Document ID: FMCSA-2012-0178-0080
Agency: fmcsa
Document Type: Rule
Title: Medical Examiner's Certification Integration
Posted Date: 2015-04-23T04:00Z

[Federal Register Volume 80, Number 78 (Thursday, April 23, 2015)]
[Rules and Regulations]
[Pages 22789-22825]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-09053]

[[Page 22789]]

Vol. 80

Thursday,

No. 78

April 23, 2015

Part II

Department of Transportation

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Federal Motor Carrier Safety Administration

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49 CFR Parts 383, 384 and 391

 Medical Examiner's Certification Integration; Final Rule

  Federal Register / Vol. 80 , No. 78 / Thursday, April 23, 2015 / 
Rules and Regulations  

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

49 CFR Parts 383, 384 and 391

[Docket No. FMCSA-2012-0178]
RIN 2126-AB40

Medical Examiner's Certification Integration

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

ACTION: Final rule.

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SUMMARY: FMCSA amends the Federal Motor Carrier Safety Regulations 
(FMCSRs) to require certified medical examiners (MEs) performing 
physical examinations of commercial motor vehicle (CMV) drivers to use 
a newly developed Medical Examination Report (MER) Form, MCSA-5875, in 
place of the current MER Form and to use Form MCSA-5876 for the Medical 
Examiner's Certificate (MEC); and report results of all CMV drivers' 
physical examinations performed (including the results of examinations 
where the driver was found not to be qualified) to FMCSA by midnight 
(local time) of the next calendar day following the examination. The 
reporting of results includes all CMV drivers who are required to be 
medically certified to operate in interstate commerce, not only those 
who hold or apply for commercial learner's permits (CLP) or commercial 
driver's licenses (CDL), and results of any examinations performed in 
accordance with the FMCSRs with any applicable State variances (which 
will be valid for intrastate operations only). For holders of CLP/CDLs 
(interstate and intrastate), FMCSA will electronically transmit driver 
identification, examination results, and restriction information from 
examinations performed from the National Registry to the State Driver's 
Licensing Agencies (SDLAs). The Agency will also transmit medical 
variance information for all CMV drivers electronically to the SDLAs.

DATES: Effective on June 22, 2015. See the amendments to 49 CFR parts 
383, 384 and 391 for compliance dates.

FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director, 
Carrier, Driver, & Vehicle Safety Standards, Federal Motor Carrier 
Safety Administration, 1200 New Jersey Avenue SE., Washington, DC 
20590-0001, by telephone at (202) 366-4001 or via email at 
fmcsamedical@dot.gov. Office hours are from 9 a.m. to 5 p.m. ET, Monday 
through Friday, except Federal holidays. If you have questions on 
viewing or submitting material to the docket, contact Docket Services, 
telephone (202) 366-9826.

SUPPLEMENTARY INFORMATION:

Table of Contents for Preamble

I. Rulemaking Documents
    A. Availability of Rulemaking Documents
    B. Privacy Act
II. Executive Summary
    A. Purpose and Summary of the Major Provisions
    B. Benefits and Costs
III. Abbreviations
IV. Legal Basis for the Rulemaking
    A. Authority Over Drivers Affected
    B. Authority To Regulate State CDL Programs
    C. Authority To Require Reporting by MEs
V. Background
    A. Medical Certification Requirements as Part of the CDL
    B. National Registry of Certified MEs
    C. MER
VI. Discussion of Comments Received on the Proposed Rule
    A. Overview
    B. Electronic Transmission and Access to MEC Information
    C. Use of Revised Medical Examination Report Form and Medical 
Examiner's Certificate
    D. Compliance Date for the States
    E. Coercion
    F. Issues Outside the Scope of This Rulemaking
VII. Section-by-Section Explanation of Changes
    A. Changes to Part 383
    B. Changes to Part 384
    C. Changes to Part 391
    D. Compliance Date
VIII. Regulatory Analyses and Notices
    A. E.O. 12866 (Regulatory Planning and Review and DOT Regulatory 
Policies and Procedures as Supplemented by E.O. 13563)
    B. Regulatory Flexibility Act
    C. Assistance for Small Entities
    D. Unfunded Mandates Reform Act of 1995
    E. E.O. 13132 (Federalism)
    F. E.O. 12988 (Civil Justice Reform)
    G. E.O. 13045 (Protection of Children)
    H. E.O. 12630 (Taking of Private Property)
    I. Privacy Impact Assessment
    J. E.O. 12372 (Intergovernmental Review)
    K. Paperwork Reduction Act
    L. National Environmental Policy Act and Clean Air Act
    M. E.O. 12898 Environmental Justice
    N. E.O. 13211 (Energy Supply, Distribution, or Use)
    O. E.O. 13175 (Indian Tribal Governments)
    P. National Technology Transfer and Advancement Act (Technical 
Standards)

I. Rulemaking Documents

A. Availability of Rulemaking Documents

    For access to docket FMCSA-2012-0178 to read background documents 
and comments received, go to http://www.regulations.gov at any time, or 
to U.S. Department of Transportation, Room W12-140, 1200 New Jersey 
Avenue SE., Washington, DC 20590, between 9 a.m. and 5 p.m. E.T., 
Monday through Friday, except Federal holidays.

B. Privacy Act

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

II. Executive Summary

A. Purpose and Summary of the Major Provisions

    The purpose of this final rule is to facilitate the electronic 
transmission of MEC information from FMCSA's National Registry to the 
SDLAs. This transmission will provide administrative cost savings to 
motor carriers, drivers, MEs, and SDLAs. In addition, it will reduce, 
to the greatest extent possible, the potential for the submission of 
falsified MECs to the States, which are required to post MEC 
information to CLP/CDL holders' records accessible via CDLIS. By 
ensuring that drivers are medically qualified, FMCSA will decrease the 
risk of CMV crashes, attributable in whole or in part, to drivers with 
medical conditions that adversely affect their ability to operate a CMV 
safely on the Nation's highways.
    The final rule requires certified MEs performing physical 
examinations of CMV drivers to use a newly developed MER Form, MCSA-
5875, in place of the current MER Form and to use the Form MCSA-5876 
for the MEC. In addition, MEs are required to report results of each 
CMV drivers' physical examination, including the results of 
examinations where the driver was found not to be qualified, to FMCSA 
by midnight local time of the next calendar day following the 
examination. This includes all CMV drivers (CDL/CLP and Non-CDL/CLP) 
who are required to be medically certified to operate in interstate 
commerce and allows, but does not require, MEs to transmit any 
information about examinations performed in accordance with the FMCSRs 
with any applicable State variances, which will be valid for intrastate 
operations only. Examination results will be reported by completing a 
CMV Driver Medical Examination Results Form, MCSA-5850, via the ME's 
individual password-protected National Registry web account.

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    For applicants/holders of CLP/CDLs (interstate and intrastate), 
FMCSA will electronically transmit from the National Registry system to 
the SDLAs driver identification, examination results, and restriction 
information for examinations performed in accordance with the FMCSRs 
(49 CFR 391.41-391.49), as well as information about any examinations 
reported by the MEs that are performed in accordance with applicable 
State variances. This includes examination results that have been 
voided by FMCSA because the Agency finds that an ME has certified a 
driver who does not meet the interstate physical certification 
standards.
    The Agency will also transmit medical variance information \1\ for 
all CMV drivers electronically to the SDLAs. Transmission of this 
information will allow authorized State and Federal enforcement 
officials to view the most current and accurate information regarding 
the medical status of the CMV driver, all information on the MEC, any 
medical variance information (if applicable), and the issued and 
expiration date.
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    \1\ When medical variance information is referenced in this 
document it means exemptions, skills performance evaluation 
certificates and grandfathered exemptions issued by FMCSA.
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B. Benefits and Costs

    The estimated cost of the final rule is not expected to exceed the 
$100 million annual threshold for economic significance. The 
modifications to the National Registry system and Commercial Driver's 
License Information System (CDLIS) that will allow the Agency to 
electronically transmit driver identification, examination results, and 
medical variance information from the National Registry system to the 
SDLAs, have been estimated to be a one-time rounded cost of 
$12,000,000.

                       Summary of Quantified Costs
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SDLA....................................................     $10,000,000
AAMVA...................................................       1,000,000
FMCSA...................................................       1,000,000
                                                         ---------------
    Total Costs (rounded)...............................      12,000,000
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    The implementation of this rule will result in changes to the 
annual paperwork burden hours and costs for the Medical Qualification 
Requirements and the Commercial Driver Licensing and Testing Standards 
information collections (ICs). As a result, the motor carriers, 
drivers, MEs, and SDLAs affected will benefit from a decrease in annual 
burden hours and economic expenditures. The estimated cost savings are 
$10.16 million annually.
    The potential estimated benefits are detailed in the table below. 
The revised Office of Management and Budget (OMB) control numbers 2126-
0006 and 2126-0011 Supporting Statements detail all revisions 
associated with the reduced annual paperwork burden hours.

                     Summary of Quantified Benefits
                        [in millions of dollars]
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Motor carriers no longer verify ME National Registry number....    $4.78
MEs no longer handwrite MECs for CLP/CDL applicants/holders....     2.87
CLP/CDL applicants/holders no longer provide MEC to SDLA.......     1.05
SDLAs no longer manually record MEC information................     1.46
                                                                --------
    Total Benefits.............................................    10.16
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III. Abbreviations

AAMVA American Association of Motor Vehicle Administrators
AAMVAnet American Association of Motor Vehicle Administrators Network
Advocates Advocates for Highway and Auto Safety
ATA American Trucking Associations
CAA Clean Air Act
CE Categorical Exclusion
CDL Commercial Driver's License
CDLIS Commercial Driver's License Information System
CLP Commercial Leaner's Permit
CMV Commercial Motor Vehicle
DOT U.S. Department of Transportation
DQ Driver Qualification
FMCSA Federal Motor Carrier Safety Administration
FMCSRs Federal Motor Carrier Safety Regulations
IC Information Collection
ICC Interstate Commerce Commission
MAP-21 Moving Ahead for Progress in the 21st Century Act
ME Certified Medical Examiner
MEC Medical Examiner's Certificate
MER Medical Examination Report
MVR Motor Vehicle Record
NPRM Notice of Proposed Rulemaking
OMB Office of Management and Budget
PIA Privacy Impact Assessment
PII Personally Identifiable Information
PRA Paper Reduction Act
RFA Regulatory Flexibility Act
SAFETEA-LU Safe, Accountable, Flexible, Efficient Transportation Equity 
Act: A Legacy for Users
SDLA State Driver Licensing Agencies
SPE Skill Performance Evaluation

IV. Legal Basis for the Rulemaking

    The purpose of this final rule is to modify the requirements 
adopted in two earlier final rules issued by FMCSA, 73 FR 73096 (Dec. 
1, 2008) and 77 FR 24104 (April 20, 2012), so that the information from 
the MEC transmitted to FMCSA after the examination by MEs for drivers 
required to have a CDL is promptly and accurately transmitted to the 
SDLAs for entry into the appropriate driver record. In view of this 
purpose, the legal bases of the two previous final rules also serve as 
the legal basis for this final rule. The primary legal basis for the 
2008 final rule, Medical Certification Requirements as Part of the 
Commercial Driver's License, is section 215 of Motor Carrier Safety 
Improvement Act [Pub. L. 106-159, 113 Stat. 1767 (Dec. 9, 1999)] (set 
out as a note to 49 U.S.C. 31305). The primary legal basis for the 2012 
final rule, National Registry of Certified Medical Examiners (National 
Registry), is 49 U.S.C. 31149, enacted by section 4116(a) of the Safe, 
Accountable, Flexible, Efficient Transportation Equity Act: A Legacy 
for Users, Public Law 109-59, 119 Stat. 1726 (Aug. 10, 2005) (SAFETEA-
LU). Detailed discussions of the legal basis for the 2008 and 2012 
final rules appear in their preambles, at 73 FR 73096-73097 and 77 FR 
24105-24106, respectively.

A. Authority Over Drivers Affected

1. Drivers Required To Obtain an MEC
    FMCSA is required by statute to establish standards for the 
physical qualifications of drivers who operate CMVs in interstate 
commerce [49 U.S.C. 31136(a)(3) and 31502(b)]. FMCSA has fulfilled the 
statutory mandate of 49 U.S.C. 31136(a)(3) by establishing physical 
qualification standards for all drivers covered by these provisions [49 
CFR 391.11(b)(4)].\2\ Such drivers must obtain from an ME a 
certification stating that the driver is physically qualified [49 CFR 
391.41(a), 391.43(g) and (h)]. FMCSA is also required by statute to 
ensure that the operation of a CMV does not have a deleterious effect 
on the physical condition of the drivers [49 U.S.C. 31136(a)(4)].
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    \2\ There are a few limited exceptions of drivers in 49 CFR 
390.3(f) and 391.2.
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    Sec. 32911 of the Moving Ahead for Progress in the 21st Century Act 
(MAP-21) (Pub. L. 112-141, 126 Stat. 405, July 6, 2012) added an 
additional requirement to ensure that ``an operator of a CMV is not 
coerced by a motor carrier, shipper, receiver, or transportation 
intermediary to operate a CMV in violation of a regulation

[[Page 22792]]

promulgated under this section, or chapter 51 or chapter 313 of this 
title'' [49 U.S.C. 31136(a)(5)]. See the discussion below. FMCSA is 
also required to consider, to the extent practicable and consistent 
with the purposes of the statute, costs and benefits of the rule. 49 
U.S.C. 31136(c)(2)(A).
2. Drivers Required To Obtain a CDL
    The authority for FMCSA to require an operator of a CMV to obtain a 
CDL rests on the authority found in 49 U.S.C. 31302.

B. Authority To Regulate State CDL Programs

    FMCSA, in accordance with 49 U.S.C. 31311 and 31314, has authority 
to prescribe procedures and requirements for the States to observe in 
order to issue CDLs [see, generally, 49 CFR part 384]. In particular, 
under section 31314, in order to avoid loss of funds apportioned from 
the Highway Trust Fund, each State shall comply with the requirement 
that the State shall adopt and carry out a program for testing and 
ensuring the fitness of individuals to operate commercial motor 
vehicles consistent with the minimum standards prescribed by FMCSA 
under section 31305(a) of Title 49 U.S.C. 49 U.S.C. 31311(a)(1). See 
also 49 CFR 384.201.

C. Authority To Require Reporting by MEs

    FMCSA has authority under 49 U.S.C. 31133(a)(8) and 31149(c)(1)(E) 
to require MEs on the National Registry to obtain information from CMV 
drivers regarding their physical health, to record and retain the 
results of the physical examinations of CMV drivers and to require 
frequent reporting of the information contained on all of the MECs they 
issue. Section 31133(a)(8) gives the Agency broad administrative powers 
(specifically ``to prescribe recordkeeping and reporting 
requirements'') to assist in ensuring motor carrier safety and driver 
health. [Sen. Report No. 98-424 at 9 (May 2, 1984)]. Section 
31149(c)(1)(E) authorizes a requirement for electronic reporting of 
certain specific information by MEs, including applicant names and 
numerical identifiers as determined by the FMCSA Administrator. Section 
31149(c)(1)(E) sets minimum monthly reporting requirements for MEs and 
does not preclude the exercise by the Agency of its broad authority 
under section 31133(a)(8) to require more frequent and more inclusive 
reports. In addition to the general rulemaking authority in 49 U.S.C. 
31136(a), the Secretary of Transportation is specifically authorized by 
section 31149(e) to ``issue such regulations as may be necessary to 
carry out this section.''
    Authority to implement these various statutory provisions has been 
delegated to the Administrator of FMCSA [49 CFR 1.87(f)].

V. Background

    On May 10, 2013, FMCSA published the Medical Examiner's 
Certification Integration notice of proposed rulemaking (NPRM) (78 FR 
27343). The public comment period for the NPRM closed on July 9, 2013. 
This final rule, as stated in the Legal Basis section, is a follow-on 
rule to both the Medical Certification Requirements as Part of the CDL 
rule (Med-Cert) final rule published on December 1, 2008 (73 FR 73096) 
and the National Registry of Certified Medical Examiners (National 
Registry) final rule published on April 20, 2012 (77 FR 2410). It is 
the third rule of an initiative to improve the driver qualification and 
medical examiner's certification process.

A. Medical Certification Requirements as Part of the CDL

    FMCSA's 2008 Med-Cert final rule, [73 FR 73096 (Dec. 1, 2008)] 
adopted a number of regulatory provisions designed to incorporate 
information from the MEC into CDLIS. Subsequent actions of the Agency 
modified some of the provisions adopted in the 2008 final rule [see 
Med-Cert; Technical, Organizational, and Conforming Amendments, 75 FR 
28499 (May 21, 2010)]. Most of the requirements established by these 
actions took effect on January 30, 2012. But some requirements 
affecting CDL holders and their employers did not take effect until 
January 30, 2015.
    In addition, FMCSA established new uniform requirements for CLPs in 
the final rule published May 9, 2011, Commercial Driver's License 
Testing and Commercial Learner's Permit Standards [76 FR 26854]. As a 
result, the medical certification requirements of the 2008 final rule 
will apply to applicants and holders of CLPs beginning on July 8, 2015 
[78 FR 17875, 17882 (Mar. 25, 2013), amending 49 CFR 384.301(f)]. As 
modified by these actions, the essential elements of these CLP/CDL 
medical certification provisions for each of the affected groups are 
summarized below:
1. SDLAs
    The Med-Cert rule mainly requires the States to modify their CDL 
procedures to: (1) Record a CLP/CDL applicant's/holder's self-
certification regarding type of driving (e.g., interstate (non-excepted 
or excepted) and intrastate (non-excepted or excepted) on the CDLIS 
driver record); (2) require submission of the original or copy of the 
MEC from a driver operating in non-excepted, interstate commerce who is 
required by 49 CFR part 391 to be medically certified; (3) post the 
required information from the certificate or a copy onto the CDLIS 
driver record within 10 calendar days; (4) update the medical 
certification status of the CDLIS driver record to show the driver as 
``not-certified'' if the certification expires; and (5) downgrade the 
CLP/CDL within 60 days of the expiration of the driver's MEC. There are 
also requirements for posting certain information about any medical 
variances issued to the driver on the CDLIS driver record.
    If the driver certifies that he or she expects to drive in 
interstate commerce and is not driving exclusively for one of the 
industries excepted from the requirements of 49 CFR part 391, the Med-
Cert rule requires the State to post the driver's information, within 
10 calendar days on the CDLIS driver record. In addition to the 
recordkeeping requirements, the SDLA must make the driver's medical 
certification status information electronically accessible to 
authorized State and Federal enforcement officials and to drivers and 
employers via CDLIS motor vehicle records (MVRs).
    Today's final rule provides a cost-effective tool to support the 
States in implementing the Med-Cert rule and reduce to the greatest 
extent possible the need for State personnel to spend time manually 
entering information from paper copies of the medical certificates. The 
rule also helps ensure that the medical certificates being uploaded are 
valid.
2. Motor Carriers and Employers
    Motor carriers who employ a CDL holder subject to the physical 
qualifications requirements under 49 CFR part 391 must place the 
driver's current CDLIS MVR documenting the driver's medical 
certification status in the driver's qualification (DQ) file before 
allowing the driver to operate a CMV. The MEC that the driver provided 
to the SDLA may be used for this purpose for up to 15 days from the 
date the certificate was issued by the ME. The CDLIS MVR will be used 
to verify the driver has the necessary medical certification and the 
results placed in the DQ file.
3. Drivers.
    All interstate CDL holders subject to the physical qualifications 
standards of

[[Page 22793]]

49 CFR part 391 must meet the following requirements:
     All drivers applying for an initial, renewal, upgrade or 
transfer of a CDL must provide the MEC to the SDLA, and update that 
information whenever a new certificate is issued.
     All existing CDL holders who do not have a renewal, 
upgrade or transfer issuance must still provide the MEC to the SDLA. 
They must update that information with the SDLA whenever a new 
certificate is issued.
     Beginning on January 30, 2015, these drivers no longer 
have to use the MEC as proof of their medical certification to 
enforcement personnel or employers, except for the first 15 days after 
issuance.
     Beginning on January 30, 2015, these drivers are no longer 
required to carry the actual MEC after the first 15 days after 
issuance, but must continue to carry any Skills Performance Evaluation 
(SPE) certificate or medical exemption document while on duty.
     Beginning on July 8, 2015, the above requirements will 
also apply to CLP holders.
    Non-CDL/CLP holders subject to the physical qualifications 
standards of 49 CFR part 391 will continue to be required to carry the 
original or a copy of the MEC and any SPE certificate or medical 
exemption document while on duty.

B. National Registry of Certified MEs

    In 2012, FMCSA issued a final rule establishing the National 
Registry [77 FR 24104 (Apr. 20, 2012)]. This rule established training 
and testing requirements for medical professionals who conduct the 
medical certification examinations of interstate CMV drivers. The 
compliance date for the National Registry final rule was May 21, 2014. 
Therefore, as to medical certifications issued on or after that date, 
the Agency considers valid only those MECs that were issued by MEs 
listed on the National Registry on the date of issuance. MECs that were 
issued prior to the May 21, 2014 compliance date, however, are 
considered valid until the MECs expiration date provided by the ME.
    The MEs who conduct medical examinations of CMV drivers must retain 
copies of the MER Forms of all drivers they examine and certify. The 
MER Form lists the specific results of the various medical tests and 
assessments used to determine if a driver meets the physical 
qualification standards set forth in 49 CFR part 391, subpart E.
    One of the administrative requirements for being listed on the 
National Registry is for the ME to submit a CMV Driver Medical 
Examination Results Form, MCSA-5850, to FMCSA for each physical 
examination conducted on both CLP/CDL and non-CDL holders. MEs are 
required to submit this information monthly. The CMV Driver Medical 
Examination Results Form, MCSA-5850, has undergone minor editorial 
changes to be more user friendly and includes most of the information 
on the MEC.

C. MER

    The current version of the MER Form and the instructions and 
requirements for its use have evolved over a number of years. In 2000, 
FMCSA issued a final rule adopting significant revisions to the 
instructions and MER Form, much as they appear today in 49 CFR 
391.43(f). The purpose of the revisions was to organize the form to: 
``(1) Gain simplicity and efficiency; (2) reflect current medical 
terminology and examination components; and (3) be a self-contained 
document. . . .'' [Physical Qualification of Drivers; Medical 
Examination; Certificate, 65 FR 59363 (Oct. 5, 2000)]. The MER Form 
also included a number of advisory criteria providing Agency guidelines 
to assist MEs in assessing a driver's physical qualifications. FMCSA 
noted that ``These guidelines are strictly advisory and were 
established after consultation with physicians, States and industry 
representatives.'' (65 FR 59364).
    Since the 2000 revisions, the MER Form and the instructions have 
been revised only to reflect changes in the advisory guidelines 
relating to hypertension and standards for the use of Schedule I drugs 
[Motor Carrier Safety Regulations; Miscellaneous Technical Amendments, 
68 FR 56199 (Sep. 30, 2003) and Harmonizing Schedule I Drug 
Requirements, 77 FR 4479 (Jan. 30, 2012) and 77 FR 10391 (Feb. 22, 
2012)].

VI. Discussion of Comments Received on the Proposed Rule

A. Overview of Comments

    In response to the May 2013 NPRM, FMCSA received 67 comments. The 
majority of the commenters were State agencies (from Alabama, 
California, Colorado, Delaware, Georgia, Illinois, Kentucky, Maryland, 
Missouri, Montana, Nebraska, New York, Ohio, Oregon, Utah, Virginia, 
and Wisconsin) and individuals, many of whom identified themselves as 
healthcare professionals. Among other commenters were the following: 
Five healthcare provider professional associations including the 
American Academy of Physician Assistants (AAPA) and the American 
College of Occupational and Environmental Medicine (ACOEM); four 
trucking/industry associations including the American Association of 
Motor Vehicle Administrators (AAMVA) and the American Trucking 
Associations, Inc. (ATA); seven motor carriers including Landstar 
Transportation Logistics, Inc.; Schneider National, Inc.; the County of 
Los Angeles, CA; Concentra Health Services jointly with U.S. 
HealthWorks Medical Group; and Advocates for Highway and Auto Safety 
(Advocates).
    The first area of comment involved the proposal for electronic 
transmission of CMV drivers' MEC information to the SDLAs, and related 
issues. The second involved the proposed revisions and handling of the 
MER Form, MCSA-5875 and, to a lesser extent, the minor changes to the 
MEC, Form MCSA-5876. A third area of comment involved provisions that 
would invalidate a driver's current MEC when the driver fails a new 
physical examination. Lastly, a number of commenters raised issues that 
were beyond the scope of the proposals in the NPRM. These comments will 
be briefly summarized with an explanation as to why the issues raised 
are not within the scope of this proceeding.
    Although no commenters explicitly expressed support for the 
proposed rule in its entirety, 17 were in support of various provisions 
of the rule. Five commenters explicitly opposed the proposed rule. 
Twenty-nine commenters provided recommendations, voiced concerns, or 
were opposed to specific parts of the proposed rule, such as 
identification of the system that will be used for the electronic 
transmission of MEC data to the SDLAs, transmission of data for all CMV 
drivers not just CLP/CDL applicants/holders, transmission of data for 
those drivers operating in intrastate commerce, daily reporting 
requirements for MEs, and new form requirements. Nine commenters 
expressed serious concerns over specific requirements that they believe 
would be detrimental to stakeholders, such as increased costs, creating 
potential shortages of certified MEs, prohibiting drivers from carrying 
their MEC as a means of proving their medical qualification, and the 
implementation date for SDLAs. Seven others commented on issues that 
are outside the scope of this rulemaking.
    The following sections provide details regarding specific issues 
raised by the commenters.

[[Page 22794]]

B. Electronic Transmission and Access to MEC Information

1. System To Be Used for Data Transfer
    FMCSA proposed to electronically transmit driver identification, 
examination results, and restriction information from the National 
Registry system to the SDLAs for CLP/CDL applicants/holders. Many 
commenters were concerned that the system FMCSA plans to use to 
transfer the MEC information electronically to the SDLAs was not 
identified. AAMVA, many States, and other commenters suggested FMCSA 
consider using the existing CDLIS platform because it is a proven, 
secure system that on a daily basis successfully moves large amounts of 
data between States. It is their opinion that it would be easier to 
create a new message type in CDLIS that allows the MEC information to 
be transmitted than it would be to develop a new system, and would not 
require manual entry of data. They recommended that all fields have 
defined formats/standards and, if standards already exist in CDLIS and 
are included in the CDLIS MVR that is available to carriers and 
drivers, FMCSA use those. Many of these commenters stated that without 
the system being identified, there was not enough information to make a 
full assessment of the technical and cost impact. Some commenters were 
also concerned about how information would be made available to 
employers, drivers and other users, such as enforcement personnel. The 
ATA suggested that FMCSA design the system so that, if a State 
consents, MEs can simultaneously and instantaneously report results to 
both the National Registry and the driver's MVR in CDLIS and other 
relevant systems.
    There were also comments addressing the length of time that the 
SDLAs would have to update the records, ranging from real time updates 
to three days or longer. Werner Enterprises, Inc. expressed concern for 
how the proposed system would work on a practical level and suggested 
that the timeframe for FMCSA to transmit the MEC information to the 
SDLA be mandated as the next day.
FMCSA Response
    Although the Agency had long recognized the benefits of using the 
CDLIS platform, the Agency did not discuss this plan in the preamble to 
the NPRM. The intent of the rulemaking was not to specify the platform, 
but to explain that the Agency made a preliminary determination that it 
was feasible to collect MEC information from MEs on a daily basis, and 
that the more frequent submission of the examination results would 
facilitate the timely transmission of information to the SDLAs. The 
Agency now agrees that CDLIS is the appropriate and most cost-effective 
means of implementing the requirements of this final rule, as many of 
the commenters urged. When it is implemented, FMCSA will receive and 
process the MEC information from the MEs, and then the data for CDL 
drivers will be electronically transmitted through the AAMVAnet 
communications system to the SDLAs. Once received, the SDLAs will be 
able to automatically populate the individual CDLIS driver records with 
the MEC information. The fields for this information have already been 
created and established in the CDLIS record as a result of the 
implementation of the 2008 Med-Cert final rule. The development of this 
electronic transfer of MEC information from the National Registry 
through the AAMVAnet communications system to the CDLIS driver records 
will be a joint effort of FMCSA, AAMVA and the SDLAs.
    While there will be one-time costs incurred by the SDLAs to 
implement this secure transmission of MEC information, SDLAs should see 
a reduction in staff time and costs in the elimination of manual input 
of this MEC information over time.
2. Transmission of MEC Information for CLP/CDL Applicants/Holders Only
    For applicants/holders of CLP/CDLs, FMCSA proposed to transmit 
driver identification, examination results, and restriction information 
electronically from the National Registry system to the SDLAs. Many 
commenters were opposed the continued use of paper MECs for non-CLP/CDL 
applicants/holders. Several commenters believe FMCSA should require the 
posting of the MEC for non-CLP/CDL applicants/holders to a database 
similar to CDLIS. For example, the ATA suggested that FMCSA examine the 
benefits of requiring SDLAs to furnish MEC information to all CMV 
drivers, including those who require medical certification but do not 
require a CDL.
    The American College of Occupational and Environmental Medicine 
(ACOEM) indicated that placing the responsibility on the ME to keep 
track of whether they are required to submit the results of the 
examination (CLP/CDL applicants/holders) or issue a paper MEC (those 
who require the MEC but do not require a CDL) could be confusing, 
especially for the intrastate CLP/CDL holders. They also stated that 
the proposed rule extends the burden on the MEs with more frequent 
submissions and tracking of different requirements for inter/intrastate 
or CLP/CDL/non-CLP/CDL holders, not to mention the excepted or non-
excepted drivers.
    Oregon's Driver and Motor Vehicle Services expressed a similar 
concern that errors occurring in the transmission of the information to 
the National Registry will result in inaccuracies that will prevent the 
National Registry from transmitting the data successfully to the 
correct State. They suggested that a process be added for States to 
access the National Registry through a password-protected web account 
to locate the MEC for a particular driver. They stated that the ability 
to pull the MEC information could resolve the concerns for those States 
with statutes that require an MEC. They also suggested, as an 
alternative, that the National Registry provide a ``help desk'' 
function that would receive requests for MECs, search for a driver, and 
mark the record so the system can transmit the MEC information to a 
particular State.
FMCSA Response
    FMCSA generally agrees with the suggestions. However, there are 
practical technical and statutory limitations that shaped the direction 
of the Agency's proposal.
    FMCSA will electronically transmit MEC information from the 
National Registry to the SDLAs only for CLP/CDL applicants/holders 
because there is currently no IT system platform comparable to CDLIS 
for non-CLP/CDL applicants/holders, and the Agency does not have 
statutory authority to impose requirements on SDLAs concerning 
licensing of non-CLP/CDL applicants/holders. The 1986 legislation 
concerning the Federal CDL program does not provide the Agency with 
authority to cover non-CDL issues. Therefore, the Agency has no 
alternative but to focus on the electronic exchange of information 
between the National Registry and the SDLAs and retain requirements for 
paper MECs for non-CLP/CDL applicants/holders.
    While some commenters expressed concern about placing a burden on 
MEs by having two different methods of processing MEC information for 
CLP/CDL applicants/holders versus non-CLP/CDL applicants/holders, FMCSA 
does not believe there is a burden on MEs. MEs need only focus on 
accurately documenting the results of the examination completely and 
accurately by completing the CMV Driver Medical Examination Results 
Form, MCSA-5850, via their individual password-protected National 
Registry account, following every examination. As long as

[[Page 22795]]

the information is complete and accurate, the FMCSA will take full 
responsibility for the electronic transmission of the MEC information 
to the SDLAs. Nothing in this rulemaking prohibits MEs from providing 
each driver with a copy of the MEC at the completion of the 
examination, so all drivers could carry a copy with them if the driver 
believes it is necessary. Drivers whose MEC information was transmitted 
electronically will have the added benefit of no longer being required 
to present proof directly to the SDLA. But the only official record of 
the CDL driver's physical qualifications will be the CDLIS driver 
record.
    FMCSA acknowledges that there will be situations where the SDLA may 
need to pull MEC information from the National Registry for a driver, 
as indicated by the comments from Oregon's Driver and Motor Vehicle 
Services. The FMCSA is committed to putting into place a push-pull 
system for transmission of information between the National Registry 
and the SDLAs. Under this system the information could be loaded 
automatically onto drivers' records, but the SDLAs could also query the 
National Registry and pull or download the MEC information for drivers 
who had not yet obtained their CLP/CDL at the time of the medical 
examination.
3. Daily Submission of CMV Driver Medical Examination Results Form, 
MCSA-5850
    FMCSA proposed that MEs be required to report results of all 
completed commercial drivers' physical examinations, including the 
results of examinations where the driver was found not to be physically 
qualified, to the National Registry system by close of business (COB) 
on the day of the examination.
    Many commenters were opposed to the daily submission of the CMV 
Driver Medical Examination Results Form, MCSA-5850 because they believe 
that daily submission will place administrative and cost burdens on MEs 
and the medical practice that may result in fewer MEs willing to become 
certified. Some commenters believed that additional resources, 
technology, and staff may be required to meet this proposed 
requirement. Several commenters suggested that FMCSA allow 
significantly more time to report results and allow various methods of 
submission and a reduction in reporting requirements.
    Southern Company believes that COB reporting is unrealistic and 
stated in detail how their MEs have estimated that the new requirements 
would increase their administrative costs by 20-25% per physical. 
Schneider National, Inc. would like FMCSA to reconsider the extent to 
which the cost of exams would increase with the daily reporting 
requirement. It asserts that the cost of this increase will be more 
than the $18.00 assumption used for additional administrative worker 
time.
    The Owner Operated Independent Drivers Association (OOIDA) asks the 
Agency to take into account certain factors that will increase the 
costs of the medical certification process to drivers: The costs 
associated with there being fewer MEs under the new system due to daily 
reporting requirements and the increased costs of those MEs being 
passed on to the driver.
    Werner Enterprises stated that they were concerned by the lack of a 
clearly defined deadline for FMCSA to deliver the information to the 
SDLA. They suggested it be defined as the next business day. ATA 
supports daily reporting, but suggested time zone considerations be 
made for downloads and batch submissions. Several commenters requested 
that FMCSA provide a means to allow the data to be automatically 
uploaded from a computer, stating that this would significantly improve 
their ability to meet the requirements and support FMCSA, the drivers, 
and the States.
    On the other hand, AAMVA and its membership (some of whom commented 
separately) stated that it is imperative for the SDLA to receive the 
MEC information by no later than COB on the day of the exam. They 
stated that without this requirement, roadside inspectors would not be 
able to verify that a driver is medically certified and there would be 
a tremendous impact on the ability of the SDLA to make an informed and 
accurate determination on the medical status of their commercial 
driving constituency.
    Many recommendations were made for modifying the reporting 
timeline, such as separate submission deadlines for those that are not 
qualified versus those that are qualified, a phase-in approach for all 
qualification statuses, and submission deadlines based on length of 
certification. One commenter, Southern Company, suggested that the 
current medical certification reporting process of the ME sending the 
MEC information to the SDLA be retained for efficiency purposes.
FMCSA Response
    After careful consideration of the comments received on this issue, 
the Agency has modified the proposed daily reporting requirement. In 
this final rule, MEs will be required to report results of all CMV 
drivers' physical examinations performed, including the results of 
examinations where the driver was found not to be physically qualified, 
to FMCSA by midnight (local time) of the next calendar day following 
the examination, instead of the proposed same-day reporting 
requirement. FMCSA disagrees with commenters who claim that the 
requirement to report exam results more quickly will increase the cost 
of that task. This requirement will not increase the time needed to 
transmit the form. MEs are encouraged to allow drivers to review the 
information that will be transmitted to FMCSA so as to reduce data 
errors and to ensure that, for CLP/CDL applicants/holders, the 
information is promptly and accurately recorded on the driver record.
    The current process requires the ME to provide the MEC to the CLP/
CDL applicant/holder, who in turn must provide the information to the 
SDLA, a requirement that was adopted in 2008 and which became fully 
implemented on January 30, 2015. 79 FR 2377 (Jan. 14, 2014). The 
purpose of this final rule is to replace that procedure with a 
procedure for electronic transmission of the MEC information from the 
MEs to FMCSA and then from FMCSA to the SDLAs. FMCSA will develop its 
systems so that, when fully implemented in three years, they will 
ensure prompt transmission of the MEC information from FMCSA to the 
SDLAs for CLP/CDL applicants/holders. This should greatly improve the 
timeliness and accuracy of the CDLIS driver record. Even though the 
information for non-CDL holders will be reported to the National 
Registry, such drivers still need to be issued a paper MEC, Form MCSA-
5876 by the ME if the driver is physically qualified. Contrary to 
Southern Company's comment, there is no national system for MEs to send 
MEC information to the SDLA.
    Finally, FMCSA believes that concerns about the number of MEs 
listed on the National Registry are no longer warranted. As of January 
5, 2015, there were more than 39,160 certified healthcare professionals 
on the National Registry, and the Agency had received the results 
concerning more than 2.8 million physical examinations conducted 
between May 21, 2014 and December 31, 2014.
4. Carrier To Obtain MEC as Part of MVR From SDLA
    FMCSA proposed retaining the requirements for motor carriers to 
obtain the CLP/CDL holders' medical information as part of the CDLIS 
MVR from the SDLA originally imposed

[[Page 22796]]

through the 2008 Med-Cert final rule. Barton Solvents, Inc. pointed out 
that they currently request MVRs twice a year and review all drivers' 
records during those two periods. They stated that the proposed rule 
would break up the requests such that MVRs would be requested 
individually after the examination and annually thereafter and that the 
administration of this change will require several more hours of staff 
time for tracking and making the requests. They requested that FMCSA 
consider removing the proposed requirement for employers to obtain the 
MVR and have it placed into the driver qualification (DQ) file within 
15 days, and return to the current requirement of an annual review. On 
the other hand, ATA fully supports FMCSA's proposed decision to allow 
motor carriers to use a driver's MVR containing medical qualification 
information to demonstrate compliance with the motor carrier's driver 
medical qualification monitoring requirement. Wisconsin's Department of 
Transportation recommended that the system allow the physician to print 
results of the exam and to email or eFax results to the driver. They 
questioned how the doctor would be notifying the driver that she/he has 
failed, how the driver/employer knows what that means, and if FMCSA is 
planning on notifying drivers when their medical certification is due 
to expire and/or expires.
FMCSA Response
    FMCSA understands the concerns underlying Barton Solvents' request 
to modify the current requirement so that the MVR only be obtained and 
placed in the DQ file once a year at a time determined by the employer. 
But the current requirement under 49 CFR 391.25(a) was established 
because the MEC or medical variance provided by the driver may expire 
before a new MVR is obtained if it is only requested once a year. This 
would leave the employer without proof for the DQ file to verify the 
medical qualification of the driver. The employer's business practices 
need to be modified so that the MVR is obtained by the employer each 
time a new physical examination is taken and at least annually between 
examinations to be in compliance with the driver qualification 
requirements in 49 CFR 391.11(b)(4) and 391.41(a).
    In response to Wisconsin's comments, the driver can request and 
receive any additional information and documents (including copies of 
the MER and the MEC). But the official record of the driver's 
qualifications (for CLP/CDL applicants/holders) will be the information 
transmitted to FMCSA by the ME and then transmitted by FMCSA to the 
SDLA for entry on the driver record. Non-CDL holders, of course, will 
still have to be provided a signed copy of the MEC in accordance with 
49 CFR 391.43. Finally, it is the driver's responsibility to ensure 
that, if required to have a valid MEC, they obtain a new one before the 
previous one expires. FMCSA will not be providing any notice to drivers 
about upcoming expiration dates. A CLP/CDL holder who allows the MEC to 
expire without obtaining a new one will, in due course, be notified by 
the SDLA that the CLP/CDL will be downgraded.
5. Carrying a Paper MEC While on Duty
    FMCSA proposed that CLP/CDL holders would no longer be required to 
carry a valid MEC while on duty operating a CMV, even during the first 
15 days after it is issued because the MEC information would be 
electronically transmitted from the ME to the National Registry system 
by close of business on the day of the examination. FMCSA would then 
promptly transmit the information from the National Registry system to 
the SDLAs electronically for entry into the appropriate CDLIS driver 
record. The MEC information would be posted to the driver's record, by 
the SDLA, within one business day of receiving the information from 
FMCSA.
    Several commenters were opposed to CLP/CDL holders no longer being 
allowed or required to carry a paper MEC. They suggested we use the 
language ``no longer required'' instead of ``not permitted.''
    Some commenters were concerned about the effect of the length of 
time it might take for the information to be posted by the SDLAs on the 
CDLIS driver record, and urged that the Agency retain the current 15-
day period during which the paper MEC would be valid. On the other 
hand, ATA supports use of the language ``no longer required to carry 
MEC.'' But it suggested FMCSA design the system to transmit to the 
National Registry and the driver's MVR at the same time.
    Schneider National, Inc. pointed out that the MEC serves as the 
driver's reminder as to when his/her certification expires; without 
this they will need to call the ME, carrier or SLDA and ask when the 
physical expires. They expressed their concern for the administrative 
burden and costs this would cause. Schneider recommended any ``pending 
decision'' be sent to the SLDA as ``not certified,'' then if no action 
is taken, no additional transmission or change of status is needed. If 
the driver resolves the issue and is certified, then upon receipt of 
that status FMCSA would communicate a status of ``certified.'' Other 
commenters suggested we retain the ``temporarily disqualified'' as an 
outcome on the MER Form, MCSA-5875, and New York's Department of Motor 
Vehicles asked that FMCSA clarify the State's responsibility when the 
driver is reported by the ME as ``pending determination.''
FMCSA Response
    FMCSA's intent in promulgating this final rule is to eliminate the 
need for CLP/CDL holders to carry a paper MEC as proof of being 
medically qualified and to reduce fraudulent activity involved in the 
issuance and forging of these documents in a paper format. For CDL 
holders (and later for CLP holders), this requirement was established 
in the Med-Cert final rule, although the requirement to have a paper 
MEC while on duty was extended to January 30, 2015 because a few States 
have not yet implemented the changes necessary to comply with that rule 
[Med-Cert, Extension of Certificate Retention Requirements, 76 FR 70661 
(Nov. 15, 2011); and Med-Cert, Extension of Certificate Retention 
Requirements, 79 FR 2377 (Jan. 14, 2014)]. FMCSA acknowledges that 
giving the ME until midnight (local time) of the next calendar day to 
submit the MCSA-5850 to the National Registry will require extra 
outreach to the drivers to encourage them not to wait until the last 
minute to renew their medical certification. This outreach will be in 
addition to general outreach to and training for drivers, employers and 
law enforcement to become comfortable with this new method of proving 
medical qualification. The electronic record of the driver's medical 
certification will be the only valid evidence that the CLP/CDL holder 
was physically qualified. Therefore, even if the CLP/CDL holder chooses 
to carry a paper MEC, it will not be considered valid evidence of 
medical qualification. As first established by the Med-Cert final rule, 
the purpose of eliminating the paper MEC for CLP/CDL holders is to 
provide current and accurate information and to reduce fraud. Non- CLP/
CDL holders will continue to be required to carry the original, or a 
copy, of the MEC while on duty. All CMV drivers will still be required 
to carry any relevant medical variance documents.
    FMCSA disagrees with Schneider's recommendation to forward any 
pending determination to the SDLAs as not certified. The pending 
determination category represents a situation where the ME needs 
additional

[[Page 22797]]

medical information to determine if a driver is medically qualified. 
When pending determination is selected, the driver may still drive 
until his/her existing MEC expires or the ME makes a qualification 
decision. This information will be submitted and stored only in the 
National Registry system. It will not be transmitted to the SDLAs. In 
addition, it would not be appropriate to forward this information as 
``not certified'' because a determination has not been made. If it was 
forwarded as ``not certified'', the SDLA will be required to enter 
``not certified'' on the driver's CDL and to begin the process of 
downgrading. If the disposition of the pending determination is not 
updated by the ME before the 45 day expiration date, FMCSA will notify 
the ME and the driver in writing that the examination is no longer 
valid and that the driver is required to be re-examined. FMCSA will 
retain the incomplete examination information in the National Registry 
System. If the driver is not medically qualified at the time of the 
exam, ``not qualified'' should be selected by the ME. This will apply 
at all times when a driver is not medically qualified including when a 
driver has a temporary and/or treatable disqualifying condition that 
may later be resolved enabling the driver to again be medically 
qualified or when a driver has not completed the recommended waiting 
period. FMCSA will use this to audit/check for irregularities in 
information transmitted to the National Registry (e.g., two or more 
conflicting certification statuses submitted).
    It should also be pointed out that the CMV Driver Medical 
Examination Results Form, MCSA-5850 clearly states that the results of 
all examinations conducted by the ME, including incomplete and failed 
examinations must be reported to FMCSA. However, the Agency does not 
have the authority to require a driver to complete the physical 
examination by a certified ME. The driver is able to stop the exam at 
any time but all exams, including those that are incomplete will be 
reported by the certified ME to the National Registry.
6. Transmission of MEC Information for Interstate Drivers Only
    FMCSA proposed to transfer MEC information to the SDLAs only for 
those CLP/CDL applicants/holders that are required to be medically 
certified to operate a CMV transporting property or passengers in 
interstate commerce.
    Commenters objected to FMCSA transmitting MEC information for only 
interstate drivers and were concerned that no consideration has been 
given for intrastate drivers that are subject to the FMCSRs. Many, 
including 10 of the 17 States that commented, suggested that FMCSA 
electronically transmit MEC information for all CMV drivers, including 
those that drive exclusively in intrastate commerce. The Colorado 
Department of Revenue/CDL Unit and AAMVA, like many others, requested 
clarification on whether it is the intent of FMCSA to send MEC 
information for interstate CLP/CDL applicants/holders only. They 
strongly objected to the process excluding intrastate drivers and 
stated that this exclusion will require the SDLAs to develop two 
different processes for receiving and entering MEC information. They 
believe that having two separate processes will be confusing to those 
law enforcement agencies that do not deal with CDL issues on a regular 
basis. The Colorado Department of Revenue/CDL Unit pointed out that 
while they understand that FMCSA does not regulate intrastate drivers, 
Motor Carrier Safety Assistance Program (MCSAP) States are required to 
treat intrastate drivers the same as interstate and suggested that 
FMCSA do the same. The Colorado Department of Revenue/CDL Unit also 
requested clarification on the use of the ``intrastate-only flag'' on 
the CMV Driver Medical Examination Results Form, MCSA-5850, 
specifically whether the driver would be certifying to inter or 
intrastate driving, and whether MCSA-5850 forms marked intrastate-only 
would be transmitted from the National Registry to the SDLAs.
    Georgia's Department of Driver Services recommended that FMCSA 
consider designating any driver whose medical certification is sent 
electronically from an ME to the SDLAs be designated by default to be 
self-certified as non-excepted interstate. Georgia's Department of 
Driver Services believes that this designation is logical because any 
driver who obtains a medical certification believes that he or she is 
non-excepted. They stated that each SDLA could impose intrastate-only 
restrictions if such are applicable to a specific driver. Oregon Driver 
and Motor Vehicle Services suggested that FMCSA develop a process that 
includes a way for each State to select which of its drivers should 
have MECs forwarded and have the ability to change that selection if 
necessary, send all MEC information regardless of driving type, or 
develop a way for States to access and retrieve the data directly from 
the National Registry.
    ACOEM suggested that the final rule make it clear that the driver 
is responsible for correctly notifying the ME of the category into 
which the driver falls--interstate/intrastate and excepted/non-
excepted. They stated that placing the responsibility on the ME to keep 
track of whether the ME is required to submit the results of the 
examination (for CDL holders) or to issue an MEC (for those who require 
an MEC but do not require a CDL) could be burdensome and confusing, 
especially as to intrastate CDL holders. In ACOEM's opinion, 
documentation requirements should not fall on the ME. ACOEM also 
suggested that FMCSA develop a process to address situations where a 
driver obtained an MEC prior to applying for a CDL, or where CDL was 
checked on the MER but the driver does not have a CDL. ATA suggested 
that FMCSA educate MEs about the differences between interstate and 
intrastate drivers, as well as those that are required to have a CDL 
and those that do not.
FMCSA Response
    The NPRM proposed that FMCSA would send MEC information to the 
SDLAs only for those CLP/CDL applicants/holders who are required to be 
medically qualified to operate in interstate commerce. In response to 
the States' comments, however, the final rule has been expanded not 
just to include transmittal of MEC information from all examinations 
performed in accordance with the FMCSRs (49 CFR 391.41-49 CFR 391.49), 
but also to allow (but not require) MEs to transmit information about 
examinations performed in accordance with the FMCSRs with any 
applicable State variances. See 49 CFR 391.43(g)(5)(i)(B) below.
    In general, States receiving MCSAP grants are required to adopt and 
apply to intrastate CMV drivers, physical qualification standards that 
are identical to or have the same effect as those applicable to 
interstate CMV drivers, (49 CFR 350.101, 350.105 (definition of 
compatible or compatibility) and 350.201(a)). A majority of States have 
adopted compatible physical qualification standards, and a 
certification that a driver has met those standards would be valid for 
both interstate and intrastate operations. But a minority of States, as 
permitted by the regulations governing MCSAP grants in 49 CFR 
350.341(h)(1) and (2), have variances from the interstate standards 
that are only valid for drivers operating in intrastate commerce.
    Moreover, States that have adopted such variances for intrastate 
drivers have the option of setting up their own registry of MEs 
qualified to apply those standards or to use MEs listed on the

[[Page 22798]]

National Registry who have knowledge of such variances. See 49 CFR 
350.341(h)(3) and the explanation in the National Registry final rule 
at 77 FR at 24109-24110 and 24120. To the extent States with variances 
from the physical qualification standards choose to require 
examinations of intrastate drivers to be conducted by MEs on the 
National Registry, FMCSA is modifying the provisions of proposed 49 CFR 
391.43(g)(5)(i)(B) to allow information about such examinations to be 
reported to the National Registry for transmission to the appropriate 
SDLA.
    The FMCSA cannot take any responsibility for determining whether 
the MEC information for a driver who declares that he or she will 
operate a CMV only in intrastate commerce meets State medical 
qualification requirements. For this reason, FMCSA is modifying all of 
the medical forms to make it clear whether an ME is examining and 
issuing an MEC to a driver under the interstate physical qualification 
standards applicable to all interstate and most intrastate drivers, or 
under a set of standards that also includes applicable State variances 
from the interstate physical qualification standards. Ultimately, after 
the certification information for CLP/CDL holders has been transmitted 
to the SDLAs, it will be the responsibility of those States with 
variances to determine through their own procedures whether the State 
variances have been properly applied for drivers who have self-
certified in accordance with 49 CFR 383.71(b)(1) that they are 
operating intrastate-only and are subject to the State standards.
    As discussed in a previous response, MEs will be receiving training 
and outreach regarding non-CLP/CDL holders who will need a paper copy 
of the MEC, Form MCSA-5876. In regard to MEs having to make a decision 
on who is excepted from the MEC requirements, FMCSA does not believe 
this decision needs to be made by the ME. Anyone taking a physical 
examination will be assumed to be non-excepted and in need of an MEC. 
CMV drivers excepted from the physical qualification requirements will 
not need to obtain an MEC.
7. Transfer of Medical Variance Information
    FMCSA proposed to electronically transmit medical variance 
information for all interstate CMV drivers to the SDLAs.
    Commenters were concerned about the transmission of medical 
variance information for all CMV drivers. The Colorado Department of 
Revenue/CDL Unit and AAMVA requested that FMCSA clarify how the SDLAs 
will receive this information for non-CDL holders and what they would 
be expected to do with the information. The Nebraska Department of 
Motor Vehicles stated that specific transmission requirements should be 
identified and that currently the transmission of medical variance 
information is not always timely. They requested that medical variance 
information be transmitted through the National Driver Registry and 
that it be done by COB on the day of the exam. ATA suggested that FMCSA 
initiate a pilot project to examine whether medical variance 
information can also be transferred from paper certificates carried by 
a driver to electronic transmission. Oregon's Driver and Motor Vehicle 
Services questioned how, without knowing whether a variance might be 
approved, an ME knows whether a patient is physically qualified. They 
suggested instructions be provided for how to proceed when checking 
``qualified . . . only when accompanied by.''
FMCSA Response
    Medical variance information for all CLP/CDL holders will be 
electronically transmitted from the National Registry to the SDLAs. 
FMCSA will input approved exemption information and approved SPE 
certificates. This information will then be promptly transmitted to the 
appropriate SDLA. Because the status of a variance may or may not be 
known at the time of the medical examination, we cannot provide a 
specific timeframe in which the variance information will be 
transmitted to the SLDA. Non-CLP/CDL applicants/holders variance 
information will continue to be electronically transmitted through 
encrypted email to the SDLAs. The SDLAs will use medical variance 
information of non-CLP/CDL applicants/holders for verifying the 
validity of medical variance documents provided by drivers and for 
informational purposes.
    For those CMV drivers who are applying for an exemption or SPE for 
the first time, the medical examination results will be held in the 
National Registry system until the variance is approved. At that time, 
the medical examination results and variance information will be 
promptly transmitted to the appropriate SDLA. Grandfathered exemption 
information will be inputted into the National Registry and promptly 
transmitted to the appropriate SDLA. However, FMCSA and the SDLAs will 
also be able to query the system to retrieve grandfathered exemption 
information. All CMV drivers are required to carry any relevant medical 
variance documents.
    When MEs select the ``qualified . . . only when accompanied by . . 
.'' option on the CMV Driver Medical Examination Results Form, MCSA-
5850; MER Form, MCSA-5875; and/or the MEC, Form MCSA-5876, they are 
certifying that the driver is physically qualified with the specified 
waiver/exemption or SPE. It is up to the driver to obtain the waiver/
exemption or SPE. In this case, the MEC is not valid unless accompanied 
by the waiver/exemption or SPE.
8. Voiding the MEC
    OOIDA pointed out that the NPRM did not elaborate on or provide 
regulatory language for the process of voiding an MEC and questioned 
the lack of detail for the procedures that FMCSA would use to void an 
MEC. OOIDA recommended that in order to protect drivers from having 
their MEC incorrectly voided and careers harmed, no final rule should 
be issued until such a procedure is proposed, the public is given an 
opportunity to comment, and provisions are written into the final rule. 
Schneider National, Inc. commented that FMCSA proposed a new 
requirement that the State must also update the medical status to ``not 
certified'' when the medical certification is voided by FMCSA. 
Schneider National, Inc. requested that this requirement be changed to 
require the State to post on the CDLIS driver record a status of 
``invalid'' rather than ``not certified'' in the cases of an 
invalidated MEC. Schneider National, Inc. also requested more detail on 
the procedures that FMCSA would follow.
FMCSA Response
    As explained in both the National Registry final rule (77 FR at 
24108) and in the NPRM in this rulemaking (78 FR at 27348), under the 
authority granted by 49 U.S.C. 31149(c)(2), FMCSA may void an MEC 
issued to a CMV driver if it finds either that an ME has issued a 
certificate to a driver ``who fails to meet the applicable standards at 
the time of the examination'' or ``that a ME has falsely claimed to 
have completed training in physical and medical examination 
standards.'' FMCSA has implemented this authority on a case-by-case 
basis as appropriate to the circumstances. The Agency has developed 
internal processes for evaluating the validity of certificates in the 
wide variety of possible situations where such review appears to be 
appropriate under the statutory

[[Page 22799]]

standard. This will include review of the data submitted by MEs to the 
National Registry system, as well as complaints, field investigations, 
crash reports and other sources. FMCSA will provide the affected driver 
a notice of the proposed action and an opportunity either to obtain a 
new MEC, if appropriate, or to provide the Agency with any legal or 
factual reasons why a new medical certificate should not be required 
before voiding the MEC. If the decision is made to void the driver's 
certificate, FMCSA will notify the driver. If the driver holds a CLP/
CDL, notification will be electronically transmitted by FMCSA to the 
driver's SDLA through the National Registry, and the SDLA will change 
the CLP/CDL holder's medical status to ``not certified'' within 10 days 
and notify the driver of the action taken.

C. Use of Revised MER Form and MEC

    FMCSA proposed to require certified ME performing physical 
examinations of CMV drivers to use a newly developed MER Form, MCSA-
5875, in place of the current MER Form and to use Form MCSA-5876 for 
the MEC. Both forms will be prescribed for mandatory use.
    While many commenters supported the changes to the MER Form, MCSA-
5875, many also raised a number of different issues related to this 
form. Each of those issues is discussed below. The only comments 
received regarding the revised and prescribed MEC, Form MCSA-5876, were 
suggestions to add a CLP indication and to remove the intrastate-only 
selection. Both issues are discussed below.
Collection of Driver Health Information
    OOIDA stated that NPRM did not attempt either to make a connection 
between the new questions and the driver medical qualification 
requirements or to otherwise justify their adoption into the medical 
certification form. They stated that FMCSA does not have the authority 
to make such changes to the MER without describing its authority to do 
so, and without dealing with the privacy implications of the proposal.
    Several other commenters raised questions about the need and 
relevance of some of the information about the drivers' health history 
requested on the revised MER. ATA expressed its concern about removing 
the instructions from the MER Form, MCSA-5875 without replacing them 
with documentation to distinguish between guidance and regulation and 
that removing the reference to guidance undermines the distinction 
between the two.
    Many other commenters made recommendations for modifying the MER 
Form, MCSA-5875. For example, AAMVA and others suggested we include a 
CLP box in addition to the CDL box on the MER Form, MCSA-5875 for 
clarification purposes and to avoid the possibility of a driver 
applying for a CLP not checking the CDL box and their MEC information 
not being forwarded to the SDLA. The Delaware Division of Motor 
Vehicles and others suggested that we remove the intrastate-only 
option, contending that all MEC information should be submitted to the 
National Registry and sent to the SDLAs.
FMCSA Response
    FMCSA believes its statutory authority for this rulemaking, as 
provided in the legal basis section, is clear. The Agency has ample 
legal authority to adopt recordkeeping requirements needed to implement 
the proposed rule, and it may adopt these ancillary provisions as part 
of the same rulemaking. The Agency does not believe it is necessary to 
articulate the separate statutory authority for each specific change to 
the form.
    FMCSA notes that proposed changes to IC burdens are covered through 
its actions to comply with the Paperwork Reduction Act. To the extent 
that the proposed changes would affect the estimated paperwork burden, 
the Agency discusses those matters and seeks public comment on the 
burden and associated costs of the recordkeeping requirement.
    With regard to privacy of medical information, FMCSA does not 
collect details of drivers' medical history. This information is 
collected to facilitate the completion of a thorough examination by the 
ME and an appropriate assessment whether the driver meets the physical 
qualifications standards. The MEs are responsible for maintaining the 
MER, but they are not required to submit those reports to FMCSA absent 
a request from the Agency or its State partners in association with an 
investigation or audit. FMCSA emphasizes that the driver health history 
questions, including those that have been added, are specifically 
linked to the physical qualification standards set out in 49 CFR 
391.41(b).
    The section for the driver's signature has been revised to read as 
follows in order to emphasize the importance of providing complete and 
accurate responses:

    I certify that the above information is accurate and complete. I 
understand that inaccurate, false or missing information may 
invalidate the examination and my Medical Examiner's Certificate, 
that submission of fraudulent or intentionally false information is 
a violation of 49 CFR 390.35, and that submission of fraudulent or 
intentionally false information may subject me to civil or criminal 
penalties under 49 CFR 390.37 and 49 CFR 386 Appendices A and B.

    The Agency proposed to remove the Instructions for Performing and 
Recording Physical Examinations from 49 CFR 391.43(f), because FMCSA 
recognizes that MEs, who have been licensed, certified, or registered 
in accordance with applicable State laws and regulations to perform 
physical examinations thereby possess the knowledge, skills, and 
abilities to perform physical examinations, and do not need general 
instructions in performing and recording physical examinations. The 
Agency proposed to publish new versions of the instructions in FMCSA 
guidance documents. To eliminate redundant or unnecessary requirements, 
the instructions have been removed from 49 CFR 391.43(f).
    The Agency also proposed to remove the information about the 
driver's role, a listing of physical qualification standards for 
drivers, detailed instructions to the medical examiner, and the medical 
advisory criteria from the newly developed MER Form, MCSA-5875, and to 
publish them in FMCSA guidance documents. Because the majority is 
information that healthcare practitioners must be knowledgeable of in 
order to be licensed, registered or certified by their States to 
perform physical examinations, this material has been removed from the 
newly developed MER Form, MCSA-5875. The Agency recognizes that MEs 
frequently refer to the guidance in the medical advisory criteria when 
determining if a driver meets the physical qualification standards, 
however, is therefore publishing the medical advisory criteria without 
substantive change as an appendix to 49 CFR part 391, instead of in the 
MER Form, MCSA-5875. In addition, brief instructions for completing the 
MER Form, MCSA-5875, are included as part of the revised form.
    For clarification purposes, an entry for CLP has been added with 
the entry for CDL on the CMV Driver Medical Examination Results Form, 
MCSA-5850; MER Form, MCSA-5875; and the MEC, Form MCSA-5876 has been 
changed from a box that reads ``CDL, YES or NO'' to a box that reads 
``CLP/CDL Applicant/Holder, YES or NO.'' These changes should cover all 
possibilities for a person who is

[[Page 22800]]

applying for, or is a holder of, a CLP or CDL, and should eliminate the 
possibility that a driver who is applying for a CLP overlooks checking 
the CDL box, which could result in MEC information not being forwarded 
to the SDLA.
    The intrastate-only option on the CMV Driver Medical Examination 
Results Form, MCSA-5850; MER Form, MCSA-5875; and the MEC, Form MCSA-
5876 has been removed and replaced with two certification options (1) 
driver certified in accordance with the FMCSRs (49 CFR 391.41-391.49) 
and (2) driver certified in accordance with the FMCSRs with any 
applicable State variances (which will only be valid for intrastate 
operations). This has been done in order to implement the Agency's 
decision explained above to facilitate the transmission of driver 
information for both interstate and intrastate operations, while 
clearly differentiating on the relevant documentation which standards 
(interstate or intrastate) are involved.
1. Privacy Act Compliance and Privacy Impact Assessment (PIA)
    OOIDA stated in its comments that the PIA was not published until 
July 2013 and contains no greater discussion concerning the content of 
the revised MER form than does the NPRM. OOIDA commented that the 
proposed expansion of the information about a driver's personal health 
history requested and recorded on a new MER greatly increases the 
opportunity for such personal information to be distributed and used by 
those without an interest in safety and for purposes other than driver 
safety. OOIDA stated that the NPRM described the Privacy Act 
requirements as not applicable to the MER because the proposed rule 
does not require the government's collection of personally identifiable 
information (PII). OOIDA explained that this is not exactly true 
because this rule greatly expands the amount of information that the 
government collects or otherwise has access to under existing rules, 
and that by changing the universe of MER information used by other 
rules, any privacy analysis performed when those rules were promulgated 
would be out-of-date under the proposed rule. OOIDA stated that FMCSA 
must now examine, under the Privacy Act, each of its rules that permit 
or require the government to obtain and review the new MERs. It asked 
if the answers to these questions will be stored and have some impact 
on the driver in the future.
FMCSA Response
    There has been and will be adequate opportunity for public 
awareness of, and in some respects for public comment on, the privacy 
interests affected by this final rule. The Agency, in conjunction with 
the Department's Chief Information Office, has prepared and made 
available a PIA.\3\ The PIA is prepared in accordance with Section 
522(a)(5) of the Fiscal Year 2005 Omnibus Appropriations Act, Pub. L. 
108-447, 118 Stat. 3268 (Dec. 8, 2004).\4\ The PIA provides a detailed 
explanation of the privacy interests involved in the entire National 
Registry program. It sets out the careful and thorough steps FMCSA and 
the Department have taken and will take to protect those interests, 
while at the same time carrying out the statutory directives to ensure 
that CMV drivers are physically qualified and can operate safely and 
that operation of a CMV does not have a deleterious effect on their 
health.\5\
---------------------------------------------------------------------------

    \3\ Available at http://www.regulations.gov/#!documentDetail;D=FMCSA-2012-0178-0039.
    \4\ Set out as a note to 5 U.S.C. 552a, the Privacy Act, 5 
U.S.C. 552a.
    \5\ 49 U.S.C. 31136(a)(3) and (4).
---------------------------------------------------------------------------

    However, because of the unexpected delays in making the PIA 
available in the rulemaking docket in support of the NPRM, FMCSA 
published a Notice of Availability advising interested members of the 
public that there was an additional, limited opportunity for comment on 
the privacy issues involved in the proposed rules until June 11, 2014. 
79 FR 30062 (May 27, 2014).\6\
---------------------------------------------------------------------------

    \6\ http://www.regulations.gov/#!documentDetail;D=FMCSA-2012-
0178-0075
---------------------------------------------------------------------------

    The Agency provided this opportunity to comment on the possible 
impact of the rules proposed in the NPRM on the protection of privacy 
of information used in determining the physical qualifications of CMV 
drivers, in light of the evaluation by the Agency and the Department of 
the protection of privacy of information set out in the PIA. In 
response to the May 27, 2014, Notice of Availability, FMCSA received 
two comments. One comment was from a driver stating that the National 
Registry was making his job more difficult. The other comment was from 
a medical office commenting on the submission requirements and 
suggesting edits to the MER Form, MCSA-5875. Both comments received 
were considered to be outside the scope of the PIA because neither 
comment addressed the protection of privacy of information collected. 
They were nevertheless considered as late-filed comments to the NPRM, 
consistent with the Agency's policy to consider, to the extent 
practicable, comments received after the close of a routine comment 
period under 5 U.S.C. 553(c).
2. Paperwork Reduction Act Compliance
    ATA suggested that FMCSA publish an IC request to examine the 
appropriateness of the amendments and investigate other potential 
additions or subtractions to the MER Form, MCSA-5875.
FMCSA Response
    As required by the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 
3507(d)), FMCSA submitted the information collection requirements 
associated with the proposed rule, including the newly developed MER 
Form, MCSA-5875, to OMB for its review. The final rule has a decrease 
in annual paperwork burden hours (401,904 hours) as detailed in OMB 
control number 2126-0011 Commercial Driver Licensing and Test Standards 
and 2126-0006 Medical Qualification Requirements Supporting Statements 
in the docket. FMCSA analyzed this rule and determined that its 
implementation will decrease the currently approved IC burden hours 
covered by both of these control numbers. A detailed analysis of each 
IC activity can be found in the Supporting Statements attachments, 
which are in the public docket for this rulemaking. The Agency believes 
that the burden has not increased from what is currently being 
collected on the MER Form, MCSA-5875 and is not a new collection of 
information but is replacing the current MER being used by MEs. Much of 
the same information is being collected, just in a different format.
3. Cost Impacts of Revised Form
    Southern Company stated that increasing reporting requirements on 
the MER Form, MCSA 5875, will have costly impacts and that form changes 
need to be evaluated in conjunction with the registration and 
certification of MEs on the National Registry and pending medical 
examination guideline changes for MEs. They indicated that together 
these rules will prove very costly, confusing, and disruptive to their 
company, the energy industry and the trucking industry. They stated 
that the expanded set of questions on medical history will increase 
direct and indirect costs of the exam because the driver will need 30-
45 more minutes to complete the medical history and the ME will have to 
discuss the answers with the driver, increasing the total time for the

[[Page 22801]]

office visit. They stated that this warrants more time to analyze the 
economic impact since this would potentially increase the trucking 
industry's costs significantly as well and negatively impact the 
nation's economy. They suggested that this regulatory action should be 
combined with the related rule changes as mentioned above and proposed 
for comments.
FMCSA Response
    The newly developed MER Form, MCSA-5875, contains much of the same 
information being collected on the current MER, but in a different 
format, and thus is not considered a new collection of information. 
Therefore, the burden has not increased from what is currently being 
collected on the MER. In addition, all questions on the MER Form, MCSA-
5875, can be specifically linked to provisions of 49 CFR 391.41, 
physical qualifications for drivers, or to ensuring that there is no 
negative or deleterious effect on the driver's health making it more 
difficult to drive a CMV safely. FMCSA does not consider the questions 
on the revised MER Form, MCSA-5875, to be long or onerous for the 
driver to complete. The time spent to fill out the form or to complete 
the exam will not increase to the extent that the commenter suggests.

D. Compliance Date for States

    FMCSA proposed that beginning 3 years after the effective date of 
the final rule, FMCSA would electronically transmit all of the 
information on the MEC from the National Registry system to the SDLAs 
for CLP/CDL applicants/holders only. FMCSA proposed this date based on 
its estimate of when all States will have the information technology 
systems in place to receive the information from the National Registry.
    Several commenters were concerned that three years is not enough 
time for the States to come into compliance. Oregon's Driver and Motor 
Vehicle Services (Oregon) stated that three years is not enough time 
for implementation because the mechanism for sending the information to 
the States has not yet been determined. Oregon commented that if FMCSA 
decides to use CDLIS, development of the system requirements will take 
at least a year, leaving two years or less for the States to do the 
work needed to comply. The State questioned why FMCSA would choose to 
build in guaranteed noncompliance by most, if not all by requiring the 
States to come into compliance within 3 years. They suggested that 
FMCSA delay the final rule until the technical details have been 
coordinated.
    California's Department of Motor Vehicles (California) agreed that 
three years is not enough time to complete all necessary program 
changes. California pointed out that many States are not able to 
implement rules within three years of being published as final, due in 
part to receiving technical specifications 18-24 months after the 
effective date, leaving the States a year or less to perform system 
analysis and programming. They also pointed out that competing 
resources with existing State-mandated projects and laws is an issue 
for them. They suggested that FMCSA delay implementation for five 
years.
    Delaware's Division of Motor Vehicles (Delaware) stated that 
shortening the proposed date would be problematic. Delaware explained 
that the State has to propose and pass legislation, fund programming, 
conduct examiner training, complete structured testing, etc., all while 
maintaining regular operations. The State indicated that changes are 
prioritized and must have established timelines. They stated that 
shortening the deadline will hinder an SDLA's ability to properly 
manage its priorities. They recommended FMCSA retain a hard date for 
implementation.
    Schneider National, Inc. (Schneider) stated that without a 
consistent implementation date for all parties, the driver will be 
unsure as to whether the ME will submit the information on the MEC to 
the SDLA. If changes have not been implemented, drivers must continue 
to use a paper copy of the MEC to ensure they remain in compliance. 
Schneider pointed out that there is no language to hold the ME 
accountable to tell drivers if the information would be communicated 
electronically or if the driver needs to deliver a paper copy to the 
SDLA.
    On the other hand, Advocates recommended that the Agency set an 
earlier date for compliance. They stated that one year should be 
sufficient but certainly no more than 18 months.
    New York's Department of Motor Vehicles (New York) stated that 
another potential cost may be SDLA upgrades to connect to the National 
Registry database; however the Agency is unable to estimate and 
quantify at this time. New York asked if States would be able to apply 
for a CDLPI grant. Several commenters questioned the date beginning on 
July 8, 2014, if the driver has a CLP and has certified that he or she 
expects to operate in interstate commerce that the driver has a valid 
MEC and any required medical variances. They believe this date should 
be July 8, 2015, based on the extension granted for the Commercial 
Driver's License Testing and Commercial Learner's Permit Standards.
FMCSA Response
    While several commenters voiced concern that three years is not 
enough time for States to come into compliance with these new 
requirements because the mechanism for sending the medical 
certification information to the States has yet to be determined, the 
Agency believes it is sufficient time because the decision has now been 
made that CDLIS will be the mechanism for sending the medical 
certification information from the National Registry to the SDLAs. 
California's Department of Motor Vehicles and several other commenters 
based their concern in part on the past history of receiving technical 
specifications 18-24 months after the effective date of the final rule, 
leaving the States a year or less to perform system analysis and 
programming. FMCSA is working to get these technical specifications to 
the States sooner than in the past. Therefore, FMCSA has decided to 
keep the State compliance date at three years from the effective date 
of the final rule, as proposed in the NPRM. Some commenters 
misunderstood the Agency's intent regarding the compliance date and 
thought that we were considering different dates for each State based 
on when they would have the information technology systems in place to 
receive the information from the National Registry. The Agency was 
simply pointing out that if all the States were ready earlier than 
three years from the effective date of the final rule that we would 
consider shortening the compliance date. The State compliance date will 
be unified as suggested by Schneider and will be three years from the 
effective date of the final rule.

E. Coercion

    No comments were received suggesting that the proposed rule would 
result in any operator of a CMV being coerced to violate any of the 
safety regulations issued pursuant to 49 U.S.C. 31136. The rule is 
intended to enhance compliance with the physical qualification 
requirements applicable to all CMV drivers. As noted in the NPRM, by 
providing MEC information and medical variance information directly to 
the SDLAs, FMCSA will reduce to the greatest extent possible the 
coercion of drivers to operate with invalid or improper medical 
certificate.

F. Issues Outside of the Scope of This Rulemaking

    A number of respondents submitted comments on topics that were 
either

[[Page 22802]]

outside the scope of what was proposed in the NPRM or were based on a 
misunderstanding of what the Agency proposed in this rulemaking. Most 
of these comments relate to the 2008 final rule, in Med-Cert and the 
2012 final rule, in National Registry. Many comments raised issues that 
either were actually raised (and previously addressed) or should have 
been raised during the proceedings that resulted in the two previous 
final rules.
FMCSA Response
    One comment outside the scope of what was proposed in the NPRM 
concerned the lost time and money associated with MEs being required to 
go through training and be tested to be listed on the National 
Registry. The training and testing that is required is part of the 
National Registry of Certified Medical Examiners final rule that was 
published on April 20, 2012. Full compliance with the National Registry 
final rule took effect on May 21, 2014. Therefore, all CMV drivers 
(both CDL and non-CDL) are now required to obtain an examination and 
MEC from an ME listed on the National Registry.
1. Fraud and How the SDLA Will Be Notified
    The Colorado Department of Revenue/CDL Unit questioned whether 
FMCSA expects the SDLA to take a false statement disqualification 
action, assuredly as contained in 49 CFR 383.73(j), when FMCSA 
determines that an individual has falsified potentially disqualifying 
medical information. They also questioned how FMCSA would notify the 
SDLA of possible fraud and how much information will be disclosed to 
the SDLA to allow them to take the false statement disqualification.
FMCSA Response
    Although this is not a matter within the scope of this rulemaking, 
it is an important point that needs explanation. As explained in the 
2008 final rule and subsequent technical amendments in Med-Cert, the 
provisions of 49 CFR 383.73(j) regarding penalties for false 
information submitted by CLP/CDL applicants/holders require SDLAs--not 
FMCSA--to take the actions specified in section 383.73(j) when the 
State determines that an applicant has falsified medical information. 
If FMCSA review of MEC information finds a CLP/CDL holder has falsified 
information in the course of obtaining the MEC, FMCSA may void the MEC 
and will then notify the SDLA. The SDLA should then notify the CLP/CDL 
holder of the ``not certified' status and begin the process for the 
downgrading of the CLP/CDL as set out in 49 CFR 383.73(o)(4)(i). The 
SDLA can also take any of the actions set out in section 383.73(j).
2. Safety Benefits
    One driver stated that there are no proven safety benefits to 
submitting private medical information to the Federal government and 
for making the medical doctors go through training on driver fitness 
and join another federally run program so they can be on the approved 
list.
FMCSA Response
    FMCSA is required by statute to establish and maintain the National 
Registry, and it did so in the final rule published in 2012. 49 U.S.C. 
31136(a)(3) and 31149. The benefits of that program were thoroughly 
discussed and explained in that final rule. Further consideration of 
them in this proceeding is not warranted. The Agency is not requiring 
the submission of private medical information, only the MEC, which 
serves as proof the driver meets the physical qualifications standards. 
Drivers have long been required to present the MEC during roadside 
inspections, and employers have long been required to maintain a copy 
of the MEC in DQ files. The private medical information is contained on 
the MER which continues to be maintained by the healthcare 
professional. While FMCSA and employers may request access to the MER, 
the Agency does not intend to request the document except as part of an 
investigation or audit.
3. MERs
    ATA suggested that after a medical examiner uploads medical 
qualification information for a driver holding a medically downgraded 
CDL, FMCSA should require SDLAs to automatically return that driver's 
license to interstate status. ATA stated that they hope that any 
forthcoming employer notification system FMCSA might develop will 
account for this process by eliminating needless paperwork for carriers 
maintaining DQ files that must be renewed upon a medical certificate's 
expiration. They suggested that the Agency examine ways to incorporate 
medical status monitoring into any forthcoming employer notification 
system authorized under section 32303 of MAP-21 instead of forcing a 
carrier to request additional reports every time the date on a driver's 
medical qualification changes.
    Schneider National, Inc. recommended that the language be changed 
to allow the motor carrier to continue to require drivers to provide a 
copy of their MEC and Form MCSA-5876. They stated that they have a 
third party vendor that ensures the drivers are disclosing all their 
known medical conditions and they also compare the prior physical (if 
available) to the new physical to identify any errors or issues. They 
pointed out that 15-20% of driver physicals require them to send the 
driver back to the clinic, either due to the driver failing to disclose 
all relevant medical information on the form or because of a clinic 
error.
FMCSA Response
    This rule will not require MEs to inform drivers' employers and 
provide the motor carrier a copy of a driver's MER Form, MCSA-5875, 
when a driver completes a medical examination. For MEs to provide the 
motor carrier employer with a copy of the MER Form, MCSA-5875, there 
will need to be an agreement between the driver and employer, often as 
a condition of employment.
    Under Sec.  391.43(g)(2), if the ME finds that the person examined 
is physically qualified to operate a CMV in accordance with Sec.  
391.41(b), he or she must complete a certificate in the form prescribed 
in paragraph (h) of this section and furnish the original to the person 
who was examined. The examiner must provide a copy to a prospective or 
current employing motor carrier who requests it. Under Sec.  391.43(i), 
each original (paper or electronic) completed MER Form, MCSA-5875 and a 
copy or electronic version of each MEC, Form MCSA-5876 must be retained 
on file at the office of the ME for at least 3 years from the date of 
examination. The ME must make all records and information in these 
files available to an authorized representative of FMCSA or an 
authorized Federal, State, or local enforcement agency representative, 
within 48 hours after the request is made.
    When the SDLA receives notification of medical qualification 
information for a driver with a CDL downgraded for medical 
qualification reasons, the driver's medical status should be updated to 
``certified'' and the CDL status updated to ``licensed.'' An SDLA may 
have additional requirements.

VII. Section-by-Section Explanation of Changes

    This section includes a summary of the regulatory changes made in 
49 CFR parts, 383, 384 and 391 organized by section number.

A. Changes to Part 383

    Part 383 contains the requirements for CLP/CDLs. With certain 
exceptions, the rules in this part apply to every person

[[Page 22803]]

required to possess a CLP/CDL to operate a CMV in commerce, to all 
employers of such persons, and to all States.
    Section 383.71(h). FMCSA changes the requirement of a CDL/CLP 
applicant/holder from providing the State with an original or copy of 
their MEC (previous edition) to FMCSA providing the State with the 
electronic MEC information beginning three years after the effective 
date of this final rule.
    Section 383.73(a)-(b). Three years after the effective date of the 
final rule, FMCSA will change the requirement that the State must post 
the MEC (previous edition) received from the CLP/CDL applicant or 
holder to the CDLIS driver record to the State posting the electronic 
MEC information received from FMCSA.
    Section 383.73(o). Three years after the effective date of the 
final rule, FMCSA will change the requirement that the State post the 
original or copy of the MEC (previous edition) information to the CDLIS 
driver record within 10 calendar days after receipt to a requirement 
that the State post the electronic MEC, Form MCSA-5876, information to 
the CDLIS driver record within 1 business day after receiving the 
electronic information from FMCSA. The final rule also adds a 
requirement that, when the SDLA receives information that a driver's 
MEC has been invalidated because the driver has been found to be not 
physically qualified in a subsequent examination by an ME on the 
National Registry, the SDLA must change the driver's status on the 
CDLIS record to ``not certified'' and begin the process for downgrading 
the CLP/CDL. FMCSA also changes the requirement that the State retain 
an original or copy of the MEC (previous edition) for 3 years to a 
requirement that it retain an electronic record of the MEC information, 
Form MCSA-5876, for 3 years.
    Paragraph (o) also requires the States to post the medical variance 
information provided by FMCSA, including the dates of issuance and 
expiration, along with the MEC, Form MCSA-5876, information. This 
variance information posting requirement was previously incorporated by 
reference in Sec.  384.107 of this chapter from AAMVA's ``Commercial 
Driver's License Information System State Procedures Manual,'' Release 
5.3.2.1, August 2013. This requirement will be effective immediately 
because States are already required to post this information. FMCSA 
also reduces the time the State has to post the medical variance 
information received from FMCSA to the CDLIS driver record from within 
10 calendar days to 1 business day from the date of receipt because the 
information will be sent and posted electronically. FMCSA also added a 
new requirement that the State must update the medical status to ``not 
certified' when the medical certification is voided by FMCSA.

B. Changes to Part 384

    Part 384 contains the requirements that the States comply with the 
provisions of section 49 U.S.C. 31311(a). Part 384 includes the minimum 
standards for the actions States must take to be in substantial 
compliance with each of the 25 requirements of 49 U.S.C. 31311(a), 
establishes procedures for FMCSA determinations of State compliance, 
and specifies the consequences of State noncompliance.
    Section 384.234. FMCSA added an administrative amendment to this 
section to include driver medical certification recordkeeping 
requirements for CLP applicants in Part 383.
    Section 384.301. FMCSA amended this section by adding a new 
paragraph (i). FMCSA has always given the States 3 years after the 
effective date of any new rule to come into substantial compliance with 
new CDL requirements. This allows the States time to pass any necessary 
legislation and to modify State systems to comply with the new 
requirements, including CDLIS. New paragraph (i) would specify the 3 
year compliance date for States.

C. Changes to Part 391

    Part 391 establishes minimum qualifications for persons who drive 
CMVs. The requirements in this part also establish minimum duties of 
motor carriers with respect to the qualifications of their drivers.
    Section 391.23(m)(2)(i)(A). FMCSA made an editorial change to 
eliminate an erroneous reference to Sec.  383.71(a)(1)(ii) and to add a 
reference to 383.71(b)(1)(ii), which describes the four types of self-
certifications.
    Section 391.23(m)(2)(i)(B). Three years after the effective date of 
the final rule FMCSA will eliminate the requirement for the motor 
carrier to verify and document in the DQ file that a CDL holder was 
certified by an ME listed on the National Registry. Employers will no 
longer need to verify the examination and ME listing, because that 
information will be sent to the SDLAs through CDLIS from the National 
Registry. Motor carriers will still be required to meet this 
requirement for non-CDL holders.
    Section 391.41(a)(2). Three years after the effective date of the 
final rule, FMCSA will eliminate the provision requiring drivers 
required to have a CLP/CDL to carry a current MEC (previous edition) 
for 15 days.
    Section 391.43. FMCSA removed the Instructions for Performing and 
Recording Physical Examinations section in Sec.  391.43(f) to eliminate 
redundant or unnecessary requirements.
    Beginning 3 years after the effective date of the final rule, FMCSA 
will eliminate in Sec.  391.43(g)(2) the requirement that MEs provide 
the MEC, Form MCSA-5876, to drivers required to have a CLP/CDL (and to 
their employers), because the MEC information will be promptly and 
accurately transmitted electronically to the SDLAs for entry on the 
CDLIS driver record. But the ME must still provide the MEC, Form MCSA-
5876, to non-CDL drivers and requesting employers, as currently 
required.
    FMCSA inserts two new paragraphs in Sec.  391.43(g). The first, 
paragraph (g)(3), requires the ME to inform the driver if a 
determination has been made that the driver is not physically 
qualified, and that this information will be reported to FMCSA. Upon 
receiving this report, FMCSA will invalidate any MECs previously issued 
to the driver that are contained in the Agency's records and will 
electronically transmit this report to the appropriate SDLA. The second 
new paragraph, (g)(4), requires the ME to inform the driver if the 
determination of whether the driver is physically qualified requires 
additional information or further examination. This pending status will 
remain in effect for 45 days, and will be reported to FMCSA. If the 
examination is not completed within the 45-day period, the examination 
will be no longer be valid and the driver will be required to obtain a 
new examination in order to obtain a MEC, Form MCSA-5876.
    In Sec.  391.43(g)(5)(i)(B) (renumbered from (g)(3) because of the 
two new paragraphs above), FMCSA requires that, beginning 3 years after 
the effective date of the final rule, the ME must report results of all 
commercial drivers' physical examinations to FMCSA by completing a CMV 
Driver Medical Examination Results Form, MCSA-5850, via the ME's 
individual password-protected National Registry web account by midnight 
(local time) of the next calendar day. MEs are required to report the 
results of all examinations conducted in accordance with the physical 
qualification standards in 49 CFR part 391, subpart E that apply to CMV 
drivers engaged in interstate operations. In addition, as a convenience 
to those States that have variances from those standards for

[[Page 22804]]

drivers operating intrastate, the rule allows MEs to transmit such 
information to the National Registry, if required by the States 
involved, for eventual transmittal to the SDLAs.
    In Sec.  391.43(g)(5)(ii), FMCSA will require MEs to report to 
FMCSA whenever the ME does not complete any driver medical examinations 
during the preceding 30 days, beginning on the effective date of the 
final rule.
    FMCSA revises Sec.  391.43(h) to require MEs to use the MEC, Form 
MCSA-5876. The form has been modified to require the ME to indicate 
whether the driver is being certified as qualified in accordance with 
either the standards applicable to all interstate drivers or any State 
standards for intrastate drivers that have variances from the Federal 
standards in effect. This replaces the designation that the driver is 
either interstate or intrastate. Other minor editorial edits have been 
made to the form for clarity. The other information required to be 
entered on the certificate is unchanged from the information required 
under the current regulation.
    Section 391.45. FMCSA has decided that when a driver has been 
determined to not be physically qualified, any previous MECs issued to 
a driver will be deemed invalid as explained above regarding Sec.  
391.43(g)(3). FMCSA has added a new paragraph at the end of this 
section that requires a driver to be medically examined and certified 
before operating a CMV after previous certifications have been 
invalidated because of a driver not being physically qualified under 
the provisions of proposed new Sec.  391.43(g)(3).
    Section 391.51. In Sec.  391.51(b)(7), FMCSA has eliminated the 
exception that allows the motor carrier to use an MEC (previous 
edition) as proof of medical certification for CLP/CDL holders in the 
DQ file, because States will be required to record medical 
certification information in driver's record automatically upon receipt 
from FMCSA.
    Appendix to Part 391. FMCSA has added medical advisory criteria as 
an Appendix at the end of this section. The advisory criteria (which 
are recommendations for use by MEs) are reproduced without substantive 
change from the advisory criteria currently included in the MER. FMCSA 
recognizes that some of these advisory criteria should be updated or 
revised. However, such substantive changes should not be made without 
notice and opportunity for public comment. FMCSA intends to seek public 
comment on revisions to the advisory criteria as promptly as feasible 
to bring them up to current standards.

D. Compliance Date

    In order to allow sufficient time for the SDLAs and FMCSA to 
develop and implement necessary information system changes, most of the 
final rule provisions will take effect three years after the effective 
date of the final rule. The provisions requiring MEs to notify FMCSA if 
they have not performed any driver physical examinations during the 
previous month and the State to update the medical status to ``not 
certified' when the medical certification is voided by FMCSA under the 
authority of 49 U.S.C. 31149(c)(2) will go into effect on the effective 
date of the final rule. To allow sufficient time for the certified MEs 
to make the necessary adjustments to their business requirements, the 
provisions requiring MEs to use the new MER Form, MCSA-5875 and MEs to 
use the prescribed Form MCSA-5876 for the MEC will go into effect six 
months after the effective date of the final rule.
    Beginning June 22, 2018, MEs will be required to report the results 
of all commercial drivers' physical examinations to FMCSA by midnight 
(local time) of the next calendar day following the examination, by 
completing a CMV Driver Medical Examination Results Form, MCSA-5850, 
via their individual password-protected National Registry web account. 
For CLP/CDL applicants/holders, FMCSA will electronically transmit 
driver identification, examination results, and restriction information 
from the National Registry system to the SDLAs, as well as information 
about MECs invalidated under new 49 CFR 391.43(g)(3) and 391.45(d). 
FMCSA will also electronically transmit medical variance information 
for all CMV drivers to the SDLAs. SDLAs will be required to post the 
medical variance information provided by FMCSA, including the dates of 
issuance and expiration, to the CDLIS driver record within 1 business 
day of receipt for CDL/CLP holders.

VIII. Regulatory Analyses and Notices

A. E.O. 12866 (Regulatory Planning and Review and DOT Regulatory 
Policies and Procedures as Supplemented by E.O. 13563)

    FMCSA has determined that this final rule is not a significant 
regulatory action within the meaning of Executive Order (E.O.) 12866, 
as supplemented by E.O. 13563 (76 FR 3821, January 21, 2011), and is 
also not significant within the meaning of DOT regulatory policies and 
procedures (DOT Order 2100.5 dated May 22, 1980; 44 FR 11034, February 
26, 1979) because it is not expected to generate substantial 
congressional or public interest. The impact of the final rule is 
estimated to be $12 million in up-front costs and $10.16 million in 
annual savings, so the rule's impact is not expected to exceed the $100 
million annual threshold for economic significance. The purpose of the 
principal requirements established in the final rule is to modify the 
requirements adopted in two previous rules so that the driver 
identification, examination results, and restriction information for 
CLP/CDL holders is electronically transmitted by a certified ME listed 
on the National Registry to the FMCSA by midnight (local time) of the 
next calendar day after the examination, and then electronically 
transmitted by FMCSA within one business day to the SDLA for entry into 
the appropriate driver record.
1. Summary of Estimated Costs
    FMCSA is not able to quantify the benefits of ensuring that CMV 
drivers are medically qualified and of reducing the falsification of 
medical certification by drivers. The revised medical forms will not 
take significantly longer to complete than the previous versions. They 
contain much of the same information being collected on the current 
MER, but in a different format. The requirement that CMV driver medical 
examination results be transmitted to FMCSA by midnight (local time) of 
the next calendar day following the exam is not expected to increase 
the burden on the ME or their staff, because the total time required to 
transmit each form does not increase based on when the form is 
completed and transmitted.
    FMCSA expects there will be costs for the SDLAs to modify their 
systems to accept transmission of MEC and variance information from the 
National Registry system. FMCSA and the AAMVA, which facilitates the 
maintenance of driver data and communication with the SDLAs, also need 
to update their systems and test the connections between databases. 
FMCSA estimates the costs of these efforts by using estimates that were 
made for previous efforts. The SDLAs (51 separate entities) will 
perform tasks similar to (but likely smaller in scope than) their 
efforts to comply with FMCSA CDL records requirements. Estimates for 
that included $6,147,000 for input and inquiry screens, $1,564,000 for 
an expanded database, $1,665,000 for systems and user acceptance 
testing, and $590,000 for testing their links with AAMVA. This

[[Page 22805]]

totals $9,966,000 for all SDLAs \7\. Additionally, FMCSA and AAMVA must 
expend funds to connect and test the links between their databases--an 
estimated $1,000,000 will be necessary in each case. The total 
expenditures needed to create and test the links between databases will 
therefore be $11,966,000.
---------------------------------------------------------------------------

    \7\ OMB Control Number 2126-0011 Supporting Statement: 
Commercial Driver Licensing and Testing Standards, approved 1/12/
2015.
---------------------------------------------------------------------------

2. Summary of Estimated Benefits
    Potential quantifiable estimated benefits, as detailed in the 
revised Medical Qualification Requirements (OMB control number 2126-
0006) and the Commercial Driver Licensing and Test Standards (OMB 
control number 2126-0011) Supporting Statements, posted in the docket, 
include: (1) Employers of drivers will no longer be required to verify 
the ME's National Registry number for CDL holder examinations because 
only MEs listed on the National Registry will be able to forward MEC 
information to the National Registry. This will result in 251,695 fewer 
annual burden hours (from 308,200 hours to 56,505 hours) and an annual 
cost savings of $4.78 million (from $5,855,800 to $1,073,595); (2) ME's 
will no longer need to handwrite the MEC for CLP/CDL applicants/holders 
because the information will be electronically transmitted by the ME to 
the National Registry and from the National Registry to the SDLAs, 
resulting in an annual time savings of 32,303 hours (from 77,050 hours 
to 44,747 hours) and an annual cost savings of $2.87 million (from 
$6,857,450 to $3,982,483), while decreasing the MEs paperwork and 
administrative burdens; (3) CLP/CDL applicants/holders will save time 
because they are no longer required to provide their MEC to the SDLAs 
as proof of medical certification. By electronically transmitting the 
MEC information and variance information (as defined in the SUMMARY 
section), FMCSA is creating a cost savings for drivers of $1.05 million 
(1,940,000 MECs x $0.54 postage plus one copy to SDLAs); (4) SDLAs will 
save 81,000 annual burden hours of administrative time recording MEC 
information for not having to attend to the driver above, resulting in 
$1.46 million (81,000 annual burden hours x $18.00 per hour) in cost 
savings. As a result, this final rule will generate a maximum $10.16 
million in overall annual cost savings. This estimate is the greatest 
possible amount, and includes the assumption that all intrastate 
drivers who can take advantage of using MEs on the National Registry 
will.
    The Agency believes that the fraud prevention in electronic 
transmission of MEC and medical variance information will continue to 
improve safety on public roads. Currently, there is potential for 
fraud, as drivers have the opportunity to forge or alter the MEC or 
medical variance information. More frequent reporting of CMV driver 
medical examination results to FMCSA by the MEs will allow the 
information to be promptly transmitted to the SDLAs for posting on the 
CDLIS driver record for CLP/CDL applicants/holders. As a result, up-to-
date and accurate information concerning the medical certification 
status of these drivers will be available to State and Federal 
enforcement personnel, SDLAs, employers, drivers, and others who rely 
on this information to determine whether a driver is in compliance with 
the applicable physical qualification standards.
    Lastly, FMCSA believes that use of the revised MER Form, MCSA-5875, 
will assist MEs in accurately determining whether CMV drivers meet the 
physical qualification standards contained in 49 CFR 391.41(b). The MER 
Form, MCSA-5875, has been streamlined for efficiency and contains 
evaluation tools that more precisely align with the qualification 
standards and the Agency's advisory criteria, and the revised MER Form 
presents those tools using a systematic physical examination approach 
similar to standards of clinical practice. When combined with the 
expected improvement in ME qualifications and performance under the 
National Registry program, the new MER Form will help ensure that the 
physical condition of CMV drivers is adequate to enable them to safely 
operate a CMV. The National Registry has only recently reached its 
compliance date; therefore, FMCSA does not have sufficient data at this 
time to quantify the expected safety benefits from adoption of the 
revised MER Form, MCSA-5875.

B. Regulatory Flexibility Act

    The Regulatory Flexibility Act of 1980 (5 U.S.C. 601 et seq.) 
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. 
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.
    Under the Regulatory Flexibility Act (RFA), as amended by the Small 
Business Regulatory Enforcement Fairness Act of 1996 (Pub. L. 104-121, 
110 Stat. 857), the final rule is not expected to have a significant 
economic impact on a substantial number of small entities. 
Consequently, I certify that the proposed action will not have a 
significant economic impact on a substantial number of small entities.
    The NPRM for this rule contained a detailed Initial Regulatory 
Flexibility Analysis which described the reasons for this action and 
its objective. The 39,160 \8\ MEs who are currently certified and will 
be impacted by this rule are considered to be small business entities. 
However, the changes to the requirements on those MEs are small and 
should not have any negative economic impact on them. The changes to 
the required medical forms (CMV Driver Medical Examination Results 
Form, MCSA-5850, MER Form, MCSA-5875 and the MEC, Form MCSA-5876) are 
not expected to increase the burden on any ME, nor is the requirement 
that the CMV driver medical examination results be submitted by 
midnight (local time) of the next calendar day following the exam.
---------------------------------------------------------------------------

    \8\ 39,160 MEs certified and listed on the National Registry as 
of January 5, 2015.
---------------------------------------------------------------------------

C. Assistance for Small Entities

    Under section 213(a) of the Small Business Regulatory Enforcement 
Fairness Act of 1996, FMCSA wants to assist small entities in 
understanding the effects of this final rule. While the Agency believes 
that the rule will adversely affect few, if any, small businesses, 
organizations, or governmental jurisdictions, any questions concerning 
its provisions or options for compliance should be directed to, the 
FMCSA personnel listed in the FOR FURTHER INFORMATION CONTACT section 
of the final rule.
    Small businesses may send comments on the actions of Federal 
employees who enforce or otherwise determine compliance with Federal 
regulations to the Small Business Administration'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

[[Page 22806]]

employees of FMCSA, call 1-888-REG-FAIR (1-888-734-3247). DOT has a 
policy ensuring the rights of small entities to regulatory enforcement 
fairness and an explicit policy against retaliation for exercising 
these rights.

D. Unfunded Mandates Reform Act of 1995

    This final rule will impose costs that do not exceed the threshold 
nor impose an unfunded Federal mandate, as defined by the Unfunded 
Mandates Reform Act of 1995 (2 U.S.C. 1532 et seq.), that will result 
in the expenditure by State, local, and tribal governments, in the 
aggregate, or by the private sector, of $151 million (which is the 
value of $100 million in 2012 after adjusting for inflation) or more in 
any 1 year.

E. E.O. 13132 (Federalism)

    A rule has implications for Federalism under Section 1(a) of 
Executive Order 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 final 
rule will 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 assessment.

F. E.O. 12988 (Civil Justice Reform)

    This final rule meets applicable standards in sections 3(a) and 
3(b)(2) of E.O. 12988, Civil Justice Reform, to minimize litigation, 
eliminates ambiguity, and reduce burden.

G. E.O. 13045 (Protection of Children)

    E.O. 13045, Protection of Children from Environmental Health Risks 
and Safety Risks (62 FR 19885, Apr. 23, 1997), requires agencies 
issuing ``economically significant'' rules, if the regulation also 
concerns an environmental health or safety risk that an agency has 
reason to believe may disproportionately affect children, to include an 
evaluation of the regulation's environmental health and safety effects 
on children. The Agency determined this final rule is not economically 
significant. Therefore, no analysis of the impacts on children is 
required. In any event, the Agency does not anticipate that this 
regulatory action could in any respect present an environmental or 
safety risk that could disproportionately affect children.

H. E.O. 12630 (Taking of Private Property)

    FMCSA reviewed this final rule in accordance with E.O. 12630, 
Governmental Actions and Interference with Constitutionally Protected 
Property Rights, and has determined it will not effect a taking of 
private property or otherwise have taking implications.

I. Privacy Impact Assessment

    FMCSA conducted a PIA of this rule as required by section 522(a)(5) 
of division H of the FY 2005 Omnibus Appropriations Act, Public Law 
108-447, 118 Stat. 3268 (Dec. 8, 2004). The assessment considered 
impacts of the final rule on the privacy of information in an 
identifiable form and related matters. The final rule would impact the 
handling of PII. FMCSA has evaluated the risks and effects the 
rulemaking might have on collecting, storing, and sharing PII and has 
evaluated protections and alternative information handling processes in 
developing the final rule in order to mitigate potential privacy risks. 
The supporting PIA, available for review in the docket, gives a full 
and complete explanation of FMCSA practices for protecting PII in 
general and specifically in relation to this final rule.
    The Privacy Act (5 U.S.C. 552a) applies only to Federal agencies 
and any non-Federal agency which receives records contained in a system 
of records from a Federal agency for use in a matching program. FMCSA 
and the Department will be publishing, with request for comment, a 
revised system of records notice that will cover the collections of 
information that are affected by this final rule and covered by the 
Privacy Act.

J. E.O. 12372 (Intergovernmental Review)

    The regulations implementing E.O. 12372 regarding intergovernmental 
consultation on Federal programs and activities do not apply to this 
program.

K. Paperwork Reduction Act

    This final rule contains the following new IC requirements. As 
required by the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)), 
FMCSA submitted the information requirements associated with the 
proposal to the OMB for its review. The Medical Qualification 
Requirements Supporting Statement, OMB control number 2126-0006 has 
been revised primarily due to the Agency's promulgation of this final 
rule. However, it has also been revised to provide new and updated data 
to the currently approved IC that is not a result of this final rule. 
As a result of this update which includes several IC program changes 
such as the inclusion of a time burden for the driver to complete the 
health history section of the MER, a correction to the calculation for 
the National Registry regarding the time for entering and submitting 
MCSA-5850s, and the Agency's decision to grant hearing and seizure 
exemptions, there is an increase from the current approved annual 
paperwork burden hours of 503,000 hours (2,130,702 hours to 2,633,702). 
As a result of this final rule, the annual burden hours will remain the 
same during the first 3 years of implementation of the final rule but 
will decrease by 283,998 hours (2,633,702 hours to 2,349,704 hours) 
during the 4th and subsequent years after the compliance date. 
Therefore, this rule has a decrease in annual paperwork burden hours of 
364,998 hours (81,000 + 283,998) as detailed in OMB control number 
2126-0011 Commercial Driver Licensing and Test Standards and 2126-0006 
Medical Qualification Requirements Supporting Statements in the docket.
    As discussed in the National Registry final rule (77 FR 24104; 
April 21, 2012), MEs have started to electronically submit MEC 
information to the National Registry on a monthly basis. The Medical 
Examiner's Certification Integration NPRM proposed that the information 
be submitted by the ME by close of business the day the examination is 
conducted, as opposed to submitting monthly. The final rule slightly 
relaxes that standard by requiring MEs to report results of all CMV 
drivers' physical examinations performed (including the results of 
examinations where the driver was found not to be qualified) to FMCSA 
by midnight (local time) of the next calendar day following the 
examination. The final rule requires FMCSA to electronically transmit 
driver identification, examination results, and restriction information 
for CLP/CDL applicants/holders, from the National Registry system to 
the SDLAs, providing more accurate and timely delivery of MEC 
information to update CDLIS driver records and for safety enforcement 
purposes. In addition, the final rule requires FMCSA to electronically 
transmit medical variance information for all CMV drivers 
electronically to the SDLAs.
    Close tracking and monitoring of certification activities and 
medical results are crucial to reducing fraudulent efforts of a subset 
of CDL applicants. Some CDL drivers avoid following the proper 
guidelines to

[[Page 22807]]

become medically qualified, posing safety risks to the public.
    While the NPRM proposed to send MEC information to the SDLAs only 
for CLP/CDL applicants/holders who are required to be medically 
qualified to operate in interstate commerce, the final rule has been 
expanded to include MEC information from examinations performed in 
accordance with the FMCSRs (49 CFR 391.41- 391.49), as well as allowing 
(but not requiring) to include those performed in accordance with 
applicable State standards. The National Registry final rule requires 
certified MEs to report to FMCSA the results of each medical 
examination of CMV drivers who are required to be medically qualified 
to operate in interstate commerce. If intrastate CMV drivers are 
subject to differing but compatible State regulations, the Agency 
anticipates that these drivers likely will use certified MEs on the 
National Registry for their medical qualification examinations. FMCSA 
recognizes that using the entire intrastate CMV driver population may 
be a high estimation, but we have used this conservatively high burden 
estimation since the Agency doesn't have an exact number, and there is 
nothing to preclude intrastate CMV drivers from being examined by a 
certified ME listed on the National Registry.
2126-0006 Medical Qualification Requirements
    This IC is currently due to expire on July 31, 2015. On December 
16, 2014, FMCSA published a Federal Register notice (79 FR 74804) 
requesting public comment to revisions made to this IC. The comment 
period closed on February 17, 2015. The publication of this IC as part 
of the Medical Examiner's Certification Integration final rule serves 
as a withdrawal of the notice for comment and replaces the previous 
ICR. This revision is primarily due to the Agency's promulgation of 
this final rule. However, as discussed above, this IC is also being 
revised to provide new and updated data to the currently approved IC 
and replaces the Federal Register notice that was previously published 
for comment. The principal purpose of this final rule is to modify the 
requirements adopted in two previous rules so that (1) the driver 
identification, examination results, and restriction information for 
CLP/CDL applicants/holders is electronically transmitted to the FMCSA 
by midnight (local time) of the next calendar day after the examination 
by a certified ME listed on the National Registry and (2) this 
information is then electronically transmitted to the SDLA for entry 
into the appropriate driver record within one business day of receipt 
from FMCSA. There are no additional burden hours and annual costs to 
respondents imposed by this final rule. Implementation of this final 
rule will result in time and cost savings to employers, however, 
because they will no longer be required to verify the ME's National 
Registry number for CLP/CDL driver examinations. Only certified MEs 
listed on the National Registry will be able to forward driver 
identification, examination results, and restriction information to the 
National Registry. MEs will no longer be required to complete and 
furnish a copy of the MEC to the driver examined when the driver is a 
CLP/CDL applicant/holder because this information will be 
electronically transmitted to the SDLA. The CLP/CDL applicants/holders 
will no longer be required to provide the SDLA with their MEC as proof 
of medical certification, and the SDLA will no longer be required to 
manually input the driver's MEC information.
    On the effective date of this final rule, MEs must notify FMCSA if 
they have not performed any driver physical examinations during the 
previous month, and States must update the medical status to ``not 
certified' when the medical certification is voided by FMCSA. In 
addition, six months after the effective date of this final rule, MEs 
must use the new MER Form, MCSA-5875 and the prescribed Form MCSA-5876 
for the MEC.
    As discussed above, as a result of an update including several IC 
program changes not related to this final rule, there is an increase in 
the annual paperwork burden hours from the currently approved IC of 
503,000 hours (2,130,702 hours to 2,633,702) during the first 3 years 
of the final rule after the compliance date. The IC activities imposed 
on the MEs, drivers, and motor carriers over the first 3 years of 
implementing this final rule will remain unchanged. This provides time 
for those States that need to pass legislation and for all States to 
make the necessary system upgrades prior to the effective date for 
updating the CDLIS driver's record. The table below shows the annual 
burden hours for the IC activities for the first three years.

                  Annual Burden Hours for First 3 Years
------------------------------------------------------------------------
                                                           Annual burden
                                                           hours for the
   IC Activities for MEs, drivers, and motor carriers      IC activities
                                                            in first 3
                                                               years
------------------------------------------------------------------------
Physical Qualification Standards: Medical Examination          2,080,350
 Report Form and Medical Examiner's Certificate.........
Resolution of Medical Conflict..........................              11
Diabetes Exemption Program..............................           2,219
Vision Exemption Program................................           2,216
Hearing Exemptions......................................              49
Seizure Exemptions......................................              96
SPE.....................................................           2,661
Medical Examiner Registration...........................           5,000
Medical Examiner Test Results (upload)..................           1,667
Reporting CMV Driver Medical Examination Results and             231,150
 filing and providing MEC...............................
Providing Medical Examination Report Copies to FMCSA....              83
Verification of National Registry Number................         308,200
                                                         ---------------
    Total...............................................       2,633,702
------------------------------------------------------------------------

    Three years after the effective date of this final rule the 
following will be required: (1) MEs must increase the frequency of 
submission of CMV driver medical examination results via Form, MCSA-
5850, from once a month to as frequent as they conduct exams. They are 
required to submit the results of all CMV driver medical examinations

[[Page 22808]]

conducted by midnight (local time) of the next calendar day following 
the exam; (2) FMCSA must electronically transmit driver identification, 
examination results, and restriction information from the National 
Registry system to the SDLAs for CLP/CDL applicants/holders; (3) FMCSA 
will electronically transmit medical variance information for all CMV 
drivers to the SDLAs; and (4) States must post the medical variance 
information provided by FMCSA, including the dates of issuance and 
expiration, to the CDLIS driver record within 1 business day of receipt 
for CLP/CDL applicants/holders. These requirements do not impose any 
additional time or cost burdens on the MEs or their staff, drivers, or 
SDLAs. MEs will no longer be required to complete and furnish a written 
copy of the MEC to the driver examined when the driver is a CLP/CDL 
holder, because this information will be electronically transmitted to 
the SDLA. This provides a time savings of 32,303 hours and a cost 
savings of $2,874,967/year. Employers will no longer be required to 
verify the ME's national registry number for CLP/CDL applicants/holders 
examinations, because only certified MEs listed on the National 
Registry will be able to forward MEC information to the National 
Registry. This provides a time savings of 251,695 hours and a cost 
savings of $4,782,205. Therefore, as a result of this final rule, the 
annual burden hours during the 4th and subsequent years after the 
compliance date of the rule have decreased by 283,998 hours (2,633,702 
hours to 2,349,704 hours) and the annual costs have decreased by 
$7,657,172 ($163,850,187 to $156,193,015). The table below shows the 
annual burden hours for the IC activities for the 4th and subsequent 
years following the effective date of this final rule.

            Annual Burden Hours for 4th and Subsequent Years
------------------------------------------------------------------------
                                                           Annual burden
                                                           hours for the
                                                           IC activities
   IC Activities for MEs, drivers, and motor carriers       in 4th year
                                                          and subsequent
                                                               years
------------------------------------------------------------------------
FMCSA Physical Qualification Standards: Medical                2,048,047
 Examination Report Form and Medical Examiner's
 Certificate............................................
Resolution of Medical Conflict..........................              11
Diabetes Exemption Program..............................           2,219
Vision Exemption Program................................           2,216
Hearing Exemptions......................................              49
Seizure Exemptions......................................              96
SPE.....................................................           2,661
Medical Examiner Registration...........................           5,000
Medical Examiner Test Results (upload)..................           1,667
Reporting CMV Driver Medical Examination Results and             231,150
 filing and providing MEC...............................
Providing Medical Examination Report Copies to FMCSA....              83
Verification of National Registry Number................          56,505
                                                         ---------------
    Total...............................................       2,349,704
------------------------------------------------------------------------

    2126-0011 Commercial Driver Licensing and Test Standards. The 
renewal of this IC was approved by OMB on January 12, 2015. This IC 
supports the DOT Strategic Goal of Safety by requiring that CLP/CDL 
applicants/holders driving CMVs subject to part 391 to be properly 
licensed according to all applicable Federal requirements. The 
information being collected ensures that CLP/CDL applicants/holders are 
qualified to hold a CLP/CDL to operate CMVs, and that States are 
administering their CDL programs in compliance with the Federal 
requirements.
    The rule requires the MEC and medical variance information for CLP/
CDL applicants/holders to be transmitted electronically by FMCSA to the 
SDLA and posted to the CLP/CDL holder's CDLIS driver record. This 
eliminates the need for the driver to carry a paper copy of the MEC and 
to physically provide a copy to his/her SDLA. Therefore, there will be 
no change in the total annual burden hours during the first 3 years. 
However, during these 3 years there will be a one-time cost that each 
State and the District of Columbia will need to expend to make updates 
to their systems to accommodate the development of the capability to 
electronically receive and post medical certification and medical 
variance information from FMCSA and to the CDLIS driver record. While 
the information technology necessary to carry out these transactions is 
still in the early development stage, FMCSA estimates that the cost 
elements to implement these new requirements will not be greater than 
the estimated cost to implement the posting of the MEC and medical 
variance information manually to the driver's record. The FMCSA 
believes that additional costs to the SDLAs associated with this IC to 
be a one- time total of approximately $9,965,163 over the first 3 years 
or an annual cost of $3,321,721. The breakdown of the $9,965,163 by 
type of work activity by dollar totals for first 3 years is as follows:

------------------------------------------------------------------------
                                                            Total state
                 Information technology                      costs \9\
------------------------------------------------------------------------
Input and Inquiry Screens...............................      $6,146,560
Expanded Database.......................................       1,563,932
Systems and User Acceptance Testing.....................       1,664,850
AAMVA Testing...........................................         589,821
                                                         ---------------
    Total One-Time Costs................................       9,965,163
------------------------------------------------------------------------

    The FMCSA believes that additional costs to AAMVA to develop the 
communications link between CDLIS and the National Registry for this IC 
to be a one- time total of approximately $1,000,000 over the first 3 
years or an annual cost of $333,333.
---------------------------------------------------------------------------

    \9\ These costs are based on a sample of nine States conducted 
by an FMCSA contractor, representing three tiers of size and 
different regions of the country.
---------------------------------------------------------------------------

    Starting in the 4th and subsequent years, there will be a decrease 
in total annual burden hours due to the implementation of the new 
program change. With medical certification and medical variance 
information being sent electronically to the SDLA by FMCSA to

[[Page 22809]]

post to the CDLIS driver record, the annual burden hours for the SDLA 
to manually post the medical certification and medical variance 
information to the CDLIS driver record will be reduced from 81,000 
hours to 0 hours based on the medical certification and variance 
information being electronically sent through the National Registry to 
the SDLA by FMCSA and electronically posted to the CDLIS driver record. 
The annual cost of interstate CDL holders providing the SDLA with an 
original or copy of the MEC will be eliminated. This is an annual cost 
savings of $1,047,600. The following table summarizes the annual IC 
burden hours for current and proposed IC activities for the first 3 
years and the subsequent years. As discussed above, the currently 
approved total annual burden of 3,651,867 hours for the first 3 years 
remains unchanged. The decrease in proposed total annual burden of 
81,000 hours in subsequent years is due to the program changes from 
implementing the new requirement.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Proposed
                                                                                     Proposed      annual burden
                                                                     Currently     annual burden   hours for IC
    Current and proposed IC activities for States and CLP/CDL        approved      hours for the   activities in
                             holders                               annual burden   IC activities      4th and
                                                                       hours        in first 3      subsequent
                                                                                       years           years
----------------------------------------------------------------------------------------------------------------
State recording of medical examiner's certification and medical           81,000          81,000               0
 variance information...........................................
State recording of the self-certification of CMV operation......           4,544           4,544           4,544
State verification of the medical certification status of all                901             901             901
 interstate CLP/CDL holders.....................................
Driver notification of convictions/disqualifications to employer         730,000         730,000         730,000
Driver providing previous employment history to new employer....         459,950         459,950         459,950
Annual State certification of compliance........................           1,632           1,632           1,632
States preparing for and participating in Annual Program Review.          10,200          10,200          10,200
CDLIS/PDPS/State Record Keeping.................................         335,668         335,668         335,668
Drivers completion of the CLP/CDL application...................          59,130          59,130          59,130
CDL Knowledge and Skills tests recordkeeping....................          95,813          95,813          95,813
Knowledge and skills test examiner certification................          25,216          25,216          25,216
Driver completion of knowledge and skills test..................       1,847,813       1,847,813       1,847,813
                                                                 -----------------------------------------------
    Total Burden Hours..........................................       3,651,867       3,651,867       3,570,867
----------------------------------------------------------------------------------------------------------------

    FMCSA analyzed this rule and determined that its implementation 
will decrease the annual burden hours for IC activities covered by OMB 
Control No. 2126-006, titled ``Medical Qualification Requirements,'' 
and OMB Control No. 2126-0011, titled ``Commercial Driver Licensing and 
Test Standards'' during the 4th and subsequent years. The Table below 
captures the current and future paperwork burden hours associated with 
the two approved supporting statements. A detailed analysis of each IC 
activity can be found in the Supporting Statements, which are in the 
public docket for this rulemaking.

                                Current and Future Information Collection Burdens
----------------------------------------------------------------------------------------------------------------
                                                                     Proposed                        Proposed
                                                                   annual burden     Proposed      annual burden
                                                     Currently      hours as a     annual burden   hours for IC
                OMB Approval No.                     approved        result of     hours for IC    activities in
                                                   annual burden   update, not a   activities in      4th and
                                                       hours         result of      1st 3 years     subsequent
                                                                    final rule                         years
----------------------------------------------------------------------------------------------------------------
2126-0006.......................................       2,130,702       2,633,702       2,633,702       2,349,704
2126-0011.......................................       3,651,867             N/A       3,651,867       3,570,867
                                                 ---------------------------------------------------------------
    Totals......................................       5,782,569             N/A       6,285,569       5,920,571
----------------------------------------------------------------------------------------------------------------

L. National Environmental Policy Act and Clean Air Act

    FMCSA analyzed this final rule for the purpose of 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, March 1, 2004), 
Appendix 2, paragraph (s)(7) and paragraph (t)(2). The Categorical 
Exclusion (CE) in paragraph (b) covers administrative or editorial 
changes; (s)(7) covers requirements for State-issued commercial license 
documentation; and paragraph (t)(2) addresses regulations that assure 
States have the appropriate information systems and procedures 
concerning CDL qualifications. The requirements in this rule are 
covered by these two CEs and this action does not have any effect on 
the quality of the environment. The CE determination is available for 
inspection or copying in the Regulations.gov Web site listed under 
ADDRESSES. FMCSA also analyzed this rule under the Clean Air Act, as 
amended (CAA), section 176(c) (42 U.S.C. 7401 et seq.), and 
implementing regulations promulgated by the Environmental Protection 
Agency. Approval of this action is exempt from the CAA's general 
conformity requirement since it does not affect direct or indirect 
emissions of criteria pollutants.

M. E.O. 12898 Environmental Justice

    FMCSA evaluated the environmental effects of this final rule in 
accordance with Executive Order 12898 and determined that there are no 
environmental justice issues associated with its provisions nor any 
collective environmental impact resulting from its promulgation. 
Environmental justice issues would be raised if there were 
``disproportionate'' and ``high and

[[Page 22810]]

adverse impact'' on minority or low-income populations.

N. E.O. 13211 (Energy Supply, Distribution, or Use)

    FMCSA has analyzed this final rule under E.O. 13211, Actions 
Concerning Regulations That Significantly Affect Energy Supply, 
Distribution, or Use. The Agency has determined that it is not a 
``significant energy action'' under that order because it is not a 
``significant regulatory action'' likely to have a significant adverse 
effect on the supply, distribution, or use of energy. Therefore, it 
does not require a Statement of Energy Effects under E.O. 13211.

O. 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.

P. National Technology Transfer and Advancement Act (Technical 
Standards)

    The National Technology Transfer and Advancement Act (NTTAA) (15 
U.S.C. 272 note) directs agencies to use voluntary consensus standards 
in their regulatory activities unless the agency provides Congress, 
through OMB, with an explanation of why using these standards would be 
inconsistent with applicable law or otherwise impractical. Voluntary 
consensus standards (e.g., specifications of materials, performance, 
design, or operation; test methods; sampling procedures; and related 
management systems practices) are standards that are developed or 
adopted by voluntary consensus standards bodies. This rule does not use 
technical standards. Therefore, we did not consider the use of 
voluntary consensus standards.

List of Subjects

49 CFR Part 383

    Administrative practice and procedure, Alcohol abuse, Drug abuse, 
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 384

    Administrative practice and procedure, Alcohol abuse, Drug abuse, 
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 391

    Alcohol abuse, Drug abuse, Drug testing, Highway safety, Motor 
carriers, Reporting and recordkeeping requirements, Safety, 
Transportation.

    For the reasons stated in the preamble, FMCSA amends 49 CFR chapter 
III, to read as follows:

PART 383--COMMERCIAL DRIVER'S LICENSE STANDARDS; REQUIREMENTS AND 
PENALTIES

0
1. The authority citation for part 383 continues to read as follows:

    Authority: 49 U.S.C. 521, 31136, 31301 et seq., and 31502; secs. 
214 and 215, Pub. L. 106-159, 113 Stat. 1748, 1766, 1767; sec. 4140, 
Pub. L. 109-59, 119 Stat. 1144, 1746; and 49 CFR 1.87.

0
2. Amend Sec.  383.71 by revising paragraphs (h)(1) and (3) to read as 
follows:

Sec.  383.71  Driver application and certification procedures.

* * * * *
    (h) * * *
    (1) New CLP and CDL applicants. (i) Before June 22, 2018, a new CLP 
or CDL applicant who certifies that he/she will operate CMVs in non-
excepted, interstate commerce must provide the State with an original 
or copy (as required by the State) of a medical examiner's certificate 
prepared by a medical examiner, as defined in 49 CFR 390.5, and the 
State will post a medical qualifications status of ``certified'' on the 
CDLIS driver record for the driver;
    (ii) On or after June 22, 2018, a new CLP or CDL applicant who 
certifies that he/she will operate CMVs in non-excepted, interstate 
commerce must be medically examined and certified in accordance with 49 
CFR 391.43 as medically qualified to operate a CMV by a medical 
examiner, as defined in 49 CFR 390.5. Upon receiving an electronic copy 
of the medical examiner's certificate from FMCSA, the State will post a 
medical qualifications status of ``certified'' on the CDLIS driver 
record for the driver;
* * * * *
    (3) Maintaining the medical certification status of ``certified.'' 
(i) In order to maintain a medical certification status of 
``certified,'' before June 22, 2018, a CLP or CDL holder who certifies 
that he/she will operate CMVs in non-excepted, interstate commerce must 
provide the State with an original or copy (as required by the State) 
of each subsequently issued medical examiner's certificate;
    (ii) In order to maintain a medical certification status of 
``certified,'' on or after June 22, 2018, a CLP or CDL holder who 
certifies that he/she will operate CMVs in non-excepted, interstate 
commerce must continue to be medically examined and certified in 
accordance with 49 CFR 391.43 as physically qualified to operate a 
commercial motor vehicle by a medical examiner, as defined in 49 CFR 
390.5. FMCSA will provide the State with an electronic copy of the 
medical examiner's certificate information for all subsequent medical 
examinations in which the driver has been deemed qualified.

0
3. Amend Sec.  383.73 by revising paragraphs (a)(2)(vii), (b)(5), 
(o)(1), (o)(2), (o)(3) and (o)(4) to read as follows:

Sec.  383.73  State procedures.

    (a) * * *
    (2) * * *
    (vii)(A) Before June 22, 2018, for drivers who certified their type 
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted 
interstate) and, if the CLP applicant submits a current medical 
examiner's certificate, date-stamp the medical examiner's certificate, 
and post all required information from the medical examiner's 
certificate to the CDLIS driver record in accordance with paragraph (o) 
of this section.
    (B) On or after June 22, 2018, for drivers who certified their type 
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted 
interstate) and, if FMCSA provides current medical examiner's 
certificate information electronically, post all required information 
matching the medical examiner's certificate to the CDLIS driver record 
in accordance with paragraph (o) of this section.
    (b) * * *
    (5)(i) Before June 22, 2018, for drivers who certified their type 
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted 
interstate) and, if the CDL holder submits a current medical examiner's 
certificate, date-stamp the medical examiner's certificate and post all 
required information from the medical examiner's certificate to the 
CDLIS driver record in accordance with paragraph (o) of this section.
    (ii) On or after June 22, 2018, for drivers who certified their 
type of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted 
interstate) and, if FMCSA provides current medical examiner's 
certificate information electronically, post all required information 
matching the medical examiner's certificate to the CDLIS driver record 
in accordance with paragraph (o) of this section.
* * * * *
    (o) Medical recordkeeping--(1)(i) Status of CLP or CDL holder. 
Before

[[Page 22811]]

June 22, 2018, for each operator of a commercial motor vehicle required 
to have a CLP or CDL, the current licensing State must:
    (A) Post the driver's self-certification of type of driving under 
Sec.  383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate 
within 10 calendar days to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e., 
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's 
certificate, such as an exemption, SPE certification, or grandfather 
provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid, 
required to have possession of an exemption letter or SPE certificate 
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted 
to the CDLIS driver record; and
    (C) Post the medical variance information within 10 calendar days 
to the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D) Retain the original or a copy of the medical examiner's 
certificate of any driver required to provide documentation of physical 
qualification for 3 years beyond the date the certificate was issued.
    (ii) Status of CLP or CDL holder. On or after June 22, 2018, for 
each operator of a commercial motor vehicle required to have a CLP or 
CDL, the current licensing State must:
    (A) Post the driver's self-certification of type of driving under 
Sec.  383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate 
received from FMCSA to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e., 
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's 
certificate, such as an exemption, Skill Performance Evaluation (SPE) 
certification, or grandfather provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid, 
required to have possession of an exemption letter or SPE certificate 
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted 
to the CDLIS driver record;
    (C) Post the medical variance information received from FMCSA 
within 1 business day to the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D) Retain the electronic record of the medical examiner's 
certificate information for any driver required to have documentation 
of physical qualification for 3 years beyond the date the certificate 
was issued.
    (2) Status update. (i) Before June 22, 2018, the State must, within 
10 calendar days of the driver's medical examiner's certificate or 
medical variance expiring, the medical variance being rescinded or the 
medical examiner's certificate being voided by FMCSA, update the 
medical certification status of that driver as ``not certified.''
    (ii) Beginning June 22, 2018, the State must, within 10 calendar 
days of the driver's medical examiner's certificate or medical variance 
expiring, the medical examiner's certificate becoming invalid, the 
medical variance being rescinded or the medical examiner's certificate 
being voided by FMCSA, update the medical certification status of that 
driver as ``not certified.''
    (3) Variance update. (i) Before June 22, 2018, within 10 calendar 
days of receiving information from FMCSA regarding issuance or renewal 
of a medical variance for a driver, the State must update the CDLIS 
driver record to include the medical variance information provided by 
FMCSA.
    (ii) Beginning June 22, 2018, within 1 business day of 
electronically receiving medical variance information from FMCSA 
regarding the issuance or renewal of a medical variance for a driver, 
the State must update the CDLIS driver record to include the medical 
variance information provided by FMCSA.
    (4) Downgrade. (i) If a driver's medical certification or medical 
variance expires, or FMCSA notifies the State that a medical 
certification was invalidated or voided or a medical variance was 
removed or rescinded, the State must:
    (A)(1) Before June 22, 2018 notify the CLP or CDL holder of his/her 
CLP or CDL ``not-certified'' medical certification status and that the 
CMV privileges will be removed from the CLP or CDL unless the driver 
submits a current medical examiner's certificate and/or medical 
variance, or changes his/her self-certification to driving only in 
excepted or intrastate commerce (if permitted by the State);
    (2) On or after June 22, 2018 notify the CLP or CDL holder of his/
her CLP or CDL ``not-certified'' medical certification status and that 
the CMV privileges will be removed from the CLP or CDL unless the 
driver has been medically examined and certified in accordance with 49 
CFR 391.43 as physically qualified to operate a commercial motor 
vehicle by a medical examiner, as defined in 49 CFR 390.5, or the 
driver changes his/her self-certification to driving only in excepted 
or intrastate commerce (if permitted by the State).
    (B) Initiate established State procedures for downgrading the CLP 
or CDL. The CLP or CDL downgrade must be completed and recorded within 
60 days of the driver's medical certification status becoming ``not-
certified'' to operate a CMV.
    (ii)(A) Before June 22, 2018, if a driver fails to provide the 
State with the certification contained in Sec.  383.71(b)(1), or a 
current medical examiner's certificate if the driver self-certifies 
according to Sec.  383.71(b)(1)(i) that he/she is operating in non-
excepted interstate commerce as required by Sec.  383.71(h), the State 
must mark that CDLIS driver record as ``not-certified'' and initiate a 
CLP or CDL downgrade following State procedures in accordance with 
paragraph (o)(4)(i)(B) of this section.
    (B) On or after June 22, 2018 if a driver fails to provide the 
State with the certification contained in Sec.  383.71(b)(1), or, if 
the driver self-certifies according to Sec.  383.71(b)(1)(i) that he/
she is operating in non-excepted interstate commerce as required by 
Sec.  383.71(h) and the information required by paragraph (o)(2)(ii) of 
this section is not received and posted, the State must mark that CDLIS 
driver record as ``not-certified'' and initiate a CLP or CDL downgrade 
following State procedures in accordance with paragraph (o)(4)(i)(B) of 
this section.
* * * * *

[[Page 22812]]

PART 384--STATE COMPLIANCE WITH COMMERCIAL DRIVER'S LICENSE PROGRAM

0
4. The authority citation for part 384 continues to read as follows:

    Authority: 49 U.S.C. 31136, 31301, et seq., and 31502; secs. 103 
and 215, Pub. L. 106-159, 113 Stat. 1748, 1753, 1767; and 49 CFR 
1.87.

0
5. Revise Sec.  384.234 to read as follows:

Sec.  384.234  Driver medical certification recordkeeping.

    The State must meet the medical certification recordkeeping 
requirements of Sec.  383.73(a)(2)(vii), (b)(5), (c)(8), (d)(8), (e)(6) 
and (o).

0
6. Amend Sec.  384.301 by adding a new paragraph (i) to read as 
follows:

Sec.  384.301  Substantial compliance--general requirements.

* * * * *
    (i) A State must come into substantial compliance with the 
requirements of subpart B of this part and part 383 of this chapter in 
effect as of June 22, 2015 as soon as practical, but, unless otherwise 
specifically provided in this part, not later than June 22, 2018.

PART 391--QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION (LCV) 
DRIVER INSTRUCTORS

0
7. The authority citation for part 391 continues to read as follows:

    Authority: 49 U.S.C. 504, 508, 31133, 31136, and 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; and 49 CFR 1.87.

0
8. Amend Sec.  391.23 by revising paragraphs (m)(2) and (3) to read as 
follows:

Sec.  391.23  Investigation and inquiries.

* * * * *
    (m) * * *
    (2) Exception. For drivers required to have a commercial driver's 
license under part 383 of this chapter:
    (i) Beginning January 30, 2015, using the CDLIS motor vehicle 
record obtained from the current licensing State, the motor carrier 
must verify and document in the driver qualification file the following 
information before allowing the driver to operate a CMV:
    (A) The type of operation the driver self-certified that he or she 
will perform in accordance with Sec.  383.71(b)(1)(ii) of this chapter.
    (B)(1) Beginning on May 21, 2014, and ending on June 22, 2015, that 
the driver was certified by a medical examiner listed on the National 
Registry of Certified Medical Examiners as of the date of medical 
examiner's certificate issuance.
    (2) Beginning on June 22, 2015, if the driver has certified under 
paragraph (m)(2)(i)(A) of this section that he or she expects to 
operate in interstate commerce, that the driver has a valid medical 
examiner's certificate and any required medical variances.
    (3) Beginning on July 8, 2015, if the driver has a commercial 
learner's permit and has certified under paragraph (m)(2)(i)(A) of this 
section that he or she expects to operate in interstate commerce that 
the driver has a valid medical examiner's certificate and any required 
medical variances.
    (C) Exception. Beginning on January 30, 2015 and until June 22, 
2018, if the driver provided the motor carrier with a copy of the 
current medical examiner's certificate that was submitted to the State 
in accordance with Sec.  383.73(a)(5) of this chapter, the motor 
carrier may use a copy of that medical examiner's certificate as proof 
of the driver's medical certification for up to 15 days after the date 
it was issued.
    (ii) Until January 30, 2015, if a driver operating in non-excepted, 
interstate commerce has no medical certification status information on 
the CDLIS MVR obtained from the current State driver licensing agency, 
the employing motor carrier may accept a medical examiner's certificate 
issued to that driver, and place a copy of it in the driver 
qualification file before allowing the driver to operate a CMV in 
interstate commerce.
    (3) Exception. For drivers required to have a commercial driver's 
license under part 383 of this chapter:
    (i) Beginning July 8, 2015, using the CDLIS motor vehicle record 
obtained from the current licensing State, the motor carrier must 
verify and document in the driver qualification file the following 
information before allowing the driver to operate a CMV:
    (A) The type of operation the driver self-certified that he or she 
will perform in accordance with Sec.  383.71(a)(1)(ii) and (g) of this 
chapter.
    (B) That the driver was certified by a medical examiner listed on 
the National Registry of Certified Medical Examiners as of the date of 
medical examiner's certificate issuance.
* * * * *

0
9. Amend Sec.  391.41 by revising paragraph (a)(2)(i) to read as 
follows:

Sec.  391.41  Physical qualifications for drivers.

    (a) * * *
    (2) CDL exception. (i)(A) Beginning on January 30, 2015 and ending 
on the day before June 22, 2018, a driver required to have a commercial 
driver's license under part 383 of this chapter, and who submitted a 
current medical examiner's certificate to the State in accordance with 
49 CFR 383.71(h) documenting that he or she meets the physical 
qualification requirements of this part, no longer needs to carry on 
his or her person the medical examiner's certificate specified at Sec.  
391.43(h), or a copy, for more than 15 days after the date it was 
issued as valid proof of medical certification.
    (B) Beginning on June 22, 2018, a driver required to have a 
commercial driver's license or a commercial learner's permit under 49 
CFR part 383, and who has a current medical examiner's certificate 
documenting that he or she meets the physical qualification 
requirements of this part, is no longer needs to carry on his or her 
person the medical examiner's certificate specified at Sec.  391.43(h).
* * * * *

0
10. Amend Sec.  391.43 by revising paragraphs (f), (g)(2), (g)(3) and 
(h), and adding paragraph (g)(4) and (g)(5), to read as follows:

Sec.  391.43  Medical examination; certificate of physical examination.

* * * * *
    (f) The medical examination shall be performed, and its results 
shall be recorded on the Medical Examination Report set out below:
BILLING CODE 4910-EX-P

[[Page 22813]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.000

[[Page 22814]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.001

[[Page 22815]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.002

[[Page 22816]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.003

[[Page 22817]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.004

[[Page 22818]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.005

[[Page 22819]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.006

[[Page 22820]]

[GRAPHIC] [TIFF OMITTED] TR23AP15.007

BILLING CODE 4910-EX-C
    (g) * * *
    (2)(i) Before June 22, 2018, if the medical examiner finds that the 
person examined is physically qualified to operate a commercial motor 
vehicle in accordance with Sec.  391.41(b), he or she must complete a 
certificate in the form prescribed in paragraph (h) of this section and 
furnish the original to the person who was examined. The examiner must 
provide a copy to a prospective or current employing motor carrier who 
requests it.
    (ii) Beginning June 22, 2018, if the medical examiner identifies 
that the person examined will not be operating a commercial motor 
vehicle that requires a commercial driver's license or a commercial 
learner's permit and finds that the driver is physically qualified to 
operate a commercial motor vehicle in accordance with Sec.  391.41(b), 
he or she must complete a certificate in the form prescribed in 
paragraph (h) of this section and furnish the original to the person 
who was examined. The examiner must provide a copy to a prospective or 
current employing motor carrier who requests it.
    (3) Beginning June 22, 2018, if the medical examiner finds that the 
person examined is not physically qualified to operate a commercial 
motor vehicle in accordance with Sec.  391.41(b), he or she must inform 
the person examined that

[[Page 22821]]

he or she is not physically qualified, and that this information will 
be reported to FMCSA. All medical examiner's certificates previously 
issued to the person are not valid and no longer satisfy the 
requirements of Sec.  391.41(a).
    (4) Beginning June 22, 2018, if the medical examiner finds that the 
determination of whether the person examined is physically qualified to 
operate a commercial motor vehicle in accordance with Sec.  391.41(b) 
should be delayed pending the receipt of additional information or the 
conduct of further examination in order for the medical examiner to 
make such determination, he or she must inform the person examined that 
the additional information must be provided or the further examination 
completed within 45 days, and that the pending status of the 
examination will be reported to FMCSA.
    (5)(i)(A) Once every calendar month, beginning May 21, 2014 and 
ending on June 22, 2018, the medical examiner must electronically 
transmit to the Director, Office of Carrier, Driver and Vehicle Safety 
Standards, via a secure Web account on the National Registry, a 
completed CMV Driver Medical Examination Results Form, MCSA-5850. The 
Form must include all information specified for each medical 
examination conducted during the previous month for any driver who is 
required to be examined by a medical examiner listed on the National 
Registry of Certified Medical Examiners.
    (B) Beginning June 22, 2018 by midnight (local time) of the next 
calendar day after the medical examiner completes a medical examination 
for any driver who is required to be examined by a medical examiner 
listed on the National Registry of Certified Medical Examiners, the 
medical examiner must electronically transmit to the Director, Office 
of Carrier, Driver and Vehicle Safety Standards, via a secure FMCSA-
designated Web site, a completed CMV Driver Medical Examination Results 
Form, MCSA-5850. The Form must include all information specified for 
each medical examination conducted for each driver who is required to 
be examined by a medical examiner listed on the National Registry of 
Certified Medical Examiners in accordance with the provisions of this 
subpart E, and should also include information for each driver who is 
required by a State to be examined by a medical examiner listed on the 
National Registry of Certified Medical Examiners in accordance with the 
provisions of this subpart E and any variances from those provisions 
adopted by such State.
    (ii) Beginning on May 21, 2014, if the medical examiner does not 
perform a medical examination of any driver who is required to be 
examined by a medical examiner listed on the National Registry of 
Certified Medical Examiners during any calendar month, the medical 
examiner must report that fact to FMCSA, via a secure FMCSA-designated 
Web site, by the close of business on the last day of such month.
    (h) The medical examiner's certificate shall be completed in 
accordance with the following Form MCSA-5876, Medical Examiner's 
Certificate.
[GRAPHIC] [TIFF OMITTED] TR23AP15.008

* * * * *

0
11. Amend Sec.  391.45 by revising paragraphs (b)(2) and (c), and 
adding new paragraph (d) to read as follows:

Sec.  391.45  Persons who must be medically examined and certified.

* * * * *
    (b) * * *
    (2) Any driver authorized to operate a commercial motor vehicle 
only with an exempt intracity zone pursuant to Sec.  391.62, or only by 
operation of the exemption in Sec.  391.64, if such driver has not been 
medically examined and certified as qualified to drive in such zone 
during the preceding 12 months;
    (c) Any driver whose ability to perform his/her normal duties has 
been

[[Page 22822]]

impaired by a physical or mental injury or disease; and
    (d) Beginning June 22, 2018, any person found by a medical examiner 
not to be physically qualified to operate a commercial motor vehicle 
under the provisions of paragraph (g)(3) of Sec.  391.43.

0
12. Amend Sec.  391.51 by revising paragraphs (b)(7)(i) and (ii), and 
(b)(9) to read as follows:

Sec.  391.51  General requirements for driver qualification files.

* * * * *
    (b) * * *
    (7)(i) The medical examiner's certificate as required by Sec.  
391.43(g) or a legible copy of the certificate.
    (ii) Exception. For CDL holders, beginning January 30, 2012, if the 
CDLIS motor vehicle record contains medical certification status 
information, the motor carrier employer must meet this requirement by 
obtaining the CDLIS motor vehicle record defined at Sec.  384.105 of 
this chapter. That record must be obtained from the current licensing 
State and placed in the driver qualification file. After January 30, 
2015 a non-excepted, interstate CDL holder without medical 
certification status information on the CDLIS motor vehicle record is 
designated ``not-certified'' to operate a CMV in interstate commerce. 
After January 30, 2015 and until June 22, 2018, a motor carrier may use 
a copy of the driver's current medical examiner's certificate that was 
submitted to the State for up to 15 days from the date it was issued as 
proof of medical certification.
* * * * *
    (9)(i) For drivers not required to have a CDL, a note relating to 
verification of medical examiner listing on the National Registry of 
Certified Medical Examiners required by Sec.  391.23(m)(1).
    (ii) Until June 22, 2018, for drivers required to have a CDL, a 
note relating to verification of medical examiner listing on the 
National Registry of Certified Medical Examiners required by Sec.  
391.23(m)(2).
* * * * *

0
13. Add Appendix A to Part 391 to read as follows:

Appendix A to Part 391--Medical Advisory Criteria

I. Introduction

    This appendix contains the Agency's guidelines in the form of 
Medical Advisory Criteria to help medical examiners assess a 
driver's physical qualification. These guidelines are strictly 
advisory and were established after consultation with physicians, 
States, and industry representatives, and, in some areas, after 
consideration of recommendations from the Federal Motor Carrier 
Safety Administration's Medical Review Board and Medical Expert 
Panels.

II. Interpretation of Medical Standards

    Since the issuance of the regulations for physical 
qualifications of commercial motor vehicle drivers, the Federal 
Motor Carrier Safety Administration has published recommendations 
called Advisory Criteria to help medical examiners in determining 
whether a driver meets the physical qualifications for commercial 
driving. These recommendations have been condensed to provide 
information to medical examiners that is directly relevant to the 
physical examination and is not already included in the Medical 
Examination Report Form.

A. Loss of Limb: Sec.  391.41(b)(1)

    A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no loss of a foot, leg, hand or an arm, 
or has been granted a Skills Performance Evaluation certificate 
pursuant to Sec.  391.49.

B. Limb Impairment: Sec.  391.41(b)(2)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no impairment of:
    (i) A hand or finger which interferes with prehension or power 
grasping; or
    (ii) An arm, foot, or leg which interferes with the ability to 
perform normal tasks associated with operating a commercial motor 
vehicle; or
    (iii) Any other significant limb defect or limitation which 
interferes with the ability to perform normal tasks associated with 
operating a commercial motor vehicle; or
    (iv) Has been granted a Skills Performance Evaluation 
certificate pursuant to Sec.  391.49.
    2. A person who suffers loss of a foot, leg, hand or arm or 
whose limb impairment in any way interferes with the safe 
performance of normal tasks associated with operating a commercial 
motor vehicle is subject to the Skills Performance Evaluation 
Certificate Program pursuant to Sec.  391.49, assuming the person is 
otherwise qualified.
    3. With the advancement of technology, medical aids and 
equipment modifications have been developed to compensate for 
certain disabilities. The Skills Performance Evaluation Certificate 
Program (formerly the Limb Waiver Program) was designed to allow 
persons with the loss of a foot or limb or with functional 
impairment to qualify under the Federal Motor Carrier Safety 
Regulations by use of prosthetic devices or equipment modifications 
which enable them to safely operate a commercial motor vehicle. 
Since there are no medical aids equivalent to the original body or 
limb, certain risks are still present, and thus restrictions may be 
included on individual Skills Performance Evaluation certificates 
when a State Director for the Federal Motor Carrier Safety 
Administration determines they are necessary to be consistent with 
safety and public interest.
    4. If the driver is found otherwise medically qualified (Sec.  
391.41(b)(3) through (13)), the medical examiner must check on the 
Medical Examiner's Certificate that the driver is qualified only if 
accompanied by a Skills Performance Evaluation certificate. The 
driver and the employing motor carrier are subject to appropriate 
penalty if the driver operates a motor vehicle in interstate or 
foreign commerce without a current Skill Performance Evaluation 
certificate for his/her physical disability.

C. Diabetes: Sec.  391.41(b)(3)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no established medical history or 
clinical diagnosis of diabetes mellitus currently requiring insulin 
for control.
    2. Diabetes mellitus is a disease which, on occasion, can result 
in a loss of consciousness or disorientation in time and space. 
Individuals who require insulin for control have conditions which 
can get out of control by the use of too much or too little insulin, 
or food intake not consistent with the insulin dosage. 
Incapacitation may occur from symptoms of hyperglycemic or 
hypoglycemic reactions (drowsiness, semi consciousness, diabetic 
coma or insulin shock).
    3. The administration of insulin is, within itself, a 
complicated process requiring insulin, syringe, needle, alcohol 
sponge and a sterile technique. Factors related to long-haul 
commercial motor vehicle operations, such as fatigue, lack of sleep, 
poor diet, emotional conditions, stress, and concomitant illness, 
compound the dangers, the Federal Motor Carrier Safety 
Administration has consistently held that a diabetic who uses 
insulin for control does not meet the minimum physical requirements 
of the Federal Motor Carrier Safety Regulations.
    4. Hypoglycemic drugs, taken orally, are sometimes prescribed 
for diabetic individuals to help stimulate natural body production 
of insulin. If the condition can be controlled by the use of oral 
medication and diet, then an individual may be qualified under the 
present rule. Commercial motor vehicle drivers who do not meet the 
Federal diabetes standard may call (202) 366-4001 for an application 
for a diabetes exemption.

D. Cardiovascular Condition: Sec.  391.41(b)(4)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no current clinical diagnosis of 
myocardial infarction, angina pectoris, coronary insufficiency, 
thrombosis or any other cardiovascular disease of a variety known to 
be accompanied by syncope, dyspnea, collapse or congestive cardiac 
failure.
    2. The term ``has no current clinical diagnosis of'' is 
specifically designed to encompass: ``a clinical diagnosis of'' a 
current cardiovascular condition, or a cardiovascular condition 
which has not fully stabilized regardless of the time limit. The 
term ``known to be accompanied by'' is designed to include a 
clinical diagnosis of a cardiovascular disease which is accompanied 
by symptoms of syncope, dyspnea, collapse or congestive cardiac 
failure; and/or which is s likely to cause syncope, dyspnea, 
collapse or congestive cardiac failure.
    3. It is the intent of the Federal Motor Carrier Safety 
Regulations to render

[[Page 22823]]

unqualified, a driver who has a current cardiovascular disease which 
is accompanied by and/or likely to cause symptoms of syncope, 
dyspnea, collapse, or congestive cardiac failure. However, the 
subjective decision of whether the nature and severity of an 
individual's condition will likely cause symptoms of cardiovascular 
insufficiency is on an individual basis and qualification rests with 
the medical examiner and the motor carrier. In those cases where 
there is an occurrence of cardiovascular insufficiency (myocardial 
infarction, thrombosis, etc.), it is suggested before a driver is 
certified that he or she have a normal resting and stress 
electrocardiogram, no residual complications and no physical 
limitations, and is taking no medication likely to interfere with 
safe driving.
    4. Coronary artery bypass surgery and pacemaker implantation are 
remedial procedures and thus, not medically disqualifying. 
Implantable cardioverter defibrillators are disqualifying due to 
risk of syncope. Coumadin is a medical treatment which can improve 
the health and safety of the driver and should not, by its use, 
medically disqualify the commercial motor vehicle driver. The 
emphasis should be on the underlying medical condition(s) which 
require treatment and the general health of the driver. The Federal 
Motor Carrier Safety Administration should be contacted at (202) 
366-4001 for additional recommendations regarding the physical 
qualification of drivers on coumadin.

E. Respiratory Dysfunction: Sec.  391.41(b)(5)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no established medical history or 
clinical diagnosis of a respiratory dysfunction likely to interfere 
with ability to control and drive a commercial motor vehicle safely.
    2. Since a driver must be alert at all times, any change in his 
or her mental state is in direct conflict with highway safety. Even 
the slightest impairment in respiratory function under emergency 
conditions (when greater oxygen supply is necessary for performance) 
may be detrimental to safe driving.
    3. There are many conditions that interfere with oxygen exchange 
and may result in incapacitation, including emphysema, chronic 
asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. 
If the medical examiner detects a respiratory dysfunction, that in 
any way is likely to interfere with the driver's ability to safely 
control and drive a commercial motor vehicle, the driver must be 
referred to a specialist for further evaluation and therapy. 
Anticoagulation therapy for deep vein thrombosis and/or pulmonary 
thromboembolism is not medically disqualifying once optimum dose is 
achieved, provided lower extremity venous examinations remain normal 
and the treating physician gives a favorable recommendation.

F. Hypertension: Sec.  391.41(b)(6)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no current clinical diagnosis of high 
blood pressure likely to interfere with ability to operate a 
commercial motor vehicle safely.
    2. Hypertension alone is unlikely to cause sudden collapse; 
however, the likelihood increases when target organ damage, 
particularly cerebral vascular disease, is present. This regulatory 
criteria is based on the Federal Motor Carrier Safety 
Administration's Cardiovascular Advisory Guidelines for the 
Examination of commercial motor vehicle Drivers, which used the 
Sixth Report of the Joint National Committee on Detection, 
Evaluation, and Treatment of High Blood Pressure (1997).
    3. Stage 1 hypertension corresponds to a systolic blood pressure 
of 140-159 mmHg and/or a diastolic blood pressure of 90-99 mmHg. The 
driver with a blood pressure in this range is at low risk for 
hypertension-related acute incapacitation and may be medically 
certified to drive for a one-year period. Certification examinations 
should be done annually thereafter and should be at or less than 
140/90. If less than 160/100, certification may be extended one time 
for 3 months.
    4. A blood pressure of 160-179 systolic and/or 100-109 diastolic 
is considered Stage 2 hypertension, and the driver is not 
necessarily unqualified during evaluation and institution of 
treatment. The driver is given a one-time certification of three 
months to reduce his or her blood pressure to less than or equal to 
140/90. A blood pressure in this range is an absolute indication for 
anti-hypertensive drug therapy. Provided treatment is well tolerated 
and the driver demonstrates a blood pressure value of 140/90 or 
less, he or she may be certified for one year from date of the 
initial exam. The driver is certified annually thereafter.
    5. A blood pressure at or greater than 180 (systolic) and 110 
(diastolic) is considered Stage 3, high risk for an acute blood 
pressure-related event. The driver may not be qualified, even 
temporarily, until reduced to 140/90 or less and treatment is well 
tolerated. The driver may be certified for 6 months and biannually 
(every 6 months) thereafter if at recheck blood pressure is 140/90 
or less.
    6. Annual recertification is recommended if the medical examiner 
does not know the severity of hypertension prior to treatment. An 
elevated blood pressure finding should be confirmed by at least two 
subsequent measurements on different days.
    7. Treatment includes nonpharmacologic and pharmacologic 
modalities as well as counseling to reduce other risk factors. Most 
antihypertensive medications also have side effects, the importance 
of which must be judged on an individual basis. Individuals must be 
alerted to the hazards of these medications while driving. Side 
effects of somnolence or syncope are particularly undesirable in 
commercial motor vehicle drivers.
    8. Secondary hypertension is based on the above stages. 
Evaluation is warranted if patient is persistently hypertensive on 
maximal or near-maximal doses of 2-3 pharmacologic agents. Some 
causes of secondary hypertension may be amenable to surgical 
intervention or specific pharmacologic disease.

G. Rheumatic, Arthritic, Orthopedic, Muscular, Neuromuscular or 
Vascular Disease: Sec.  391.41(b)(7)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no established medical history or 
clinical diagnosis of rheumatic, arthritic, orthopedic, muscular, 
neuromuscular or vascular disease which interferes with the ability 
to control and operate a commercial motor vehicle safely.
    2. Certain diseases are known to have acute episodes of 
transient muscle weakness, poor muscular coordination (ataxia), 
abnormal sensations (paresthesia), decreased muscular tone 
(hypotonia), visual disturbances and pain which may be suddenly 
incapacitating. With each recurring episode, these symptoms may 
become more pronounced and remain for longer periods of time. Other 
diseases have more insidious onsets and display symptoms of muscle 
wasting (atrophy), swelling and paresthesia which may not suddenly 
incapacitate a person but may restrict his/her movements and 
eventually interfere with the ability to safely operate a motor 
vehicle. In many instances these diseases are degenerative in nature 
or may result in deterioration of the involved area.
    3. Once the individual has been diagnosed as having a rheumatic, 
arthritic, orthopedic, muscular, neuromuscular or vascular disease, 
then he/she has an established history of that disease. The 
physician, when examining an individual, should consider the 
following: The nature and severity of the individual's condition 
(such as sensory loss or loss of strength); the degree of limitation 
present (such as range of motion); the likelihood of progressive 
limitation (not always present initially but may manifest itself 
over time); and the likelihood of sudden incapacitation. If severe 
functional impairment exists, the driver does not qualify. In cases 
where more frequent monitoring is required, a certificate for a 
shorter period of time may be issued.

H. Epilepsy: Sec.  391.41(b)(8)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no established medical history or 
clinical diagnosis of epilepsy or any other condition which is 
likely to cause loss of consciousness or any loss of ability to 
control a motor vehicle.
    2. Epilepsy is a chronic functional disease characterized by 
seizures or episodes that occur without warning, resulting in loss 
of voluntary control which may lead to loss of consciousness and/or 
seizures. Therefore, the following drivers cannot be qualified:
    (i) A driver who has a medical history of epilepsy;
    (ii) A driver who has a current clinical diagnosis of epilepsy; 
or
    (ii) A driver who is taking antiseizure medication.
    3. If an individual has had a sudden episode of a nonepileptic 
seizure or loss of consciousness of unknown cause which did not 
require antiseizure medication, the decision as to whether that 
person's condition will likely cause loss of consciousness or loss 
of ability to control a motor vehicle is made on an individual basis 
by the medical examiner in consultation with

[[Page 22824]]

the treating physician. Before certification is considered, it is 
suggested that a 6 month waiting period elapse from the time of the 
episode. Following the waiting period, it is suggested that the 
individual have a complete neurological examination. If the results 
of the examination are negative and antiseizure medication is not 
required, then the driver may be qualified.
    4. In those individual cases where a driver has a seizure or an 
episode of loss of consciousness that resulted from a known medical 
condition (e.g., drug reaction, high temperature, acute infectious 
disease, dehydration or acute metabolic disturbance), certification 
should be deferred until the driver has fully recovered from that 
condition and has no existing residual complications, and not taking 
antiseizure medication.
    5. Drivers with a history of epilepsy/seizures off antiseizure 
medication and seizure-free for 10 years may be qualified to drive a 
commercial motor vehicle in interstate commerce. Interstate drivers 
with a history of a single unprovoked seizure may be qualified to 
drive a commercial motor vehicle in interstate commerce if seizure-
free and off antiseizure medication for a 5-year period or more.

I. Mental Disorders: Sec.  391.41(b)(9)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no mental, nervous, organic or 
functional disease or psychiatric disorder likely to interfere with 
ability to drive a motor vehicle safely.
    2. Emotional or adjustment problems contribute directly to an 
individual's level of memory, reasoning, attention, and judgment. 
These problems often underlie physical disorders. A variety of 
functional disorders can cause drowsiness, dizziness, confusion, 
weakness or paralysis that may lead to incoordination, inattention, 
loss of functional control and susceptibility to accidents while 
driving. Physical fatigue, headache, impaired coordination, 
recurring physical ailments and chronic ``nagging'' pain may be 
present to such a degree that certification for commercial driving 
is inadvisable. Somatic and psychosomatic complaints should be 
thoroughly examined when determining an individual's overall fitness 
to drive. Disorders of a periodically incapacitating nature, even in 
the early stages of development, may warrant disqualification.
    3. Many bus and truck drivers have documented that ``nervous 
trouble'' related to neurotic, personality, or emotional or 
adjustment problems is responsible for a significant fraction of 
their preventable accidents. The degree to which an individual is 
able to appreciate, evaluate and adequately respond to environmental 
strain and emotional stress is critical when assessing an 
individual's mental alertness and flexibility to cope with the 
stresses of commercial motor vehicle driving.
    4. When examining the driver, it should be kept in mind that 
individuals who live under chronic emotional upsets may have deeply 
ingrained maladaptive or erratic behavior patterns. Excessively 
antagonistic, instinctive, impulsive, openly aggressive, paranoid or 
severely depressed behavior greatly interfere with the driver's 
ability to drive safely. Those individuals who are highly 
susceptible to frequent states of emotional instability 
(schizophrenia, affective psychoses, paranoia, anxiety or depressive 
neuroses) may warrant disqualification. Careful consideration should 
be given to the side effects and interactions of medications in the 
overall qualification determination.

J. Vision: Sec.  391.41(b)(10)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has distant visual acuity of at least 20/40 
(Snellen) in each eye with or 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.
    2. The term ``ability to recognize the colors of'' is 
interpreted to mean if a person can recognize and distinguish among 
traffic control signals and devices showing standard red, green and 
amber, he or she meets the minimum standard, even though he or she 
may have some type of color perception deficiency. If certain color 
perception tests are administered, (such as Ishihara, 
Pseudoisochromatic, Yarn) and doubtful findings are discovered, a 
controlled test using signal red, green and amber may be employed to 
determine the driver's ability to recognize these colors.
    3. Contact lenses are permissible if there is sufficient 
evidence to indicate that the driver has good tolerance and is well 
adapted to their use. Use of a contact lens in one eye for distance 
visual acuity and another lens in the other eye for near vision is 
not acceptable, nor telescopic lenses acceptable for the driving of 
commercial motor vehicles.
    4. If an individual meets the criteria by the use of glasses or 
contact lenses, the following statement shall appear on the Medical 
Examiner's Certificate: ``Qualified only if wearing corrective 
lenses.'' commercial motor vehicle drivers who do not meet the 
Federal vision standard may call (202) 366-4001 for an application 
for a vision exemption.

K. Hearing: Sec.  391.41(b)(11)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: First perceives a forced whispered voice in 
the better ear at not less than 5 feet with or without the use of a 
hearing aid, or, if tested by use of an audiometric device, does not 
have an average hearing loss in the better ear greater than 40 
decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing 
aid when the audiometric device is calibrated to American National 
Standard (formerly ADA Standard) Z24.5-1951.
    2. Since the prescribed standard under the Federal Motor Carrier 
Safety Regulations is from the American National Standards 
Institute, formerly the American Standards Association, it may be 
necessary to convert the audiometric results from the International 
Organization for Standardization standard to the American National 
Standards Institute standard. Instructions are included on the 
Medical Examination Report Form.
    3. If an individual meets the criteria by using a hearing aid, 
the driver must wear that hearing aid and have it in operation at 
all times while driving. Also, the driver must be in possession of a 
spare power source for the hearing aid.
    4. For the whispered voice test, the individual should be 
stationed at least 5 feet from the medical examiner with the ear 
being tested turned toward the medical examiner. The other ear is 
covered. Using the breath which remains after a normal expiration, 
the medical examiner whispers words or random numbers such as 66, 
18, 3, etc. The medical examiner should not use only sibilants (s 
sounding materials). The opposite ear should be tested in the same 
manner.
    5. If the individual fails the whispered voice test, the 
audiometric test should be administered. If an individual meets the 
criteria by the use of a hearing aid, the following statement must 
appear on the Medical Examiner's Certificate ``Qualified only when 
wearing a hearing aid.''

L. Drug Use: Sec.  391.41(b)(12)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person does not use any drug or substance identified 
in 21 CFR 1308.11, an amphetamine, a narcotic, or other habit-
forming drug. A driver may use a non-Schedule I drug or substance 
that is identified in the other Schedules in 21 CFR part 1308 if the 
substance or drug is prescribed by a licensed medical practitioner 
who:
    (i) Is familiar with the driver's medical history, and assigned 
duties; and
    (ii) Has advised the driver that the prescribed substance or 
drug will not adversely affect the driver's ability to safely 
operate a commercial motor vehicle.
    2. This exception does not apply to methadone. The intent of the 
medical certification process is to medically evaluate a driver to 
ensure that the driver has no medical condition which interferes 
with the safe performance of driving tasks on a public road. If a 
driver uses an amphetamine, a narcotic or any other habit-forming 
drug, it may be cause for the driver to be found medically 
unqualified. If a driver uses a Schedule I drug or substance, it 
will be cause for the driver to be found medically unqualified. 
Motor carriers are encouraged to obtain a practitioner's written 
statement about the effects on transportation safety of the use of a 
particular drug.
    3. A test for controlled substances is not required as part of 
this biennial certification process. The Federal Motor Carrier 
Safety Administration or the driver's employer should be contacted 
directly for information on controlled substances and alcohol 
testing under Part 382 of the FMCSRs.
    4. The term ``uses'' is designed to encompass instances of 
prohibited drug use determined by a physician through established 
medical means. This may or may not involve body fluid testing. If 
body fluid testing takes place, positive test results

[[Page 22825]]

should be confirmed by a second test of greater specificity. The 
term ``habit-forming'' is intended to include any drug or medication 
generally recognized as capable of becoming habitual, and which may 
impair the user's ability to operate a commercial motor vehicle 
safely.
    5. The driver is medically unqualified for the duration of the 
prohibited drug(s) use and until a second examination shows the 
driver is free from the prohibited drug(s) use. Recertification may 
involve a substance abuse evaluation, the successful completion of a 
drug rehabilitation program, and a negative drug test result. 
Additionally, given that the certification period is normally two 
years, the medical examiner has the option to certify for a period 
of less than 2 years if this medical examiner determines more 
frequent monitoring is required.

M. Alcoholism: Sec.  391.41(b)(13)

    1. A person is physically qualified to drive a commercial motor 
vehicle if that person: Has no current clinical diagnosis of 
alcoholism.
    2. The term ``current clinical diagnosis of'' is specifically 
designed to encompass a current alcoholic illness or those instances 
where the individual's physical condition has not fully stabilized, 
regardless of the time element. If an individual shows signs of 
having an alcohol-use problem, he or she should be referred to a 
specialist. After counseling and/or treatment, he or she may be 
considered for certification.

    Issued under the authority delegated in 49 CFR 1.87 on: April 
15, 2015.
T.F. Scott Darling, III,
Chief Counsel.
[FR Doc. 2015-09053 Filed 4-22-15; 8:45 am]
BILLING CODE 4910-EX-P