1. Martin Duke, MD, MRO February 20, 2014

2. Introduction Who can be a Medical Examiner? Medical Examiner Training and Certification Medical Examiner Requirements Employer Responsibility

3. Federal Register – April 10, 2012 Final Rule for National Registry of Certified ME Compliance Date – May 21, 2014 Where employer information available National Registry of Certified ME 49 CFR 390.101- 390.115 Subpart D Driver and employer instructions 49 CFR 391.23, 49 CFR 391.42-43, 49 CFR 391.51

4. Doctor of Medicine – MD Doctor of Osteopathy – DO Doctor of Chiropractic – DC Advanced Practical Nurse - APN Physician Assistant – PA Any Health Care Professional permitted by their state to perform physical examinations

5. Complete Training for CDL Course must meet core curriculum specifications established by FMCSA ME Training & Certification

6. Core Curriculum Specifications Background, rationale, mission and goals of the FMCSA medical examiner’s role in reducing crashes, injuries and fatalities involving CMV Familiarization with the responsibilities and work environment of CMV operations Identification of the driver and obtaining, reviewing, and documenting driver medical history, including prescription and OTC medications Performing, reviewing and documenting the driver’s medical examination

7. Core Curriculum Specifications Performing, obtaining, and documenting diagnostic tests and obtaining additional testing or medical opinion from a medical specialist or treating physician Informing and educating the driver about medications and non-disqualifying medical conditions that require remedial care Determining driver certification outcome and period for which certification should be valid FMCSA reporting and documentation requirements

8. Satisfactorily pass certification exam approved by FMCSA Certification exam based on FMCSA regulations and guidelines Be issued a FMCSA certification credential and unique number ME Training & Certification

9. Initial Certification Retraining Every 5 years to continue certification Retesting Every 10 years to maintain certification Record Retention Minimum of 3 years required by Federal Government State laws may require longer than 3 years ME Certification & Requirements

10. After Driver Examination If fully qualified, driver must be told results and given copy of “Medical Examiners Certificate.” If conditionally qualified, must be told how to achieve full qualification and time frame. If permanently disqualified, must be told why. Monthly Electronic Transmissions All driver examinations performed during the preceding month MUST be electronically transmitted to the Registry

11. May refer the employee to a Certified ME in the local area or employee may see his/her own private physician as long as the examiner is certified. A list of certified examiners can be found at FMCSA registry – http://nrcme.fmcsa.dot.gov http://nrcme.fmcsa.dot.gov

12. Must verify that the ME who issued the medical certificate is certified on the National Registry http://nrcme.fmcsa.dot.gov http://nrcme.fmcsa.dot.gov Must obtain a copy of the medical certificate from the Driver (49 CFR 391.23) OR from the Medical Examiner. The ME must provide copy to employer if requested (49 CFR 391.43) Must put a note in driver ’ s qualification file indicating that review was performed (49 CFR 391.51)

14. Recent Changes by FMCSA January 14, 2014 – Drivers must continue to carry the Medical Examiners Certificate on their person until January 30, 2015 February 12, 2014 – National Drug and Alcohol Testing Clearinghouse Notice of Proposed Rulemaking information release (publication date TBA) Would require employers to check clearinghouse before hiring and annually thereafter.

15. Questions?