Saying that the number of certified medical examiners is insufficient, the Owner-Operator Independent Drivers Assn. has called on the Federal Motor Carrier Safety Administration to delay the requirement that beginning May 21 medical exams must be conducted by a medical examiner listed on the National Registry of Certified Medical Examiners. In a petition for direct rulemaking, OOIDA asked that for now drivers be allowed to obtain medical certification from individuals who are either certified under the new rules or qualified under current regulations. A direct rulemaking is a mechanism that allows an agency to issue a final rule without following the formal rulemaking process if it finds that those procedures are impractical or unnecessary.
“OOIDA is concerned that, as a result of the shortage of registered examiners, some drivers will not be able to become recertified before their current certification expires, thereby disrupting their employability and business opportunities,” the group said in its petition. Drivers who can find an examiner on the registry and make an appointment “will face much greater costs and burdens in doing so than contemplated by” the final regulation, it said.
The 10,223 number of registered medical examiners as of March 28, 2014 “is little more than half of those that would be needed under FMCSA’s most optimistic (although unsupported by the record) estimate that 20,000 would be a sufficient number of medical examiners to perform all of the examinations required by the regulated community,” OOIDA said in its petition.
Based on the assumption that 2.6 million annual examinations are needed, the average examiner would need to perform 130 certifications per year – far more than FMCSA’s expectations in the record for average medical examiner performance, OOIDA said. “The 10,223 number falls dramatically short of the 40,000 number of medical examiners FMCSA embraced in both the NPRM and the Final Rule.” A more conservative estimate suggests that as many as 70,000 medical examiners could be needed, the group said.
The consequences of this situation justify immediate action, OOIDA argued. Many drivers won’t be able to find registered examiners to certify them before their prior certification expires. Other drivers will face burdens such as having to travel further to find an examiner, and the true availability of medical examiners is not accurately reported by a simple review of FMCSA registry data – especially in areas where the numbers are sparse, OOIDA said.
“There are also instances where examiners are putting additional conditions on CDL holders before they will give them a certification appointment – including requiring the CDL holder to make that examiner their primary care physician and transfer all medical files to him or her,” OOIDA told FMCSA. Another concern is that due to scarcity examiners might raise their prices.
In response to OOIDA’s petition, FMCSA said it is “closely monitoring the growing list and locations of certified medical examiners to ensure that an adequate number are registered by the May 21 deadline.” The agency says more than 13,000 medical professionals have passed the exam to be added to the registry. In addition, 4,200 more are scheduled to take the test, and another 19,600 have signed up to start the process, FMCSA said. “There are certified examiners in every state, and dozens or hundreds in most cities.” FMCSA also emphasized that most drivers will not need a new physical exam immediately following the May deadline as certificates remain valid until the expiration date.
The American Trucking Associations supports the national registry as a way to ensure that all drivers are medically qualified. "However, we are concerned with the relatively slow pace at which medical professionals are being certified by FMCSA to be listed on the registry, as well as the geographic dispersion of certified examiners,” ATA said in response to the OOIDA petition. “We continue to work with FMCSA and our state association partners to identify underserved areas and we encourage FMCSA to be flexible in addressing any shortcomings."
A group representing small trucking companies praised OOIDA’s request for a delay of the May 21 deadline. “It’s a much larger problem for trucking than anyone knows,” said David Owen, president of the National Assn. of Small Trucking Companies. “The registry won’t treat rural-based long-haul trucking companies very well.” The sheer number of registered examiners is just one issue; the distribution of those examiners is critical, he said.
Also, NASTC says that the registry requirement is driving an increase in some medical practitioners at the expense of “true doctors,” Owen said. “We need to push back the implementation date and know more about the type of professionals joining the registry.”
Owen is concerned, for example, that a substantial proportion of the registered professionals are affiliated with sleep clinics or are otherwise not as qualified as they should be to make medical judgments. “They will send every male over 50 with a neck size of more than 15.75 inches for a sleep study,” Owen said, referring to literature he says FMCSA continues to distribute even though Congress has ordered the agency to rescind regulatory guidance on sleep apnea.
