81_FR_74908 81 FR 74700 - Physical Qualifications and Examinations: Medical Examination Report and Medical Examiner's Certificate Forms

81 FR 74700 - Physical Qualifications and Examinations: Medical Examination Report and Medical Examiner's Certificate Forms

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 208 (October 27, 2016)

Page Range74700-74711
FR Document2016-25976

FMCSA announces its decision to allow certified Medical Examiners (MEs) to use the Medical Examination Report (MER) Form, MCSA- 5875, and Medical Examiner's Certificate (MEC), Form MCSA-5876, with October, November, and December, 2015 revision dates that are located in the top left corner of the forms until existing stocks are depleted. For MEs in an office where these forms have been programmed into an electronic system that will require IT programming, the current approved versions of the forms should be programmed as soon as practicable. FMCSA published sample versions of the forms in October and November 2015 prior to posting fillable Portable Document Format (PDF) versions in December 2015. Based on the fact that the October and November 2015 forms contain minor differences yet collect the same information as the fillable PDF version, FMCSA determined the October and November versions are acceptable. In addition, MEs are also allowed to continue to use the versions of the MER Form, MCSA-5875, that include the Privacy Act Statement on page one until stocks are depleted. For MEs in an office where these forms have been programmed into an electronic system that will require IT programming, the current approved versions of the forms should be programmed as soon as practicable. The versions of the forms currently posted by FMCSA include nonsubstantive changes that were approved by the Office of Management and Budget (OMB) on April 7, 2016 and September 6, 2016, and no longer include the Privacy Act Statement or a revision date in the top left corner. State Driver's Licensing Agencies (SDLAs) should not accept versions of the MEC that have not been approved by OMB, and do not display both the FMCSA form number (MCSA-5876) and the OMB expiration date of August 31, 2018.

Federal Register, Volume 81 Issue 208 (Thursday, October 27, 2016)
[Federal Register Volume 81, Number 208 (Thursday, October 27, 2016)]
[Rules and Regulations]
[Pages 74700-74711]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-25976]


=======================================================================
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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

49 CFR Part 391

[Docket No. FMCSA-2012-0178]


Physical Qualifications and Examinations: Medical Examination 
Report and Medical Examiner's Certificate Forms

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of decision on use of Medical Examination Report and 
Medical Examiner's Certificate Forms.

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

SUMMARY: FMCSA announces its decision to allow certified Medical 
Examiners (MEs) to use the Medical Examination Report (MER) Form, MCSA-
5875, and Medical Examiner's Certificate (MEC), Form MCSA-5876, with 
October, November, and December, 2015 revision dates that are located 
in the top left corner of the forms until existing stocks are depleted. 
For MEs in an office where these forms have been programmed into an 
electronic system that will require IT programming, the current 
approved versions of the forms should be programmed as soon as 
practicable. FMCSA published sample versions of the forms in October 
and November 2015 prior to posting fillable Portable Document Format 
(PDF) versions in December 2015. Based on the fact that the October and 
November 2015 forms contain minor differences yet collect the same 
information as the fillable PDF version, FMCSA determined the October 
and November versions are acceptable. In addition, MEs are also allowed 
to continue to use the versions of the MER Form, MCSA-5875, that 
include the Privacy Act Statement on page one until stocks are 
depleted. For MEs in an office where these forms have been programmed 
into an electronic system that will require IT programming, the current 
approved versions of the forms should be programmed as soon as 
practicable. The versions of the forms currently posted by FMCSA 
include nonsubstantive changes that were approved by the Office of 
Management and Budget (OMB) on April 7, 2016 and September 6, 2016, and 
no longer include the Privacy Act Statement or a revision date in the 
top left corner. State Driver's Licensing Agencies (SDLAs) should not 
accept versions of the MEC that have not been approved by OMB, and do 
not display both the FMCSA form number (MCSA-5876) and the OMB 
expiration date of August 31, 2018.

DATES: This decision is in effect on October 27, 2016.

ADDRESSES: You may search background documents or comments to the 
docket for this rule, identified by docket number FMCSA-2012-0178, by 
visiting the:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the online instructions for reviewing documents and comments. 
Regulations.gov is available electronically 24 hours each day, 365 days 
a year; or
     DOT Docket Management Facility (M-30): U.S. Department of 
Transportation (DOT), 1200 New Jersey Avenue SE., West Building, Ground 
Floor, Room 12-140, Washington, DC 20590-0001.
    Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits 
comments from the public to better inform its rulemaking process. DOT 
posts these comments, without edit, including any personal information 
the commenter provides, to www.regulations.gov, as described in the 
system of records notice (DOT/ALL-14 FDMS), which can be reviewed at 
www.dot.gov/privacy.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division, Office of Policy, Federal Motor Carrier 
Safety Administration, 1200 New Jersey Avenue SE., Washington, DC 
20590; telephone (202) 366-4001; [email protected]. If you have 
questions about viewing or submitting material to the docket, contact 
Docket Services, telephone (202) 366-9826.

SUPPLEMENTARY INFORMATION: 

I. Background

    On April 23, 2015, FMCSA published a final rule adopting 
regulations to facilitate the electronic transmission of MEC 
information from FMCSA's National Registry system to SDLAs for holders 
of Commercial Driver's Licenses (CDL) and Commercial Learner's Permits 
(CLP). The final rule also requires the use of the prescribed MER Form, 
MCSA-5875, in place of the MER and the prescribed MEC, Form MCSA-5876, 
in place of the MEC. Medical Examiner's Certification Integration (80 
FR 22790, April 23, 2015). On August 5, 2015, FMCSA received approval 
from OMB, for use of the MER Form, MCSA-5875, and MEC, Form MCSA-5876, 
in a fillable Adobe AcrobatTM format.
    FMCSA published sample versions of the MER Form, MCSA-5875, and 
MEC, Form MCSA-5876, with October and November, 2015 revision dates on 
the National Registry Web site with the intent and purpose of educating 
MEs regarding the use of new categories on the forms and assisting MEs 
in programming electronic medical records prior to the Agency's posting 
of the fillable Adobe AcrobatTM versions. At that time, at 
least one company that produces regulatory compliance publications and 
forms began printing and selling the MER Form, MCSA-5875, and MEC, Form 
MCSA-5876, with October and November, 2015 revision dates. On December 
14, 2015, FMCSA posted the fillable Adobe AcrobatTM versions 
of the MER Form, MCSA-5875, and MEC, Form MCSA-5876, with December 2015 
revision dates on the FMCSA and National Registry Web sites. Based on 
the fact that the October and November, 2015 forms contain minor 
differences yet collect the same information as the fillable Adobe 
AcrobatTM versions posted by FMCSA on December 14, 2015, 
FMCSA made the decision to allow MEs to use any previously purchased 
existing stock of the MER Form, MCSA-5875, and MEC, Form MCSA-5876, 
with October or November, 2015 revision dates until stocks are 
depleted. For MEs in an office where these forms have been

[[Page 74701]]

programmed into an electronic system that will require IT programming, 
the current approved versions of the forms should be programmed as soon 
as practicable.
    On December 21, 2015, FMCSA published guidance providing a 120-day 
grace period during which MEs were allowed to use either the old MER 
and MEC or the newly prescribed MER Form, MCSA-5875, and MEC, Form 
MCSA-5876, until April 20, 2016 (80 FR 79273).
    Subsequently, after receiving OMB approval for nonsubstantive 
changes to the forms, FMCSA posted the current versions of the MER 
Form, MCSA-5875, and MEC, Form MCSA-5876, on the FMCSA and National 
Registry Web sites on April 13, 2016. The current versions include 
several OMB approved nonsubstantive and functional changes but no 
longer include a revision date in the top left corner. The specific OMB 
approved non-substantive and functional changes can be found on the 
Office of Information and Regulatory Affairs Web site by selecting the 
following link, http://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=201604-2126-006, and then selecting the link 
for ``Justification of Nonmaterial/Non-substantive Change.''
    On June 7, 2016, the Department of Transportation's Chief Privacy 
Officer and Office of General Counsel reviewed the requirements of the 
rulemaking and determined that the collection of information maintained 
and held by MEs does not constitute information protected by the 
Privacy Act. Therefore, FMCSA submitted to OMB for approval a request 
for additional nonsubstantive changes including removal of the Privacy 
Act statement on page one of the MER Form, MCSA-5875, and the addition 
of disclaimer language regarding the protection of sensitive 
information that was approved on September 6, 2016. FMCSA has posted 
the current versions of the MER Form, MCSA-5875 and MEC, Form MCSA-5876 
on the FMCSA and National Registry Web sites. The additional OMB-
approved non-substantive changes can be found on the Office of 
Information and Regulatory Affairs Web site by selecting the following 
link http://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=201604-2126-006, and then selecting the link for ``Justification of 
Nonmaterial/Non-substantive Change.''

II. Acceptable Versions of Forms

    All changes to the MER and MEC forms since the August 5, 2015, date 
on which OMB provided approval for use of the forms were nonsubstantive 
in nature. Therefore, MEs are allowed to use MER Form, MCSA-5875, and 
MEC, Form MCSA-5876, with October, November, and December, 2015 
revision dates until existing stocks are depleted. This includes forms 
produced by the private sector with October or November, 2015 revision 
dates that FMCSA never intended to be published for use by the public 
and fillable forms posted on the FMCSA and National Registry Web sites 
on December 14, 2015, as well as the MER Form, MCSA-5875, that includes 
the Privacy Act Statement on page one. For MEs in an office where these 
forms have been programmed into an electronic system that will require 
IT programming, the current approved versions of the forms should be 
programmed as soon as practicable. MEs are also encouraged to use the 
current versions of the forms that no longer include the Privacy Act 
Statement or a revision date in the top left corner, and can be found 
on the FMCSA and National Registry Web sites.
    Under the provisions of 49 CFR 383.71(h), until June 22, 2018, 
commercial motor vehicle (CMV) drivers operating vehicles that require 
a CDL or CLP are required to provide SDLAs with an original or a copy 
of the MEC, Form MCSA-5876, for entry of the medical certification 
status on the driver record. FMCSA has learned that some SDLAs are 
refusing to accept from CMV drivers the MEC, Form MCSA-5876, with an 
October or November, 2015 revision date. In view of the clarification 
in this document of the status of the MEC, Form MCSA-5876, with various 
revision dates, FMCSA is directing SDLAs to accept the MEC, Form MCSA-
5876, with October, November, and December, 2015 revision dates until 
existing stocks are depleted. SDLAs should also be accepting the 
versions that were posted on April 13, 2016, on the FMCSA and National 
Registry Web sites that no longer include a revision date in the top 
left corner and the current version of the MER Form, MCSA-5875, that is 
posted on the FMCSA and National Registry Web sites that no longer 
includes the Privacy Act Statement on page one. On the other hand, 
SDLAs should not accept versions of the MEC that have not been approved 
by OMB and do not display both the FMCSA form number (MCSA-5876) and 
the OMB expiration date of August 31, 2018. The final versions of the 
forms published on the FMCSA and National Registry Web sites are shown 
below for your reference.
 BILLING CODE 4910-EX-P

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    Issued on: October 20, 2016.
T.F. Scott Darling, III,
Administrator.
[FR Doc. 2016-25976 Filed 10-26-16; 8:45 am]
 BILLING CODE 4910-EX-c



                                                74700            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations

                                                § 1329.23   Compliance reviews.                         that will require IT programming, the                 FOR FURTHER INFORMATION CONTACT:     Ms.
                                                  (a) Centers receiving Part C funding                  current approved versions of the forms                Christine A. Hydock, Chief, Medical
                                                shall be subject to periodic reviews,                   should be programmed as soon as                       Programs Division, Office of Policy,
                                                including on-site reviews, in accordance                practicable. FMCSA published sample                   Federal Motor Carrier Safety
                                                with sections 706(c), 722(g), and 723(g)                versions of the forms in October and                  Administration, 1200 New Jersey
                                                of the Act and guidance set forth by the                November 2015 prior to posting fillable               Avenue SE., Washington, DC 20590;
                                                Administrator, to verify compliance                     Portable Document Format (PDF)                        telephone (202) 366–4001;
                                                with the standards and assurances in                    versions in December 2015. Based on                   fmcsamedical@dot.gov. If you have
                                                section 725(b) and (c) of the Act and the               the fact that the October and November                questions about viewing or submitting
                                                grant terms and conditions. The                         2015 forms contain minor differences                  material to the docket, contact Docket
                                                Administrator shall annually conduct                    yet collect the same information as the               Services, telephone (202) 366–9826.
                                                reviews of at least 15 percent of the                   fillable PDF version, FMCSA                           SUPPLEMENTARY INFORMATION:
                                                Centers.                                                determined the October and November
                                                  (b) A copy of each review under this                  versions are acceptable. In addition,                 I. Background
                                                section shall be provided, in the case of               MEs are also allowed to continue to use                  On April 23, 2015, FMCSA published
                                                section 723(g), by the director of the                  the versions of the MER Form, MCSA–                   a final rule adopting regulations to
                                                DSE to the Administrator and to the                     5875, that include the Privacy Act                    facilitate the electronic transmission of
                                                SILC, and in the case of section 722(g),                Statement on page one until stocks are                MEC information from FMCSA’s
                                                by the Administrator to the SILC and                    depleted. For MEs in an office where                  National Registry system to SDLAs for
                                                the DSE.                                                these forms have been programmed into                 holders of Commercial Driver’s Licenses
                                                                                                        an electronic system that will require IT             (CDL) and Commercial Learner’s
                                                § 1329.24 Training and technical                        programming, the current approved
                                                assistance to Centers for Independent                                                                         Permits (CLP). The final rule also
                                                Living.
                                                                                                        versions of the forms should be                       requires the use of the prescribed MER
                                                                                                        programmed as soon as practicable. The                Form, MCSA–5875, in place of the MER
                                                  The Administrator shall reserve                       versions of the forms currently posted
                                                between 1.8% and 2% of appropriated                                                                           and the prescribed MEC, Form MCSA–
                                                                                                        by FMCSA include nonsubstantive                       5876, in place of the MEC. Medical
                                                funds to provide training and technical                 changes that were approved by the
                                                assistance to Centers through grants,                                                                         Examiner’s Certification Integration (80
                                                                                                        Office of Management and Budget                       FR 22790, April 23, 2015). On August 5,
                                                contracts or cooperative agreements,                    (OMB) on April 7, 2016 and September
                                                consistent with section 721(b) of the                                                                         2015, FMCSA received approval from
                                                                                                        6, 2016, and no longer include the                    OMB, for use of the MER Form, MCSA–
                                                Act. The training and technical                         Privacy Act Statement or a revision date
                                                assistance funds shall be administered                                                                        5875, and MEC, Form MCSA–5876, in a
                                                                                                        in the top left corner. State Driver’s                fillable Adobe AcrobatTM format.
                                                in accordance with section 721(b) of the                Licensing Agencies (SDLAs) should not
                                                Act.                                                                                                             FMCSA published sample versions of
                                                                                                        accept versions of the MEC that have                  the MER Form, MCSA–5875, and MEC,
                                                [FR Doc. 2016–25918 Filed 10–26–16; 8:45 am]
                                                                                                        not been approved by OMB, and do not                  Form MCSA–5876, with October and
                                                BILLING CODE 4150–04–P
                                                                                                        display both the FMCSA form number                    November, 2015 revision dates on the
                                                                                                        (MCSA–5876) and the OMB expiration                    National Registry Web site with the
                                                                                                        date of August 31, 2018.                              intent and purpose of educating MEs
                                                DEPARTMENT OF TRANSPORTATION
                                                                                                        DATES:This decision is in effect on                   regarding the use of new categories on
                                                Federal Motor Carrier Safety                            October 27, 2016.                                     the forms and assisting MEs in
                                                Administration                                                                                                programming electronic medical records
                                                                                                        ADDRESSES:    You may search background
                                                                                                                                                              prior to the Agency’s posting of the
                                                                                                        documents or comments to the docket
                                                49 CFR Part 391                                                                                               fillable Adobe AcrobatTM versions. At
                                                                                                        for this rule, identified by docket
                                                                                                                                                              that time, at least one company that
                                                [Docket No. FMCSA–2012–0178]                            number FMCSA–2012–0178, by visiting
                                                                                                                                                              produces regulatory compliance
                                                                                                        the:
                                                                                                                                                              publications and forms began printing
                                                Physical Qualifications and                               • Federal eRulemaking Portal: http://               and selling the MER Form, MCSA–5875,
                                                Examinations: Medical Examination                       www.regulations.gov. Follow the online                and MEC, Form MCSA–5876, with
                                                Report and Medical Examiner’s                           instructions for reviewing documents                  October and November, 2015 revision
                                                Certificate Forms                                       and comments. Regulations.gov is                      dates. On December 14, 2015, FMCSA
                                                AGENCY: Federal Motor Carrier Safety                    available electronically 24 hours each                posted the fillable Adobe AcrobatTM
                                                Administration (FMCSA), DOT.                            day, 365 days a year; or                              versions of the MER Form, MCSA–5875,
                                                                                                           • DOT Docket Management Facility                   and MEC, Form MCSA–5876, with
                                                ACTION: Notice of decision on use of
                                                                                                        (M–30): U.S. Department of                            December 2015 revision dates on the
                                                Medical Examination Report and
                                                                                                        Transportation (DOT), 1200 New Jersey                 FMCSA and National Registry Web
                                                Medical Examiner’s Certificate Forms.
                                                                                                        Avenue SE., West Building, Ground                     sites. Based on the fact that the October
                                                SUMMARY:   FMCSA announces its                          Floor, Room 12–140, Washington, DC                    and November, 2015 forms contain
                                                decision to allow certified Medical                     20590–0001.                                           minor differences yet collect the same
                                                Examiners (MEs) to use the Medical                         Privacy Act: In accordance with 5                  information as the fillable Adobe
                                                Examination Report (MER) Form,                          U.S.C. 553(c), DOT solicits comments                  AcrobatTM versions posted by FMCSA
                                                MCSA–5875, and Medical Examiner’s                       from the public to better inform its                  on December 14, 2015, FMCSA made
jstallworth on DSK7TPTVN1PROD with RULES




                                                Certificate (MEC), Form MCSA–5876,                      rulemaking process. DOT posts these                   the decision to allow MEs to use any
                                                with October, November, and December,                   comments, without edit, including any                 previously purchased existing stock of
                                                2015 revision dates that are located in                 personal information the commenter                    the MER Form, MCSA–5875, and MEC,
                                                the top left corner of the forms until                  provides, to www.regulations.gov, as                  Form MCSA–5876, with October or
                                                existing stocks are depleted. For MEs in                described in the system of records                    November, 2015 revision dates until
                                                an office where these forms have been                   notice (DOT/ALL–14 FDMS), which can                   stocks are depleted. For MEs in an office
                                                programmed into an electronic system                    be reviewed at www.dot.gov/privacy.                   where these forms have been


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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                        74701

                                                programmed into an electronic system                    addition of disclaimer language                       Statement or a revision date in the top
                                                that will require IT programming, the                   regarding the protection of sensitive                 left corner, and can be found on the
                                                current approved versions of the forms                  information that was approved on                      FMCSA and National Registry Web
                                                should be programmed as soon as                         September 6, 2016. FMCSA has posted                   sites.
                                                practicable.                                            the current versions of the MER Form,                    Under the provisions of 49 CFR
                                                   On December 21, 2015, FMCSA                          MCSA–5875 and MEC, Form MCSA–
                                                published guidance providing a 120-day                                                                        383.71(h), until June 22, 2018,
                                                                                                        5876 on the FMCSA and National
                                                grace period during which MEs were                                                                            commercial motor vehicle (CMV)
                                                                                                        Registry Web sites. The additional
                                                allowed to use either the old MER and                   OMB-approved non-substantive changes                  drivers operating vehicles that require a
                                                MEC or the newly prescribed MER                         can be found on the Office of                         CDL or CLP are required to provide
                                                Form, MCSA–5875, and MEC, Form                          Information and Regulatory Affairs Web                SDLAs with an original or a copy of the
                                                MCSA–5876, until April 20, 2016 (80                     site by selecting the following link                  MEC, Form MCSA–5876, for entry of the
                                                FR 79273).                                              http://www.reginfo.gov/public/do/                     medical certification status on the driver
                                                   Subsequently, after receiving OMB                    PRAViewDocument?ref_nbr=201604-                       record. FMCSA has learned that some
                                                approval for nonsubstantive changes to                  2126-006, and then selecting the link for             SDLAs are refusing to accept from CMV
                                                the forms, FMCSA posted the current                     ‘‘Justification of Nonmaterial/Non-                   drivers the MEC, Form MCSA–5876,
                                                versions of the MER Form, MCSA–5875,                    substantive Change.’’                                 with an October or November, 2015
                                                and MEC, Form MCSA–5876, on the                                                                               revision date. In view of the clarification
                                                FMCSA and National Registry Web sites                   II. Acceptable Versions of Forms
                                                                                                                                                              in this document of the status of the
                                                on April 13, 2016. The current versions                    All changes to the MER and MEC                     MEC, Form MCSA–5876, with various
                                                include several OMB approved                            forms since the August 5, 2015, date on               revision dates, FMCSA is directing
                                                nonsubstantive and functional changes                   which OMB provided approval for use                   SDLAs to accept the MEC, Form MCSA–
                                                but no longer include a revision date in                of the forms were nonsubstantive in                   5876, with October, November, and
                                                the top left corner. The specific OMB                   nature. Therefore, MEs are allowed to                 December, 2015 revision dates until
                                                approved non-substantive and                            use MER Form, MCSA–5875, and MEC,                     existing stocks are depleted. SDLAs
                                                functional changes can be found on the                  Form MCSA–5876, with October,                         should also be accepting the versions
                                                Office of Information and Regulatory                    November, and December, 2015 revision                 that were posted on April 13, 2016, on
                                                Affairs Web site by selecting the                       dates until existing stocks are depleted.
                                                                                                                                                              the FMCSA and National Registry Web
                                                following link, http://www.reginfo.gov/                 This includes forms produced by the
                                                                                                                                                              sites that no longer include a revision
                                                public/do/PRAViewDocument?ref_                          private sector with October or
                                                                                                                                                              date in the top left corner and the
                                                nbr=201604-2126-006, and then                           November, 2015 revision dates that
                                                                                                        FMCSA never intended to be published                  current version of the MER Form,
                                                selecting the link for ‘‘Justification of
                                                Nonmaterial/Non-substantive Change.’’                   for use by the public and fillable forms              MCSA–5875, that is posted on the
                                                   On June 7, 2016, the Department of                   posted on the FMCSA and National                      FMCSA and National Registry Web sites
                                                Transportation’s Chief Privacy Officer                  Registry Web sites on December 14,                    that no longer includes the Privacy Act
                                                and Office of General Counsel reviewed                  2015, as well as the MER Form, MCSA–                  Statement on page one. On the other
                                                the requirements of the rulemaking and                  5875, that includes the Privacy Act                   hand, SDLAs should not accept versions
                                                determined that the collection of                       Statement on page one. For MEs in an                  of the MEC that have not been approved
                                                information maintained and held by                      office where these forms have been                    by OMB and do not display both the
                                                MEs does not constitute information                     programmed into an electronic system                  FMCSA form number (MCSA–5876) and
                                                protected by the Privacy Act. Therefore,                that will require IT programming, the                 the OMB expiration date of August 31,
                                                FMCSA submitted to OMB for approval                     current approved versions of the forms                2018. The final versions of the forms
                                                a request for additional nonsubstantive                 should be programmed as soon as                       published on the FMCSA and National
                                                changes including removal of the                        practicable. MEs are also encouraged to               Registry Web sites are shown below for
                                                Privacy Act statement on page one of                    use the current versions of the forms                 your reference.
                                                the MER Form, MCSA–5875, and the                        that no longer include the Privacy Act                BILLING CODE 4910–EX–P
jstallworth on DSK7TPTVN1PROD with RULES




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                                                74702            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations

                                                                               Medical Examination Report Form, MCSA-5875 Posted September 20, 2016


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                                                                                                                                                                                                                                                          ER27OC16.000</GPH>




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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                                                            74703


                                                                                                                    First Name:                             008:

                                                                  DRIVER   ~IEALTH   HISTORY           ,
                                                                                                                                            Not                                                                               Not
                                                                  Doyw have- haveyw- .....                                        Ys No Sul'e                                                                         Ys No Sul'e
                                                                   I. Hudibrain injuriftorillnesses (eg.cooaJSSioti)               000            16. Diulnes$, hudach..., numbnau, tingling. or mamory               00 0
                                                                                                                                                       loss
                                                                  2. Seizure, epilepsy                                             00 0
                                                                  3. Eye problams (~g~D=sorconttxts)                               00 0           I 7. U,_p!ained weight loss                                         00 0
                                                                  4. Ear and/or hearing pRlblem5                                   00 0           !8; Strolal.minktrok» (TIA). paralysis, or weakness                 000
                                                                  s. Hean disease; heart attack. bvpass.orotherheart               00 0           19. Missing or limited use of a1111, hand, finger, leg. foot, toe   00 0
                                                                      problarns                                                                   20. Neck or back problems                                           00 0
                                                                  6. Pacemaker, stents, Implantable devices, or other hurt         00 0           21. Bone. muscle. Joint or nerve problems                           00 0
                                                                     procedUiti                                                                   22. Blood clots or bi<Ndf1g pRlblams                                00 0
                                                                   7. High blood prusun~                                           00 0           23.Cancer                                                           000
                                                                  s. High cholesterol                                              000            24. Chronic (long-term)lnfection or other chronic: dls8ses          00 0
                                                                  9. Chronic: llong"'lilm'i! cough, shortnfiS ofb-11. or other     00 0           25. Slap dis:ordGH, pauses in b-hingwhile asleep,                   00 0
                                                                       breathing problams                                                              daytlmesleepinau,loud snoring
                                                                  I G. lung disease {e:g. asthma!                                  00 0           26. Have you ever had a !IMp test (eg.,s/eepapt~e/1)1               00 0
                                                                  11. Kicbey pRlblems, kidney stone, or palnlpd>lems with          00 0           27. HII\'IOyou- spent a night In the hospital!'                     000
                                                                       urination
                                                                  I z. Stomach.llwr, or digestive problans                         00        0
                                                                                                                                                  28. Have you ever had a broken bone?                                00 0
                                                                  I !1. Diabetes or blood sugar problems                           00        0
                                                                                                                                                  29.Hawyou-usedordoyounowUHtobacc:o7                                 00 0
                                                                       lmullnused                                                  00        0
                                                                                                                                                  3tl. Do ycu CUINMiy drink alcchol7                                  00 0
                                                                  14. Anxitty, depression. MrVOUsness,other mental health          00        0
                                                                                                                                                  31. Have ycu used an IUegal submnc• wllhln the past two             00 0
                                                                                                                                                       yors?
                                                                     problems
                                                                 IS. Ftintlng or pa,sslng out                                      00 0
                                                                                                                                                  32. H-you ever ailed a drug test or been dependent on               00 0
                                                                                                                                                       lin lftegal substance?

                                                                  Olharholth condltlan(s) not dascribecl above:                                                                                        OM      ORo ONotSUH




                                                                 Did you answ«"Yes"toany of questiOns 1-32? If so. please comment further on those health conditions belcw.                            Ov- 0No ONotSUH




                                                                 Icertiljr that the aboveillfonnation is accul'lltaand complata.l understand that inamnta. false or missing infonnatiOn may invalidate the l!lfllmination
                                                                 and my Medical Examillel's Cettific:ata, tllllt submlsslon affrauclulllnt or intentionally false information in 'iiolation of§ CFR 3!!!l35, and tllllt submission
                                                                 offraudulent or intentionaUyalse: informlitiOn may subject me to civil or criminal penalties under42CFB39!!.37 and~ Appendices Aand a.
                                                                 Drivar's Signatu111:




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                                                74704            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations


                                                                 I
                                                                 last Name:                                         First Name:                                                                 Exam Date:

                                                                  TESTING

                                                                 Pulseratil< · - - - Pulserhythmregular:OYes 0No

                                                                                         Systolic                    Diastolic                     Urin¥s                      Sp, Gr.       Protl!in     Blood        Sugar
                                                                  Sitting                                                                           Urinalysis lnequlred.
                                                                  Se<cnd reading                                                                    Num!!lkal readingS
                                                                  (optional)                                                                        must be recorda<!.
                                                                  Oth• tasting lflndlcatad                                                          Plme/Jl llloc4 orwgarin the: urinemaybeanindicatior> forfilrthe:rtesting to
                                                                                                                                                   lilleoutanyood.~medicaiPfO!;IIem.




                                                                 Vklon                                                                             Htlring
                                                                 Stondard i$ «least 20140acuity(Sneffen) in each eye with orwilhwtcorreaia!.At Stat>dcrd:Must lil:st petee/vewhisperedvoice<ltoot less than 5feet0Ravetage
                                                                 least 70"fieldafvision in horizontal meridian meawredin each eye. The: use ofa:JF· hemingmofless thanorl!!qlalto4/ld8, in better.ear(with or without hearing ail$.
                                                                 red:ive /ensesshouldbenotedon theMedital&ominefs Cettifil::ate.
                                                                 AcUity                Uncorrected      Corrected     Horizontal Field ofVIslofl   Checkifht~~~ringaidUSI!dfor-:  ORightE'ar OlaftE'ar OHeither
                                                                                                                                                   Whisper Test lleaults                            Right E'ar Laft EaT
                                                                                       201_             201_          Aight Eye: _dagrMS           Record dis!ance (in ~from dl'lwratwhlch a foKI!d
                                                                                       201_             20/_          LeftEye: _degrees            whispe!'Uvoicecanflrstbeheard
                                                                                       201_             201_                            Yti1 No OH
                                                                 Applicant can recognizund distinguish among traffic control             0 0       A!ldl•etricTestllwula
                                                                 signals and devla!s shQwlng red, gra1n, and amber colors                          flight Ear                               Left Ear
                                                                 Mcnocularvision                                                         0 0       SOOHz        1000Hz       2000Hz         500Hz        1000Hz       2000Hz
                                                                 Referred to ophthalmologist or optometrist7                             00
                                                                 flecl!IV«< documentation frorn cphthalmologis! or optomMrlst?




                                                                  llodyS,St.m                                              Normal Abnormal          Bod,S,St.m                                                Normal Abnormal
                                                                  1.General                                                   0           0         &Abdomen                                                      0         0
                                                                  2 Skin                                                      0           0         9. Genfto.ur!Nl')l $)'Starn Including hemlas                  0         0
                                                                  Hyes                                                        0           0         10. Back/Spine                                                0         0
                                                                  4. E'ars                                                    0           0         11. Extremities/joints                                        0         0
                                                                  s. MoutMhroat                                               0           0         12. Neurological system including~                            0         0
                                                                  6. Cardiovascular                                           0           0         13. Gait                                                      0         0
                                                                  7. Lungs/chest                                              0           0         14. Vascular system                                           0         0
                                                                  DlscJssanyabnarmal ~In derollin tht sprxebelow!llldindla!rrwtltthe:r itwoold affect.flledrlvers ablliry rooperarro CMv.
                                                                  Etlterappl/albklfein nurnberbe(Qr!teodlcomment




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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                                                             74705


                                                                 Ilast Name:                                             First Name;                             0011:



                                                                  MEDICAl EXAMINER DETERMINATION                 F"d"'"l'
                                                                 USe tha~·mmm~mtilwperfonnedln!l«l1td!itlcewltltthl!f!<deml ,«owrCoiritrSakf¥Regulation$ t49CFRW.4!:39J.421:
                                                                  0   ~:leG$ not mtilt standards (specify 111!1!00):

                                                                  0   MlllltSstandaldsin49CFR 3!11 Al:qualiflts for 2-yurc~
                                                                  0   Meets standardr, but periodic monitoring required (specify reasoo):
                                                                    Dr(wr qualified for: 0 3months 0 6months 0 1yaar                   Qothar(spt!<:lzyr.
                                                                  0 W.rlng c:orrec~lve lenses     0 Wearing hearing aid 0 Accompanied by a waiver/exemption (spe.a1ji(JIPe):
                                                                  0 A«ompanied by a Skill ParformancA> Evalilatioo (SPE) Cartificata 0 Qualified by oparatfl:m of49 CfB 3!U 64 l&:dggO
                                                                  0 Driving within an exempt intracity zone (see49CFR39L@~
                                                                  0 Determination pending (spedfy111!1!00):
                                                                      0 Return to medical acam officteforfolfow.upon (rOOSt be45 days orkss}:
                                                                      0 Medical Examination Reporumended (spec:i/ytWS011}!
                                                                               llfamendet:JJ Medical Examlnet"sSignatune:                                                    Data:
                                                                  0   Incomplete examfnatlon {sped(yreaSOil}!

                                                                      !lftl!ell'lvlrmHIIII!e~•llnlllln~mtmo!],lhencomplateaMeclkalbM!Ina's(lrtlftateassfilltdln~IJRDJ.dhl.asappreprlin.[
                                                                 t haw performed this evaluation for certification. I have personally reviewed all.availablerecords and recorded Information pertaining to this evaluation,
                                                                 and attest that to the best of my lcnowle.clge, I believe It to be true and correct.
                                                                  Medical Examiner's Slgnatura:

                                                                  Medical Examlnal's Nama (please print or~

                                                                 Medical &aminal's Address:                                                                 City:                            State _ _ ZipCodR:.

                                                                 Medical ExaminenTelephone Number:                                                          DateO!I'tiflc:ate Signed:
                                                                 Medical EXaminer's State License. catiflcate. or Reglstratfl:m Number:                                                                          Issuing State: _ _

                                                                 0MD Doo 0 l'tiysiclan AssiStant                 0     Chiropractor    0   Advanced Praetlc:e Nu!'H
                                                                 0 OtherPmctitione.r (speclzyr.
                                                                 National RegistiY Number:                                                                   1Medical Examinel's Certificate: Expiration Date:                    I




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                                                74706            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations


                                                                 Ilast Name:                                                              First Name:                         DOB:

                                                                 MEDICAl EXAM!NtR PEHRMINATION '$tot¢'

                                                                 /Jtethlsteaiol'lfMV~Jmfntltlons~ill~wltlt!MFedem!MotorCarrier&!fely~fftCFR3?l.4!-39U91wltltiHiy~State
                                                                 .vaflanas (which wi/JOnlybevalldfMiiltnJsttJteopetiJI»ns}:
                                                                  0   Does not meet standards in 49 CFR391A1 with any appllcableStatevarianc:es (specify reasoni:
                                                                  0   Memstandardsln49 CFU!!1.41 with any applcableStatnarlances:
                                                                  0   Meets standards, but periodic monitcring required {spedfyMason}:
                                                                      err-qualll!ed for: Q3months Q6months Q!yur Q other (spocify):
                                                                  0   Waaring ccrra:ti~len-        0 waring h1111ring aid 0 Accompanied by a wai-/exA~tnption C;pedl'ytype;:
                                                                  0   Accompani.t by a Skill Performance Evaluation (SPE) Certificata 0 GrandfatMred from State requiram~~nts c;totl!)
                                                                      llfthdilnrllillllslhellaMar&tdlne41n~aB~I~,wfthapplaiMtStatt:'llllllal-, lhiR-JIIIttaMiilk:ll ~IRI'll Ce111caR.•Iplll'lllllaa.l
                                                                 I haU. parfonned this evaluation for Cllrtifrc:ation.l ha~ piiiSOnally re'llii!Wid all availableNCOrds and l'8alrded Information pertaining to this evaluation,
                                                                 and attest that to the best of my linowledge, I believe it to be true and correct.
                                                                 Medicall?xaminm Signature:

                                                                  Medio::tll?xamlnen Name (J>feaseptirot« type~
                                                                  Medical !x~tmiMI's Address:                                                                            City:                           State--· Zfp Code:
                                                                  Medicall?xaminmTalephona Number:                                                                       Dlte~ificateSigMd:

                                                                  Medlcall?xaminen State ll~ c.rtlficate, cr Registration Number:                                                                                           Issuing State _ _

                                                                 0MD       ODD    0 Physician Assistant 0 Chllopractor 0 Advanced Practice Num~
                                                                 0 Other Practitioner (specify):
                                                                                             r,,-..
                                                                 Na!lional Registry Number. L ... ~.
                                                                                                      ,~",·~~"'   ~ •'~-~-~"-'




                                                                                                                        -~
                                                                                                                                 '"- -~- ----

                                                                                                                                 ~     ~--
                                                                                                                                                '
                                                                                                                                                l                         IMedical Examiner's Certificala Expiration Date
                                                                                                                                                                                                                                            I




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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                          74707



                                                                           Instru.ctions for Completing the Medical Examination Report Form (MCSA-5875)

                                                                 L Step-By-Step .lnstm.etiom
                                                                     Ddver:
                                                                         Semon 1: Driver information
                                                                              PenonaliJd'o:rmation: Please complete 1his section using your name as written on your driver's license. your
                                                                              outterJt address and phone number, your date ofbirlh. age, gender> driver's license number and issuing state.
                                                                              o   CLPICDL Applicant/Holder: Check ''yes" if you are a commercial teamer's pennit (CLP) or com~
                                                                                  mercial driver's license (CDL) hOlder, or are applying for aCLP or CDL. CDLttteans a license
                                                                                  issued by a State orlhe District of Cohmbia which authorizes the individual to operate a class of a
                                                                                  commercial motor vehicle (CMV). A CMV that requires a CDL is one that: (l) has a gross combina-
                                                                                  tion weight rating or gross combination weight of 26.001 pounds or more inclusive of a towed unit
                                                                                  with a gross vehicle weight rating (GVWR) or gross vehicle weight (GVW) of more than 10,000
                                                                                  pounds; or (2) bas a GVWR or GVW of26,001 pounds or more; or (3) is designed to transport 16 or
                                                                                  more passengers, including the driver;. or (4) is used to transport either hazardous materials requiring
                                                                                  hazardous materials placards on the vehicle or any quantity of a select agent or toxin.
                                                                              o Driver ID Verified By: The Medical Examiner/staff completes this item and notes the type of photo ID
                                                                                used to verifY the driver's identity sud~ as, commercial driver's license, driver's license, or pas!IJI'Od. etc.
                                                                              o Question: Has your USDOTIFMCSA medical certlfleate ever been denlecl or Issued for less than
                                                                                two years? Please check the correct box "yes" or "no" and ifyou aren't sure Check the ''not sure" box.
                                                                              Driver Health mstory:
                                                                              o Have yoo ever had ftll'lleJ'Y! Please check ''yes" ifyou have ever had surgery and provide a written
                                                                                explanation of the details (type of surgery, date of S\lrgel'y, etc.)
                                                                              o   Are you c:u.rrently taking medleatiODS (pD!SCI'Iptlon., over-the-counter, herbal remedies, dJet
                                                                                  supplements): Please check "yes" if you are taking any diet supplements, herbal remedies. or
                                                                                  prescription or over the counter medications. In the box below the question, indicate the name of the
                                                                                  medication and the dosage.
                                                                              o #l-32: .Please complete this sectioo by cbecldngthe "yes" box to indicate that you have, or have ever bad,
                                                                                the health oondit:ion listed or the "No" box if you have not. Check the "not sure" box if you are unsure.
                                                                              o other Health CondltiODS not tlescriiJed allove; Ifyou have. or have had, any other health condi-
                                                                                tions not listed in the section above. dleck:''Yes" and in the box provided and list those condition(s).
                                                                              o Any yes IIIISWers to qaestions #1-32 above: lfyou have answered "yes" to any ofthe questions in
                                                                                the Driver Health History section above, please explain your answers further in the box. below the
                                                                                question. For example, if you answered "yes" to question #5 regarding heart disease, heart attack.
                                                                                bypass, or other heart problem, indicate which type of heart condition. If you checked "yes" toques-
                                                                                tion #23 regarding cancer, indicate the type of cancer. Please add any infonnation that win be heJpful
                                                                                to the Medical Examiner,

                                                                             CMV Driver Signature and Date: Please read the certification statement, sign and date it, indicating
                                                                             that the information you provided in Section 1 is accurate and complete.
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                                                74708            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations




                                                                      Me4ieal Examiner:
                                                                          Section 2: Examination Report
                                                                              Driver Health History Review: .Review answers provided by the driver in the driver health history
                                                                              section and discuss any «yes" and "not sure" responses. In addition. be sure to oompare the medication
                                                                              list to the health history responses ensuring that the medication list matches the medical conditions
                                                                              noted. Explore with the driver any answers that seem unclear. Record any information that the driver
                                                                              omitted. As the Medical Examiner conducting the driver's physical examination you are required to
                                                                              complete the entire medical examination even if you detect a medical condition that you consider
                                                                              disqualifYing. such as deafuess. Medical Examiners are expected to determine the driver's physical
                                                                              qualification for operating a commercial vehicle safely. Thus, if you find a disqualifYing condition for
                                                                              which a driver may receive a Federal Motor Carrier Safety Administration medical exemption, please
                                                                              record that on the driver's Medical Examiner's Certificate, Form MCSA-5876. as well as on the Medical
                                                                              Examination Report Form. MCSA-5875.
                                                                              Testing:
                                                                              o Pulse rate and rhythm, JaeiPt, and wdght: record these as indicated on the form.
                                                                              o   Blood Pressure: record the blood pressure (systolic and diastolic) ofthe driver being examined. A
                                                                                  second reading is optional and should be recorded if found to be necessary.
                                                                              o       Urinalysis: record the numerical readings for the speeific gravity. prolein. blood and sugar.
                                                                              o Vlsioa: The current vision standard is provided on the form. When other than the Snellen chart is
                                                                                used, give test results in SneHen•oomparable values. When recording distance vision, use 20 feet as
                                                                                normal. Record the vision acuity results and indicate if the driver can recognize and distinguish
                                                                                among traffic control signals and devices showing red, green. and amber colors; has monocular
                                                                                vision; has been referred to an ophthalmologist or optometrist; and if documentation has been
                                                                                received from an ophthalmologist or optometrist.
                                                                              o   Bearing: The current hearing standard is provided on the form. Hearing can be tested using either a
                                                                                  whisper lest or audiometric test. Record the test results in the corresponding section for the lest used.
                                                                              PhyUeal Examination: Check the body systems for abnormalities and indicate normal or abnormal for
                                                                              each body system listed. Discuss any abnormal answers in detail in the space provided and indicate
                                                                              whether it would affect the driver's ability to safely operate a commercial motor vehicle.
                                                                          ln. litis nut Bdtm, you will be contpleting either the FedJmll or Stllttl ~not IJotlt.
                                                                              Medieal Examiner Determination (Federal): Use this section for examinations performed in
                                                                              accordance with the FMCSRs (49 CFR 391.41-39:1.49). Complete the medical examiner determination
                                                                              sectionoompletely. When determining a driver's physical qualification. please note that English language
                                                                              proficiency (49 CFR part 391.11: General qualifications of drivers) is not factored into that
                                                                              determination.
                                                                               o Does not meet standards: Select this option when a driver is determined to be not qualified and
                                                                                 provide an explanation of why the driver does not meet the standards in 49 CFR391.41.
                                                                              o Mods standa:nls in 49 CFR 391.41; qualities for l-year t:erliliadioa: Select this option when a
                                                                                driver is determined to be qualified and will be issned a 2-year Medical Examiner's Certificate.




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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                          74709



                                                                              o Meets standards, hut periodi~ monitoring is n:quired~ Select this option when a driver is deter-
                                                                                mined to be qualified but needs periodic monitoring and provide an explanation ofwhy periodic
                                                                                monitoring is required. Select the corresponding time frame that the driver is qualified and if select-
                                                                                ing other, specifY the time frame.
                                                                                       Dderminatioa that driver meets standards: Select all categories that apply to the driver's
                                                                                       certification (e.g., wearing coiTeCtive lenses, accompanied by a waiver/exemption, driving
                                                                                       within an exempt intracity zone, etc.).
                                                                              o Ddemdnatlon pending: Select this option when more infonnation is needed to make a qualification
                                                                                decision snd specifY a date, on or before the 45 day expiration date, for the driver to return to the
                                                                                medical exam office for follow-up. This will allow for a delay of the qualification decision for as
                                                                                msny as 45 days. If1he disposition of the pending examination is not updated via 1he Nab.Onal Regis·
                                                                                tty on or before the 45 day expiration date, FMCSA will notifY the examining medical examiner snd
                                                                                1he driver in writing that the examination is no longer valid snd that the driver is required to be re-
                                                                                examined.
                                                                                       MER amended: .A Medical Examination Report Fonn (MER). MCSA-5875, may only be
                                                                                       amended white in determination pending status for situations where new infonnation (e.g., test
                                                                                       results. etc.) has been received or there has been a change in the driver's medical status since the
                                                                                       initial examination. but prior to a fmal qualification determination. Select this option wherta Medic-
                                                                                       al Examination Report Forttt, MCSA-5875, is being amended; provide the reason for the amendm-
                                                                                       ent, sign snd date. In addition_ initial and date any chsnges made on the Medical Examination
                                                                                       Report Form, MCSA-5875. A Medical Examinatioo Report Forttt, MCSA-5875, cannot be
                                                                                       amended after sn examination has been in determination pending stalus for more than 45 days or
                                                                                       after a final qualification detetmination has been made. The driver is required to obtain a new phys-
                                                                                       ical examination snd auew Medical Examination Report Form. MCSA-5875, should be oompleted.
                                                                              o   Ineomplete examinatlou: Select this when the physical examination is not completed for sny
                                                                                  reason (e.g., driver decides they do not want to continue with the examinatloo snd leaves) other
                                                                                  thsn situations outlined under determination pending.
                                                                              o Metlical Examiner illfonnation, signature and date: Provide your name. address. phone number.
                                                                                occupation. license, certificate. or registration number snd issuing state. national registty number.
                                                                                sigoature snd date.
                                                                              o Metlieal Examiner's CertUicate .Expiration Date: Enter the date the driver's Medical Examiner's
                                                                                Certificate (MEC) expires.
                                                                              Medieal Examiner Detennination (State)~ Use this section for examinations perfonned in accordance
                                                                              with the FMCSRs (49 CFR 391.41-391.49) with any applicable State varisnoes (which will ooly be valid
                                                                              for intrastate operations). Complete the medical examiner determination section completely.
                                                                              o Does not meet standanls in 49 CFR 391.41 with llftY applicable State variances: Select this
                                                                                option when a driver is determined to be not qualified and provide sn explanation of why the driver
                                                                                does not meet the standards in 49 CFR 391.41 with any applicable State variances.
                                                                              o Meets standards in 49 CFR 391.41 with IIDY .applleable State vadanees: Select this Option when
                                                                                a driver is determined to be qualified snd will be issued a 2-year Medical Examiner's Certificate.
                                                                              o   Meets standanls,.llut periodic monitoring is required! Select this optioo when a driver is deter-
                                                                                  mined to be qualified but needs periodic mooitoring and provide an explanation of why periodic
                                                                                  monitoring is required. Select the corresponding time frame that the driver is qualifted snd if select-
                                                                                  ing other, specifY the time frame.
                                                                                       Determinatiou that driver meets stand.arcls: Select aU categories that apply to the driver's
                                                                                       certification (e.g,. wearing corrective lenses, accompanied by a waiver/exemption, etc.).
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                                                74710            Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations




                                                                              o Medkal Examinerinfonnation. signature and date; Provide your name. address. phone number,
                                                                                occupation, Hcense. certificate, or registration number and issuing state, national registty number,
                                                                                signature and date.
                                                                              o Medkal Examiner'sCerttfteate Expiratioo Date: Enterthe date the 41riverts Medical Examiner's
                                                                                Certificate (MEC) expires.
                                                                      n.   Ifupdating an esfsting exam, you must l'elllbmit the new exam results, via the Medical Exandnatlou
                                                                           Results Fonn, MCSA-5850, to tbe National Registry, and the most neent dated exam wDI take
                                                                           precedence.
                                                                      m. To obtaill ad.ditlooal infonnation regarding tbis fonn go to the Medkal Program's page on tbe Federal
                                                                           Motor Carrier Safety Administration's website at http;/lmyw.fmqa.d.ot.&Qv!J:gulaflonslmedkal.




                                                                                                                                                                                   Pagel!
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                                                                 Federal Register / Vol. 81, No. 208 / Thursday, October 27, 2016 / Rules and Regulations                                      74711




                                                  Issued on: October 20, 2016.                          pursuant to the Marine Mammal                         FOR FURTHER INFORMATION CONTACT:
                                                T.F. Scott Darling, III,                                Protection Act (MMPA). This action is                 Shannon Bettridge, Shannon.Bettridge@
                                                Administrator.                                          being taken as a result of a status review            noaa.gov, Office of Protected Resources,
                                                [FR Doc. 2016–25976 Filed 10–26–16; 8:45 am]            conducted by NMFS in response to a                    301–427–8402.
                                                BILLING CODE 4910–EX–c                                  petition to designate a group of beluga               SUPPLEMENTARY INFORMATION:
                                                                                                        whales in the western Sea of Okhotsk as
                                                                                                        a depleted stock. The biological                      Background
                                                DEPARTMENT OF COMMERCE                                  evidence indicates that the group is a                   Section 115(a) of the MMPA (16
                                                                                                        population stock as defined by the                    U.S.C. 1383b(a)) allows interested
                                                National Oceanic and Atmospheric                        MMPA, and the stock is depleted as                    parties to petition NMFS to initiate a
                                                Administration                                          defined by the MMPA.                                  status review to determine whether a
                                                                                                             This final rule is effective
                                                                                                        DATES:                                                species or stock of marine mammals
                                                50 CFR Part 216                                         November 28, 2016.                                    should be designated as depleted. On
                                                [Docket No. 151113999–6950–02]                                                                                April 23, 2014, we received a petition
                                                                                                        ADDRESSES:   Copies of supporting                     from the Animal Welfare Institute,
                                                RIN 0648–BF55                                           documents, including the status review,               Whale and Dolphin Conservation,
                                                                                                        the proposed rule, and a list of                      Cetacean Society International, and
                                                Designating the Sakhalin Bay-Nikolaya                   references cited in the final rule, are               Earth Island Institute (petitioners) to
                                                Bay-Amur River Stock of Beluga                          available via the Federal e-rulemaking                ‘‘designate the Sakhalin Bay-Amur River
                                                Whales as a Depleted Stock Under the                    Portal, at www.regulations.gov (search                stock of beluga whales as depleted
                                                Marine Mammal Protection Act (MMPA)                     for Docket ID NOAA–NMFS–2015–                         under the MMPA.’’ We published a
                                                AGENCY:  National Marine Fisheries                      0154), or at http://                                  notification that the petition was
                                                Service (NMFS), National Oceanic and                    www.fisheries.noaa.gov/pr/species/                    available (79 FR 28879; May 20, 2014).
                                                Atmospheric Administration (NOAA),                      mammals/whales/beluga-whale.html.                     After evaluating the petition, we
                                                Commerce.                                               Those documents are also available                    determined that the petition contained
jstallworth on DSK7TPTVN1PROD with RULES




                                                ACTION: Final rule.                                     from NMFS at the following address:                   substantial information indicating that
                                                                                                        Chief, Marine Mammal and Sea Turtle                   the petitioned action may be warranted
                                                SUMMARY:   We, NMFS, issue a final                      Conservation Division, Office of                      (79 FR 44733; August 1, 2014).
                                                determination to designate the Sakhalin                 Protected Resources, National Marine                  Following the determination that the
                                                Bay-Nikolaya Bay-Amur River Stock of                    Fisheries Service, 1315 East-West                     petitioned action may be warranted, we
                                                beluga whales (Delphinapterus leucas)                   Highway, Silver Spring, MD 20910–                     convened a status review team and
                                                                                                                                                                                                         ER27OC16.009</GPH>




                                                as a depleted stock of marine mammals                   3226.                                                 conducted a status review to evaluate


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Document Created: 2016-10-27 01:52:51
Document Modified: 2016-10-27 01:52:51
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionNotice of decision on use of Medical Examination Report and Medical Examiner's Certificate Forms.
DatesThis decision is in effect on October 27, 2016.
ContactMs. Christine A. Hydock, Chief, Medical Programs Division, Office of Policy, Federal Motor Carrier Safety Administration, 1200 New Jersey Avenue SE., Washington, DC 20590; telephone (202) 366-4001; [email protected] If you have questions about viewing or submitting material to the docket, contact Docket Services, telephone (202) 366-9826.
FR Citation81 FR 74700 

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