completed MEC. See completed example below.

Note: Items on the MEC that are highlighted are entries that were added to the MEC as a result of the National Registry of Certified Medical Examiners Final Rule that took effect on May 21, 2012.

Federal Motor Carrier Safety Administration Website: www.fmcsa.dot.gov
Medical Review Board Website: mrb.fmcsa.dot.gov
National Registry of Certified Medical Examiners Website: nrcme.fmcsa.dot.gov

Important: Medical Examiners must continue to issue Medical Examiner’s Certificates.

There seems to be confusion amongst medical examiners about whether or not to give a driver a hard copy of his/her medical certificate.

Yes, now, medical examiners must give drivers a hard copy of their medical certificate so they can submit it to the state driver’s licensing authority to obtain or maintain their Commercial Driver’s License.

FMCSA believes this confusion has been caused by two regulations being published near the same time:

The National Registry of Certified Medical Examiners which is the current regulation that went to its compliance date on May 21, 2014.
The Medical Integration Rulemaking which we call “National Registry II” for which a Notice of Proposed Rulemaking was published but it has not been published as a final rule, yet.

Information presented below clarifies the differences between the two rulemakings the current rule and the proposed rule.

Medical Certification Integration (National Registry II)

On May 10, 2013, FMCSA published a notice of proposed rulemaking, the Medical Examiner’s Certification Integration (78 FR 27343) (http://www.regulations.gov/#!documentDetail;D=FMCSA-2012-0178-0001). This rule is not in effect, and may change due to the notice and comment rulemaking process before it is published as a final rule.

What Medical Examination Report and Medical Examiner’s Certificate must I use?

Current: Since May 21, 2012, there has been no change in the Medical Examination Report (MER) and the Medical Examiner’s Certificate (MEC). The forms are found at http://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-applications-and-forms.
Proposed: FMCSA proposed a revised Form 5875 (Medical Examination Report Form) and Form 5876 (Medical Examiner’s Certificate). You should not use these forms, because they are not in effect.

Does FMCSA transmit driver exam results to the State Driver Licensing Agencies (SDLA)?

Current: No, FMCSA does not transmit driver exam results to the SDLAs.
Proposed: FMCSA proposed to require SDLAs to receive and post driver exam results transmitted from the National Registry for Commercial Driver’s License (CDL) and Commercial Learner’s Permit (CLP) applicants and holders.

Do I have to issue a MEC to the driver?

Current: Yes, you are required to issue a MEC to the driver if qualified (49 CFR 391.43(g)(2)). Drivers need to carry the MEC with them when they drive. CDL and CLP holders or applicants must provide a copy to their SDLA, and carry their MECs for 15 days.
Proposed: Yes, even though FMCSA would transmit driver exam results to the SDLAs, drivers would need to carry the MEC with them when they drive. CDL or CLP holders or applicants would have to carry their MECs for 15 days.

Does the driver have to provide a copy of the MEC to the SDLA?

Current: Yes, CDL or CLP holders or applicants have to provide a copy to their State Driver Licensing Agency.
Proposed: No, FMCSA would transmit driver exam results to the SDLAs for CDL or CLP holders or applicants.

How soon do I have to report driver exam results?

Current: You must report the driver exam results by the end of the month following the exam.
Proposed: You would be required to report driver exam results on a daily basis.

IMPORTANT MESSAGE: ISSUING MEDICAL CERTIFICATES TO ALL DRIVERS

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.

WHEN DO I ENTER “YES” FOR CDL?

We have had frequent questions from Medical Examiners asking when they should mark CDL “Yes” on the Medical Examiner’s Certificate.

Enter “Yes” for CDL if the driver is a holder or applicant for a commercial driver’s license (CDL) or a commercial learner’s permit (CLP).

Cardiovascular Updates

FAQs Posted to National Registry

FMCSA has posted Frequently Asked Questions (FAQs) regarding the newly revised driver examination forms in the Resource Center of the National Registry website. These FAQs are a collection of questions we received during our question and answer sessions and from phone calls and emails received. The FAQs can be accessed by clicking on the link below.

FAQs Driver Examination Forms

Notice of Publication for the Qualification of Drivers; Diabetes Standard final rule

On September 19, 2018, Federal Motor Carrier Safety Administration (FMCSA) published the Qualification of Drivers; Diabetes Standard final rule adopting a revised physical qualification standard for operators of commercial motor vehicles (CMVs) with insulin-treated diabetes mellitus (ITDM) (83 FR 47486). The revised standard lifts the blanket prohibition on insulin use and provides that Certified Medical Examiners may evaluate and determine, with input from the treating clinician, whether to issue a Medical Examiner’s Certificate, MCSA-5876, to qualify the driver to operate a commercial motor vehicle in interstate commerce. The effective date of this final rule is November 19, 2018.
In light of the final rule, FMCSA has determined that an exemption program for ITDM individuals is no longer necessary. The Agency intends to publish a Federal Register notice to withdraw the 2003 final disposition (68 FR 52441) and the 2005 revised final disposition (70 FR 67777) notices concerning the decision to issue exemptions to certain ITDM individuals. Once published, FMCSA will send notification to all Certified Medical Examiners.

FMCSA encourages all certified medical examiners to familiarize themselves with the revised rule and begin medical certification of ITDM individuals under the new rule. Please note that the final rule stated that the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 is posted on the FMCSA and National Registry websites. However, the form has not been approved by OMB and is not yet posted. Once approval is received, the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 will be posted on the FMCSA website. In addition, FMCSA will conduct webinars for Certified Medical Examiners to provide an overview of the final rule. The webinar dates and times will be announced by email to all certified medical examiners once scheduled.

Federal Motor Carrier Safety Administration Website: www.fmcsa.dot.gov
Medical Review Board Website: fmcsa.dot.gov/mrb
National Registry of Certified Medical Examiners Website: nationalregistry.fmcsa.dot.gov