Free Oregon Dot Card For Cdl PDF Form

Free Oregon Dot Card For Cdl PDF Form

The Oregon DOT Card for CDL, formally known as the CDL Medical Examiner’s Certificate, is a crucial document that is filled out exclusively by licensed medical examiners. This certificate confirms that a commercial driver has been examined in accordance with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49) and meets the necessary medical standards to operate a commercial vehicle. It indicates whether a driver is qualified under various conditions, such as using corrective lenses, having a Skill Performance Evaluation Certificate (SPE), or being granted a specific exemption or waiver, ensuring the safety and compliance of drivers within Oregon.

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The Oregon DOT Card for CDL, formally known as the Commercial Driver's License (CDL) Medical Examiner's Certificate, is a critical document for commercial drivers in Oregon. Issued upon the successful completion of a medical examination, this certificate is proof that a driver meets the stringent health standards dictated by the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49). The examination must be conducted by a licensed medical examiner, including a wide range of healthcare professionals like MDs, DOs, chiropractors, and advanced practice nurses, among others. It assesses a driver's physical ability to safely operate commercial vehicles, taking into account their overall health and any conditions that may require the use of corrective lenses, hearing aids, or entail restrictions such as driving only within exempt intracity zones or carrying a Skill Performance Evaluation (SPE) Certificate for physical impairments. There's a stringent warning against fraudulent use of this certificate, emphasizing its legal importance. Additionally, the form details conditions under which drivers may still qualify to drive through the use of exemptions or waivers, particularly for those with vision, diabetes, seizure, hearing conditions, or physical impairments, and outlines specific submission instructions for drivers to follow post-examination. This document not only ensures the safety of the driver but also the well-being of the general public by mandating health requisites for operating large or potentially hazardous vehicles.

Document Example

CDL MEDICAL EXAMINER’S

CERTIFICATE

Completed by Licensed Medical Examiner Only!

Fraudulent use is punishable under applicable

State and Federal laws

(For Oregon Licensed Drivers Only)

MEDICAL EXAMINER’S CERTIFICATE

I certify I have examined __________________________________________________ in accordance with the Federal

Motor Carrier Safety Regulations (49 CFR 391.41-391.49) and with knowledge of the driving duties, I find this person is

qualified; and, if applicable, only when:

 

 

 

Wearing corrective lenses

 

Driving within an exempt intracity zone (49 CFR 391.62)

 

 

 

Wearing hearing aid

 

Accompanied by a Skill Performance Evaluation Certificate (SPE)

 

 

 

Accompanied by a ________ waiver/exemption

 

Qualified by operation of 49 CFR 391.64

 

 

The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly, and is on file in my office.

SIGNATURE OF MEDICAL EXAMINER

 

 

 

 

 

TELEPHONE

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL EXAMINER’S NAME (PRINT)

 

 

 

 

 

 

 

 

MD

 

 

 

 

DO

 

 

Chiropractor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physician

 

 

Naturopath

 

Advance Practice

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Assistant

 

 

 

 

 

Nurse

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL EXAMINER’S LICENSE OR CERTIFICATE NO./ISSUING STATE

 

NATIONAL REGISTRY NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF DRIVER

INTRASTATE ONLY

CDL

 

 

 

DRIVER’S LICENSE NO.

STATE

 

 

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS OF DRIVER

MEDICAL CERTIFICATE EXPIRATION DATE

Notes for Examiner:

Instructions for Medical Examiner:

1.Complete examination in accordance with regulations.

2.Enter all information except signatures and print.

3.Sign the form and either submit to DMV using one of the options below or give it to the patient to submit to DMV.

4.You should also complete a medical examiner's certificate for retention of the driver and motor carrier, as you have in the past.

Instructions for Driver:

After completion by your examiner, submit this entire form to DMV, using one of the options below.

Submission Options:

Mail: DMV Driver Safety

CDL Medical Certification

1905 Lana Ave NE

Salem, OR 97314

Fax: 503.945.5329

E-mail: DSMEC@odot.state.or.us

1.Please ensure you have positively identified the patient by checking the driver license or commercial driver license before conducting the examination and entering the driver’s name, license number and state on the certificate.

2.“Driving within an exempt intracity zone” is not applicable in Oregon.

3.Only a very small number (< 10) of drivers are “qualified by operation of 49 CFR 391.64 in Oregon. If your patient was a participant in this 1990s waiver pilot program, he/she should be able to present documentary evidence of that participation.

4.If the patient is not medically qualified under 49 CFR 391.43, he or she may qualify through issuance of a waiver/ exemption or a skill performance evaluation (SPE). Oregon waivers are valid for intrastate commerce only while FMCSA waivers/exemptions/SPEs are valid for both interstate and intrastate commerce.

a.Waivers or exemptions may be available from FMCSA for vision, diabetic, seizure or hearing conditions. Check “Accompanied by a _____________ waiver/exemption” on the Medical Examiner’s Certificate, filling in the blank with “vision,” “diabetes,” “hearing” or “seizure” and have the patient call 503.399.5775.

b.A Skill Performance Evaluation Certificate may be available from FMCSA for loss/impairment of limbs. Check “Accompanied by a Skill Performance Evaluation Certificate (SPE)” and have the patient call 503.399.5775.

c.An Oregon waiver may be available for vision, insulin dependent diabetes mellitus, limb impairments or amputation, hearing or seizure/seizure disorder. This waiver permits operation of a commercial vehicle in intrastate commerce only. Check “Accompanied by a _____________ waiver/exemption” on the Medical Examiner’s Certificate, filling in the blank with “vision,” “diabetes,” “limb,” “hearing” or “seizure” and have the patient call 503.945.0891.

5.Expiration date may not be more than 2 years after date of examination. If, for instance, the examination was completed on March 15, 2012, the expiration date may be no later than March 15, 2014.

735-7375 (2-13)

File Features

Fact Detail
Purpose Ensures CDL drivers meet Federal Motor Carrier Safety Regulations physical standards
Applicability For Oregon Licensed Drivers Only
Governing Law Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49)
Punishment for Fraudulent Use Punishable under applicable State and Federal laws
Medical Examiner Qualifications Must be a licensed Medical Examiner (MD, DO, Chiropractor, Physician, Naturopath, Advance Practice Nurse, Assistant)
Waiver/Exemption Types Available for vision, diabetic, seizure or hearing conditions via FMCSA; Oregon waivers for intrastate commerce only
Certificate Validity Expiration date may not be more than 2 years after date of examination

Oregon Dot Card For Cdl: Usage Guide

Filling out the Oregon DOT Card for CDL accurately is essential for drivers who need to comply with medical requirements. This document ensures that individuals are medically fit to operate commercial vehicles safely. Completing this form involves providing detailed information about the medical examination conducted by a licensed medical examiner. To ensure the process goes smoothly, both the driver and the medical examiner need to be aware of their respective roles and the steps they must follow.

Steps for the Medical Examiner:

  1. Verify the driver's identity using their driver license or commercial driver license before starting the examination.
  2. Conduct the examination following the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49), ensuring all required health standards are met.
  3. If necessary, indicate on the Medical Examiner’s Certificate if the driver is qualified only when wearing corrective lenses, a hearing aid, or is accompanied by a Skill Performance Evaluation Certificate (SPE) or a specific waiver/exemption.
  4. Fill in all sections of the Certificate with the information obtained during the examination, except for the signatures. This includes the driver's name, license number, address, and the medical certificate expiration date, which should not exceed two years from the examination date.
  5. Sign the Medical Examiner’s Certificate and note the medical license or certificate number/issuing state, along with the National Registry number.
  6. Provide the completed form to the driver or submit directly to the DMV using the options provided (mail, fax, or email).
  7. Also, complete a medical examiner’s certificate for the driver and motor carrier’s retention, as done in the past.

Steps for the Driver:

  1. Ensure the Medical Examiner has all the information needed to fill out the certificate properly.
  2. Once the examination is complete and the form is filled out and signed by the Medical Examiner, gather any additional documents required, such as waivers or exemptions.
  3. Submit the entire form and any attachments to the DMV through mail, fax, or email as indicated on the form.
  4. Keep a copy of the submitted form and any correspondence or confirmation received from the DMV for your records.

By following these steps carefully, drivers can ensure that their Oregon DOT Card for CDL is correctly filled out and submitted. This organized approach helps in meeting the medical requirements needed to maintain or obtain a commercial driver's license.

Crucial Points on Oregon Dot Card For Cdl

What is the Oregon DOT Card for CDL?

The Oregon DOT Card for CDL, also known as the CDL Medical Examiner's Certificate, is a document that certifies a commercial driver is physically qualified to operate a commercial vehicle. It is completed by a licensed medical examiner who confirms the driver has passed a physical exam in accordance with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49). This certificate is a requirement for all Oregon licensed drivers who operate commercial vehicles.

Who can complete the CDL Medical Examiner's Certificate?

The certificate must be completed by a licensed medical examiner who is authorized to conduct physical examinations for commercial drivers. This includes:

  • Medical Doctors (MD)
  • Doctors of Osteopathy (DO)
  • Chiropractors
  • Physician Assistants
  • Advanced Practice Nurses
  • Naturopaths
The examiner must be familiar with the driver's duties and the requirements of the Federal Motor Carrier Safety Regulations.

How do I submit my Oregon DOT Card for CDL once it's completed?

After the medical examiner completes your examination and fills out the certificate, you have several options for submitting it to the DMV:

  1. Mail it to DMV Driver Safety CDL Medical Certification, 1905 Lana Ave NE, Salem, OR 97314.
  2. Fax it to 503.945.5329.
  3. Email it to DSMEC@odot.state.or.us.
Make sure the form is complete, including all necessary signatures, before submitting.

What conditions might require a waiver or exemption to qualify for a CDL Medical Certificate?

Some drivers may not meet the medical standards under 49 CFR 391.43 but could still qualify for a CDL by obtaining a waiver or exemption for certain conditions, such as:

  • Vision
  • Diabetic conditions
  • Seizure disorders
  • Hearing conditions
  • Physical impairments affecting limbs
Waivers or exemptions can come from both the Federal Motor Carrier Safety Administration (FMCSA) for interstate commerce, and specific Oregon waivers for intrastate commerce. Drivers needing such accommodations should follow the instructions on the CDL Medical Examiner’s Certificate to apply for the appropriate waiver or exemption.

How long is the Oregon DOT Card for CDL valid?

The expiration date of the medical certificate cannot be more than two years from the date of examination. For example, if your exam was completed on March 15, 2021, the latest your certificate could expire would be March 15, 2023. Drivers are responsible for ensuring their certificate remains valid and must undergo a new examination before the current one expires.

Can the "driving within an exempt intracity zone" condition apply in Oregon?

No, the "driving within an exempt intracity zone" condition mentioned on the Medical Examiner’s Certificate is not applicable in Oregon. This specific exemption allows some drivers to operate in certain areas without meeting all of the physical qualifications, but Oregon does not use this exemption.

Common mistakes

When filling out the Oregon DOT Card for CDL form, individuals often make mistakes that can lead to delays or complications in obtaining their commercial driver's license. Awareness and careful attention to detail can help avoid these common errors:

  1. Incorrect or Incomplete Personal Information: One of the most common mistakes is entering inaccurate personal information, such as an incorrect driver's license number, state, or failing to provide a complete address. Ensuring that all personal details are accurate and match those on your driver's license is crucial.

  2. Overlooking Required Signatures: Both the medical examiner and the driver must sign the form. Occasionally, individuals submit the form without one or both required signatures, which is essential for the form's validity. Double-checking that all signature fields are completed before submission can prevent this error.

  3. Not Specifying Applicable Waivers/Exemptions: If a driver is operating under a specific waiver or exemption, such as for vision, diabetes, or seizure conditions, it is necessary to check the appropriate box and specify the type of waiver or exemption. Failing to indicate these details can lead to misunderstandings about the driver’s qualifications.

  4. Misunderstanding Expiration Date Rules: The medical certificate's expiration date cannot exceed two years from the date of examination. Occasionally, individuals incorrectly calculate this date, leading to the submission of forms with invalid expiration dates. It is important to accurately compute and enter the correct expiration date to ensure compliance.

By paying close attention to these areas, drivers can improve the accuracy of their Oregon DOT Card for CDL submissions, facilitating a smoother process in maintaining or obtaining their commercial driving qualifications.

Documents used along the form

Securing a Commercial Driver's License (CDL) in Oregon calls for more than just passing a driving test. It demands a thorough understanding of both physical and legal requirements, one of which is the Oregon Department of Transportation (DOT) Card for CDL, also known as the CDL Medical Examiner’s Certificate. This crucial document verifies that a driver meets the necessary health standards to safely operate commercial vehicles. However, the Medical Examiner's Certificate is just a part of the puzzle. Several other forms and documents often accompany this certificate to ensure compliance with federal and state regulations.

  • Application for Commercial Driver License (CDL Application): This is the initial step in obtaining a CDN. The application gathers personal information, driving history, and specifies the type of commercial vehicles the applicant intends to drive.
  • Commercial Driver's License Skills Test Receipt: Before a CDL can be issued, applicants must pass a skills test specific to the commercial vehicle class they plan to operate. This receipt proves that the test has been completed and passed.
  • Medical Examination Report Form: This detailed form is filled out by the Medical Examiner alongside the DOT Card. It contains a comprehensive record of the physical examination, noting any conditions or limitations.
  • Self-Certification Affidavit: CDL holders must self-certify their type of vehicle operation with the DMV. This affidavit indicates whether they operate interstate or intrastate and if they are subject to or exempt from medical examinations.
  • Record of Duty Status: For drivers who operate vehicles in certain conditions, maintaining a log of hours worked and rest periods is mandatory to ensure they comply with the Hours of Service regulations.
  • Vehicle Inspection Report: Commercial vehicle drivers are required to inspect their vehicle before trips. The report identifies the vehicle inspected and any defects that were found and corrected.
  • Hazardous Materials Endorsement Background Check Application: Drivers who wish to transport hazardous materials must undergo a TSA background check and provide fingerprinting. This application initiates that process.

Together, these documents form a comprehensive portfolio that addresses health, safety, and legal compliance for commercial vehicle operations. While the Oregon DOT Card for CDL validates the health and physical readiness of a driver, the other documents ensure a holistic adherence to the regulations governing commercial driving. In navigating the CDL certification process, understanding and properly managing these documents can significantly ease the journey to becoming a certified commercial driver.

Similar forms

The Federal Motor Carrier Safety Administration (FMCSA) Medical Examination Report Form is quite similar to the Oregon DOT Card for CDL. Both documents are essential for commercial drivers to establish their physical fitness for duty. The FMCSA form is used nationwide and requires a thorough medical examination by a licensed healthcare professional, who certifies whether a driver meets the federal medical standards for operating commercial motor vehicles. Similar to the Oregon DOT Card, it includes sections for personal information, examination results, and the medical examiner's certification and signature.

The Commercial Driver's License (CDL) Self-Certification Form closely resembles the Oregon DOT Card for CDL in that it involves the driver's health status but focuses more on the driver's declaration regarding the type of commercial driving they intend to perform. Drivers must self-certify their driving type (interstate or intrastate and whether they are subject to or exempt from federal medical regulations), similar to how the Oregon form differentiates between standard qualifications and those drivers needing waivers or exemptions for certain medical conditions.

An Application for Military Skills Test Waiver is also similar due to its relation to CDL requirements, although it focuses specifically on waiving certain tests for military personnel based on their military driving experience. Like the Oregon DOT Card, it serves as a means to facilitate certain qualifications for a specific group, emphasizing the parallel goal of ensuring qualified individuals can legally drive commercial vehicles under particular conditions.

The CDL Hazardous Materials Endorsement Application shares a connection with the Oregon DOT Card by targeting a specific aspect of commercial driving. While the DOT Card assesses medical fitness, the Hazardous Materials Endorsement Application evaluates a driver’s eligibility to transport hazardous materials. Both require thorough background information and ultimately ensure that the commercial driver can safely operate under their designated conditions.

A Driver Qualification File Checklist, used by employers to ensure their drivers meet all regulatory requirements, shares similarities with the Oregon DOT Card as it often includes the medical certificate among its required documents. This checklist ensures all necessary paperwork, including proof of medical fitness for duty, is maintained in accordance with federal regulations, highlighting the importance of the medical certification in the broader context of driver qualification.

The Pre-Employment Screening Program (PSP) Report is somewhat similar in its aim to improve road safety. While it provides a history of a driver's crashes and inspections rather than medical fitness, like the Oregon DOT Card, it is a tool used to evaluate a driver's eligibility and suitability for safely operating commercial vehicles. Both forms are integral in the decision-making process for hiring and continuing the employment of commercial drivers.

The National Registry of Certified Medical Examiners (NRCME) Application mirrors the Oregon DOT Card in that it is part of the process ensuring that commercial vehicle drivers are evaluated by qualified medical professionals. The NRCME certifies examiners who are then eligible to conduct the medical exams required for the DOT Card, ensuring a standardized level of competency in evaluating driver fitness.

A Vision Exemption Form directly correlates with the Oregon DOT Card’s consideration for drivers needing waivers or exemptions due to specific medical conditions, such as vision impairment. This exemption allows drivers who don't meet the standard vision requirements to still qualify for a CDL, provided they pass certain tests and evaluations, similar to the process detailed for obtaining waivers through the Oregon DOT Card.

A Diabetes Exemption Form follows a similar vein, offering a pathway for drivers with insulin-treated diabetes mellitus to obtain certification to drive commercially. Like the Oregon DOT Card, it involves detailed documentation of the driver's condition and how it is managed, ensuring that the condition does not impair the driver’s ability to safely operate a commercial vehicle.

Lastly, the Skill Performance Evaluation (SPE) Certificate Application parallels the Oregon DOT Card by offering an accommodation, in this case for drivers with physical impairments. The SPE process allows drivers who may not meet all physical criteria under standard regulations to demonstrate their ability to safely drive a commercial vehicle through a skills test, similar to how the Oregon document allows for exemptions and waivers for certain conditions.

Dos and Don'ts

Filling out the Oregon DOT Card for CDL form correctly is essential for ensuring compliance with the Department of Transportation’s requirements. The process must be approached with care to avoid any potential issues that may arise from incorrect or incomplete information. Here are some do's and don'ts to consider when completing this form:

  • Do ensure that the medical examiner who completes your form is licensed and properly credentialed under the medical professional categories listed. This includes MD, DO, Chiropractor, Physician, Naturopath, Nurse, or Advanced Practice Assistant.
  • Do check that all the information provided on the form is accurate and thoroughly completed, including your name, CDL driver’s license number, and the state it is issued in.
  • Do verify the medical examiner’s certificate expiration date to ensure it is no more than 2 years from the date of examination.
  • Do not overlook any sections that require additional documentation if you have specific health conditions needing waivers or exemptions. These include vision, diabetes, hearing, or seizure conditions that may require an FMCSA waiver or an Oregon-specific waiver.
  • Do not submit the form without ensuring that the medical examiner has signed and dated the certificate. Their signature verifies that they have completed the examination following Federal Motor Carrier Safety Regulations.
  • Do not forget to keep a copy of the completed form for your records, as well as submitting the original form to the DMV via mail, fax, or email as indicated on the form.

Following these guidelines will help ensure that the Oregon DOT Card for CDL form is filled out correctly and submitted properly, facilitating compliance with regulations and supporting the maintenance of your commercial driving privileges.

Misconceptions

There are several misconceptions about the Oregon DOT Card for CDL form, which can lead to confusion among drivers and medical examiners. Clarifying these misconceptions is important for ensuring the process is handled correctly and efficiently. Here are nine common misconceptions and the facts that debunk them:

  1. All medical examiners can complete the form. Only licensed medical examiners with a certification from the National Registry of Certified Medical Examiners are authorized to complete the CDL Medical Examiner’s Certificate for Oregon drivers.

  2. The medical examination is standard and doesn't consider the driver's duties. The examination does take into account the specific driving duties in accordance with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49), ensuring the driver is fit for their particular role.

  3. The form is valid indefinitely. The Medical Examiner’s Certificate has an expiration date and may not be valid for more than two years from the date of the examination.

  4. All Oregon CDL drivers need to submit this form to the DMV. This requirement is specifically for Oregon-licensed drivers who must submit the completed form to the DMV for their records.

  5. Any condition disqualifies a driver. Drivers may still qualify by obtaining a waiver/exemption or a Skill Performance Evaluation Certificate (SPE) for certain conditions that would otherwise disqualify them.

  6. The form can be submitted in any manner by the medical examiner. The medical examiner must sign the form and either submit it to the DMV using specified methods or give it to the patient to submit to the DMV.

  7. Driving within an exempt intracity zone applies in Oregon. This exemption does not apply in Oregon, a fact that needs to be understood by both drivers and examiner

Key takeaways

Filling out and using the Oregon DOT Card for a Commercial Driver's License (CDL) requires understanding and attention to specific details to ensure the legal and safe operation of commercial vehicles within the state. Here are six key takeaways from the CDMC (CDL Medical Examiner's Certificate) process:

  • The CDL Medical Examiner's Certificate must be completed by a licensed medical examiner who is authorized and recognized under applicable state and federal laws. This includes professionals such as MDs, DOs, chiropractors, physicians, naturopaths, and advanced practice nurses.
  • It is crucial for the medical examiner to conduct the examination in strict accordance with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49), taking into full consideration the driver's specific driving duties and any pertinent health issues.
  • Drivers may only be qualified under specific conditions beyond the general health examination, such as the necessity to wear corrective lenses, use of a hearing aid, possession of a Skill Performance Evaluation (SPE) Certificate, or holding a specific waiver/exemption for conditions like vision, diabetes, hearing, or seizures.
  • The validity of the medical certificate is subject to an expiration date, which cannot extend more than two years from the date of the examination. This ensures that a driver's health condition is regularly verified as adequate for safe commercial vehicle operation.
  • Submission of the completed CDL Medical Examiner's Certificate to the Oregon DMV can be done via mail, fax, or email, offering multiple avenues for drivers to comply with state requirements efficiently.
  • It is imperative for medical examiners to accurately and completely fill out the examination form and any attachments, as the information provided forms the basis for determining a driver's medical qualification for holding a CDL in Oregon.

Understanding these key aspects of the Oregon DOT Card for CDL ensures that drivers, medical examiners, and regulatory bodies are aligned in their goal to maintain high safety standards on the roads while accommodating the health conditions and needs of commercial drivers.

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