391.41 CMV Driver Medication Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form MCSA 5895 391.41 CMV Driver Medication Form MCSA 5895	Form and Instruction	Modified	Available
30-Day FR for 2126-0064.pdf	Supplementary Document	Uploaded 2026-09-15	Available
FMCSA-2026-0760-0002_attachment_1.pdf	Public Comments	Uploaded 2026-06-18	Available
PRA-2126-0064 Supporting Statement 09.16.26.docx	Supporting Statement A	Uploaded 2026-09-16	Available
60-da FR for 2126-0064 5-7-26.pdf	Supplementary Document	Uploaded 2026-06-22	Available
Justification for non-substantive change for form for 2126-0064.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-07-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
220971	391.41 CMV Driver Medication Form	Form and Instruction	Modified	391.41 CMV Driver Medication Form MCSA 5895

ICR Details

OMB Control No: 2126-0064	ICR Reference No: 202606-2126-001
Status: Received in OIRA	Previous ICR Reference No: 202302-2126-003
Agency/Subagency: DOT/FMCSA	Agency Tracking No:
Title: 391.41 CMV Driver Medication Form
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: 09/16/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2026
Responses	2,335,310	2,095,990
Time Burden (Hours)	311,375	279,465
Cost Burden (Dollars)	0	0

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Abstract: FMCSA is seeking to renew the currently OMB-approved ICR number PRA-2126-0064. The renewal includes an increased burden cost due to updated population and wage data. FMCSA is required by statute to establish standards for the physical qualifications of drivers who operate CMVs in interstate commerce for non-excepted industries. The FMCSRs at 49 CFR 391.41 set forth the physical qualification standards that 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 purpose of the voluntary collection of this information is to enable the certified ME to determine if the driver is physically qualified under 49 CFR 391.41 and if there are disqualifying medical conditions that would adversely affect the driver’s ability to drive safely. Section 391.41(b)(12) states that a person is physically qualified to drive a CMV if that person does not use any drug or substance identified in 21 CFR 1308.11 Schedule I, an amphetamine, a narcotic, or other habit-forming drug; or does not use any non-Schedule I drug or substance that is identified in the other Schedules in 21 CFR part 1308 except when the use is prescribed by a licensed medical practitioner, as defined in 49 CFR 382.107, who is familiar with the driver’s medical history and has advised the driver that the substance will not adversely affect the driver’s ability to safely operate a CMV. Therefore, this voluntary collection allows certified MEs responsible for issuing Medical Examiner’s Certificates (MECs) to CMV drivers to communicate with healthcare professionals responsible for prescribing the use of certain medications. The information obtained allows certified MEs to fully understand the reasons the medications have been prescribed and to determine whether the use of the medications and the underlying condition being treated preclude the issuance of an MEC. Third-party requirements of this ICR are being considered. Certified MEs will be asking the prescribing healthcare professionals to complete the 391.41 CMV Driver Medication Form, MCSA-5895, for CMV drivers. In addition to the population of prescribing healthcare professionals, the population of CMV drivers who certified MEs may ask to have the 391.41 CMV Driver Medication Form, MCSA-5895, completed by a prescribing healthcare professional, has been calculated. This ICR reflects both interstate drivers subject to the FMCSRs and intrastate drivers subject to compatible State regulations. If intrastate CMV drivers are subject to compatible State regulations, the Agency anticipates that it is likely that these drivers use certified MEs on the National Registry of Certified Medical Examiners (National Registry) for their physical qualification examinations, which may result in certified MEs requesting prescribing healthcare professionals to complete the 391.41 CMV Driver Medication Form, MCSA-5895. The use of this ICR is at the discretion of the certified ME to facilitate communication with treating healthcare professionals, who are responsible for prescribing certain medications, to fully understand the reasons the medications have been prescribed. This information assists the certified ME in determining whether the underlying medical condition and the prescribed medication will adversely affect the driver’s safe operation of a CMV. Therefore, there is no required collection frequency.

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Authorizing Statute(s): US Code: 49 USC 31136(a)(3) and 31502(b)
  

Citations for New Statutory Requirements: None

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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:
	91 FR 21958	05/07/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 58523	09/15/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
391.41 CMV Driver Medication Form	MCSA 5895	391.41 CMV Driver Medication Form MCSA 5895

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ICR Summary of Burden

table that charts list 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	2,335,310	2,095,990	0	0	239,320	0
Annual Time Burden (Hours)	311,375	279,465	0	0	31,910	0
Annual Cost Burden (Dollars)	0	0	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: Program adjustment – due to updated population and wage data. As a result of the above updates, the annual burden hours have increased by 31,910 hours and the annual costs have decreased by $11,615,958.

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Annual Cost to Federal Government: $0

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: 09/16/2026

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