03 / MEDICAL CERTIFICATION AND FITNESS
Medical certification and fitness
Check whether medical certification is valid and whether a shorter examination interval applies. An unexpired certificate does not automatically authorize driving after a disqualifying injury or illness.
Check whether medical certification is valid and whether a shorter examination interval applies. An unexpired certificate does not automatically authorize driving after a disqualifying injury or illness.
For commercial drivers covered by the federal Part 391 medical qualification rules, subject to applicable exceptions. This guide does not decide individual fitness or medication safety, or treat the federal rules as the complete requirements for every California intrastate operation.
Start with these requirements
Use an eligible medical examiner
- What the rule requires
- The examination generally must be performed by a medical examiner on the National Registry. An eligible eye specialist may perform the visual portion; an eye examination alone is not the full medical qualification examination.
(a) (a) Except as provided by paragraph (b) of this section, the medical examination must be performed by a medical examiner listed on the National Registry of Certified Medical Examiners under subpart D of part 390 of this chapter.
(b) (b) Exceptions:
(b)(1) (1) A licensed ophthalmologist or licensed optometrist may perform the part of the medical examination that involves visual acuity, field of vision, and the ability to recognize colors as specified in § 391.41(b)(10).
(b)(2) (2) A certified VA medical examiner must only perform medical examinations of veteran operators.
Uses a fixed source edition; check the original and statutory history for operative dates and exceptions.
Twenty-four months is a general interval, not a guaranteed certificate term
- What the rule requires
- The general rule requires examination and certification within the preceding 24 months. Drivers qualifying under the alternative vision standard in §391.44 or the insulin-treated diabetes standard in §391.46 must check the 12-month requirement and any shorter certification issued. An injury or disease impairing normal driving ability calls for examination and certification.
- Conditions and exceptions
- Additional category-specific and post-disqualification provisions also apply; do not rely solely on the printed expiration date.
(b) (b) Any driver who has not been medically examined and certified as qualified to operate a commercial motor vehicle during the preceding 24 months, unless the driver is required to be examined and certified in accordance with paragraph (c), (e), (f), (g), or (h) of this section;
(e) (e) Any driver who has diabetes mellitus treated with insulin for control and who has obtained a medical examiner's certificate under the standards in § 391.46, if such driver's most recent medical examination and certification as qualified to drive did not occur during the preceding 12 months;
(f) (f) Any driver who does not satisfy, with the worse eye, either the distant visual acuity standard with corrective lenses or the field of vision standard, or both, in § 391.41(b)(10)(i) and who has obtained a medical examiner's certificate under the standards in § 391.44, if such driver's most recent medical examination and certification as qualified to drive did not occur during the preceding 12 months;
(g) (g) Any driver whose ability to perform his or her normal duties has been impaired by a physical or mental injury or disease; and
(h) (h) On or after June 23, 2025, any person found by a medical examiner not to be physically qualified to operate a commercial motor vehicle under the provisions of paragraph (g)(3) of § 391.43.
Uses a fixed source edition; check the original and statutory history for operative dates and exceptions.
Check the medical status recorded in the CDL driving record
- What the rule requires
- For CDL holders, obtain the CDLIS motor vehicle record containing medical certification status from the current licensing state and retain it under §391.51(b)(6)(ii). The nationwide temporary paper-MEC exemption ended October 11, 2026. A separate provisional exemption applies to Alaska-issued CDLs and CLPs under the conditions below. Resolve submission or synchronization issues with the examiner, licensing agency and carrier.
(ii) For CDL holders, beginning January 30, 2012, if the CDLIS motor vehicle record contains medical certification status information, the motor carrier employer must meet this requirement by obtaining the CDLIS motor vehicle record defined at § 384.105 of this chapter. That record must be obtained from the current licensing State and placed in the driver qualification file. After January 30, 2015, a non-excepted, interstate CDL holder without medical certification status information on the CDLIS motor vehicle record is designated “not-certified” to operate a CMV in interstate commerce. After January 30, 2015, and through June 22, 2025, a motor carrier may use a copy of the driver's current medical examiner's certificate that was submitted to the State for up to 15 days from the date it was issued as proof of medical certification.
Uses a fixed source edition; check the original and statutory history for operative dates and exceptions.
WORKED EXAMPLE
An unexpired certificate after an intervening injury
Illustrative scenario: a driver has several months left on a medical certificate but recently sustained an injury and wants to resume long-haul work.
Check whether re-examination is triggered
Give the eligible examiner accurate information about any impairment; dispatch cannot replace that assessment by saying the certificate has not expired.
Check both certification and the state record
Confirm the certification result and term, then have the carrier check the required state driving record before assigning work.
The certification term, current fitness and qualification record all matter.
Common mistakes in day-to-day work
“I have a medical card, so I can drive in any condition”
Certification does not remove the obligation to avoid driving when illness, fatigue or another condition makes it unsafe; individual medical decisions belong with qualified professionals.
Temporary paper-MEC exception for Alaska-issued CDLs and CLPs
FMCSA’s October 8, 2026 notice provisionally extends relief only for Alaska-issued CDL/CLP holders and their motor carrier employers, from October 12, 2026 through October 12, 2027. During that period, eligible drivers and employers may rely on a valid paper MEC for up to 60 days after issuance. The driver must carry a copy and the carrier must retain one. Physical qualification requirements remain unchanged. This relief does not cover California-issued or other non-Alaska CDLs/CLPs; see the FMCSA notice below for its conditions.
Full text and sources
REGULATION TEXT · ENGLISH
§ 391.43 Medical examination; certificate of physical examination.
§ 391.43 Medical examination; certificate of physical examination.
- Source edition date
- 2026-10-08
- Captured
Edition noteOfficial-source snapshot; current consolidated law and subsequent amendments have not been verified.
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REGULATION TEXT · ENGLISH
§ 391.45 Persons who must be medically examined and certified.
§ 391.45 Persons who must be medically examined and certified.
- Source edition date
- 2026-10-08
- Captured
Edition noteOfficial-source snapshot; current consolidated law and subsequent amendments have not been verified.
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REGULATION TEXT · ENGLISH
§ 391.51 General requirements for driver qualification files.
§ 391.51 General requirements for driver qualification files.
- Source edition date
- 2026-10-08
- Captured
Edition noteOfficial-source snapshot; current consolidated law and subsequent amendments have not been verified.
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Drafted from linked official texts and agency guidance. Both language interpretations are CTAC AI-assisted drafts pending human review; examples are illustrative, not member records. Capture dates are not legal effective dates.