FMCSA DOT Physical Medical Examiner
Test
Interstate commerce definition? - Answer Any material transported from 1 state to
another state, even if the individual driver never leaves 1 state, that:
a) weighs >10,001 lbs (if >26,001 lbs, they also need a drug test)
b) 9-15 passengers for compensation
c) 16+ passengers regardless of compensation
d) that requires placarding for hazardous materials
Does interstate commerce refer to the cargo or to the driver? - Answer It refers to the
cargo, tools, vehicle, NOT to the driver.
When is a 12 month (or shorter) certification required? - Answer a) intracity zone
exempt drivers
b) waiver program drivers
c) insulin
d) any driver whose job duties have been impaired by mental/physical injury
Does the driver need a new exam after sustaining an injury? - Answer That is up to the
employer.
Can an examiner write schedule/MSK restrictions? - Answer No.
Document every abnormality? - Answer Yes, and then just write in comments, "not likely
to interfere."
Whisper test okay for hearing? - Answer Yes
Need to fill out both state and federal? - Answer No, one or the other
Is determination pending okay on both state and federal? - Answer No, only permissible
on federal
When to fill out state form? - Answer If truly intrastate. Need to know the state variances
for the state in which the driver operates.
How short a period can you put on the card? - Answer As short as you want. Eg. 30
days, 45 days, 3 months, etc.
2 reasons for not medically qualified? - Answer 1) Disease/condition that temporarily or
permanently DQs them OR 2) Haven't fulfilled appropriate waiting period, eg. 1 year
What do you document if driver stops exam? - Answer "Incomplete exam"
,If you do determination pending, what do you put as the expiration date? - Answer The
date they come back with whatever documentation you needed.
Is the medical certification limited to their current employer? - Answer No. They are
allowed to switch employers that might require more strenuous tasks/different schedule,
etc.
What is "acceptable risk?" - Answer 1% annual risk of sudden incapacitation. If the
driver is at increased risk compared to the general population, than they shouldn't be
operating a CMV.
When to certify for less than 2 years? - Answer If their condition requires more frequent
monitoring by specialist/PCP, etc.
What do you put in the "medical record" box? - Answer Can be blank, employee ID, etc.
Up to you.
Okay to examine drivers from Canada and Mexico? - Answer Yes
Driver ID requirements? - Answer You must see some sort of government issued ID to
make sure they're not having a friend/family member take the medical exam for them.
If they leave blank, check yes, or not sure under "medical certificate issued for less than
2 years," then what? - Answer Ask why and address. Review old exams done in your
clinic!!!
If driver wrote "not sure" to any answer... - Answer Ask about and address. Never cross
out what driver wrote but you can put additional comments below.
Does determination pending require a new exam? - Answer No. A short medical
certificate does, but a DP does not.
What to do if current med certificate expires tomorrow, but you need their HgbA1C, etc?
- Answer 1) You can issue a short term certificate AND do determination pending but
will need to repeat exam
2) DQ and do determination pending if you do not think driver is safe to be on the road
in the meantime before you get the info
How long do you have to submit driver determination online after doing exam? - Answer
Close of next calendar business day.
Whose responsibility is it to address driver's age and language? - Answer Employer
, What do you do after you make your determination? - Answer Required to discuss with
the driver and what they need to do. Must be clear that you are making your decision
based on best practice/guidelines and NOT on regulation.
What if a driver from another country has a variance/waiver? - Answer They are not
qualified in the US.
What are the 13 physical qualifications for drivers? - Answer 1 + 2. No loss/impairment
of foot/leg/hand/arm.
3. No IDDM (new waiver)
4. No dx of heart dz that might cause syncope, SOB, collapse, or CHF
5. No respiratory dysfunction likely to interfere
6. No HTN likely to interfere
7. No hx or dx of MSK dz likely to interfere
8. No hx of epilepsy or dz causing LOC
9. No mental/psych dz likely to interfere
10. Distance vision of 20/40 in each eye and together, 70 degrees horizontal field, and
ability to recognize red/green/yellow
11. Whisper at 5 feet in BETTER ear or no average HL in better ear>40 DBs at
500,1000,and 2000 hz
12. No schedule 1, amphetamine, narcotic, habit forming drugs except when prescribed
by someone who says it will not affect ability to operate CMV
13. No dx of alcoholism
Can a medical examiner grant a waiver? - Answer No. They have to go through the
online FMCSA processes.
Don't certify until etiology is _______, and _____ is shown to be _____, ______, and
_____. - Answer Confirmed, treatment, safe, effective, stable.
What if multiple waiting periods for multiple comorbidities? - Answer Wait until longest
one is done.
When to get additional tests/consults? - Answer Case by case basis to adequately
address fitness for duty. No required to accept the consult/testing.
What are the only required regulations? - Answer Vision, hearing, epilepsy, IDDM.
What to do if choose not to follow a guideline? - Answer Document extensively why you
did not.
What testing MUST be done for the exam? - Answer Height, weight, vision, hearing, BP,
pulse, urinalysis.
What optional testing may be done? - Answer BMI, audiometry, PFTs, ECHO, EKG,
sleep study, CT scan, etc, based on H&P and your determination. CAUTION: If you
Test
Interstate commerce definition? - Answer Any material transported from 1 state to
another state, even if the individual driver never leaves 1 state, that:
a) weighs >10,001 lbs (if >26,001 lbs, they also need a drug test)
b) 9-15 passengers for compensation
c) 16+ passengers regardless of compensation
d) that requires placarding for hazardous materials
Does interstate commerce refer to the cargo or to the driver? - Answer It refers to the
cargo, tools, vehicle, NOT to the driver.
When is a 12 month (or shorter) certification required? - Answer a) intracity zone
exempt drivers
b) waiver program drivers
c) insulin
d) any driver whose job duties have been impaired by mental/physical injury
Does the driver need a new exam after sustaining an injury? - Answer That is up to the
employer.
Can an examiner write schedule/MSK restrictions? - Answer No.
Document every abnormality? - Answer Yes, and then just write in comments, "not likely
to interfere."
Whisper test okay for hearing? - Answer Yes
Need to fill out both state and federal? - Answer No, one or the other
Is determination pending okay on both state and federal? - Answer No, only permissible
on federal
When to fill out state form? - Answer If truly intrastate. Need to know the state variances
for the state in which the driver operates.
How short a period can you put on the card? - Answer As short as you want. Eg. 30
days, 45 days, 3 months, etc.
2 reasons for not medically qualified? - Answer 1) Disease/condition that temporarily or
permanently DQs them OR 2) Haven't fulfilled appropriate waiting period, eg. 1 year
What do you document if driver stops exam? - Answer "Incomplete exam"
,If you do determination pending, what do you put as the expiration date? - Answer The
date they come back with whatever documentation you needed.
Is the medical certification limited to their current employer? - Answer No. They are
allowed to switch employers that might require more strenuous tasks/different schedule,
etc.
What is "acceptable risk?" - Answer 1% annual risk of sudden incapacitation. If the
driver is at increased risk compared to the general population, than they shouldn't be
operating a CMV.
When to certify for less than 2 years? - Answer If their condition requires more frequent
monitoring by specialist/PCP, etc.
What do you put in the "medical record" box? - Answer Can be blank, employee ID, etc.
Up to you.
Okay to examine drivers from Canada and Mexico? - Answer Yes
Driver ID requirements? - Answer You must see some sort of government issued ID to
make sure they're not having a friend/family member take the medical exam for them.
If they leave blank, check yes, or not sure under "medical certificate issued for less than
2 years," then what? - Answer Ask why and address. Review old exams done in your
clinic!!!
If driver wrote "not sure" to any answer... - Answer Ask about and address. Never cross
out what driver wrote but you can put additional comments below.
Does determination pending require a new exam? - Answer No. A short medical
certificate does, but a DP does not.
What to do if current med certificate expires tomorrow, but you need their HgbA1C, etc?
- Answer 1) You can issue a short term certificate AND do determination pending but
will need to repeat exam
2) DQ and do determination pending if you do not think driver is safe to be on the road
in the meantime before you get the info
How long do you have to submit driver determination online after doing exam? - Answer
Close of next calendar business day.
Whose responsibility is it to address driver's age and language? - Answer Employer
, What do you do after you make your determination? - Answer Required to discuss with
the driver and what they need to do. Must be clear that you are making your decision
based on best practice/guidelines and NOT on regulation.
What if a driver from another country has a variance/waiver? - Answer They are not
qualified in the US.
What are the 13 physical qualifications for drivers? - Answer 1 + 2. No loss/impairment
of foot/leg/hand/arm.
3. No IDDM (new waiver)
4. No dx of heart dz that might cause syncope, SOB, collapse, or CHF
5. No respiratory dysfunction likely to interfere
6. No HTN likely to interfere
7. No hx or dx of MSK dz likely to interfere
8. No hx of epilepsy or dz causing LOC
9. No mental/psych dz likely to interfere
10. Distance vision of 20/40 in each eye and together, 70 degrees horizontal field, and
ability to recognize red/green/yellow
11. Whisper at 5 feet in BETTER ear or no average HL in better ear>40 DBs at
500,1000,and 2000 hz
12. No schedule 1, amphetamine, narcotic, habit forming drugs except when prescribed
by someone who says it will not affect ability to operate CMV
13. No dx of alcoholism
Can a medical examiner grant a waiver? - Answer No. They have to go through the
online FMCSA processes.
Don't certify until etiology is _______, and _____ is shown to be _____, ______, and
_____. - Answer Confirmed, treatment, safe, effective, stable.
What if multiple waiting periods for multiple comorbidities? - Answer Wait until longest
one is done.
When to get additional tests/consults? - Answer Case by case basis to adequately
address fitness for duty. No required to accept the consult/testing.
What are the only required regulations? - Answer Vision, hearing, epilepsy, IDDM.
What to do if choose not to follow a guideline? - Answer Document extensively why you
did not.
What testing MUST be done for the exam? - Answer Height, weight, vision, hearing, BP,
pulse, urinalysis.
What optional testing may be done? - Answer BMI, audiometry, PFTs, ECHO, EKG,
sleep study, CT scan, etc, based on H&P and your determination. CAUTION: If you
