by midnight (local time) of the next calendar day after the examination
by a certified ME listed on the National Registry and (2) this
information is then electronically transmitted to the SDLA for entry
into the appropriate driver record within one business day of receipt
from FMCSA. There are no additional burden hours and annual costs to
respondents imposed by this final rule. Implementation of this final
rule will result in time and cost savings to employers, however,
because they will no longer be required to verify the ME's National
Registry number for CLP/CDL driver examinations. Only certified MEs
listed on the National Registry will be able to forward driver
identification, examination results, and restriction information to the
National Registry. MEs will no longer be required to complete and
furnish a copy of the MEC to the driver examined when the driver is a
CLP/CDL applicant/holder because this information will be
electronically transmitted to the SDLA. The CLP/CDL applicants/holders
will no longer be required to provide the SDLA with their MEC as proof
of medical certification, and the SDLA will no longer be required to
manually input the driver's MEC information.
    On the effective date of this final rule, MEs must notify FMCSA if
they have not performed any driver physical examinations during the
previous month, and States must update the medical status to ``not
certified' when the medical certification is voided by FMCSA. In
addition, six months after the effective date of this final rule, MEs
must use the new MER Form, MCSA-5875 and the prescribed Form MCSA-5876
for the MEC.
    As discussed above, as a result of an update including several IC
program changes not related to this final rule, there is an increase in
the annual paperwork burden hours from the currently approved IC of
503,000 hours (2,130,702 hours to 2,633,702) during the first 3 years
of the final rule after the compliance date. The IC activities imposed
on the MEs, drivers, and motor carriers over the first 3 years of
implementing this final rule will remain unchanged. This provides time
for those States that need to pass legislation and for all States to
make the necessary system upgrades prior to the effective date for
updating the CDLIS driver's record. The table below shows the annual
burden hours for the IC activities for the first three years.

                  Annual Burden Hours for First 3 Years
------------------------------------------------------------------------
                                                           Annual burden
                                                           hours for the
   IC Activities for MEs, drivers, and motor carriers      IC activities
                                                            in first 3
                                                               years
------------------------------------------------------------------------
Physical Qualification Standards: Medical Examination          2,080,350
 Report Form and Medical Examiner's Certificate.........
Resolution of Medical Conflict..........................              11
Diabetes Exemption Program..............................           2,219
Vision Exemption Program................................           2,216
Hearing Exemptions......................................              49
Seizure Exemptions......................................              96
SPE.....................................................           2,661
Medical Examiner Registration...........................           5,000
Medical Examiner Test Results (upload)..................           1,667
Reporting CMV Driver Medical Examination Results and             231,150
 filing and providing MEC...............................
Providing Medical Examination Report Copies to FMCSA....              83
Verification of National Registry Number................         308,200
                                                         ---------------
    Total...............................................       2,633,702
------------------------------------------------------------------------

    Three years after the effective date of this final rule the
following will be required: (1) MEs must increase the frequency of
submission of CMV driver medical examination results via Form, MCSA-
5850, from once a month to as frequent as they conduct exams. They are
required to submit the results of all CMV driver medical examinations

conducted by midnight (local time) of the next calendar day following
the exam; (2) FMCSA must electronically transmit driver identification,
examination results, and restriction information from the National
Registry system to the SDLAs for CLP/CDL applicants/holders; (3) FMCSA
will electronically transmit medical variance information for all CMV
drivers to the SDLAs; and (4) States must post the medical variance
information provided by FMCSA, including the dates of issuance and
expiration, to the CDLIS driver record within 1 business day of receipt
for CLP/CDL applicants/holders. These requirements do not impose any
additional time or cost burdens on the MEs or their staff, drivers, or
SDLAs. MEs will no longer be required to complete and furnish a written
copy of the MEC to the driver examined when the driver is a CLP/CDL
holder, because this information will be electronically transmitted to
the SDLA. This provides a time savings of 32,303 hours and a cost
savings of $2,874,967/year. Employers will no longer be required to
verify the ME's national registry number for CLP/CDL applicants/holders
examinations, because only certified MEs listed on the National
Registry will be able to forward MEC information to the National
Registry. This provides a time savings of 251,695 hours and a cost
savings of $4,782,205. Therefore, as a result of this final rule, the
annual burden hours during the 4th and subsequent years after the
compliance date of the rule have decreased by 283,998 hours (2,633,702
hours to 2,349,704 hours) and the annual costs have decreased by
$7,657,172 ($163,850,187 to $156,193,015). The table below shows the
annual burden hours for the IC activities for the 4th and subsequent
years following the effective date of this final rule.

            Annual Burden Hours for 4th and Subsequent Years
------------------------------------------------------------------------
                                                           Annual burden
                                                           hours for the
                                                           IC activities
   IC Activities for MEs, drivers, and motor carriers       in 4th year
                                                          and subsequent
                                                               years
------------------------------------------------------------------------
FMCSA Physical Qualification Standards: Medical                2,048,047
 Examination Report Form and Medical Examiner's
 Certificate............................................
Resolution of Medical Conflict..........................              11
Diabetes Exemption Program..............................           2,219
Vision Exemption Program................................           2,216
Hearing Exemptions......................................              49
Seizure Exemptions......................................              96
SPE.....................................................           2,661
Medical Examiner Registration...........................           5,000
Medical Examiner Test Results (upload)..................           1,667
Reporting CMV Driver Medical Examination Results and             231,150
 filing and providing MEC...............................
Providing Medical Examination Report Copies to FMCSA....              83
Verification of National Registry Number................          56,505
                                                         ---------------
    Total...............................................       2,349,704
------------------------------------------------------------------------

    2126-0011 Commercial Driver Licensing and Test Standards. The
renewal of this IC was approved by OMB on January 12, 2015. This IC
supports the DOT Strategic Goal of Safety by requiring that CLP/CDL
applicants/holders driving CMVs subject to part 391 to be properly
licensed according to all applicable Federal requirements. The
information being collected ensures that CLP/CDL applicants/holders are
qualified to hold a CLP/CDL to operate CMVs, and that States are
administering their CDL programs in compliance with the Federal
requirements.
    The rule requires the MEC and medical variance information for CLP/
CDL applicants/holders to be transmitted electronically by FMCSA to the
SDLA and posted to the CLP/CDL holder's CDLIS driver record. This
eliminates the need for the driver to carry a paper copy of the MEC and
to physically provide a copy to his/her SDLA. Therefore, there will be
no change in the total annual burden hours during the first 3 years.
However, during these 3 years there will be a one-time cost that each
State and the District of Columbia will need to expend to make updates
to their systems to accommodate the development of the capability to
electronically receive and post medical certification and medical
variance information from FMCSA and to the CDLIS driver record. While
the information technology necessary to carry out these transactions is
still in the early development stage, FMCSA estimates that the cost
elements to implement these new requirements will not be greater than
the estimated cost to implement the posting of the MEC and medical
variance information manually to the driver's record. The FMCSA
believes that additional costs to the SDLAs associated with this IC to
be a one- time total of approximately $9,965,163 over the first 3 years
or an annual cost of $3,321,721. The breakdown of the $9,965,163 by
type of work activity by dollar totals for first 3 years is as follows:

------------------------------------------------------------------------
                                                            Total state
                 Information technology                      costs \9\
------------------------------------------------------------------------
Input and Inquiry Screens...............................      $6,146,560
Expanded Database.......................................       1,563,932
Systems and User Acceptance Testing.....................       1,664,850
AAMVA Testing...........................................         589,821
                                                         ---------------
    Total One-Time Costs................................       9,965,163
------------------------------------------------------------------------

    The FMCSA believes that additional costs to AAMVA to develop the
communications link between CDLIS and the National Registry for this IC
to be a one- time total of approximately $1,000,000 over the first 3
years or an annual cost of $333,333.
---------------------------------------------------------------------------

    \9\ These costs are based on a sample of nine States conducted
by an FMCSA contractor, representing three tiers of size and
different regions of the country.
---------------------------------------------------------------------------

    Starting in the 4th and subsequent years, there will be a decrease
in total annual burden hours due to the implementation of the new
program change. With medical certification and medical variance
information being sent electronically to the SDLA by FMCSA to

post to the CDLIS driver record, the annual burden hours for the SDLA
to manually post the medical certification and medical variance
information to the CDLIS driver record will be reduced from 81,000
hours to 0 hours based on the medical certification and variance
information being electronically sent through the National Registry to
the SDLA by FMCSA and electronically posted to the CDLIS driver record.
The annual cost of interstate CDL holders providing the SDLA with an
original or copy of the MEC will be eliminated. This is an annual cost
savings of $1,047,600. The following table summarizes the annual IC
burden hours for current and proposed IC activities for the first 3
years and the subsequent years. As discussed above, the currently
approved total annual burden of 3,651,867 hours for the first 3 years
remains unchanged. The decrease in proposed total annual burden of
81,000 hours in subsequent years is due to the program changes from
implementing the new requirement.

----------------------------------------------------------------------------------------------------------------
                                                                                Proposed
                                                                                Proposed      annual burden
                                                                     Currently     annual burden   hours for IC
    Current and proposed IC activities for States and CLP/CDL        approved      hours for the   activities in
                             holders                               annual burden   IC activities      4th and
                                                                       hours        in first 3      subsequent
                                                                                years           years
----------------------------------------------------------------------------------------------------------------
State recording of medical examiner's certification and medical           81,000          81,000               0
 variance information...........................................
State recording of the self-certification of CMV operation......           4,544           4,544           4,544
State verification of the medical certification status of all                901             901             901
 interstate CLP/CDL holders.....................................
Driver notification of convictions/disqualifications to employer         730,000         730,000         730,000
Driver providing previous employment history to new employer....         459,950         459,950         459,950
Annual State certification of compliance........................           1,632           1,632           1,632
States preparing for and participating in Annual Program Review.          10,200          10,200          10,200
CDLIS/PDPS/State Record Keeping.................................         335,668         335,668         335,668
Drivers completion of the CLP/CDL application...................          59,130          59,130          59,130
CDL Knowledge and Skills tests recordkeeping....................          95,813          95,813          95,813
Knowledge and skills test examiner certification................          25,216          25,216          25,216
Driver completion of knowledge and skills test..................       1,847,813       1,847,813       1,847,813
                                                                 -----------------------------------------------
    Total Burden Hours..........................................       3,651,867       3,651,867       3,570,867
----------------------------------------------------------------------------------------------------------------

    FMCSA analyzed this rule and determined that its implementation
will decrease the annual burden hours for IC activities covered by OMB
Control No. 2126-006, titled ``Medical Qualification Requirements,''
and OMB Control No. 2126-0011, titled ``Commercial Driver Licensing and
Test Standards'' during the 4th and subsequent years. The Table below
captures the current and future paperwork burden hours associated with
the two approved supporting statements. A detailed analysis of each IC
activity can be found in the Supporting Statements, which are in the
public docket for this rulemaking.

                                Current and Future Information Collection Burdens
----------------------------------------------------------------------------------------------------------------
                                                                     Proposed                        Proposed
                                                                   annual burden     Proposed      annual burden
                                                     Currently      hours as a     annual burden   hours for IC
                OMB Approval No.                     approved        result of     hours for IC    activities in
                                                   annual burden   update, not a   activities in      4th and
                                                       hours         result of      1st 3 years     subsequent
                                                                    final rule                         years
----------------------------------------------------------------------------------------------------------------
2126-0006.......................................       2,130,702       2,633,702       2,633,702       2,349,704
2126-0011.......................................       3,651,867             N/A       3,651,867       3,570,867
                                                 ---------------------------------------------------------------
    Totals......................................       5,782,569             N/A       6,285,569       5,920,571
----------------------------------------------------------------------------------------------------------------

L. National Environmental Policy Act and Clean Air Act

    FMCSA analyzed this final rule for the purpose of the National
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.) and
determined this action is categorically excluded from further analysis
and documentation in an environmental assessment or environmental
impact statement under FMCSA Order 5610.1 (69 FR 9680, March 1, 2004),
Appendix 2, paragraph (s)(7) and paragraph (t)(2). The Categorical
Exclusion (CE) in paragraph (b) covers administrative or editorial
changes; (s)(7) covers requirements for State-issued commercial license
documentation; and paragraph (t)(2) addresses regulations that assure
States have the appropriate information systems and procedures
concerning CDL qualifications. The requirements in this rule are
covered by these two CEs and this action does not have any effect on
the quality of the environment. The CE determination is available for
inspection or copying in the Regulations.gov Web site listed under
ADDRESSES. FMCSA also analyzed this rule under the Clean Air Act, as
amended (CAA), section 176(c) (42 U.S.C. 7401 et seq.), and
implementing regulations promulgated by the Environmental Protection
Agency. Approval of this action is exempt from the CAA's general
conformity requirement since it does not affect direct or indirect
emissions of criteria pollutants.

M. E.O. 12898 Environmental Justice

    FMCSA evaluated the environmental effects of this final rule in
accordance with Executive Order 12898 and determined that there are no
environmental justice issues associated with its provisions nor any
collective environmental impact resulting from its promulgation.
Environmental justice issues would be raised if there were
``disproportionate'' and ``high and

adverse impact'' on minority or low-income populations.

N. E.O. 13211 (Energy Supply, Distribution, or Use)

    FMCSA has analyzed this final rule under E.O. 13211, Actions
Concerning Regulations That Significantly Affect Energy Supply,
Distribution, or Use. The Agency has determined that it is not a
``significant energy action'' under that order because it is not a
``significant regulatory action'' likely to have a significant adverse
effect on the supply, distribution, or use of energy. Therefore, it
does not require a Statement of Energy Effects under E.O. 13211.

O. E.O. 13175 (Indian Tribal Governments)

    This rule does not have tribal implications under E.O. 13175,
Consultation and Coordination with Indian Tribal Governments, because
it does not have a substantial direct effect on one or more Indian
tribes, on the relationship between the Federal Government and Indian
tribes, or on the distribution of power and responsibilities between
the Federal Government and Indian tribes.

P. National Technology Transfer and Advancement Act (Technical
Standards)

    The National Technology Transfer and Advancement Act (NTTAA) (15
U.S.C. 272 note) directs agencies to use voluntary consensus standards
in their regulatory activities unless the agency provides Congress,
through OMB, with an explanation of why using these standards would be
inconsistent with applicable law or otherwise impractical. Voluntary
consensus standards (e.g., specifications of materials, performance,
design, or operation; test methods; sampling procedures; and related
management systems practices) are standards that are developed or
adopted by voluntary consensus standards bodies. This rule does not use
technical standards. Therefore, we did not consider the use of
voluntary consensus standards.

List of Subjects

49 CFR Part 383

    Administrative practice and procedure, Alcohol abuse, Drug abuse,
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 384

    Administrative practice and procedure, Alcohol abuse, Drug abuse,
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 391

    Alcohol abuse, Drug abuse, Drug testing, Highway safety, Motor
carriers, Reporting and recordkeeping requirements, Safety,
Transportation.

    For the reasons stated in the preamble, FMCSA amends 49 CFR chapter
III, to read as follows:

PART 383--COMMERCIAL DRIVER'S LICENSE STANDARDS; REQUIREMENTS AND
PENALTIES

0
1. The authority citation for part 383 continues to read as follows:

    Authority: 49 U.S.C. 521, 31136, 31301 et seq., and 31502; secs.
214 and 215, Pub. L. 106-159, 113 Stat. 1748, 1766, 1767; sec. 4140,
Pub. L. 109-59, 119 Stat. 1144, 1746; and 49 CFR 1.87.

0
2. Amend Sec.  383.71 by revising paragraphs (h)(1) and (3) to read as
follows:

Sec.  383.71  Driver application and certification procedures.

* * * * *
    (h) * * *
    (1) New CLP and CDL applicants. (i) Before June 22, 2018, a new CLP
or CDL applicant who certifies that he/she will operate CMVs in non-
excepted, interstate commerce must provide the State with an original
or copy (as required by the State) of a medical examiner's certificate
prepared by a medical examiner, as defined in 49 CFR 390.5, and the
State will post a medical qualifications status of ``certified'' on the
CDLIS driver record for the driver;
    (ii) On or after June 22, 2018, a new CLP or CDL applicant who
certifies that he/she will operate CMVs in non-excepted, interstate
commerce must be medically examined and certified in accordance with 49
CFR 391.43 as medically qualified to operate a CMV by a medical
examiner, as defined in 49 CFR 390.5. Upon receiving an electronic copy
of the medical examiner's certificate from FMCSA, the State will post a
medical qualifications status of ``certified'' on the CDLIS driver
record for the driver;
* * * * *
    (3) Maintaining the medical certification status of ``certified.''
(i) In order to maintain a medical certification status of
``certified,'' before June 22, 2018, a CLP or CDL holder who certifies
that he/she will operate CMVs in non-excepted, interstate commerce must
provide the State with an original or copy (as required by the State)
of each subsequently issued medical examiner's certificate;
    (ii) In order to maintain a medical certification status of
``certified,'' on or after June 22, 2018, a CLP or CDL holder who
certifies that he/she will operate CMVs in non-excepted, interstate
commerce must continue to be medically examined and certified in
accordance with 49 CFR 391.43 as physically qualified to operate a
commercial motor vehicle by a medical examiner, as defined in 49 CFR
390.5. FMCSA will provide the State with an electronic copy of the
medical examiner's certificate information for all subsequent medical
examinations in which the driver has been deemed qualified.

0
3. Amend Sec.  383.73 by revising paragraphs (a)(2)(vii), (b)(5),
(o)(1), (o)(2), (o)(3) and (o)(4) to read as follows:

Sec.  383.73  State procedures.

    (a) * * *
    (2) * * *
    (vii)(A) Before June 22, 2018, for drivers who certified their type
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted
interstate) and, if the CLP applicant submits a current medical
examiner's certificate, date-stamp the medical examiner's certificate,
and post all required information from the medical examiner's
certificate to the CDLIS driver record in accordance with paragraph (o)
of this section.
    (B) On or after June 22, 2018, for drivers who certified their type
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted
interstate) and, if FMCSA provides current medical examiner's
certificate information electronically, post all required information
matching the medical examiner's certificate to the CDLIS driver record
in accordance with paragraph (o) of this section.
    (b) * * *
    (5)(i) Before June 22, 2018, for drivers who certified their type
of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted
interstate) and, if the CDL holder submits a current medical examiner's
certificate, date-stamp the medical examiner's certificate and post all
required information from the medical examiner's certificate to the
CDLIS driver record in accordance with paragraph (o) of this section.
    (ii) On or after June 22, 2018, for drivers who certified their
type of driving according to Sec.  383.71(b)(1)(ii)(A) (non-excepted
interstate) and, if FMCSA provides current medical examiner's
certificate information electronically, post all required information
matching the medical examiner's certificate to the CDLIS driver record
in accordance with paragraph (o) of this section.
* * * * *
    (o) Medical recordkeeping--(1)(i) Status of CLP or CDL holder.
Before

June 22, 2018, for each operator of a commercial motor vehicle required
to have a CLP or CDL, the current licensing State must:
    (A) Post the driver's self-certification of type of driving under
Sec.  383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate
within 10 calendar days to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e.,
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's
certificate, such as an exemption, SPE certification, or grandfather
provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid,
required to have possession of an exemption letter or SPE certificate
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted
to the CDLIS driver record; and
    (C) Post the medical variance information within 10 calendar days
to the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D) Retain the original or a copy of the medical examiner's
certificate of any driver required to provide documentation of physical
qualification for 3 years beyond the date the certificate was issued.
    (ii) Status of CLP or CDL holder. On or after June 22, 2018, for
each operator of a commercial motor vehicle required to have a CLP or
CDL, the current licensing State must:
    (A) Post the driver's self-certification of type of driving under
Sec.  383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate
received from FMCSA to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e.,
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's
certificate, such as an exemption, Skill Performance Evaluation (SPE)
certification, or grandfather provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid,
required to have possession of an exemption letter or SPE certificate
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted
to the CDLIS driver record;
    (C) Post the medical variance information received from FMCSA
within 1 business day to the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D) Retain the electronic record of the medical examiner's
certificate information for any driver required to have documentation
of physical qualification for 3 years beyond the date the certificate
was issued.
    (2) Status update. (i) Before June 22, 2018, the State must, within
10 calendar days of the driver's medical examiner's certificate or
medical variance expiring, the medical variance being rescinded or the
medical examiner's certificate being voided by FMCSA, update the
medical certification status of that driver as ``not certified.''
    (ii) Beginning June 22, 2018, the State must, within 10 calendar
days of the driver's medical examiner's certificate or medical variance
expiring, the medical examiner's certificate becoming invalid, the
medical variance being rescinded or the medical examiner's certificate
being voided by FMCSA, update the medical certification status of that
driver as ``not certified.''
    (3) Variance update. (i) Before June 22, 2018, within 10 calendar
days of receiving information from FMCSA regarding issuance or renewal
of a medical variance for a driver, the State must update the CDLIS
driver record to include the medical variance information provided by
FMCSA.
    (ii) Beginning June 22, 2018, within 1 business day of
electronically receiving medical variance information from FMCSA
regarding the issuance or renewal of a medical variance for a driver,
the State must update the CDLIS driver record to include the medical
variance information provided by FMCSA.
    (4) Downgrade. (i) If a driver's medical certification or medical
variance expires, or FMCSA notifies the State that a medical
certification was invalidated or voided or a medical variance was
removed or rescinded, the State must:
    (A)(1) Before June 22, 2018 notify the CLP or CDL holder of his/her
CLP or CDL ``not-certified'' medical certification status and that the
CMV privileges will be removed from the CLP or CDL unless the driver
submits a current medical examiner's certificate and/or medical
variance, or changes his/her self-certification to driving only in
excepted or intrastate commerce (if permitted by the State);
    (2) On or after June 22, 2018 notify the CLP or CDL holder of his/
her CLP or CDL ``not-certified'' medical certification status and that
the CMV privileges will be removed from the CLP or CDL unless the
driver has been medically examined and certified in accordance with 49
CFR 391.43 as physically qualified to operate a commercial motor
vehicle by a medical examiner, as defined in 49 CFR 390.5, or the
driver changes his/her self-certification to driving only in excepted
or intrastate commerce (if permitted by the State).
    (B) Initiate established State procedures for downgrading the CLP
or CDL. The CLP or CDL downgrade must be completed and recorded within
60 days of the driver's medical certification status becoming ``not-
certified'' to operate a CMV.
    (ii)(A) Before June 22, 2018, if a driver fails to provide the
State with the certification contained in Sec.  383.71(b)(1), or a
current medical examiner's certificate if the driver self-certifies
according to Sec.  383.71(b)(1)(i) that he/she is operating in non-
excepted interstate commerce as required by Sec.  383.71(h), the State
must mark that CDLIS driver record as ``not-certified'' and initiate a
CLP or CDL downgrade following State procedures in accordance with
paragraph (o)(4)(i)(B) of this section.
    (B) On or after June 22, 2018 if a driver fails to provide the
State with the certification contained in Sec.  383.71(b)(1), or, if
the driver self-certifies according to Sec.  383.71(b)(1)(i) that he/
she is operating in non-excepted interstate commerce as required by
Sec.  383.71(h) and the information required by paragraph (o)(2)(ii) of
this section is not received and posted, the State must mark that CDLIS
driver record as ``not-certified'' and initiate a CLP or CDL downgrade
following State procedures in accordance with paragraph (o)(4)(i)(B) of
this section.
* * * * *

PART 384--STATE COMPLIANCE WITH COMMERCIAL DRIVER'S LICENSE PROGRAM

0
4. The authority citation for part 384 continues to read as follows:

    Authority: 49 U.S.C. 31136, 31301, et seq., and 31502; secs. 103
and 215, Pub. L. 106-159, 113 Stat. 1748, 1753, 1767; and 49 CFR
1.87.

0
5. Revise Sec.  384.234 to read as follows:

Sec.  384.234  Driver medical certification recordkeeping.

    The State must meet the medical certification recordkeeping
requirements of Sec.  383.73(a)(2)(vii), (b)(5), (c)(8), (d)(8), (e)(6)
and (o).

0
6. Amend Sec.  384.301 by adding a new paragraph (i) to read as
follows:

Sec.  384.301  Substantial compliance--general requirements.

* * * * *
    (i) A State must come into substantial compliance with the
requirements of subpart B of this part and part 383 of this chapter in
effect as of June 22, 2015 as soon as practical, but, unless otherwise
specifically provided in this part, not later than June 22, 2018.

PART 391--QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION (LCV)
DRIVER INSTRUCTORS

0
7. The authority citation for part 391 continues to read as follows:

    Authority: 49 U.S.C. 504, 508, 31133, 31136, and 31502; sec.
4007(b), Pub. L. 102-240, 105 Stat, 1914, 2152; sec. 114, Pub. L.
103-311, 108 Stat. 1673, 1677; sec. 215, Pub. L. 106-159, 113 Stat.
1748, 1767; and 49 CFR 1.87.

0
8. Amend Sec.  391.23 by revising paragraphs (m)(2) and (3) to read as
follows:

Sec.  391.23  Investigation and inquiries.

* * * * *
    (m) * * *
    (2) Exception. For drivers required to have a commercial driver's
license under part 383 of this chapter:
    (i) Beginning January 30, 2015, using the CDLIS motor vehicle
record obtained from the current licensing State, the motor carrier
must verify and document in the driver qualification file the following
information before allowing the driver to operate a CMV:
    (A) The type of operation the driver self-certified that he or she
will perform in accordance with Sec.  383.71(b)(1)(ii) of this chapter.
    (B)(1) Beginning on May 21, 2014, and ending on June 22, 2015, that
the driver was certified by a medical examiner listed on the National
Registry of Certified Medical Examiners as of the date of medical
examiner's certificate issuance.
    (2) Beginning on June 22, 2015, if the driver has certified under
paragraph (m)(2)(i)(A) of this section that he or she expects to
operate in interstate commerce, that the driver has a valid medical
examiner's certificate and any required medical variances.
    (3) Beginning on July 8, 2015, if the driver has a commercial
learner's permit and has certified under paragraph (m)(2)(i)(A) of this
section that he or she expects to operate in interstate commerce that
the driver has a valid medical examiner's certificate and any required
medical variances.
    (C) Exception. Beginning on January 30, 2015 and until June 22,
2018, if the driver provided the motor carrier with a copy of the
current medical examiner's certificate that was submitted to the State
in accordance with Sec.  383.73(a)(5) of this chapter, the motor
carrier may use a copy of that medical examiner's certificate as proof
of the driver's medical certification for up to 15 days after the date
it was issued.
    (ii) Until January 30, 2015, if a driver operating in non-excepted,
interstate commerce has no medical certification status information on
the CDLIS MVR obtained from the current State driver licensing agency,
the employing motor carrier may accept a medical examiner's certificate
issued to that driver, and place a copy of it in the driver
qualification file before allowing the driver to operate a CMV in
interstate commerce.
    (3) Exception. For drivers required to have a commercial driver's
license under part 383 of this chapter:
    (i) Beginning July 8, 2015, using the CDLIS motor vehicle record
obtained from the current licensing State, the motor carrier must
verify and document in the driver qualification file the following
information before allowing the driver to operate a CMV:
    (A) The type of operation the driver self-certified that he or she
will perform in accordance with Sec.  383.71(a)(1)(ii) and (g) of this
chapter.
    (B) That the driver was certified by a medical examiner listed on
the National Registry of Certified Medical Examiners as of the date of
medical examiner's certificate issuance.
* * * * *

0
9. Amend Sec.  391.41 by revising paragraph (a)(2)(i) to read as
follows:

Sec.  391.41  Physical qualifications for drivers.

    (a) * * *
    (2) CDL exception. (i)(A) Beginning on January 30, 2015 and ending
on the day before June 22, 2018, a driver required to have a commercial
driver's license under part 383 of this chapter, and who submitted a
current medical examiner's certificate to the State in accordance with
49 CFR 383.71(h) documenting that he or she meets the physical
qualification requirements of this part, no longer needs to carry on
his or her person the medical examiner's certificate specified at Sec.
391.43(h), or a copy, for more than 15 days after the date it was
issued as valid proof of medical certification.
    (B) Beginning on June 22, 2018, a driver required to have a
commercial driver's license or a commercial learner's permit under 49
CFR part 383, and who has a current medical examiner's certificate
documenting that he or she meets the physical qualification
requirements of this part, is no longer needs to carry on his or her
person the medical examiner's certificate specified at Sec.  391.43(h).
* * * * *

0
10. Amend Sec.  391.43 by revising paragraphs (f), (g)(2), (g)(3) and
(h), and adding paragraph (g)(4) and (g)(5), to read as follows:

Sec.  391.43  Medical examination; certificate of physical examination.

* * * * *
    (f) The medical examination shall be performed, and its results
shall be recorded on the Medical Examination Report set out below:
BILLING CODE 4910-EX-P

[GRAPHIC] [TIFF OMITTED] TR23AP15.000

[GRAPHIC] [TIFF OMITTED] TR23AP15.001

[GRAPHIC] [TIFF OMITTED] TR23AP15.002

[GRAPHIC] [TIFF OMITTED] TR23AP15.003

[GRAPHIC] [TIFF OMITTED] TR23AP15.004

[GRAPHIC] [TIFF OMITTED] TR23AP15.005

[GRAPHIC] [TIFF OMITTED] TR23AP15.006

[GRAPHIC] [TIFF OMITTED] TR23AP15.007

BILLING CODE 4910-EX-C
    (g) * * *
    (2)(i) Before June 22, 2018, if the medical examiner finds that the
person examined is physically qualified to operate a commercial motor
vehicle in accordance with Sec.  391.41(b), he or she must complete a
certificate in the form prescribed in paragraph (h) of this section and
furnish the original to the person who was examined. The examiner must
provide a copy to a prospective or current employing motor carrier who
requests it.
    (ii) Beginning June 22, 2018, if the medical examiner identifies
that the person examined will not be operating a commercial motor
vehicle that requires a commercial driver's license or a commercial
learner's permit and finds that the driver is physically qualified to
operate a commercial motor vehicle in accordance with Sec.  391.41(b),
he or she must complete a certificate in the form prescribed in
paragraph (h) of this section and furnish the original to the person
who was examined. The examiner must provide a copy to a prospective or
current employing motor carrier who requests it.
    (3) Beginning June 22, 2018, if the medical examiner finds that the
person examined is not physically qualified to operate a commercial
motor vehicle in accordance with Sec.  391.41(b), he or she must inform
the person examined that

he or she is not physically qualified, and that this information will
be reported to FMCSA. All medical examiner's certificates previously
issued to the person are not valid and no longer satisfy the
requirements of Sec.  391.41(a).
    (4) Beginning June 22, 2018, if the medical examiner finds that the
determination of whether the person examined is physically qualified to
operate a commercial motor vehicle in accordance with Sec.  391.41(b)
should be delayed pending the receipt of additional information or the
conduct of further examination in order for the medical examiner to
make such determination, he or she must inform the person examined that
the additional information must be provided or the further examination
completed within 45 days, and that the pending status of the
examination will be reported to FMCSA.
    (5)(i)(A) Once every calendar month, beginning May 21, 2014 and
ending on June 22, 2018, the medical examiner must electronically
transmit to the Director, Office of Carrier, Driver and Vehicle Safety
Standards, via a secure Web account on the National Registry, a
completed CMV Driver Medical Examination Results Form, MCSA-5850. The
Form must include all information specified for each medical
examination conducted during the previous month for any driver who is
required to be examined by a medical examiner listed on the National
Registry of Certified Medical Examiners.
    (B) Beginning June 22, 2018 by midnight (local time) of the next
calendar day after the medical examiner completes a medical examination
for any driver who is required to be examined by a medical examiner
listed on the National Registry of Certified Medical Examiners, the
medical examiner must electronically transmit to the Director, Office
of Carrier, Driver and Vehicle Safety Standards, via a secure FMCSA-
designated Web site, a completed CMV Driver Medical Examination Results
Form, MCSA-5850. The Form must include all information specified for
each medical examination conducted for each driver who is required to
be examined by a medical examiner listed on the National Registry of
Certified Medical Examiners in accordance with the provisions of this
subpart E, and should also include information for each driver who is
required by a State to be examined by a medical examiner listed on the
National Registry of Certified Medical Examiners in accordance with the
provisions of this subpart E and any variances from those provisions
adopted by such State.
    (ii) Beginning on May 21, 2014, if the medical examiner does not
perform a medical examination of any driver who is required to be
examined by a medical examiner listed on the National Registry of
Certified Medical Examiners during any calendar month, the medical
examiner must report that fact to FMCSA, via a secure FMCSA-designated
Web site, by the close of business on the last day of such month.
    (h) The medical examiner's certificate shall be completed in
accordance with the following Form MCSA-5876, Medical Examiner's
Certificate.
[GRAPHIC] [TIFF OMITTED] TR23AP15.008

* * * * *

0
11. Amend Sec.  391.45 by revising paragraphs (b)(2) and (c), and
adding new paragraph (d) to read as follows:

Sec.  391.45  Persons who must be medically examined and certified.

* * * * *
    (b) * * *
    (2) Any driver authorized to operate a commercial motor vehicle
only with an exempt intracity zone pursuant to Sec.  391.62, or only by
operation of the exemption in Sec.  391.64, if such driver has not been
medically examined and certified as qualified to drive in such zone
during the preceding 12 months;
    (c) Any driver whose ability to perform his/her normal duties has
been

impaired by a physical or mental injury or disease; and
    (d) Beginning June 22, 2018, any person found by a medical examiner
not to be physically qualified to operate a commercial motor vehicle
under the provisions of paragraph (g)(3) of Sec.  391.43.

0
12. Amend Sec.  391.51 by revising paragraphs (b)(7)(i) and (ii), and
(b)(9) to read as follows:

Sec.  391.51  General requirements for driver qualification files.

* * * * *
    (b) * * *
    (7)(i) The medical examiner's certificate as required by Sec.
391.43(g) or a legible copy of the certificate.
    (ii) Exception. For CDL holders, beginning January 30, 2012, if the
CDLIS motor vehicle record contains medical certification status
information, the motor carrier employer must meet this requirement by
obtaining the CDLIS motor vehicle record defined at Sec.  384.105 of
this chapter. That record must be obtained from the current licensing
State and placed in the driver qualification file. After January 30,
2015 a non-excepted, interstate CDL holder without medical
certification status information on the CDLIS motor vehicle record is
designated ``not-certified'' to operate a CMV in interstate commerce.
After January 30, 2015 and until June 22, 2018, a motor carrier may use
a copy of the driver's current medical examiner's certificate that was
submitted to the State for up to 15 days from the date it was issued as
proof of medical certification.
* * * * *
    (9)(i) For drivers not required to have a CDL, a note relating to
verification of medical examiner listing on the National Registry of
Certified Medical Examiners required by Sec.  391.23(m)(1).
    (ii) Until June 22, 2018, for drivers required to have a CDL, a
note relating to verification of medical examiner listing on the
National Registry of Certified Medical Examiners required by Sec.
391.23(m)(2).
* * * * *

0
13. Add Appendix A to Part 391 to read as follows:

Appendix A to Part 391--Medical Advisory Criteria

I. Introduction

    This appendix contains the Agency's guidelines in the form of
Medical Advisory Criteria to help medical examiners assess a
driver's physical qualification. These guidelines are strictly
advisory and were established after consultation with physicians,
States, and industry representatives, and, in some areas, after
consideration of recommendations from the Federal Motor Carrier
Safety Administration's Medical Review Board and Medical Expert
Panels.

II. Interpretation of Medical Standards

    Since the issuance of the regulations for physical
qualifications of commercial motor vehicle drivers, the Federal
Motor Carrier Safety Administration has published recommendations
called Advisory Criteria to help medical examiners in determining
whether a driver meets the physical qualifications for commercial
driving. These recommendations have been condensed to provide
information to medical examiners that is directly relevant to the
physical examination and is not already included in the Medical
Examination Report Form.

A. Loss of Limb: Sec.  391.41(b)(1)

    A person is physically qualified to drive a commercial motor
vehicle if that person: Has no loss of a foot, leg, hand or an arm,
or has been granted a Skills Performance Evaluation certificate
pursuant to Sec.  391.49.

B. Limb Impairment: Sec.  391.41(b)(2)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no impairment of:
    (i) A hand or finger which interferes with prehension or power
grasping; or
    (ii) An arm, foot, or leg which interferes with the ability to
perform normal tasks associated with operating a commercial motor
vehicle; or
    (iii) Any other significant limb defect or limitation which
interferes with the ability to perform normal tasks associated with
operating a commercial motor vehicle; or
    (iv) Has been granted a Skills Performance Evaluation
certificate pursuant to Sec.  391.49.
    2. A person who suffers loss of a foot, leg, hand or arm or
whose limb impairment in any way interferes with the safe
performance of normal tasks associated with operating a commercial
motor vehicle is subject to the Skills Performance Evaluation
Certificate Program pursuant to Sec.  391.49, assuming the person is
otherwise qualified.
    3. With the advancement of technology, medical aids and
equipment modifications have been developed to compensate for
certain disabilities. The Skills Performance Evaluation Certificate
Program (formerly the Limb Waiver Program) was designed to allow
persons with the loss of a foot or limb or with functional
impairment to qualify under the Federal Motor Carrier Safety
Regulations by use of prosthetic devices or equipment modifications
which enable them to safely operate a commercial motor vehicle.
Since there are no medical aids equivalent to the original body or
limb, certain risks are still present, and thus restrictions may be
included on individual Skills Performance Evaluation certificates
when a State Director for the Federal Motor Carrier Safety
Administration determines they are necessary to be consistent with
safety and public interest.
    4. If the driver is found otherwise medically qualified (Sec.
391.41(b)(3) through (13)), the medical examiner must check on the
Medical Examiner's Certificate that the driver is qualified only if
accompanied by a Skills Performance Evaluation certificate. The
driver and the employing motor carrier are subject to appropriate
penalty if the driver operates a motor vehicle in interstate or
foreign commerce without a current Skill Performance Evaluation
certificate for his/her physical disability.

C. Diabetes: Sec.  391.41(b)(3)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no established medical history or
clinical diagnosis of diabetes mellitus currently requiring insulin
for control.
    2. Diabetes mellitus is a disease which, on occasion, can result
in a loss of consciousness or disorientation in time and space.
Individuals who require insulin for control have conditions which
can get out of control by the use of too much or too little insulin,
or food intake not consistent with the insulin dosage.
Incapacitation may occur from symptoms of hyperglycemic or
hypoglycemic reactions (drowsiness, semi consciousness, diabetic
coma or insulin shock).
    3. The administration of insulin is, within itself, a
complicated process requiring insulin, syringe, needle, alcohol
sponge and a sterile technique. Factors related to long-haul
commercial motor vehicle operations, such as fatigue, lack of sleep,
poor diet, emotional conditions, stress, and concomitant illness,
compound the dangers, the Federal Motor Carrier Safety
Administration has consistently held that a diabetic who uses
insulin for control does not meet the minimum physical requirements
of the Federal Motor Carrier Safety Regulations.
    4. Hypoglycemic drugs, taken orally, are sometimes prescribed
for diabetic individuals to help stimulate natural body production
of insulin. If the condition can be controlled by the use of oral
medication and diet, then an individual may be qualified under the
present rule. Commercial motor vehicle drivers who do not meet the
Federal diabetes standard may call<PHONE_NUMBER> for an application
for a diabetes exemption.

D. Cardiovascular Condition: Sec.  391.41(b)(4)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no current clinical diagnosis of
myocardial infarction, angina pectoris, coronary insufficiency,
thrombosis or any other cardiovascular disease of a variety known to
be accompanied by syncope, dyspnea, collapse or congestive cardiac
failure.
    2. The term ``has no current clinical diagnosis of'' is
specifically designed to encompass: ``a clinical diagnosis of'' a
current cardiovascular condition, or a cardiovascular condition
which has not fully stabilized regardless of the time limit. The
term ``known to be accompanied by'' is designed to include a
clinical diagnosis of a cardiovascular disease which is accompanied
by symptoms of syncope, dyspnea, collapse or congestive cardiac
failure; and/or which is s likely to cause syncope, dyspnea,
collapse or congestive cardiac failure.
    3. It is the intent of the Federal Motor Carrier Safety
Regulations to render

unqualified, a driver who has a current cardiovascular disease which
is accompanied by and/or likely to cause symptoms of syncope,
dyspnea, collapse, or congestive cardiac failure. However, the
subjective decision of whether the nature and severity of an
individual's condition will likely cause symptoms of cardiovascular
insufficiency is on an individual basis and qualification rests with
the medical examiner and the motor carrier. In those cases where
there is an occurrence of cardiovascular insufficiency (myocardial
infarction, thrombosis, etc.), it is suggested before a driver is
certified that he or she have a normal resting and stress
electrocardiogram, no residual complications and no physical
limitations, and is taking no medication likely to interfere with
safe driving.
    4. Coronary artery bypass surgery and pacemaker implantation are
remedial procedures and thus, not medically disqualifying.
Implantable cardioverter defibrillators are disqualifying due to
risk of syncope. Coumadin is a medical treatment which can improve
the health and safety of the driver and should not, by its use,
medically disqualify the commercial motor vehicle driver. The
emphasis should be on the underlying medical condition(s) which
require treatment and the general health of the driver. The Federal
Motor Carrier Safety Administration should be contacted at (202)
366-4001 for additional recommendations regarding the physical
qualification of drivers on coumadin.

E. Respiratory Dysfunction: Sec.  391.41(b)(5)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no established medical history or
clinical diagnosis of a respiratory dysfunction likely to interfere
with ability to control and drive a commercial motor vehicle safely.
    2. Since a driver must be alert at all times, any change in his
or her mental state is in direct conflict with highway safety. Even
the slightest impairment in respiratory function under emergency
conditions (when greater oxygen supply is necessary for performance)
may be detrimental to safe driving.
    3. There are many conditions that interfere with oxygen exchange
and may result in incapacitation, including emphysema, chronic
asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea.
If the medical examiner detects a respiratory dysfunction, that in
any way is likely to interfere with the driver's ability to safely
control and drive a commercial motor vehicle, the driver must be
referred to a specialist for further evaluation and therapy.
Anticoagulation therapy for deep vein thrombosis and/or pulmonary
thromboembolism is not medically disqualifying once optimum dose is
achieved, provided lower extremity venous examinations remain normal
and the treating physician gives a favorable recommendation.

F. Hypertension: Sec.  391.41(b)(6)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no current clinical diagnosis of high
blood pressure likely to interfere with ability to operate a
commercial motor vehicle safely.
    2. Hypertension alone is unlikely to cause sudden collapse;
however, the likelihood increases when target organ damage,
particularly cerebral vascular disease, is present. This regulatory
criteria is based on the Federal Motor Carrier Safety
Administration's Cardiovascular Advisory Guidelines for the
Examination of commercial motor vehicle Drivers, which used the
Sixth Report of the Joint National Committee on Detection,
Evaluation, and Treatment of High Blood Pressure (1997).
    3. Stage 1 hypertension corresponds to a systolic blood pressure
of 140-159 mmHg and/or a diastolic blood pressure of 90-99 mmHg. The
driver with a blood pressure in this range is at low risk for
hypertension-related acute incapacitation and may be medically
certified to drive for a one-year period. Certification examinations
should be done annually thereafter and should be at or less than
140/90. If less than 160/100, certification may be extended one time
for 3 months.
    4. A blood pressure of 160-179 systolic and/or 100-109 diastolic
is considered Stage 2 hypertension, and the driver is not
necessarily unqualified during evaluation and institution of
treatment. The driver is given a one-time certification of three
months to reduce his or her blood pressure to less than or equal to
140/90. A blood pressure in this range is an absolute indication for
anti-hypertensive drug therapy. Provided treatment is well tolerated
and the driver demonstrates a blood pressure value of 140/90 or
less, he or she may be certified for one year from date of the
initial exam. The driver is certified annually thereafter.
    5. A blood pressure at or greater than 180 (systolic) and 110
(diastolic) is considered Stage 3, high risk for an acute blood
pressure-related event. The driver may not be qualified, even
temporarily, until reduced to 140/90 or less and treatment is well
tolerated. The driver may be certified for 6 months and biannually
(every 6 months) thereafter if at recheck blood pressure is 140/90
or less.
    6. Annual recertification is recommended if the medical examiner
does not know the severity of hypertension prior to treatment. An
elevated blood pressure finding should be confirmed by at least two
subsequent measurements on different days.
    7. Treatment includes nonpharmacologic and pharmacologic
modalities as well as counseling to reduce other risk factors. Most
antihypertensive medications also have side effects, the importance
of which must be judged on an individual basis. Individuals must be
alerted to the hazards of these medications while driving. Side
effects of somnolence or syncope are particularly undesirable in
commercial motor vehicle drivers.
    8. Secondary hypertension is based on the above stages.
Evaluation is warranted if patient is persistently hypertensive on
maximal or near-maximal doses of 2-3 pharmacologic agents. Some
causes of secondary hypertension may be amenable to surgical
intervention or specific pharmacologic disease.

G. Rheumatic, Arthritic, Orthopedic, Muscular, Neuromuscular or
Vascular Disease: Sec.  391.41(b)(7)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no established medical history or
clinical diagnosis of rheumatic, arthritic, orthopedic, muscular,
neuromuscular or vascular disease which interferes with the ability
to control and operate a commercial motor vehicle safely.
    2. Certain diseases are known to have acute episodes of
transient muscle weakness, poor muscular coordination (ataxia),
abnormal sensations (paresthesia), decreased muscular tone
(hypotonia), visual disturbances and pain which may be suddenly
incapacitating. With each recurring episode, these symptoms may
become more pronounced and remain for longer periods of time. Other
diseases have more insidious onsets and display symptoms of muscle
wasting (atrophy), swelling and paresthesia which may not suddenly
incapacitate a person but may restrict his/her movements and
eventually interfere with the ability to safely operate a motor
vehicle. In many instances these diseases are degenerative in nature
or may result in deterioration of the involved area.
    3. Once the individual has been diagnosed as having a rheumatic,
arthritic, orthopedic, muscular, neuromuscular or vascular disease,
then he/she has an established history of that disease. The
physician, when examining an individual, should consider the
following: The nature and severity of the individual's condition
(such as sensory loss or loss of strength); the degree of limitation
present (such as range of motion); the likelihood of progressive
limitation (not always present initially but may manifest itself
over time); and the likelihood of sudden incapacitation. If severe
functional impairment exists, the driver does not qualify. In cases
where more frequent monitoring is required, a certificate for a
shorter period of time may be issued.

H. Epilepsy: Sec.  391.41(b)(8)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no established medical history or
clinical diagnosis of epilepsy or any other condition which is
likely to cause loss of consciousness or any loss of ability to
control a motor vehicle.
    2. Epilepsy is a chronic functional disease characterized by
seizures or episodes that occur without warning, resulting in loss
of voluntary control which may lead to loss of consciousness and/or
seizures. Therefore, the following drivers cannot be qualified:
    (i) A driver who has a medical history of epilepsy;
    (ii) A driver who has a current clinical diagnosis of epilepsy;
or
    (ii) A driver who is taking antiseizure medication.
    3. If an individual has had a sudden episode of a nonepileptic
seizure or loss of consciousness of unknown cause which did not
require antiseizure medication, the decision as to whether that
person's condition will likely cause loss of consciousness or loss
of ability to control a motor vehicle is made on an individual basis
by the medical examiner in consultation with

the treating physician. Before certification is considered, it is
suggested that a 6 month waiting period elapse from the time of the
episode. Following the waiting period, it is suggested that the
individual have a complete neurological examination. If the results
of the examination are negative and antiseizure medication is not
required, then the driver may be qualified.
    4. In those individual cases where a driver has a seizure or an
episode of loss of consciousness that resulted from a known medical
condition (e.g., drug reaction, high temperature, acute infectious
disease, dehydration or acute metabolic disturbance), certification
should be deferred until the driver has fully recovered from that
condition and has no existing residual complications, and not taking
antiseizure medication.
    5. Drivers with a history of epilepsy/seizures off antiseizure
medication and seizure-free for 10 years may be qualified to drive a
commercial motor vehicle in interstate commerce. Interstate drivers
with a history of a single unprovoked seizure may be qualified to
drive a commercial motor vehicle in interstate commerce if seizure-
free and off antiseizure medication for a 5-year period or more.

I. Mental Disorders: Sec.  391.41(b)(9)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no mental, nervous, organic or
functional disease or psychiatric disorder likely to interfere with
ability to drive a motor vehicle safely.
    2. Emotional or adjustment problems contribute directly to an
individual's level of memory, reasoning, attention, and judgment.
These problems often underlie physical disorders. A variety of
functional disorders can cause drowsiness, dizziness, confusion,
weakness or paralysis that may lead to incoordination, inattention,
loss of functional control and susceptibility to accidents while
driving. Physical fatigue, headache, impaired coordination,
recurring physical ailments and chronic ``nagging'' pain may be
present to such a degree that certification for commercial driving
is inadvisable. Somatic and psychosomatic complaints should be
thoroughly examined when determining an individual's overall fitness
to drive. Disorders of a periodically incapacitating nature, even in
the early stages of development, may warrant disqualification.
    3. Many bus and truck drivers have documented that ``nervous
trouble'' related to neurotic, personality, or emotional or
adjustment problems is responsible for a significant fraction of
their preventable accidents. The degree to which an individual is
able to appreciate, evaluate and adequately respond to environmental
strain and emotional stress is critical when assessing an
individual's mental alertness and flexibility to cope with the
stresses of commercial motor vehicle driving.
    4. When examining the driver, it should be kept in mind that
individuals who live under chronic emotional upsets may have deeply
ingrained maladaptive or erratic behavior patterns. Excessively
antagonistic, instinctive, impulsive, openly aggressive, paranoid or
severely depressed behavior greatly interfere with the driver's
ability to drive safely. Those individuals who are highly
susceptible to frequent states of emotional instability
(schizophrenia, affective psychoses, paranoia, anxiety or depressive
neuroses) may warrant disqualification. Careful consideration should
be given to the side effects and interactions of medications in the
overall qualification determination.

J. Vision: Sec.  391.41(b)(10)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has distant visual acuity of at least 20/40
(Snellen) in each eye with or without corrective lenses or visual
acuity separately corrected to 20/40 (Snellen) or better with
corrective lenses, distant binocular acuity of at least 20/40
(Snellen) in both eyes with or without corrective lenses, field of
vision of at least 70 degrees in the horizontal meridian in each
eye, and the ability to recognize the colors of traffic signals and
devices showing standard red, green, and amber.
    2. The term ``ability to recognize the colors of'' is
interpreted to mean if a person can recognize and distinguish among
traffic control signals and devices showing standard red, green and
amber, he or she meets the minimum standard, even though he or she
may have some type of color perception deficiency. If certain color
perception tests are administered, (such as Ishihara,
Pseudoisochromatic, Yarn) and doubtful findings are discovered, a
controlled test using signal red, green and amber may be employed to
determine the driver's ability to recognize these colors.
    3. Contact lenses are permissible if there is sufficient
evidence to indicate that the driver has good tolerance and is well
adapted to their use. Use of a contact lens in one eye for distance
visual acuity and another lens in the other eye for near vision is
not acceptable, nor telescopic lenses acceptable for the driving of
commercial motor vehicles.
    4. If an individual meets the criteria by the use of glasses or
contact lenses, the following statement shall appear on the Medical
Examiner's Certificate: ``Qualified only if wearing corrective
lenses.'' commercial motor vehicle drivers who do not meet the
Federal vision standard may call<PHONE_NUMBER> for an application
for a vision exemption.

K. Hearing: Sec.  391.41(b)(11)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: First perceives a forced whispered voice in
the better ear at not less than 5 feet with or without the use of a
hearing aid, or, if tested by use of an audiometric device, does not
have an average hearing loss in the better ear greater than 40
decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing
aid when the audiometric device is calibrated to American National
Standard (formerly ADA Standard) Z24.5-1951.
    2. Since the prescribed standard under the Federal Motor Carrier
Safety Regulations is from the American National Standards
Institute, formerly the American Standards Association, it may be
necessary to convert the audiometric results from the International
Organization for Standardization standard to the American National
Standards Institute standard. Instructions are included on the
Medical Examination Report Form.
    3. If an individual meets the criteria by using a hearing aid,
the driver must wear that hearing aid and have it in operation at
all times while driving. Also, the driver must be in possession of a
spare power source for the hearing aid.
    4. For the whispered voice test, the individual should be
stationed at least 5 feet from the medical examiner with the ear
being tested turned toward the medical examiner. The other ear is
covered. Using the breath which remains after a normal expiration,
the medical examiner whispers words or random numbers such as 66,
18, 3, etc. The medical examiner should not use only sibilants (s
sounding materials). The opposite ear should be tested in the same
manner.
    5. If the individual fails the whispered voice test, the
audiometric test should be administered. If an individual meets the
criteria by the use of a hearing aid, the following statement must
appear on the Medical Examiner's Certificate ``Qualified only when
wearing a hearing aid.''

L. Drug Use: Sec.  391.41(b)(12)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person does not use any drug or substance identified
in 21 CFR 1308.11, an amphetamine, a narcotic, or other habit-
forming drug. A driver may use a non-Schedule I drug or substance
that is identified in the other Schedules in 21 CFR part 1308 if the
substance or drug is prescribed by a licensed medical practitioner
who:
    (i) Is familiar with the driver's medical history, and assigned
duties; and
    (ii) Has advised the driver that the prescribed substance or
drug will not adversely affect the driver's ability to safely
operate a commercial motor vehicle.
    2. This exception does not apply to methadone. The intent of the
medical certification process is to medically evaluate a driver to
ensure that the driver has no medical condition which interferes
with the safe performance of driving tasks on a public road. If a
driver uses an amphetamine, a narcotic or any other habit-forming
drug, it may be cause for the driver to be found medically
unqualified. If a driver uses a Schedule I drug or substance, it
will be cause for the driver to be found medically unqualified.
Motor carriers are encouraged to obtain a practitioner's written
statement about the effects on transportation safety of the use of a
particular drug.
    3. A test for controlled substances is not required as part of
this biennial certification process. The Federal Motor Carrier
Safety Administration or the driver's employer should be contacted
directly for information on controlled substances and alcohol
testing under Part 382 of the FMCSRs.
    4. The term ``uses'' is designed to encompass instances of
prohibited drug use determined by a physician through established
medical means. This may or may not involve body fluid testing. If
body fluid testing takes place, positive test results

should be confirmed by a second test of greater specificity. The
term ``habit-forming'' is intended to include any drug or medication
generally recognized as capable of becoming habitual, and which may
impair the user's ability to operate a commercial motor vehicle
safely.
    5. The driver is medically unqualified for the duration of the
prohibited drug(s) use and until a second examination shows the
driver is free from the prohibited drug(s) use. Recertification may
involve a substance abuse evaluation, the successful completion of a
drug rehabilitation program, and a negative drug test result.
Additionally, given that the certification period is normally two
years, the medical examiner has the option to certify for a period
of less than 2 years if this medical examiner determines more
frequent monitoring is required.

M. Alcoholism: Sec.  391.41(b)(13)

    1. A person is physically qualified to drive a commercial motor
vehicle if that person: Has no current clinical diagnosis of
alcoholism.
    2. The term ``current clinical diagnosis of'' is specifically
designed to encompass a current alcoholic illness or those instances
where the individual's physical condition has not fully stabilized,
regardless of the time element. If an individual shows signs of
having an alcohol-use problem, he or she should be referred to a
specialist. After counseling and/or treatment, he or she may be
considered for certification.

    Issued under the authority delegated in 49 CFR 1.87 on: April
15, 2015.
T.F. Scott Darling, III,
Chief Counsel.
[FR Doc. 2015-09053 Filed 4-22-15; 8:45 am]
BILLING CODE 4910-EX-P


[Federal Register Volume 77, Number 210 (Tuesday, October 30, 2012)]
[Notices]
[Pages 65680-65681]
[FR Doc No: 2012-26595]

-----------------------------------------------------------------------

DEPARTMENT OF ENERGY

Federal Energy Regulatory Commission

Notice of Commission Staff Attendance

    The Federal Energy Regulatory Commission hereby gives notice that
members of the Commission's staff may attend the following meetings
related to the interregional transmission planning activities of the
Southwest Power Pool (SPP):

SPP Seams FERC Order 1000 Task Force Meeting--November 2, 2012.
    The above-referenced meeting will be a teleconference.
    The above-referenced meeting is open to the public.
    Further information may be found at www.spp.org.
    The discussions at the meeting described above may address matters
at issue in the following proceedings:

    Docket No. ER09-35-001, Tallgrass Transmission, LLC
Docket No. ER09-36-001, Prairie Wind Transmission, LLC
Docket No. ER09-548-001, ITC Great Plains, LLC
Docket No. ER09-659-002, Southwest Power Pool, Inc.
Docket No. ER11-4105-000, Southwest Power Pool, Inc.
Docket No. EL11-34-001, Midwest Independent Transmission System
Operator, Inc.
Docket No. ER12-1401-000, Southwest Power Pool, Inc.
Docket No. ER12-1402-000, Southwest Power Pool, Inc.
Docket No. ER12-1415-000, Southwest Power Pool, Inc.
Docket No. ER12-1460-000, Southwest Power Pool, Inc.
Docket No. ER12-1586-000 et al., Southwest Power Pool, Inc.
Docket No. ER12-1610-000, Southwest Power Pool, Inc.
Docket No. ER12-1772-000, Southwest Power Pool, Inc.
Docket No. ER12-2366-000, Southwest Power Pool, Inc.
Docket No. EL12-2-000, Southwest Power Pool, Inc.
Docket No. EL12-60-000, Southwest Power Pool, Inc., et al.
Docket No. ER12-2387-000 et al., Southwest Power Pool, Inc.

    For more information, contact Luciano Lima, Office of Energy
Markets Regulation, Federal Energy Regulatory Commission at (202) 288-
6738 or<EMAIL_ADDRESS>

    Dated: October 23, 2012.
Kimberly D. Bose,
Secretary.
[FR Doc. 2012-26595 Filed 10-29-12; 8:45 am]
BILLING CODE 6717-01-P


[Federal Register Volume 86, Number 55 (Wednesday, March 24, 2021)]
[Notices]
[Page 15733]
[FR Doc No: 2021-05997]

-----------------------------------------------------------------------

SECURITIES AND EXCHANGE COMMISSION

[Release No. 34-91355; File No. SR-NYSEAMER-2021-05]

Self-Regulatory Organizations; NYSE American LLC; Notice of
Designation of a Longer Period for Commission Action on Proposed Rule
Change To Amend Rule 970NY and Rule 970.1NY To Eliminate the Use of
Dark Series on the Exchange

March 18, 2021.
    On January 26, 2021, NYSE American LLC (``Exchange'') filed with
the Securities and Exchange Commission (``Commission'') pursuant to
Section 19(b)(1) of the Securities Exchange Act of 1934 (``Act'') \1\
and Rule 19b-4 thereunder,\2\ a proposed rule change to eliminate the
exclusion of inactive or ``dark'' series from the requirements of Rule
970NY (Firm Quotes). In addition, the Exchange proposes to delete Rule
970.1NY (Quote Mitigation) in its entirety. The proposed rule change
was published for comment in the Federal Register on February 8,
2021.\3\ The Commission has received no comment letters on the proposed
rule change.
---------------------------------------------------------------------------

    \1\ 15 U.S.C. 78s(b)(1).
    \2\ 17 CFR 240.19b-4.
    \3\ See Securities Exchange Act Release No. 91039 (February 2,
2021), 86 FR 8659.
---------------------------------------------------------------------------

    Section 19(b)(2) of the Act \4\ provides that within 45 days of the
publication of notice of filing of a proposed rule change, or within
such longer period up to 90 days as the Commission may designate if it
finds such longer period to be appropriate and publishes its reasons
for so finding or as to which the self-regulatory organization
consents, the Commission shall either approve the proposed rule change,
disapprove the proposed rule change, or institute proceedings to
determine whether the proposed rule change should be disapproved. The
45th day after publication of the notice for this proposed rule change
is March 25, 2021.
---------------------------------------------------------------------------

    \4\ 15 U.S.C. 78s(b)(2).
---------------------------------------------------------------------------

    The Commission is extending the 45-day time period for Commission
action on the proposed rule change. The Commission finds that it is
appropriate to designate a longer period to take action on the proposed
rule change so that it has sufficient time to consider the proposed
rule change. Accordingly, pursuant to Section 19(b)(2) of the Act,\5\
the Commission designates May 9, 2021 as the date by which the
Commission should either approve or disapprove, or institute
proceedings to determine whether to disapprove, the proposed rule
change (File No. SR-NYSEAMER-2021-05).
---------------------------------------------------------------------------

    \5\ 15 U.S.C. 78s(b)(2).

    For the Commission, by the Division of Trading and Markets,
pursuant to delegated authority.\6\
---------------------------------------------------------------------------

    \6\ 17 CFR 200.30-3(a)(31).
---------------------------------------------------------------------------

Eduardo A. Aleman,
Deputy Secretary.
[FR Doc. 2021-05997 Filed 3-23-21; 8:45 am]
BILLING CODE 8011-01-P