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FMCSA Publishes Entries into the Federal Register

January 25, 2024

This week, the Federal Motor Carrier Safety Administration published 3 notices in the Federal Register all addressing the commercial driver medical examination. The first 2 notices are related directly to medical guidance provided to medical examiners. The 3rd notice addresses the need for Medical Examiners to use to access the National Registry of Certified Medical Examiners (NRCME) or be removed from the list of certified examiners.

Notice 1: Updated Medical Advisory Criteria

On Friday, January 19, 2024, FMCSA published in the Federal Register a notice they were updating the Medical Advisory Criteria found in Appendix A of 49 CFR Part 391. The updated Medical Advisory Criteria replaces all previous versions and is effective January 19, 2024.

Notice 2: 2024 Revised Medical Examiners’ Handbook

On Monday, January 22 FMCSA entered in the register that they have a brand new 2024 version of the Medical Examiner's Handbook (MEH). In 2022 FMCSA issued a draft of their MEH which filled the gap created when they discontinued the use of the handbook in 2015. FMCSA requested comments from the public on the 2022 draft of the MEH and the 2024 version was revised based on comments received. Highlights of the revision include:

  • Containing the updated Medical Advisory Criteria published on January 19, 2024.
  • Edits to several sections emphasizing privacy protections for the driver.
  • Addressing that once a Medical Examiner begins an examination, the results must be reported to the National Registry, even if exam is not completed.
  • Explains when a medical exemption is required, the MCSA-5876 is not valid unless the individual applies for and is issued the exemption by FMXSA.
  • Clarifies the use of determination pending, including that it does not extend the expiration date of an individual’s current Medical Examiner’s Certificate.
  • Removal of references to additional sources of information to address inconsistency in prior drafts.
  • Edits, clarifications, and removal of guidance on several health conditions including but not limited to alternative vision standard, renal dialysis, obstructive sleep apnea, hypertension, drug and alcohol standards, narcolepsy and idiopathic hypersomnia.

The 2024 edition of the MEH replaces all previous handbook editions and the guidance is effective January 22, 2024.

According to FMCSA both the MEH and Appendix to 49 CFR Part 391 are guidance documents and should not be considered regulatory documents.

Notice 3: Required use of by Examiners on NRCME

On January 24, 2024, FMCSA published in the Federal Register a notice stating all NRCME medical examiners must use to access their National Registry account. FMCSA first communicated to examiners on June 22, 2018, of the security requirement to use FMCSA states there are 92,625 examiners listed on NRCME and 76,898 are using to access their account. There are 15,727 Medical Examiners who have not used to access their NRCME account. Examiners who fail to use to access NRCME on or before February 23.2024 will be removed from the National Register by FMCSA.