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[Federal Register Volume 89, Number 180 (Tuesday, September 17, 2024)]
[Notices]
[Pages 76177-76180]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-21076]

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2024-0158]

Agency Information Collection Activities; Renewal of an Approved 
Information Collection: Medical Qualification Requirements

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

ACTION: Notice and request for comments.

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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.

[[Page 76178]]

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, (202) 366-4001, [email protected], 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 Sec.  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 Sec. Sec.  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 Sec.  391.47 
mandate that the applicant

[[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 Sec.  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 Sec.  
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 Sec.  
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 Sec.  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

[[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 Sec.  
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]
BILLING CODE 4910-EX-P
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