Updates to the Federal Motor Carriers Safety Administration Regulations

Effective January 30, 2012 the FMCSA changed the medical regulations for drivers who hold a DOT/Commercial Driver’s Licenses.  The information provided will help prepare you for your next CDL/DOT medical physical, and to understand the latest requirements that must be met.

Who can perform a DOT PHYSICAL?

A DOT Physical exam must be conducted by a licensed “Medical Examiner” listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.  Those who may have had their primary care providers perform their DOT physical in the past, must now ensure that their PCPs are registered with the FMCSA.  If a DOT Physical has been performed by a provider that is not a registered “medical examiner” with the FMCSA, the physical will be null and void.  Therefore, the driver will not have a valid medical card. 

To find a list of medical examiners that are certified by the FMCSA to perform DOT physical exams, please visit:  https://nationalregistry.fmcsa.dot.gov/NRPublicUI/Driversseam.  The providers at MedAccess Urgent Care, PLLC are certified medical examiners by the FMCSA.

How long is my medical examiner’s certificate valid?

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.

What are the latest updates regarding FMCSA regulations pertaining to DOT/CDL exam?

  1. Loss of foot, leg, hand or arm - Driver will be medically disqualified unless a waiver has been obtained from the regional director of motor carriers.
  2. Impairments of hand or lower extremity – Any significant limb defect that interferes with the ability to perform tasks associated with operating a motor vehicle will disqualify the driver unless a waiver has been obtained.
  3. Insulin-controlled Diabetes- A driver taking insulin cannot be certified for interstate driving.  However, a driver who has diabetes that is controlled by oral medications and diet, may be qualified if the disease is well controlled and the driver is under medical supervision.
  4. Cardiovascular Disease – Any condition known to be accompanied by sudden and unexpected syncope, collapse or congestive heart failure is disqualifying.  Conditions such as Myocardial Infarction (heart attack), angina and cardiac dysrhythmias should be evaluated by a cardiologist before certification is issued.
  5. Respiratory Dysfunction – If a driver has clear symptoms of significant pulmonary disease, basic spirometry (PFT) and lung volume tests will be required.  This same rule applies to drivers who have a history of smoking and are over the age of 35.
  6. Sleep Apnea – Any driver with diagnosed sleep apnea must present a report to the Medical Examiner at time of examination. 
  7. Hypertension – Driver blood pressure must be 140/90 mm Hg or lower to obtain a full 2 year certification.  If blood pressure is higher than 160/90mm Hg but lower than 180/105mm Hg, temporary certification may be granted for 3 months to allow time for the driver to be evaluated and treated.

If you are a driver, that has any of the previously discussed medical problems and are under a physician’s supervision, you MUST present documentation at time your Physical is performed.  Examples of documentation are listed below:

  1. Loss of limb – You must present a waiver from FMSCA stating that you are cleared to drive.
  2. Non-insulin dependent Diabetes– If you take oral medications, or if your diabetes is controlled by diet, you will need to present documentation from your primary care physician/endocrinologist stating:
    1. You have a treatment plan to manage your diabetes without the use of insulin.  Also have an updated medication list available.
    2. You have no signs or symptoms of peripheral neuropathy.
    3. Proof that your blood glucose levels are acceptable.  You must present lab results from your last A1c level (must be within last 12 months).
    4. Results from an Eye examination.
    5. Your PCP must state that your diabetes and diabetic medication does not interfere with safe driving.
  3. Cardiovascular Disease- You will need to present documentation from your Cardiologist that you are safe to drive a CMV if you have had any of the following:
    1. Angioplasty with coronary stent placement
    2. Myocardial Infarction (Heart Attack)

                     i.     Your cardiologist must make note that your current condition and medication regimen does not interfere with driving a CMV.

                     ii.     Will need to present the medical examiner with results of most recent Exercise Tolerance Test (ETT).

  1. Respiratory Dysfunction- You may be required to have spirometry (PFT), or a lung capacity test, if: 
    1. The medical examiner has any questions on your respiratory history
    2.  You are over the age of 35 and smoke.


  1. Sleep Apnea – Must present with a report containing
    1.  90 days of data from C-PAP machine. (Contact the provider who services your C-PAP machine to find out how to obtain this report.)
    2. Report of most recent sleep study.
  2. Hypertension – Blood pressure must be 140/90mm Hg or less to possibly obtain a 24 month certificate. 

Any documentation presented must state that your medical status and current medications (if any) are not likely to interfere with your ability to drive or operate and Commercial Motor Vehicle.


An individual may apply for an exemption from the diabetes and vision standard, section 391.41(b)(3) and 391.41(b)(10) of the regulation, by utilizing these programs. If you do not currently meet the diabetes and/or vision standard and are unable to obtain a medical card, you may be an eligible candidate.


Please note that all exemption programs are for drivers who intend to operate commercial motor vehicles (CMVs) in interstate commerce. FMCSA does not have statutory authority to grant waivers/exemptions to drivers from states' intrastate requirements. Therefore, the FMCSA waivers/exemptions do not permit regulatory relief for drivers who plan to limit their operations to intrastate commerce

- See more at: http://www.fmcsa.dot.gov/medical/driver-medical-requirements/driver-exemption-programs#sthash.UrB1Dlw1.dpuf


Diabetes Exemption Application


Vision Package


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