Employers Report Of Medical Exam Failure-Request For Reexamination Of Driver {DS 524}

DS 524, EMPLOYER’S REPORT OF MEDICAL EXAM FAILURE/EMPLOYER REQUEST FOR REEXAMINATION OF DRIVER, California Vehicle Code (CVC) §14606(b) requires employers to report commercial class A or B drivers who fail to qualify for a medical certificate on reexamination to the Department of Motor Vehicles (DMV). CVC §13800 allows the DMV to investigate the qualifications of any driver when it appears necessary upon receiving information or upon a showing of its records. This form may be used to request the DMV to investigate the qualifications of any driver when a driver's condition or behavior may impair his or her ability to safely operate a motor vehicle. To have a driver's qualifications reevaluated by the department, please identify the driver by filling out the applicable driver information below and briefly describe the condition or actions of the driver which make you believe a reexamination by the department is necessary. This form may be used to report a commercial class A or B driver to the DMV when the driver fails to qualify for renewal of a medical certificate. www.FormsWorkflow.com