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Medical Examination Report Form

Disqualify

As a medical examiner, you must disqualify the driver who does not meet one or more of 49 CFR 391.41 physical qualification standards. You should complete the physical examination of the driver and discuss with him/her the reason(s) for disqualification and any steps that can be taken to meet certification standards.

Disqualify — Discuss and Document Decision

  Regulations — Disqualify driver who does not meet standards

As a medical examiner, you must disqualify the driver who:

  • Fails to meet a physical qualification requirement cited in the standards (e.g., vision test result, hearing loss test result, epilepsy, or insulin use).
  • You believe has a medical condition that endangers the health and safety of the driver and the public.

Disqualify (Does Not Meet Standards)

Document the decision to disqualify on the Medical Examination Report form.

  • Mark the "Does not meet standards" box.
  • Note the reason for disqualification.
  • Document the discussion with the driver explaining the rationale for the decision to disqualify.

NOTE: DO NOT issue a medical examiner's certificate.

Before a disqualified driver can return to commercial motor vehicle (CMV) driving, a medical examiner must find the driver to be medically fit for duty.

Disqualify Temporarily

When the disqualifying condition or treatment has a clinical course likely to restore driver medical fitness for duty, you may complete the:

  • “Temporarily disqualified due to (condition or medication):_____________” line.
  • “Return to medical examiner's office for follow up on __________________” line.

When a recommended waiting period is applicable, the date:

  • Should be greater than or equal to the waiting period.
  • Should be greater than or equal to the longest waiting period when the driver has multiple medical conditions.

NOTE: DO NOT issue a medical examiner's certificate.

REMEMBER

The driver is disqualified and not allowed to operate a CMV until a medical examiner finds the driver to be medically fit for duty.

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