Document ID: FMCSA-2019-0049-0118
Agency: fmcsa
Document Type: Proposed Rule
Title: Medical Review Board Task 21-1 Report: Proposed Alternative Vision Standard
Posted Date: 2021-08-24T04:00Z

[Federal Register Volume 86, Number 161 (Tuesday, August 24, 2021)]
[Proposed Rules]
[Pages 47278-47280]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-17850]

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

49 CFR Part 391

[Docket No. FMCSA-2019-0049]
RIN 2126-AC21

Medical Review Board Task 21-1 Report: FMCSA Proposed Alternative 
Vision Standard

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

ACTION: Notice of availability (NOA); request for comments.

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SUMMARY: In January 2021, FMCSA published a notice of proposed 
rulemaking (NPRM) to amend its regulations to permit individuals who 
cannot meet either the current distant visual acuity or field of vision 
standard, or both, in one eye to be physically qualified to operate a 
commercial motor vehicle (CMV) in interstate commerce. The comment 
period closed on March 15, 2021. The Agency received 69 comments. In 
May 2021, FMCSA requested, in part, that FMCSA's Medical Review Board 
(MRB) review and analyze the comments from medical professionals and 
associations and make recommendations regarding the proposed 
alternative vision standard for FMCSA to consider. The Agency announces 
the availability of the MRB's report and requests comments on the MRB's 
recommendations. MRB Task 21-1 Report is available in Docket Number 
FMCSA-2019-0049.

DATES: Comments must be received on or before September 23, 2021.

ADDRESSES: You may submit comments identified by Docket Number FMCSA-
2019-0049 using any of the following methods:
     Federal eRulemaking Portal: Go to https://www.regulations.gov/docket/FMCSA-2019-0049/document. Follow the online 
instructions for submitting comments.
     Mail: Dockets Operations, U.S. Department of 
Transportation, 1200 New Jersey Avenue SE, West Building, Ground Floor, 
Room W12-140, Washington, DC 20590-0001.
     Hand Delivery or Courier: Dockets Operations, U.S. 
Department of Transportation, 1200 New Jersey Avenue SE, West Building, 
Ground Floor, Room W12-140, 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.
     Fax: (202) 493-2251.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, FMCSA,1200 New Jersey Avenue SE, Washington, 
DC 20590, (202) 366-4001, FMCSAMedical@dot.gov. If you have questions 
on viewing or submitting material to the docket, call Dockets 
Operations at (202) 366-9826.

SUPPLEMENTARY INFORMATION:

I. Public Participation and Request for Comments

A. Submitting Comments

    If you submit a comment, please include the docket number for this 
NOA (FMCSA-2019-0049), indicate the specific section of this document 
to which your comment applies, and provide a reason for each suggestion 
or recommendation. You may submit your comments and material online or 
by fax, mail, or hand delivery, but please use only one of these means. 
FMCSA recommends that you include your name and a mailing address, an 
email address, or a phone number in the body of your document so FMCSA 
can contact you if there are questions regarding your submission.
    To submit your comment online, go to https://www.regulations.gov/docket/FMCSA-2019-0049/document, click on this NOA, click ``Comment,'' 
and type your comment into the text box on the following screen.
    If you submit your comments by mail or hand delivery, submit them 
in an unbound format, no larger than 8\1/2\ by 11 inches, suitable for 
copying and electronic filing. If you submit comments by mail and would 
like to know that they reached the facility, please enclose a stamped, 
self-addressed postcard or envelope.
    FMCSA will consider all comments and material received during the 
comment period.
Confidential Business Information (CBI)
    CBI is commercial or financial information that is both customarily 
and actually treated as private by its owner. Under the Freedom of 
Information Act (5 U.S.C. 552), CBI is exempt from public disclosure. 
If your comments responsive to this NOA contain commercial or financial 
information that is customarily treated as private, that you actually 
treat as private, and that is relevant or responsive to this NOA, it is 
important that you clearly designate the submitted comments as CBI. 
Please mark each page of your submission that constitutes CBI as 
``PROPIN'' to indicate it contains proprietary information. FMCSA will 
treat such marked submissions as confidential under the Freedom of 
Information Act, and they will not be placed in the public docket. 
Submissions containing CBI should be sent to Mr. Brian Dahlin, Chief, 
Regulatory Analysis Division, Office of Policy, FMCSA, 1200 New Jersey 
Avenue SE, Washington DC 20590-0001. Any comments FMCSA receives not 
specifically designated as CBI will be placed in the public docket.

B. Viewing Comments and Documents

    To view any documents mentioned as being available in the docket, 
go to https://www.regulations.gov/docket/FMCSA-2019-0049/document and 
choose the document to review. To view

[[Page 47279]]

comments, click this NOA, and click ``Browse Comments.'' If you do not 
have access to the internet, you may view the docket online by visiting 
Dockets Operations in Room W12-140 on the ground floor of the DOT West 
Building, 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.

C. Privacy Act

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

II. Background

    FMCSA's mission is to reduce crashes, injuries, and fatalities 
involving large trucks and buses. FMCSA is authorized by statute to 
establish minimum physical qualification standards for drivers of CMVs 
operating in interstate commerce. To ensure the physical qualification 
of CMV drivers, the Agency has established a vision standard, along 
with several other physical standards. The current vision standard can 
be found at 49 CFR 391.41(b)(10).
    The Federal Highway Administration, the predecessor agency to 
FMCSA, adopted the current vision standard April 22, 1970 (35 FR 6458). 
Under this standard, an individual is physically qualified to drive a 
CMV if the individual 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 
degrees 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 (49 CFR 391.41(b)(10)). This standard has not 
changed since it became effective on January 1, 1971.
    Since 1998, FMCSA has maintained an exemption program for 
individuals who do not meet certain vision standards. The Agency 
considers vision exemptions on a case-by-case basis upon application by 
CMV drivers who do not meet either the distant visual acuity or field 
of vision standard, or both, of Sec.  391.41(b)(10) in one eye. The 
Agency does not grant exemptions for color blindness.
    On January 12, 2021, FMCSA published an NPRM that proposed an 
alternative vision standard for individuals unable to meet either the 
current distant visual acuity or field of vision standard, or both (86 
FR 2344). The comment period on the NPRM closed on March 15, 2021. The 
Agency received 69 comments.

III. MRB Task 21-1

    The MRB was established to provide FMCSA with medical advice and 
recommendations on medical standards and guidelines for the physical 
qualifications of CMV operators, medical examiner education, and 
medical research (49 U.S.C. 31149(a)(1)). The MRB, in view of its 
statutory creation and advisory function, is chartered by DOT as an 
advisory committee under the provisions of the Federal Advisory 
Committee Act (5 U.S.C. App.) See also Announcement of Establishment of 
the Federal Motor Carrier Safety Administration Medical Review Board 
(70 FR 57642; Oct. 3, 2005). The members of the MRB are appointed by 
the Secretary to reflect expertise in a variety of medical specialties 
relevant to the driver fitness requirements of FMCSA (49 U.S.C. 
31149(a)(2)).
    To assist in the development of a final rule, on May 11, 2021, 
FMCSA requested advice from the MRB for the Agency to consider. 
Specifically, FMCSA asked the MRB to review and analyze all 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 recommendations with respect 
to whether the information requested from eye specialists on the 
proposed Vision Evaluation Report provides sufficient information for a 
medical examiner to make a medical certification determination. The MRB 
held a public meeting to discuss MRB Task 21-1 on May 19 and 20, 2021. 
The Agency received the MRB's final report on July 20, 2021. 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-mrb-meeting-topics.

IV. MRB Task 21-1 Report

    The MRB's final report is available in the docket (in addition to 
being available on the Agency's public website). The MRB Task 21-1 
Report contains detailed recommendations for FMCSA to consider as it 
develops a final rule. The Agency believes that public comment on the 
recommendations will assist it in evaluating the advice it has received 
from the MRB. Comments must be limited to addressing the 
recommendations in the MRB Task 21-1 Report. The MRB made the following 
recommendations in its MRB Task 21-1 Report:

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

[[Page 47280]]

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 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 insulin-treated diabetes 
mellitus.

    The Vision Evaluation Report, Form MCSA-5871, with the MRB's 
recommended edits is an attachment to the MRB Task 21-1 Report, which 
can be found in the docket (in addition to being available on the 
Agency's public website).

V. Comments Requested

    Comments are requested on any and all of the recommendations 
provided in the MRB Task 21-1 Report but only on those recommendations. 
To the extent possible, comments should include supporting materials, 
such as data analyses, studies, reports, or journal articles. FMCSA 
will consider these comments, in addition to the comments submitted in 
response to the NPRM, in determining how to proceed in the vision 
rulemaking.

    Issued under authority delegated in 49 CFR 1.87.
Meera Joshi,
Deputy Administrator.
[FR Doc. 2021-17850 Filed 8-23-21; 8:45 am]
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