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###### Department of Transportation

###### Federal Motor Carrier Safety Administration

          - [Docket No. FMCSA-2024-0158]

# AGENCY:

Federal Motor Carrier Safety Administration (FMCSA), Department of Transportation (DOT).

# ACTION:

Notice and request for comments.

# SUMMARY:

In accordance with the Paperwork Reduction Act of 1995, FMCSA announces its plan to submit the Information Collection Request (ICR) described below to the Office of Management and Budget (OMB) for its review and approval and invites public comment. The FMCSA requests approval to renew an ICR titled, “Medical Qualification Requirements,” due to updated information for several of the Information Collections (ICs) discussed. This ICR is needed to ensure that drivers, motor carriers and the States are complying with the physical qualification requirements of commercial motor vehicle (CMV) drivers. The information collected is used to determine and certify driver medical fitness and must be collected in order for our highways to be safe.

# DATES:

Comments on this notice must be received on or before November 18, 2024.

# ADDRESSES:

You may submit comments identified by Federal Docket Management System (FDMS) Docket Number FMCSA-2024-0158 using any of the following methods:
      -  Federal eRulemaking Portal: https://www.regulations.gov.                          Follow the online instructions for submitting comments.                    
      -  Mail:                          Dockets Operations; U.S. Department of Transportation, 1200 New Jersey Avenue SE, West Building, Ground Floor, Washington, DC 20590-0001.                    
      -  Hand Delivery or Courier:                          U.S. Department of Transportation, 1200 New Jersey Avenue SE, West Building, Ground Floor, Washington, DC 20590-0001 between 9 a.m. and 5 p.m. ET, Monday through Friday, except Federal holidays.                    
      -  Fax:                          (202) 493-2251.                    

                        To avoid duplication, please use only one of these four methods. See the “Public Participation and Request for Comments” portion of the                         **SUPPLEMENTARY INFORMATION**                         section for instructions on submitting comments.                    

      ( print page 76178)    

# FOR FURTHER INFORMATION CONTACT:

                        Ms. Christine A. Hydock, Chief, Medical Programs Division, (202) 366-4001,                         *fmcsamedical@dot.gov,*                         FMCSA, Department of Transportation, 1200 New Jersey Avenue SE, Room W64-224, Washington, DC 20590-0001. Office hours are 8:30 a.m. to 5 p.m., ET, Monday through Friday, except Federal holidays. If you have questions regarding viewing or submitting material to the docket, call Dockets Operations at (202) 366-9826.                    

# SUPPLEMENTARY INFORMATION:

## Instructions

                    All submissions must include the Agency name and docket number. For detailed instructions on submitting comments, see the Public Participation heading below. Note that all comments received will be posted without change to                     *https://www.regulations.gov,*                     including any personal information provided. Please see the Privacy Act heading below.                

## Public Participation and Request for Comments

If you submit a comment, please include the docket number for this notice (FMCSA-2024-0158), indicate the specific section of this document to which your comment applies, and provide a reason for each suggestion or recommendation. You may submit your comments and material online or by fax, mail, or hand delivery, but please use only one of these means. FMCSA recommends that you include your name and a mailing address, an email address, or a phone number in the body of your document so FMCSA can contact you if there are questions regarding your submission.

                    To submit your comment online, go to                     *https://www.regulations.gov/​docket/​FMCSA-2024-0158/​document,*                     click on this notice, click “Comment,” and type your comment into the text box on the following screen.                

                    If you submit your comments by mail or hand delivery, submit them in an unbound format, no larger than 8                    1/2                     by 11 inches, suitable for copying and electronic filing.                

Comments received after the comment closing date will be included in the docket and will be considered to the extent practicable.

## Privacy Act

                    In accordance with 5 U.S.C. 553(c), DOT solicits comments from the public to better inform its rulemaking process. DOT posts these comments, without edit, including any personal information the commenter provides, to                     *www.regulations.gov,*                     as described in the system of records notice (DOT/ALL-14 FDMS), which can be reviewed at                     *www.dot.gov/​privacy.*

## Background

CMVs (trucks and buses) are longer, heavier, and more difficult to maneuver than automobiles, making them a threat to highway safety if not operated properly by qualified individuals. The public interest in, and right to have, safe highways requires the assurance that drivers of CMVs can safely perform the increased physical and mental demands of their duties. FMCSA's physical qualification standards provide this assurance by requiring drivers to be examined and medically certified as physically and mentally qualified to drive. Therefore, information used to determine and certify driver medical fitness must be collected. FMCSA is the Federal government agency authorized to require the collection of this information. FMCSA is required by statute to establish standards for the physical qualifications of drivers who operate CMVs in interstate commerce for non-excepted industries (49 U.S.C. 31136(a)(3) and 31502(b)). The regulations discussing this collection are outlined in the Federal Motor Carrier Safety Regulations (FMCSRs) at 49 CFR 390 through 399.

Below is a brief description of the included IC activities and how the information is used.

### Physical Qualification Standards

The FMCSRs at 49 CFR 391.41 set forth the physical qualification standards that interstate CMV drivers who are subject to part 391 must meet, with the exception of commercial driver's license/commercial learner's permit (CDL/CLP) drivers transporting migrant workers (who must meet the physical qualification standards set forth in 49 CFR 398.3). The FMCSRs covering driver physical qualification records are found at § 391.43, which specify that a medical examination be performed on CMV drivers subject to part 391 who operate in interstate commerce. The results of the examination shall be recorded in accordance with the requirements set forth in that section. The current provisions of §§ 391.51 and 398.3 require that a motor carrier retain the Medical Examiner's Certificate (MEC), Form MCSA-5876, in the driver's qualification (DQ) file for 3 years. The certificate affirms that the driver is physically qualified to drive a CMV in interstate commerce.

                    Due to potential onset of new conditions or changes in existing conditions that may adversely affect a driver's ability to safely operate a CMV and/or cause incapacitation that could be a risk to public safety, periodic evaluation and certification is required to assess driver physical qualification. MECs may be issued for up to 2 years after the date of examination. However, drivers with certain medical conditions must be certified more frequently than every 2 years. Medical examiners (MEs) have discretion to certify for shorter time periods on a case-by-case basis for medical conditions that require closer monitoring or that are more likely to change over time. In addition, the Safe, Accountable, Flexible, Efficient Transportation Act: A Legacy for Users (Pub .L. 109-59, 119 Stat. 1144, August 10, 2005) requires MEs to transmit to FMCSA's Chief Medical Officer, electronically and on a monthly basis, driver information and results of any CMV driver medical examinations conducted during the previous month. MEs are required to maintain records of the CMV driver medical examinations they conduct. FMCSA does not require MEs to maintain these records electronically. However, there is nothing to preclude an ME from maintaining electronic records of the medical examinations they conduct. FMCSA is continuously evaluating new information technology in an attempt to decrease the burden on motor carriers and MEs. Less frequent collection of driver data, Medical Examination Report Forms, MCSA-5875, and MECs, Form MCSA-5876, would compromise FMCSA's ability to determine ME compliance with FMCSA's physical qualification standards and guidelines in performing CMV driver physical qualification examinations, which could result in MEs listed on the National Registry of Certified Medical Examiners who should be removed and possibly drivers that don't meet the physical qualification standards possessing an MEC. Less frequent data collection would also result in decreased validity of the data (                    *i.e.,*                     less frequent data submission may increase the error rate due to unintentional omission of examination information). Therefore, less frequent collection of driver examination results is not an option.                

### Resolution of Medical Conflict

                    The medical conflict provision provides a mechanism for drivers and motor carriers to request that FMCSA make a final decision to resolve conflicting medical evaluations when either party does not accept the decision of a medical specialist. If two MEs disagree about the medical certification of a driver, the requirements set forth in § 391.47 mandate that the applicant                           ( print page 76179)                        (driver or motor carrier) submit a copy of a report including results of all medical testing and the opinion of an impartial medical specialist in the field in which the medical conflict arose. The applicant may, if they choose to do so, submit the information above using fax and/or email. FMCSA uses the information collected from the applicant, including medical information, to determine if the driver should or should not be qualified. Without this provision and its incumbent driver medical information collection requirements, an unqualified person may be permitted to drive and qualified persons may be prevented from driving.                

### Medical Exemptions and Skill Performance Evaluation (SPE) Certificates

FMCSA may, on a case-by-case basis, grant a medical exemption from a physical qualification standard set forth in § 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. Individuals with limb impairments are permitted to operate a CMV, but only when they are otherwise qualified and are granted an SPE certificate by FMCSA. Section 381.310 establishes the procedures that persons must follow to request exemptions from the FMCSRs. Without an exemption, individuals who do not meet the requirements in § 391.41 would not be qualified to operate a CMV in interstate commerce. The application process for all medical exemptions currently provides for electronic collection of the application information by FMCSA for those applicants that choose to do so. They are able to fax or scan and email documents to FMCSA. In addition, the SPE Certificate Program maintains a database of application information and the Medical Programs Division maintains a database of application information for hearing and seizure exemptions. FMCSA must collect medical information about the driver's medical condition in order to determine eligibility to receive a medical exemption or an SPE certificate. The Agency requires all medical exemptions be renewed every 2 years to ensure that the granting of the exemption does not diminish safety under § 381.310. Exemption holders are required to submit annual medical information for review to ensure the driver continues to meet the physical qualification requirements. In the interest of highway safety, the medical examination, medical exemption, and SPE certificate renewal should not be performed less frequently.

### The National Registry of Certified Medical Examiners (National Registry)

The National Registry requires MEs who perform physical qualification examinations for interstate CMV drivers to complete training concerning FMCSA's physical qualification standards, pass a certification test, and maintain competence through periodic training and testing, all of which require information collection. ME candidates submit demographic and eligibility data in order to register on the National Registry website to begin the certification process. This data is used to provide the public with contact information for those medical professionals who are certified by FMCSA to perform interstate CMV driver physical qualification examinations. Less frequent collection of ME candidate test results and identity and eligibility information would mean fewer healthcare professionals attempting to become certified which would result in fewer certified MEs being available to the CMV driver and motor carrier population. This could place a huge burden on drivers and motor carriers to find certified MEs to perform their physical qualification examinations. Therefore, less frequent collection of ME candidate test results and identity and eligibility information is not an option. MEs must provide specific driver physical qualification examination information for every driver they examine on driver examination forms required by FMCSA and into the National Registry. Drivers must provide identification and health history information on the driver examination forms required by FMCSA. The purpose for providing this information is to enable the ME to determine if the driver meets the physical qualification standards under § 391.41 and to ensure that there are no disqualifying medical conditions that could adversely affect their safe driving ability or cause incapacitation constituting a risk to the public. If this information were not required, the threat to public safety would be immense and unacceptable.

The National Registry also requires motor carriers to verify the National Registry number of the MEs who certify their drivers and place a note in the DQ file. Less frequent verification of the National Registry numbers by motor carriers would mean drivers may not have been examined by a certified ME listed on the National Registry and they may no longer meet the physical qualifications standards of the FMCSRs even though they were previously certified as physically qualified.

As a follow-on rule to the National Registry, the final rule titled “Medical Examiner`s Certification Integration” (80 FR 22790), modified several of the requirements adopted in the National Registry final rule, some of which had a scheduled compliance date of June 22, 2018. Specifically, it requires (1) FMCSA to electronically transmit from the National Registry to the State Driver's Licensing Agencies (SDLAs) the driver identification information, examination results, and restriction information from examinations performed for holders of CLPs/CDLs (interstate and intrastate); (2) FMCSA to transmit electronically to the SDLAs the medical variance information for all CMV drivers; and (3) SDLAs to post the driver identification, examination results, and restriction information received electronically from FMCSA.

However, as the Medical Examiner's Certification Integration final rule compliance date approached, FMCSA concluded that the information technology infrastructure necessary to implement the portions of the final rule that required the electronic transmission of data would not be available on June 22, 2018. FMSCA extended the compliance two additional times, and that date is now June 23, 2025, for several provisions of the final rule. Since the compliance date for these provisions occurs during this renewal period, the annual burden hours and costs are now being covered as part of this ICR.

### Qualifications of Drivers; Diabetes Standard

Under 49 CFR 391.41(b), drivers with a stable insulin regimen and properly controlled Insulin-Treated Diabetes Mellitus (ITDM) are permitted to operate CMVs in interstate commerce. An individual with ITDM is able to obtain an MEC from a certified ME for up to a maximum of 12 months if the (1) Treating Clinician (TC), the healthcare professional who manages and prescribes insulin for the treatment of the individual's diabetes, completes the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870, and attests to the certified ME that the individual maintains a stable insulin regimen and proper control of their diabetes, and (2) the certified ME determines that the individual meets FMCSA's physical qualification standards.

                    FMCSA allows TCs to provide the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870, to the                           ( print page 76180)                        certified MEs, if the TCs choose to do so, using electronic communication such as fax or email. Consistent with OMB's commitment to minimizing respondents' recordkeeping and paperwork burdens, and the increased use of secure electronic modes of communication, the Agency anticipates that approximately 25 percent of the forms will be transmitted electronically.                

### Qualifications of Drivers; Vision Standard

Under 49 CFR 391.41(b), drivers who do not satisfy, with the worse eye, either FMCSA's existing distant visual acuity standard with corrective lenses or the field of vision standard, or both, in § 391.41(b)(10) are permitted to be physically qualified to operate a CMV in interstate commerce under specified conditions. The alternative vision standard adopted in the final rule uses a collaborative process for physical qualification. Before an individual may be medically certified under the alternative vision standard, the individual must have a vision evaluation conducted by an ophthalmologist or optometrist. The ophthalmologist or optometrist records the findings and provides specific medical opinions on the Vision Evaluation Report, Form MCSA-5871. Then, an ME performs an examination, considers the information provided on the Vision Evaluation Report, Form MCSA-5871, and determines whether the individual meets the alternative vision standard, as well as FMCSA's other physical qualification standards. If the ME determines the individual meets the physical qualification standards, the ME may issue an MEC for up to 12 months.

FMCSA allows ophthalmologists and optometrists to provide the Vision Evaluation Report, Form MCSA-5871, to the certified MEs, if they choose to do so, using electronic communication such as fax or email. Consistent with OMB's commitment to minimizing respondents' recordkeeping and paperwork burdens, and the increased use of secure electronic modes of communication, the Agency anticipates that approximately 25 percent of the forms will be transmitted electronically.

*Title:*                     Medical Qualification Requirements.                

*OMB Control Number:*                     2126-0006.                

*Type of Request:*                     Renewal of a currently approved collection.                

*Respondents:*                     Commercial motor vehicle drivers, motor carriers, medical examiners, testing centers.                

*Estimated Number of Respondents:*                     8,123,976.                

Expiration Date: March 31, 2025.

*Estimated Total Annual Burden:*                     3,243,525 hours.                

This information collection is comprised of the following seven information collection activities.

*Physical Qualification Standards:*

2,776,978 annual burden hours.

7,175,796 annual respondents.

*Resolution of Medical Conflict:*

11 annual burden hours.

3 annual respondents.

*Medical Exemptions:*

293 annual burden hours.

1,176 annual respondents.

*SPE Certificate Program:*

2,808 annual burden hours.

2,567 annual respondents.

*National Registry of Certified Medical Examiners:*

462,162 annual burden hours.

934,887 annual respondents.

*Qualification of Drivers; Diabetes Standard:*

654 annual burden hours.

4,906 annual respondents.

*Qualification of Drivers; Vision Standard:*

619 annual burden hours.

4,641 annual respondents.

*Public Comments Invited:*                     You are asked to comment on any aspect of this information collection, including: (1) whether the proposed collection is necessary for the performance of FMCSA's functions; (2) the accuracy of the estimated burden; (3) ways for FMCSA to enhance the quality, usefulness, and clarity of the collected information; and (4) ways that the burden could be minimized without reducing the quality of the collected information. The Agency will summarize or include your comments in the request for OMB's clearance of this ICR.                

Issued under the authority of 49 CFR 1.87.

Thomas P. Keane,

Associate Administrator, Office of Research and Registration.

[FR Doc. 2024-21076 Filed 9-16-24; 8:45 am]

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