Genesis is a medical management organization with over 25 years of experience. Commercial driver fitness determination pdf dot medical form 2003. While it may not disqualify you from becoming a commercial motor vehicle cmv driver, it may require a sleep test or lifestyle change to prove your eligibility. You will need to carry a copy of this certificate with you when operating a commercial motor vehicle. If application is for a corporation, partnership, or other organization. Before we issue the medical examination report that you need, we put you through driver fitness determination tests that include a series of medical exams. A person is physically q ualified to drive a commercial motor. The driver fitness basic addresses the requirements within the federal motor carrier safety regulations fmcsrs, specifically 49 cfr parts 383 and 391, and refers to the. We will complete the medical examination report for commercial driver fitness determination form and supporting documents, including dot physical forms. Having been examined and approved by a cardiologist for medical fitness.
As part of the physical, drivers are required to fill out the medical history portion of the medical examination report mer form, mcsa5875. The demands of a commercial driving job can take a toll on your body and your health, so the department of transportation created a standardized. We provide patients, insurance companies, businesses, employers, government agencies and other entities direct access to multispecialty physicians with expertise in conducting medical evaluations, comprehensive diagnostic testing, and support services. You must pass all dot physical requirements in order to be cleared for your cdl medical card. Driver fitness basic factsheet driver fitness overview what is the driver fitness basic. System sms determines an overall basic status for each motor carrier based upon. Which one should i submit to update my cdl medical card information. Interpretation of bedside urinalysis this post was published in life in the fast lane, a blog from a group of docs from down under australia new zealand, and would serve well to answer many of the. As a cmv commercial motor vehicle driver, you are aware that you are driving a vehicle capable of causing serious harm. Department of transportation american postal workers union.
A copy of your signed medical examiners certificate. Driver medical fitness for duty drivers are critical to highway safety. Florida school bus operators medical examination report for. While a commercial drivers license cdl and drug and alcohol testing is not required to operate this size of vehicle, companies are required to obtain a dot number. Dsms results are not available to motor carriers, drivers, thirdparty providers, or the public. It does not affect a drivers commercial drivers license, or a carriers safety rating. Drivers information driver completes this section drivers name last.
Medical examination report for commercial driver fitness determination 1. Under the new requirement by the federal motor carrier safety administration, all states must begin collecting and maintaining medical certification information. Your medical examination report for commercial driver fitness determination will be send electronically to the commercial drivers license information system cdlis, along with your dot physical forms. Dot medical examination report for commercial driver fitness determination. Our physicians can prepare a completed medical examination report form for your certification. Report for commercial driver fitness determination the form the examiner. Commercial driver fitness determinations are used by transportation companies to determine if their drivers are medically capable of performing all tasks required of commercial drivers. It takes skill, knowledge, and a level of physical and metal. The department of transportation dot requires commercial motor vehicle cmv operators to have the dot physical exam to maintain their driver certification. Department of transportation federal motor carrier safety administration. Drivers information driver completes this section date of exam m recertification m d y drivers name last, first, middle social security no. Medical examination report for commercial driver fitness determination. The dot exam cmv driver medical fitness examination we appreciate the opportunity to partner with you to provide your medical fitness evaluation. Department of transportation federal motor carrier safety administration public burden statement.
A medical evaluation summary completed only by either a board qualified or board certified physiatrist doctor of physical. Revised blood pressure guidelines for commercial drivers. Each time you turn the key, you are responsible for your own safety, as well as the safety of. The driver fitness basic addresses the requirements within the federal motor carrier. Genesis physicians are certified to perform all testing in regulation with department of transportation dot and. The use of ps form 2485 for dot medical exams, which the union considered invasive, is no longer required. If you pass the dot physical, your dot physical provider will fill out the medical examiners certificate and give you a copy.
Csa and your company us department of transportation. Dot withdraws rule to set sleep apnea screening criteria for. A medical evaluation summary completed only by either a board qualified or board certified physiatrist doctor of physical medicine or orthopedic surgeon will be accepted. 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 drivers medical examiners certificate, form mcsa5876, as well as on the medical examination report form, mcsa5875. A cdl physical is the medical exam required to obtain your commercial drivers license. Safety fitness determination notice of proposed rulemaking.
Visit us at the miami dot exams for appointments and physical exam with our dotcertified doctor. Ny cdl medical certification requirements dot medical examiner. In order to meet the physical requirements for a dot medical certification, its important to disclose any medical problems you may be experiencing, including sleep apnea. Driver s information driver completes this section. Dec 17, 2019 driver medical fitness for duty drivers are critical to highway safety. A person is physically qualified to drive a commercial motor. For more information, email us or call 605 7736883. Also known as the dot physical, the point of the physical is to determine your fitness to perform your job. Form search results west virginia department of transportation. A letter pdf from the department of transportation. Medical examination report for commercial driver fitness. Applicants seeking a commercial drivers license or renewing or transferring their cdl will be required to provide proof of medical certification under a federal law that takes effect at the end of january 2012. Dot medical examination formscertificate download dot.
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject. Driver s information driver completes this section date of exam m recertification m d y driver s name last, first, middle social security no. Driver must carry certificate when operating a commercial vehicle. Commercial vehiclescdl iowa department of transportation. A drivers guide to the dot physical urine dipstick test. Federal motor carrier safety administration fmcsa skill. Effective september 30, 2003, the federal motor carrier safety administration fmcsa published revised blood pressure guidelines that medical examiners may follow for the evaluation, certification, and followup testing of commercial drivers when performing department of transportation dot physical examinations pursuant to 49 cfr part 391. If you need these templates, you can visit our website and. A department of transportation dot physical examination must be conducted by a licensed medical examiner listed on the federal motor carrier safety administration fmcsa national registry. Firsttime applicants must use the unified registration system urs. Dot withdraws rule to set sleep apnea screening criteria. When performing a commercial motor vehicle driver medical. I have read and understand the dot guidelines pertaining to diabetic disease as described above.
The department of transportation dot physical exam is the default for commercial drivers who are examined in. Incomplete or illegible certificates will be returned and must be resubmitted. When the medical examiners certificate expires, the medical status will change from certified to notcertified. Please mail the selfcertification form and medical certificate if. Medical examination report for commercial driver fitness determination 649f 6045 1. Dsms results are only available to enforcement officials for examining commercial motor vehicle. Ps form 2485 is no longer used for cdl medical cards. A medical examination form for commercial driver fitness determination will not be accepted or returned to you. Medical examination report mer form, mcsa5875 fmcsa. Your practitioner will complete your medical examination report for commercial driver fitness determination form, provide a summary, a receipt and a medical examiners certificate, as.
What are the dot physical requirements for people with sleep apnea. Drivers information driver must complete this section. Medical certification department of transportation. For commercial motor vehicle cmv drivers, the most important safety feature is you the driver. Most operators of commercial motor vehicles cmv must have a commercial drivers license cdl. What are the dot physical requirements for people with sleep. Florida school bus operators medical examination report.
Medical examination report, dotcertified miami, fl. After december 12, 2015, mcs150 and opseries forms can only be used to update company records or apply for additional authorities, not for initial registration with fmcsa. For more information about urs, or to apply for the first time, click here. Fmcsa driver fitness basic fmcsacsa us department of. To obtain a cdl, the applicant must provide a valid medical examination report for commercial driver fitness determination and medical examiners certificate medical report and medical examiners certificate, pass applicable vision and. The federal motor carrier safety administration requires that interstate commercial motor vehicle drivers maintain a current medical examiners certificate mec, form mcsa5876 to drive. A medical examiner on the national registry will need to complete the fmcsa medical examination report for commercial driver fitness determination as well as the certificate at the end of the packet.
Our website offers some different templates, for example, dot physical form, and medical examination report for commercial driver fitness determination. It will remain valid in the system for two years from the date of issuance, unless you have a medical condition that requires more frequent examination. Listed below are some areas that will be evaluated during the exam, along with qualification criteria. 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. Dot physical queens new york city dot medical examiner. As discussed in the dot cdl physical examination page on this website, 49cfr part 391. A medical examiners certificate signed by a health care professional, pursuant to 390. Dot medical exam and commercial motor vehicle certification about the exam.
What are the dot physical requirements for people with. Has a gross vehicle weight rating or gross combination weight rating, or gross vehicle weight or gross combination weight, of. Dot withdraws rule to set sleep apnea screening criteria for truckers. Walk out with a completed medical examination report for commercial driver fitness determination and a medical examiners certificate. The commercial motor vehicle driver medical examination aafp. Visit us at the miami dot exams for appointments and physical exam with our dot certified doctor. Indiana clpcdl holder must maintain on file a valid medal examinationmedical examiners certificate. Commercial drivers license program improvement grant maintenance of expenditure sample 2. The department of motor vehicles is authorized to issue the medical certificate form dl 51b, pursuant to 28.
Each time you turn the key, you are responsible for your own safety, as well as the safety of all the people who share the road with you. Commercial driver license medical eligibility california. Qualification to drive a commercial vehicle requires the driver to complete a department of transportation dot medical exam. Examination report for commercial driver fitness determination along with the medical examiners certificate. Dsms results are only available to enforcement officials for examining commercial motor vehicle driver performance as part of csa investigations.
Faxing the certificate to the office of driver services at. Dot physical forms printable fill out and sign printable pdf. Commercial drivers have an increased propensity for the development of. Iowa department of transportation office of driver services p. You must still provide your employer with the medical examination report for commercial driver fitness determination long form. Driver fitness determination exam dot product documentation. The driver fitness behavior analysis and safety improvement category basic is one of seven categories that the federal motor carrier safety administration fmcsa uses to determine how a motor carrier ranks relative to other.
415 886 509 298 982 714 981 1358 436 1305 1131 864 397 1437 751 468 1184 289 1420 48 1553 1426 62 1402 1397 1275 575 993 854 21 837 1437 1514 1008 952 641 9 909 571 351 278 109 518 964 311 487