For commercial motor vehicle (CMV) drivers, the most imperative security peculiarity is YOU – the driver! Everytime you turn the key, you are in charge of your own security, and the well-being of all individuals who share the road with you. The CDL physical examination has been put in place to ensure that you are sufficiently meet the DOT physical requirements to operate a commercial vehicle, and safely perform the rigorous job of a commercial driver.

Today, we’ll be going over some of the important fundamentals of the DOT medical exam, and what to expect during this process. This examination is very important, and you won’t be able to pursue any work until you have successfully completed this part.

About DOT Medical Exam

The Department of Transportation (DOT) medical examination must be led by an authorized “medical inspector” listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry. The term incorporates, however is not restricted to, specialists of medicine (MD), specialist doctors of osteopathy (DO), physician assistant (PA), advanced practice nurses (APN), and specialist doctors of chiropractic (DC).

Go through this link to get a listing of DOT medical examiner that are approved by the FMCSA to perform DOT physical exams:

National Registry of Certified Medical Examiners

A DOT physical test is applicable for up to 24 months. The medical inspector might issue a medical analyst’s endorsement for less than 24 months when it’s important to monitor a condition more frequently, for example – hypertension.


If by any chance the medical analyst finds that the individual he/she inspected is physically competent to drive a commercial motor vehicle (CMV), the DOT medical examiner will furnish one duplicate of the results to the individual who was analyzed and complete a Medical Examiner’s Certificate.

Driver Exemption Programs


The Federal Diabetes and Vision Exemption Programs have certain prerequisites for every application. Medical tests, vocation history, driving background and motor vehicle records must be submitted with the application. The Agency will settle on a conclusion within 180 days of acknowledgement of the completed application.

Seeking an Exemption

An individual may request an exclusion from the diabetes and vision standard, segment 391.41(b)(3) and 391.41(b)(10) of the regulation, by using these programs. If for any reason, you don’t meet the diabetes and/or vision standard, and are not able to receive the DOT medical card, you may apply for exemption.

It’s important to note that all exclusion programs are for drivers looking to operate commercial motor vehicles (CMVs) in interstate trade. FMCSA does not have statutory power to allow waivers/exemptions to drivers from states’ intrastate necessities. Consequently, the FMCSA waivers/exclusions don’t allow administrative alleviation for drivers who plan to confine their operations to intrastate trade.

Diabetes Package

Vision Package

Interstate Commerce

Interstate Commerce is the involvement of transportation, traffic, or trade crossing the state boundary. To be considered as interstate carrier, cargo, passengers, or vehicle should cross a state boundary or should have the intent of crossing a state boundary. Within a single state, intrastate commerce is transportation, traffic, or trade.

What determines interstate commerce is the manifested character movement by the shipper’s persistent and fixed intent and is ascertained from all of the circumstances and facts that surround the transportation. The commercial motor vehicle (CMV) and the driver are subject to Federal Motor Carrier when the intent of the transportation that is being conducted is interstate in nature, even if the route is just within the boundaries of a single state.

DOT Medical Safety Regulations

Exemption programs are specifically designed for those drivers of CMVs who intend to operate in the United States in interstate commerce. The Federal Motor Carrier Safety Regulations define the U.S.A. as the District of Columbia and the fifty states.

About the SPE Program

The SPE (Skill Performance Evaluation) program is specifically designed for CMV drivers who tend to drive in interstate commerce. If drivers are wearing the adequate prosthetic device and can show their capability to drive safely by completing off and on-road activities, this program’s certification permits drivers who suffer from impaired or missing limbs to drive CMVs across the lines of states. A driver receives SPE certificate if he or she passes the driving test. FMCSA has already granted more than 3,000 SPE certificates over the years to truck drivers who have passed this test. This test showcases that they can drive safely on the country’s highways.

SPE Certificates

Any driver who has physical impairments, such missing limbs, leg, foot, finger, hand, arm, or etc., are required to obtain SPE certificates.

  1. New Driver Application Package
  2. Renewal Package


Frequently Asked Questions About Driver Medical Requirements

1. How can a limp-impaired Canadian show officials his or her ability to drive a commercial motor vehicle?

A limb-impaired Canadian driver can demonstrate to enforcement officials with his or her valid Canadian commercial driver’s license (with the adequate class for the vehicle that is being operated) their ability to drive a CMV in accordance with the NSC.

2. In order to drive in the United States, may a Canadian driver apply for an SPE?

The Medical fitness requirements of Canada must be met in order for Canadian drivers to be permitted to drive in the U.S.A.; this is due to the reciprocity agreement between Canada and the United States. Canadian drivers who do not meet the medical provisions that are found in the National Safety Code of Canada but have some sort of waiver by a Canadian province or territory will not be qualified to operate commercial motor vehicles in the U.S.A. Both countries agreed on this particular matter in order for our roads to be safer. According to the National Safety Code, a driver must utilize his/her prosthesis while demonstrating his or her ability in an on-road test. The National Safety Code has not been adapted by all Canadian provinces. When entering the United States, if the driver is not utilizing his or her prosthesis, this driver won’t be able to operate in this country.

In order to drive in the United States, a Canadian driver is not required to apply for a Skill Performance Evaluation certificate. In order to show proof of medical fitness to drive, all that is required is a commercial driver’s license that is valid and issued by a Canadian territory or province. Canadian drivers who are required to utilize their prosthesis must wear them while operating a commercial motor vehicle in the United States. If a Canadian driver opts to not utilize prosthesis when entering the United States, he or she won’t be qualified to operate in this particular nation.

3. May one utilize foreign medical certificate if operating a commercial motor vehicle in the U.S.A but residing outside of it?

If you are a current resident of Canada or Mexico, then the answer to this question is ‘yes.’ Drivers who are certified to drive in Canada are also certified to drive in the U.S.A., providing they meet all requirements in the United States. For drivers who are Mexican, the medical test is part of the Licencia Federal. It is not required for Mexican drivers to have a separate document that regard to medical certifying.

A medical certificate is no longer required for commercial motor vehicle operators who are traveling from Canada or Mexico as long as they have been issued a commercial driver’s license that is valid and issued by the Mexican Licencia Federal or a Canadian Province. Proof of medical fitness to drive in the U.S.A. is the driver’s medical exam which is also part of a driver’s license process. However, Mexican and Canadian drivers who are vision-and-hearing impaired, have epilepsy, or who are insulin-using diabetics are not qualified to drive commercial motor vehicles in the U.S.A. Furthermore, drivers who are Canadian and who do not meet the medical fitness requirements that are established in the Canadian National Safety Code for Motor Carriers but who have been granted a waiver by a Canadian territory or province are not permitted to drive commercial motor vehicles in the U.S.A. Similarly, drivers who are Mexican and who do not meet the medical fitness requirements that are established in the Licencia Federal de Conductor but who have been granted a waiver by the Licencia Federal de Conductor are not permitted to drive commercial motor vehicles in the U.S.A.

4. Is CPR certificate required for commercial motor drivers?

No, commercial motor drivers do not have to have a CPR certificate, as there is no regulation that requires it at the moment.

5. Can a driving record affect an individual’s eligibility to attain a medical certificate?

No, a driving record cannot affect someone’s eligibility for a medical certificate.

6. What medicines disqualify a commercial motor driver?

A driver is not permitted to intake a controlled prescription medication or substance without having a prescription for it from a licensed physician.

If a driver opts to utilize a narcotic, amphetamine, or any other drug that is known for forming habits, the driver is medically unqualified.

An exception exists for those who take medication: a physician can write a statement that states that the driver is safe to operate while taking prescribed medication. If this happens, the Medical Examiner is the one who will decide if the driver will be certified or not.

Any medication that is anti-seizure that is utilized to prevent seizures is disqualifying.

Methadone usage is disqualifying.

The Medical Examiner utilizes two ways in order to determine if a medication might negatively affect a driver’s operation of a commercial motor vehicle:

  1. Review each medicine that is supplement, non-prescription, and prescription
  2. Request a letter from the physician who prescribed medication

7. May one still be able to attain a medical certificate if medical condition is currently being treated by a certified physician?

As previously mentioned, the Medical Examiner is the one who makes the decision. The Medical Examiner may certainly request information about the condition of a driver by contacting his or her physician. Usually, certification is granted if the driver is not suffering from a condition, receives treatment that impairs a safe drive, or takes medication.

8. If a medical certificate of someone who is currently suffering from a medical condition that developed after receiving it is still valid, is this individual prohibited from operating a commercial moving vehicle?

The regulations of the FMCSA prohibit that a driver operates a commercial vehicle if his or her alertness and/or ability is impaired by illness, fatigue, or any other cause that makes it unsafe to continue to drive.

It doesn’t matter if the driver has a valid medical certificate, as the he or she is still prohibited from driving a commercial motor vehicle if the medical condition is disqualifying or interferes with safe operation of a commercial motor vehicle. When a medical condition that is disqualifying is resolved, the driver must obtain re-certification from a Medical Examiner.

9. Is medical evaluation accessible by employer?

The medical Examiner is not required by the FMCSRs to grant a copy of a Medical Examination Report to an employer, but that doesn’t mean that they are not able to obtain copies of it, as the FMCSA does not prohibit this action. If the employer wants to obtain a copy of the medical examination form, the Medical Examiners first has to have a release form signed by the driver.

Applicable State and Federal laws that regard to the maintenance and privacy of employee medical information must be followed by employers. To attain more information on the provisions of the Standards for Privacy of individually Identifiable Health Information, which is mandated by the Health Insurance Portability & Accountability Act of 1996, one can get in touch with the United States Department of Health & Human Services at the Office of Civil Rights. One can contact them by dialing 1-866-627-7748.

10. Are all CMV drivers in the United States required to attain a medical certificate?

Yes. In general, a medical certification from a Medical Examiner must be attained by every commercial motor vehicle driver who drives in interstate commerce in the United States. Commercial motor drivers from Mexico and Canada may be medically qualified in their respective country.

11. What medical conditions may disqualify a commercial truck or bus driver?

The driver of the truck is required to be medically qualified to secure the load, do post and pre trip safety inspections, drive safely, and to make sure that the load does not shift. Demands are different for bus drivers.

The specific medically disqualifying conditions that are found under regulation are insulin use, epilepsy, vision loss, and hearing loss.

Drivers who require a vision or diabetes exemption to safely drive a commercial motor vehicle are disqualified until they receive such exemption.

Medical Applications and Forms

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