Determination Pending – The DOT CME Most Misunderstood Standard

Max Lebow, MD, MPH, FACOEM, FACEP

Case Report:

A 51-year-old commercial driver presents to the clinic for his biannual commercial driver physical exam. His expiration date fell on Sunday, but he presented two days early, on Friday for his exam.

Results of Exam – The driver met all standards, except for his visual acuity of 20/60 in both eyes, with corrections. The examiner discussed the issue with the driver, informing him that he needed to see his optometrist for a new exam and a stronger glasses prescription.

The examiner placed the patient on a Determination Pending (DP), telling him that he must return before the DP expiration to complete the visual acuity portion of his exam. Otherwise, his DP would expire, and he could not drive.

On review of this case, the Medical Director informed the examiner that he had made two errors.  

Can you see why the chart did not comply with FMCSA commercial driver standards?

Discussion:

Determination Pending first appeared as an option on Medical Examination Report Form 5875 in 2016. Despite an FAQ published by FMCSA one year later, Determination Pending still causes confusion for many Certified Medical Examiners.

Fortunately, the 2024 Medical Examiners Handbook has clarified the FMCSA position on Determination Pending (Handbook pages 20, 100, 108-109).  Here is a review of their explanation.

Proper use of Determination Pending requires an understanding of the following principles:

Principle #1

Determination Pending alone does not permit a driver to operate a commercial vehicle. There must be an underlying valid and unexpired driver certification in force for a driver to operate a commercial vehicle.

Principle #2

Once a new DOT physical exam is performed, this new exam supersedes all previous exams. So if a driver fails the new physical exam, she/he cannot continue to drive on the older certification, even if it has not yet expired. The new exam voids all previous exams – with one exception – see #3.

Principle #3

Determination Pending is the one exception to Principle #2 that allows an older certification to remain active despite a new exam. However, if the older certification expires during a Determination Pending period, the driver must stop driving unless the DP can be resolved before the expiration of the old certification. Note that the start date of the newer exam is when the Determination Pending is resolved, NOT the date of the original new exam, thus leaving a gap if the old certification expires during a DP period.

With an understanding of the three principles above, let’s examine the case report again.

There are two reasons why the determination pending was used improperly in the case report.

First, when the driver failed his vision test, he was no longer qualified to drive a commercial vehicle. The proper course is to disqualify the driver. The driver may not be put on Determination Pending or Short-Term Certification if she/he fails a nondiscretionary requirement and no exemption is available, such as failure of visual acuity bilaterally or Grade 3 Hypertension.

The second reason this exam failed audit was because Determination Pending was used inappropriately: The driver only had three days left on his current certification. Even under the best circumstances, the Determination Pending would have allowed commercial driving only until the old certification expired, or three days in this case. The examiner must know the expiration date of the old certificate if DP is used. If only a few days are left on the old certificate, then Short Term Certification is usually a better option – although not appropriate in this case.

For further information and an explanation of DP, please consult the 2024 Medical Examiners Handbook for additional information.

As always, reach out if you have any questions.

Max Lebow, MD

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