DOT EXAM.LATEST QUESTIONS AND ANSWERS FOR AN A+
NRCME
National Registry of Certified Medical Examiners
FMCSA
Federal Motor Carrier Safety Administration
(One of nine administrations in the DOT)
Office of Medical Programs
Lead federal agency within FMCSA on regulation of CMV driver's health and safety
Office of Medical Programs Duties
Oversee medical certification for CMV drivers
Med regs, policies and procedures
Oversee and support Medical Review Board
Implements National Registry Program
Oversee Medical Exemptions and Certifications
CMV Health, Safety and Medical Research
Office of ART
FMCSA Office of Analysis, Research and Technology
Provides data and analysis for FMCSA
Federal Motor Carrier Safety Regulations
49 CFR 391.41 - medical fitness for duty
49 CFR 391.43 - examiner responsibilities
49 CFR 391.45 - who needs CMV exam
49 CFR 391.47 - conflict resolution
49 CFR 391.49 - Skill Performance Evaluation
49 CFR 391.64 - vision and diabetes waiver
49 CFR 40
Drug and Alcohol testing regulations
Medical Review Officer - Physician evaluates results
Substance Abuse Professional - evaluates driver
Non-Discretionary Standards (No examiner discretion)
,Vision
Hearing
Epilepsy
CMV Definition
weight of > 10,000 lbs
> 8 passengers (inc. driver) for compensation
> 15 passengers (inc. driver) regardless of compensation
Transport of Hazardous materials
How long must Examiner retain Medical Examination Report
3 years from date of examination
(and must provide within 48 hours of authorized request)
Maximum time in determination pending status?
45 days
Regulation vs Guidance
Regulation = NO choice
Guidance is up to discretion
Must document exceptions in DETAIL
Driver requirements
49 CFR 391.11
21 yo; Speak and Read English
Capable of safely operating CMV
Have current Medical Examiners Certificate
Have a valid CMV operators license
Provided background and violations info
No Disqualifications (49 CFR 391.15)
Successful completed drivers road test
Driver Maximum Work Hours
No more than:
60 hours in 7 consecutive days
-or-
70 hours in 8 consecutive days
,Driving Log Requirements
Driver must carry driving log for last 7 days
Proper exam attire
Underwear and a gown
Health History YES Response requirements
Onset date and Diagnosis for all current and previous conditions
Treating provider contact information
Resulting past or present limitations
Medications, dose, frequency (Rx, OTC, Herbal)
Necessary steps, tests and evaluation
Requirements of Every Examination
BP
UA
Vision
Hearing
Also: Pulse, reg rhythm, Height and Weight
Medical Clearance
Clearance from specialist with CMV knowledge
Knowledgeable about medications and side effects
Tolerate medications
Free from side effects that compromise driving
Compliant with ongoing treatment plan
When to provide copy of Medical Exam Report Form
Skilled Performance Evaluation certificate
Hearing exemption certificate
Vision exemption certificate
Medical Examiner's Certificate. MCSA-5876
Expires at midnight on date written on form
No grace period for expiration date
Copy goes to Employee
Copy goes to Employer (upon request)
, MCSA-5850
Electronic Medical Examiners Report
Must be submitted by midnight of next calendar day
Federal 2 year Exemptions
Monocular Vision
Hearing
Seizure
Skilled performance evaluation
Urinalysis
Specific Gravity, Protein, Blood , Glucose
Examiner's discretion to Certify, Time Limit, or Disqualify
In any case: referral to primary or specialist for further evaluation and treatment
Xanthelasma
raised yellowish plaque on eyelid caused by lipid disorder
Anisocoria
Unequal pupil size
Many benign causes
Can certify
Clubbing
Referral to pulmonary specialist prior to certification
Positive Babinski Reflex
May indicate abnormalities in motor control in pathways leading from the cerebral cortex
DQ until neurological consultation
Hand Function requirements
Prehension
Power grasping
No set measurement; must be able to perform duties
(average grip for male = 105-113 lbs)
NRCME
National Registry of Certified Medical Examiners
FMCSA
Federal Motor Carrier Safety Administration
(One of nine administrations in the DOT)
Office of Medical Programs
Lead federal agency within FMCSA on regulation of CMV driver's health and safety
Office of Medical Programs Duties
Oversee medical certification for CMV drivers
Med regs, policies and procedures
Oversee and support Medical Review Board
Implements National Registry Program
Oversee Medical Exemptions and Certifications
CMV Health, Safety and Medical Research
Office of ART
FMCSA Office of Analysis, Research and Technology
Provides data and analysis for FMCSA
Federal Motor Carrier Safety Regulations
49 CFR 391.41 - medical fitness for duty
49 CFR 391.43 - examiner responsibilities
49 CFR 391.45 - who needs CMV exam
49 CFR 391.47 - conflict resolution
49 CFR 391.49 - Skill Performance Evaluation
49 CFR 391.64 - vision and diabetes waiver
49 CFR 40
Drug and Alcohol testing regulations
Medical Review Officer - Physician evaluates results
Substance Abuse Professional - evaluates driver
Non-Discretionary Standards (No examiner discretion)
,Vision
Hearing
Epilepsy
CMV Definition
weight of > 10,000 lbs
> 8 passengers (inc. driver) for compensation
> 15 passengers (inc. driver) regardless of compensation
Transport of Hazardous materials
How long must Examiner retain Medical Examination Report
3 years from date of examination
(and must provide within 48 hours of authorized request)
Maximum time in determination pending status?
45 days
Regulation vs Guidance
Regulation = NO choice
Guidance is up to discretion
Must document exceptions in DETAIL
Driver requirements
49 CFR 391.11
21 yo; Speak and Read English
Capable of safely operating CMV
Have current Medical Examiners Certificate
Have a valid CMV operators license
Provided background and violations info
No Disqualifications (49 CFR 391.15)
Successful completed drivers road test
Driver Maximum Work Hours
No more than:
60 hours in 7 consecutive days
-or-
70 hours in 8 consecutive days
,Driving Log Requirements
Driver must carry driving log for last 7 days
Proper exam attire
Underwear and a gown
Health History YES Response requirements
Onset date and Diagnosis for all current and previous conditions
Treating provider contact information
Resulting past or present limitations
Medications, dose, frequency (Rx, OTC, Herbal)
Necessary steps, tests and evaluation
Requirements of Every Examination
BP
UA
Vision
Hearing
Also: Pulse, reg rhythm, Height and Weight
Medical Clearance
Clearance from specialist with CMV knowledge
Knowledgeable about medications and side effects
Tolerate medications
Free from side effects that compromise driving
Compliant with ongoing treatment plan
When to provide copy of Medical Exam Report Form
Skilled Performance Evaluation certificate
Hearing exemption certificate
Vision exemption certificate
Medical Examiner's Certificate. MCSA-5876
Expires at midnight on date written on form
No grace period for expiration date
Copy goes to Employee
Copy goes to Employer (upon request)
, MCSA-5850
Electronic Medical Examiners Report
Must be submitted by midnight of next calendar day
Federal 2 year Exemptions
Monocular Vision
Hearing
Seizure
Skilled performance evaluation
Urinalysis
Specific Gravity, Protein, Blood , Glucose
Examiner's discretion to Certify, Time Limit, or Disqualify
In any case: referral to primary or specialist for further evaluation and treatment
Xanthelasma
raised yellowish plaque on eyelid caused by lipid disorder
Anisocoria
Unequal pupil size
Many benign causes
Can certify
Clubbing
Referral to pulmonary specialist prior to certification
Positive Babinski Reflex
May indicate abnormalities in motor control in pathways leading from the cerebral cortex
DQ until neurological consultation
Hand Function requirements
Prehension
Power grasping
No set measurement; must be able to perform duties
(average grip for male = 105-113 lbs)
