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Medical Examiner’s Handbook

Newsletter Update

The Federal Motor Carrier Safety Administration (FMCSA) has released the draft Medical Examiner’s Handbook (MEH), which includes updates to the Medical Advisory Criteria published in the Code of Federal Regulations (CFR). The MEH and Medical Advisory Criteria provide information about regulatory requirements and guidance to medical examiners who perform physical qualification examinations of interstate commercial motor vehicle (CMV) drivers. The draft MEH with proposed changes to the Medical Advisory Criteria is available in Docket Number FMCSA–2022–0111.

The Medical Examiner’s Handbook was first posted on FMCSA’s website in 2008 to provide guidance to medical examiners (ME) on the physical qualification standards and the conduct of the physical qualification examination. FMCSA has also issued guidance for medical examiners in the form of Medical Advisory Criteria, now published at 49 CFR part 391, Appendix A.

In 2015, FMCSA withdrew the Handbook because some of the information was obsolete or was prescriptive in nature. Medical examiners were told that they should no longer consider the Handbook as Agency guidance. The FMCSRs, in 49 CFR 391.41 through 391.49, provide the basic driver physical qualification standards for interstate CMV operators. Medical examiners currently make physical qualification determinations on a case-by-case basis and may consider guidance to assist with making those determinations.

Although some of the medical qualification regulations are fairly straightforward, others are not. Over the past few years there has been a great deal of discussion about apnea, and an updated handbook would be well suited to answer those questions.

The revised Medical Advisory Criteria, in addition to being included in the Medical Examiners Handbook, would also be published in Appendix A to 49 CFR part 391. The final version of the criteria would be identical in both publications.

No timeline has been established for these updates.