Where fitness meets compliance
Physical examinations are mandatory for commercial motor vehicle (CMV) drivers to ensure they’re physically qualified to drive. Such exams must be repeated at least every 2 years, although medical examiners (MEs) can choose to set a more frequent renewal cycle based on a driver’s medical condition. A successful medical exam results in the ME completing a Medical Examiner’s
Certificate (MEC) — also known as the wallet card or med card — that serves as the driver’s proof of being physically qualified.
At all times, drivers and the motor carriers employing them must be able to show proof that the driver is physically qualified to drive. This is achieved either through the med card, or, for drivers with a commercial driver’s license (CDL), by means of a current driving record from the state.
CDL drivers, on and after June 23, 2025, no longer receive an MEC, unless they ask for one.
Print handouts outlining drivers’ overall medical certification requirements and make them available for any driver who needs it.
Physical qualifications and examinations
The purpose of the physical qualification requirements is to make certain that a driver doesn’t have a physical or mental condition that could seriously affect their ability to safely control a CMV.
Just a few of the conditions that could prohibit a driver from receiving a med card include if the driver:
• Has lost a foot, leg, hand, or arm, and hasn’t been granted a skill performance evaluation certificate;
• Has diabetes requiring insulin for control (unless the requirements in 391.46 are met);
• Has heart disease, which causes chest pain, fainting, or shortness of breath;
• Has chest or breathing problems like chronic asthma, emphysema, and chronic bronchitis likely to interfere with control and driving of a CMV.
Medical exam
Medical exams are required:
• Prior to the first time a driver operates a CMV;
• Once every 24 months after the initial exam;
• Once every 12 months if the driver:
Exclusively operates within an exempt intracity zone; or
Has diabetes mellitus treated with insulin for control and has met the requirements in 391.46;
• When a driver’s ability to operate a CMV is impaired by a physical or mental disease; and
• When an ME determines that a driver isn’t physically qualified to operate a CMV and this is reported to the Federal Motor Carrier Safety Administration (FMCSA), resulting in the invalidation of all medical certificates previously issued to the driver (as of June 23, 2025).
The medical exam must be performed by an ME who’s certified by the FMCSA and listed on the National Registry of Certified Medical Examiners (NRCME).
Certified MEs from the Department of Veterans Affairs (VA) may perform driver medical exams, but only for veterans enrolled in the VA healthcare system.
A licensed optometrist may perform the visual portion of the exam.
TIP: Hold a question-and-answer session to address any questions your drivers may have about medical exams.
Medical examiner’s certificate
If the ME finds that a driver is physically qualified to drive a CMV, the ME will fill out an MEC.
Since June 23, 2025, if the ME finds that the CDL driver is physically qualified to drive a CMV, the examiner will complete a CMV Driver Medical Examination Results Form (MCSA-5850) in the RCME and that information will transfer to the driver’s state licensing authority. Upon receiving this information, the state will post a medical qualification status of “certified” on the driver’s motor
vehicle record (MVR) along with other required exam information. As of August 2026, there are three states (AK, LA, NH) that aren’t connected to the NRCME. CDL drivers in these states must continue to submit their MEC information directly to the state.
If there’s a conflict between the medical certification information provided electronically by the FMCSA and the paper copy of the MEC, the electronic certification is considered the correct document.
Provided by J.J. Keller & Associates
To view the full monthly newsletter click here: Physical Exams & Med Card Requirements October 2026
