DOT Medical Cards: Everything a Carrier Needs to Know

An expired medical card is one of the top driver out-of-service violations. And it's 100% preventable. Yet we see it happen constantly — a driver's card expires, nobody catches it, and they get shut down at a scale house 300 miles from home.

The Basics

Every CMV driver must carry a valid Medical Examiner's Certificate (also called a "med card" or "DOT physical card"). The exam must be performed by a provider listed on the FMCSA (Federal Motor Carrier Safety Administration) National Registry of Certified Medical Examiners (the FMCSA's list of certified medical examiners authorized to perform DOT physicals).

Not just any doctor — a National Registry doctor. That distinction matters. Exams from non-registered providers are not valid for interstate commerce.

How Long Is It Valid?

A standard DOT physical is valid for up to 2 years. But the examiner can issue shorter certificates based on medical conditions:

• 1-year certificate: Common for drivers with controlled diabetes, high blood pressure requiring medication, or sleep apnea on CPAP
• 3-month to 6-month certificate: Issued when a condition needs closer monitoring

Disqualifying Conditions

Some conditions automatically disqualify a driver:

• Epilepsy or seizures (unless seizure-free for 10+ years off medication, with exemption)
• Insulin-dependent diabetes (requires an FMCSA exemption — which takes 3-6 months to obtain)
• Certain cardiovascular conditions
• Loss of a limb (requires a Skill Performance Evaluation)
• Vision standards: 20/40 in each eye (with correction allowed), 70-degree field of vision in each eye
• Hearing: perceive a forced whisper from 5 feet

The FMCSA Vision and Diabetes Exemption Programs

If a driver doesn't meet vision or diabetes standards, FMCSA offers exemption programs. But they're not quick:

• Diabetes exemption: Requires application, endocrinologist evaluation, 3+ years of insulin use history, no severe hypoglycemic episodes
• Vision exemption: Requires 3 years of CMV experience, ophthalmologist evaluation, no involvement in preventable crashes related to vision

Both exemptions must be renewed every 2 years. Start the process early — 6 months before the driver needs to be behind the wheel.

Carrier Responsibilities

As the carrier, you must:

• Verify the examiner is on the National Registry (check FMCSA's site)
• Keep a copy of the medical certificate in the DQF (Driver Qualification File — the folder of documents you keep for each driver)
• Track expiration dates and alert drivers at least 60 days before expiration
• Never dispatch a driver with an expired medical card — this is on you, not just the driver