Medical Qualification Requirements

Forms and Documents

Document Name	Status
Form MCSA 5870 IC7 -Qualification of Driver; Diabetes Standard Form	Modified
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	Modified
30-day FR for 2126-0006 10.14.21.pdf Supplementary Document	2021-10-14
PRA-2126-0006 Supporting Statement 09.08.21.docx Supporting Statement A	2021-09-08
60-day FR for 2126-0006 05.06.21.pdf Supplementary Document	2021-09-06
Justification of Non-substantive Changes for MCSA-5875 07.08.20.docx Supplementary Document	2020-07-08
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 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 - FMCSA Physical Qualification Standards	Modified
233017	IC7 -Qualification of Driver; Diabetes Standard Form	Modified
220813	IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction	Modified
216256	IC4 - Skill Performance Evaluation (SPE) Certificate Program	Modified
216253	IC3 - Exemptions - Vision, Hearing, Seizure Exemptions	Modified
216251	IC2 - Resolution of Medical Conflict	Modified
201967	IC5 - National Registry Certified Medical Examiners Form	Modified

ICR Details

OMB Control No: 2126-0006	ICR Reference No: 202109-2126-001
Status: Received in OIRA	Previous ICR Reference No: 202007-2126-001
Agency/Subagency: DOT/FMCSA	Agency Tracking No:
Title: Medical Qualification Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/19/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2021
Responses	35,544,723	31,582,513
Time Burden (Hours)	2,707,479	2,393,370
Cost Burden (Dollars)	0	155,302,782

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Abstract: This request for renewal provides updated driver and motor carrier population information, program statistics, National Registry of Certified Medical Examiners statistics, and wage data. The information collection requirements are mandatory and apply to drivers, motor carriers, MEs, ME applicant testing organizations, and TCs. IC-1: Physical Qualification Standards; MEs must provide driver medical exam information for drivers they examine on medical forms and in the National Registry. The ME can determine if the driver is medically qualified. The ME must complete and furnish the original paper MEC to the driver. The driver must complete driver health history portion of the MER Form at least every 2 years. The motor carrier must file a MEC in DQ record. 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. Motor carriers are required to submit an application to FMCSA for resolution (up to 3 cases a year) and attend a hearing (1 per year) if FMCSA deems necessary. IC-3: Medical Exemptions; FMCSA may grant a vision, hearing, or seizure exemption from a physical qualification standard. The driver is to complete an application for new exemption and exemption renewal every 2 years and the motor carrier is to copy and file the exemption in the DQ file. IC4: Skill Performance Evaluation Certificate; The SPE Certificate program requires drivers to complete an application for the new SPE certificate, complete an application for SPE certificate renewal every 2 years, provide a copy of the MER Form and MEC to FMCSA, and for motor carriers to copy and file the SPE Certificate in the DQ record. 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 daily, copies of MER forms, and MECs via the National Registry. IC-6: Medical Examiner’s Certification Integration Final Rule; Beginning on June 23, 2025, MEs will no longer be required to complete and furnish the original written MEC to qualified drivers when the driver is a CDL/CLP holder. This information will be electronically transmitted to the SDLA. Employers will no longer need to request a copy of the handwritten MEC for CDL/CLP holders. In addition, employers will no longer be required to verify the ME’s National Registry number for MECs issued to CDL/CLP holders because only MEs listed on the National Registry will be able to forward MEC information to the National Registry. Therefore, there will be a reduction in the number of respondents and responses for the information collection requirements noted beginning on June 23, 2025. However, since the compliance date for these provisions is June 23, 2025, the annual burden hours and costs are not covered in this supporting statement. IC-7: Qualifications of Drivers; Diabetes Standard; An individual with ITDM is able to obtain an MEC from an ME for up to a maximum of 12 months if the TC, the healthcare professional who manages, and prescribes insulin for the treatment of the individual’s diabetes, attests to the ME the individual maintains a stable insulin regimen and proper control of diabetes, and the ME determines the individual meets FMCSA’s physical qualification standards. The information provided by the TC enables the ME to make a qualification determination based on whether the driver meets all the physical qualification requirements.

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

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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 24433	05/06/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 57246	10/14/2021
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
IC1 - FMCSA Physical Qualification Standards
IC2 - Resolution of Medical Conflict
IC3 - Exemptions - Vision, Hearing, Seizure Exemptions
IC4 - Skill Performance Evaluation (SPE) Certificate Program
IC5 - National Registry Certified Medical Examiners	MCSA-5850	CMV Driver Medical Examination Results Form
IC6 - Medical Examiner's Certification Integration Final Rule	MCSA-5875 , MCSA-5876	Medical Examination Report Form Revised ,   Medical Examiner's Certificate Revised
IC7 -Qualification of Driver; Diabetes Standard	MCSA 5870	Insulin-Treated Diabetes Mellitus Assessment Form

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ICR Summary of Burden

	Total Request	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	35,544,723	31,582,513	0	0	3,962,210	0
Annual Time Burden (Hours)	2,707,479	2,393,370	0	0	314,109	0
Annual Cost Burden (Dollars)	0	155,302,782	0	0	-155,302,782	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: An increase in 314,109 burden hours is due to adjustments that were made to reflect updated driver and motor carrier population information, program statistics, National Registry statistics, and wage data. $155,302,782 wage related costs were inadvertently reported in the table above with the previous ICR submission and have been removed from the table with this submission. The proposed wage related costs is now $195,009,396 as seen in section 12 of the supporting statement. There are no other estimated annual costs to respondents.

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Annual Cost to Federal Government: $2,800,547

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? No

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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: 10/19/2021

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