How to Get and Keep Your DOT Medical Card

These terms are often used as though they mean the same thing, but they do not.

• DOT physical: The actual physical qualification examination.
• Medical Examination Report, Form MCSA-5875: The detailed form containing the driver's medical history, testing, examination findings, and the examiner's determination.
• Medical Examiner's Certificate, Form MCSA-5876: The certification document issued when the driver is found physically qualified. Drivers usually call this the medical card.
• CDL or CLP: The commercial driver's license or commercial learner's permit issued by a state.
• Medical variance: An FMCSA exemption or Skill Performance Evaluation certificate that allows an otherwise qualified driver to operate under specified conditions.

A medical card is not a CDL. It does not grant commercial driving privileges by itself. A CDL does not replace medical certification when medical certification is required.

The current federal examination report and certificate are available on FMCSA's Medical Applications and Forms page.

Federal medical certification generally applies to drivers operating commercial motor vehicles in interstate commerce under 49 CFR Part 391.

This includes many CDL drivers, but it can also include drivers of certain interstate commercial vehicles that do not require a CDL. For example, the federal definition of a commercial motor vehicle for this purpose includes certain vehicles or combinations with a gross weight or rating of 10,001 pounds or more, as well as certain passenger and placarded hazardous-materials operations. The definition is in 49 CFR 390.5.

Not every CDL holder has the same medical-card requirement. Every CDL or CLP holder must self-certify with the licensing state in one of four operating categories:

A driver who performs both excepted and non-excepted interstate work must self-certify as non-excepted interstate. The formal categories and examples of excepted operations are in 49 CFR 383.71.

If you are unsure which category applies, contact the state agency that issued your license. Do not change your self-certification category simply to avoid a medical requirement. The category must match the work you actually perform or expect to perform.

Interstate drivers who need federal medical certification must be examined by a medical examiner who is currently certified and listed on the FMCSA National Registry.

Use the official National Registry examiner search. You can search by location and use the advanced search for an examiner's name, business, or National Registry number.

When scheduling:

1. Confirm that the examiner is currently listed on the National Registry.
2. Tell the office that you need an FMCSA physical qualification examination.
3. Ask what identification and medical documentation the office wants you to bring.
4. If you have a condition under treatment, ask whether the office wants recent records, a specialist letter, test results, or a particular FMCSA form.
5. Schedule early enough to obtain missing records or complete follow-up before your current certificate expires.

An examiner may need information from a treating clinician, but the certified medical examiner makes the federal qualification determination.

The exact documents depend on your health history and the examiner's office. A useful preparation list includes:

Some conditions have specific federal documentation requirements. For example:

• A driver with insulin-treated diabetes may need a completed Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 from the treating clinician. The medical examination must begin within 45 days after the treating clinician completes the form.
• A driver being evaluated under the alternative vision standard may need a completed Vision Evaluation Report, MCSA-5871 from an ophthalmologist or optometrist. That examination also must begin within the applicable 45-day period.
• When more information about medication is needed, the examiner may ask a prescribing clinician to complete the optional 391.41 CMV Driver Medication Form, MCSA-5895.

The appointment normally has several parts.

The purpose is to determine whether a medical condition, symptom, treatment, or medication could interfere with safely operating a commercial motor vehicle. The examination is not designed to disqualify every driver who has a diagnosis.

The examiner considers the federal standards in 49 CFR 391.41, the examination requirements, current medical guidance, the driver's individual information, and the examiner's independent medical judgment.

The driver signs Form MCSA-5875 certifying that the information provided is accurate and complete. Under the form instructions, false information or omitted information can invalidate the examination and a certificate based on it and may carry civil or criminal consequences.

Accurate answers also help the examiner make a decision based on the driver's actual condition and treatment. Missing records may delay a decision that could have been completed with proper documentation.

Do not hide a diagnosis, leave out a medication, or try to manipulate the examination. If you are unsure how to answer a question, ask the examiner to explain what the form is requesting.

The ordinary federal maximum is 24 months, but two years is not guaranteed.

An examiner may issue a certificate for a shorter period when the driver qualifies but needs earlier monitoring. Some federal standards also have shorter maximum periods. For example, drivers certified under the insulin-treated diabetes standard and drivers using the alternative vision standard generally must be examined at least annually.

A three-month, six-month, or one-year certificate does not necessarily mean the driver failed. It means the examiner found the driver qualified for the period stated on the certificate, subject to any listed restrictions or variance requirements.

For CDL and CLP holders, the permanent federal process is now primarily electronic:

1. The medical examiner completes and retains the detailed Medical Examination Report, Form MCSA-5875.
2. The examiner reports the examination result electronically on Form MCSA-5850 through the National Registry by midnight, local time, on the next calendar day.
3. The National Registry attempts to match the driver's last name, date of birth, licensing state, and license number to commercial licensing data.
4. If the information matches, FMCSA transmits the medical-certification information to the State Driver Licensing Agency.
5. The state posts the medical status and applicable restrictions or variance information to the driver's CDLIS motor-vehicle record.

The state licensing record is the official record of medical-certification status for CDL and CLP holders under this process. The driver's complete medical-history form is not placed on the ordinary CDLIS motor-vehicle record; the examiner retains the detailed examination record.

FMCSA explains the process in its National Registry II Driver Fact Sheet and Driver FAQs.

This temporary exemption does not replace electronic reporting. It does not extend the certificate's expiration date, authorize a medically unqualified driver to operate, or make the paper certificate controlling when paper and electronic information conflict. The electronic information controls if there is a conflict.

Because this temporary rule is in effect, request a paper copy and carry it during the first 60 days after issuance. Read the FMCSA April 2026 exemption announcement and the full exemption.

As of August 4, 2026, the live NRII Learning Center lists Alaska, Louisiana, and New Hampshire as states that have not yet implemented NRII. A driver licensed in a state that has not implemented NRII must continue to obtain a paper certificate and submit it to the licensing state under that state's instructions. Check the live list because state status can change.

Drivers who need federal medical certification but do not hold a CDL or CLP are outside the CDLIS electronic process. Qualified non-CDL drivers must still receive and carry the paper medical certificate while operating.

Even when the electronic state record is official, request and keep:

The paper card can be valuable when correcting an electronic transmission problem. It does not permanently replace the official state record for a CDL or CLP holder.

Do not assume that electronic means instant or error-free. Before leaving the appointment, make sure the examiner's office has your identifying information exactly as it appears on your license.

After the examination, use your state's official online service, motor-vehicle record, or CDL contact channel to check whether your medical status updated. Processing time and verification methods vary by state.

If the result does not appear correctly:

If you receive a downgrade or not-certified notice even though you completed an examination and were told you qualified, act immediately. Do not assume the notice will correct itself.

The best renewal plan is simple:

1. Write down the exact expiration date on your current certificate.
2. Begin the renewal process well before that date.
3. Ask the examiner's office what updated documentation it needs.
4. Obtain specialist records and required FMCSA forms before the appointment.
5. Bring accurate medication and treatment information.
6. Request a paper copy of the new certificate.
7. Verify that the state record shows the new medical status and expiration date.
8. Keep any medical variance or SPE certificate current and carry it when required.

Starting early matters for two reasons: the examiner may need additional information, and the electronic record may need correction before the old certificate expires.

The state record and CDL downgrade process are separate from the medical expiration itself. Under 49 CFR 383.73, an affected state record can be marked not certified, the driver must be notified, and the state must complete the CDL or CLP downgrade within the required period.

That administrative notice period is not permission to keep driving after the medical certificate has expired.

A downgrade commonly removes the commercial privilege from the license while leaving an ordinary noncommercial driving privilege, but the exact license action and terminology depend on the state. Read every notice from your licensing agency and follow its instructions promptly.

Obtaining a new medical certificate may be necessary, but it may not automatically restore a CDL after the state has already completed a downgrade.

Depending on the state and how much time has passed, a driver may also need to:

• Contact or visit the licensing agency.
• Request restoration of commercial privileges.
• Submit a state form or supporting document.
• Pay a transaction or reinstatement fee.
• Resolve another suspension, disqualification, or eligibility issue.
• Retake some or all CDL tests if the state's reinstatement window has passed or the CDL was surrendered.

Use the FMCSA directory of State Driver Licensing Agencies to find your state's official instructions. Federal medical standards and state licensing procedures work together, but they are not the same system.

Passing a DOT physical means the certified medical examiner found the driver physically qualified under the applicable medical standards for the period and conditions stated.

It does not require a carrier to hire the driver. A carrier may separately evaluate:

• CDL class and endorsements
• Driving record and safety history
• Verifiable experience
• Ability to perform the actual job
• Drug-and-alcohol testing requirements
• Company safety standards
• Insurance eligibility
• Other lawful hiring qualifications

A carrier may also require an examination by a preferred National Registry-certified examiner. The examiner—not the carrier—makes the medical qualification determination under the federal standards.