3390 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

DEPARTMENT OF TRANSPORTATION 

Federal Motor Carrier Safety 

Administration 

49 CFR Part 391 

[Docket No. FMCSA–2019–0049] 

RIN 2126–AC21 

Qualifications of Drivers; Vision 

Standard 

AGENCY: Federal Motor Carrier Safety 

Administration (FMCSA), Department 

of Transportation (DOT). 

ACTION: Final rule. 

SUMMARY: FMCSA amends its 

regulations to permit individuals who 

do not satisfy, with the worse eye, either 

the existing distant visual acuity 

standard with corrective lenses or the 

field of vision standard, or both, to be 

physically qualified to operate a 

commercial motor vehicle (CMV) in 

interstate commerce under specified 

conditions. Currently, such individuals 

are prohibited from driving CMVs in 

interstate commerce unless they obtain 

an exemption from FMCSA. The new 

alternative vision standard replaces the 

current vision exemption program as the 

basis for determining the physical 

qualification of these individuals. 

DATES: This final rule is effective March 

22, 2022. 

Comments on the information 

collections in this final rule must be 

submitted to the Office of Information 

and Regulatory Affairs (OIRA) at the 

Office of Management and Budget 

(OMB) by February 22, 2022. 

Petitions for Reconsideration of this 

final rule must be submitted to the 

FMCSA Administrator no later than 

February 22, 2022. 

ADDRESSES: Comments and 

recommendations for the information 

collections should be sent within 30 

days of publication of this final rule to 

https://www.reginfo.gov/public/do/ 

PRAMain. Find the particular 

information collection by selecting 

‘‘Currently under Review—Open for 

Public Comments’’ or by entering the 

OMB control number in the search bar. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Christine A. Hydock, Chief, Medical 

Programs Division, FMCSA, 1200 New 

Jersey Avenue SE, Washington, DC 

20590–0001, (202) 366–4001, 

fmcsamedical@dot.gov. 

SUPPLEMENTARY INFORMATION: FMCSA 

organizes this final rule as follows: 

I. Availability of Rulemaking Documents 

II. Executive Summary 

A. Purpose and Summary of the Final Rule 

B. Summary of the Major Provisions 

C. Costs and Benefits 

III. Abbreviations 

IV. Legal Basis for the Rulemaking 

V. Regulatory History 

A. NPRM 

B. MRB Task 21–1 and Report 

C. Notice of Availability 

VI. Discussion of Comments and Responses 

A. Comment Overview 

B. Data Used To Determine the Safety 

Impact of the Alternative Vision 

Standard 

C. The Two-Step Physical Qualification 

Process 

D. The Role of Ophthalmologists and 

Optometrists 

E. Frequency of Vision Evaluations 

F. Vision Evaluation Report, Form MCSA– 

5871 

G. The Role of MEs 

H. Frequency of Physical Qualification 

Examinations and Maximum Period of 

Certification 

I. Individuals Eligible for the Alternative 

Vision Standard 

J. Acceptable Field of Vision 

K. Meaning of Stable Vision 

L. Elimination of the Exemption Program’s 

3-Year Driving Experience Criterion 

M. Road Test Requirement for Alternative 

Vision Standard 

N. Review of an Individual’s Safety 

Performance 

O. Restricting Eligibility To Use the 

Alternative Vision Standard by Vehicle 

Type 

P. The Alternative Vision Standard Creates 

More Employment Opportunities 

Q. Change to the Medical Examination 

Process in 49 CFR 391.43(b)(1) 

R. Outside the Scope of the Rulemaking 

VII. Changes From the NPRM 

A. Alternative Vision Standard 

B. The Vision Evaluation Report, Form 

MCSA–5871 

VIII. International Impacts 

IX. Section-by-Section Analysis 

A. Regulatory Provisions 

B. Guidance 

X. Regulatory Analyses 

A. Executive Order (E.O.) 12866 

(Regulatory Planning and Review), E.O. 

13563 (Improving Regulation and 

Regulatory Review), and DOT Regulatory 

Policies and Procedures 

B. Congressional Review Act 

C. Regulatory Flexibility Act (Small 

Entities) 

D. Assistance for Small Entities 

E. Unfunded Mandates Reform Act of 1995 

F. Paperwork Reduction Act 

G. E.O. 13132 (Federalism) 

H. Privacy 

I. E.O. 13175 (Indian Tribal Governments) 

J. National Environmental Policy Act of 

1969 

I. Availability of Rulemaking 

Documents 

To view any documents mentioned as 

being available in the docket or 

comments received, go to https://

www.regulations.gov/docket/FMCSA2019-0049/document and choose the 

document to review. To view 

comments, click the notice of proposed 

rulemaking (NPRM) or Medical Review 

Board Task 21–1 Report: Proposed 

Alternative Vision Standard, and click 

‘‘Browse Comments.’’ If you do not have 

access to the internet, go to Dockets 

Operations at the Department of 

Transportation, Room W12–140, 1200 

New Jersey Avenue SE, Washington, DC 

20590–0001, between 9 a.m. and 5 p.m., 

Monday through Friday, except Federal 

holidays. To be sure someone is there to 

help you, please call (202) 366–9317 or 

(202) 366–9826 before visiting Dockets 

Operations. 

II. Executive Summary 

A. Purpose and Summary of the Final 

Rule 

FMCSA amends its regulations to 

permit an individual who does not 

satisfy, with the worse eye, either the 

existing distant visual acuity standard 

with corrective lenses or the field of 

vision standard, or both, to be 

physically qualified to operate a CMV in 

interstate commerce under specified 

conditions. The individual must satisfy 

the new alternative vision standard, 

along with FMCSA’s other physical 

qualification standards. In addition, 

with limited exceptions, individuals 

physically qualified under the 

alternative standard for the first time 

must satisfactorily complete a road test 

administered by the employing motor 

carrier before operating a CMV in 

interstate commerce. This rule 

eliminates the need for the current 

Federal vision exemption program, as 

well as the grandfather provision in 49 

CFR 391.64 for drivers operating under 

the previously administered vision 

waiver study program. The alternative 

vision standard enhances employment 

opportunities while remaining 

consistent with FMCSA’s safety 

mission. 

B. Summary of the Major Provisions 

This rule establishes an alternative 

vision standard, as proposed in the 

NPRM (86 FR 2344 (Jan. 12, 2021)), with 

minor clarifications. The final rule 

clarifies that the alternative vision 

standard is applicable to individuals 

who do not satisfy, with the worse eye, 

the existing FMCSA distant visual 

acuity standard with corrective lenses or 

the field of vision standard, or both. 

The alternative vision standard is 

comparable to the regulatory framework 

FMCSA adopted in § 391.46 for 

individuals with insulin-treated 

diabetes mellitus (see 83 FR 47486 

(Sept. 19, 2018)). The alternative vision 

standard takes the same collaborative 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3391 

1FMCSA data as of August 5, 2021. 

2FMCSA data as of August 5, 2021. 

3As discussed below in section X.F. with respect 

to the information collection titled ‘‘Medical 

Qualification Requirements,’’ FMCSA attributes 

2,236 annual burden hours at a cost of $67,486 for 

drivers to request and maintain a vision exemption. 

The final rule eliminates this entire burden. 

approach to medical certification that 

includes a medical specialist, in this 

case an ophthalmologist or optometrist, 

in addition to a medical examiner (ME) 

on FMCSA’s National Registry of 

Certified Medical Examiners. 

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 of the vision evaluation and 

provides specific medical opinions on 

the new Vision Evaluation Report, Form 

MCSA–5871. Then, an ME performs a 

physical qualification examination 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 a Medical Examiner’s 

Certificate (MEC), Form MCSA–5876, 

for a maximum of 12 months. 

In making the physical qualification 

determination, the ME considers the 

information in the Vision Evaluation 

Report, Form MCSA–5871, and utilizes 

independent medical judgment to apply 

the following four standards. The new 

alternative vision standard provides 

that, to be physically qualified, the 

individual must: (1) Have, in the better 

eye, distant visual acuity of at least 20/ 

40 (Snellen), with or without corrective 

lenses, and field of vision of at least 70 

degrees in the horizontal meridian; (2) 

be able to recognize the colors of traffic 

signals and devices showing standard 

red, green, and amber; (3) have a stable 

vision deficiency; and (4) have had 

sufficient time pass since the vision 

deficiency became stable to adapt to and 

compensate for the change in vision. 

FMCSA clarifies in the last of the four 

standards that there must be a period for 

the individual to adapt to and 

compensate for the vision loss after the 

vision deficiency is deemed stable by a 

medical professional. 

Subject to limited exceptions, 

individuals physically qualified under 

the alternative vision standard for the 

first time must satisfactorily complete a 

road test before operating in interstate 

commerce. The employing motor carrier 

conducts the road test in accordance 

with the road test already required by 

§ 391.31. Individuals are excepted from 

the road test requirement if they have 3 

years of intrastate or specific excepted 

interstate CMV driving experience with 

the vision deficiency, hold a valid 

Federal vision exemption, or are 

medically certified under the previously 

administered vision waiver study 

program in § 391.64(b). 

This rule takes a more individualized 

approach to medical certification than 

the vision exemption program it 

replaces and ensures that individuals 

medically certified under the alternative 

vision standard are physically qualified 

to operate a CMV safely. The process 

creates a clear and consistent framework 

to assist MEs with the physical 

qualification determination that is 

equally as effective as a program based 

on considering exemptions under 49 

U.S.C. 31315(b). In addition, the 

approach of MEs making the physical 

qualification determination, instead of 

FMCSA as in the current exemption 

program, is consistent with Congress’ 

directive in 49 U.S.C. 31149(d) for 

trained and certified MEs to determine 

the individual’s physical qualification 

to operate a CMV. 

The alternative vision standard 

replaces the current vision exemption 

program as the basis for determining the 

physical qualification of individuals to 

operate a CMV. Accordingly, the 1,967 

current vision exemption holders 1 will 

no longer have to apply for an 

exemption. Exemption holders have 1 

year after the effective date of this rule 

to comply with the alternative vision 

standard, at which time all exemptions 

issued under 49 U.S.C. 31315(b) become 

void. This transition year provides time 

to learn the new process for individuals 

whose MEC, Form MCSA–5876, expires 

near the time this rule becomes 

effective. Exemption holders will be 

notified by letter with details of the 

transition to the new standard. 

Similarly, the approximately 1,800 

individuals currently physically 

qualified under the grandfather 

provisions in § 391.64(b) 2 have 1 year 

after the effective date of this rule to 

comply. One year after the effective date 

of this rule all MECs, Form MCSA– 

5876, issued under § 391.64(b) become 

void. 

C. Costs and Benefits 

FMCSA estimates this rule will 

reduce barriers to entry, thereby 

increasing employment opportunities, 

for current and future CMV drivers. The 

1,967 drivers holding vision exemptions 

will no longer have to apply for an 

exemption, and potential drivers who 

would not qualify for an exemption 

because they do not have 3 years of 

intrastate driving experience may meet 

the alternative vision standard and be 

able to operate a CMV in interstate 

commerce. Additionally, previously 

qualified interstate CMV drivers who no 

longer satisfy, with the worse eye, either 

the distant visual acuity standard with 

corrective lenses or field of vision 

standard, or both, will be able to return 

sooner than 3 years to operating in 

interstate commerce. These drivers are 

also relieved of the time and paperwork 

burden associated with applying for or 

renewing an exemption.3 A one-time 

road test is less burdensome on drivers 

than obtaining 3 years of intrastate 

driving experience and addresses the 

consideration that some drivers live in 

States that do not issue vision waivers. 

The final rule results in incremental 

cost savings of approximately $1.6 

million annually by eliminating the 

need for the Federal vision exemption 

program. This estimate includes the 

additional annual impact of 

approximately $44,000 for the road test. 

The Agency does not expect negative 

impacts on safety. The Agency also 

notes that no safety organizations 

commented on the NPRM. 

III. Abbreviations 

ACOEM American College of Occupational 

and Environmental Medicine 

AOA American Optometric Association 

ATA American Trucking Associations, Inc. 

BLS Bureau of Labor Statistics 

CDL Commercial Driver’s License 

CFR Code of Federal Regulations 

CMV Commercial Motor Vehicle 

DOL Department of Labor 

DOT Department of Transportation 

E.O. Executive Order 

FHWA Federal Highway Administration 

FMCSA Federal Motor Carrier Safety 

Administration 

FR Federal Register 

GDP Gross Domestic Product 

ICR Information Collection Request 

ME Medical Examiner 

MEC Medical Examiner’s Certificate, Form 

MCSA–5876 

MRB Medical Review Board 

NAICS North American Industry 

Classification System 

NOA Notice of Availability 

NPRM Notice of Proposed Rulemaking 

OIRA Office of Information and Regulatory 

Affairs 

OMB Office of Management and Budget 

OOIDA Owner-Operator Independent 

Drivers Association 

RFA Regulatory Flexibility Act 

SBA Small Business Administration 

Secretary Secretary of Transportation 

§ Section 

U.S.C. United States Code 

IV. Legal Basis for the Rulemaking 

FMCSA has authority under 49 U.S.C. 

31136(a) and 31502(b)—delegated to the 

Agency by 49 CFR 1.87(f) and (i), 


jspears on DSK121TN23PROD with RULES2
3392 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

4 Details of the meeting, including MRB Task 21– 

1, the MRB Task 21–1 Report, and supporting 

materials used by the MRB, are posted on the 

Agency’s public website at https://

www.fmcsa.dot.gov/medical-review-board-mrbmeeting-topics (last accessed Aug. 31, 2021). The 

MRB Task 21–1 Report is also available in the 

docket at https://www.regulations.gov/document/ 

FMCSA-2019-0049-0117. 

respectively—to establish minimum 

qualifications, including physical 

qualifications, for individuals operating 

CMVs in interstate commerce. Section 

31136(a)(3) requires specifically that the 

Agency’s safety regulations ensure that 

the physical condition of CMV drivers 

is adequate to enable them to operate 

their vehicles safely and that certified 

MEs trained in physical and medical 

examination standards perform the 

physical examinations required of such 

drivers. 

In addition to the statutory 

requirements specific to the physical 

qualifications of CMV drivers, section 

31136(a) requires the Secretary of 

Transportation (Secretary) to issue 

regulations on CMV safety, including 

regulations to ensure that CMVs ‘‘are 

maintained, equipped, loaded, and 

operated safely’’ (section 31136(a)(1)). 

The remaining statutory factors and 

requirements in section 31136(a), to the 

extent they are relevant, are also 

satisfied here. The final rule does not 

impose any responsibilities on CMV 

drivers that ‘‘impair their ability to 

operate the vehicles safely’’ (section 

31136(a)(2)), or ‘‘have a deleterious 

effect on the physical condition’’ of 

CMV drivers (section 31136(a)(4)). 

FMCSA does not anticipate that drivers 

will be coerced to operate a vehicle 

because of this rule (section 

31136(a)(5)). 

Additionally, in 2005, Congress 

authorized the creation of the Medical 

Review Board (MRB), comprised of 

experts in a variety of medical 

specialties relevant to the driver fitness 

requirements, to provide medical advice 

and recommendations on physical 

qualification standards (49 U.S.C. 

31149(a)). The position of Chief Medical 

Examiner was authorized at the same 

time (49 U.S.C. 31149(b)). Under section 

31149(c)(1), the Agency, with the advice 

of the MRB and Chief Medical 

Examiner, is directed to establish, 

review, and revise medical standards for 

CMV drivers that will ensure their 

physical condition is adequate to enable 

them to operate the vehicles safely (see 

also 49 U.S.C. 31149(d)). Finally, the 

Secretary has discretionary authority 

under 49 U.S.C. 31133(a)(8) to prescribe 

recordkeeping and reporting 

requirements. 

FMCSA has considered the costs and 

benefits associated with this final rule 

(49 U.S.C. 31136(c)(2)(A) and 31502(d)). 

Those factors are discussed in the 

Regulatory Analyses section of this rule. 

V. Regulatory History 

A. NPRM 

On January 12, 2021, FMCSA 

published an NPRM titled 

‘‘Qualifications of Drivers; Vision 

Standard’’ (86 FR 2344). The NPRM 

included a detailed discussion of the 

background and regulatory history for 

this action, including the existing vision 

standard, the vision waiver study 

program and grandfathered drivers, and 

the Federal vision exemption program. 

It also included a discussion of the 

reports and analyses undertaken since 

1990 to gather information and evaluate 

the vision standard, the vision waiver 

study program, and the vision 

exemption program, as well as the MRB 

recommendations pertaining to vision 

and FMCSA’s conclusions regarding 

those reports and analyses. While not 

repeated here, these discussions can be 

found in the NPRM (86 FR 2348–56). 

A detailed discussion of the rationale 

for the proposed alternative vision 

standard is set forth in the NPRM (86 FR 

2356–61) and will not be repeated here. 

Summaries of the relevant provisions of 

the NPRM are included in the 

discussion of the comments below. The 

NPRM’s comment period closed on 

March 15, 2021. 

B. MRB Task 21–1 and Report 

The NPRM provided that following 

the closure of the comment period 

FMCSA would ask the MRB to review 

all comments from medical 

professionals and associations. 

Accordingly, in May 2021, FMCSA 

requested in MRB Task 21–1 that the 

MRB review and analyze the nine 

comments from medical professionals 

and associations, make 

recommendations regarding the 

proposed alternative vision standard, 

and identify factors the Agency should 

consider regarding next steps in the 

vision rulemaking. In addition, FMCSA 

requested the MRB’s recommendations 

with respect to whether the information 

requested from ophthalmologists and 

optometrists on the proposed Vision 

Evaluation Report, Form MCSA–5871, 

provided sufficient information for an 

ME to make a medical certification 

determination. 

In May 2021, the MRB held a public 

meeting to consider MRB Task 21–1, 

among other topics. On July 20, 2021, 

the MRB provided its recommendations 

to FMCSA in MRB Task Report 21–1.4

The MRB made the following 

recommendations: 

I. Overview 

A. With respect to the medical aspects of 

the proposed alternative vision standard 

only, if the MRB does not make a specific 

recommendation to change a provision, the 

MRB concurs with the provision as proposed 

in the January 2021 NPRM. 

B. The MRB recommends that the Agency 

deemphasize that the alternative vision 

standard begins with the vision evaluation 

because the individual may be examined first 

by the medical examiner. 

II. Recommendations for the Regulatory 

Standards 

A. The MRB recommends that the current 

field of vision requirement be changed from 

70 degrees to 120 degrees for the alternative 

vision standard for monocular vision drivers. 

B. The MRB agrees that the requirement for 

sufficient time to adapt to and compensate 

for the vision deficiency should not be 

changed in the proposed alternative vision 

standard. The MRB notes it does not have 

sufficient data to establish a specific waiting 

period for an individual who has a new 

vision deficiency. 

III. Recommendations for the Vision 

Evaluation Report 

A. The MRB recommends that the physical 

qualification standards for the alternative 

vision standard, as set forth in the paragraph 

below from Task 21–1 but modified to reflect 

a field of vision of at least 120 degrees, be 

added to page 1 in the instructions after 

FMCSA’s definition of monocular vision: 

The proposal would provide that, to be 

physically qualified under the alternative 

vision standard, the individual must: (1) 

Have in the better eye distant visual acuity 

of at least 20/40 (Snellen), with or without 

corrective lenses, and field of vision of at 

least 120 degrees in the horizontal meridian; 

(2) be able to recognize the colors of traffic 

signals and devices showing standard red, 

green, and amber; (3) have a stable vision 

deficiency; and (4) have had sufficient time 

to adapt to and compensate for the vision 

deficiency. 

B. The MRB recommends that the Agency 

expand the medical opinion in question 12 

to require that the individual can drive a 

CMV safely with the vision condition. The 

MRB notes that the medical opinion 

provided by the ophthalmologist or 

optometrist regarding whether the individual 

has adapted to and compensated for the 

change in vision sufficiently encompasses 

depth perception. The MRB notes further that 

question 12 sufficiently implies that time is 

needed to adapt and compensate for the 

change in vision but appropriately relies on 

the ophthalmologist or optometrist 

conducting the vision evaluation to 

determine the appropriate period of time on 

a case-by-case basis. 

C. The MRB recommends that the requests 

for information about stability in questions 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3393 

5The MRB indicated in the MRB Task 21–1 

Report that it limited its recommendations to the 

medical aspects of the proposed alternative vision 

standard. Therefore, FMCSA does not reference the 

MRB Task 21–1 Report in sections that do not relate 

to the medical aspects of the alternative vision 

standard. 

11 and 13 both be retained. The questions 

solicit different information. 

D. The MRB recommends that the Agency 

change the order of the requested information 

to be questions 1 through 9, 10, 12, 13, and 

then 11. 

E. The MRB recommends that the vision 

evaluation report not request information 

relating to severe non-proliferative diabetic 

retinopathy and proliferative diabetic 

retinopathy because they are evaluated 

separately under the standard for insulintreated diabetes mellitus. 

C. Notice of Availability 

On August 24, 2021, FMCSA 

published a notice of availability (NOA) 

of the MRB’s recommendations in the 

Federal Register and requested public 

comment on them (86 FR 47278). The 

comment period closed on September 

23, 2021. 

VI. Discussion of Comments and 

Responses 

A. Comment Overview 

In this final rule, FMCSA responds to 

public comments to the NPRM and the 

NOA regarding the recommendations in 

the MRB Task 21–1 Report. 

1. NPRM 

In response to the NPRM, FMCSA 

received 69 submissions. One 

submission was identified as not 

relevant, two submissions were 

duplicates, and one commenter 

provided two different submissions. 

Accordingly, 65 commenters (primarily 

individuals) provided responsive 

comments to the NPRM. The 

commenters were healthcare providers, 

one medical association, drivers, motor 

carriers, two trade associations, and 

private citizens. Fourteen commenters 

were anonymous. No safety 

organizations commented on the NPRM. 

The majority of commenters (45) 

expressed general support for the 

proposed rule. These commenters 

included a board-certified retina 

surgeon and ophthalmologist, two MEs, 

CMV drivers with either Federal vision 

exemptions or State vision waivers, 

former drivers who no longer satisfy the 

vision standard, individuals who have 

not had the opportunity to drive a CMV 

because of their vision, the OwnerOperator Independent Drivers 

Association (OOIDA), and individuals 

who viewed the rule as reducing 

discrimination. Common reasons cited 

for supporting the proposal include the 

following: The evidence shows 

monocular drivers are safe and have no 

adverse impact on safety; the rule would 

remove barriers to entry, create job 

opportunities, encourage more 

individuals to enter the workforce, keep 

experienced drivers, and reduce the 

driver shortage; the rule is modeled on 

the approach used to eliminate the 

exemption program and create an 

alternative physical qualification 

standard for insulin-treated diabetes 

mellitus that has worked well; the rule 

would be a step toward less 

discrimination and more inclusion in 

the workforce; and the proposed 

standard is more streamlined than the 

exemption process so it would decrease 

time and paperwork burdens for drivers. 

Twenty commenters generally 

opposed the proposed rule (including 

commenters who supported the 

proposal in concept but wanted further 

study before implementing it). These 

commenters included four MEs, the 

American College of Occupational and 

Environmental Medicine (ACOEM), 

Concentra (a healthcare company that 

delivers occupational medicine and 

urgent care services to employers and 

patients), two drivers, and the American 

Trucking Associations, Inc. (ATA). 

Common reasons cited for opposing the 

proposal include the following: The 

proposal fails to demonstrate an 

appropriate level of safety or the data is 

inconclusive on safety; findings from 

drivers enrolled in the waiver and 

exemption programs cannot be applied 

to the general population of drivers; the 

road test is not a suitable alternative to 

3 years of driving experience and places 

a burden on motor carriers; the field of 

vision requirement should be greater 

than 70 degrees; and the MRB has not 

recommended changes to the vision 

standard. 

2. NOA 

In response to the NOA on the MRB 

Task 21–1 Report, FMCSA received 14 

submissions. The commenters were one 

ME, one medical association, drivers 

and individuals with vision loss in one 

eye, one motor carrier, one trade 

association, private citizens, and five 

anonymous commenters. No safety 

organizations commented on the NOA. 

The NOA stated that ‘‘Comments 

must be limited to addressing the 

recommendations in the MRB Task 21– 

1 Report’’ (86 FR 47279). Only four 

commenters provided comments that 

were responsive, at least in part, to the 

MRB recommendations. Five 

commenters provided general support 

for the alternative vision standard. Two 

commenters opposed the new vision 

standard. Three comments were outside 

the scope of the rulemaking. 

The MRB’s recommendations and 

public comments responsive to them are 

addressed where applicable in the 

discussion of comments and responses 

below.5 Because comments to the NOA 

were limited to the MRB 

recommendations, comments relating to 

other aspects of the alternative vision 

standard are not discussed. FMCSA 

notes that none of these comments 

presented new issues or information not 

raised in the comments submitted in 

response to the NPRM. 

B. Data Used To Determine the Safety 

Impact of the Alternative Vision 

Standard 

NPRM: FMCSA summarized the 

reports and analyses undertaken since 

1990 to gather information and evaluate 

the vision standard, previous waiver 

study program, and current exemption 

program, as well as the MRB 

recommendations pertaining to vision. 

FMCSA concluded that the available 

information did not call into question 

the validity of the vision exemption 

program. The Agency noted the 

available information did not establish 

strong relationships between specific 

measures of vision and their correlation 

to driver safety. FMCSA acknowledged 

‘‘Data on the relationship between 

monocular vision and crash 

involvement is sparse, conflicting with 

respect to crash risk, and not definitive. 

Moreover, the Agency must exercise 

caution when interpreting the data 

because of the different definitions of 

‘monocular vision’ in the literature’’ (86 

FR 2356). 

Accordingly, FMCSA found the 

experience with the vision waiver study 

and exemption programs to be most 

relevant in establishing an alternative 

vision standard. Based on that 

experience, FMCSA determined the 

safety performance of the individuals in 

the vision waiver study and vision 

exemption programs is at least as good 

as that of the general population of CMV 

drivers. FMCSA stated that, if an 

individual meets the proposed 

alternative vision standard, the Agency 

expects there will be no adverse impact 

on safety due to the individual’s vision. 

Comments on the Data Used To 

Determine the Safety Impact of the 

Alternative Vision Standard: Robert E. 

Morris, M.D., a board-certified retina 

surgeon and ophthalmologist, stated, ‘‘it 

is well recognized in medical journals 

that individuals who have experienced 

a vision loss in one eye can and usually 

develop compensatory viewing behavior 

to mitigate the vision loss. My 


jspears on DSK121TN23PROD with RULES2
3394 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

experience in treating patients with the 

loss of vision in one eye is that these 

individuals, over time, are not limited 

by their lack of binocularity with 

respect to driving once they have 

adapted to and compensated for the 

change in vision.’’ Dr. Morris indicated 

that if an individual meets the 

alternative vision standard there will be 

no adverse impact on safety due to the 

vision. Dr. Morris encouraged, ‘‘without 

any reservation,’’ that the alternative 

vision standard be adopted as proposed. 

A commenter who is an ME and has 

examined a moderate number of drivers 

with monocular vision stated that they 

have adapted to the monocular vision 

and ‘‘have been driving professionally 

successfully.’’ The commenter referred 

to an August 2005 abstract published in 

Optometry and Vision Science, titled 

‘‘The Impact of Visual Field Loss on 

Driving Performance: Evidence from 

On-Road Driving Assessments,’’ that 

‘‘concluded ‘a large proportion of 

monocular drivers were safe drivers.’ ’’ 

OOIDA stated that the ‘‘research 

presented demonstrates that individuals 

with monocular vision can safely 

operate a CMV.’’ OOIDA stated further 

that ‘‘There is also considerable medical 

literature indicating that individuals 

with vision loss in one eye can and do 

develop compensatory viewing behavior 

to mitigate their vision loss.’’ OOIDA 

commented that the alternative vision 

standard ‘‘ensures sufficient physical 

qualifications are met.’’ 

Three commenters stated studies 

show the alternative vision standard 

will not compromise safety. A different 

commenter stated, ‘‘There is no factual 

evidence to support the idea that 

reduced vision has a negative impact on 

driving abilities.’’ Another commenter, a 

motor carrier, also commented that the 

alternative vision standard would not 

increase danger to the public. 

A commenter stated the alternative 

vision standard ‘‘comports with current 

scientific findings’’ and ‘‘is not 

arbitrary, . . . It is based on actual 

reports from credentialed 

professionals.’’ The commenter noted 

that ‘‘safeguards will be in place to 

catch and mitigate any safety issues.’’ 

For example, an ME makes the vision 

determinations instead of an FMCSA 

employee. The road test ensures a driver 

operating under the alternative vision 

standard can physically drive the CMV 

safely. Finally, the proposed 12-month 

maximum certification period ensures a 

driver will be re-evaluated in a year to 

determine continued eligibility for CMV 

driving. 

A commenter who holds a Federal 

vision exemption stated individuals 

who have had time to adapt and 

‘‘compensate for their deficiency are, 

indeed, safer and more conscientious 

than your average driver.’’ Several other 

commenters who hold intrastate vision 

waivers noted their safe driving records 

or that their vision does not hinder them 

in any way. They stated it does not 

make sense that they can drive in 

intrastate commerce but not in interstate 

commerce. A commenter, who has 

always had monocular vision and has a 

‘‘terrific driving record,’’ stated ‘‘Having 

one eye increases your awareness of the 

need to be diligent about your 

surroundings.’’ 

In contrast, ACOEM and Concentra 

commented that the studies cited are 

inconsistent in the definition of the 

conditions studied (i.e., different 

definitions of monocular vision were 

used) and conclusions reached. They 

stated that some of the studies reported 

insufficient evidence of monocular 

drivers being at higher risk of crash; 

however, they reminded ‘‘all concerned 

that lack of evidence of the risk is not 

evidence of absence.’’ They stated that 

the study findings from drivers enrolled 

in the vision waiver and exemption 

programs cannot be applied to the 

general population of drivers. According 

to ACOEM and Concentra, the drivers in 

these programs were a carefully selected 

(subject to very specific criteria that 

included 3 years of driving experience 

and a good driving record), highly 

motivated, and closely vetted and 

monitored group. ACOEM added that 

‘‘making the jump to apply these 

findings to the general population of 

drivers is lacking in sufficient evidence 

to modify the current vision standard.’’ 

Concentra commented that one of the 

rebuttals to its concerns will be that 

there have not been any significant 

problems with monocular drivers in the 

last 30 years. It stated this ‘‘could lead 

one to conclude drivers with monocular 

vision are as safe as other drivers.’’ 

Concentra reminded readers that data is 

either absent or conflicting regarding the 

safety of monocular drivers. 

Additionally, with such a small 

percentage of drivers having monocular 

vision, Concentra stated the ‘‘data will 

continue to be difficult to obtain in a 

statistically significant manner.’’ 

Two commenters, who are medical 

doctors and MEs, stated that the existing 

vision standard should not be changed. 

One stated that the existing standard is 

loose enough as it is. The other added 

that, as a criterion for safe driving, it is 

imperative to have acuity in vision to 

drive a multi-ton vehicle around other 

drivers and pedestrians on the road. A 

commenter agreed with the doctors, 

stating that when it comes to public 

safety individuals with vision 

impairments should not drive CMVs 

because the impairments affect their 

capabilities. A different commenter who 

is an ME expressed ‘‘concern about 

changing the vision requirements.’’ 

ATA commented that since 1992 it 

has consistently objected to loosening 

the vision standard in the absence of 

robust data showing such revisions 

would not deteriorate the current level 

of safety. ATA stated it ‘‘has 

consistently advocated that a revised 

but universally applied vision standard 

would be superior to the current 

exemption program and the 

inconsistency that results from its ad 

hoc application.’’ ATA noted that its 

‘‘members accept FMCSA’s analysis that 

the Agency ‘has observed no adverse 

impact on CMV safety due to the vision 

exemption program.’’’ However, ATA 

continued that it ‘‘strongly objects to 

FMCSA’s use of the federal vision 

exemption program data without 

factoring in the safety implications of 

removing essential safeguards contained 

within the program to warrant the 

proposed revision to the vision 

standard.’’ ATA stated that ‘‘FMCSA’s 

NPRM fails to propose a standard that 

would demonstrably maintain the 

appropriate level of safety.’’ 

Three commenters recommended that 

FMCSA undertake further studies before 

proposing an alternative vision 

standard. The first commenter stated: (1) 

The statement about vision data from 

the ‘‘Visual Requirements and 

Commercial Drivers’’ report supports 

maintaining the current requirements 

for overall safety; (2) the MRB 

recommended in 2008 that the vision 

standard should not be changed; and (3) 

the 2008 evidence report summarized 

that the data was not conclusive to 

determine crash risk so more study is 

required. The commenter noted that the 

accident rate study conducted from 

August 1992 to November 1995 found 

the accident rates of both the waiver 

group and control group were 

significantly better/lower than that of 

the national rates because both groups 

were being monitored. The commenter 

stated that one can infer that if all CMV 

drivers were in a similar monitoring 

program then the overall national 

accident rates would follow this 

reduced accident rate trend and 

improve overall safety. The commenter 

also stated that, before any reduction to 

existing vision standards can occur, all 

relevant data must be evaluated through 

consistent methodologies (i.e., the 

creation of studies, defined terms, data 

collection, reports, documentation 

standards, safety standards, etc.). The 

second commenter supported the ‘‘idea 

of this rule,’’ but the commenter stated 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3395 

6The Curriculum Vitae submitted establishes Dr. 

Morris as an expert in the vision field (see https:// 

www.regulations.gov/comment/FMCSA-2019-0049- 

0087). 

7Although the study titled ‘‘The Impact of Visual 

Field Loss on Driving Performance: Evidence from 

On-Road Driving Assessments’’ referred to by a 

commenter generally supports the safety of 

monocular drivers, FMCSA does not rely on the 

study to support this rule due to the study’s small 

sample size. 

that further study must be done to 

determine the full impact of this rule 

before it is adopted. The third 

commenter stated that, as ‘‘the study 

results are mixed, a more detailed study 

or review of the available literature 

should be conducted before this rule is 

finalized. The current literature does not 

appear to support the argument that 

there will be no impact on safety.’’ 

One commenter noted a finding in the 

November 2016 Analysis Brief that the 

crash rate of vision exemption drivers 

was statistically different and higher 

than the crash rate in the control group. 

That commenter ‘‘would feel safer if the 

vision standards became a little stricter 

for CMVs.’’ 

Another commenter stated the 

proposed amendment finds ‘‘the perfect 

balance between the correct 

qualification need for these individuals 

and road safety.’’ The commenter 

continued that modification of the 

existing vision standard is needed and 

the proposal seems to provide a 

framework for who ensures proper 

evaluation and criteria are met. 

However, the commenter noted the need 

to remain vigilant of the data presented 

because of inconsistencies among 

studies and ‘‘limitations in regard to our 

populations.’’ 

A commenter, who acknowledged not 

reading the reports discussed in the 

NPRM, stated that as a safety-minded 

professional the commenter saw ‘‘the 

reduced standards as a gateway for more 

accidents.’’ The commenter asked, if 

FMCSA has data to indicate drivers 

with vision exemptions had no 

significant issues, is it possible the data 

was based on limited markets where 

drivers operated in areas with less 

traffic. The commenter concluded that 

the alternative vision standard ‘‘will 

have a profound impact on public 

safety’’ and ‘‘hope[d] the FMCSA 

discards this NPRM in the interest of 

public safety.’’ 

Several additional commenters 

opposed the alternative vision standard 

based on general safety concerns. For 

example, one commenter stated, while 

agencies are working to get more drivers 

on the road and make it easier for 

drivers to obtain their Federal medical 

certification, ‘‘there should remain 

certain criteria for obvious safety 

reasons.’’ The commenter continued 

that an amendment to the vision 

standard would not be in the best 

interest of the driver or the public on 

the road. Similarly, a different 

commenter noted the rule would be 

effective in creating more job 

opportunities and saving a big amount 

of money but did ‘‘not think that this 

rule is effective in ensuring roads are 

safe for every driver.’’ Another 

commenter stated our roads are 

dangerous enough already and did not 

want people with vision impairments 

on the road. One commenter, who has 

been driving for more than 34 years, 

stated the vision standards should be 

left alone. Finally, another commenter 

stated that FMCSA needs to be more 

worried about other issues and that the 

existing standard is not a cause in that 

many accidents. 

MRB Task 21–1 Report: The MRB 

stated with respect to the medical 

aspects of the proposed alternative 

vision standard only, if the MRB did not 

make a specific recommendation to 

change a provision, the MRB concurred 

with the provision as proposed in the 

January 2021 NPRM. The MRB did not 

recommend that FMCSA forego 

adoption of the alternative vision 

standard. 

Comments on MRB Task 21–1 Report: 

ATA repeated its prior comments that 

the data on which the rule is based is 

insufficient. ATA stated data collected 

from the vision exemption program 

included a requirement that drivers 

have 3 years of intrastate driving 

experience with a stable vision 

deficiency and exempted drivers must 

meet strict driving record requirements. 

‘‘Accordingly, the data collected under 

the exemption program does not 

accurately indicate the level of safety 

that can be expected from all drivers 

qualified under the proposed alternative 

standard should the new standard 

remove these safeguards.’’ ATA urged 

FMCSA ‘‘to collect more data on the 

safety of drivers with a vision deficiency 

prior to adopting the alternative 

standard as introduced.’’ 

Response: The Agency stands by its 

conclusion that individuals who satisfy 

the alternative vision standard 

requirements do not create an increased 

risk of unsafe operation of a CMV due 

to their vision that would cause injury 

to persons or property. The alternative 

vision standard is therefore ‘‘adequate to 

enable them to operate the vehicles 

safely’’ (49 U.S.C. 31136(a)(3)). Indeed, 

the comments provided by Dr. Morris,6

a board-certified retina surgeon and 

ophthalmologist who encouraged the 

adoption of the alternative standard 

without reservation, are consistent with 

FMCSA’s assessment of the safety 

impact of the new standard. 

Commenters provided no new 

information or data that persuades the 

Agency to depart from its conclusion.7

Moreover, the MRB generally supports 

moving ahead with an alternative vision 

standard. 

The Agency acknowledges, as it did 

in the NPRM, that the data on the 

relationship between monocular vision 

and crash involvement is sparse, 

conflicting with respect to crash risk, 

and not definitive. It does not establish 

strong relationships between specific 

measures of vision and their correlation 

to driver safety. FMCSA also 

acknowledges that different definitions 

of ‘‘monocular vision’’ are used in the 

literature. These limitations in studies 

relating to crash risk explain why the 

Agency elects to rely on its long 

experience with the vision waiver study 

and exemption programs as a basis for 

this rule in addition to the medical 

literature. 

Further studies evaluating the impact 

of a vision deficiency in one eye on 

driving performance are unnecessary for 

the purposes of this rule. Considering 

the long period over which the vision 

waiver and exemption programs have 

operated, the Agency has sufficient 

information and experience to reach 

generalized conclusions. The experience 

with the programs has allowed FMCSA 

to evaluate the vision criteria used in 

the programs since 1992 and adopted in 

this rule in the context of actual CMV 

driving experience. Contrary to the 

implication by one commenter, FMCSA 

finds no basis for the assertion that the 

experience of drivers in the programs 

occurred in limited markets with less 

traffic. 

FMCSA disagrees that the experience 

and safety determinations based on the 

vision waiver study and exemption 

programs cannot be applied to the 

alternative vision standard. To isolate 

the impact of a vision deficiency on 

driving, the Agency excluded drivers 

with a history of unsafe driving 

behaviors. After 30 years of experience 

with the vision waiver study and 

exemption programs, FMCSA finds it is 

reasonable to conclude that, if the vision 

deficiency had an adverse impact on the 

ability to operate a CMV, there would be 

observed evidence of that adverse 

impact over the long period, even 

though the individuals were generally 

safe drivers, experienced in driving with 

the vision deficiency, or monitored. 

FMCSA has no such evidence. 


jspears on DSK121TN23PROD with RULES2
3396 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

One commenter noted a finding in the 

November 2016 Analysis Brief that the 

crash rate of vision exemption drivers 

was statistically different and higher 

than the crash rate in the control group. 

As FMCSA explained in the NPRM, that 

finding is not cause for concern. The 

findings of the Analysis Brief represent 

a limited period and are subject to 

several limitations. In particular, the 

crash information did not consider 

whether the CMV driver was at fault in 

any given crash. Moreover, it is not 

possible to know whether visual 

function caused or contributed to the 

crash. FMCSA monitors the 

performance of individual drivers in the 

vision exemption program 

continuously. FMCSA has no evidence 

to suggest drivers in the exemption 

program are less safe than the general 

population of CMV drivers. 

Another commenter stated that the 

August 1992 to November 1995 study 

found the accident rates of the waiver 

group and control group were 

significantly lower than that of the 

national rate. The commenter inferred 

that was because the wavier and control 

groups were monitored in some manner. 

The Agency clarifies that study did not 

include a control group. The 

comparison was of the accident rate in 

the waiver group to the national rate. 

FMCSA disagrees that the alternative 

vision standard presents a ‘‘loosening’’ 

or ‘‘reduction’’ in vision standards. The 

Agency finds, as did Dr. Morris, that the 

requirements adopted are appropriate 

and will not adversely impact safely. 

The rule allows individuals who have 

developed the skills to adapt to and 

compensate for the vision loss to 

demonstrate that they also have the 

skills to operate a CMV safely. The rule 

includes safeguards to ensure that only 

individuals who have developed the 

skills to adapt to and compensate for the 

vision loss will be physically qualified. 

As compared to the existing physical 

qualification process, individuals 

physically qualified under the 

alternative vision standard are subject to 

more stringent requirements. 

Individuals physically qualified under 

the existing vision standard undergo 

only a basic vision screening test 

performed by MEs at least once every 2 

years. Individuals physically qualified 

under the alternative vision standard 

must undergo a thorough eye evaluation 

conducted by an ophthalmologist or 

optometrist using sophisticated 

equipment at least once a year. As 

discussed further below, the 

ophthalmologists and optometrists 

performing the evaluations are to 

provide their medical opinions 

regarding whether the individuals 

evaluated have adapted to and 

compensated for the change in vision 

such that they can drive a CMV safely 

with the vision deficiency. Moreover, 

individuals physically qualified under 

the alternative vision standard must 

undergo a physical qualification 

examination at least once a year. 

As compared to the case-by-case 

determinations made in the exemption 

program, the alternative vision standard 

provides a consistent approach to 

medical certification of individuals who 

do not meet the existing vision 

standard. This approach of MEs making 

the physical qualification 

determination, instead of FMCSA, as in 

the exemption program, is consistent 

with Congress’ directive in 49 U.S.C. 

31149(d) for trained and certified MEs 

to assess the individual’s health status. 

C. The Two-Step Physical Qualification 

Process 

NPRM: FMCSA proposed a two-step 

process for physical qualification under 

the alternative vision standard. First, an 

individual seeking physical 

qualification would obtain a vision 

evaluation from an ophthalmologist or 

optometrist who would record the 

findings and provide specific medical 

opinions on the proposed Vision 

Evaluation Report, Form MCSA–5871. 

Next, an ME would perform an 

examination and determine whether the 

individual meets the proposed vision 

standard, as well as FMCSA’s other 

physical qualification standards. 

Comments on the Two-Step Physical 

Qualification Process: Six commenters 

remarked favorably regarding the 

collaborative physical qualification 

process. Three stated the approach has 

worked well in the standard for insulintreated diabetes mellitus. For example, 

one commenter who is an ME stated the 

alternative standard for insulin-treated 

diabetes mellitus, which involves a 

similar two-step process for physical 

qualification, has worked very well in 

practice. The commenter continued that 

the proposed changes to the vision 

standard would make the certification 

process easier for both MEs and drivers. 

Other commenters agreed that medical 

professionals should determine whether 

an individual meets the physical 

qualification standards. OOIDA stated 

that, as in the current Federal vision 

exemption program, the alternative 

vision standard still requires 

consultation with and approval from 

medical professionals, but it will 

eliminate time and paperwork burdens 

that are required under the exemption 

program. 

MRB Task 21–1 Report: The MRB 

recommended that the Agency 

deemphasize that the alternative vision 

standard begins with the vision 

evaluation because the individual may 

be examined first by the ME. 

Comments on MRB Task 21–1 Report: 

The American Optometric Association 

(AOA) supported the two-step process 

to physically qualify drivers and the 

requirement to have the first step be for 

the individual to seek an evaluation by 

an ophthalmologist or optometrist. It 

continued that ensuring all individuals 

are thoroughly evaluated by an expert in 

eye care is critical and the information 

and opinions should be carefully 

considered and respected. The AOA 

commented that ‘‘Relying on the 

information provided by the doctor of 

optometry or ophthalmologist will be 

critical in evaluating potential drivers.’’ 

ATA cautioned ‘‘that deemphasizing 

the two-step process might result in 

additional burdens for a driver who 

would need to make multiple visits to 

a medical examiner.’’ ATA emphasized 

that individuals who know they will be 

physically qualified under the 

alternative vision standard should see 

the vision specialist first. However, if a 

driver is evaluated by an ME first and 

subsequently referred to a vision 

specialist, that driver will have to return 

to the ME again. At the same time, ATA 

stated its concern that deemphasizing 

the two-step certification process would 

result in some individuals with a vision 

deficiency being wrongly issued 

medical certification because MEs are 

not vision specialists, so individuals 

should see an ophthalmologist or 

optometrist before the physical 

qualification examination. 

Response: FMCSA agrees that the 

alternative vision standard would lessen 

the complexity of the medical 

certification process for individuals who 

do not meet the vision standard without 

an exemption. The similar streamlined 

approach for medical certification of 

individuals with insulin-treated 

diabetes mellitus has worked well and 

received positive acceptance from 

drivers and employers in the motor 

carrier industry. The collaborative 

physical qualification process in this 

final rule provides sufficient safeguards 

to ensure that only individuals who 

have adapted to and compensated for 

their vision deficiency will receive 

medical certification. 

In response to the MRB’s 

recommendation, FMCSA made changes 

to the terminology in this preamble to 

emphasize that a vision evaluation must 

be completed before an individual may 

be physically qualified under the 

alternative vision standard (see 49 CFR 

391.44(b) and (c)). FMCSA uses 

‘‘collaborative’’ to describe the process 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3397 

without emphasizing which medical 

professional first assesses the 

individual. 

For individuals who are aware they 

will be physically qualified under 

§ 391.44, they begin the certification 

process by going to an ophthalmologist 

or optometrist for a vision evaluation. 

For some, however, the need for a vision 

evaluation will not be known until they 

fail to satisfy the existing vision 

standards at a physical qualification 

examination. In this situation, a second 

visit to an ME is unavoidable. Because 

MEs are not vision specialists, a visit to 

an ophthalmologist or optometrist is 

always necessary to ensure the 

individual’s vision is evaluated 

sufficiently before an ME may issue a 

medical certificate that ensures the 

individual can operate a CMV safely. 

This process is no different from current 

practice for other conditions when an 

ME makes a request for a referral to or 

consultation with another appropriate 

healthcare provider. 

Regardless of how an individual 

begins the certification process, an 

individual being evaluated under the 

alternative vision standard must have an 

eye evaluation by an ophthalmologist or 

optometrist to be medically certified. 

Therefore, there is no concern that 

deemphasizing the order of the 

certification process will result in some 

individuals with a vision deficiency 

being incorrectly certified as physically 

qualified. The Vision Evaluation Report, 

Form MCSA–5871, contains the 

information necessary for an ME to 

determine whether the individual 

satisfies the existing vision standard 

using more sophisticated testing 

equipment or requires certification 

under the alternative vision standard. 

FMCSA emphasizes that the ME is to 

consider the information provided on 

the Vision Evaluation Report, Form 

MCSA–5871, but is to use independent 

medical judgment to evaluate the 

information and determine whether the 

individual meets the alternative vision 

standard. It is the ME who makes the 

physical qualification determination in 

the collaborative process. 

D. The Role of Ophthalmologists and 

Optometrists 

NPRM: FMCSA proposed that an 

individual seeking physical 

qualification under the alternative 

vision standard would obtain a vision 

evaluation from an ophthalmologist or 

optometrist who would record the 

findings and provide specific medical 

opinions on the proposed Vision 

Evaluation Report, Form MCSA–5871. 

Comments on the Role of 

Ophthalmologists and Optometrists: 

Three commenters endorsed requiring 

an individual to be seen by an 

ophthalmologist or optometrist. Two 

other commenters, however, expressed 

concerns about allowing the individual 

to select the ophthalmologist or 

optometrist. One stated that having the 

evaluation by a doctor of an individual’s 

choosing may be ineffective in proving 

whether an individual can operate a 

CMV with limited vision. The other 

commenter asked what would prevent a 

driver with recent loss of vision from 

‘‘doctor shopping’’ until the driver finds 

an ophthalmologist or optometrist who 

is willing to state the driver has adjusted 

to the loss of vision. The commenter 

stated that FMCSA would have no way 

to be aware of drivers who doctor shop. 

The same commenter remarked that 

the proposed process appears to be one 

that can be subjective, rather than 

objective like the regulation for 

individuals with insulin-treated 

diabetes mellitus that relies on numbers. 

The commenter noted a driver could 

simply report that the driver has 

adjusted to the partial vision loss when 

that may not be the case. The 

commenter asked if there could be 

direct numbers or procedures assigned 

to the driver’s eye evaluation to prevent 

that from happening. In contrast, one 

commenter stated no doctor is going to 

sign off on a driver if the doctor knows 

a driver cannot drive in a safe manner. 

MRB Task 21–1 Report: The MRB 

made five recommendations relating to 

the Vision Evaluation Report, Form 

MCSA–5871, that generally relate to the 

role of ophthalmologists or optometrists 

in the certification process. Those 

recommendations are discussed in 

detail in connection with the report and 

the relevant requirement in the 

alternative vision standard. 

Response: FMCSA expects that 

ophthalmologists and optometrists will 

not complete the Vision Evaluation 

Report, Form MCSA–5871, unless they 

have reliable information on which to 

base their opinions, as stated by one 

commenter. Concerning the comments 

on drivers self-selecting 

ophthalmologists and optometrists and 

doctor shopping for favorable results, 

FMCSA anticipates that often the 

ophthalmologist or optometrist 

completing the report will have treated 

the individual seeking evaluation and 

have knowledge of the individual’s 

vision medical history. However, the 

Agency is not requiring the 

ophthalmologist or optometrist 

completing the report to have provided 

medical treatment to the individual 

previously. If the ophthalmologist or 

optometrist does not have a previous 

relationship with an individual seeking 

evaluation, typical medical practice 

would be for the ophthalmologist or 

optometrist to request and review the 

individual’s prior vision and medical 

records. 

The Vision Evaluation Report, Form 

MCSA–5871, requests objective 

information that is the basis for the 

medical opinions rendered by the 

ophthalmologist or optometrist. The 

information is obtained through a vision 

evaluation that includes formal 

perimetry results for the field of vision 

and prior medical documentation. The 

Agency finds it unlikely an 

ophthalmologist or optometrist would 

merely accept an individual’s statement 

that the individual has adapted to and 

compensated for the vision loss. Instead, 

the ophthalmologist or optometrist 

makes that determination based on 

multiple factors such as the clinical 

examination, test results, history of the 

cause and duration of the vision loss, 

and medical information regarding the 

time needed to adapt to and compensate 

for the vision loss based on all the 

relevant factors. In addition, 

ophthalmologists and optometrists 

completing the report must attest that 

the information provided is true and 

correct to the best of their knowledge. 

E. Frequency of Vision Evaluations 

NPRM: FMCSA proposed that 

individuals physically qualified under 

the alternative vision standard would 

have vision evaluations by an 

ophthalmologist or optometrist before 

each annual or more frequent physical 

qualification examination by an ME. 

Comments on the Frequency of Vision 

Evaluations: Dr. Morris, a boardcertified retina surgeon and 

ophthalmologist, encouraged FMCSA, 

‘‘without any reservation,’’ to adopt the 

alternative vision standard. Another 

commenter agreed that vision 

evaluations should be completed at least 

yearly. A different commenter, an ME, 

stated the MRB recommended that 

FMCSA seek comments from 

ophthalmologists, optometrists, or their 

professional associations regarding the 

frequency of evaluation because there 

are many different eye conditions and 

they could be fixed or progressive. 

MRB Task 21–1 Report: The MRB did 

not recommend a change to the 

frequency of vision evaluations; 

therefore, the MRB concurred with the 

frequency of vision evaluations as 

proposed. 

Response: FMCSA continues to find 

that at least annual vision evaluations 

are appropriate for individuals 

physically qualified under the 

alternative vision standard. The Vision 

Evaluation Report, Form MCSA–5871, 


jspears on DSK121TN23PROD with RULES2
3398 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

asks ophthalmologists and optometrists 

to provide an opinion on whether a 

vision evaluation is required more often 

than annually for the individual 

evaluated. If so, they are to state how 

often a vision evaluation should be 

required. In addition, the ME 

performing the physical qualification 

examination may exercise medical 

discretion, based on the findings of the 

examination and driver health history, 

and require an eye evaluation more 

often than annually by medically 

certifying the individual for less than 

the maximum 12-month period. Finally, 

ophthalmologists, optometrists, and 

their professional associations had the 

opportunity to submit comments on this 

issue in response to the NPRM. 

F. Vision Evaluation Report, Form 

MCSA–5871 

NPRM: FMCSA proposed that an 

ophthalmologist or optometrist would 

record the findings from the vision 

evaluation and provide specific medical 

opinions on the Vision Evaluation 

Report, Form MCSA–5871. The report 

would be provided to and considered by 

the ME in making a qualification 

determination. 

Comments on the Vision Evaluation 

Report, Form MCSA–5871: No 

comments were received on the 

substance or format of the report. 

ACOEM commented, however, that the 

MRB recommended in September 2015 

that, if the vision standard is changed, 

a form should be designed to be 

completed by the ophthalmologist or 

optometrist that includes all the 

information required by the current 

vision exemption program, which could 

then be reviewed by the ME. Another 

commenter, an ME, stated similarly that 

FMCSA should seek comment from 

professional associations for 

ophthalmologists or optometrists 

regarding comorbid conditions, disease 

processes, and any other additional 

helpful information. 

MRB Task 21–1 Report: In the first of 

five recommendations for the Vision 

Evaluation Report, Form MCSA–5871, 

the MRB recommended that the 

physical qualification standards for the 

alternative vision standard (modified to 

reflect a field of vision of at least 120 

degrees) be added to page 1 after 

FMCSA’s definition of monocular vision 

as information for the ophthalmologist 

or optometrist. 

The second recommendation was to 

expand the medical opinion for 

question 12, regarding sufficient time to 

adapt and compensate for the change in 

vision, to require that the individual can 

drive a CMV safely with the vision 

condition. The MRB noted that the 

medical opinion regarding whether the 

individual has adapted to and 

compensated for the change in vision 

sufficiently encompasses depth 

perception. The MRB further noted that 

question 12 sufficiently implies that 

time is needed to adapt and compensate 

for the change in vision, but 

appropriately relies on the 

ophthalmologist or optometrist 

conducting the vision evaluation to 

determine the appropriate period of 

time on a case-by-case basis. 

The remainder of the MRB 

recommendations, three through five, 

concerned the order of questions and 

the necessity of certain questions. The 

MRB recommended the information 

about stability in questions 11 (vision 

deficiency) and 13 (progressive eye 

conditions) be retained because the 

questions solicit different information. 

The MRB recommended the Agency 

change the order of the requested 

information to be questions 1 through 9, 

10, 12, 13, and then 11. This would 

place the question concerning stability 

of the vision deficiency (question 11) 

after the question about progressive eye 

diseases (question 13). Finally, the MRB 

recommended the Agency not request 

information on the report relating to 

severe non-proliferative diabetic 

retinopathy and proliferative diabetic 

retinopathy because they are evaluated 

separately under the standard for 

insulin-treated diabetes mellitus. 

Response: With respect to ACOEM 

and the ME’s comments to the NPRM, 

FMCSA followed the MRB’s September 

2015 recommendations and developed a 

form for ophthalmologists and 

optometrists to complete that is 

provided to MEs. The Vision Evaluation 

Report, Form MCSA–5871, is based on 

the September 2015 recommendations 

and information obtained in the current 

vision exemption program. It includes 

requests for information about 

progressive eye conditions. A summary 

of the proposed report was included in 

the NPRM, and a draft of the report was 

available in the rulemaking docket. The 

NPRM afforded the opportunity for all 

interested parties, including eye 

professionals and their organizations, to 

provide comment on the proposed rule 

and report. 

The final Vision Evaluation Report, 

Form MCSA–5871, includes the 

alternative vision standards on page 1 as 

requested by the MRB. However, 

FMCSA does not modify the vision 

standards to reflect a field of vision of 

at least 120 degrees for the reasons 

discussed below. 

FMCSA agrees with the MRB that 

reordering the medical opinions and 

information about progressive eye 

conditions improves the report. 

Accordingly, FMCSA inserts the 

question about progressive eye 

conditions before the medical opinions. 

That move consolidates all the vision 

information before the medical opinions 

are provided. Question 11, which 

provides the medical opinion 

concerning whether the vision 

deficiency is stable, follows the question 

about progressive eye conditions as the 

MRB recommended. FMCSA does not 

place the medical opinion about 

stability of the vision deficiency after 

the other medical opinions, however. 

The alternative vision standard requires 

that the vision deficiency must be stable 

first, and then there must be time to 

adapt and compensate for the vision 

change. As recommended, FMCSA 

expands question 12, regarding adapting 

to and compensating for the vision 

deficiency, to include that the 

individual can drive the CMV safely. 

FMCSA agrees with the MRB’s 

recommendation and rationale 

regarding not to include questions 

concerning severe non-proliferative and 

proliferative diabetic retinopathy on the 

report. These conditions are covered by 

the separate standard for insulin-treated 

diabetes mellitus. 

The final Vision Evaluation Report, 

Form MCSA–5871, is available in the 

docket for this rulemaking. The Agency 

invites public comment on the report 

under the Paperwork Reduction Act as 

provided in the information collection, 

titled ‘‘Medical Qualification 

Requirements,’’ discussed in section 

X.F. below. Comments should be 

submitted to OIRA at OMB as provided 

in the ADDRESSES section above. 

G. The Role of MEs 

NPRM: FMCSA proposed that, at least 

annually, but no later than 45 days after 

an ophthalmologist or optometrist signs 

and dates the Vision Evaluation Report, 

Form MCSA–5871, an ME would 

conduct a physical qualification 

examination and determine whether the 

individual meets the alternative vision 

standard, as well as the other physical 

qualification standards. 

Comments on the Role of MEs: A 

commenter stated one safeguard in the 

alternative vision standard is that 

determinations regarding whether an 

individual can operate a CMV safely 

will be made by an ME, a licensed 

healthcare professional, instead of an 

FMCSA employee. In contrast, ACOEM 

stated the proposed standard would 

shift considerable responsibility to the 

ME who may not have the training or 

experience to adequately assess the 

vision deficiency. An ME commented 

that the ME would refuse to examine 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3399 

any drivers who fall within the 

proposed alternative vision standard 

‘‘for the sake of the driving public and 

as a personal liability concern.’’ 

MRB Task 21–1 Report: The MRB did 

not recommend a change with respect to 

the role of the ME in the proposed 

alternative vision standard; therefore, 

the MRB concurred with the role of the 

ME as proposed. 

Response: FMCSA disagrees that 

under the alternative vision standard 

more responsibility or liability is shifted 

to MEs for which they are not trained 

or have experience. FMCSA has 

determined that MEs are qualified to 

perform their role in this collaborative 

medical certification process and to 

perform physical qualification 

examinations on all individuals, 

including those with vision 

deficiencies. The role of the 

ophthalmologist or optometrist is to 

provide relevant information and 

medical opinions regarding the 

individual’s vision status to assist the 

ME to determine whether the individual 

meets the alternative vision standard. 

The role and responsibility of the ME, 

who is licensed by a State authority to 

perform physical examinations and is 

trained in FMCSA’s physical 

qualification standards and the 

demands of operating a CMV, is to 

exercise independent medical judgment 

to medically certify that the individual 

can safely operate a CMV. The ME’s role 

with the alternative vision standard is 

consistent with current practice for any 

medical condition for which the ME 

considers additional information to 

reach a medical certification 

determination. 

MEs have proven experience making 

medical certification determinations. 

This approach of MEs making the 

physical qualification determination is 

consistent with Congress’ directive in 49 

U.S.C. 31149(d) for trained and certified 

MEs to determine the individual’s 

physical qualification to operate a CMV. 

If an ME determines that additional 

information is necessary to make the 

certification determination, the ME 

could confer with the ophthalmologist 

or the optometrist for more information 

on the individual’s vision medical 

history and current status, make 

requests for other appropriate referrals, 

or request medical records from the 

individual’s treating provider, all with 

the appropriate consent. MEs routinely 

confer with and obtain opinions from 

treating providers concerning the 

stability of individuals’ underlying 

medical conditions and how the 

medical conditions may impact safety. 

H. Frequency of Physical Qualification 

Examinations and Maximum Period of 

Certification 

NPRM: FMCSA proposed that 

individuals medically certified under 

the alternative vision standard have 

physical qualification examinations at 

least every 12 months and be medically 

certified for a maximum period of 12 

months. 

Comments on the Frequency of 

Physical Qualification Examinations 

and Maximum Period of Certification: A 

commenter stated the 12-month 

maximum certification period is a 

safeguard that ensures an individual 

will be re-evaluated in a year to 

determine continued eligibility for CMV 

driving. One commenter, an ME, stated 

that the MRB recommended 

certification for 1 year if FMCSA 

develops an alternative vision standard. 

Another commenter who also is an ME 

noted that FMCSA issues vision 

exemptions for 2 years. The commenter 

asked if individuals designated as 

legally blind could be medically 

certified for 2 years because their vision 

is not going to change. 

MRB Task 21–1 Report: The MRB did 

not recommend a change with respect to 

the frequency of physical qualification 

examinations or maximum period of 

certification; therefore, the MRB 

concurred with the requirement for 

physical qualification examinations at 

least every 12 months and certification 

for a maximum of 12 months. 

Response: FMCSA continues to find it 

appropriate for individuals medically 

certified under the alternative vision 

standard to have physical qualification 

examinations at least every 12 months 

and to be medically certified for a 

maximum of 12 months. The Agency 

agrees with the first commenter cited 

above that the 12-month maximum 

certification period is a safeguard that 

allows for early detection and 

consideration of conditions that may 

impact an individual’s ability to safely 

operate a CMV. 

FMCSA continues to conclude, as 

stated in the NPRM, that even 

individuals who have a non-functional 

eye or have lost an eye must undergo 

vision evaluations at least annually. It is 

important to monitor compliance with 

the vision standard in the unaffected 

eye because of the potential for vision 

changes in that eye (86 FR 2358). 

Accordingly, at least annual physical 

qualification examinations are 

appropriate for individuals designated 

as legally blind in one eye. Although 

Federal vision exemptions are issued for 

2 years, individuals undergo a vision 

evaluation and a physical qualification 

examination at least annually. The 

maximum certification period is 12 

months for an individual with a vision 

exemption. Thus, the approach in the 

alternative vision standard is consistent 

with the vision exemption program. 

If an ME determines an individual 

merits closer monitoring, the ME may 

certify the individual for less than the 

maximum 12-month period. This 

approach allows the ME to exercise 

medical discretion as necessary in 

making individualized medical 

certification determinations. 

I. Individuals Eligible for the Alternative 

Vision Standard 

NPRM: FMCSA proposed that the 

physical qualification standard for 

vision would be satisfied if an 

individual meets the requirements of 

the existing vision standard or the 

requirements of the alternative vision 

standard in § 391.44. Section 391.44 

proposed an alternative vision standard 

for an individual ‘‘who cannot satisfy 

either the distant visual acuity or field 

of vision standard, or both,’’ in the 

existing vision standard in one eye. On 

the Vision Evaluation Report, Form 

MCSA–5871, FMCSA defined 

monocular vision ‘‘as (1) in the better 

eye, distant visual acuity of at least 20/ 

40 (with or without corrective lenses) 

and field of vision of at least 70 degrees 

in the horizontal meridian, and (2) in 

the worse eye, either distant visual 

acuity of less than 20/40 (with or 

without corrective lenses) or field of 

vision of less than 70 degrees in the 

horizontal meridian, or both.’’ 

Comments on Individuals Eligible for 

the Alternative Vision Standard: 

ACOEM stated that the proposed 

alternative vision standard goes beyond 

the scope of the current vision 

exemption program. ACOEM 

commented that the current exemption 

program is only applicable to drivers 

whose best corrected vision in their 

worse eye prevents them from meeting 

the vision standard. The proposed 

alternative vision standard, however, 

seems to allow any driver to meet the 

vision standard if vision in one eye is 

at least 20/40 with or without corrective 

lenses. This would permit a driver who 

chooses not to obtain corrective lenses 

to use the proposed standard if the 

driver’s vision in the better eye meets 

the existing vision standard. ACOEM 

continued, ‘‘True monocular vision is 

defined by medical professionals as 

vision with only one eye whether it be 

due to functional loss or physical loss 

of the eye.’’ However, the alternative 

vision standard would apply to a driver 

who simply does not meet the existing 

visual acuity requirements and does not 


jspears on DSK121TN23PROD with RULES2
3400 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

8FMCSA Medical Review Board, Meeting 

Summary, Oct. 19, 2012, available at https://

www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/ 

October_2012_Certified_Meeting_Summary.pdf (last 

accessed Aug. 17, 2021). 

specify whether due to a long-term 

condition, surgery, or just normal vision 

changes. Concentra made a similar 

comment. Both ACOEM and Concentra 

commented that the proposed 

alternative vision standard would 

permit having one eye corrected to 

distant vision and the other corrected 

for near vision. 

MRB Task 21–1 Report: The MRB did 

not recommend a change with respect to 

eligibility for the alternative vision 

standard; therefore, the MRB concurred 

with the alternative standard as 

proposed in this regard. 

Response: FMCSA clarifies in this 

final rule that only individuals who do 

not satisfy, with the worse eye, either 

the distant visual acuity standard with 

corrective lenses or the field of vision 

standard, or both, in the existing vision 

standard are eligible to be physically 

qualified under the alternative vision 

standard. FMCSA changes the 

regulatory text and definition of 

monocular vision on the Vision 

Evaluation Report, Form MCSA–5871, 

accordingly. Individuals who choose 

not to obtain corrective lenses for the 

worse eye when the better eye meets the 

existing vision standard must not be 

physically qualified under § 391.44. It 

was not the Agency’s intent to change 

the scope of the current vision 

exemption program in this regard or to 

allow individuals who simply need 

corrective lenses to be physically 

qualified under the alternative vision 

standard. The Agency elects to optimize 

overall safety on our roadways by 

requiring individuals to satisfy the 

existing vision standard when they are 

able to do so with the use of corrective 

lenses. Moreover, FMCSA assumes that 

individuals will make the rational 

decision to improve their vision if it is 

less burdensome than incurring the 

additional expense of annual eye 

evaluations and physical qualification 

examinations. 

The alternative vision standard is not 

an option for an individual who can 

meet the existing vision standard with 

correction. The Vision Evaluation 

Report, Form MCSA–5871, specifically 

questions whether the individual has 

corrected or uncorrected vision, and 

whether the correction is by glasses or 

contacts. An ME who receives and 

reviews a Vision Evaluation Report, 

Form MCSA–5871, and detects the 

individual in each eye meets the 

minimum visual acuity standard of 20/ 

40 with correction, has a field of vision 

of 70 degrees, and is able to recognize 

the standard red, green, and amber 

traffic control signal colors, should 

inform the individual that medical 

certification under the alternative vision 

standard is not applicable. 

Under FMCSA’s existing vision 

standard, it is permissible for an 

individual to have one eye corrected to 

distant vision and the other corrected 

for near vision if each eye meets the 

existing visual acuity standard. If one 

eye does not meet the visual acuity 

standard, the individual must obtain 

and wear corrective lenses that enable 

the individual to satisfy the visual 

acuity standard in each eye while 

operating a CMV. 

J. Acceptable Field of Vision 

NPRM: FMCSA proposed that an 

individual must have, in the better eye, 

field of vision of at least 70 degrees in 

the horizontal meridian to be physically 

qualified under the alternative vision 

standard. The Agency stated in the 

NPRM that it was ‘‘not proposing 

changes to the current vision standard 

found in § 391.41(b)(10)’’ (86 FR 2358). 

Comments on Acceptable Field of 

Vision: Dr. Morris, a board-certified 

retina surgeon and ophthalmologist, 

encouraged FMCSA, ‘‘without any 

reservation,’’ to adopt the alternative 

vision standard as proposed. Dr. Morris 

indicated that if an individual meets the 

proposed vision standard there will be 

no adverse impact on safety due to the 

individual’s vision, and that the loss of 

vision is not likely to play a significant 

role in whether the individual can drive 

a CMV safely. A commenter, who holds 

a Federal vision exemption, stated that 

when an individual has reduced vision 

in one eye the peripheral field sharpens 

over time. Another commenter also 

noted an improvement in the field of 

vision due to compensation when 

compared to before the vision loss. 

Concentra and ACOEM commented 

that the existing vision standard 

considers 70 degrees in the horizontal 

meridian in each eye to be sufficient; 

however, normal field of vision is twice 

that, i.e., 50 degrees nasally and 90 

degrees temporally for a total of 140 

degrees. Concentra noted pilots are 

required to have normal field of vision. 

It recommended that 120 degrees 

bilaterally be considered the minimum 

acceptable standard for § 391.41, and 

that drivers not meeting that standard 

should be disqualified. Concentra 

continued that ‘‘Depending on the cause 

of the vision deficit, perhaps the driver 

could be eligible for an exemption 

under either the current exemption 

program or the proposed § 391.44.’’ 

ACOEM stated that the field of vision 

standard has long been an area of 

controversy and that this rule would be 

an appropriate time to address the field 

of vision standard. It noted the MRB 

previously recommended that a 120- 

degree field of vision be adopted.8

Concentra provided diagrams that it 

states demonstrate a driver with 70 

degrees of horizontal field of vision has 

a markedly decreased field of vision. 

Concentra continued that a ‘‘field of 

vision limited to 70 degrees is not 

normal vision and if detected on an 

examination, is reason to have a 

comprehensive evaluation by a 

specialist.’’ ACOEM noted the proposed 

rule would allow a quarter of a normal 

visual field to meet the standard. Both 

Concentra and ACOEM commented 

than any discussion of field of vision 

should specify if it is from nasal, 

temporal, or total. 

A commenter stated that FMCSA 

needs to seek comment from eye 

specialists and professional associations 

regarding field of vision criteria, which 

is not supposed to be 70 degrees as 

stated in the existing vision standard. 

MRB Task 21–1 Report: The MRB 

recommended that the field of vision 

requirement be changed from 70 degrees 

to 120 degrees for the alternative vision 

standard. 

Comments on MRB Task 21–1 Report: 

The AOA supported the MRB’s 

recommendation. The AOA commented 

that ‘‘Using 120 degrees in the 

horizontal meridian as a requirement 

would create greater consistency with 

recognized driving standards.’’ ATA 

noted Concentra and Dr. Morris 

supported a 120-degree field of vision 

instead of the proposed 70 degrees. ATA 

stated that it supports ‘‘efforts to 

maintain a stringent vision standard for 

commercial drivers and believes that the 

MRB recommendation to increase the 

required [field of vision] and the 

required evaluation from a vision 

specialist accomplishes this goal.’’ 

In contrast, an ME commenter 

recommended keeping the 70-degree 

peripheral vision requirement. A 

different commenter asked if there have 

been any studies showing that drivers 

with a wider field of vision have fewer 

accidents. The commenter continued ‘‘If 

not, then leave things alone,’’ especially 

when there is no evidence that drivers 

with a narrower field of vision are more 

dangerous on the road. 

Response: The Agency has long 

considered 70 degrees in the horizontal 

meridian in each eye to be the sufficient 

minimum standard for field of vision. 

As stated above, the NPRM did not 

propose changes to the field of vision 

requirement for the existing vision 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3401 

standard. Accordingly, the comments 

recommending changes to the existing 

vision standard are out of the scope of 

this rulemaking and will not be 

addressed here. 

Dr. Morris concluded, as has FMCSA, 

that if an individual meets the proposed 

vision standard there will be no adverse 

impact on safety due to the individual’s 

vision. Contrary to ATA’s interpretation, 

Dr. Morris did not support a 120-degree 

field of vision for the alternative vision 

standard. Dr. Morris noted only that his 

patient has field of vision of 120 degrees 

in the horizontal meridian. 

The alternative vision standard adopts 

the major vision criteria of the current 

Federal vision exemption program, 

which were also used in the preceding 

Federal vision waiver study program 

since the early 1990s. Under the current 

vision exemption program, FMCSA 

considers exemptions for those 

individuals who have a field of vision 

of at least 70 degrees in the horizontal 

meridian in the better eye. An 

ophthalmologist or optometrist must 

conduct formal perimetry to assess the 

field of vision of each eye, including 

central and peripheral fields, utilizing a 

testing modality that tests to at least 120 

degrees in the horizontal meridian. The 

ophthalmologist or optometrist must 

submit the formal perimetry for each 

eye and interpret the results in degrees 

of field of vision. The Vision Evaluation 

Report, Form MCSA–5871, includes the 

same requirements for testing and 

formal perimetry. The report also 

requires a medical opinion from the 

ophthalmologist or optometrist 

regarding whether the individual has 

adapted to and compensated for the 

change in vision and can drive a CMV 

safely. 

Commenters did not provide in 

response to the NPRM or NOA any new 

data that shows drivers with a 

horizontal field of vision of 70 degrees 

in the better eye are less safe than 

drivers with a field of vision of 120 

degrees. The Agency has nearly 30 years 

of experience with drivers who have 

been physically qualified under the 

vision waiver study and the exemption 

programs with a field of vision of at 

least 70 degrees. Based on that 

experience, which has not revealed 

concerns regarding a horizontal field of 

vision of 70 degrees in the better eye, 

FMCSA has determined that individuals 

who meet the alternative vision 

standard will be at least as safe as the 

general population of CMV drivers. 

K. Meaning of Stable Vision 

NPRM: FMCSA proposed that an 

individual is not physically qualified 

under the alternative vision standard to 

operate a CMV ‘‘if the individual’s 

vision deficiency is not stable.’’ FMCSA 

did not propose a definition for what 

constitutes stable vision. 

Comments on the Meaning of Stable 

Vision: Concentra commented that the 

‘‘term ‘stable’ is too broad and is 

guaranteed to cause controversy and 

confusion.’’ Similarly, ACOEM asked 

how stable would be defined. ACOEM 

also asked if a modest change in vision 

in the worse eye over a 5- to 10-year 

period would be considered stable. 

Concentra asked FMCSA to consider the 

driver who needs new corrective lenses 

every 2 to 3 years to even reach 20/40 

in the worse eye. Concentra and 

ACOEM both asked if any progressive 

eye diseases should ever be considered 

stable. They commented that, not only 

will eye care professionals have 

different opinions on stability, but many 

MEs will not have sufficient knowledge 

of vision disorders to evaluate whether 

an eye disorder is stable or progressive. 

They stated that removing the 3-year 

driving experience requirement will 

only amplify this issue. 

MRB Task 21–1 Report: The MRB did 

not recommend a change with respect to 

the meaning of stable vision; therefore, 

the MRB concurred with the alternative 

vision standard in this regard. As noted 

above with respect to the Vision 

Evaluation Report, Form MCSA–5871, 

the MRB recommended the questions 

about stability of the vision deficiency 

and progressive eye conditions be 

retained because the questions solicit 

different information. 

Comment on the MRB Task 21–1 

Report: The AOA stated the MRB noted 

that the medical opinion provided by 

the ophthalmologist or optometrist must 

be respected regarding whether the 

individual has stable vision deficiency. 

Response: FMCSA declines to 

incorporate a specific definition of 

stable vision in the final rule that 

applies to all individuals who are 

physically qualified under the 

alternative vision standard. Instead, 

ophthalmologists and optometrists who 

are trained to evaluate vision and know 

what constitutes stable vision are to 

provide medical opinions regarding 

when an individual’s vision is stable. 

However, FMCSA changes the Vision 

Evaluation Report, Form MCSA–5871, 

by adding a question after the 

ophthalmologist or optometrist provides 

an opinion regarding whether the 

individual’s vision deficiency is stable. 

It asks, ‘‘If yes, when did the vision 

deficiency become stable?’’ With respect 

to progressive eye conditions, FMCSA 

also adds a request for additional 

information if the condition is not 

stable. These changes provide 

additional information for the ME to 

independently assess whether the 

individual’s vision is stable. 

Determining when vision is stable 

requires an individualized assessment. 

Many variables, such as the nature, 

severity, and duration of the underlying 

medical condition or vision deficiency, 

treatment, and response to treatment, 

influence when an ophthalmologist or 

optometrist deems vision to be stable for 

both progressive and fixed vision 

deficiencies. Therefore, the Agency 

finds that whether an individual has 

stable vision is a clinical rather than a 

regulatory determination and most 

appropriately defined for the individual 

by healthcare professionals. 

FMCSA does not expect MEs will 

make unassisted or uninformed vision 

qualification determinations, as 

indicated by commenters. The 

alternative vision standard emphasizes 

the separate but collaborative roles of 

ophthalmologists or optometrists and 

MEs in the medical certification 

process. Specifically, the 

ophthalmologist or the optometrist 

performs a vision evaluation and 

completes the required Vision 

Evaluation Report, Form MCSA–5871, 

based on the clinical findings of the 

evaluation of the individual and 

knowledge of the individual’s medical 

history. The report provides the relevant 

information and medical opinions for 

the ME to consider when making the 

final physical qualification 

determination. The MRB did not state 

that the medical opinions provided by 

ophthalmologists and optometrists must 

be respected. FMCSA emphasizes that 

the final determination rests with the 

ME regarding whether the individual 

meets the alternative vision standard. 

L. Elimination of the Exemption 

Program’s 3-Year Driving Experience 

Criterion 

NPRM: FMCSA stated the 3 years of 

intrastate driving experience with the 

vision deficiency criterion in the vision 

exemption program has been equated to 

sufficient time for the driver to adapt to 

and compensate for the change in 

vision. Rather than continuing the 

criterion, FMCSA proposed for the 

alternative vision standard that an 

individual is not physically qualified to 

operate a CMV ‘‘if there has not been 

sufficient time to allow the individual to 

adapt to and compensate for the change 

in vision.’’ FMCSA did not propose a 

minimum period for the time to adapt 

to and compensate for the change in 

vision. Instead, the medical 

professionals would determine when an 

individual has adapted to and 

compensated for a change in vision 


jspears on DSK121TN23PROD with RULES2
3402 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

based on an individualized assessment 

of all the relevant factors. As an 

alternative to the driving experience 

criterion, FMCSA proposed that 

individuals physically qualified for the 

first time ever under the alternative 

vision standard must satisfactorily 

complete a road test before operating in 

interstate commerce, with limited 

exceptions. 

Comments on Elimination of the 

Exemption Program’s 3-Year Driving 

Experience Criterion: Dr. Morris, a 

board-certified retina surgeon and 

ophthalmologist, encouraged that the 

alternative vision standard be adopted 

as proposed. Dr. Morris stated, ‘‘As a 

retina surgeon, it is well recognized in 

medical journals that individuals who 

have experienced a vision loss in one 

eye can and usually develop 

compensatory viewing behavior to 

mitigate the vision loss. My experience 

in treating patients with the loss of 

vision in one eye is that these 

individuals, over time, are not limited 

by their lack of binocularity with 

respect to driving once they have 

adapted to and compensated for the 

change in vision.’’ 

OOIDA stated the prolonged period of 

required intrastate driving can 

discourage drivers from staying in the 

industry. OOIDA commented that the 

alternative vision standard ‘‘ensures 

sufficient physical qualifications are 

met, but also establishes a more 

practical process that will help safe 

drivers continue to operate in the 

trucking industry.’’ 

A commenter noted that not adopting 

the alternative vision standard would 

prolong the process for previously 

qualified interstate CMV drivers who 

are no longer able to meet the existing 

vision standard to return to driving. The 

commenter also stated the rule would 

reduce barriers of entry. Another 

commenter supported the alternative 

vision standard but emphasized that 

adequate depth perception is key to 

avoiding collisions. The commenter 

continued that under the new standard 

an individual’s depth perception should 

be assessed first and foremost. 

ATA stated it strongly opposed 

replacing the vision exemption 

program’s criterion of 3 years of driving 

experience with the road test required 

in § 391.31. ATA strongly objected to 

FMCSA’s use of vision exemption 

program data without factoring in the 

safety implications of removing 

essential safeguards of the program. 

ATA also strongly disagreed with 

FMCSA’s assessment that, by 

eliminating the intrastate CMV 

experience requirement and replacing it 

with the mandated road test in § 391.31, 

the alternative vision standard could 

increase the number of drivers entering 

the industry without adversely 

impacting safety. ATA stated that, 

regardless of age, years of experience 

consistently equates to lower rates of 

crashes, crash involvements, and 

moving violations, which are factors 

that were overlooked in the NPRM. 

ACOEM commented that the ‘‘current 

requirement for 3 years of commercial 

driving experience with the vision 

deficiency would allow the individual 

with a vision impairment a period of 

time under which they could adjust to 

the vision deficit.’’ ACOEM and 

Concentra stated that a simple road test 

is insufficient evaluation for drivers 

lacking experience operating CMVs. 

They stated further that the ‘‘presently 

available data regarding the safety of 

drivers with monocular vision is 

inconclusive.’’ They referred to 

statements in the NPRM that noted 

crash data on drivers with monocular 

vision is sparse and conflicting, and 

cautioned on interpreting data because 

‘‘monocular vision’’ is defined 

differently in the literature. ACOEM and 

Concentra concluded that these 

observations ‘‘actually support 

maintaining the requirement for 

experience over a road test.’’ 

One commenter who is an ME stated 

FMCSA should retain the 3-year driving 

experience criterion. Another 

commenter stated the 3-year driving 

experience criterion should be kept as a 

minimum, but that time should be 

compared with ME reports and driving 

logs and records for increased safety. A 

different commenter stated that the 3 

years of driving experience does a better 

job of proving that an individual can 

safely operate a vehicle than a simple 

test would. 

Another commenter, who noted a 

modification of the existing standard is 

needed, stated a one-time test may not 

be sufficient to balance road safety, but 

that does not necessarily imply that the 

current 3-year driving criterion should 

stay in place. The commenter continued 

that the alternative vision standard must 

take into account a reasonable standard 

time period for individuals to 

demonstrate their abilities. 

ATA, ACOEM, and Concentra 

commented generally that establishing 

an alternative vision standard 

contradicts the MRB’s advice, which 

they stated consistently supported 

continuing the existing vision standards 

and current exemption program. It was 

noted that the MRB raised concerns that 

data suggest drivers who suffer 

traumatic eye loss often need time to 

adjust to their condition and 

recommended that FMCSA seek 

comment from eye specialists on the 

minimum amount of time for 

individuals to return to CMV driving 

after a sudden change in binocular 

vision. The commenters also stated the 

MRB recommended that FMCSA should 

investigate whether the 3-year driving 

experience criterion could be shortened. 

ATA stated, while the alternative 

standard includes a requirement that 

individuals are not physically qualified 

to operate a CMV if there has not been 

sufficient time to allow the individual to 

adapt to and compensate for the change 

in vision, the requirement does not 

entirely address the MRB’s 

recommendation that a period of 

adjustment is necessary after a sudden 

loss of vision. ATA stated further that 

the NPRM fails to sufficiently address 

why the Agency moved forward with a 

revision against the MRB’s support to 

maintain the status quo. 

MRB Task 21–1 Report: The MRB 

stated generally that with respect to the 

medical aspects of the proposed 

alternative vision standard, if the MRB 

did not make a specific 

recommendation to change a provision, 

the MRB concurred with the provision 

as proposed in the January 2021 NPRM. 

‘‘The MRB agree[d] that the requirement 

for sufficient time to adapt to and 

compensate for the vision deficiency 

should not be changed in the proposed 

alternative vision standard. The MRB 

note[d] it [did] not have sufficient data 

to establish a specific waiting period for 

an individual who has a new vision 

deficiency.’’ 

With respect to the Vision Evaluation 

Report, Form MCSA–5871, the MRB 

noted that ‘‘the medical opinion 

provided by the ophthalmologist or 

optometrist regarding whether the 

individual has adapted to and 

compensated for the change in vision 

sufficiently encompasses depth 

perception.’’ The MRB continued that 

the requested medical opinion 

‘‘sufficiently implies that time is needed 

to adapt and compensate for the change 

in vision but appropriately relies on the 

ophthalmologist or optometrist 

conducting the vision evaluation to 

determine the appropriate period of 

time on a case-by-case basis.’’ The MRB 

recommended, however, that FMCSA 

expand the medical opinion ‘‘to require 

that the individual can drive a CMV 

safely with the vision condition.’’ 

Comments on MRB Task 21–1 Report: 

The AOA commented that it supports 

the MRB’s recommendation that the 

ophthalmologist or optometrist 

conducting the vision evaluation should 

‘‘independently determine’’ the 

appropriate period needed to adapt on 

a case-by-case basis. It also stated that 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3403 

the MRB noted the medical opinions 

provided by the ophthalmologist or 

optometrist ‘‘must be respected’’ 

regarding whether the individual has 

adapted to and compensated for the 

change in vision. Finally, the AOA 

commented that considerations may 

come into play when determining vision 

issues that can hinder driving beyond 

monocular Snellen visual acuity, 

horizontal visual fields, and color 

testing, which include inferior, superior, 

and central field visual assessment; 

contrast sensitivity assessment; visual 

processing assessments; and eye and 

systemic disease assessments. 

ATA commented that it understands 

it is difficult to establish a standardized 

waiting period for adjustment. 

Nevertheless, ATA expressed concern 

‘‘that without any guidance, there will 

be an inconsistency in the certification 

of a driver depending on the judgement 

of his or her optometrist, 

ophthalmologist, or medical examiner.’’ 

ATA stated FMCSA ‘‘should seek to 

gather more data and establish clearer 

guidance on when a medical examiner 

can assure that a driver has sufficiently 

adapted to their vision deficiency.’’ 

Response: FMCSA has fully factored 

in the safety implications of not 

continuing the 3 years of intrastate 

driving experience criterion in the 

alternative vision standard. FMCSA 

continues to find that once an 

individual has adapted to and 

compensated for the loss of vision in 

one eye the individual has the visual 

capacity to operate a CMV safely. While 

most drivers benefit from practice and 

experience, the Agency finds there is no 

persuasive evidence that supports 

continuing to hold individuals 

physically qualified under the 

alternative vision standard to the higher 

standard of driving in intrastate 

commerce after they have adapted to 

and compensated for the vision loss. 

The alternative vision standard with its 

collaborative physical qualification 

approach and one-time road test ensures 

drivers are visually capable of driving a 

CMV safely before they operate a CMV 

in interstate commerce. 

As stated in the NPRM, and affirmed 

by Dr. Morris, it is well recognized in 

the medical literature that individuals 

with vision loss in one eye can and do 

develop compensatory viewing behavior 

to mitigate the vision loss. The 30 years 

of experience with the vision waiver 

study and exemption programs has 

shown that individuals with vision loss 

in one eye are not limited by their lack 

of binocularity with respect to driving 

once they have adapted to and 

compensated for the change in vision. 

Dr. Morris has had similar experience 

with drivers with vision loss in one eye. 

The medical literature also shows the 

time needed to adapt to and compensate 

for the loss of vision in one eye varies. 

FMCSA noted in the NPRM that when 

the criterion was selected in the 1990s 

the medical community indicated it can 

take several months to a full year to 

compensate for a vision impairment (86 

FR 2356). FMCSA cited a 2002 study 

that found the time to adapt to sudden 

vision loss was 8.8 months and to adapt 

to gradual vision loss was 3.6 months 

(86 FR 2357). Thus, the 3 years of 

intrastate driving experience criterion 

far exceeds the findings of the medical 

community that it can take up to a year 

to adapt to and compensate for vision 

loss in one eye. In the alternative vision 

standard, the additional time after a 

vision deficiency becomes stable 

provides the period of adjustment 

needed to adapt to and compensate for 

the vision loss. 

It is no longer necessary to discuss the 

previous MRB recommendations 

because it has made new 

recommendations. In MRB Task 21–1 

Report, the MRB accepted moving ahead 

with the alternative vision standard 

without the 3 years of driving 

experience criterion. The MRB agreed 

with FMCSA’s approach of not 

requiring a minimum period to adapt to 

and compensate for the loss of vision in 

one eye. The MRB indicated the time 

varies by individual and stated it did 

not have data to establish a specific 

waiting period. Thus, as the MRB stated, 

the alternative vision standard 

‘‘appropriately relies’’ on the 

ophthalmologist or optometrist 

conducting the vision evaluation, which 

includes a thorough evaluation of depth 

perception, to determine on a case-bycase basis when an individual has 

adapted to and compensated for the loss 

of vision in one eye. It is therefore 

appropriate that there be inconsistency 

in the time intervals it takes to adapt to 

and compensate for the loss of vision in 

one eye. Because the time needed to 

adapt to and compensate for a loss of 

vision is highly dependent on 

individual factors, gathering more data 

and attempting to establish clearer 

guidance is not necessary or feasible. 

FMCSA finds a change to the 

alternative vision standard requirements 

will help to clarify that there must be a 

period for the individual to adapt to and 

compensate for the vision loss after the 

vision deficiency is deemed stable by a 

medical professional. Accordingly, 

FMCSA changes § 391.44(c)(2)(iv) to 

read, ‘‘The individual is not physically 

qualified to operate a commercial motor 

vehicle if sufficient time has not passed 

since the vision deficiency became 

stable to allow the individual to adapt 

to and compensate for the change in 

vision.’’ FMCSA also makes conforming 

changes in the Vision Evaluation 

Report, Form MCSA–5871, to the 

medical opinion regarding whether the 

individual has adapted to and 

compensated for the change in vision. 

In response to the AOA comments 

that it supports the ophthalmologist or 

optometrist ‘‘independently 

determining’’ the appropriate period of 

time needed to adapt and that such a 

determination ‘‘must be respected,’’ 

FMCSA clarifies that the MRB noted 

only that question 12 sufficiently 

implies that time is needed to adapt to 

and compensate for the change in 

vision. FMCSA does not expect the 

ophthalmologist or optometrist 

conducting the vision evaluation to 

independently determine the 

appropriate period of time to adapt to or 

compensate for the vision loss or to 

determine whether an individual meets 

the relevant standard. Rather, as the 

MRB indicated, it expects the ME to 

appropriately rely on all the information 

provided by the ophthalmologist or 

optometrist to make the final 

determination of whether the individual 

meets the alternative vision standard 

and should be physically qualified. 

FMCSA further revises question 12 to 

incorporate the MRB’s recommendation 

to expand the medical opinion provided 

by the ophthalmologist or optometrist to 

require that the individual can drive a 

CMV safely with the vision condition. 

FMCSA also adds a request in the report 

to provide the month and year the 

vision deficiency became stable. The 

additional information could assist MEs 

to evaluate whether the period over 

which the individual adapted to and 

compensated for the change in vision 

seems reasonable. 

The Vision Evaluation Report, Form 

MCSA–5871, requests the information 

MEs need to determine whether an 

individual meets the alternative vision 

standard. The specific requirements of 

the alternative vision standard are 

provided on the report for the 

informational awareness of 

ophthalmologists and optometrists 

conducting the vision evaluations. 

While there may be multiple ways to 

evaluate vision, FMCSA expects 

ophthalmologists and optometrists to 

provide the information as requested on 

the report, which requires an evaluation 

of visual acuity measured in terms of 

the Snellen chart and field of vision 

measured in the horizontal meridian, for 

example. 

Comments relating to the safety of 

drivers in the vision waiver study and 


jspears on DSK121TN23PROD with RULES2
3404 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

exemption programs, as well as drivers 

with monocular vision generally, and 

the data used to support this rulemaking 

are discussed above. Comments relating 

to specific aspects of the road test are 

discussed below. 

M. Road Test Requirement for 

Alternative Vision Standard 

NPRM: FMCSA proposed that, instead 

of requiring 3 years of intrastate driving 

experience with the vision deficiency as 

in the current exemption program, 

individuals physically qualified under 

the proposed alternative vision standard 

for the first time would complete a road 

test before operating in interstate 

commerce. Individuals would be 

excepted from the road test requirement 

if they have 3 years of intrastate or 

specific excepted interstate CMV 

driving experience with the vision 

deficiency, hold a valid Federal vision 

exemption, or are medically certified 

under 49 CFR 391.64(b). These 

individuals have already demonstrated 

they can operate a CMV safely with the 

vision deficiency. Motor carriers would 

conduct the road test in accordance 

with the road test already required by 49 

CFR 391.31. 

1. Need To Separate the Physical 

Qualification Process From Driving Skill 

Comments on the Need to Separate 

the Physical Qualification Process from 

Driving Skill: ATA stated it ‘‘strongly 

believes FMCSA must separate the 

process of evaluating an individual’s 

skill level in operating specific CMV 

equipment and physical qualification 

status.’’ ATA stated that ‘‘separation 

would help ensure certified medical 

experts are the ones making medical 

certification determinations, and not 

motor carriers.’’ 

Response: The commenter’s 

characterization of the process for 

enabling drivers with a vision 

deficiency to operate a CMV is 

mistaken. The road test conducted by 

the employer is separate from the 

physical qualification determination 

made by the ME. Employers are not 

making the medical certification 

determination by conducting a road test, 

but are making the same type of 

determination that is already required 

that an employee can operate a CMV 

safely. As stated in the NPRM, 

‘‘individuals physically qualified under 

the alternative vision standard for the 

first time must successfully complete a 

road test before operating a CMV in 

interstate commerce. The road test 

would demonstrate individuals are able 

to operate a CMV safely with the vision 

deficiency’’ (86 FR 2359). The 

individual has been physically qualified 

by the ME and FMCSA expects there 

will be no adverse impact on safety due 

to the individual’s vision. However, by 

requiring a road test, FMCSA takes an 

additional step to ensure that, even 

though medically certified, the 

individual can operate a CMV safely. 

The Agency anticipates the road test 

will alleviate any concerns about 

employing a driver with a vision 

deficiency because the test provides the 

opportunity to assess the driver’s actual 

ability to operate a CMV safely. 

The road test requirement in § 391.31 

has been a long-standing provision that 

was adopted in 1970 to promote CMV 

safety by ensuring that drivers have 

demonstrated their skill and knowledge 

(35 FR 6458, 6459 (Apr. 22, 1970)). This 

road test requirement (or the equivalent 

skills test for commercial driver’s 

license (CDL) drivers, see 49 CFR 

391.33(a)(1)) is an important aspect of 

the employer’s obligation to ensure that 

drivers they employ can operate a CMV 

safely, such as pre-employment record 

checks (49 CFR 391.23(a) and (d)) and 

the annual review of a drivers safety 

performance (49 CFR 391.25). 

The employer, rather than the ME, is 

most familiar with the nature of the 

operation and the type of equipment the 

individual will be expected to operate, 

a particularly important consideration 

given the substantial variety of 

commercial vehicles operated in the 

industry. This circumstance is clearly 

recognized in the provisions of new 

§ 391.44(d)(1), because it requires the 

road test to be conducted in accordance 

with the existing provisions of 

§ 391.31(b) through (g). In particular, the 

road test regulation states, ‘‘The road 

test must be of sufficient duration to 

enable the person who gives it to 

evaluate the skill of the person who 

takes it at handling the commercial 

motor vehicle, and associated 

equipment, that the motor carriers 

intends to assign to him/her’’ (49 CFR 

391.31(c)). That section goes on to 

specify the minimum tasks that the 

employer must include in the road test, 

all of which are essential aspects for safe 

operation of the particular CMV to be 

operated by the individual. 

An individual must first be physically 

qualified by an ME under the alternative 

vision standard in § 391.44. Then the 

next step is a road test conducted with 

both the appropriate vehicle and under 

the operating conditions the individual 

has with the vision deficiency. This 

two-step process ensures that CMV 

operations can be performed safely. In 

other words, even if an individual with 

the vision deficiency is certified as 

physically qualified by an ME for the 

first time under the alternative standard, 

CMV operation will not be permitted by 

the individual unless and until safe 

operation can be demonstrated. 

2. The Road Test Requirement Creates a 

Burden on Motor Carriers 

Comments on the Road Test 

Requirement Creates a Burden on Motor 

Carriers: ATA commented that 

FMCSA’s use of the road test would 

create an undue burden on employers 

by shifting some of the responsibility of 

the medical certification process from 

the ME to a non-medical professional, 

i.e., the motor carrier. Additionally, 

ATA stated that § 391.31(b) requires 

motor carriers to ensure that road test 

evaluators are competent to evaluate 

and determine whether the individual 

tested can operate the assigned CMV. 

ATA continued that most road test 

evaluators are not medical professionals 

trained to evaluate and identify factors 

in which an individual’s vision 

deficiency would impact the ability to 

operate a CMV; therefore, FMCSA’s 

proposal would place an undue burden 

on motor carriers. 

ACOEM stated the alternative vision 

standard shifts responsibility to the 

employer, who would be responsible for 

conducting a road test, which could 

result in inconsistent standards for 

assessing driver safety. In addition, 

ACOEM stated there is a concern the 

number of employer-required road tests 

will increase significantly. Concentra 

also commented that the alternative 

vision standard shifts responsibility to 

the employer for performing a road test. 

In contrast, several commenters 

supported the inclusion of the road test 

as part of the alternative vision 

standard. For example, three 

commenters stated the road test is an 

additional safeguard that ensures a 

driver operating under the alternative 

vision standard can physically drive the 

CMV safely and a much more secure 

driver verification. Another commenter 

who has held a Federal vision 

exemption stated that a driving test 

would tell as much about the ability to 

drive safely ‘‘as a bunch of vision tests.’’ 

Response: FMCSA agrees with the 

commenters who stated the road test is 

another safeguard to ensure individuals 

with a vision deficiency can operate a 

CMV safely. As explained in the 

previous response, the road test is not 

part of the physical qualification 

determination, but an important 

additional requirement to ensure that 

the employer is satisfied that the 

individual qualified under the 

alternative standard can operate a CMV 

safely under the conditions involved in 

the operation. An employer should not 

consider an opportunity to verify the 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3405 

9See Section X.A. of the Regulatory Analyses 

below for a full description of how these estimates 

are calculated. 

ability of a CMV driver it employs to 

operate safely to be an undue burden. 

Employers are already under an 

obligation to ensure compliance by 

CMV drivers with other safety 

regulations as well (see 49 CFR 390.11 

and 392.1(a)). 

FMCSA disagrees that road test 

examiners lack the skills necessary to 

evaluate the operation of a CMV by an 

individual with a vision deficiency. The 

road test examiners required by 

§ 391.31(b) must be able ‘‘to evaluate 

and determine whether the person who 

takes the test has demonstrated that he/ 

she is capable of operating the 

commercial motor vehicle.’’ Observation 

by the road test examiner of the specific 

minimum operational tasks specified in 

§ 391.31(c) (as well as any additional 

tasks included because of the type of 

CMV to be operated) does not require 

any specialized knowledge about the 

vision deficiency. The road test 

examiner should observe and evaluate 

activities involved in operation of a 

CMV in the same manner for all drivers 

requiring a road test. 

As for ACOEM’s concerns about the 

number of road tests increasing 

‘‘significantly,’’ FMCSA does not find 

this will be the case. Drivers who have 

an appropriate level of experience 

operating a CMV with the vision 

deficiency are excepted from the road 

test, as provided in new § 391.44(d)(3) 

through (5). FMCSA uses a high 

estimate of 868 drivers who would be 

required to take the road test each year 

under the new alternative vision 

standard. The cost for each road test is 

estimated to be about $50.77, for a total 

annual cost of $44,000,9 in addition to 

the costs of road tests already required. 

This is clearly not a financial or 

administrative burden on either any 

motor carrier required to administer a 

road test or the industry as a whole. The 

alternative vision standard offers an 

opportunity for CMV drivers unable to 

obtain a vision exemption to become 

qualified to operate a CMV in interstate 

commerce. The benefits, at a minimal 

cost, to the carriers and the industry of 

additions to the pool of CMV drivers are 

clear. 

3. Road Test Creates Employer Conflicts 

of Interest 

Comments on the Road Test Creates 

Employer Conflicts of Interest: ATA 

stated the road test could create 

conflicts of interest if a motor carrier has 

a financial interest in permitting the 

evaluated individual to work or a 

personal relationship with the 

individual. ACOEM commented that 

‘‘some carriers, especially smaller ones, 

may be more lenient on the passing 

criteria of the road test.’’ Another 

commenter noted motor carriers have a 

self-interest in making sure drivers pass 

the road test and many make the road 

test simple with a limited number of 

ways it can be failed. 

Response: FMCSA recognizes the 

potential existence of conflicts of 

interest in having an employer 

administer a road test to employees but 

finds the existence of such conflicts to 

be unlikely. Also, the potential for such 

conflicts is not unique to drivers 

physically qualified under the 

alternative vision standard but is 

possible with respect to all drivers 

tested. However, the governing 

regulation includes particular 

requirements to mitigate such conflicts, 

such as specifying the type of vehicle to 

be used and the tasks to be included (49 

CFR 391.31(c)). It also precludes an 

owner-operator (i.e., a person who is 

both a motor carrier and a driver) from 

self-administering the road test (49 CFR 

391.31(b)). The certificate required to be 

issued by the road test examiner is 

subject to the requirement that it not be 

fraudulent or intentionally false (49 CFR 

390.35) and includes an affirmative 

statement from the road test examiner 

that the individual tested can operate 

safely (49 CFR 391.31(f)). Most 

importantly, employers have a strong 

financial interest in ensuring the safety 

of their operations by engaging drivers, 

including those physically qualified 

with a vision deficiency under the 

alternative standard, who are able to 

operate safely. 

4. Sufficiency of the Road Test 

Comments on the Sufficiency of the 

Road Test: Concentra and ACOEM 

commented that the road test as 

outlined in § 391.31 is fairly minimal. It 

only requires demonstrating use of the 

CMV controls, turning, operating in 

traffic, and pre- and post-trip duties. 

There is no requirement for evaluating 

safe operation in conditions of darkness, 

inclement weather, or complex 

multisensory environments, such as 

congested traffic and construction 

zones, where a vision deficiency may be 

detrimental. According to Concentra 

and ACOEM, the road test also is not 

specific to a vehicle. They stated a 

simple road test cannot substitute for 

drivers lacking experience operating 

CMVs. ACOEM stated that having 

employers conduct the road test could 

result in inconsistent standards for 

assessing driver safety. 

Similarly, ATA stated that a road test 

is an inadequate method to determine if 

an individual’s vision deficiency will 

impact driving ability. ATA noted the 

driving environment would vary 

significantly among carriers and would 

not be a consistent evaluation tool. 

Two commenters were generally 

supportive of the alternative vision 

standard as a way of opening the door 

for more job opportunities. However, 

one of the commenters stated that a 

single driving test may be too lenient to 

evaluate the full scope of driving 

capabilities. The commenter continued 

that it might be in the public interest to 

revise the proposed rule to scrutinize 

more than the proposed driving test. 

The other commenter stated that a onetime driving test may not be sufficient 

because individuals know they are 

under observation and can perform the 

one test safely. 

Another commenter noted many 

motor carrier § 391.31 road tests are an 

exercise in ‘‘check the box,’’ and not a 

thorough test of the driver’s ability. If 

motor carriers are going to conduct the 

road tests, the commenter stated clear 

road-testing standards aimed at 

determining if the loss of vision is 

affecting the driver’s abilities and pass/ 

fail criteria need to be provided. 

Response: FMCSA finds the road test 

required under the alternative vision 

standard will be sufficiently 

comprehensive to evaluate and assess 

an individual’s capability to operate a 

CMV safely. In addition, the Agency 

fails to discern different considerations 

for administering road tests for drivers 

physically qualified under the 

alternative vision standard as compared 

to drivers who are not. After 30 years 

with the vision waiver study and 

exemption programs, experience shows 

that individuals with vision loss in one 

eye are not limited by their lack of 

binocularity with respect to driving 

once they have adapted to and 

compensated for the change in vision. If 

an individual meets the alternative 

vision standard, the Agency expects 

there will be no adverse impact on 

safety due to the individual’s vision. 

Therefore, employers should apply the 

same road test requirements to all 

drivers. 

FMCSA disagrees with commenters 

that the road test outlined in § 391.31 is 

fairly minimal. The regulation requires 

demonstration of the essential elements 

of operating a CMV, including driving 

in traffic, passing other vehicles, 

turning, braking, backing, and parking. 

FMCSA acknowledges employers may 

have somewhat different standards for 

assessing driver safety; however, 

§ 391.31 ensures all drivers demonstrate 


jspears on DSK121TN23PROD with RULES2
3406 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

the fundamental skills necessary to 

operate a CMV safely. As noted above, 

employers have a strong financial 

interest in ensuring they employ drivers 

who can operate a CMV safely. 

As also noted above, the road test, 

contrary to commenters’ assertions, does 

require the use of the specific type of 

vehicle that will be assigned to the 

individual to operate (see 49 CFR 

391.31(c)). In addition, the applicable 

regulation requires that ‘‘The motor 

carrier shall provide a road test form on 

which the person who gives the test 

shall rate the performance of the person 

who takes it at each operation or activity 

which is a part of the test’’ (49 CFR 

391.31(d)). If the road test is completed 

satisfactorily, the road test examiner 

must sign a certificate that states that it 

is the examiner’s considered opinion 

that the individual has ‘‘sufficient 

driving skill to operate safely’’ (49 CFR 

391.31(f)). The employer then retains 

both the road test form and the 

certificate (or a copy) in the driver 

qualification file required by 49 CFR 

391.51, along with additional 

documentation that supports a 

determination that the individual can 

operate safely. 

The road test, when required under 

the alternative vision standard, is only 

one of multiple regulatory elements that 

can work together to ensure that an 

individual physically qualified under 

the standard can operate a CMV safely. 

The alternative vision standard includes 

the additional safeguards of the 

collaborative physical qualification 

process by medical professionals and 

limiting certification to 12 months. All 

in all, the road test for individuals 

qualified under the alternative vision 

standard is one part of a comprehensive 

regulatory approach to ensure safe 

operations of a CMV. 

5. Addition of a Driver Training 

Requirement 

Comments on the Addition of a Driver 

Training Requirement: One commenter 

who supported the alternative vision 

standard stated a driving test should 

show proof that an individual qualified 

under the new standard can drive a 

CMV. However, the commenter did not 

agree with a one-time road test but 

stated a road test every year or every 

couple of years would suffice. The 

commenter continued that maybe there 

should be specialized training for 

individuals seeking certification under 

the alternative vision standard. 

Response: FMCSA elects not to 

require any specialized training for 

individuals physically qualified under 

the alternative vision standard. The 

experience with the vision waiver and 

exemption programs has not revealed 

the need for specialized training for 

drivers with a vision deficiency. As 

stated above, experience shows that 

individuals with vision loss in one eye 

are not limited by their lack of 

binocularity with respect to driving 

once they have adapted to and 

compensated for the change in vision. 

Also, the driver will be subject to 

periodic review. Once a driver is hired, 

the employer is required to review the 

driver’s safety performance through the 

annual motor vehicle record review (49 

CFR 391.25). 

N. Review of an Individual’s Safety 

Performance 

NPRM: FMCSA proposed that review 

of the safety performance of individuals 

medically certified under the alternative 

vision standard be performed by motor 

carriers in accordance with current 

regulatory requirements applicable to all 

drivers. 

Comments on the Review of an 

Individual’s Safety Performance: ATA 

stated it strongly opposes replacing the 

Agency review of an individual’s 

driving record, as is done in the current 

exemption program, with the road test 

required in § 391.31. ACOEM 

commented that the MRB questioned in 

2019 how a driver’s safety record would 

be adequately assessed under an 

alternative vision standard, given that 

FMCSA reviews the driving safety 

record in the exemption program. 

ACOEM also stated the alternative 

vision standard shifts responsibility to 

the employer, who would be 

responsible for reviewing the safety 

record, which could result in 

inconsistent standards for assessing 

driver safety. Concentra made a similar 

comment. 

Response: FMCSA does not find these 

comments persuasive and continues to 

find that the safety performance of 

individuals who are medically certified 

under the alternative vision standard 

should be evaluated in the same manner 

as that of other drivers. Motor carriers 

already routinely review and evaluate 

driving records for prospective and 

current employees, including employees 

with Federal vision exemptions. They 

must review both the motor vehicle 

records and the safety performance 

history, which must include accident 

information from previous employers 

for the prior 3 years when hiring a 

driver (49 CFR 391.23(a) and (d)). Motor 

carriers also must review motor vehicle 

records for all drivers annually (49 CFR 

391.25). There is nothing different about 

evaluating a motor vehicle record for an 

individual medically certified under the 

alternative vision standard as compared 

to any other driver. Motor carriers are 

also required to ensure compliance by 

drivers with all safety regulations (49 

CFR 390.11) and that drivers are 

generally qualified to drive a CMV (49 

CFR 391.11). Thus, reviewing the safety 

performance of individuals certified 

under the alternative vision standard 

presents nothing new or novel for motor 

carriers and does not add or change a 

responsibility for them. 

As stated in the NPRM, the 3-year safe 

driving history criterion of the prior 

vision waiver study and exemption 

programs with FMCSA’s review of the 

driving record has served its purpose 

and is no longer necessary (see 86 FR 

2356–57). Finally, the MRB’s 2021 

recommendations supersede its 2019 

recommendations. 

O. Restricting Eligibility To Use the 

Alternative Vision Standard by Vehicle 

Type 

NPRM: FMCSA did not propose to 

restrict eligibility to use the alternative 

vision standard based on the type of 

vehicle an individual operates. 

Comments on Restricting Eligibility to 

Use the Alternative Vision Standard by 

Vehicle Type: A commenter who is an 

ME was ‘‘very concerned about 

changing the vision requirements.’’ The 

commenter stated that most of the 

commenter’s clients do not drive large 

CMVs, but rather drive delivery trucks, 

passenger vehicles, or emergency 

medical transport vehicles, which 

require ‘‘decent vision’’ for parking, 

maneuvering in traffic with lane 

changes, and driving in emergent 

conditions. The commenter suggested a 

‘‘carve out’’ of eligibility to use the 

proposed alternative vision standard for 

individuals operating certain types of 

vehicles. 

Response: FMCSA elects not to 

change the alternative vision standard 

based on this comment. The Agency 

continues to conclude that individuals 

who satisfy the alternative vision 

standard requirements do not create an 

increased risk of injury to themselves or 

others due to their vision and are 

physically qualified to operate any type 

of CMV safely. Neither the vision waiver 

study program nor the current 

exemption program restricted 

participation in the program based on 

the type of CMV the individual 

operated. Thus, the Agency has 30 years 

of experience evaluating individuals 

driving all types of CMVs. Commenters 

provided no new information or data 

that persuades the Agency to depart 

from its conclusion that the safety 

performance of individuals in the vision 

waiver study and the current exemption 

programs is at least as good as that of 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3407 

10See Section X.A. of the Regulatory Analyses 

below for a full description of how this number is 

calculated. 

the general population of CMV drivers, 

without regard to the type of vehicle 

operated. Accordingly, the Agency finds 

there is no available evidence to support 

holding individuals physically qualified 

under the alternative vision standard to 

a higher standard merely because of the 

type of CMV they operate. 

P. The Alternative Vision Standard 

Creates More Employment 

Opportunities 

NPRM: FMCSA stated in the NPRM 

that eliminating the prohibition on 

certifying individuals who cannot meet 

either the current visual acuity or field 

of vision standard, or both, in one eye 

(without an exemption) would enable 

more qualified individuals to operate as 

interstate CMV drivers without 

compromising safety. Eliminating the 

exemption program criterion of 3 years 

of intrastate CMV driving experience 

with the vision deficiency would allow 

individuals who live in States that do 

not issue vision waivers to be physically 

qualified. In addition, individuals who 

live in a State that issues vision waivers 

would be able to begin a career as an 

interstate CMV driver more quickly and 

may have more employment 

opportunities. Previously qualified 

interstate CMV drivers who are no 

longer able to meet either the distant 

visual acuity or field of vision standard, 

or both, in one eye would be able to 

return sooner to operating interstate. 

Comments on the Alternative Vision 

Standard Creates More Employment 

Opportunities: Just over 40 percent of 

commenters supporting the proposed 

alternative vision standard stated it will 

provide more job opportunities for 

individuals to become interstate CMV 

drivers or provide the opportunity for 

existing drivers to stay in the industry. 

For example, OOIDA stated that, in 

many cases, drivers with decades of 

experience without any at-fault crashes 

must leave the profession because of the 

economic obstacles associated with the 

Federal vision exemption criteria. ‘‘The 

prolonged period of required intrastate 

driving can discourage these drivers 

from staying in the industry.’’ OOIDA 

commented that the alternative vision 

standard will ‘‘reduce barriers to entry 

for both active and future CMV drivers’’ 

and ‘‘allow safe and experienced drivers 

to stay on the road.’’ Another 

commenter stated the alternative vision 

standard could allow thousands of 

drivers who do not meet the existing 

vision standard to begin operating 

CMVs in interstate commerce without 

the need for an exemption. A different 

commenter stated the alternative vision 

rule allows for a larger pool of qualified 

drivers without compromising safety, 

and noted the country is short of 

drivers. 

One commenter, a motor carrier, 

stated that the alternative vision 

standard would be good for the trucking 

industry and not increase danger to the 

public. The new standard would open 

the field to many drivers who do not 

have or have not been able to get a 

vision waiver. The commenter noted it 

would add two drivers with proven 

work ethic and ability to the company’s 

interstate driving pool right off. Another 

commenter who is an ME has been 

unable to certify a few good drivers after 

they did not pass the vision standard. 

The commenter noted that it is difficult, 

particularly for local small businesses, 

to find qualified CDL operators. 

Another commenter stated the 

proposed regulation has far reaching 

benefits. It would give individuals with 

vision that does not meet the existing 

outdated vision standard the 

opportunity to drive CMVs. It would 

boost the CMV driver industry; a boost 

that is needed now more than ever due 

to COVID–19. The rule also has the 

potential to bring greater efficiency to 

interstate commerce and the country in 

general. According to the commenter, it 

stands to reason that if fewer drivers are 

available it will take longer for goods to 

travel from place-to-place. 

Six commenters who hold intrastate 

waivers stated they would benefit from 

being able to operate in interstate 

commerce. One of these commenters 

noted missing many good paying loads 

because of the intrastate restriction and 

further noted that eliminating it would 

increase the commenter’s income 

greatly. Seven commenters supported 

the proposed alternative vision standard 

because it would either allow them to 

return to work as a CMV driver 

following an eye injury or give them the 

opportunity to become a CMV driver, 

which they did not have before due to 

poor vision in one eye. 

Several commenters supported the 

alternative vision standard because the 

more individualized approach allows 

capable individuals to demonstrate their 

ability to operate a CMV safely. For 

example, the commenters stated the 

new standard is a step toward less 

discrimination in the workplace, 

inclusion of individuals with vision 

deficiencies, less frequent denial of job 

opportunities for individuals when a 

disability does not affect the ability to 

do the task at hand, and the opportunity 

for people to change their lives and to 

live more independently. Several more 

commenters noted specifically that the 

alternative vision standard would 

benefit older workers and especially 

older drivers with good work ethics and 

millions of miles worth of experience 

that benefits the industry and motoring 

public. 

In contrast, one commenter, who has 

been driving for more than 34 years, 

stated the vision standard should be left 

alone. The commenter continued that 

the proposed alternative vision standard 

could put a lot of good drivers off the 

road. 

Response: FMCSA continues to 

conclude the alternative vision 

standard, with its more individualized 

approach, is more equitable than the 

current exemption program and will 

enable more qualified individuals to 

operate as interstate CMV drivers 

without an adverse impact on safety. 

However, FMCSA clarifies that the new 

standard will not have a substantial 

impact on the industry or the number of 

available drivers. Although the rule 

provides substantial benefits to some 

individuals and will be beneficial to 

motor carriers and the industry, the 

Agency estimates approximately 868 

interstate drivers will be added each 

year due to the new standard.10

The commenter who stated the 

alternative vision standard could take 

good drivers off the road 

misunderstands this rule. This rule does 

not change the existing vision standard. 

FMCSA expects current Federal vision 

exemption holders, as well as 

grandfathered drivers, will satisfy the 

alternative vision standard because it 

includes requirements they should 

already meet. Therefore, drivers who are 

currently operating in interstate 

commerce should not fail to satisfy the 

vision physical qualification standards, 

unless their vision has deteriorated. 

Q. Change to the Medical Examination 

Process in 49 CFR 391.43(b)(1) 

NPRM: FMCSA proposed to amend 

§ 391.43(b)(1) by adding an 

ophthalmologist as a category of eye 

care professional who may perform the 

part of the physical qualification 

examination that involves visual acuity, 

field of vision, and the ability to 

recognize colors. Currently, the 

provision is limited to licensed 

optometrists. 

Comments on the Change to the 

Medical Examination Process in 49 CFR 

391.43(b)(1): ACOEM stated that the 

‘‘change allowing an ophthalmologist to 

complete the vision portion of the 

examination appears to be an oversight 

not previously identified and certainly 

makes sense. In fact, an ophthalmologist 


jspears on DSK121TN23PROD with RULES2
3408 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

may be preferred for complicated 

cases.’’ 

Response: FMCSA adopts the changes 

to § 391.43(b)(1) as proposed in the 

NPRM with one minor change. FMCSA 

inserts ‘‘licensed’’ before optometrist for 

clarity and to conform to the existing 

regulatory text. FMCSA did not propose 

and declines to require the use of an 

ophthalmologist in any particular case. 

R. Outside the Scope of the Rulemaking 

Comments to the NPRM Outside the 

Scope of the Rulemaking: Rather than 

responding to the proposed rule, one 

commenter reported on the commenter’s 

own driving record. 

Comments to the NOA Outside the 

Scope of the Rulemaking: One 

commenter suggested consistent Federal 

vision requirements across all types of 

vehicles, including passenger vehicles. 

Another commenter stated that if 

FMCSA keeps adding more regulation 

the trucking business will fade away 

and that FMCSA does not have any 

concept of what a good regulation is. A 

different commenter stated that, with all 

that is going on in the trucking industry, 

FMCSA should be focusing on other 

concerns, such as truck parking. Finally, 

the AOA made suggestions that relate to 

the physical qualification standard for 

individuals who are treated with insulin 

to control diabetes mellitus. 

Response: Because these comments 

are outside the scope of this rulemaking 

or are not responsive to the NPRM or 

NOA, no response from FMCSA is 

required. Commenters presenting an 

issue that is outside of the scope of this 

rulemaking may wish to consult 

§ 389.31 for information on how to 

petition FMCSA to establish, amend, 

interpret, clarify, or withdraw a 

regulation to the extent such options 

relate to their concerns. 

VII. Changes From the NPRM 

This section describes changes 

relating to the alternative vision 

standard made in the final rule other 

than minor and editorial changes. The 

Agency discusses those changes in the 

Section-by-Section Analysis below. 

With respect to the Vision Evaluation 

Report, Form MCSA–5871, FMCSA 

describes all changes to the report 

because it is not discussed in the 

Section-by-Section Analysis. 

A. Alternative Vision Standard 

FMCSA proposed an alternative 

vision standard for an individual ‘‘who 

cannot satisfy either the distant visual 

acuity or field of vision standard, or 

both,’’ in the existing vision standard in 

one eye. ACOEM commented the 

proposed vision standard seems to 

allow any driver to meet the vision 

standard if one eye is at least 20/40 with 

or without corrective lenses. ACOEM 

continued that this would permit a 

driver who chooses not to obtain 

corrective lenses to use the proposed 

standard if the driver’s vision in the 

better eye meets the existing vision 

standard. Concentra provided a similar 

comment. As discussed above, it was 

not the Agency’s intent to change the 

scope of the current vision exemption 

program in this regard or to allow 

individuals who simply need corrective 

lenses to be physically qualified under 

the alternative vision standard. 

FMCSA clarifies in the final rule that 

the alternative vision standard is 

applicable only if the worse eye does 

not meet the distant visual acuity 

standard with corrective lenses. FMCSA 

adds the limitation in § 391.41(b)(10)(ii) 

that a person who meets the 

requirements in § 391.44 is physically 

qualified to operate a CMV ‘‘if the 

person does not satisfy, with the worse 

eye, either the distant visual acuity 

standard with corrective lenses or the 

field of vision standard, or both, in 

paragraph (b)(10)(i) of this section.’’ The 

Agency makes conforming changes in 

the title of § 391.44, in paragraphs (a) 

and (c) of § 391.44, and in new 

§ 391.45(f). 

In paragraph (c) of § 391.44, FMCSA 

proposed, ‘‘At least annually, but no 

later than 45 days after an 

ophthalmologist or optometrist signs 

and dates the Vision Evaluation Report, 

Form MCSA–5871, an individual who 

cannot satisfy either the distant visual 

acuity or field of vision standard, or 

both, in § 391.41(b)(10)(i) in one eye 

must be medically examined and 

certified by a medical examiner as 

physically qualified to operate a 

commercial motor vehicle in accordance 

with § 391.43.’’ The sentence is long and 

not easy to follow. To improve 

readability, FMCSA removes the clause 

‘‘but no later than 45 days after an 

ophthalmologist or optometrist signs 

and dates the Vision Evaluation Report, 

Form MCSA–5871,’’ and includes the 

substance in a new second sentence. To 

provide additional clarity, the Agency 

changes ‘‘no later than’’ to ‘‘not more 

than’’ 45 days. The second sentence 

reads, ‘‘The examination must begin not 

more than 45 days after an 

ophthalmologist or optometrist signs 

and dates the Vision Evaluation Report, 

Form MCSA–5871.’’ 

FMCSA proposed in § 391.44(c)(2)(iv) 

that an individual is not physically 

qualified to operate a CMV ‘‘if there has 

not been sufficient time to allow the 

individual to adapt to and compensate 

for the change in vision.’’ FMCSA has 

determined a change to this requirement 

will help to clarify that there must a 

period for the individual to adapt to and 

compensate for the vision loss after the 

vision deficiency is deemed stable by a 

medical professional. Accordingly, 

FMCSA removes ‘‘there has not been 

sufficient time’’ and inserts ‘‘sufficient 

time has not passed since the vision 

deficiency became stable.’’ Section 

391.44(c)(2)(iv) reads, ‘‘The individual 

is not physically qualified to operate a 

commercial motor vehicle if sufficient 

time has not passed since the vision 

deficiency became stable to allow the 

individual to adapt to and compensate 

for the change in vision.’’ 

B. The Vision Evaluation Report, Form 

MCSA–5871 

For the final Vision Evaluation 

Report, Form MCSA–5871, FMCSA 

makes several editorial changes on page 

1. The paragraph reminding that the 

report contains sensitive information 

moves to the footer and appears on 

every page. FMCSA changes the heading 

‘‘Instructions to the Individual’’ to 

‘‘Information for the Individual’’ and 

places the paragraph before the new 

heading ‘‘Information for the 

Ophthalmologist or Optometrist.’’ The 

style for the definition of monocular 

vision changes from a paragraph to a 

numerical list for consistency purposes. 

Other minor editorial and formatting 

changes are made throughout the report 

for clarity, consistency, or as a result of 

making the report a fillable document. 

The Agency deletes ‘‘(if applicable)’’ 

after the request for a driver’s license 

number because it is not necessary. All 

individuals obtaining a vision 

evaluation will have some type of 

driver’s license. 

In the ‘‘Information for the 

Individual’’ section, FMCSA changes 

‘‘no later than’’ to ‘‘not more than’’ 45 

calendar days to conform the report to 

the revised regulatory text. FMCSA 

deletes ‘‘certified’’ before ‘‘medical 

examiner’’ in this section, as well as in 

the ‘‘Information for the 

Ophthalmologist or Optometrist’’ 

section, because it is no longer 

necessary. All MEs have been required 

to be certified and listed on FMCSA’s 

National Registry of Certified Medical 

Examiners for several years. 

In the first paragraph under the new 

heading ‘‘Information for the 

Ophthalmologist or Optometrist,’’ 

FMCSA adds in the first sentence that 

the individual is being evaluated ‘‘as 

part of the process’’ to determine 

whether the individual meets FMCSA’s 

vision standard. This change clarifies 

that the physical qualification of 

individuals to operate a CMV is a 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3409 

process, and the vision evaluation is one 

part of the process. In the second 

sentence, after ‘‘monocular vision,’’ 

FMCSA adds ‘‘as defined by FMCSA,’’ 

to signal to the reader that FMCSA has 

its own definition of monocular vision. 

The Agency deletes the sentence that 

provided, ‘‘Completion of this report 

does not imply that the ophthalmologist 

or optometrist is making a decision to 

qualify the individual to drive a 

commercial motor vehicle.’’ Instead, in 

the last sentence, FMCSA changes the 

word ‘‘Any’’ to ‘‘The’’ and inserts the 

following quoted language to provide 

more clearly that the determination as to 

whether the individual ‘‘meets the 

vision standard and’’ is physically 

qualified is made by an ME. FMCSA 

makes other minor changes for clarity, 

grammar, and to delete the use of 

pronouns. 

In paragraph (2) of FMCSA’s 

definition of monocular vision, the 

Agency conforms the language to the 

regulatory text and current vision 

exemption program. It provides that 

monocular vision means the individual 

has, in the worse eye, distant visual 

acuity of less than 20/40 ‘‘with 

corrective lenses.’’ 

As the MRB recommended, FMCSA 

adds the alternative vision standard that 

individuals with monocular vision, as 

defined by FMCSA, must satisfy to be 

physically qualified. The Agency states 

that the standard is provided ‘‘For 

general informational purposes only’’ to 

ensure that ophthalmologists and 

optometrists understand that they do 

not determine whether the individual 

meets the alternative vision standard for 

medical certification to operate a CMV. 

In question 3 on page 2 pertaining to 

distant visual acuity, FMCSA replaces 

‘‘(please provide both if applicable)’’ 

with ‘‘(select N/A if there is no vision 

in an eye).’’ The Agency adds boxes that 

can be checked to indicate distant visual 

acuity is not applicable when there is no 

vision in an eye. 

With respect to question 7 on page 2, 

which asks if the individual has 

monocular vision as defined by FMCSA, 

the Agency includes a follow-up 

request. It provides, ‘‘If yes, cause of the 

monocular vision (describe),’’ which 

was question 8 in the draft report. 

FMCSA makes this change for 

consistency with the style for other 

follow-up questions in the report. 

FMCSA renumbers the following 

questions accordingly. 

In question 8, ‘‘When did the 

monocular vision begin?’’ changes to 

‘‘Date the monocular vision began:’’ for 

consistency with the style of other 

entries. 

Question 10 relating to progressive 

eye conditions, which was question 13 

in the draft report, follows the questions 

regarding monocular vision to 

consolidate the medical information on 

the report. All the medical opinions 

follow. Instead of providing information 

about progressive eye conditions in a 

table, the report now uses a narrative 

format. FMCSA adds a request for 

additional information if the condition 

is not stable. 

As recommended by the MRB, the 

medical opinion regarding whether the 

vision deficiency is stable follows the 

information about progressive eye 

conditions as question 11. FMCSA adds 

a follow-up request in question 11 for 

the date the vision deficiency became 

stable if it is deemed stable. This change 

provides additional information for the 

ME regarding how long the vision 

deficiency has been stable. In question 

12, the Agency conforms the language to 

the revised regulatory text and expands 

the medical opinion as recommended 

by the MRB. It reads, ‘‘In your medical 

opinion, has sufficient time passed 

since the vision deficiency became 

stable to allow the individual to adapt 

to and compensate for the change in 

vision and to drive a commercial motor 

vehicle safely?’’ 

FMCSA numbers the medical opinion 

asking if a vision evaluation is required 

more often than annually as question 

13. FMCSA includes in the follow-up 

request not only how often a vision 

evaluation should be required, but why. 

FMCSA adds space to enter additional 

comments and instructions to attach 

additional pages as needed as a new 

question 14. Finally, FMCSA makes 

minor style changes to conform 

punctuation and formatting throughout 

the report. 

The final Vision Evaluation Report, 

Form MCSA–5871, is available in the 

docket for this rulemaking. The Agency 

invites public comment on the report 

under the Paperwork Reduction Act as 

provided in the information collection, 

titled ‘‘Medical Qualification 

Requirements,’’ discussed in section 

X.F. below. Comments should be 

submitted to OIRA at OMB as provided 

in the ADDRESSES section above. 

VIII. International Impacts 

Motor carriers and drivers are subject 

to the laws and regulations of the 

countries in which they operate unless 

an international agreement states 

otherwise. Drivers and carriers should 

be aware of the regulatory differences 

among nations. Pursuant to the terms of 

the 1998 medical reciprocity agreement 

with Canada, the United States will 

notify Canada that it has adopted an 

alternative vision standard and propose 

the countries review their applicable 

vision standards to determine whether 

they remain equivalent. 

IX. Section-by-Section Analysis 

This section-by-section analysis 

provides changes from the proposed 

rule. FMCSA discusses regulatory 

changes first in numerical order, 

followed by changes to Agency 

guidance. 

A. Regulatory Provisions 

Section 391.31—Road Test 

FMCSA adopts § 391.31(f) as 

proposed and removes the driver’s 

social security number, the driver’s 

license number, and the State of 

issuance of the driver’s license from the 

Certification of Road Test. The Agency 

adopts paragraph (h) as proposed but 

adds the control number (2126–0072) 

provided by OMB for the information 

collection. 

Section 391.41—Physical Qualifications 

for Drivers 

FMCSA adopts § 391.41(b)(10) as 

proposed but adds a limitation to clarify 

when the alternative vision standard is 

applicable. Specifically, the Agency 

adds the limitation in § 391.41(b)(10)(ii) 

that a person is physically qualified to 

operate a CMV who meets the 

requirements in § 391.44, ‘‘if the person 

does not satisfy, with the worse eye, 

either the distant visual acuity standard 

with corrective lenses or the field of 

vision standard, or both, in paragraph 

(b)(10)(i) of this section.’’ 

Section 391.43—Medical Examination; 

Certificate of Physical Examination 

FMCSA adds in § 391.43(b)(1) that an 

ophthalmologist may perform the vision 

part of the physical qualification 

examination as proposed. FMCSA also 

inserts the word ‘‘licensed’’ before 

optometrist to conform with the existing 

regulation. 

Section 391.44—Physical Qualification 

Standards for an Individual Who Does 

Not Satisfy, With the Worse Eye, Either 

the Distant Visual Acuity Standard With 

Corrective Lenses or the Field of Vision 

Standard, or Both 

FMCSA changes the title of § 391.44 

and introductory paragraphs (a) and (c) 

to conform to the change in 

§ 391.41(b)(10)(ii). Specifically, FMCSA 

clarifies the alternative vision standard 

is applicable to an individual ‘‘who 

does not satisfy, with the worse eye, 

either the distant visual acuity standard 

with corrective lenses or the field of 

vision standard, or both,’’ in 

renumbered § 391.41(b)(10)(i). 


jspears on DSK121TN23PROD with RULES2
3410 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

11Agency identifier FMCSA–MED–391.41–Q3, 

available at https://www.fmcsa.dot.gov/medical/ 

driver-medical-requirements/what-are-physicalqualification-requirements-operating-cmv (last 

accessed Sept. 7, 2021). 

In introductory paragraph (b), the 

Agency inserts the word ‘‘licensed’’ 

before optometrist for consistency and 

clarity. In paragraph (b)(2), FMCSA 

replaces ‘‘his or her’’ with ‘‘the 

ophthalmologist or optometrist’s.’’ 

To improve readability in 

introductory paragraph (c), FMCSA 

removes the clause ‘‘but no later than 45 

days after an ophthalmologist or 

optometrist signs and dates the Vision 

Evaluation Report, Form MCSA–5871,’’ 

and includes the substance in a new 

second sentence. To provide additional 

clarity, the Agency changes ‘‘no later 

than’’ to ‘‘not more than’’ 45 days. The 

second sentence reads, ‘‘The 

examination must begin not more than 

45 days after an ophthalmologist or 

optometrist signs and dates the Vision 

Evaluation Report, Form MCSA–5871.’’ 

FMCSA makes clarifying changes to 

paragraph (c)(2)(iv). FMCSA removes 

‘‘there has not been sufficient time’’ and 

inserts ‘‘sufficient time has not passed 

since the vision deficiency became 

stable.’’ The paragraph reads, ‘‘The 

individual is not physically qualified to 

operate a commercial motor vehicle if 

sufficient time has not passed since the 

vision deficiency became stable to allow 

the individual to adapt to and 

compensate for the change in vision.’’ 

FMCSA makes minor changes in 

paragraph (d). In paragraph (d)(3)(ii)(A), 

FMCSA inserts ‘‘in the specific’’ before 

excepted interstate commerce to remind 

the reader that only interstate commerce 

excepted by either § 390.3T(f) or § 391.2 

satisfies the requirements of the 

regulation. FMCSA changes a citation in 

paragraph (d)(4) from ‘‘§ 391.41(b)(10)’’ 

to ‘‘§ 391.41(b)(10)(i)’’ to clarify that the 

existing vision standard is being 

referenced. In addition, the Agency 

makes a tense change from ‘‘holds’’ to 

‘‘held.’’ FMCSA also makes a tense 

change in paragraph (d)(5) from ‘‘is’’ to 

‘‘was.’’ 

Section 391.45—Persons Who Must Be 

Medically Examined and Certified 

FMCSA makes conforming changes to 

§ 391.45(f). It provides, in relevant part, 

any driver ‘‘who does not satisfy, with 

the worse eye, either the distant visual 

acuity standard with corrective lenses or 

the field of vision standard, or both, in 

§ 391.41(b)(10)(i)’’ must be recertified at 

least every 12 months. 

Section 391.51—General Requirements 

for Driver Qualification Files 

FMCSA adopts § 391.51(b)(3) as 

proposed, which provides the driver 

qualification file must include the 

written statement from the motor carrier 

and certification from the driver 

required by § 391.44(d)(3). 

Section 391.64—Grandfathering for 

Certain Drivers Who Participated in a 

Vision Waiver Study Program 

FMCSA proposed to change the title 

of § 391.64 to remove a reference to a 

prior diabetes waiver study program; 

however, that change was made in a 

different rule (86 FR 35637 (July 7, 

2021)). Otherwise, FMCSA adopts 

§ 391.64 as proposed. This section 

provides that this rule does not apply to 

individuals certified under § 391.64(b) 

for 1 year from the effective date of this 

rule. After 1 year, any MEC, Form 

MCSA–5876, issued under § 391.64(b) 

will be void. 

B. Guidance 

This rule amends a regulation that has 

associated guidance. Such guidance 

does not have the force and effect of 

law, is strictly advisory, and is not 

meant to bind the public in any way. 

Conformity with guidance is voluntary. 

Guidance is intended only to provide 

information to the public regarding 

existing requirements under the law or 

FMCSA policies. Guidance does not 

alter the substance of a regulation. 

Appendix A to Part 391—Medical 

Advisory Criteria 

FMCSA removes section II.J., Vision: 

§ 391.41(b)(10), in the Medical Advisory 

Criteria of appendix A to part 391 in its 

entirety as proposed. 

Guidance for § 391.41 

Guidance for specific regulations is 

available through the Guidance Portal 

on FMCSA’s website. The Agency 

revises the guidance to Question 3 for 

§ 391.41 11 to reflect the changes made 

by this rule as proposed. FMCSA 

conforms the language to the number of 

medical conditions that are not subject 

to an ME’s judgment (i.e., two medical 

conditions), and removes ‘‘vision’’ from 

the list of conditions for which an ME 

has no discretion. In addition, FMCSA 

changes ‘‘physical examinations’’ to 

‘‘physical qualification examinations’’ 

to reflect current Agency terminology. 

Finally, the Agency removes the 

following quoted language that provides 

the ME is knowledgeable about whether 

‘‘a particular condition would interfere 

with the driver’s ability to operate a 

CMV safely.’’ In its place, FMCSA 

inserts ‘‘the driver’s physical condition 

is adequate to enable the driver to 

operate the vehicle safely.’’ The inserted 

language aligns with the requirements 

in 49 U.S.C. 31136(a)(3) and reflects that 

each of FMCSA’s physical qualification 

standards has different regulatory 

requirements regarding how an ME is to 

evaluate a condition. The guidance for 

Question 3 reads as follows: 

Question 3: What are the physical 

qualification requirements for operating 

a CMV in interstate commerce? 

Guidance: The physical qualification 

regulations for drivers in interstate 

commerce are found at § 391.41. 

Instructions to medical examiners 

performing physical qualification 

examinations of these drivers are found 

at § 391.43. 

The qualification standards cover 13 

areas, which directly relate to the 

driving function. All but two of the 

standards require a judgment by the 

medical examiner. A person’s 

qualification to drive is determined by 

a medical examiner who is 

knowledgeable about the driver’s 

functions and whether the driver’s 

physical condition is adequate to enable 

the driver to operate the vehicle safely. 

In the case of hearing and epilepsy, the 

current standards are absolute, 

providing no discretion to the medical 

examiner. However, drivers who do not 

meet the current requirements may 

apply for an exemption as provided by 

49 CFR part 381. 

X. Regulatory Analyses 

A. Executive Order (E.O.) 12866 

(Regulatory Planning and Review), E.O. 

13563 (Improving Regulation and 

Regulatory Review), and DOT 

Regulatory Policies and Procedures 

FMCSA has considered the impact of 

this final rule under E.O. 12866 (58 FR 

51735 (Oct. 4, 1993)), Regulatory 

Planning and Review; E.O. 13563 (76 FR 

3821 (Jan. 21, 2011)), Improving 

Regulation and Regulatory Review; and 

DOT’s regulatory policies and 

procedures. OIRA within OMB has 

determined that this final rule is not a 

significant regulatory action under 

section 3(f) of E.O. 12866, as 

supplemented by E.O. 13563, and does 

not require an assessment of potential 

costs and benefits under section 6(a)(3) 

of E.O. 12866. Accordingly, OMB has 

not reviewed it under that E.O. The 

Agency has determined that the final 

rule results in cost savings. 

The Regulatory Impact Assessment 

follows: 

Baseline for the Analysis 

Drivers who do not satisfy, with the 

worse eye, either the existing distant 

visual acuity standard with corrective 

lenses or the field of vision standard, or 

both, may apply to FMCSA for an 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3411 

12A copy of the application template is available 

in the docket and at https://www.fmcsa.dot.gov/ 

sites/fmcsa.dot.gov/files/docs/regulations/medical/ 

driver-medical-requirements/10451/visionexemption-package-0918.pdf (last accessed Aug. 19, 

2021). 

13FMCSA data as of August 5, 2021. 

14FMCSA 2020 Pocket Guide to Large Truck and 

Bus Statistics, available at https://

www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2020- 

10/FMCSA%20Pocket%20Guide%202020-v8- 

FINAL-10-29-2020.pdf (last accessed Aug. 9, 2021). 15Compared to all (interstate and intrastate) CMV 

drivers, 6.8 million, or CDL drivers, 4.9 million, the 

percentage is even lower. 

16The provisions of 49 CFR 391.41(b)(10) do not 

apply to drivers who were in good standing on 

March 31, 1996 in a vision waiver study program; 

provided, they meet certain conditions (49 CFR 

391.64(b)). This figure may not represent active 

drivers. 

exemption from the standard to operate 

CMVs in interstate commerce (49 CFR 

part 381, subpart C). To do so, the driver 

must submit a letter of application and 

supporting documents to enable FMCSA 

to evaluate the safety impact of the 

exemption.12 Currently, FMCSA grants 

exemptions to applicants who meet 

specific criteria, including stable vision 

and experience safely operating a CMV 

with the vision deficiency. Since the 

inception of the vision exemption 

program, the predominant reason for 

denial of an exemption is less than 3 

years of experience operating with the 

vision deficiency. The Agency must 

ensure that the exemption will likely 

achieve a level of safety that is 

equivalent to or greater than the level 

that would be achieved by complying 

with the regulations. 

If an exemption is granted, the driver 

must meet certain conditions to 

maintain the exemption. The driver 

must receive an annual vision 

evaluation by an ophthalmologist or 

optometrist and an annual physical 

qualification examination by an ME. In 

addition, the Agency must monitor the 

implementation of each exemption and 

immediately revoke an exemption if: 

The driver fails to comply with the 

terms and conditions; the exemption 

has resulted in a lower level of safety 

than was maintained before the 

exemption; or continuation of the 

exemption would not be consistent with 

the goals and objectives of the Federal 

Motor Carrier Safety Regulations (49 

CFR 381.330). 

FMCSA monitors vision-exempted 

drivers on a quarterly basis. If any 

potentially disqualifying information is 

identified, FMCSA will request a copy 

of the violation or crash report from the 

driver. Should the violation be 

disqualifying, FMCSA will revoke the 

exemption immediately. 

Currently, 1,967 drivers hold vision 

exemptions.13 Compared to all interstate 

CMV drivers operating in the United 

States in 2019 (4 million, including 3.4 

million who hold CDLs),14 these drivers 

represent less than 0.1 percent of the 

population.15 There are approximately 

1,806 grandfathered drivers.16 FMCSA 

checks the driving records of 

grandfathered drivers to determine if 

they continue to operate CMVs safely. 

Impact of the Final Rule: Physical 

Qualification and Road Test 

Physical Qualification 

As a result of this final rule, an 

individual who does not satisfy, in the 

worse eye, either the existing distant 

visual acuity standard with corrective 

lenses or field of vision standard, or 

both, can be physically qualified 

without applying for or receiving an 

exemption. The individual will still 

have to receive a vision evaluation by an 

ophthalmologist or optometrist. The 

ophthalmologist or optometrist will 

complete the Vision Evaluation Report, 

Form MCSA–5871. 

For those who obtain an MEC, Form 

MCSA–5876, this action may represent 

a streamlined process compared to the 

requirements of the vision exemption 

program in that the driver will not need 

to compile and submit the letter of 

application and supporting 

documentation to FMCSA, or respond to 

any subsequent requests for 

information. However, it is possible that 

the ME could issue a certificate that is 

valid for a shorter time to monitor the 

condition. In such circumstances, under 

the vision exemption program, the 

applicant would likely not receive an 

exemption. For those who do not obtain 

an MEC, Form MCSA–5876, the result 

may or may not have been the same 

under the vision exemption program. 

This final rule will result in the 

discontinuation of the Federal vision 

exemption program. Instead, the 

physical qualification determination of 

individuals in, or who would be 

applying to, the exemption program will 

be made by an ME, who is trained and 

qualified to make such determinations, 

considering the information received in 

the Vision Evaluation Report, Form 

MCSA–5871, from the ophthalmologist 

or optometrist. 

Road Test 

Instead of requiring 3 years of 

intrastate driving experience with the 

vision deficiency as in the current 

exemption program, individuals 

physically qualified under the 

alternative vision standard for the first 

time must complete a road test before 

operating in interstate commerce. The 

road test will be conducted by motor 

carriers in accordance with the road test 

already required by § 391.31. 

As described in the NPRM, 

individuals will be excepted from the 

road test requirement if they have 3 

years of intrastate or specific excepted 

interstate CMV driving experience with 

the vision deficiency, hold a valid 

Federal vision exemption, or are 

medically certified under § 391.64(b). 

These individuals have already 

demonstrated they can operate a CMV 

safely with the vision deficiency. 

FMCSA finds that a road test is an 

appropriate indicator of an individual’s 

ability to operate a CMV safely with the 

vision deficiency. Thus, the Agency 

expects there will be no adverse impact 

on safety from eliminating the intrastate 

driving experience criterion. When the 

Federal Highway Administration 

(FHWA), the predecessor agency to 

FMCSA, adopted the road test in 

§ 391.31, it stated that the interests of 

CMV safety would be promoted by 

ensuring drivers have demonstrated 

their skill by completing the road test 

(35 FR 6458, 6450 (Apr. 22, 1970)). 

The intrastate driving experience 

criterion has the limitation that some 

States do not have waiver programs 

through which drivers can obtain the 

driving experience necessary to meet 

the criteria of the Federal vision 

exemption program. The removal of the 

3-year experience criterion under this 

final rule will more readily allow these 

individuals to operate in interstate 

commerce. However, the current 

number of exemption holders, 

grandfathered drivers, and applicants 

denied exemptions annually represents 

less than 1 percent of all interstate CMV 

drivers. 

The Agency expects this final rule 

will be safety neutral. FMCSA notes 

that, although it will no longer directly 

monitor the safety performance of 

drivers, motor carriers will continue to 

monitor individuals’ safety performance 

when hiring drivers and during the 

annual inquiry and review of the 

driving record required by §§ 391.23 

and 391.25, respectively. 

Costs 

FMCSA estimates that the final rule 

will result in incremental cost savings of 

approximately $1.6 million annually 

from the elimination of the Federal 

vision exemption program and contract 

expenditures (Table 1). As described in 

detail below, FMCSA also accounts for 


jspears on DSK121TN23PROD with RULES2
3412 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

17 In 2018 there were 1,073 applicants, in 2019 

there were 1,030, and in 2020 there were 500 

((1,073 + 1,030 + 500) ÷ 3 = 868). 18 Department of Labor (DOL), Bureau of Labor 

Statistics (BLS). Occupational Employment and 

Wages, May 2020, 53–0000 Transportation and 

Material Moving Occupations. Available at https:// 

www.bls.gov/oes/current/oes530000.htm (last 

accessed Aug. 26, 2021). 

19 DOL, BLS. Occupational Employment and 

Wages, May 2020, 13–1041 Compliance Officers. 

Available at https://www.bls.gov/oes/current/ 

oes131041.htm (last accessed Aug. 26, 2021). 

20 In addition to the fringe benefit rate of 52 

percent, FMCSA also applied an overhead rate of 

27 percent to the compliance officer’s wage. The 

Agency used industry data gathered for the Truck 

Costing Model developed by the Upper Great Plains 

Transportation Institute, North Dakota State 

University (Berwick, Farooq. Truck Costing Model 

for Transportation Managers. North Dakota State 

University. Upper Great Plains Transportation 

Institute. Aug. 2003. Appendix A, pp. 42–47. 

Available at: http://www.mountain-plains.org/pubs/ 

pdf/MPC03-152.pdf (last accessed Aug. 20, 2021)). 

Research conducted for this model found an 

average cost of $0.107 per mile of CMV operation 

for management and overhead, and $0.39 per mile 

for labor, indicating an overhead rate of 27 percent 

(27% = $0.107 ÷ $0.39 (rounded to the nearest 

whole percent)). 

the annual cost of the road test 

requirement at approximately $44,000. 

TABLE 1—COST SAVINGS: FEDERAL VISION EXEMPTION PROGRAM CONTRACT AND ROAD TEST

[2020 dollars] 

Fiscal year Contract 

cost (a) (b) Road test Total 

2021–2022 ................................................................................................................. ($1,596,375) $44,048 ($1,552,327) 

2022–2023 ................................................................................................................. (1,644,267) 44,048 (1,600,219) 

2023–2024 ................................................................................................................. (1,693,595) 44,048 (1,649,547) 

2024–2025 ................................................................................................................. (1,744,402) 44,048 (1,700,354) 

(a)For years 2022–2023, 2023–2024, and 2024–2025, FMCSA estimated an average contract cost increase of 3 percent and extrapolated 

based on the percent increase of previous years. 

(b)The program contract estimate for 2021–2022 was adjusted to 2020 dollars from the value of $1,577,268 in 2019 dollars used in the NPRM. 

FMCSA applied a multiplier of 1.012114, extracted from the Bureau of Economic Analysis Gross Domestic Product (GDP) Implicit Price Deflator 

series from December 21, 2020. The GDP deflator for 2020 of 113.625 divided by the deflator of 112.265 for 2019 is equal to 1.012114. 

$1,577,268 × 1.012114 = $1,596,375. 

The 1,967 current vision exemption 

holders will no longer have to apply for 

exemptions and potential drivers who 

would not qualify for an exemption 

because they do not have 3 years of 

intrastate driving experience may meet 

the alternative vision standard and be 

able to operate a CMV in interstate 

commerce. This rule leads to a 

reduction in burden, as drivers will no 

longer be required to create and 

assemble the substantial amount of 

information and documentation 

necessary to apply for or renew an 

exemption, or to respond to subsequent 

requests for information. However, the 

affected population is small (less than 1 

percent of CMV drivers), and the 

relative advantages for these individuals 

are unlikely to affect market conditions 

in the truck and bus industries. 

FMCSA estimates that the road test 

will result in a total annual cost impact 

of $44,000 (Table 2). There will be 

approximately 868 drivers requiring a 

road test under § 391.44 each year. This 

number is the average of new 

applications for the vision exemption 

program FMCSA received over years 

2018 through 2020.17 FMCSA 

recognizes this is a high estimation and 

overstates the burden associated with 

the road test. While some of the 

individuals will already be required to 

obtain a road test under § 391.31, in the 

absence of the requirement in 

§ 391.44(d), FMCSA lacks internal data 

to estimate how many individuals will 

already be required to obtain a road test. 

Therefore, FMCSA opted for a 

conservative approach of assuming all 

868 individuals would require a road 

test. 

As described above, motor carriers 

will be responsible for administering the 

test to the drivers, which is estimated to 

take 0.55 hours (33 minutes). For the 

hourly wage rates, FMCSA used $31 for 

the drivers 18 (Table 3) and $61 for the 

motor carrier’s compliance officer.19

TABLE 2—ROAD TEST COST

CALCULATIONS

[2020 dollars] 

Drivers/Motor carriers ............... 868 

Test Hours ................................ 0.55 

Driver Wage .............................. $30.95 

Subtotal ............................. $14,770 

Compliance Officer Wage 20 ..... $61.35 

Subtotal ............................. $29,278 

Sum ............................ $44,048 

Note: Totals may not sum due to rounding. 

TABLE 3—WAGE RATES FOR CMV TRUCK DRIVERS

Occupational title 

BLS standard 

occupation 

code 

North American Industry 

Classification System 

(NAICS) occupational 

designation 

Total 

employees 

Median hourly 

base wage 

Fringe 

benefit 

rate (c)

Median hourly 

base wage + 

fringe 

benefits 

Heavy and Tractor-Trailer 

Truck Drivers.

53–3032 All Industry ......................... 1,797,710 $22.66 52% $34.47 

Light Truck Drivers .............. 53–3033 All Industry ......................... 929,470 17.81 52% 27.09 

Bus drivers, school and or 

special client.

53–3052 All Industry ......................... 162,850 22.07 52% 33.57 

Bus drivers, transit and 

intercity.

53–3058 All Industry ......................... 431,986 15.54 52% 23.64 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3413 

21 ($61.35 × 0.55) + ($30.95 × 0.55) = $50.77. 

22As discussed below in section X.F. with respect 

to the information collection titled ‘‘Medical 

Qualification Requirements,’’ FMCSA attributes 

2,236 annual burden hours at a cost of $67,486 for 

drivers to request and maintain a vision exemption. 

The final rule eliminates this entire burden. 

23A major rule means any rule that OMB finds 

has resulted in or is likely to result in (a) an annual 

effect on the economy of $100 million or more; (b) 

a major increase in costs or prices for consumers, 

individual industries, Federal agencies, State 

agencies, local government agencies, or geographic 

regions; or (c) significant adverse effects on 

competition, employment, investment, 

productivity, innovation, or on the ability of United 

States-based enterprises to compete with foreignbased enterprises in domestic and export markets 

(5 U.S.C. 804(2)). 

24Public Law 104–121, 110 Stat. 857 (Mar. 29, 

1996), 5 U.S.C. 601 note. 

TABLE 3—WAGE RATES FOR CMV TRUCK DRIVERS—Continued 

Occupational title 

BLS standard 

occupation 

code 

North American Industry 

Classification System 

(NAICS) occupational 

designation 

Total 

employees 

Median hourly 

base wage 

Fringe 

benefit 

rate (c)

Median hourly 

base wage + 

fringe 

benefits 

Weighted Driver Wage ........................ ............................................. ........................ ........................ ........................ 30.95 

(c) DOL, BLS. ‘‘Employer Cost of Employee Compensation Dec. 2020 News Release,’’ Table 4: Employer Costs for Employee Compensation 

for private industry workers by occupational and industry group. Available at https://www.bls.gov/news.release/pdf/ecec.pdf (last accessed Nov. 2, 

2020). The fringe benefit rate is the ratio of hourly wage for average hourly wage for a private industry worker and the associated hourly benefit 

rate (52% = 13.78 ÷ $26.45 (rounded to the nearest whole percent)). FMCSA does not apply an overhead rate to the driver’s hourly wage, as the 

road test occurs prior to being employed. 

Although the Agency acknowledges 

there are motor carriers employing 

multiple drivers who would be certified 

under the new alternative vision 

standard, FMCSA lacks data to estimate 

the exact number of motor carriers 

impacted by this rule. Therefore, to 

ensure the inclusion of all affected 

motor carriers, FMCSA opted for a 

conservative approach of assuming a 1:1 

ratio of drivers per motor carrier, 

making $44,000 a likely overestimate. 

Additionally, there may be some drivers 

medically certified under the new 

alternative vision standard who are also 

motor carriers, in which case the test 

must be given by a person other than 

themselves (49 CFR 391.31(b)). FMCSA 

treats the impacts on these drivers as 

equivalent to those of all affected 

drivers. Using this approach, the 

Agency estimates the cost for each road 

test at $50.77.21

Benefits 

Eliminating the prohibition on 

certifying individuals who do not 

satisfy, in the worse eye, either the 

existing visual acuity standard with 

corrective lenses or field of vision 

standard, or both, without an exemption 

will enable more qualified individuals 

to operate as interstate CMV drivers 

without compromising safety. These 

drivers are relieved of the time and 

paperwork burden associated with 

applying for or renewing an 

exemption.22 The alternative vision 

standard allows previously qualified 

interstate CMV drivers who are no 

longer able to satisfy, in the worse eye, 

either the existing distant visual acuity 

standard with corrective lenses or field 

of vision standard, or both, to return 

sooner to operating interstate. 

Additional employment opportunities 

may also result from the removal of the 

3 years of intrastate driving experience 

requirement, which is a criterion of the 

current exemption program. Drivers 

who do not have 3 years of intrastate 

driving experience may meet the 

alternative vision standard and be able 

to operate a CMV in interstate 

commerce. A one-time road test is less 

burdensome on drivers than obtaining 3 

years of intrastate driving experience. It 

also addresses the consideration that 

many drivers live in States that do not 

issue vision waivers. The road test 

provides more drivers the opportunity 

to operate a CMV. 

Regarding risk, the Agency expects no 

changes in risk resulting from the very 

small number of additional individuals 

affected by this final rule relative to 

those of the baseline. Therefore, FMCSA 

considers this final rule to be safety 

neutral. 

B. Congressional Review Act 

This final rule is not a major rule as 

defined under the Congressional Review 

Act (5 U.S.C. 801–808).23

C. Regulatory Flexibility Act (Small 

Entities) 

The Regulatory Flexibility Act (RFA) 

(5 U.S.C. 601 et seq.), as amended by the 

Small Business Regulatory Enforcement 

Fairness Act of 1996,24 requires Federal 

agencies to consider the effects of the 

regulatory action on small business and 

other small entities and to minimize any 

significant economic impact. The term 

‘‘small entities’’ comprises small 

businesses and not-for-profit 

organizations that are independently 

owned and operated and are not 

dominant in their fields, and 

governmental jurisdictions with 

populations of less than 50,000 (5 U.S.C. 

601(6)). Accordingly, DOT policy 

requires an analysis of the impact of all 

regulations on small entities, and 

mandates that agencies strive to lessen 

any adverse effects on these businesses. 

This rule affects drivers and motor 

carriers. Drivers are not considered 

small entities because they do not meet 

the definition of a small entity in 

section 601 of the RFA. Specifically, 

drivers are considered neither a small 

business under section 601(3) of the 

RFA, nor are they considered a small 

organization under section 601(4) of the 

RFA. 

The Small Business Administration 

(SBA) defines the size standards used to 

classify entities as small. SBA 

establishes separate standards for each 

industry, as defined by the NAICS. This 

rule will affect many different industry 

sectors in addition to the Transportation 

and Warehousing sector (NAICS sectors 

48 and 49); for example, the 

Construction sector (NAICS sector 23), 

the Manufacturing sector (NAICS 

sectors 31, 32, and 33), and the Retail 

Trade sector (NAICS sectors 44 and 45). 

Industry groups within these sectors 

have size standards for qualifying as 

small based on the number of 

employees (e.g., 500 employees), or on 

the amount of annual revenue (e.g., 

$27.5 million in revenue). To determine 

the NAICS industries potentially 

affected by this rule, FMCSA crossreferenced occupational employment 

statistics from the BLS with NAICS 

industry codes. A maximum of 868 

motor carriers will be impacted in a 

given year. Even if all affected motor 

carriers were small and operated in the 

same NAICS code, it is unlikely that this 

rule will impact a substantial number of 

small entities. 

The RFA does not define a threshold 

for determining whether a specific 

regulation results in a significant 

impact. However, the SBA, in guidance 

to government agencies, provides some 

objective measures of significance that 

the agencies can consider using. One 

measure that could be used to illustrate 

a significant impact is revenue costs, 


jspears on DSK121TN23PROD with RULES2
3414 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

25The motor carrier’s wage is estimated at $61.35, 

as described in more detail in the Regulatory Impact 

Assessment. The motor carrier would spend 30 

minutes administering the road test, and 3 minutes 

on the associated paperwork, leading to a total of 

33 minutes, or 0.55 hours. 0.55 hours × $61.35 = 

$33.74. 

26Public Law 104–121, 110 Stat. 857, 858 (Mar. 

29, 1996), 5 U.S.C. 601 note. 

specifically, if the cost of the regulation 

exceeds 1 percent of the average annual 

revenues of small entities in the sector. 

Given the rule’s average annual perentity impact of $33.74,25 a small entity 

would need to have average annual 

revenues of less than $3,374 to 

experience an impact greater than 1 

percent of average annual revenue. This 

is an average annual revenue that is 

smaller than would be required for a 

firm to support one employee; therefore, 

this action will not result in a 

significant impact. 

Consequently, I certify that this action 

will not have a significant economic 

impact on a substantial number of small 

entities. 

D. Assistance for Small Entities 

In accordance with section 213(a) of 

the Small Business Regulatory 

Enforcement Fairness Act of 1996,26

FMCSA wants to assist small entities in 

understanding this final rule so they can 

better evaluate its effects on themselves 

and participate in the rulemaking 

initiative. If the final rule will affect 

your small business, organization, or 

governmental jurisdiction and you have 

questions concerning its provisions or 

options for compliance; please consult 

the person listed under FOR FURTHER

INFORMATION CONTACT. 

Small businesses may send comments 

on the actions of Federal employees 

who enforce or otherwise determine 

compliance with Federal regulations to 

the SBA’s Small Business and 

Agriculture Regulatory Enforcement 

Ombudsman and the Regional Small 

Business Regulatory Fairness Boards. 

The Ombudsman evaluates these 

actions annually and rates each agency’s 

responsiveness to small business. If you 

wish to comment on actions by 

employees of FMCSA, call 1–888–REG– 

FAIR (1–888–734–3247). DOT has a 

policy regarding the rights of small 

entities to regulatory enforcement 

fairness and an explicit policy against 

retaliation for exercising these rights. 

E. Unfunded Mandates Reform Act of 

1995 

The Unfunded Mandates Reform Act 

of 1995 (2 U.S.C. 1531–1538) requires 

Federal agencies to assess the effects of 

their discretionary regulatory actions. In 

particular, the Act addresses actions 

that may result in the expenditure by a 

State, local, or Tribal government, in the 

aggregate, or by the private sector of 

$170 million (which is the value 

equivalent of $100 million in 1995, 

adjusted for inflation to 2020 levels) or 

more in any 1 year. Although this final 

rule will not result in such an 

expenditure, the Agency discusses the 

effects of this rule elsewhere in this 

preamble. 

F. Paperwork Reduction Act 

The Paperwork Reduction Act of 1995 

(44 U.S.C. 3501–3520) requires that an 

agency consider the impact of 

paperwork and other information 

collection burdens imposed on the 

public. An agency is prohibited from 

collecting or sponsoring an information 

collection, as well as imposing an 

information collection requirement, 

unless it displays a valid OMB control 

number (5 CFR 1320.8(b)(3)(vi)). 

This final rule impacts an existing 

information collection request (ICR) 

titled ‘‘Medical Qualification 

Requirements’’ (OMB control number 

2126–0006), and a new ICR titled 

‘‘391.31 Road Test Requirement’’ (OMB 

control number 2126–0072). The ICRs 

will be discussed separately below, 

followed by a discussion of the net 

information collection and reporting 

burdens of the final rule. FMCSA will 

submit a copy of the final rule to OIRA 

at OMB for review and approval of the 

information collections. 

1. Information Collection Requests 

a. Medical Qualification Requirements 

ICR 

This final rule revises the existing 

approved Medical Qualification 

Requirements ICR (OMB control number 

2126–0006), which expires on December 

31, 2024. FMCSA seeks approval for the 

revision of the ICR due to the Agency’s 

development of this rule, which 

includes the use of the Vision 

Evaluation Report, Form MCSA–5871. 

Title: Medical Qualification 

Requirements. 

OMB Control Number: 2126–0006. 

Type of Review: Revision of a 

currently approved information 

collection. 

Summary: In this final rule, FMCSA 

establishes an alternative vision 

standard for individuals 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 

renumbered 49 CFR 391.41(b)(10)(i) to 

be physically qualified to operate a 

CMV in interstate commerce under 

specified conditions. The alternative 

vision standard 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 from the vision evaluation 

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 report, 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, Form MCSA–5876, for a 

maximum of 12 months. The Vision 

Evaluation Report, Form MCSA–5871, 

supports safety by ensuring that CMV 

drivers are physically qualified to 

operate trucks and buses on our 

Nation’s highways. 

Response to comments: The NPRM 

served as the 60-day notice for the 

information collection revision and 

requested public comment on the draft 

Vision Evaluation Report, Form MCSA– 

5871, and information collection. 

FMCSA received no substantive 

comments regarding the report, or the 

burden associated with the information 

collection, in response to the NPRM. As 

discussed above in sections V.B. and C., 

the MRB recommended minor changes 

to the report and FMCSA published an 

NOA seeking comment on the 

recommendations. FMCSA again 

received no substantive comments 

regarding the report or burden of the 

information collection. Section VII.B. 

above describes all the changes made to 

the report in the final rule. With respect 

to the information collection burden, 

FMCSA adds requests on the report for 

a date and a couple of words to explain 

why a progressive eye condition is not 

stable and the rationale when a vision 

evaluation is needed more frequently 

than annually. However, FMCSA finds 

that the minor changes to the Vision 

Evaluation Report, Form MCSA–5871, 

do not require revision of FMCSA’s time 

estimate to complete the report. FMCSA 

finds no basis from the comments to 

change the analysis of the burden for the 

information collection. 

Burden estimates: Because of this 

final rule, FMCSA adds a new 

information collection (IC–8 

Qualifications of Drivers; Vision 

Standard) to the existing ICR for an 

ophthalmologist or optometrist to 

complete a Vision Evaluation Report, 

Form MCSA–5871. FMCSA estimates 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3415 

27An hourly wage rate for ophthalmologists is not 

available. 

28Public Law 74–255, 49 Stat. 543 (Aug. 9, 1935). 

29Public Law 98–554, 98 Stat. 2829 (Oct. 30, 

1984). 

that ophthalmologists and optometrists 

will complete 4,641 reports annually 

and that it will take them 8 minutes to 

complete a report. Thus, the estimated 

annual burden hours associated with 

the information collection is 619 hours 

(4,641 forms × 8 minutes per form ÷ 60 

minutes = 619 hours, rounded to the 

nearest whole hour). At an average 

hourly labor cost of $84.22 for 

optometrists,27 the estimated salary cost 

associated with this information 

collection is $52,130 ($84.22 hourly 

labor costs × 619 hours = $52,130, 

rounded to the nearest dollar). 

Estimated number of respondents: 

4,641 ophthalmologists and 

optometrists. 

Estimated responses: 4,641. 

Frequency: At least annually. 

Estimated burden hours: 619. 

Estimated cost: $52,130. 

The alternative vision standard 

eliminates the need for the Federal 

vision exemption program and the 

related information collection (IC–3a). 

The vision exemption program requires 

individuals to submit personal, health, 

and driving information during the 

application process. In addition, motor 

carriers must copy and file the vision 

exemption in the driver qualification 

file. FMCSA attributes, in the OMBapproved supporting statement for IC– 

3a, 2,236 annual burden hours at a cost 

of $67,486 to obtain and maintain a 

vision exemption, which is eliminated 

by this rule. 

The net effect of this rule on this ICR 

is a reduction in burden hours of 1,617 

hours (619 hours related to the Vision 

Evaluation Report, Form MCSA–5871 

¥2,236 hours related to the current 

vision exemption program = ¥1,617). In 

addition, the net effect of the rule with 

respect to costs is a reduction of $15,356 

($52,130 related to the report ¥$67,486 

related to the current vision exemption 

program = ¥$15,356). 

The revised total annual estimated 

burden associated with the Medical 

Qualification Requirements ICR that 

reflects the addition of the information 

collection for the Vision Evaluation 

Report, Form MCSA–5871, and 

elimination of the Federal vision 

exemption program is as follows. 

Total estimated number of 

respondents: 6,226,330 CMV drivers, 

motor carriers, MEs, treating clinicians, 

ophthalmologists, and optometrists. 

Total estimated responses: 

35,545,790. 

Total estimated burden hours: 

2,705,862. 

Total estimated cost: $194,994,040. 

Additional information for the 

assumptions, calculations, and 

methodology summarized above is 

provided in the supporting statement for 

the Medical Qualification Requirements 

ICR. The supporting statement is 

available in the docket for this 

rulemaking. 

b. 391.31 Road Test Requirement ICR 

FMCSA establishes a new 391.31 

Road Test Requirement ICR. The ICR 

estimates the paperwork burden motor 

carriers incur to comply with the 

reporting and recordkeeping tasks 

required for the road test associated 

with 49 CFR 391.31. FMCSA has not 

previously accounted for the burden 

associated with § 391.31 road tests; 

accordingly, the ICR accounts for the 

burden. The ICR includes the 

incremental burden for motor carriers 

associated with § 391.31 road tests due 

to this final rule. 

Title: 391.31 Road Test Requirement. 

OMB Control Number: 2126–0072. 

Type of Review: Approval of a new 

information collection. 

Summary: The road test provision in 

§ 391.31 provides an individual must 

not drive a CMV until the individual 

has successfully completed a road test 

and has been issued a certificate of 

driver’s road test. It was adopted by 

FHWA in 1970 (35 FR 6458, 6462 (Apr. 

22, 1970)). At that time, FHWA stated 

that the interests of CMV safety would 

be promoted by ensuring drivers have 

demonstrated their skill by completing 

a road test (35 FR 6459). The related 

requirement in § 391.51 that the motor 

carrier include information relating to 

the road test in the driver qualification 

file was also adopted in 1970 (35 FR 

6465). The information documents the 

driver’s ability to operate a CMV safely. 

Sections 391.31 and 391.51 are based 

on the authority of the Motor Carrier Act 

of 1935 28 (1935 Act) and the Motor 

Carrier Safety Act of 1984 29 (1984 Act), 

both as amended. The 1935 Act, as 

codified at 49 U.S.C. 31502(b), 

authorizes the Secretary to prescribe 

requirements for the qualifications of 

employees of a motor carrier and the 

safety of operation and equipment of a 

motor carrier. The 1984 Act, as codified 

at 49 U.S.C. 31136, provides concurrent 

authority to regulate drivers, motor 

carriers, and vehicle equipment. Section 

31136(a) requires the Secretary to issue 

regulations on CMV safety, including 

regulations to ensure that CMVs are 

operated safely. The Secretary has 

discretionary authority under 49 U.S.C. 

31133(a)(8) to prescribe recordkeeping 

and reporting requirements. The 

Administrator of FMCSA is delegated 

authority under 49 CFR 1.87 to carry out 

the functions vested in the Secretary by 

49 U.S.C. Chapters 311 and 315 as they 

relate to CMV operators, programs, and 

safety. 

Motor carriers must ensure each 

driver has the skill to operate a CMV 

safely. The information collected and 

maintained by motor carriers in each 

driver qualification file related to the 

road test substantiates the driver can 

operate a CMV safely and the motor 

carrier has fulfilled its regulatory 

requirements. It also aids Federal and 

State safety investigators in assessing 

the qualifications of drivers. 

Public interest in highway safety 

dictates that employers hire drivers who 

can safely operate CMVs amid the 

various physical and mental demands of 

truck and bus driving. Section 391.31 

requires a motor carrier to conduct a 

road test when the motor carrier hires a 

new driver. The motor carrier is 

required to rate the performance of the 

driver during the test on a road test 

form. If the road test is successfully 

completed, the motor carrier completes 

a certificate of driver’s road test and 

provides a copy to the driver. Motor 

carriers may maintain the required road 

test form and certificate electronically or 

via paper copy. The motor carrier must 

retain the signed road test form and the 

signed certificate in the driver 

qualification file. Generally, driver 

qualification files must be maintained at 

the motor carrier’s principal place of 

business. Neither the road test form nor 

the certificate is routinely submitted to 

FMCSA. A motor carrier would only 

make the information available when 

requested by an FMCSA or State safety 

investigator for an investigation or 

audit. 

As indicated above, there are three 

reporting and recordkeeping tasks motor 

carriers perform regarding the road test 

required by § 391.31 when they hire a 

new driver. The three tasks are: 

1. The motor carrier completes and signs 

the road test form while the driver performs 

a pre-trip inspection and the driving portion 

of the road test (49 CFR 391.31(d)). 

2. If the driver successfully passes the road 

test, the motor carrier completes a certificate 

of driver’s road test in substantially the form 

prescribed in § 391.31(f) (49 CFR 391.31(e)) 

and gives the driver a copy (49 CFR 

391.31(g)). 

3. The motor carrier retains in the driver 

qualification file the original signed road test 

form and the original, or a copy, of the signed 

certificate of driver’s road test (49 CFR 

391.31(g)(1) and (2)). 

Response to comments: The NPRM 

served as the 60-day notice for the 


jspears on DSK121TN23PROD with RULES2
3416 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

30Public Law 108–447, 118 Stat. 2809, 3268 (Dec. 

8, 2004), 5 U.S.C. 552a note. 

31Available at https://www.transportation.gov/ 

individuals/privacy/privacy-act-system-recordsnotices (last accessed Sept. 21, 2021). 

information collection and requested 

public comment on it. FMCSA received 

no substantive comments regarding the 

burden associated with the information 

collection in response to the NPRM. 

However, ATA referenced ‘‘a 30-minute 

road test,’’ which is consistent with 

FMCSA’s estimate for the road test. 

ACOEM expressed general concern that 

the number of employer-required road 

tests would significantly increase due to 

the alternative vision standard but 

provided no specific data or number. 

FMCSA finds no basis from the 

comments to change the analysis of the 

burden for the information collection. 

Burden estimates: To estimate the 

total burden hours, FMCSA multiplies 

the number of respondents by the 

hourly burden per response. FMCSA 

estimates a burden of 30 minutes for the 

motor carrier to complete the road test 

form while conducting the road test. 

Should the driver successfully pass the 

road test, FMCSA assumes it will take 

the motor carrier 2 minutes to complete 

the certification of driver’s road test and 

an additional 1 minute to store 

documents in the driver qualification 

file. 

To estimate costs, FMCSA assumes a 

compliance officer will be the person 

who will complete the road test form 

and associated certificate, and a file 

clerk will be the person who will store 

the documents. The median salary for a 

compliance officer is $61.35 per hour. 

The median salary for a file clerk is 

$29.42 per hour. 

The ICR estimates the informationcollection burden incurred by motor 

carriers associated with the § 391.31 

road test in two circumstances. The first 

is when the road test is required by 

§ 391.31 (IC–1); the second is when the 

road test is required as part of the 

alternative vision standard in § 391.44 

(IC–2). Most of the motor carrier burden 

hours and cost for the information 

collection relates to IC–1 and is 

reflected below in the total burden and 

cost amounts for the ICR. 

IC–2 consists of the incremental 

burden associated with the requirement 

in this rule that individuals physically 

qualified under the alternative vision 

standard in § 391.44 for the first time 

must complete a road test in accordance 

with § 391.31. However, individuals are 

excepted from the road test requirement 

if they have 3 years of intrastate or 

specific excepted interstate CMV 

driving experience with the vision 

deficiency, hold a valid Federal vision 

exemption, or are medically certified 

under § 391.64(b). FMCSA estimates 

there will be approximately 868 drivers 

requiring a road test under § 391.44 each 

year. Therefore, the respondent universe 

of motor carriers is also 868. 

The estimated incremental annual 

burden associated with the requirement 

in this rule that certain individuals 

physically qualified under § 391.44 for 

the first time must complete a road test 

in accordance with § 391.31 (IC–2), is as 

follows. 

Estimated number of respondents: 

868 motor carriers. 

Estimated responses: 2,604. 

Frequency: Once. 

Estimated burden hours: 477. 

Estimated cost: $28,735. 

The total estimated annual burden 

associated with the 391.31 Road Test 

Requirement ICR for IC–1 and IC–2 is as 

follows: 

Total estimated number of 

respondents: 497,981 motor carriers. 

Total estimated responses: 1,493,943. 

Total estimated burden hours: 

273,888. 

Total estimated cost: $16,485,764. 

Additional information for the 

assumptions, calculations, and 

methodology summarized above is 

provided in the supporting statement for 

the 391.31 Road Test Requirement ICR. 

The supporting statement is available in 

the docket for this rulemaking. 

2. Net Information Collection Reporting 

Burdens 

As shown in Table 4 below, the 

combined net effect of the rule on the 

two ICRs is a reduction in burden hours 

of 1,140 and an addition of cost in the 

amount of $12,255. 

TABLE 4—NET BURDEN OF MEDICAL

QUALIFICATIONS REQUIREMENTS ICR 

AND ROAD TEST ICR 

ICR Burden 

hours Cost 

Medical Qualifications 

Requirements ........ (1,617) ($16,480) 

Road Test ................. 477 $28,735 

Net Burden ........ (1,140) $12,255 

3. Request for Comments 

FMCSA asks for comment on the 

information collection requirements of 

this rule, as well as the revised total 

estimated burden associated with the 

Medical Qualification Requirements ICR 

and the total estimated burden 

associated with the new 391.31 Road 

Test Requirement ICR. Specifically, the 

Agency asks for comment on: (1) 

Whether the proposed information 

collections are necessary for FMCSA to 

perform its functions; (2) how the 

Agency can improve the quality, 

usefulness, and clarity of the 

information to be collected; (3) the 

accuracy of FMCSA’s estimate of the 

burden of this information collection; 

and (4) how the Agency can minimize 

the burden of the information 

collection. 

If you have comments on the 

collection of information, you must 

submit those comments as outlined 

under ADDRESSES at the beginning of 

this final rule. 

G. E.O. 13132 (Federalism) 

A rule has implications for federalism 

under section 1(a) of E.O. 13132 if it has 

‘‘substantial direct effects on the States, 

on the relationship between the national 

government and the States, or on the 

distribution of power and 

responsibilities among the various 

levels of government.’’ FMCSA has 

determined that this rule does not have 

substantial direct costs on or for States, 

nor will it limit the policymaking 

discretion of States. Nothing in this 

document preempts any State law or 

regulation. Therefore, this rule does not 

have sufficient federalism implications 

to warrant the preparation of a 

Federalism Impact Statement. 

H. Privacy 

Section 522 of title I of division H of 

the Consolidated Appropriations Act, 

2005,30 requires the Agency to conduct 

a privacy impact assessment of a 

regulation that will affect the privacy of 

individuals. The assessment considers 

impacts of the rule on the privacy of 

information in an identifiable form and 

related matters. 

This rule requires the collection of 

personally identifiable information and 

protected health information via the 

Vision Evaluation Report, Form MCSA– 

5871. The privacy risks and effects 

associated with this rule are not unique 

and have been addressed previously by 

the DOT/FMCSA 009—National 

Registry of Certified Medical Examiners 

system of records notice published on 

October 4, 2019 (84 FR 53211).31 The 

DOT Chief Privacy Officer will 

determine whether a new system of 

records notice for this rule is required. 

Before an individual may be 

medically certified under the alternative 

vision standard adopted in this rule, the 

individual must have a vision 

evaluation conducted by an 

ophthalmologist or optometrist. The 

ophthalmologist or optometrist records 

the findings of the vision evaluation and 

provides specific medical opinions on 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3417 

the new Vision Evaluation Report, Form 

MCSA–5871. Then, an ME performs a 

physical qualification examination and 

uses the information provided on the 

report to determine whether the 

individual meets the alternative vision 

standard. The Vision Evaluation Report, 

Form MCSA–5871, is used exclusively 

as part of the physical qualification 

process. It collects only the information 

that is necessary for the ME to 

determine whether an individual meets 

the alternative vision standard and may 

be medically certified. 

The Vision Evaluation Report, Form 

MCSA–5871, provides a means for 

healthcare professionals to exchange 

information about an individual for 

purposes of regulatorily required 

medical certification to operate a CMV. 

The report promotes uniform and 

consistent communication between 

ophthalmologists or optometrists and 

the certifying MEs. This is the same type 

of communication that occurs when the 

ME needs to follow up with an 

individual’s primary care provider 

regarding the individual’s health and 

exchanges information. Therefore, no 

new category of medical or privacy 

information is generated because of this 

rule. 

The Agency expects that the Vision 

Evaluation Report, Form MCSA–5871, 

will be safeguarded along with all the 

other medical information that these 

healthcare providers retain. The report 

must be treated and retained as part of 

the Medical Examination Report Form, 

MCSA–5875, in the ME’s medical 

records for the individual. The report 

must be retained by the ME for at least 

3 years from the date of the physical 

qualification examination. The Vision 

Evaluation Report, Form MCSA–5871, is 

provided to FMCSA only upon request 

if there is an investigation or audit. 

Therefore, this rule provides a privacypositive outcome because it results in 

less sensitive data being held by the 

Agency. There is privacy risk not 

controlled by the Agency because the 

Vision Evaluation Report, Form MCSA– 

5871, is retained by MEs. However, as 

healthcare providers, MEs are required 

to retain and disclose medical 

information and personally identifiable 

information in accordance with 

applicable Federal and State privacy 

laws. 

With respect to the requirement that 

a Vision Evaluation Report, Form 

MCSA–5871, must be completed as part 

of the new alternative vision standard, 

the Agency has completed a Privacy 

Threshold Assessment to evaluate the 

risks and effects the requirement has on 

collecting, storing, and sharing 

personally identifiable information and 

protected health information. 

With respect to the requirement for a 

road test as part of the alternative vision 

standard, the Agency also has 

completed a Privacy Threshold 

Assessment to evaluate the risks and 

effects the requirement has on 

collecting, storing, and sharing 

personally identifiable information. 

I. E.O. 13175 (Indian Tribal 

Governments) 

This rule does not have Tribal 

implications under E.O. 13175, 

Consultation and Coordination with 

Indian Tribal Governments, because it 

does not have a substantial direct effect 

on one or more Indian Tribes, on the 

relationship between the Federal 

Government and Indian Tribes, or on 

the distribution of power and 

responsibilities between the Federal 

Government and Indian Tribes. 

J. National Environmental Policy Act of 

1969 

FMCSA analyzed this final rule 

pursuant to the National Environmental 

Policy Act of 1969 (42 U.S.C. 4321 et 

seq.) and determined this action is 

categorically excluded from further 

analysis and documentation in an 

environmental assessment or 

environmental impact statement under 

FMCSA Order 5610.1 (69 FR 9680 (Mar. 

1, 2004)), Appendix 2, paragraph 6.z. 

The content in this rule is covered by 

the categorical exclusions in paragraph 

6.z.(1) regarding the minimum 

qualifications for individuals who drive 

CMVs, and in paragraph 6.z.(2) 

regarding the minimum duties of motor 

carriers with respect to the 

qualifications of their drivers. In 

addition, the rule does not have any 

effect on the quality of the environment. 

List of Subjects in 49 CFR Part 391 

Alcohol abuse, Drug abuse, Drug 

testing, Highway safety, Motor carriers, 

Reporting and recordkeeping 

requirements, Safety, Transportation. 

Accordingly, FMCSA amends 49 CFR 

part 391 as follows: 

PART 391—QUALIFICATIONS OF 

DRIVERS AND LONGER 

COMBINATION VEHICLE (LCV) 

DRIVER INSTRUCTORS 

■ 1. The authority citation for part 391 

continues to read as follows: 

Authority: 49 U.S.C. 504, 508, 31133, 

31136, 31149, 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; sec. 

32934, Pub. L. 112–141, 126 Stat. 405, 830; 

secs. 5403 and 5524, Pub. L. 114–94, 129 

Stat. 1312, 1548, 1560; sec. 2, Pub. L. 115– 

105, 131 Stat. 2263; and 49 CFR 1.87. 

■ 2. Amend § 391.31 by: 

■ a. In paragraph (f), removing the 

entries ‘‘Social Security No’’, 

‘‘Operator’s or Chauffeur’s License No’’, 

and ‘‘State’’ in the Certification of Road 

Test form; and 

■ b. Adding paragraph (h). 

The addition reads as follows: 

§ 391.31 Road test. 

* * * * * 

(h) The information collection 

requirements of this section have been 

reviewed by the Office of Management 

and Budget (OMB) pursuant to the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 3501 et seq.) and have been 

assigned OMB control number 2126– 

0072. 

■ 3. Revise § 391.41(b)(10) to read as 

follows: 

§ 391.41 Physical qualifications for 

drivers. 

* * * * * 

(b) * * * 

(10)(i) Has distant visual acuity of at 

least 20/40 (Snellen) in each eye 

without corrective lenses or visual 

acuity separately corrected to 20/40 

(Snellen) or better with corrective 

lenses, distant binocular acuity of at 

least 20/40 (Snellen) in both eyes with 

or without corrective lenses, field of 

vision of at least 70° in the horizontal 

meridian in each eye, and the ability to 

recognize the colors of traffic signals 

and devices showing standard red, 

green, and amber; or 

(ii) Meets the requirements in 

§ 391.44, if the person does not satisfy, 

with the worse eye, either the distant 

visual acuity standard with corrective 

lenses or the field of vision standard, or 

both, in paragraph (b)(10)(i) of this 

section; 

* * * * * 

■ 4. Revise § 391.43(b)(1) to read as 

follows: 

§ 391.43 Medical examination; certificate 

of physical examination. 

* * * * * 

(b) * * * 

(1) A licensed ophthalmologist or 

licensed optometrist may perform the 

part of the medical examination that 

involves visual acuity, field of vision, 

and the ability to recognize colors as 

specified in § 391.41(b)(10). 

* * * * * 

■ 5. Add § 391.44 to read as follows: 


jspears on DSK121TN23PROD with RULES2
3418 Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 

§ 391.44 Physical qualification standards 

for an individual who does not satisfy, with 

the worse eye, either the distant visual 

acuity standard with corrective lenses or 

the field of vision standard, or both. 

(a) General. An individual who does 

not satisfy, with the worse eye, either 

the distant visual acuity standard with 

corrective lenses or the field of vision 

standard, or both, in § 391.41(b)(10)(i) is 

physically qualified to operate a 

commercial motor vehicle in interstate 

commerce provided: 

(1) The individual meets the other 

physical qualification standards in 

§ 391.41 or has an exemption or skill 

performance evaluation certificate, if 

required; and 

(2) The individual has the vision 

evaluation required by paragraph (b) of 

this section and the medical 

examination required by paragraph (c) 

of this section. 

(b) Evaluation by an ophthalmologist 

or optometrist. Prior to the examination 

required by § 391.45 or the expiration of 

a medical examiner’s certificate, the 

individual must be evaluated by a 

licensed ophthalmologist or licensed 

optometrist. 

(1) During the evaluation of the 

individual, the ophthalmologist or 

optometrist must complete the Vision 

Evaluation Report, Form MCSA–5871. 

(2) Upon completion of the Vision 

Evaluation Report, Form MCSA–5871, 

the ophthalmologist or optometrist must 

sign and date the Report and provide 

the ophthalmologist or optometrist’s full 

name, office address, and telephone 

number on the Report. 

(c) Examination by a medical 

examiner. At least annually, an 

individual who does not satisfy, with 

the worse eye, either the distant visual 

acuity standard with corrective lenses or 

the field of vision standard, or both, in 

§ 391.41(b)(10)(i) must be medically 

examined and certified by a medical 

examiner as physically qualified to 

operate a commercial motor vehicle in 

accordance with § 391.43. The 

examination must begin not more than 

45 days after an ophthalmologist or 

optometrist signs and dates the Vision 

Evaluation Report, Form MCSA–5871. 

(1) The medical examiner must 

receive a completed Vision Evaluation 

Report, Form MCSA–5871, signed and 

dated by an ophthalmologist or 

optometrist for each required 

examination. This Report shall be 

treated and retained as part of the 

Medical Examination Report Form, 

MCSA–5875. 

(2) The medical examiner must 

determine whether the individual meets 

the physical qualification standards in 

§ 391.41 to operate a commercial motor 

vehicle. In making that determination, 

the medical examiner must consider the 

information in the Vision Evaluation 

Report, Form MCSA–5871, signed by an 

ophthalmologist or optometrist and, 

utilizing independent medical 

judgment, apply the following standards 

in determining whether the individual 

may be certified as physically qualified 

to operate a commercial motor vehicle. 

(i) The individual is not physically 

qualified to operate a commercial motor 

vehicle if, in the better eye, the distant 

visual acuity is not at least 20/40 

(Snellen), with or without corrective 

lenses, and the field of vision is not at 

least 70° in the horizontal meridian. 

(ii) The individual is not physically 

qualified to operate a commercial motor 

vehicle if the individual is not able to 

recognize the colors of traffic signals 

and devices showing standard red, 

green, and amber. 

(iii) The individual is not physically 

qualified to operate a commercial motor 

vehicle if the individual’s vision 

deficiency is not stable. 

(iv) The individual is not physically 

qualified to operate a commercial motor 

vehicle if sufficient time has not passed 

since the vision deficiency became 

stable to allow the individual to adapt 

to and compensate for the change in 

vision. 

(d) Road test. (1) Except as provided 

in paragraphs (d)(3), (4), and (5) of this 

section, an individual physically 

qualified under this section for the first 

time shall not drive a commercial motor 

vehicle until the individual has 

successfully completed a road test 

subsequent to physical qualification and 

has been issued a certificate of driver’s 

road test in accordance with § 391.31. 

An individual physically qualified 

under this section for the first time must 

inform the motor carrier responsible for 

completing the road test under 

§ 391.31(b) that the individual is 

required by paragraph (d) of this section 

to have a road test. The motor carrier 

must conduct the road test in 

accordance with § 391.31(b) thorough 

(g). 

(2) For road tests required by 

paragraph (d)(1) of this section, the 

provisions of § 391.33 for the equivalent 

of a road test do not apply. If an 

individual required to have a road test 

by paragraph (d)(1) of this section 

successfully completes the road test and 

is issued a certificate of driver’s road 

test in accordance with § 391.31, then 

any otherwise applicable provisions of 

§ 391.33 will apply thereafter to such 

individual. 

(3) An individual physically qualified 

under this section for the first time is 

not required to complete a road test in 

accordance with § 391.31 if the motor 

carrier responsible for completing the 

road test under § 391.31(b) determines 

the individual possessed a valid 

commercial driver’s license or noncommercial driver’s license to operate, 

and did operate, a commercial motor 

vehicle in either intrastate commerce or 

in interstate commerce excepted by 

§ 390.3T(f) of this subchapter or § 391.2 

from the requirements of this subpart 

with the vision deficiency for the 3-year 

period immediately preceding the date 

of physical qualification under this 

section for the first time. 

(i) The individual must certify in 

writing to the motor carrier the date the 

vision deficiency began. 

(ii) If the motor carrier determines the 

individual possessed a valid 

commercial driver’s license or noncommercial driver’s license to operate, 

and did operate, a commercial motor 

vehicle in either intrastate commerce or 

in interstate commerce excepted by 

either § 390.3T(f) of this subchapter or 

§ 391.2 from the requirements of this 

subpart with the vision deficiency for 

the 3-year period immediately 

preceding the date of physical 

qualification in accordance with this 

section for the first time, the motor 

carrier must— 

(A) Prepare a written statement to the 

effect that the motor carrier determined 

the individual possessed a valid license 

and operated a commercial motor 

vehicle in intrastate or in the specific 

excepted interstate commerce (as 

applicable) with the vision deficiency 

for the 3-year period immediately 

preceding the date of physical 

qualification in accordance with this 

section for the first time and, therefore, 

is not required by paragraph (d) of this 

section to complete a road test; 

(B) Give the individual a copy of the 

written statement; and 

(C) Retain in the individual’s driver 

qualification file the original of the 

written statement and the original, or a 

copy, of the individual’s certification 

regarding the date the vision deficiency 

began. 

(4) An individual physically qualified 

under this section for the first time is 

not required to complete a road test in 

accordance with § 391.31 if the 

individual held on March 22, 2022, a 

valid exemption from the vision 

standard in § 391.41(b)(10)(i) issued by 

FMCSA under 49 CFR part 381. Such an 

individual is not required to inform the 

motor carrier that the individual is 

excepted from the requirement in 

paragraph (d)(1) of this section to have 

a road test. 

(5) An individual physically qualified 

under this section for the first time is 


jspears on DSK121TN23PROD with RULES2
Federal Register / Vol. 87, No. 14 / Friday, January 21, 2022 / Rules and Regulations 3419 

not required to complete a road test in 

accordance with § 391.31 if the 

individual was medically certified on 

March 22, 2022, under the provisions of 

§ 391.64(b) for drivers who participated 

in a previous vision waiver study 

program. Such an individual is not 

required to inform the motor carrier that 

the individual is excepted from the 

requirement in paragraph (d)(1) of this 

section to have a road test. 

■ 6. Amend § 391.45 by: 

■ a. Revising paragraph (b); 

■ b. Redesignating paragraphs (f) and (g) 

as paragraphs (g) and (h), respectively; 

and 

■ c. Adding a new paragraph (f). 

The revision and addition read as 

follows: 

§ 391.45 Persons who must be medically 

examined and certified. 

* * * * * 

(b) Any driver who has not been 

medically examined and certified as 

qualified to operate a commercial motor 

vehicle during the preceding 24 months, 

unless the driver is required to be 

examined and certified in accordance 

with paragraph (c), (d), (e), (f), (g), or (h) 

of this section; 

* * * * * 

(f) Any driver who does not satisfy, 

with the worse eye, either the distant 

visual acuity standard with corrective 

lenses or the field of vision standard, or 

both, in § 391.41(b)(10)(i) and who has 

obtained a medical examiner’s 

certificate under the standards in 

§ 391.44, if such driver’s most recent 

medical examination and certification 

as qualified to drive did not occur 

during the preceding 12 months; 

* * * * * 

■ 7. Revise § 391.51(b)(3) to read as 

follows: 

§ 391.51 General requirements for driver 

qualification files. 

* * * * * 

(b) * * * 

(3) The certificate of driver’s road test 

issued to the driver pursuant to 

§ 391.31(e), a copy of the license or 

certificate which the motor carrier 

accepted as equivalent to the driver’s 

road test pursuant to § 391.33, or the 

original of the written statement 

providing that the motor carrier 

determined the driver is not required by 

§ 391.44(d) to complete a road test 

pursuant to § 391.44(d)(3)(ii)(A) and the 

original, or a copy, of the driver’s 

certification required by 

§ 391.44(d)(3)(i); 

* * * * * 

■ 8. Amend § 391.64 by revising 

paragraph (b) introductory text and 

adding paragraph (b)(4) to read as 

follows: 

§ 391.64 Grandfathering for certain drivers 

who participated in a vision waiver study 

program. 

* * * * * 

(b) Until March 22, 2022, the 

provisions of § 391.41(b)(10) do not 

apply to a driver who was a participant 

in good standing on March 31, 1996, in 

a waiver study program concerning the 

operation of commercial motor vehicles 

by drivers with visual impairment in 

one eye; provided: 

* * * * * 

(4) On March 22, 2022, the provisions 

of paragraph (b) of this section are no 

longer in effect, and any medical 

examiner’s certificate issued under 

§ 391.43 on the basis that the driver is 

qualified by operation of the provisions 

of paragraph (b) of this section, related 

to drivers with visual impairment in one 

eye, is void. 

Appendix A to Part 391—[Amended] 

■ 9. Remove and reserve paragraph II.J. 

of appendix A to part 391. 

Issued under the authority of delegation in 

49 CFR 1.87. 

Meera Joshi, 

Deputy Administrator. 

[FR Doc. 2022–01021 Filed 1–20–22; 8:45 am] 

BILLING CODE 4910–EX–P 


jspears on DSK121TN23PROD with RULES2