Agency Information Collection Activities; Renewal of an Approved Information Collection: Medical Qualification Requirements Publication: Federal Register Agency: Federal Motor Carrier Safety Administration Byline: Thomas P. Keane Date: 14 October 2021 Subjects: American Government , Safety

[Federal Register Volume 86, Number 196 (Thursday, October 14, 2021)]
[Notices]
[Pages 57246-57249]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-22285]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2021-0066]


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

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

ACTION: Notice and request for comments.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995, FMCSA 
announces its plan to submit the Information Collection Request (ICR) 
described below to the Office of Management and Budget (OMB) for review 
and approval. FMCSA requests approval to renew an ICR, titled ``Medical 
Qualification Requirements,'' and provides updated information for 
several of the information collections discussed. This ICR is needed to 
ensure that drivers, motor carriers, Medical Examiners (ME), and the 
States are complying with the physical qualification requirements of 
commercial motor vehicle (CMV) drivers. The information collected is 
used primarily to determine and certify driver medical fitness and must 
be collected in order for our highways to be safe. On May 6, 2021, 
FMCSA published a 60-day notice requesting comment on the renewal of 
this ICR. In response to this notice, two comments were received.

DATES: Please submit your comments by November 15, 2021. OMB must 
receive your comments by this date in order to act quickly on the ICR.

ADDRESSES: Comments and recommendations for the proposed information 
collection should be submitted within 30 days of publication of this 
notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, Department of Transportation, Federal Motor 
Carrier Safety Administration, 6th Floor, West Building, 1200 New 
Jersey Avenue SE, Washington, DC 20590-0001. Telephone: (202) 366-4001. 
Email Address: fmcsamedical@dot.gov. Office hours are from 9:00 a.m. to 
5:00 p.m., ET, Monday through Friday, except Federal Holidays.

SUPPLEMENTARY INFORMATION: 
    Title: Medical Qualification Requirements.
    OMB Control Number: 2126-0006.
    Type of Request: Renewal of a currently approved information 
collection.
    Respondents: CMV drivers, motor carriers, Medical Examiners, 
testing centers, treating clinicians.
    Estimated Number of Respondents: 6,225,262.
    Expiration Date: November 30, 2021.
    Estimated Total Annual Burden: 2,707,479 hours.
    This information collection is comprised of the following six 
information collection activities.
    Physical Qualification Standards: 2,144,680 annual burden hours; 
5,444,680 annual respondents.
    Resolution of Medical Conflict: 11 annual burden hours; 3 annual 
respondents.
    Medical Exemptions: 2,529 annual burden hours; 4,749 annual 
respondents.

[[Page 57247]]

    SPE Certificate Program: 2,808 annual burden hours; 2,567 annual 
respondents.
    National Registry of Certified Medical Examiners: 556,797 annual 
burden hours; 768,357 annual respondents.
    Qualification of Drivers; Diabetes Standard: 654 annual burden 
hours; 4,906 annual respondents.
    Background: CMVs (trucks and buses) are longer, heavier, and more 
difficult to maneuver than automobiles, making them a threat to highway 
safety if not operated properly by qualified individuals. The public 
interest in, and right to have, safe highways requires the assurance 
that drivers of CMVs can safely perform the increased physical and 
mental demands of their duties. FMCSA's physical qualification 
standards provide this assurance by requiring drivers to be examined 
and medically certified as physically and mentally qualified to drive. 
Therefore, information used to determine and certify driver medical 
fitness must be collected. FMCSA is the Federal government agency 
authorized to require the collection of this information. FMCSA is 
required by statute to establish standards for the physical 
qualifications of drivers who operate CMVs in interstate commerce for 
non-excepted industries (49 U.S.C. 31136(a)(3) and 31502(b)). The 
physical qualification regulations relating to this information 
collection are found in the Federal Motor Carrier Safety Regulations 
(FMCSRs) at 49 CFR parts 390-399.
    Below is a brief description of the included information collection 
activities and how the information is used.

Physical Qualification Standards

    The FMCSRs at 49 CFR 391.41 set forth the physical qualification 
standards interstate CMV drivers who are subject to part 391 must meet, 
with the exception of commercial driver's license/commercial learner's 
permit (CDL/CLP) drivers transporting migrant workers (who must meet 
the physical qualification standards set forth in 49 CFR 398.3). The 
FMCSRs covering driver physical qualification records applicable to all 
drivers subject to part 391 are found at 49 CFR 391.43, which specifies 
that a physical qualification examination be performed on CMV drivers 
subject to part 391 who operate in interstate commerce. The results of 
examinations must be recorded on the Medical Examination Report (MER) 
Form, MCSA-5875. If the ME finds a driver is physically qualified to 
operate a CMV in accordance with 49 CFR 391.41, the ME must complete 
and furnish to the driver a Medical Examiner's Certificate (MEC), Form 
MCSA-5876. The provisions of 49 CFR 391.51 require that a motor carrier 
retain the MEC or, for CDL drivers, the Commercial Driver's License 
Information System (CDLIS) motor vehicle record, if it contains medical 
certification status, in the driver's qualification (DQ) file for 3 
years. The MEC and CDLIS motor vehicle record affirm that the driver is 
physically qualified to operate a CMV in interstate commerce. With 
respect to drivers transporting migrant workers, 49 CFR 398.3 requires 
a motor carrier to retain in its files a copy of a doctor's certificate 
that affirms the driver has been examined in accordance with that 
section and determined to be physically qualified to operate a CMV.
    Due to the potential for the onset of new conditions or changes in 
existing conditions that may adversely affect a driver's ability to 
safely operate a CMV and cause a risk to public safety, FMCSA requires 
drivers to be medically certified at least every 2 years. However, 
drivers with certain medical conditions must be certified more 
frequently than every 2 years. MEs have discretion to certify for 
shorter time periods on a case-by-case basis for medical conditions 
that require closer monitoring or that are more likely to change over 
time.
    MEs are required to maintain records of the CMV driver physical 
qualification examinations they conduct. FMCSA does not require MEs to 
maintain these records electronically. However, there is nothing to 
preclude an ME from maintaining electronic records of the medical 
examinations the ME conducts. FMCSA is continuously evaluating new 
information technology in an attempt to decrease the burden on motor 
carriers and MEs.
    Less frequent collection of driver data, MER Forms, and MECs would 
compromise FMCSA's ability to determine ME compliance with FMCSA's 
requirements for performing CMV driver physical qualification 
examinations. This could result in MEs being listed on FMCSA's National 
Registry of Certified Medical Examiners (National Registry) who should 
be removed and possibly drivers who do not meet the physical 
qualification standards possessing an MEC. Less frequent data 
collection would also result in decreased validity of the data (i.e., 
less frequent data submission may increase the error rate due to 
unintentional omission of examination information). Therefore, less 
frequent collection of driver examination results is not an option.

Resolution of Medical Conflict

    If two MEs disagree about the medical certification of a driver, 
the medical conflict provision provides a mechanism for drivers and 
motor carriers to request that FMCSA resolve the conflicting medical 
evaluations when either party does not accept the decision of a medical 
specialist. The requirements set forth in 49 CFR 391.47 mandate that 
the applicant (driver or motor carrier) submit a copy of a report 
including results of all medical testing and the opinion of an 
impartial medical specialist in the field in which the medical conflict 
arose. The applicant may choose to submit the information using fax or 
email. FMCSA uses the information collected from the applicant, 
including medical information, to determine if the driver should be 
qualified. Without this provision and its incumbent driver medical 
information collection requirements, an unqualified person may be 
permitted to drive and qualified persons may be prevented from driving.

Medical Exemptions and the Skill Performance Evaluation (SPE) 
Certificate Program

    FMCSA may, on a case-by-case basis, grant a medical exemption from 
a physical qualification standard set forth in 49 CFR 391.41. To do so, 
the Agency must determine the exemption would likely achieve a level of 
safety that is equivalent to, or greater than, the level that would be 
achieved by complying with the regulation. Without an exemption, 
individuals who do not meet the requirements in 49 CFR 391.41 would not 
be qualified to operate a CMV in interstate commerce. Section 381.300 
establishes the procedures that persons must follow to request 
exemptions from the FMCSRs. The Agency requires all medical exemptions 
to be renewed every 2 years to ensure that the granting of the 
exemption does not diminish safety. Exemption holders are required to 
submit annual medical information for review to ensure the driver 
continues to meet the criteria for an exemption.
    Individuals with loss or impairment of limbs are permitted to 
operate a CMV if they are otherwise physically qualified and are issued 
an SPE certificate by FMCSA. The SPE certificate must be renewed every 
2 years by submitting a renewal application.
    The application process for medical exemptions and SPE certificates 
provides for electronic collection of the application information by 
FMCSA for those applicants who choose to submit

[[Page 57248]]

the information electronically. They may fax or scan and email 
documents to FMCSA. The Vision Exemption Program and the SPE 
Certificate Program maintain a database of application information. The 
Medical Programs Division maintains a database of application 
information for hearing and seizure exemptions.
    FMCSA must collect medical information about the driver's medical 
condition in order to determine eligibility to receive a medical 
exemption or an SPE certificate. In the interest of highway safety, the 
medical examination, medical exemption renewal, and SPE certificate 
renewal should not be performed less frequently.

The National Registry of Certified Medical Examiners

    The National Registry of Certified Medical Examiners final rule (77 
FR 24104, Apr. 20, 2012) requires MEs who conduct physical 
qualification examinations for interstate CMV drivers to complete 
training concerning FMCSA's physical qualification standards, pass a 
certification test, and maintain competence through periodic training 
and testing, all of which require information collection. ME candidates 
submit demographic and eligibility data in order to register with the 
National Registry and begin the certification process. This data is 
used to provide the public with contact information for those 
healthcare professionals who are certified by FMCSA to conduct 
interstate CMV driver physical qualification examinations. Less 
frequent collection of ME candidate identity and eligibility 
information and test results could mean there are fewer MEs available 
to perform physical qualification examinations and to meet the needs of 
the CMV driver and motor carrier population. This could place a burden 
on drivers and motor carriers. Therefore, less frequent collection of 
ME candidate identity and eligibility information and test results is 
not an option.
    MEs are required to transmit to FMCSA via the National Registry 
results of any CMV driver physical qualification examinations completed 
by midnight (local time) of the next calendar day following the 
examination. The reporting of results 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. Less frequent collection of 
driver data would compromise FMCSA's ability to determine ME compliance 
with FMCSA requirements for performing CMV driver physical 
qualification examinations. This could result in MEs being listed on 
the National Registry who should be removed and possibly drivers who do 
not meet the physical qualification standards possessing an MEC. Less 
frequent data collection would also result in decreased validity of the 
data (i.e., less frequent data submission may increase the error rate 
due to unintentional omission of examination information). Therefore, 
less frequent collection of driver examination results is not an 
option.
    The National Registry final rule also requires motor carriers to 
verify the National Registry number of the MEs who certify their 
drivers and place a note in the DQ file. Less frequent verification of 
the National Registry numbers by motor carriers could mean drivers may 
not have been examined by an ME listed on the National Registry and may 
not meet the physical qualifications standards of the FMCSRs.
    As a follow-on rule to the National Registry final rule, the 
Medical Examiner's Certification Integration final rule (80 FR 22790, 
Apr. 23, 2015), modified several of the requirements adopted in the 
National Registry final rule, some of which had a scheduled compliance 
date of June 22, 2018. Specifically, it requires (1) FMCSA to 
electronically transmit from the National Registry to the State 
Driver's Licensing Agencies (SDLAs) the driver identification 
information, examination results, and restriction information from 
examinations performed for holders of CLPs/CDLs (interstate and 
intrastate); (2) FMCSA to transmit electronically to the SDLAs the 
medical variance information for all CMV drivers; and (3) SDLAs to post 
the driver identification, examination results, and restriction 
information received electronically from FMCSA.
    However, as the Medical Examiner's Certification Integration final 
rule compliance date approached, FMCSA concluded that the information 
technology infrastructure necessary to implement the portions of the 
final rule that required the electronic transmission of data would not 
be available on June 22, 2018. Accordingly, on June 21, 2018, FMCSA 
published a notice extending the compliance date for several of the 
provisions in the Medical Examiner's Certification Integration final 
rule to June 22, 2021 (83 FR 28774).
    As the June 22, 2021 compliance date approached, FMCSA again 
concluded that additional time was needed for FMCSA to complete certain 
information technology system development tasks for its National 
Registry and to provide the SDLAs sufficient time to make the necessary 
information technology programming changes after the new National 
Registry system is available. Accordingly, on June 22, 2021, FMCSA 
amended its regulations to extend the compliance date from June 22, 
2021, to June 23, 2025, for several provisions of its Medical 
Examiner's Certification Integration final rule (86 FR 32643). Since 
the compliance date for these provisions will be extended until June 
23, 2025, the annual burden hours and costs are not covered as part of 
this ICR.

Qualifications of Drivers; Diabetes Standard

    As a result of the September 19, 2018, Qualifications of Drivers; 
Diabetes Standard final rule (83 FR 47486), the FMCSRs were amended to 
permit drivers with a stable insulin regimen and properly controlled 
insulin-treated diabetes mellitus (ITDM) to operate CMVs in interstate 
commerce. An individual with ITDM can obtain an MEC from an ME for up 
to a maximum of 12 months. To do so, the treating clinician, the 
healthcare professional who manages, and prescribes insulin for, the 
treatment of the individual's diabetes must complete the Insulin-
Treated Diabetes Mellitus Assessment Form, MCSA-5870, and attest to the 
ME that the individual maintains a stable insulin regimen and proper 
control of the individual's diabetes. The ME must review the form and 
determine the individual meets FMCSA's ITDM standard and other physical 
qualification standards. The information collection is necessary to 
ensure drivers meet these standards. FMCSA allows treating clinicians 
and drivers to provide the form to MEs, if they choose to do so, using 
electronic communication such as fax or email.

Comments to the 60-Day Notice

    On May 6, 2021, FMCSA published a 60-day notice (86 FR 24433) 
requesting comment on the renewal of this ICR. In response to the 
notice, comments were received from the National School Transportation 
Association (NSTA) and the U.S. Equal Employment Opportunity Commission 
(EEOC). NSTA commented that it was in support of the renewal of this 
information collection. The EEOC suggested that FMCSA consider revising 
the requests for medical information on the MER Form to focus on 
medical conditions and medications that may interfere, are likely to 
interfere, or do interfere with

[[Page 57249]]

individuals' ability to control, drive, or otherwise operate a CMV 
safely. It also suggested that that FMCSA consider narrowing the length 
of time that certain medical issues must be reported. In addition, it 
provided other comments regarding information on FMCSA's website that 
were not related to information collection activities or the renewal of 
this ICR. Those comments will be considered by FMCSA outside of this 
ICR renewal process.
    Regarding the EEOC's suggestions for the MER Form, the information 
collected in the driver health history section of the MER Form is 
relevant and necessary to obtain a full health history from the driver. 
The information obtained facilitates the completion of a thorough 
examination by the ME. An ME needs all pertinent information to make an 
appropriate assessment of whether the driver meets the physical 
qualifications standards. FMCSA emphasizes that the driver health 
history questions are linked to the physical qualification standards 
set out in 49 CFR 391.41(b). Most of the standards are worded broadly 
because many medical conditions may interfere with an individual's 
ability to operate a CMV safely. Therefore, it is not in the interest 
of safety for FMCSA to provide less information to the ME.
    Public Comments Invited: You are asked to comment on any aspect of 
this information collection, including: (1) Whether the proposed 
collection is necessary for FMCSA to perform its functions; (2) the 
accuracy of the estimated burden; (3) ways for FMCSA to enhance the 
quality, usefulness, and clarity of the collected information; and (4) 
ways that the burden could be minimized without reducing the quality of 
the collected information.

    Issued under the authority delegated in 49 CFR 1.87.
Thomas P. Keane,
Associate Administrator, Office of Research and Registration.
[FR Doc. 2021-22285 Filed 10-13-21; 8:45 am]
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