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Medical Examination Guidelines Summary

Medical Examination Report Form - Page 3

Record the physical examination and certification status on the third page of the Medical Examination Report form.

Physical Examination


The physical examination should be as thorough as described in the Medical Examination Report form, at a minimum. Note any abnormal finding, including the safety implication, even if not disqualifying. Inform the driver of any abnormal findings and as needed advise the driver to obtain follow-up evaluation.

Physical examination may indicate the need for additional evaluation and/or tests. Specialists, such as cardiologists and endocrinologists, may perform additional medical evaluation, but it is the medical examiner who decides if the driver is medically qualified to drive. Document the certification decision, including the rationale for any decision that does not concur with the recommendations.

Follow the links in the table for more information on the physical examination requirements.

Vision (b)(10)

Musculoskeletal (b)(1)(2)(7)

Hearing (b)(11)

Diabetes Mellitus (b)(3)

High Blood Pressure/Hypertension (b)(6)

Other Diseases (b)(9)

Psychological Disorders

Cardiovascular (b)(4)

Respiratory (b)(5)

Drug Abuse and Alcoholism (b)(12)(13)

Neurological (b)(7)(8)(9)

Medications/Drug Use (b)(12)

Certification Status: Document the certification decision in the space provided for certification status. There are two possible outcomes: the driver is certified and issued a medical examiner's certificate or the driver is disqualified and is not issued a medical examiner's certificate.

  • Certify the driver
    • The driver meets all the standards — The maximum length of time a driver can be medically certified is 2 years. The driver who must wear corrective lenses, a hearing aid, or have a Skill Performance Evaluation certificate may be certified for up to 2 years when there are no other conditions that require periodic monitoring.
    • The driver meets the standards but has a condition that requires frequent monitoring (and certification) — Certify for less than 2 years as needed to monitor continued medical fitness for duty. Federal exemptions and some Federal Motor Carrier Safety Administration guidelines specify annual medical examinations.
  • Disqualify the driver
    • The driver does not meet the standards — Do not issue a medical examiner's certificate.
    • Discuss the disqualification decision with the driver, including what the driver can do to meet the Federal qualification requirements for commercial drivers.

Certification and recertification occur only when the medical examiner determines that the driver is medically fit for duty in accordance with Federal qualification requirements for commercial drivers.

Medical Examiner's Certificate

Provide the medical examiner's certificate to the qualified driver. Ensure that the date entered is the date of the physical examination. The expiration date should be consistent with the Medical Examination Report form certification status and cannot exceed 2 years from the date of the examination. The driver must sign the medical examiner's certificate. The certificate expires at midnight on the date of expiration. There is no grace period.

The driver must carry a valid medical examiner's certificate when operating a commercial vehicle. The motor carrier is also required to maintain a copy of the medical examiner's certificate.

The certificate can be the original or a photocopy, and can be reduced in size (usually wallet-sized). Lamination is prohibited in some States.


49 CFR 391.43 REGULATION AMENDMENT 73 FR 73127, Dec. 1, 2008

There are now two paragraphs in 49 CFR 391.43(g).

(g)(1) If the medical examiner finds that the person examined is physically qualified to operate a commercial motor vehicle in accordance with §391.41(b), the medical examiner should complete a certificate in the form prescribed in paragraph (h) of this section and furnish the original to the person who was examined. The examiner may provide a copy to a prospective or current employing motor carrier who requests it.

(g)(2) For all drivers examined, the medical examiner should retain a copy of the Medical Examination Report at least 3 years from the date of the examination. If the driver was certified as physically qualified, then the medical examiner should also retain the medical certificate as well for at least 3 years from the date the certificate was issued.

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