Audit Finds Flaws in FMCSA Monitoring of Drivers’ Medical Qualifications

Man getting medical checkup
The IG audit said that a seven-month registry outage, which began in December 2017, resulted in driver examination reports not being entered, creating “data-quality issues, including missing records." (Portra/Getty Images)

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A Department of Transportation Inspector General audit has found weaknesses in federal regulators’ monitoring of medical examiner qualifications and ensuring that truck drivers meet physical qualification standards to safely operate commercial vehicles.

“The Federal Motor Carrier Safety Administration’s ability to oversee whether drivers meet physical qualification standards to safely operate a commercial vehicle is limited because of a lengthy outage of the [Medical Examiners] National Registry and a resulting backlog of driver examination reports that were not entered into the Registry,” said the IG’s audit results, made public Jan. 15. “Furthermore, FMCSA has not fully implemented requirements for random periodic monitoring of medical examiners’ eligibility and performance.”

The IG audit said that a seven-month registry outage, which began in December 2017, resulted in driver examination reports not being entered, creating “data-quality issues, including missing records,” and weaknesses associated with the accuracy and completeness of data that “limit the effectiveness of FMCSA’s oversight.”



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“Because of the outage and technical issues in relaunching the National Registry, we estimate that approximately 780,000 driver examinations could be missing from the database,” the audit said. “FMCSA is building a new National Registry, but it is unclear when it will be complete.”

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The audit also said, “Our analysis of National Registry data indicated that 46% of its 70,208 records of certified medical examiners as of May 2019 had outdated medical license information. Additionally, our analysis of two separate samples totaling 452 driver examinations from three state driver’s licensing agencies we visited found that 21% were not recorded in the National Registry.”

The examiner registry first went live in May 2014.

Physicians and other eligible medical professionals must register to begin the certification process to perform driver examinations. Medical examiner requirements include being licensed in the state in which they will conduct the examinations, meeting training requirements and passing the required test.

A DOT physical exam for truck drivers is valid for up to two years. The medical examiner also may issue a medical examiner’s certificate for less than 24 months when it is desirable to monitor a condition, such as high blood pressure.

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“Of critical importance, certified medical examiners must submit to the National Registry reports of the results of driver examinations they perform and the medical certificates they issue to qualified drivers,” the audit said.

The audit noted that FMCSA has conducted initial certification reviews of medical examiners’ eligibility qualifications, but the agency is not yet conducting annual eligibility audits after initial certification.

“Without these oversight reviews, FMCSA may be missing fraud indicators or other risks that may require mitigation and has less assurance that drivers are physically qualified to safely operate a commercial vehicle,” according to the audit.

Identifying and preventing medical certificate fraud remains a key safety concern, the IG said.

Since August 2014, Office of Inspector General investigations have resulted in 14 convictions involving fraudulent medical certifications.

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Notably, in August 2017, a medical examiner in Georgia was charged with falsification of records, and more than 600 drivers were required to renew their medical certificates. Additionally, in January 2019, a medical examiner in Alabama was sentenced to more than three years in prison and fined $10,000, and two employees were collectively sentenced to five years of probation for their role in a scheme to submit falsified driver examinations to the National Registry. As a result, FMCSA required that more than 2,100 drivers renew their medical certificates.

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In its response to the audit, FMCSA said the agency’s current interim Registry system provides only partial functionality.

“A fully functional National Registry is a priority under the FMCSA IT Modernization Plan. FMCSA plans to award a contract to rebuild the National Registry in the second quarter of fiscal-year 2021,” the agency said.

The agency also said it concurred with the IG’s audit recommendations for improvement. It plans to address some of the technical recommendations by March 31, completing all of the recommendations by June 30, 2023.

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