New Rule to Require Use of Certified Medical Examiners

Beginning in early 2014, interstate commercial drivers who need a medical exam will be forced to turn to a centralized database of government-approved healthcare providers.

Under new regulations, medical examiners who wish to be listed in the database — known as the National Registry of Certified Medical Examiners — will first have to meet strict new training and testing standards to ensure they are qualified to perform drivers’ medical exams.

Examiner training and testing began last summer, and certified examiners are now appearing in the Registry. The Registry is available online at http://nrcme.fmcsa.dot.gov.

The new rule says interstate drivers and motor carriers will have to begin using the Registry to find certified medical examiners beginning on May 21, 2014. Examiners who are not on the Registry will not be allowed to perform DOT medical exams after that date.

Medical certificates will get a new look as well. All certificates issued after May 21, 2014, will have to include the examiner’s National Registry number.

Motor carriers will have to ensure that their drivers’ exams are being performed by certified examiners, and will have to place a note into each driver’s qualification file indicating that they did so.

According to the Federal Motor Carrier Safety Administration (FMCSA), the new rule — as required by Congress — is part of the agency’s commitment to enhancing the medical oversight of interstate drivers and preventing crashes, injuries, and fatalities. The agency estimates that the rule will prevent over 1,200 crashes each year.

States are not required to adopt the new rule for in-state use, and in-state-only (intrastate) drivers will be allowed to use medical examiners who are not in the federal Registry, assuming the state allows that.

The new rule also responds to four recommendations from the National Transportation Safety Board (NTSB), which has long sought comprehensive training for medical examiners and tracking of driver medical certificates.

The new rule will require examiners to send the FMCSA a monthly list of drivers who were examined, including their names, driver’s license numbers, and whether they were medically certified. The FMCSA says it will not routinely collect or store medical examination reports.

“Safety is our top priority and requires cooperation from everyone involved, including our medical examiners,” said DOT Secretary Ray LaHood. “This new rule will ensure that healthcare professionals conducting exams keep in mind all of the demands required to operate large trucks and passenger buses safely.”

Scarcity

Despite industry concerns that the rule could make it tough to find an approved examiner in rural areas, the FMCSA says it expects to certify about 40,000 examiners and “even half that number … would be sufficient to provide comprehensive national coverage.”

Though examiners will not be evenly spread across the country, “coverage should be sufficient to ensure reasonably convenient access in all but the most remote areas of the nation,” the FMCSA wrote.

The agency acknowledges that exams may become costlier in rural areas and some drivers may have to travel farther than they do today to find an approved examiner.

Training

The new rule does not prescribe how long training has to last, as long as it covers FMCSA regulations and guidelines and the mental and physical demands of driving. The agency estimated that those topics could be covered in one day, but at least one training provider said it could take a whole week of classroom instruction to cover the topics thoroughly.

The rule also requires periodic re-certification at five-year intervals, and examiners will have to re-take a certification test every 10 years. Those who fail to maintain federal standards will be removed from the registry.

Training providers will have to register with the FMCSA and will be listed on the Registry website along with the mandatory training and testing standards. Organizations approved to administer the certification test will have to undergo a site visit by the FMCSA.

“Truck and bus drivers deserve highly-trained medical examiners that think safety first,” said FMCSA Administrator Anne S. Ferro. “By holding medical examiners accountable to high standards of practice, we raise the bar for safety and save lives through increased commercial driver and vehicle safety.”

Medical examiners perform approximately three million examinations on commercial truck and bus drivers each year. The exam looks at a range of conditions to determine a driver’s medical fitness, including cardiovascular disease, respiratory and muscular functions, vision, and hearing.

The types of examiners allowed to perform exams today will not change with the new rule. That list includes medical doctors, doctors of osteopathy, physician assistants, advanced practice nurses, and chiropractors.

All commercial drivers must pass a DOT medical exam at least every two years in order to obtain a valid medical certificate, maintain their commercial driver’s license, and legally drive a commercial motor vehicle.

National Registry Schedule

As of April 2012:

  • Training organizations can develop curriculum according to FMCSA guidelines.
  • Training organizations can start to offer training to medical examiners when they are ready.
  • The National Registry is available online at http://nrcme.fmcsa.dot.gov.
  • Training organizations can register to be listed on the Registry when they are ready to offer training.
  • Medical examiners can complete the training when available.
  • Test delivery organizations can apply for approval, submit their policies and procedures, undergo a security site visit, and begin offering testing at physical locations or online.

As of August 20, 2012:

  • Medical examiners can register on the National Registry and take the certification test from an FMCSA-approved test center. Once medical examiners successfully pass the test, they will be listed on the National Registry.
  • Drivers and carriers may search for certified medical examiners via the National Registry.

As of May 21, 2014:

  • All medical examiners who wish to conduct FMCSA medical examinations for CMV drives must be trained according to the FMCSA regulations and guidelines, pass a certification test, and be listed on the National Registry.
  • All CMV drivers seeking a medical examination/certificate must use a certified medical examiner listed on the National Registry.
  • Motor carriers must verify that drivers getting a medical exam after May 21, 2014, have used an examiner who is listed on the Registry.
  • Examiners must begin using the new medical certificate form, which includes a space for their National Registry number. 

About the Author: Daren Hansen – Senior Editor, Transportation Safety for J.J. Keller & Associates Inc.

Copyright 2011 J. J. Keller & Associates, Inc.®, P.O. Box 368, 3003 Breezewood Lane, Neenah, WI 54957. Copied by permission.

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