The National Registry of Medical Examiners has been plagued with problems since its rollout in 2014, and the Federal Motor Carrier Safety Administration has done a poor job of oversight, according to a review by the Department of Transportation’s Office of Inspector General.

FMCSA regulations require commercial motor vehicle drivers to obtain a valid medical certificate, and since May of 2014, those were required to be done by qualified health professionals listed on the National Registry of Certified Medical Examiners.

In February 2019, the DOT IG announced the audit, saying it was prompted by a spate of fraudulent activity. The agency pointed out that since August 2014, its own criminal investigations had resulted in eight indictments and six convictions resulting from fraud in the medical certification process. It cited an August 2017 indictment of a medical examiner in Georgia resulted in more than 600 truck operators having to renew their FMCSA medical certifications.

Even before that, in 2016, an Atlanta chiropracter was charged with falsifying documents, resulting in more than 6,000 drivers having to get new exams.

In this new report, the IG’s office concluded that FMCSA’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 National Registry and a resulting backlog of driver examination reports that were not entered into the Registry.

An unsuccessful attempt to hack the database in late 2017 resulted in the website going down. Drivers weren’t able to access it until late the following June, and in August, it was still not back to full functionality. (Not surprisingly, the FMCSA is now working on a new national registry.)

In addition, the IG report said that weaknesses in the accuracy and completeness of data in the National Registry limit the effectiveness of FMCSA’s oversight.

Furthermore, it said, FMCSA has not fully implemented requirements for random periodic monitoring of medical examiners’ eligibility and performance. While FMCSA has conducted initial certification reviews of medical examiners’ eligibility qualifications, 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.”

The report noted that its audit occurred during a transition period while the FMCSA is working to design and deploy a new National Registry. FMCSA agreed with the IG’s four recommendations to improve its oversight once it deploys the new website. Those recommendations are:

• Implement agency plans for eliminating the backlog of driver examination results held by medical examiners.

• Develop a plan to allocate resources to the Medical Programs Division to fully implement requirements for medical examiner eligibility audits and random selection performance monitoring.

• Update agency processes for conducting periodic medical examiner eligibility audits and random selection performance monitoring as needed to incorporate upgraded National Registry tools.

• Reinstate the conduct of eligibility audits and random selection performance monitoring of medical examiners.

The Medical Examiner Registry’s Bumpy Roll-Out

The program was slow to get examiners certified and on the registry, with both the American Trucking Associations and the Owner-Operator Independent Drivers association (who rarely agree on anything) both asking the agency to delay the implementation. However, the agency went ahead as planned.

Two years later, in 2016, the American Transportation Research Institute reported that the registry was not fixing the problems fleets and drivers have had with the DOT exam process, and may have made them worse.

That study, done in conjunction with the Mayo Clinic, found “a polarity in the quality of medical examiners,” with more than a quarter of drivers reporting exams taking 20 minutes or less, with some examiners, particularly chiropractors, skipping parts of the exams.

In 2018, the FMCSA had to delay several provisions of a rule that was supposed to electronically integrate the paperwork into a digital registry that included state licensing agencies, citing challenges with IT programming. That rule is supposed to take effect this coming June.