By Max Lebow, MD, MPH, FACEP, FACPM, Medical Director, Reliant Immediate Care Medical Group, Inc.
In my practice, a common scenario is a phone call from one of our Medical Examiners (ME) with a commercial driver in the exam room, asking for advice on whether to use Determination Pending (DP) or Short-Term Certification (STC). Here is my short answer.
- Use Determination Pending – when additional information is required.
- Use Short-Term Certification – when additional treatment is required, but the driver is qualified today.
- In both DP and STC, the driver must be safe to drive a CMV. If not, the decision is to disqualify, not to temporize or compromise with either of the options above.
While it is easy to state this difference, circumstances are often nuanced to blur the differentiation. A quick review of DP versus STC may be helpful.
Determination Pending
Determination Pending, first appearing as an option on form Medical Examination Report Form 5875 in 2016, serves three purposes. First, it replaced temporary certifications often used for hypertension, and it avoided charts held in informal limbo without final action. Finally, DP makes FMCSA aware when a CMV driver has been examined, even if no formal decision is made, and alerts them when multiple exams are performed, as in doctor shopping.
At its heart, Determination Pending is a delay in the certification decision, allowing the examination to remain open for up to 45 days. DP’s most common features include:
- DP allows the original examination to remain open for up to 45 days without a certification decision – so when the driver returns, a new physical exam is not required but may be performed at the discretion of the ME.
- DP is not a temporary certification – it is no decision – so a driver may not operate a CMV during the 45 days unless the driver has an existing valid certificate.
- The driver may not operate a CMV on a DP – it does not extend a current driver certification – If the driver’s current certificate expires during the 45-day DP, the driver must stop driving upon expiration.
- DP must be amended (updated) on or before the 45-day expiration date – at expiration, the exam becomes invalid, and a new exam must be initiated if the driver returns outside the 45-day window.
- If certification is granted, the new expiration date is the date of Determination – not the original exam date.
- Each DP requires a new examination and Form 5875 – no more than one DP per exam, although there is no prohibition of a new exam, resulting in another DP.
Short-Term Certification
There are some situations when a Short-Term Certification may be appropriate. Some features of STC:
- STC length is up to the discretion of the ME for up to 2 years – while the checkbox options are defined lengths of time, the ME has full discretion to choose any certification length, theoretically down to one day.
- STC is used when a driver is fully medically qualified to operate a CMV – but has a medical condition that, if left unaddressed, may result in the driver becoming disqualified. For example, poorly controlled hypertension.
- STC invalidates all previous certifications and expiration dates – the most recent certification decision always takes precedence over any prior decision. If a new STC expires in 30 days, that is the new termination date, regardless of previous certifications.
- Multiple STCs may be used consecutively – however, the ME should examine the underlying condition that would require such an approach to determine if the driver is genuinely safe.
As the medical examiner completes the Medical Examiner Determination on Form 5875, there are a number of decisions open. However, the most fundamental decision: Is the driver qualified to operate a CMV safely? For the options discussed above, both Determination Pending and Short-Term Certification, the answer must be yes. If that is not the case, then only one option is available – “Does not meet standards,” and the driver must be disqualified.
