How FMCSA’s SMS Changes Will Impact MEs

How FMCSA’s New Safety Measurement System (SMS) Changes Will Impact Certified Medical Examiners

The Federal Motor Carrier Safety Administration (FMCSA) is rolling out major changes to its Safety Measurement System (SMS), and while these updates are primarily aimed at motor carriers and drivers, Certified Medical Examiners (CMEs) should be paying close attention. These SMS revisions will reshape how driver responsibility is evaluated, potentially influencing how CMEs assess and document a driver’s medical fitness.

What Are the New SMS Changes?

The FMCSA is replacing the current seven BASICs (Behavior Analysis and Safety Improvement Categories) with six new Compliance Categories. These updates are designed to provide a clearer picture of safety violations and who is responsible for them—especially drivers.

Key changes include:

• The “Controlled Substances and Alcohol” category will be merged into “Unsafe Driving”.
• All Out-of-Service (OOS) violations will now fall under the “Unsafe Driving” umbrella.
• The Vehicle Maintenance category will now separate violations into a new category called “Vehicle Maintenance: Driver Observed.”
• The violation severity scoring system will change from a 1–10 scale to a two-tiered scale:

1. Severity 2 = OOS violations and disqualifying events
2. Severity 1 = All other violations

These changes may seem administrative, but they have real implications for CMEs.

Why CMEs Should Pay Attention

While Certified Medical Examiners are not directly responsible for interpreting CSA data or SMS scores, the changes in how violations are attributed—especially those categorized as “driver observed”—will likely affect how the industry views a driver’s fitness for duty. Here’s how:

1. Pre-Trip Inspections and Driver Fitness

Violations that could have been identified during a pre-trip inspection will now be tied directly to the driver. This increases pressure on CMEs to ensure that:

1. The driver has the physical capability (mobility, dexterity, vision, and cognitive function) to perform thorough inspections.
2. Any conditions that may impair these abilities are properly assessed and documented.

2. Hiring and Safety Evaluations

The Pre-Employment Screening Program (PSP) will begin to reflect these driver-responsible violations. Drivers flagged for neglecting vehicle inspections or unsafe driving may have difficulty securing employment—even if they were recently certified as medically fit.

This places increased importance on the accuracy and thoroughness of medical certifications issued by CMEs. Employers may also begin to scrutinize the medical certification process if discrepancies emerge between driver performance and medical evaluations.

3. Greater Emphasis on Documentation

FMCSA’s emphasis on individual accountability may lead to more audits and legal scrutiny of the certification process. CMEs should ensure that all medical determinations are:

• Based strictly on FMCSA medical standards
• Supported by detailed clinical documentation
• Justified with clear rationale, especially in borderline cases

Be Prepared for What’s Ahead

As FMCSA modernizes how driver safety is measured and enforced, Certified Medical Examiners are becoming even more vital to the integrity of the commercial driving industry. These new SMS changes make it clear: medical examiners must be proactive, precise, and well-informed when certifying drivers.

Now is the time to refresh your knowledge, sharpen your documentation practices, and ensure you’re fully aligned with FMCSA expectations.

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