§391.43 Medical Examination;
Certificate of Physical Examination
Question 1: May a motor carrier, for the purposes
of §391.41, or a State
driver licensing agency, for the purposes of §383.71, accept the results
of a medical examination performed by a foreign medical examiner?
Guidance: Yes. Foreign drivers operating in the
U.S. with a driver's license recognized as equivalent to the CDL may be
medically certified in accordance with the requirements of part 391, subpart E, by a medical examiner
in the driver's home country who is licensed, certified, and/or registered to
perform physical examinations in that country. However,
Question 2: May a urine sample
collected for purposes of performing a subpart H test be used to
test for diabetes as part of a driver's FHWA-required
physical examination?
Guidance: In general, no. However, the DOT has recognized an exception to
this general policy whereby, after 60 milliliters of urine have been set aside
for subpart H testing, any remaining portion of the sample may be used for
other nondrug
testing, but only if such other nondrug testing is required by
the FHWA (under part 391, subpart E) such as
testing for glucose and protein levels.
Question 3: Is a chest x-ray
required under the minimum medical requirements of the
FMCSRs?
Guidance: No, but a medical examiner may take an
x-ray if appropriate.
Question 4: Does §391.43 of the FMCSRs
require that physical examinations of applicants for employment be conducted by
medical examiners employed by or designated by the carrier?
Guidance: No.
Question 5: Does a medical
certificate displaying a facsimile of a medical examiner's signature meet the
"signature of examining health care professional" requirement?
Guidance: Yes.
Question 6: The driver's medical
exam is part of the Mexican Licencia Federal. If a
roadside inspection reveals that a Mexico-based driver has not had the medical
portion of the Licencia Federal re- validated, is the driver
considered to be without a valid medical certificate or without a valid license?
Guidance: The Mexican Licencia
Federal is issued for a period of 10 years but must be re-validated every 2
years. A condition of re- validation is that the driver must pass a new
physical examination. The dates for each re-validation are on the Licencia
Federal and must be stamped at the completion of each physical. This
constitutes documentation that the driver is medically qualified. Therefore, if
the Licencia
Federal is not re-validated every 2 years as specified by Mexican law, the
driver's license is considered invalid.
Question 7: If a motor carrier sends
a potential interstate driver to a medical examiner to have both a
pre-employment medical examination and a pre-employment controlled substances
test performed, how must the medical examiner conduct the medical examination
including the certification the driver meets the physical qualifications of § 391.41(b)? [Editor's Note]
Guidance: The medical examiner must complete the
physical examination first without collecting the Part 382 controlled
substances urine specimen. If the potential driver meets the requirements of Part 391, Subpart E
[especially §
391.41(b)] and the medical examiner chooses to certify the potential driver
as qualified to operate commercial motor vehicles (CMV) in interstate commerce,
the medical examiner may prepare the medical examiner's certificate. [Editor's Note]
After the medical examiner has completed the medical
examiner's certificate and provided a copy to the potential driver and to the
motor carrier who will use the potential driver's services, the medical
examiner may collect the specimen for the 49 CFR Part 382 pre-employment
controlled substances test. The motor carrier is held fully responsible
for ensuring the potential driver is not used to operate CMVs until
the carrier receives a verified negative controlled substances test result from
the medical review officer. A Department of Transportation pre-employment
controlled substances test is not a medical examination test. [Editor's Note]