Information Collection Request

Medical Qualification Requirements

ICR 202507-2126-009 · OMB 2126-0006 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form MCSA-5876 Medical Examiner's Certificate (MEC) Form Modified Available
Form MCSA-5875 Medical Examination Report (MER) Form Form and Instruction Modified Available
Form MCSA-5875 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction Modified Repair queued
Form MCSA 5871 Vision Evaluation Report Form and Instruction Modified Available
Form MCSA 5871 IC8 - Qualification of Drivers: Vision Standard Form and Instruction Modified Repair queued
Form MCSA-5850 CMV Driver Medical Examination Results Form Form and Instruction Modified Available
Form MCSA-5850 IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form and Instruction Modified Repair queued
Form MCSA 5870 Insulin-Treated Diabetes Mellitus Assessment Form Form Modified Available
Form MCSA 5870 IC7 -Qualification of Driver; Diabetes Standard Form Modified Repair queued
Justification for Non-Substantive Change for 2126-0006 September 2025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-09-19 Available
Justification for Non-Substantive Change for 2126-0006 September 2025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-09-19 Missing upstream
30-day FR 2126-0006.pdf Supplementary Document Uploaded 2025-01-08 Available
30-day FR 2126-0006.pdf Supplementary Document Uploaded 2025-01-08 Repair queued
PRA-2126-0006 Supporting Statement 11.25.24.docx Supporting Statement A Uploaded 2024-11-25 Available
PRA-2126-0006 Supporting Statement 11.25.24.docx Supporting Statement A Uploaded 2024-11-25 Repair queued
60-day FR for 2126-0006.pdf Supplementary Document Uploaded 2024-11-25 Available
60-day FR for 2126-0006.pdf Supplementary Document Uploaded 2024-11-25 Missing upstream
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 MCSA-5876 and MCSA-5850 030223.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-04-26 Available
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 MCSA-5876 and MCSA-5850 030223.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-04-26 Repair queued
Justification of Non-substantive Changes for MCSA-5875 07.08.20.docx Supplementary Document Uploaded 2020-07-08 Available
Justification of Non-substantive Changes for MCSA-5875 07.08.20.docx Supplementary Document Uploaded 2020-07-08 Repair queued
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 031920.docx Supplementary Document Uploaded 2020-04-22 Repair queued
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 031920.docx Supplementary Document Uploaded 2020-04-22 Repair queued
60-day FR for Insulin-Treated Diabetes Mellitus Assessment Form.pdf Supplementary Document Uploaded 2018-09-18 Available
60-day FR for Insulin-Treated Diabetes Mellitus Assessment Form.pdf Supplementary Document Uploaded 2018-09-18 Missing upstream
PRA-2126-0006 Justification NonSubstantive Change 061416.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-07-18 Available
PRA-2126-0006 Justification NonSubstantive Change 061416.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-07-18 Repair queued
PRA-2126-0006.Justification NonSubstantive Change final 032916.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-30 Repair queued
PRA-2126-0006.Justification NonSubstantive Change final 032916.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-30 Repair queued
Section4116 of SAFETEA-LU(Public Law 109-59) 081005.doc Supplementary Document Uploaded 2012-04-18 Source copy available
Section4116 of SAFETEA-LU(Public Law 109-59) 081005.doc Supplementary Document Uploaded 2012-04-18 Missing upstream
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2012-04-18 Available
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2012-04-18 Available
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2010-01-22 Available
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2010-01-22 Repair queued
Diabetes Exemption Qualifications of Drivers (70FR67777)110805.pdf Supplementary Document Uploaded 2010-01-22 Available
Diabetes Exemption Qualifications of Drivers (70FR67777)110805.pdf Supplementary Document Uploaded 2010-01-22 Repair queued
Diabetes Exemption Applications Qualifications of Drivers (68FR52441)090303.pdf Supplementary Document Uploaded 2010-01-22 Available
Diabetes Exemption Applications Qualifications of Drivers (68FR52441)090303.pdf Supplementary Document Uploaded 2010-01-22 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
26039 IC1 - FMCSA Physical Qualification Standards Unchanged
259884 IC6 - Medical Examiner's Certification Integration Final Rule Form ModifiedMedical Examiner's Certificate (MEC)
259884 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction ModifiedMedical Examination Report (MER) Form
259884 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction Modified
251311 IC8 - Qualification of Drivers: Vision Standard Form and Instruction ModifiedVision Evaluation Report
251311 IC8 - Qualification of Drivers: Vision Standard Form and Instruction Modified
251310 IC5d - National Registry of Certified Medical Examiners - Verification of National Registry Number Unchanged
251309 IC5c - National Registry of Certified Medical Examiners - Providing Medical Examination Reports to FMCSA Upon Request Unchanged
251308 IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form and Instruction ModifiedCMV Driver Medical Examination Results Form
251308 IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form and Instruction Modified
251303 IC5a - National Registry of Certified Medical Examiners - Registering and Testing Unchanged
251302 IC3a - Hearing Exemptions Unchanged
251301 IC3b - Seizure Exemptions Unchanged
233017 IC7 -Qualification of Driver; Diabetes Standard Form ModifiedInsulin-Treated Diabetes Mellitus Assessment Form
233017 IC7 -Qualification of Driver; Diabetes Standard Form Modified
216256 IC4 - Skill Performance Evaluation (SPE) Certificate Program Unchanged
216251 IC2 - Resolution of Medical Conflict Unchanged
ICR Details
2126-0006 202507-2126-009
Active 202411-2126-002
DOT/FMCSA
Medical Qualification Requirements
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/05/2025
Retrieve Notice of Action (NOA) 09/22/2025
  Inventory as of this Action Requested Previously Approved
03/31/2028 03/31/2028 03/31/2028
38,069,391 0 38,069,391
3,243,525 0 3,243,525
0 0 0

This request for a non-substantive change to this ICR updates the expiration dates to the five collection instruments associated with this ICR. 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. 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.

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
  
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)

Not associated with rulemaking

  89 FR 76177 09/17/2024
90 FR 1954 01/08/2025
No

  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 38,069,391 38,069,391 0 0 0 0
Annual Time Burden (Hours) 3,243,525 3,243,525 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$3,126,093
No
    Yes
    Yes
No
No
No
No
Robin Hamilton 202 366-0072

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/22/2025