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DOT Medical Card Requirements

A "DOT medical card" is the Medical Examiner's Certificate issued under 49 CFR 391.43 after a driver passes the physical qualification exam in 49 CFR 391.41. Not every CDL holder is federally required to carry one; whether you need one depends on which of fourself-certification categories you fall into, not just whether you hold a CDL. This step fits into the broaderCDL application process as part of meeting age and medical requirements.

Who actually needs one

Under 49 CFR 383.71(b), every CDL applicant and holder must self-certify into one of four categories. Only "non-excepted interstate" drivers, those who operate in interstate commerce and aren't engaged in an excepted type of transportation, are federally required to hold a medical certificate under 49 CFR 391.45. "Excepted interstate" drivers don't need one federally. Drivers in the two intrastate categories fall under their own state's driver qualification rules instead, which may or may not require a medical certificate. If you're not sure which category applies to you, that's a question for your state's CDL licensing office, not something a practice site can determine for you.

Who can perform the exam

The exam must be performed by a medical examiner listed on theNational Registry of Certified Medical Examiners, established under 49 CFR Part 390 Subpart D, per 49 CFR 391.43(a). A general practitioner who isn't on that registry can't issue a valid certificate. The two narrow exceptions, under 49 CFR 391.43(b), are a licensed ophthalmologist or optometrist for the vision portion of the exam only, and certified VA medical examiners for veteran drivers.

The physical qualification standards

The standards a driver has to meet are listed in 49 CFR 391.41(b), including:

  • Vision: distant visual acuity of at least 20/40 in each eye (corrected or uncorrected), at least 20/40 binocular acuity, a field of vision of at least 70 degrees horizontally in each eye, and the ability to recognize red, green, and amber traffic-signal colors.
  • Hearing: the ability to perceive a forced whisper at 5 feet in the better ear, with or without a hearing aid, or an average hearing loss no greater than 40 decibels when tested with an audiometer.
  • Blood pressure and cardiovascular health: no current diagnosis of high blood pressure likely to interfere with safely operating a commercial motor vehicle.
  • Epilepsy and seizure conditions: no history or diagnosis of epilepsy or any condition likely to cause a loss of consciousness or vehicle control.
  • Diabetes: no current insulin treatment for diabetes, unless the driver qualifies under the separate exemption program in 49 CFR 391.46.
  • Drug and substance use: no use of a Schedule I substance, an amphetamine, or a narcotic, and no other substance except as prescribed by a licensed medical practitioner.

How long a certificate lasts

A medical certificate is generally valid for up to 24 months under 49 CFR 391.45. Three specific categories get a shorter, 12-month window instead: drivers limited to an exempt intracity zone, insulin-treated diabetic drivers certified under the 391.46 exemption program, and drivers certified under a vision-deficiency exception.

This isn't medical advice

This page describes the federal regulation, not whether any individual driver will pass the exam. Whether a specific medical condition disqualifies you, or whether you can qualify for an exemption program, is a question for a National Registry-listed medical examiner, not a practice test website.

Frequently asked questions

Does every CDL holder need a DOT medical card?

No. Under 49 CFR 383.71(b), every CDL applicant and holder must self-certify into one of four categories, but only "non-excepted interstate" drivers are federally required to hold a medical certificate, under 49 CFR 391.45. The other three categories either don't need one federally or fall under their own state's rules.

Who can perform the DOT physical exam?

Only a medical examiner listed on the National Registry of Certified Medical Examiners can perform it, under 49 CFR 391.43(a). A general practitioner who isn't on that registry can't issue a valid certificate. The narrow exceptions, under 391.43(b), are a licensed ophthalmologist or optometrist for the vision portion only, and certified VA examiners for veterans.

How long does a DOT medical card last?

A medical certificate is generally valid for up to 24 months, under 49 CFR 391.45. Three categories get a shorter, 12-month window instead: drivers limited to an exempt intracity zone, insulin-treated diabetic drivers certified under the 391.46 insulin standard, and drivers certified under a vision-deficiency exception.

What vision standard do I need to pass the DOT physical?

You need distant visual acuity of at least 20/40 in each eye, corrected or uncorrected, plus at least 20/40 binocular acuity and a 70-degree horizontal field of vision in each eye, under 49 CFR 391.41(b). You must also be able to recognize red, green, and amber traffic-signal colors.