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 CDL 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 National Registry of Certified Medical Examiners.

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
• 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