Changes to Driver Vision Qualification Standards

On January 21, 2022, the Federal Motor Carrier Safety Administration (FMCSA) published the Qualifications of Drivers; Vision Standard final rule, allowing individuals who do not satisfy, with the worse eye, either the existing distant visual acuity standard with corrective lenses or the field of vision standard, or both, to be physically qualified to operate a commercial motor vehicle without obtaining an exemption from FMCSA (87 FR 3390).

The new alternative vision standard eliminates the need for a Federal vision exemption program and allows certified medical examiners, in consultation with an ophthalmologist or optometrist and utilizing the new Vision Evaluation Report, Form MCSA-5871, to evaluate and determine whether to grant a Medical Examiner’s Certificate (MEC), Form MCSA-5876, for up to one year. Final Rule Effective Date: On March 22, 2022, the rule becomes effective, and medical examiners must begin to apply the provisions adopted in the final rule. All provisions are discussed further in the final rule located on FMCSA’s website at

The Vision Evaluation Report, Form MCSA-5871, is also effective on this date and will be available on FMCSA’s website at

Medical Examination Forms: Based on the adoption of the final rule, FMCSA has determined that the Federal vision exemption program is no longer necessary. As of March 22, 2022, medical examiners should not mark the box for accompanied by a Federal vision waiver/exemption on the Medical Examination Report (MER) Form, MCSA-5875, or the Medical Examiner’s Certificate (MEC), Form MCSA-5876. On and after March 22, 2022, any individual who might have been physically qualified by a vision exemption issued by FMCSA will have to be qualified by a medical examiner under the provisions adopted in the final rule. All individuals certified under the new alternative vision standard must provide the medical examiner with a Vision Evaluation Report, Form MCSA-5871, that has been signed and dated by an ophthalmologist or optometrist not more than 45 days before the physical qualification examination begins.

The medical examiner considers the information provided by the ophthalmologist or optometrist, but the final qualification decision rests with the medical examiner. Medical examiners may qualify these individuals for up to one year and a copy of the Vision Evaluation Report, Form MCSA-5871, must be treated and retained as part of the MER Form for three years.

Federal Vision Exemptions: As of January 21, 2022, FMCSA stopped accepting applications for new exemptions or renewal of previously granted exemptions under the Federal vision exemption program. Individuals holding exemptions in effect on March 22, 2022, have until March 22, 2023 to be medically certified under the alternative vision standard, at which time all MECs issued with vision exemptions will become void. FMCSA will notify exemption holders, applicants, and grandfathered drivers by letter with details of the transition to the new standard.

Grandfathered Drivers: The final rule eliminates 49 CFR 391.64(b), commonly known as the grandfather provision for drivers operating under the previous vision waiver study program, on March 22, 2023. Medical examiners may continue to physically qualify individuals under section 391.64(b) until this time. However, individuals physically qualified under section 391.64(b) have until March 22, 2023 to be medically certified under the alternative standard, at which time all MECs issued under 391.64(b) will become void.

Webinars: FMCSA has posted a webinar on the FMCSA website for medical examiners learn more about the new alternative vision standard and their responsibilities in applying it to certification of individual with monocular vision. The webinar can be found at

Update Regarding Periodic Training Issued by FMCSA

The following update regarding the periodic training delay was issued by the Federal Motor Carrier Safety Administration on 2/20/2020.

Dear Medical Examiner:

Certified Medical Examiners (MEs) listed on the National Registry must complete periodic training every five (5) years under 49 CFR 390.111(a)(5)(i) to maintain their National Registry certification to conduct examinations of interstate CMV drivers. The periodic training will be provided by FMCSA and will only be available to certified ME’s through their National Registry account. However, due to unexpected delays, the training is still not yet available. FMCSA will notify MEs once the training becomes available, and will ensure that all MEs required to complete the training have ample time to do so. In addition, FMCSA will not take action against affected MEs for noncompliance with the regulations for not completing the training within the five-year timeframe.

Note: Training from other third-party training organizations does not meet the regulatory requirement for periodic training, and FMCSA does not provide continuing education units for completing the periodic training.

If you have questions, please contact the National Registry at 202-366-4001 or This email address is being protected from spambots. You need JavaScript enabled to view it..


Charles A. Horan, III
Director, Office of Carrier, Driver and Vehicle Safety Standards

Insulin Treated Diabetes Mellitus 2019 Update

On September 19, 2018, Federal Motor Carrier Safety Administration (FMCSA) published the Qualification of Drivers; Diabetes Standard final rule adopting a revised physical qualification standard for operators of commercial motor vehicles (CMVs) with insulin-treated diabetes mellitus (ITDM) (83 FR 47486). The revised standard lifts the blanket prohibition on insulin use and provides that Certified Medical Examiners may evaluate and determine, with input from the treating clinician, whether to issue a Medical Examiner's Certificate, MCSA-5876, to qualify the driver to operate a commercial motor vehicle in interstate commerce. The effective date of this final rule is November 19, 2018.

In light of the final rule, FMCSA has determined that an exemption program for ITDM individuals is no longer necessary. The Agency intends to publish a Federal Register notice to withdraw the 2003 final disposition (68 FR 52441) and the 2005 revised final disposition (70 FR 67777) notices concerning the decision to issue exemptions to certain ITDM individuals. Once published, FMCSA will send notification to all Certified Medical Examiners.

FMCSA encourages all certified medical examiners to familiarize themselves with the revised rule and begin medical certification of ITDM individuals under the new rule. Please note that the final rule stated that the Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 is posted on the FMCSA and National Registry websites. In addition, FMCSA will conduct webinars for Certified Medical Examiners to provide an overview of the final rule. The pre-recorded webinar is currently available at the following link:

The NRCME Training Online program and spiral bound study guide book have been updated to reflect changes in the 2019 Diabetes Standards.

The new Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 can be downloaded here:


National Registry of Certified Medical Examiners Remains Offline



The Federal Motor Carrier Safety Administration’s (FMCSA) website used by medical providers to obtain their certification as a NRCME medical examiner is down indefinitely according to a press release from the FMCSA.

“The National Registry of Certified Medical Examiners website is currently down,” the website said. “FMCSA IT Support is aware of the issue and is working on a solution to remedy the situation. Once the site returns to service, a notification will be sent to all certified medical examiners. We suggest drivers and carriers continue to visit the site periodically to determine availability.”

The FMCSA’s National Registry of Certified Medical Examiners online system was hacked that prompted its outage. Concerns about the vulnerability of drivers’ and examiners’ data were raised. The FMCSA on January 9 ensured that the data was protected, and apparently, nothing sensitive was stolen. We will post an update when the NRCME website returns to functionality. In the mean time continue to check for updates on the national registry website located at:

Don't miss our latest NRCME Training updates! Connect with us.

Instagram NRCMEtraining Facebook-icon Twitter-icon Linked-In-icon