Medical Qualification Requirements

Forms and Documents

Document Name	Status
Form MCSA 5870 IC7 - Insulin-Treated Diabetes Mellitus Assessment Form Form	Unchanged
Form MCSA-5875 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction	Modified
Form MCSA-5850 IC5 - National Registry Certified Medical Examiners Form	Unchanged
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 031920.docx Supplementary Document	2020-04-22
60-day FR for Insulin-Treated Diabetes Mellitus Assessment Form.pdf Supplementary Document	2018-09-18
PRA-2126-0006 SS diabetes final rule updated 091918.doc Supporting Statement A	2018-09-19
30-Day FR for 2126-0006.pdf Supplementary Document	2018-07-30
60-Day FR for 2126-0006 04.27.18.pdf Supplementary Document	2018-07-30
PRA-2126-0006 Justification NonSubstantive Change 061416.docx Justification for No Material/Nonsubstantive Change	2016-07-18
PRA-2126-0006.Justification NonSubstantive Change final 032916.docx Justification for No Material/Nonsubstantive Change	2016-03-30
Section4116 of SAFETEA-LU(Public Law 109-59) 081005.doc Supplementary Document	2012-04-18
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document	2012-04-18
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document	2010-01-22
Diabetes Exemption Qualifications of Drivers (70FR67777)110805.pdf Supplementary Document	2010-01-22
Diabetes Exemption Applications Qualifications of Drivers (68FR52441)090303.pdf Supplementary Document	2010-01-22

IC Document Collections

IC ID	Document Title	Status
26039	IC1 - Physical Qualification Standards	Unchanged
233017	IC7 - Insulin-Treated Diabetes Mellitus Assessment Form Form	Unchanged
220813	IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction	Modified
216256	IC4 - Skill Performance Evaluation (SPE) Certificate Program	Unchanged
216253	IC3 - Medical Exemptions Excluding the Diabetes Exemption Program	Unchanged
216251	IC2 - Resolution of Medical Conflict	Unchanged
201967	IC5 - National Registry Certified Medical Examiners Form	Unchanged

ICR Details

OMB Control No: 2126-0006	ICR Reference No: 202004-2126-003
Status: Historical Active	Previous ICR Reference No: 201809-2126-001
Agency/Subagency: DOT/FMCSA	Agency Tracking No:
Title: Medical Qualification Requirements
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/04/2020
	Date Received in OIRA: 05/01/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	31,582,513	0	31,582,513
Time Burden (Hours)	2,393,370	0	2,393,370
Cost Burden (Dollars)	155,302,782	0	155,302,782

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Abstract: The revision to the ICR is due to the Agency’s development of a final rule titled Qualifications of Drivers; Diabetes Standard to revise its regulations to eliminate the blanket prohibition against insulin-dependent diabetic individuals’ operation of CMVs in interstate commerce. The purpose of the final rule is to permit drivers with a stable insulin regimen and properly controlled insulin-treated diabetes mellitus to operate CMVs in interstate commerce. The final rule eliminates the need for the Diabetes Exemption Program and its IC-3a. It adds a new IC requirement for the TC to complete a form, IC-7, titled Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870. The TC provides the form to the certified ME. 5 comments were received from the public on the form in response to a 60-day comment period FR publication. IC-1: Physical Qualification Standards; MEs must provide driver medical exam information for drivers they examine on medical forms required by FMCSA and into the National Registry. The ME can determine if the driver is medically qualified. IC-2: Resolution of Medical Conflict; The medical conflict application provision provides a mechanism for drivers and motor carriers to request FMCSA to make a final decision to resolve conflicting medical evaluations when either party does not accept the decision of a medical specialist. FMCSA uses the information to determine if the driver should or should not be qualified. IC-3: Medical Exemptions; FMCSA may grant a vision, hearing, or seizure exemption from a physical qualification standard. IC4: Skill Performance Evaluation Certificate; Limb impairment individuals must file an application for an SPE Certificate. IC-5: National Registry of Certified Medical Examiners; MEs are required to provide contact and employment data when registering to become a certified ME. This data is used to provide the public with contact information for those medical professionals who are certified by FMCSA to conduct interstate CMV driver medical exams. MEs are required to submit the results of each CMV driver medical exam they complete, copies of MER forms, and MECs via the National Registry. IC-6(a): certified MEs performing medical exams on CMV drivers are required to use a newly developed MER Form, MCSA-5875, in place of the current MER Form, to record the details and results of a CMV driver’s medical exam and will be maintained by the ME. IC-6(b): certified MEs are required to use Form MCSA-5876 for the MEC form to document the driver has been medically examined and certified as physically qualified to operate a CMV in interstate commerce. FMCSA will provide MEC information via the CMV Driver Medical Examination Results Form, MCSA-5850, for CDL/CLP drivers to the SDLA electronically via CDLIS for entry into the appropriate CDL driver record. IC-6(c): certified MEs are to report results of each completed CMV drivers’ medical exam to FMCSA via the MCSA-5850, including all CMV who are required to be medically certified to operate in interstate commerce. IC-6(d): CLP/CDL applicants/holders; FMCSA to electronically transmit the data including driver identification, exam results, and restriction information, from the National Registry system, to the SDLAs for examinations performed, for entry into the appropriate CDL driver record where it becomes an electronic version of the MEC. IC-6(e); FMCSA to electronically transmit medical variance (exemptions, skill performance evaluation certificates, and grandfathered exemptions) information for all CMV drivers to the SDLAs. The information originates with FMCSA who electronically transmits the information for all CMV drivers from the National Registry to the appropriate SDLAs.

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Authorizing Statute(s): PL: Pub.L. 109 - 59 4129 Name of Law: Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users
   PL: Pub.L. 109 - 59 4116 Name of Law: Safe, Accountable, Flexible, Efficent Transportation Equity Act:: A legacy for Users (SAFETEA-LU)
  

Citations for New Statutory Requirements: PL: Pub.L. 106 - 159 215 Name of Law: Motor Carrier Safety Improvement Act of 1999 (MCSIA)
PL: Pub.L. 109 - 59 4129 Name of Law: Safe, Accountable, Flexible and Efficient Transporataion Equity Act: A Legacy for Users

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2126-AA95	Final or interim final rulemaking	83 FR 47486	09/19/2018

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 35041	07/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 47486	09/19/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
IC7 - Insulin-Treated Diabetes Mellitus Assessment Form	MCSA 5870	Insulin-Treated Diabetes Mellitus Assessment Form
IC5 - National Registry Certified Medical Examiners	MCSA-5850	CMV Driver Medical Examination Results Form
IC1 - Physical Qualification Standards
IC4 - Skill Performance Evaluation (SPE) Certificate Program
IC2 - Resolution of Medical Conflict
IC3 - Medical Exemptions Excluding the Diabetes Exemption Program
IC6 - Medical Examiner's Certification Integration Final Rule	MCSA-5875 , MCSA-5876	Medical Examination Report Form Revised ,   Medical Examiner's Certificate Revised

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	31,582,513	31,582,513	0	0	0	0
Annual Time Burden (Hours)	2,393,370	2,393,370	0	0	0	0
Annual Cost Burden (Dollars)	155,302,782	155,302,782	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,658,315

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/01/2020

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