Critical Updates to 49 CFR 391.49-SPE Certificate Program: What Certified Medical Examiners Need to Know!
On November 18, 2024, FMCSA published the attached technical amendment final rule that amends 49 CFR 391.49(d)(3)(i)(B) and (d)(3)(ii)(C) to clarify the meaning and effect of the current requirement that individuals with upper limb loss or impairment must be capable of demonstrating precision prehension and power grasp prehension to be eligible for a skill performance evaluation (SPE) certificate issued by FMCSA. The amendments clarify that a functioning hand is necessary to demonstrate precision prehension and power grasp prehension and that a prosthesis is required if the applicant does not have a hand. The amendments also clarify when an applicant has upper limb impairment that a prosthesis or orthotic device is required if the applicant is not capable of demonstrating precision prehension and power grasp prehension with each hand separately without a prosthesis or orthotic device.
Specifically, paragraphs (B) (for limb loss) and (C) (for limb impairment) relating to the statements made by the physiatrists and orthopedic surgeons in the medical evaluation summary have been amended to read as follows:
(B) A statement by the examiner that the applicant is capable of demonstrating precision prehension (e.g., grasping and manipulating knobs and switches using the fingers/thumb) and power grasp prehension (e.g., grasping, holding, and maneuvering the steering wheel using a hand) with each hand separately. Prior to applying for an SPE certificate, an applicant with loss of a hand or arm must be fitted and proficient with a proper prosthesis that enables the applicant to demonstrate precision prehension and power grasp prehension with each hand separately. This requirement does not apply to an individual who was granted a waiver, absent a prosthetic device, prior to January 6, 1986, the effective date of the requirement.
(C) A statement by the examiner that the applicant is capable of demonstrating precision prehension (e.g., grasping and manipulating knobs and switches using the fingers/thumb) and power grasp prehension (e.g., grasping, holding, and maneuvering the steering wheel using a hand) with each hand separately. Prior to applying for an SPE certificate, an applicant with upper limb impairment must be fitted and proficient with a proper prosthesis or orthotic device, if the applicant is not capable of demonstrating precision prehension and power grasp prehension with each hand separately without a prosthesis or orthotic device. This requirement does not apply to an individual who was granted a waiver, absent an orthotic device, prior to January 6, 1986, the effective date of the requirement.
In addition to the attached technical amendment final rule, FMCSA has also attached information outlining prevalent issues present when MEs are documenting evaluation outcomes of limb loss and impairment under 49 CFR 391.41(b)(1) and (2) during the physical qualification examination. These errors require FMCSA to void the examinations and require the drivers to obtain a new examination. FMCSA requests that all MEs review this information closely to ensure that examinations are recorded in accordance with the Federal Motor Carrier Safety Regulations.
Alternative Physical Qualification Standards for the Loss or Impairment of Limbs
