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Federal Register / Vol. 86, No. 127 / Wednesday, July 7, 2021 / Rules and Regulations
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lnstrucdonr MCSA-S87S

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Meets standards, but periodic monitoring Is required: Select this option when a driver Is detennined to be qualified but needs periodic monitoring and provide an explanation of why periodic monitoring is required. Select the corresponding tme frame that the driver is qualified for, and ifselectfng nother" specify the time frarne.
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Determination pending: Selec.t this option when more information is needed to make a qualification decision and specify a date, on or before the 45 day expiration date, for the driver to return. to the medlcal exam office for follow-up. lhis will allow for a delay of the qualification decision for as many as 45 days. If the disposition oflhe pending examination is not updated via the National Registry on or before the 45 day expiration date, FMCSA will notify the examining medical examiner and the driver in writing that the examination is no longer valid and thatthe driver fsrequfred to be re,examined.
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Incomplete examination: Select this when the physical examination is not completed for any reason e.g., c:lriver decides they do nc>t want to continue with the examination and leaves other than situations outlined under determination pending.
Medical Examiner information, signature and date: Provide your name, address, phone number, occupation, license, certificate, or registration number and issuing state, national registry number;
signature and date.
Medi.cal Examiners Certificate Expiration Date: Enter the date the drivers Medical Examiners Certificate MEC expires;

Medical Examiner Determination State: Use this .section for examinations performed in accordance with the FMCSRs 49 CFR 391 AE391.49 with any applicable State variances which wrn only .be valid for intrastate operations. Complete the medical examiner determination section to.rnpletely, 0

VerDate Sep<11>2014

MERamended: A Medical Examination Report Form MER, MCSA-5875, may only be amended while in determination pending status for situations where new information e.g., test results, etc. has been received or there has been a change in the drivers medical status since the initial examination; but prior to a final qualification determination. Select this option when a Medical Examination Report Form, MCSAa5875, is being amended; provide the reason for the amendment, signand date. In addition, initial and date any changes made on the Medical Examination RE!port Form, MCSA-5875. A Medical Examination Report Form, MCSA-5875, cannot be .amended after an examination has been indetermination pending status tor more than 45 days or after a final qualification determination has been.made. The driver is required to obtain a new physical examination and a new Medical Examination Report Form, IIICSA-5875, should be completed.

Does not .meet standards In 49 CFR 391.41 with any applicable State variances! Select this option when a dr.iver is determined to be not qualified and provide a.n explanation of why the driver does:notmeet the standards in 49 CFR 391,41 with any applicable State variances.
Meets standards In 49Cfll391.41 with any appUcableStatevarlances: Select this.option when a driver is determined to be qualified and will be issued a2-year Medical Examiners certificate.

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Determination that driv.er meets standards: Select. all categories that apply to the drivers certification e.g., wearing corrective lenses, accompanied by a waiver/exemption, driving within an exempt intracity tone, etc..