Commercial Motor Vehicle Drivers
Mercy Urgent Care has Department of Transportation certified examiners at all its locations. Using 3bExam, an electronic version of the DOT form, our examiners are able to provide an accurate and complete form and medical card that meets FMCSA regulations.
“The mission of the FMCSA Medical Program Division is to promote the safety of America’s roadways through the promulgation and implementation of medical regulations, guidelines and policies that ensure commercial motor vehicle drivers engaged in interstate commerce are physically qualified to do so.” -Federal Motor Carrier Safety Administration (FMCSA)
Below are the acknowledgements and release statements drivers are asked to sign prior to the exam:
- I understand that deliberate omissions and inaccurate, false or misleading information invalidate the examination and medical examiner’s certificate, (examiner will enter ‘incomplete’ or ‘does not meet standards’).
- I understand that FMCSA relies on the medical examiner’s clinical judgment to decide whether additional information should be obtained from the driver’s treating physician(s). If asked for additional information or testing, I will respectfully comply with the request.
- I certify that I will speak respectfully to all providers and staff at Mercy Urgent Care. Use of foul language, attempts to intimidate and attempts to manipulate are considered inappropriate conduct and Mercy Urgent Care will reserve the right to dismiss me from their clinics.
- I understand I may obtain a second opinion with another provider at another facility but in doing so will honestly disclose all my medical information.
- I understand that payment is due to Mercy Urgent Care for services rendered (performing the exam and evaluation) regardless of whether I pass the exam or not.
- I consent to the release of my medical form, any attachments and the medical card to my employer.
- I have reviewed the information below and understand it is not an exhaustive list of conditions or requirements.
Below are common conditions with general requirements Mercy Urgent Care providers will request based on federal regulations:
- Providing the listed documentation does not guarantee a passed exam
- Providers may require additional documentation not listed below
- Results of AIC blood test within last 3 months
- List of medicines (name and dosages)
- If on insulin, the healthcare professional who manages, and prescribes insulin for the treatment of the individual’s diabetes, provides the ITDM Assessment Form, MCSA-5870, to the certified ME indicating that the individual maintains a stable insulin regimen and proper control of his or her diabetes
High blood pressure
- List of medicines (name and dosages)
- Well controlled BP on day of exam
Sleep Apnea or using CPAP machine
- Letter from a sleep specialist stating a study was performed and treatment not required
- If treatment with a CPAP is required, a printed CPAP compliance report from the last 3 months prior to the exam. Must meet FMCSA guidelines for adequate usage
Heart conditions, surgeries or prior heart attack
- Depending on the heart condition, there may be a waiting period of 1-3 months
- ECG within last 1 year
- Echocardiogram after event and in some cases, every 2 years
- Exercise stress test every 2 years
- List of medications (names and dosages)
- Letter from cardiologist stating you have been evaluated and are stable to operate a CMV
- Printed INR results for the past 3 months
- Reason you are on Coumadin and a statement that the condition is stable
Taking opioids or controlled medication
- Letter from the prescribing doctor stating the medication will not impair your ability to drive a commercial motor vehicle. (This is at the Examiner’s discretion. Certain medicines and dosages may still not pass)
The following will typically result in a failed exam. Please ask for details.
- Implanted defibrillator—not allowed
- Certain heart conditions or procedures less than 1-3 months before exam
- Stroke within one year of exam
- Some seizure disorders
- Uncorrected hearing loss (depends on severity)
- Uncorrected vision loss (depends on severity)
- And many other conditions