To record results of a drivers physical examination, to determine qualification. National registry driver examination forms frequently asked. Nov 26, 2018 the federal motor carrier safety administration requires that interstate commercial motor vehicle drivers maintain a current medical examiners certificate mec, form mcsa5876 to drive. Are mes required to complete the cmv driver medical examination results form, mcsa5850.
Complete the certification section on the dot form. The electroniconly cmv driver medical examination results form mcsa5850 that examiners complete through the national registry website to report exam results to the fmcsa. Department of transportation office of the secretary privacy. Medical examination report form dot fmcsafaauscgrules. The intrastateonly option on the cmv driver medical examination results form, mcsa5850. A third new form, the cmv driver medical examination results form mcsa5850, is an onlineonly form that examiners complete through the national registry website to report exam.
A once every calendar month, beginning may 21, 2014 and ending on june 22, 2018, the medical examiner must electronically transmit to the director, office of carrier, driver and vehicle safety standards, via a secure web account on the national registry, a completed cmv driver medical examination results form, mcsa5850. Therefore, when entering results for examinations conducted on or after december 22, 2015, the national registry system will automatically present the me with the revised version of the cmv driver medical examination results form, mcsa5850. Fmcsa medical examiner certification test questions. Because the cmv driver medical examination results form, mcsa5850 is an electronic form and only available through the mes national registry account, the sample is a representation of what mes will see when entering cmv driver examination results into the national registry system. Medical examiners certificate mcsa5876, a short form usually referred to as the department of transportation dot card. Fmcsa form mcsa5875 us department of transportation. Reporting driver examination results as a certified medical examiner listed on the national registry, you are required to complete and submit form mcsa5850, cmv driver medical examination results form for each driver exam you perform during the month once the may 21, 2014 compliance date is reached. Fmcsa mandated dot examination process changes 5875.
New dot physical exam forms for 2016 finalized dot. Fmcsa rule change medical examiners reporting submitted on jun 10, 20 in addition, mes would be required to report results of all completed commercial drivers physical examinations including the results of examinations where the driver was found not to be qualified to fmcsa by close of business on the day of the examination. Fmcsa mandated dot examination process changes 5875 mcsa5876. They know that they must complete and submit form mcsa5850, cmv driver medical examination results and that they must retain each original paper or electronic completed medical examination report and a copy or electronic version of each medical examiners certificate on file for at least 3 years from the date of the of examination. The new forms are part of a larger fmcsa effort that will launch in 2018 to streamline medical certification information from medical examiners to the fmcsa and back to. New dot physical exam forms for 2016 finalized dot fmcsa.
To support certified medical examiners in managing their registry account, they may authorize administrative assistants to access the national registry system and perform certain activities on. Dec 22, 2015 because the cmv driver medical examination results form, mcsa5850 is an electronic form and only available through the mes national registry account, the sample is a representation of what mes will see when entering cmv driver examination results into the national registry system. The proposed mer form, mcsa5875, is an updated version of the mer form currently being used by mes and its use is a requirement of the medical examiners certification integration nprm. Medical examination report form mcsa5875, a long form completed as part of the exam. A third new form, the cmv driver medical examination results form mcsa 5850, is an onlineonly form that examiners complete through the national registry. The form would also add a place for an me to amend the certification decision if the driver did not require a completely new examination. May 26, 2016 the electroniconly cmv driver medical examination results form mcsa5850 that examiners complete through the national registry website to report exam results to the fmcsa.
When entering results for examinations conducted on or after december 22, 2015, you will be presented with a revised version of the cmv driver medical examination results form, mcsa5850 attached. To submit the cmv driver medical examination results, follow these steps. This has been added to the cmv driver medical examination results form, mcsa5850 21260006. Fmcsa proposes to require certified medical examiners mes performing physical examinations on drivers of commercial motor vehicles cmv to use a newly developed. New fmcsa medical exam forms and certificates now mandatory. National registry of certified medical examiners frequently. Fmcsa rule change medical examiners reporting submitted on jun 10, 20 in addition, mes would be required to report results of all completed commercial drivers physical examinations including the. As a result of these added collections, the drivers address, optional email address, and results of examinations performed in accordance with the fmcsrs with any applicable state variances, have been added to the cmv driver medical examination results form, mcsa5850. Update on commercial driver medical examination rules and.
These tips will make your examination process go smoother and help you receive the maximum certification length. In addition, if you have not completed any exams during the month, you must. May 21, 2014 cmes must report driver examination results. The examination date is on the data collection screen of the cmv driver medical examination results form, mcsa5850. National registry driver examination forms frequently. This has been added to the cmv driver medical examination results form, mcsa5850. Medical examiners certification integration final rule. May 21, 2014 is just around the corner and on that date you will be required to complete and submit all driver medical examination forms for the previous month using the online mcsa5850 form available through your national registry account. There is no need for examiners or motor carriers to have paper copies of this form.
For applicantsholders of clpcdls interstate and intrastate, fmcsa will electronically transmit from the national registry system to the sdlas driver identification. Fmcsa proposes to require certified medical examiners mes performing physical examinations on drivers of commercial motor vehicles cmv to use a newly developed medical examination report mer form, mcsa5875, in place of the current mer form and to use form mcsa5876 for the medical examiners certificate mec. December 22, 2015 must be reported using the revised electronic cmv driver medical examination. A sample cmv driver medical examination results form, mcsa5850 has been posted in the resource center of the national registry website and is accessible by clicking on the link below. December 22, 2015, the national registry system will automatically present the me with the revised version of the. They know that they must complete and submit form mcsa5850, cmv driver medical examination results and that they must retain each original paper or electronic completed medical examination. Mcsa5876 and cmv driver medical examination results form mcsa5850 beginning april 20, 2016. Local changes are not authorized and company logos or symbols are not allowed. Department of transportation office of the secretary. Enter the date the drivers medical examiners certificate mec expires 11. To support certified medical examiners in managing their registry account, they may authorize administrative assistants to access the national registry system and perform certain activities on their behalf. Mes are required to continue to report cmv driver medical. Reporting driver examination results as a certified medical examiner listed on the national registry, you are required to complete and submit form mcsa5850, cmv driver medical examination results. The cmv driver medical examination results, form mcsa5850, is a secure, online form that is only available through your national registry account.
Update regarding posting and use of driver examination forms. What this means to individuals seeking dot certification. May 21, 2014 is just around the corner and on that date you will be required to complete and submit all driver medical examination forms for the previous month using the online mcsa5850. Because the cmv driver medical examination results form, mcsa5850 is an electronic form and only available through the mes national registry account, the sample is a representation of. Cmv driver medical examination results form, mcsa5850 2 these new forms are all. Check all items on the medical from to indicate if the driver is medically qualified, medically disqualified or temporarily medically disqualified. Fmcsa would consider any cmv driver medical examination results form, mcsa5850, displaying a pending determination status as an incomplete examination. Update regarding posting and use of driver examination. As a certified medical examiner listed on the national registry, you are required to complete and submit form mcsa5850, cmv driver medical examination results form for each driver exam you perform during the month once the may 21, 2014 compliance date is reached. When entering results of examinations conducted on or after december 22, 2015, the national registry system will automatically present the me with the revised version of the cmv driver medical examination results form, mcsa5850.
In addition, fmcsa allows mes to designate a third party that simultaneously uploads bulk upload multiple cmv driver medical examination results from their medical system to the national registry. Fmcsa will not accept submissions by any other means. The driver is required to obtain a new phys ical examination and a new medical examination report form, mcsa 5875, should be completed. The me must provide the qualified cmv driver with a paper copy of the mcsa5876 form so that the commercial learners. Are mes required to complete the cmv driver medical examination results form, mcsa5850 as it appears in the sample, or is the sample a representation of what the form looks like on the national. Apr 01, 20 cmv in interstate commerce according to the requirements in 49 cfr 391. Medical examiners are required to complete the medical examination report form for every driver physical examination performed in accordance with 49 cfr 391. Results form, mcsa5850, to the national registry, and the most recent. Therefore, when entering results for examinations conducted on or after. Cmv driver medical examination results form, mcsa5850.
Instructions for completing the medical examination report form. Results form, mcsa5850, to the national registry, and the most recent dated exam will take. Why is the examination date not on the cmv driver medical examination results form, mcsa5850 or the mec form, mcsa5876. As part of the physical, drivers are required to fill out the medical history portion of the medical examination report mer. Commercial motor vehicle cmv driver medical examination results form mcsa5850, an electronic form. Medical examiners are required to complete the medical examination report form for every driver physical. As a certified medical examiner listed on the national registry, you are. Electronically transmit the examination results to the fmcsa. As part of the physical, drivers are required to fill out the medical history portion of the medical examination report mer form, mcsa5875. How have the commercial motor vehicle cmv driver examination forms, including the cmv driver medical examination results form, mcsa5850, changed. New dot medical exam forms to be required april 20 catto.
Jun 17, 2015 may 21, 2014 cmes must report driver examination results on nrcme form mcsa5850 by randolph rosarion m. Because the cmv driver medical examination results form, mcsa5850 is an electronic form and only available through the mes national registry account, the sample is a representation of what mes will. A medical examination report form, mcsa 5875, cannot be amended after an examination has been in determination pending status for more than 45 days or after a final qualification determination has been made. Medical examiners certificate mec form, mcsa5876 c. May 21, 2014 cmes must report driver examination results on. A medical examination report form, mcsa5875, cannot be amended after an examination has been in determination pending status for more than 45 days or after a final qualification determination has. The cmv driver medical examination results form, mcsa5850, found in appendix a is a representation of the electronic form. What fmcsa requires of certified medical examiners dot. May 21, 2014 cmes must report driver examination results on nrcme form mcsa5850 by randolph rosarion m. Departmentof transportation privacy impact assessment. Select submit cmv driver exam results, input driver information and exam data, and click submit.
As a certified medical examiner listed on the national registry, you are required to complete and submit form mcsa5850, cmv driver medical examination results form for each driver exam you perform. Complete guide to medical certification dot health systems. A third new form, the cmv driver medical examination results form mcsa5850, is an onlineonly form that examiners complete through the national registry website to report exam results to the fmcsa. Fmcsa would consider any cmv driver medical examination results form, mcsa5850. Because the cmv driver medical examination results form, mcsa5850.
Department of transportation dplqhuv certification. Cmv driver medical examination results form, mcsa5850 2 these new forms are all formally approved by omb and must be used as approved. If updating an existing exam, you must resubmit exam results, via the medical examination results form, mcsa5850. The date of the examination is not on the mec, form mcsa5876, nor has it ever been, because it is not needed. Maintain certification by completing periodic training every 5 years, and recertify by passing the fmcsa medical examiner certification test every 10 years. Fmcsa rule change medical examiners reporting mobile. In addition, fmcsa allows mes to designate a third party that. Examination results will be reported by completing a cmv driver medical examination results form, mcsa5850, via the mes individual passwordprotected national registry. Even if no exams were performed during the month, you must report. Added optional collection of cmv driver examination results when performed in accordance with the fmcsrs with any applicable state variances for electronic transmission at the request of several states.
Sample fmcsa medical examiner certification test items 35 appendix d. Medical examination report mer form, mcsa5875 fmcsa. A third new form, the cmv driver medical examination results form mcsa5850, is an onlineonly form that examiners complete through the national registry. To begin this enrollment process, the medical examiners support staff must enroll on the national registry system and create their own. Cmv in interstate commerce according to the requirements in 49 cfr 391. Commercial motor vehicle cmv driver medical examination results form mcsa5850.