Medical Certification of Drivers

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[accordion title=”Regulation Simplified – Medical Certifications of Drivers”]

We are a free tool for motor carriers. The information provided does not cover the full regulatory requirements. To view the full regulation go to “Quick Links” at the bottom of this page.

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[accordion-item title=”General Medical Certifications of Drivers”]

All commercial drivers are required to have a medical exam prior to operating a commercial motor vehicle in interstate commerce. This may include non CDL holders as well as CDL holders. Many states have adopted the federal regulations and required intrastate drivers to have a medical card as well.  Check your state regulations to see if they require a medical card. This regulation is outlined at 49 CFR Part 391.


  • Interstate commerce: The driver is crossing state lines to deliver the freight, freight originated or is destined for another state per information on bill of lading, a load is picked up at a port or a rail yard. This may include an empty truck if it is operating in commerce picking up or just dropping off a load that meets the definitions of interstate commerce.
  • Intrastate commerce: The driver is staying within the state, not crossing state lines.

What are the regulations regarding a driver medical certification?

A Department of Transportation (DOT) physical examination must be conducted by a licensed “medical examiner” listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry. 

A DOT physical exam is valid for up to 24 months. The medical examiner may also issue a medical examiner’s certificate for less than 24 months when it is desirable to monitor a condition, such as high blood pressure.

The medical card is not required to be kept on file by the motor carrier like it once was.

Motor carriers must now keep a copy of the motor vehicle report (driver abstract) which verifies:

  • The driver is self-certified
  • Medical examiner name
  • Expiration date of the medical card
  • The medical examiners registry number

Not all states provide this information on the MVR ( however, they will have a work around if you contact them)

Drivers must submit their medical card to the state after each renewal.  See “State Regulatory Agency Links” and “Medical Certificate Submission” to see if drivers can submit online.

Beginning January 15th, 2015, drivers are required to carry their medical card with them for 15 days after it was issued.  Same with CDL permit holders.

Beginning June 22, 2021 drivers are no longer required to carry a medical card. Same for CDL permit holders.

Motor carriers are required within 15 days to pull a new MVR to verify the medical card has been renewed and submitted by the driver.


[accordion-item title=”Skill Performance Evaluation Program & Exception Letters”]

What is a SPE certificate or medical exception letter?

The Skill Performance Evaluation program is for CMV drivers who drive in interstate commerce. The SPE certification allows drivers with missing or impaired limbs to drive CMVs across state lines if they have been fitted with (and are wearing) the right prosthetic device, and the driver can demonstrate the ability to drive the truck safely by completing on-and off-road activities. If the driver passes the driving test, he or she will receive a SPE certificate.

Drivers with physical impairments including diabetes, high blood pressure, seizures, and vision issues that can affect their ability to safely operate CMVs according to their medical examiners are required to obtain SPE certificates or exception letter from the FMCSA.

Drivers that qualify must carry a copy of the exception letter or SPE certificate when on duty.

FMCSA application to apply to New Driver Application Packet for SPE

FMCSA renewal application to apply for a renewal of a Driver SPE.

Additional Exceptions – Diabetes, Hearing, Seizure, Vision


[accordion-item title=”Recordkeeping Requirements”]

See “Driver Qualification Files


[accordion-item title=”Tips from Industry Professionals”]

Tips from industry professionals.

  • Put an alert system in place to notify drivers at 90, 60, 30 and one week before their medical card expires.
  • Remind drivers that they are responsible for filing their medical card with the state. See “State Agency” for how the driver can complete this.


[accordion-item title=”Quick Links”]

Medical Certification Regulations – 49 CFR Part 391

Medical Qualification Regulations – Interpretations

Driver Medical Fitness Requirements 

Medical Examiner Registry

Medical Exceptions, Evaluations, and Forms 


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